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目的 探讨青春期多囊卵巢综合征 (PCOS)胰岛素抵抗 (IR)和葡萄糖耐量减低 (IGT)的发生率。方法 选择 2 0 0 3年 2～ 9月复旦大学附属妇产科医院 2 9例 14～ 19岁的青春期PCOS患者 ,测定体重指数 (BMI)、腰臀比 (WHR)、卵巢体积、血清卵泡刺激素 (FSH)、黄体生成激素 (LH)和睾酮 (T) ,并行口服糖耐量试验 (OGTT)和胰岛素释放试验 ,根据空腹血糖 /胰岛素之比 (GIR)将其分为IR组 15例和非IR组 14例。结果 所有研究对象的空腹血糖均正常 ,两组间卵巢体积、LH/FSH比值、T水平无明显差异 (P >0 0 5 ) ,IR组BMI、WHR、曲线下葡萄糖面积 (AUC葡萄糖)和曲线下胰岛素面积 (AUC胰岛素)均高于非IR组 (P <0 0 5 ) ,而非IR组LH水平高于IR组 (P <0 0 5 ) ;IR组IGT患者占 4 0 0 % ,高于非IR组的 7 1% ,相关分析则显示GIR与BMI、WHR、空腹胰岛素水平、AUC葡萄糖 和AUC胰岛素 呈负相关。结论 肥胖和BMI正常者青春期PCOS均存在IR ,表现IR的青春期PCOS患者更易发生IGT ,要重视青春期PCOS患者IR的评估以及IGT的筛选。
Objective To investigate the incidence of insulin resistance (IR) and impaired glucose tolerance (IGT) in adolescent polycystic ovary syndrome (PCOS). Methods From February to September 2003, 29 adolescent PCOS patients aged 14 to 19 years old at Fudan University Obstetrics and Gynecology Hospital were enrolled in this study. Body mass index (BMI), WHR, ovarian volume, serum follicle stimulation (FSH), testosterone (LH) and testosterone (T), oral glucose tolerance test (OGTT) and insulin release test were conducted. According to the fasting plasma glucose / insulin ratio IR group of 14 cases. Results The fasting blood glucose was normal in all the subjects. There was no significant difference in ovarian volume, LH / FSH ratio and T level between the two groups (P> 0.05), BMI, WHR, glucose area under curve (AUC glucose) Lower insulin area (AUC insulin) than non-IR group (P <0 05), but non-IR LH group was higher than IR group (P <0 05); IR group IGT patients accounted for 400% In the non-IR group, 71% showed a negative correlation between GIR and BMI, WHR, fasting insulin, AUC glucose, and AUC insulin. Conclusions There is IR in adolescent PCOS with obesity and normal BMI. Adolescent PCOS patients with IR are more likely to develop IGT. The evaluation of IR in adolescent PCOS patients and the screening of IGT should be emphasized.