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目的探讨多囊卵巢综合征(PCOS)胰岛素抵抗与非胰岛素抵抗患者临床及代谢特征。方法回顾性分析2012年1月至2014年12月就诊于广东省妇幼保健院妇科门诊的218例PCOS患者,按HOMA稳态模型(HOMA-IR)分为两组,PCOS胰岛素抵抗(PCOS-IR)组和PCOS非胰岛素抵抗(PCOS-NIR)组,比较两组临床及生化指标。结果 PCOSIR组体重指数、腰围、腰臀比均高于PCOS-NIR组,差异有统计学意义(P<0.01)。PCOS-IR组总胆固醇、三酰甘油、低密度脂蛋白、空腹血糖、3 h血糖、尿酸水平明显高于PCOS-NIR组,血脂异常(72.62%)、空腹糖耐量受损(4.8%)、糖耐量异常(32.1%)、糖尿病(8.3%)、高尿酸血症(83.1%)的发生率均高于PCOS-NIR组,差异均有统计学意义(P<0.05)。两组高密度脂蛋白、1 h血糖、2 h血糖,差异无统计学意义(P>0.05)。结论 PCOS-IR组患者存在更为严重的血糖、血脂及尿酸的代谢紊乱。葡萄糖耐量试验在筛查PCOS患者糖耐量异常及诊断糖尿病中具有重要的意义。尽早改善患者胰岛素抵抗,干预血糖、血脂、尿酸代谢紊乱,可能对延缓并发症发生有一定的作用。
Objective To investigate the clinical and metabolic characteristics of patients with polycystic ovary syndrome (PCOS) with and without insulin resistance. Methods A retrospective analysis of 218 PCOS patients attending the Gynecology Clinic of Guangdong Provincial Maternal and Child Health Hospital from January 2012 to December 2014 were divided into two groups according to HOMA-IR model: PCOS-IR ) Group and PCOS non-insulin resistance (PCOS-NIR) group. The clinical and biochemical indexes were compared between the two groups. Results PCOSIR group body mass index, waist circumference and waist to hip ratio were higher than the PCOS-NIR group, the difference was statistically significant (P <0.01). The levels of total cholesterol, triglyceride, low density lipoprotein, fasting blood glucose, 3h blood glucose and uric acid in PCOS-IR group were significantly higher than those in PCOS-NIR group (72.62%), impaired fasting glucose tolerance (4.8% The incidence of impaired glucose tolerance (32.1%), diabetes (8.3%) and hyperuricemia (83.1%) were higher than those in PCOS-NIR group (P <0.05). Two groups of high-density lipoprotein, 1 h blood glucose, 2 h blood glucose, the difference was not statistically significant (P> 0.05). Conclusion There are more serious metabolic disorders of blood glucose, blood lipid and uric acid in patients with PCOS-IR. Glucose tolerance test in the screening of PCOS patients with impaired glucose tolerance and diagnosis of diabetes is of great significance. As soon as possible to improve insulin resistance in patients with interventions in blood glucose, blood lipids, uric acid metabolism, may delay the occurrence of complications have a role.