肥胖型多囊卵巢综合征患者不同糖代谢状态的临床特征分析

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摘要目的探讨肥胖型多囊卵巢综合征（PCOS）患者不同糖代谢状态下的临床表现及糖脂代谢特征。方法选取2014年10月~2016年10月就诊于黑龙江中医药大学附属第一医院的PCOS患者378例，采集患者的年龄、腰围、臀围以及性激素和糖脂代谢指标。根据口服糖耐量试验(OGTT）结果将肥胖型PCOS患者分为糖耐量正常（NGT）组246例、糖耐量受损(IGT）组96例及2型糖尿病(T2DM）组36例，比较各组间激素水平以及糖脂代谢的差异。结果 ①肥胖型PCOS患者IGT的发生率为25.4%，T2DM的发生率为9.5%；②IGT组患者的年龄、腰臀比（WHR）、收缩压明显高于NGT组，T2DM组患者体重指数（BMI）、收缩压、舒张压明显高于其他两组，年龄、WHR、腰围高于NGT组，差异均有统计学意义（P < 0.05）；③T2DM组患者黄体生成素（LH）水平明显低于其他两组，差异均有统计学意义（P < 0.05）；④在五点血糖、葡萄糖曲线下面积方面，T2DM组>IGT组>NGT组；NGT组的总胆固醇、三酰甘油、低密度脂蛋白水平明显低于其他两组，差异均有统计学意义（P < 0.05）；⑤在五点胰岛素、HOMA-IR、ln（ISI）、第一时相功能方面T2DM组>IGT组>NGT组；T2DM组HOMA-β明显低于其他两组；NGT组的IGI明显高于其他两组，差异均有统计学意义（P < 0.05）。结论肥胖型PCOS患者糖代谢异常主要表现为IGT，逐渐发展为T2DM；临床上表现为糖代谢异常程度的逐渐加重，而机体内部是胰岛β细胞功能受损不断加重。

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	孟小钰侯丽辉张春兰徐芳孙淼

关键词 ：多囊卵巢综合征, 肥胖, 临床科研信息共享, 糖耐量受损, 2型糖尿病

Abstract：Objective To discuss the metabolism characteristics of different glucose metabolic states of obese women with polycystic ovary syndrome. Methods From October 2014 to October 2016, 378 obese patients with PCOS were selected, the age, waist circumference, hip circumference and other indicators of hormones and glucolipid metabolism of patients were collected. These patients were all treated in the First Affiliated Hospital of the Heilongjiang University of Chinese Medicine. Patients were divided into three groups of normal glucose tolerance (NGT group, n = 246), impaired glucose tolerance (IGT group, n = 96), and type 2 diabetes mellitus (T2DM group, n = 36) according to oral glucose tolerance test results. The patients′ hormone levels and glucolipid metabolism were compared in the study. Results ①The incidence of obese PCOS patients with IGT was 25.4%, with T2DM was 9.5%; ②the age, WHR and systolic pressure of IGT group were significantly higher than the NGT group; the BMI, systolic pressure and diastolic pressure of T2DM group were significantly higher than the other groups; the age, WHR and waistline of T2DM group were significantly higher than NGT group, the differences were statistically significant (P < 0.05); ③the LH of T2DM group was significantly lower than the other groups, the differences were statistically significant (P < 0.05); ④the levels of OGTT at five time points and Aucg in T2DM group were significantly higher than IGT group, and in IGT group were significantly higher than NGT group; the levels of TC, TG and LDL in NGT group were significantly lower than the other groups, the differences were statistically significant (P < 0.05); ⑤the levels of INS at five time points, HOMA-IR, ln(ISI) and AIR in T2DM group were significantly higher than IGT group, and IGT group were significantly higher than NGT group; the level of HOMA-β in T2DM group was significantly lower than the other groups; the level of IGI in NGT group was significantly higher than the other groups, the differences were statistically significant (P < 0.05). Conclusion The obese patients of PCOS with abnormal glucose metabolism are mainly impaired glucose tolerance and then developed into type 2 diabetes gradually. The internal insulin-β-cell function of these patients was damaged as the deterioration of sugar metabolic abnormalities.

Key words： Polycystic ovary syndrome Obesity Clinical scientific research information sharing system Impaired glucose tolerance Type 2 diebetes mellitus

基金资助:国家自然科学基金资助项目（81804138）；
中医药行业科研专项课题（201207001）；
黑龙江中医药大学校科研基金资助项目（2015bs10）。

通讯作者: 孙淼（1982.4-），女，博士，副主任医师，主要从事中西医结合诊疗多囊卵巢综合征的临床及科研工作。

作者简介: 孟小钰（1984.12-），女，博士，主要从事中西医结合诊疗多囊卵巢综合征的临床及科研工作。

引用本文:

孟小钰侯丽辉张春兰徐芳孙淼. 肥胖型多囊卵巢综合征患者不同糖代谢状态的临床特征分析[J]. 中国医药导报, 2019, 16(12): 85-88.
MENG Xiaoyu HOU Lihui ZHANG Chunlan XU Fang SUN Miao . Clinical and biochemical characteristics of different glucose metabolic states of obese women with polycystic ovary syndrome. 中国医药导报, 2019, 16(12): 85-88.

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[1] Zhao X，Xu F，Qi B，et al. Serum metabolomics study of polycystic ovary syndrome based on liquid chromatography-mass spectrometry [J]. J Proteome Res，2014，13（2）：1101-1111.
[2] 李蓉，乔杰.生殖内分泌疾病诊断与治疗[M].北京：北京大学医学出版社，2012：115-116.
[3] Lu C，Zhao X，Li Y，et al. Serum metabolomics study of Traditional Chinese medicine formula intervention to polycystic ovary syndrome [J]. J Pharm Biomed Anal，2016， 120：127-133.
[4] Yildirim B，Sabir N，Kaleli B. Relation of intra-abdominal fat distribution to metabolic disorders in nonobese patients with polycystic ovary syndrome [J]. Fertil Steril，2003，79(6）：1358-1364.
[5] 木良善，赵越，乔杰.肥胖与多囊卵巢综合征的关联性及潜在机制[J].中华生殖与避孕杂志，2018，38（4）：343-349.
[6] Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome(PCOS） [J]. Hum Reprod，2004，19（1）：41-47.
[7] 李昕，林金芳.肥胖型多囊卵巢综合征患者临床及内分泌代谢特征的研究[J].中华医学杂志，2005，85（46）：3266-3271.
[8] Livada S，Kollias A，Panidis D，et al. Diverse impacts of aging on insulin resistance in lean and obese women with polycystic ovary syndrome：evidence from 1345 women with the syndrome [J]. Eur J Eedocrinol，2014，171（3）：301-309.
[9] 余红英，熊燕.年龄及BMI对多囊卵巢综合征患者胰岛素抵抗和糖脂代谢的影响[J].山东医药，2016，56（1）：66-68.
[10] 潘长玉.糖尿病学[M].北京：人民卫生出版社，2007：550-552.
[11] 王泽，石玉华.多囊卵巢综合征与慢性炎症因子[J].实用妇产科杂志，2014，30（5）：339-341.
[12] Diamanti E，Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited：an update on mechanisms and implications [J]. Endocr Rev，2012，33（6）：981-1030.
[13] 薛海峰.中国成人腹型肥胖与糖尿病发病关系的前瞻性队列研究[D].北京：北京协和医学院，2014.
[14] 李薇.高血压与胰岛素抵抗的研究现状和进展[J].实用临床医学，2015，16（2）：102-103，107.
[15] 李弘磊，周玲，杨涛，等.肥胖对糖脂代谢和血压水平影响的分析[J].医学综述，2014，20（23）：4382-4384.
[16] 俞丹，王宏星，华文进，等.代谢综合征高危人群胰岛功能的特点研究[J].中国全科医学，2014，17（5）：504-508.
[17] 高婧，周莉，陈慧，等.口服葡萄糖耐量试验和胰岛素释放试验在多囊卵巢综合征患者中的临床应用[J].生殖医学杂志，2016，25（6）：505-510.
[18] 张鸢，蒋惠.胰岛素抵抗与体质量指数对PCOS妇女脂代谢及性激素的影响[J].中国妇幼健康研究，2017，28（11）：1412-1414.
[19] Pasquali R，Gambineri A. Glucose intolerance states in women with the polycystic ovary syndrome[J]. J Endocrinol Invest，2013，36（8）：648-653.
[20] Mordent R，Williams T. Metabolic syndrome：polycystic ovary syndrone [J]. FP Essent，2015，435：30-42.