脂质蓄积指数在多囊卵巢综合征合并代谢综合征患者中的预测价值

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摘要目的探讨脂质蓄积指数（LAP）对多囊卵巢综合征（PCOS）患者发生代谢综合征（MS）的预测价值。方法选择2015年6月—2019年12月于黑龙江中医药大学附属第一医院妇科门诊就诊的PCOS患者507例。根据MS诊断标准分为PCOS合并MS组200例，PCOS非MS组307例。收集患者的一般临床资料、临床生化指标以及计算LAP值。结果两组的收缩压、舒张压、体重、体重指数、腰围、臀围、腰臀比、黄体生成素、黄体生成素/卵泡刺激素、雄烯二酮、性激素结合球蛋白、游离雄激素指数、空腹血糖、餐后2 h血糖、空腹胰岛素、餐后2 h胰岛素、稳态模型胰岛素抵抗指数、三酰甘油、总胆固醇、高密度脂蛋白、低密度脂蛋白、载脂蛋白A、载脂蛋白B、载脂蛋白B/载脂蛋白A、LAP水平及肥胖、中心性肥胖、黑棘皮、痤疮、胰岛素抵抗发生率比较，差异有统计学意义（P ＜ 0.05）。Spearman相关性分析显示，LAP与体重、体重指数、腰围、臀围、腰臀比、空腹胰岛素、稳态模型胰岛素抵抗指数、三酰甘油、总胆固醇、载脂蛋白B、载脂蛋白B/载脂蛋白A呈正相关（r = 0.398、0.452、0.469、0.345、0.349、0.308、0.269、0.800、0.143、0.214、0.172，均P < 0.05）；与黄体生成素、黄体生成素/卵泡刺激素、性激素结合球蛋白、高密度脂蛋白呈负相关（r = -0.179、-0.142、-0.143、-0.327，均P < 0.05）。ROC曲线显示，LAP曲线下面积为0.90，最佳切点为47.51，敏感度为86.50%，特异度为81.40%。结论 LAP对PCOS患者发生MS的预测价值较高，可作为PCOS患者筛查MS的可靠标志物。

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	郝松莉侯丽辉徐芳孙淼张春兰孟小钰

关键词 ：脂质蓄积指数, 多囊卵巢综合征, 代谢综合征, 预测价值

Abstract：Objective To explore the predictive value of lipid accumulation index (LAP) for the occurrence of metabolic syndrome (MS) in patients with polycystic ovary syndrome (PCOS). Methods From June 2015 to December 2019, 507 patients with PCOS were selected from the Gynecological Outpatient Department of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine. According to MS diagnostic criteria, they were divided into PCOS with MS group (200 cases) and PCOS non MS group (307 cases). The general clinical data, clinical biochemical indexes and LAP value were collected. Results Systolic blood pressure, diastolic blood pressure, body weight, body mass index, waist circumference, hip circumference, waist to hip ratio, luteinizing hormone, luteinizing hormone/follicle stimulating hormone, androstenedione, sex hormone binding globulin, free androgen index, fasting blood glucose, postprandial 2 h blood glucose, fasting insulin, postprandial 2 hours insulin, insulin resistance index of steady-state model, triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein, apolipoprotein A, apolipoprotein B, apolipoprotein B/apolipoprotein A, LAP levels and the incidence rate of obesity, central obesity, black acanthosis, acne and insulin resistance between two groups were compared, the differences were statistically significant (P < 0.05). Spearman correlation analysis showed that: LAP was positively correlated with body weight, body mass index, waist circumference, hip circumference, waist hip ratio, fasting insulin, homeostasis model insulin resistance index, triacylglycerol, total cholesterol, apolipoprotein B, apolipoprotein B/apolipoprotein A (r = 0.398, 0.452, 0.469, 0.345, 0.349, 0.308, 0.269, 0.800, 0.143, 0.214, 0.172, all P < 0.05). LAP was negatively correlated with luteinizing hormone, luteinizing hormone/follicle stimulating hormone, sex hormone binding globulin and high density lipoprotein (r = -0.179, -0.142, -0.143, -0.327, all P < 0.05). ROC curve showed that the area under LAP curve was 0.90, the optimal tangent point was 47.51, the sensitivity was 86.50%, and the specificity was 81.40%. Conclusion LAP has a high predictive value for the occurrence of MS in PCOS patients, and can be a reliable marker for screening MS in PCOS.

Key words： Lipid accumulation index Polycystic ovary syndrome Metabolic syndrome Predictive value

基金资助:国家中医临床研究基地科研项目（JDZX2015059）；
黑龙江中医药大学校科研基金资助项目（201828）；
黑龙江省中医药管理局科研项目（ZHY18-004）。

作者简介: 郝松莉（1978.3-），女，博士，副主任医师，主要从事中西医结合诊疗不孕症、多囊卵巢综合征等生殖内分泌疾病的临床及科研工作。

引用本文:

郝松莉侯丽辉徐芳孙淼张春兰孟小钰. 脂质蓄积指数在多囊卵巢综合征合并代谢综合征患者中的预测价值[J]. 中国医药导报, 2020, 17(30): 126-129.
HAO Songli HOU Lihui XU Fang SUN Miao ZHANG Chunlan MENG Xiaoyu. Predictive value of lipid accumulation index for metabolic syndrome in patients with polycystic ovary syndrome. 中国医药导报, 2020, 17(30): 126-129.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I30/126

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