胰岛素抵抗对PCOS患者内分泌代谢及卵巢超声指标的影响

doi:10.3969/j.issn.1671-7171.2017.04.024

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摘要【目的】探讨胰岛素抵抗(IR)对多囊卵巢综合征(PCOS)患者内分泌代谢及卵巢超声指标的影响,并分析二者的相关性。【方法】120例PCOS患者以是否伴IR分为IR-PCOS组(n=65)和NIR-PCOS组(n=55)。检测并比较两组血清雌二醇(E₂)、黄体生成激素(LH)、卵泡刺激素(FSH)、胆固醇(TC)、空腹胰岛素(Fins)等内分泌代谢指标;阴道超声检查囊泡数量、卵巢体积(OV)、卵泡数目(NF)等。分析内分泌代谢及卵巢超声指标的相关性。【结果】IR-PCOS组空腹血糖(FPG)、甘油三酯(TG)、Fins、TC、LH水平明显高于NIR-PCOS组,FSH水平明显低于NIR-PCOS组(P＜0.05),两组其他内分泌代谢指标比较差异无统计学意义(P＞0.05)。与NIR-PCOS组相比,IR-PCOS组囊泡数量、NF显著较多,血管化-血流指数(VFI)、OV显著增大(P＜0.05),两组卵巢间质面积(SA)及卵巢间质面积/总面积比值(SA/TA)比较差异无统计学意义(P＞0.05)。相关性分析显示囊泡数量、NF、OV与PFG、Fins、TC、LH均呈正相关(P＜0.05),与FSH均呈负相关(P＜0.05);IR-PCOS组其他超声特征指标与其余内分泌指标无相关性。【结论】IR可增加PCOS患者内分泌代谢紊乱发生风险,改变卵巢超声指标,且伴IR-PCOS患者的内分泌代谢指标与卵巢超声指标具有一定的相关性。

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	王海艳
	于占凤

关键词 ：多囊卵巢综合征/超声检查, 卵巢/超声检查, 多囊卵巢综合征/代谢, 胰岛素抗药性

Abstract：【Objective】To investigate the effect of insulin resistance (IR) on endocrine metabolism and ovarian ultrasound features in patients with polycystic ovary syndrome (PCOS), and to analyze the relationships between the two. 【Methods】A total of 120 patients with PCOS were divided into IR - PCOS group (with IR,n=65) and NIR - PCOS group (without IR,n=55). The related indicators of endocrine metabolism [serum estradiol (E₂), luteinizing hormone (LH), follicle stimulating hormone (FSH), total cholesterol (TC), fasting insulin (Fins)] were detected. The transvaginal ultrasound was performed to analyze related characteristic indexes [number of vesicles, ovarian volume (OV), number of follicles (NF)]. The correlation between endocrine metabolism and ovarian ultrasound indexes was analyzed. 【Results】Compared to the NIR - PCOS group, the levels of fasting plasma glucose (FPG), triglyceride (TG), Fins, TC, and LH in IR - PCOS group were significantly higher (P<0.05), while FSH level was significantly lower (P<0.05). There was no significant difference between two groups in terms of other endocrine metabolism indexes, such as E₂ (P>0.05). The number of vesicles, NF, OV, and vascularization flow index (VFI) were significantly higher than those in the NIR- PCOS group (P<0.05), while there were no significant differences in ovarian stromal area (SA) or the ratio of ovarian stroma / total area (SA/TA) between the two groups (P>0.05). Correlation analysis showed that the number of vesicles, NF, and OV were positively correlated with PFG, Fins, TC, and LH (P<0.05) and negatively correlated with FSH (P<0.05). There was no correlation between other ultrasound characteristic indexes and other endocrine indexes in IR - PCOS group. 【Conclusion】IR can increase the risk of endocrine metabolic disorders in patients with PCOS and change the characteristics of ovarian ultrasound. The endocrine metabolism showed a certain correlation with ovarian ultrasound features in patients with IR-PCOS.

Key words： Polycystic Ovary Syndrome/US Ovary/US Polycystic Ovary Syndrome/ME Insulin Resistance

收稿日期: 2017-01-04

PACS:

R781.63

引用本文:

王海艳;于占凤;. 胰岛素抵抗对PCOS患者内分泌代谢及卵巢超声指标的影响[J]. 医学临床研究, 2017, 34(4): 698-701.
WANG Hai-yan, YU Zhan-feng. Effect of Insulin Resistance on Endocrine Metabolism and Ovarian Ultrasound Features in Patients with PCOS. JOURNAL OF CLINICAL RESEARCH, 2017, 34(4): 698-701.

链接本文:

http://www.jcr.net.cn/CN/10.3969/j.issn.1671-7171.2017.04.024 或 http://www.jcr.net.cn/CN/Y2017/V34/I4/698

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(本文编辑:邓丽萍) [收稿日期] 2017-01-04