浙江医学Issue(2)：108-111,4.
青春期多囊卵巢综合征胰岛素抵抗及其与生殖内分泌代谢异常的相关性分析
Endocrinal abnormalities in adolescents with polycystic ovary syndrome
摘要
Abstract
Objective To investigate the endocrinal abnormalities of adolescent polycystic ovary syndrome(PCOS) with or without insulin resistance (IR). Methods Eighty eight adolescent patients with polycystic ovary syndrome(PCOS group), includ-ing 40 cases with IR and 48 cases without IR, and 87 healthy women (control group) were enrol ed in the study. The serum en-docrine levels were measured and their relationships with homeostasis model of assessment for insulin resistance (HOMA- IR ) were analyzed. Results Compared to control group, PCOS group had a higher levels of 1uteinizing hormone (LH), luteinizing hormone/follicle stimulating hormone ratio(LH/FSH ratio), dehydroepiandrosterone sulfate(DHEAS), total testosterone(TT) and free androgen index (FAI), but a lower level of the sex hormone binding globulin (SHBG). There was a significant difference in serum fasting insulin (FINS) and HOMA- IR levels, but no difference in serum fasting blood- glucose (FBG) between adolescent PCOS and control groups. The adolescent PCOS group had a higher level of leptin, but there was no difference in adiponectin level be-tween two groups. The DHEAS and FAI levels in IR group of PCOS patients were higher, while SHBG and LH levels were lower than those in non- IR group. The serum SHBG level was negatively correlated with BMI(r=- 0.31, P<0.05) and serum DHEAS level (r=- 0.225, P<0.05) in adolescent patients with PCOS. There were no significant differences in TT and LH/FSH ratio between two groups. The IR group had a higher levels of FINS, FBG and HOMA- IR. The FBG level was positively correlated with BMI (r=- 0.348, P<0.05). The leptin level was significantly higher and adiponectin level was lower in IR group than those in non- IR group. The adiponectin level was negatively correlated with BMI(r=- 0.418, P<0.05);while the leptin level was positively correlat- <br> ed with BMI (r=0.605, P<0.05). Conclusion The PCOS patients have decreased insulin sensitivity with various degrees and in-creased incidence of IR. IR is reciprocal y correlated with hyperandrogenism and obesity, forming a vicious cycle of endocrinal metabolism and a higher risk of long- term complications. The adiponectin and leptin might be a predictive index for insulin resis-tance, which need to be confirmed by further study.关键词
青春期/多囊卵巢综合征/胰岛素抵抗/高雄激素血症/脂肪因子Key words
Adolescence/Polycystic ovary syndrome/Insulin resistence/Hperandrogenism/Adipokine引用本文复制引用
刘畅,张治芬..青春期多囊卵巢综合征胰岛素抵抗及其与生殖内分泌代谢异常的相关性分析[J].浙江医学,2014,(2):108-111,4.基金项目
浙江省科技计划项目（2009C33114）；浙江省医药卫生科学研究基金 （）
