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目的了解青年多囊卵巢综合征(PCOS)患者是否存在亚临床动脉粥样硬化,并分析其相关危险因素,为探讨疾病发病机制提供科学依据。方法选择36例青年PCOS患者和30例年龄、体质指数(BMI)相匹配的健康体检者分别作为PCOS组和对照组。两组研究对象均进行颈动脉内中膜厚度(CIMT)测量,进行体格检查,测定血脂、糖代谢指标和性激素水平等。结果 PCOS组腰臀比(WHR)(0.79±0.10)、睾酮(T)[(1.70±0.40)nmol/L]、黄体生成素(LH)[(10.90±5.70)m IU/L]、甘油三酯(TG)[(1.28±0.40)mmol/L]、总胆固醇(TC)[(4.53±0.90)mmol/L]、低密度脂蛋白胆固醇(LDL-C)[(3.05±0.90)mmol/L]、空腹胰岛素水平(INS0 min)[(12.10±4.80)m U/ml]、胰岛素抵抗指数(HOMA-IR)(2.68±1.90)、血糖曲线下面积(AUCGLU(0-120 min))[(843.73±171.60)min·mmol/L]、胰岛素曲线下面积(AUCINS(0-120 min))[(4 104±928)min·m U/ml]和CIMT[(0.54±0.09)mm]显著高于对照组[分别为0.76±0.10、(0.60±0.20)nmol/L、(4.60±1.60)m IU/L、(0.94±0.40)mmol/L、(3.40±0.72)mmol/L、(2.66±0.57)mmol/L、(6.50±2.00)m U/ml、1.44±0.81、(730.90±155.50)min·mmol/L、(2 350±552)min·m U/ml和(0.41±0.06)mm],差异均有统计学意义(P<0.05,P<0.01)。PCOS组HDL-C[(1.16±0.36)mmol/L]、AUCGLU/AUCINS(0.20±0.31)显著低于对照组[分别为(1.47±0.33)mmol/L、0.32±0.20],差异均有统计学意义(P<0.01)。多元线性逐步回归分析结果显示,年龄、BMI、HOMA-IR与CIMT相关(P<0.01)。结论青年PCOS患者有亚临床动脉粥样硬化趋势,年龄增大、体重增加、胰岛素抵抗可能是青年PCOS患者早发亚临床动脉粥样硬化的危险因素。
Objective To investigate whether subclinical atherosclerosis exists in patients with polycystic ovary syndrome (PCOS) and to analyze the related risk factors so as to provide a scientific basis for exploring the pathogenesis of the disease. Methods Thirty-six young patients with PCOS and 30 healthy subjects with matched age and body mass index (BMI) were selected as PCOS group and control group. Two groups of subjects were measured carotid intima-media thickness (CIMT), physical examination, determination of blood lipids, glucose metabolism and sex hormone levels. Results Compared with PCOS group, the ratio of WHR (0.79 ± 0.10), testosterone (1.70 ± 0.40) nmol / L, LH [(10.90 ± 5.70) m IU / L] (TG) [(1.28 ± 0.40) mmol / L], total cholesterol (TC) [(4.53 ± 0.90) mmol / L] and low density lipoprotein cholesterol [(3.05 ± 0.90) mmol / L ], Fasting insulin (INS0 min) [(12.10 ± 4.80) mU / ml], insulin resistance index (HOMA-IR) 843.73 ± 171.60) min · mmol / L, and the area under the curve of insulin (AUCINS (0-120 min)) [(4 104 ± 928) min · mU / ml] and CIMT [(0.54 ± 0.09) mm] (0.66 ± 0.10), (0.60 ± 0.20) nmol / L, (4.60 ± 1.60) m IU / L, (0.94 ± 0.40) mmol / L and (3.40 ± 0.72) mmol / L respectively in the control group 0.57 mmol / L, 6.50 ± 2.00 mU / ml, 1.44 ± 0.81, (730.90 ± 155.50) min · mmol / L, (2350 ± 552) min · mU / ml and (0.41 ± 0.06) mm ], The differences were statistically significant (P <0.05, P <0.01). HDL-C [(1.16 ± 0.36) mmol / L] and AUCGLU / AUCINS (0.20 ± 0.31) in PCOS group were significantly lower than those in control group [(1.47 ± 0.33) mmol / L, 0.32 ± 0.20, respectively] Significance (P <0.01). Multiple linear stepwise regression analysis showed that age, BMI and HOMA-IR were correlated with CIMT (P <0.01). Conclusion Young PCOS patients have the trend of subclinical atherosclerosis, age, weight gain and insulin resistance may be the risk factors for early subclinical atherosclerosis in young patients with PCOS.