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目的探讨多囊卵巢综合征(PCOS)胰岛素抵抗(IR)患者的临床特征。方法选取48例PCOS患者,将稳态模型胰岛素抵抗指数(HOMA-IR)>3.8或葡萄糖及胰岛素曲线下面积比值(AUC葡萄糖/AUC胰岛素)<1.0的PCOS患者作为IR组(30例),上述两个标准均不符合的PCOS患者作为非IR组(18例)。比较IR组和非IR组患者的体质指数(BMI)、血脂水平及各项性激素水平。结果 (1)IR组患者BMI及肥胖者所占比例均显著高于非IR组,差异有统计学意义(P<0.05);(2)IR组患者三酰甘油、载脂蛋白B水平均显著高于非IR组,而高密度脂蛋白、载脂蛋白AⅠ水平则显著低于非IR组,差异均有统计学意义(P<0.05);(3)IR组患者黄体生成素水平显著低于非IR组,睾酮水平则显著高于非IR组,差异亦有统计学意义(P<0.05)。结论 (1)存在IR的PCOS患者更容易出现血脂异常;(2)PCOS患者性激素有不同改变,存在IR者以睾酮升高为主而非IR患者则以黄体生成素升高为主。
Objective To investigate the clinical features of patients with polycystic ovary syndrome (PCOS) with insulin resistance (IR). Methods 48 patients with PCOS were selected as the IR group (30 patients) with stable model insulin resistance index (HOMA-IR)> 3.8 or the area under the curve of glucose and insulin curve (AUC glucose / AUC insulin <1.0) Two non-standard PCOS patients were treated as non-IR patients (n = 18). Body mass index (BMI), blood lipid levels and sex hormones were compared between IR and non-IR groups. Results (1) The proportion of BMI and obesity in IR group was significantly higher than that in non-IR group (P <0.05). (2) The levels of triglyceride and apolipoprotein B in IR group were significantly (P <0.05). (3) The level of luteinizing hormone in IR group was significantly lower than that in non-IR group (P <0.05), while the levels of HDL and apolipoprotein AⅠ were significantly lower than those in non-IR group The levels of testosterone in non-IR group were significantly higher than those in non-IR group (P <0.05). Conclusions (1) Patients with PCOS in IR are more likely to have dyslipidemia. (2) There are different changes in sex hormones in patients with PCOS. Elevated testosterone is predominant in IR patients but elevated in patients without IR.