不同高雄激素血症表型多囊卵巢综合征患者临床特征分析
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摘要
目的分析不同高雄激素血症表型多囊卵巢综合征(PCOS)患者的临床特征。方法选取我院2016年1月—2017年12月期间收治的183例PCOS患者,根据不同的表型将所有患者分为高雄激素无排卵组、高雄激素有排卵组、非高雄激素无排卵组,同时取60例健康体检女性作为对照组,检测所有受试者的胰岛素抵抗指数、肥胖、血脂及C-反应蛋白(CPR)临床指标情况并进行对比分析。结果高雄激素无排卵组胰岛素抵抗和肥胖发生率明显高于其他三组(P<0.05),高雄激素无排卵组、高雄激素有排卵组、非高雄激素无排卵组胰岛素抵抗和肥胖发生率均明显高于对照组(P<0.05),高雄激素无排卵组TG、TC、LDL、HDL及CRP含量均高于其他3组,其中TG、LDL及CRP与其他三组对比,差异均具有统计学意义(P<0.01)。结论 PCOS患者合并高雄激素无排卵更容易发生脂代谢紊乱、肥胖及胰岛素抵抗,临床治疗时应重视患者的内分泌及代谢特征,从而给予更加有针对性的治疗。
Objective To analyze the clinical features of polycystic ovary syndrome(PCOS)with different phenotypes of hyperandrogenemia.Methods A total of 183 patients with PCOS cared at our hospital between January 2016 and December 2017 were selected.According to different phenotype all patients were divided into a high androgen anovulatory group,a high androgen ovulation group,a non-high androgen anovulatory group.At the same time,60 women underwent health physical examination were selected as the control group.We measured the insulin resistant indexes,obesity and blood lipids and C-reactive protein(CPR)for all subjects and the obtained data was compared and analyzed.Results The incidences of insulin resistance and obesity in group of patients with high androgen anovulatory were obviously higher than those in the other three groups(P<0.05).High androgen anovulatory group,high androgen ovulation group and non-high androgen anovulatory group had higher incidences of insulin resistance and obesity than the control group(P<0.05).High androgen anovulatory group had higher levels of triglyceride(TG),total cholesterol(TC),low density lipoprotein(LDL),high density lipoprotein(HDL)and C-reactive protein(CRP)than other three groups,TG,LDL and CRP compared with the other three groups.Comparison of TG,LDL and CRP between the high androgen anovulatory group and the other three groups showed statistically significant differences(P<0.01).Conclusion Patients with PCOS complicated with hyperandrogen without ovulation are more prone to have lipid metabolism disorder,obesity and insulin resistance.Therefore,the endocrine and metabolic characteristics of patients should be paid attention to in clinical treatment,so as to give more targeted treatment.
Objective To analyze the clinical features of polycystic ovary syndrome(PCOS)with different phenotypes of hyperandrogenemia.Methods A total of 183 patients with PCOS cared at our hospital between January 2016 and December 2017 were selected.According to different phenotype all patients were divided into a high androgen anovulatory group,a high androgen ovulation group,a non-high androgen anovulatory group.At the same time,60 women underwent health physical examination were selected as the control group.We measured the insulin resistant indexes,obesity and blood lipids and C-reactive protein(CPR)for all subjects and the obtained data was compared and analyzed.Results The incidences of insulin resistance and obesity in group of patients with high androgen anovulatory were obviously higher than those in the other three groups(P<0.05).High androgen anovulatory group,high androgen ovulation group and non-high androgen anovulatory group had higher incidences of insulin resistance and obesity than the control group(P<0.05).High androgen anovulatory group had higher levels of triglyceride(TG),total cholesterol(TC),low density lipoprotein(LDL),high density lipoprotein(HDL)and C-reactive protein(CRP)than other three groups,TG,LDL and CRP compared with the other three groups.Comparison of TG,LDL and CRP between the high androgen anovulatory group and the other three groups showed statistically significant differences(P<0.01).Conclusion Patients with PCOS complicated with hyperandrogen without ovulation are more prone to have lipid metabolism disorder,obesity and insulin resistance.Therefore,the endocrine and metabolic characteristics of patients should be paid attention to in clinical treatment,so as to give more targeted treatment.
引文
[1]吴淑芳,余海洋,颜仙.不同表型多囊卵巢综合征患者代谢综合征特征及代谢紊乱发生危险因素[J].医学临床研究,2017,34(8):1552-1554.
[2]Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group.Revised 2003consensus on diagnostic criteria and long-term health risks related to PCOS[J].Hum Reprod,2004,19(1):41-47.
[3]刘丽,邵洁白,张红萍,等.不同表型多囊卵巢综合征患者的代谢特征[J].全科医学临床与教育,2011,9(5):505-507.
[4]WHO Western Pacific Region,IASO INTERNATION-AL ASSOCIATION FOR THE STUDY OF OBESITY,International Obesity Taskforce.The Asia-Pacific perspective:Redefining obesity and its treatment[S].Sydney:Health Communications Australia Pty Limited on behalf of the Steering Committee,2000.
[5]Apridonidze T,Essah PA,Iuomo MJ,et al.Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome[J].J Clin Endocrinol Metab,2005,90(4):1929-1935.
[6]李立楠.不同表型多囊卵巢综合征患者代谢特征、胰岛素敏感性分析[J].临床和实验医学杂志,2016,15(10):978-981.
[7]吴淑芳,余海洋,颜仙.不同表型多囊卵巢综合征患者代谢综合征特征及代谢紊乱发生危险因素[J].医学临床研究,2017,34(8):1552-1555.
[8]于传鑫.实用妇科内分泌学[M].2版.上海:复旦大学出版社,2006:142.
[9]陶弢,刘伟,赵爱民,等.不同表型多囊卵巢综合征患者代谢综合征患病特点及风险研究[J].中华内分泌代谢杂志,2013,29(3):200-205.
[10]Gooren L.Hormone treatment of the adult transsexual patient[J].Horm Res,2005,64(Suppl 2):31-36.
[11]李爱群,吴寿岭,元小冬,等.2型糖尿病患者血清高敏C反应蛋白水平与代谢综合征的相关性研究[J].中国糖尿病杂志,2006,14(1):32-34.
[2]Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group.Revised 2003consensus on diagnostic criteria and long-term health risks related to PCOS[J].Hum Reprod,2004,19(1):41-47.
[3]刘丽,邵洁白,张红萍,等.不同表型多囊卵巢综合征患者的代谢特征[J].全科医学临床与教育,2011,9(5):505-507.
[4]WHO Western Pacific Region,IASO INTERNATION-AL ASSOCIATION FOR THE STUDY OF OBESITY,International Obesity Taskforce.The Asia-Pacific perspective:Redefining obesity and its treatment[S].Sydney:Health Communications Australia Pty Limited on behalf of the Steering Committee,2000.
[5]Apridonidze T,Essah PA,Iuomo MJ,et al.Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome[J].J Clin Endocrinol Metab,2005,90(4):1929-1935.
[6]李立楠.不同表型多囊卵巢综合征患者代谢特征、胰岛素敏感性分析[J].临床和实验医学杂志,2016,15(10):978-981.
[7]吴淑芳,余海洋,颜仙.不同表型多囊卵巢综合征患者代谢综合征特征及代谢紊乱发生危险因素[J].医学临床研究,2017,34(8):1552-1555.
[8]于传鑫.实用妇科内分泌学[M].2版.上海:复旦大学出版社,2006:142.
[9]陶弢,刘伟,赵爱民,等.不同表型多囊卵巢综合征患者代谢综合征患病特点及风险研究[J].中华内分泌代谢杂志,2013,29(3):200-205.
[10]Gooren L.Hormone treatment of the adult transsexual patient[J].Horm Res,2005,64(Suppl 2):31-36.
[11]李爱群,吴寿岭,元小冬,等.2型糖尿病患者血清高敏C反应蛋白水平与代谢综合征的相关性研究[J].中国糖尿病杂志,2006,14(1):32-34.