摘要
目的 了解肥胖型多囊卵巢综合征(polycystic ovarian syndrome,PCOS)与非肥胖型PCOS妇女的代谢特征及身体组成特点,为后期对不同体质指数(body mass index,BMI)的PCOS患者进行针对性的体重管理指导提供科学依据。方法 本研究为横断面研究,收集2019年1月—2020年10月在湖南省妇幼保健院妇科内分泌诊疗中心首次被诊断为PCOS患者的代谢指标及身体成分指标,对比不同BMI PCOS患者的代谢特征,同时通过Pearson相关分析方法分析代谢指标与身体成分的关系。结果 本研究共纳入219例PCOS的临床资料,其中78例(35.6%)为消瘦或正常,141例(64.4%)为超重或肥胖。不同BMI PCOS患者的空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting insulin,FINS)、稳态模式评估法胰岛素抵抗指数(homeostasismodel assessment-insulin,HOMA-IR)、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度胆固醇(low density lipoprotein cholesterol,LDL)、尿酸(uric acid,UA)超过上限、高密度胆固醇(high density lipoprotein cholesterol,HDL)低于下限的发生率不同(P <0.05);不同BMI PCOS患者之间,随着BMI的增加,FPG、FINS、HOMA-IR、TG、LDL、UA的平均值均有所上升(P <0.05),HDL的平均值有所下降(P <0.05),TC的平均值差异无统计学意义(P> 0.05)。FPG、FINS、HOMAIR、TG、UA与体脂肪含量、体脂占比、内脏脂肪面积、腰臀比均呈正相关关系(P <0.05);HDL与骨骼肌含量、骨骼肌占比呈正相关关系(P <0.05)。FPG与骨骼肌占比,FINS、HOMA-IR、TG、UA与骨骼肌含量、骨骼肌占比呈负相关关系;HDL与体脂肪含量、体脂占比、内脏脂肪面积、腰臀比呈负相关关系(P <0.05)。结论 即使体重为消瘦、正常的PCOS患者也会发生代谢指标异常,体重为消瘦、正常的PCOS患者发生代谢异常的原因与骨骼肌含量少而体脂肪含量相对增多、腰臀比增大、内脏脂肪面积增多有关。
Objective To understand metabolic and body composition characteristics of obese and lean PCOS(polycystic ovarian syndrome)women so as to provide scientific evidence for targeted weight management guidance among PCOS patients with different BMI(body mass indexes)at later stages.Methods PCOS patients who were first diagnosed in the gynecologic endocrine diagnosis and treatment center of Hunan maternal and child health hospital from January 2019 to October 2020 were recruited in this cross-sectional study.Their metabolic indexes and body composition indexes were recorded,the metabolic characteristics of PCOS patients with different BMI were compared,and the relationship between metabolic indexes and body composition was analyzed through Pearson correlation analysis.Results A total of 219 PCOS cases were involved in this study.78 cases were lean or normal,accounting for 35.6%,and 141 cases were overweight or obese,accounting for 64.4%.The incidence of FPG(fasting plasma glucose),FINS(fasting insulin),HOMA-IR(homeostasismodel assessment-insulin),TG(triglyceride),TC(total cholesterol),LDL(low density lipoprotein cholesterol),UA(uric acid)exceeding upper limit and HDL(high density lipoprotein cholesterol)below the lower limit were different among PCOS patients with different BMI(P<0.05).The mean values of FPG,FINS,HOMA-IR,TG,TC,HDL,LDL and UA elevated(P<0.05),the mean value of HDL decreased(P<0.05),and the mean value of TC were not different(P>0.05)with BMI increased.FPG,FINS,HOMA-IR,TG,UA were positively correlated with body fat content,body fat ratio,visceral fat area,and waist hip ratio(P<0.05),while HDL was positively correlated with skeletal muscle content,and skeletal muscle ratio(P<0.05).FPG was negatively correlated with skeletal muscle ratio,FINS,HOMA-IR,TG,UA were negatively correlated with skeletal muscle content and skeletal muscle ratio,while HDL was negatively correlated with body fat content,body fat ratio,visceral fat area,and waist to hip ratio(P<0.05).Conclusion Even the PCOS patients with lean and normal body mass may have abnormal metabolic indexes.The reasons for that are less skeletal muscle mass but relatively higher body fat mass,increased waistto-hip ratio and visceral fat area.
作者
陈霞
穆仪冰
CHEN Xia;MU Yi Bing(Hunan Provincial Maternal and Child Health Care Hospital,Changsha 410008,Hunan Province,China)
出处
《中国妇幼卫生杂志》
2022年第6期51-56,共6页
Chinese Journal of Women and Children Health
基金
中国疾病预防控制中心妇幼保健中心2020年度“母婴营养与健康研究项目”(2020FYH010)
湖南创新型省份建设专项(2021ZK4048)
关键词
体质指数
多囊卵巢综合征
代谢指标
body mass index
polycystic ovary syndrome
metabolic index
作者简介
通信作者:穆仪冰,Email:muyibing@126.com
