CAJ | 학술논문

目的探讨多囊卵巢综合征患者糖代谢异常特点及其发生率.方法回顾性分析2006年6月1日至2009年2月1日广州中山大学孙逸仙纪念医院妇产科收治的初诊多囊卵巢综合征患者654例(青春期101例,成人553例),以120名年龄匹配的健康志愿者为对照组(青春期40名,成人80名).病例和对照组均行口服葡萄糖耐量试验和胰岛素释放试验,比较病例组和对照组、成人多囊卵巢综合征与青春期多囊卵巢综合征、不同体重指数亚组中糖代谢异常的特点及其发生率.结果多囊卵巢综合征患者糖代谢异常的发生率为24.5%(160/654),显著高于对照组的3.3%(4/120)(χ2=27.11,P<0.0001);成人病例组糖代谢异常的发生率高于青春期病例组(分别为26.6%、12.9%,χ2=8.688,P=0.003),青春期病例组代谢异常的发生率高于青春期对照组(分别为12.9%、0%,χ2=5.671,P=0.02).多囊卵巢综合征患者糖代谢异常主要表现为糖耐量受损(62.5%),其次为空腹血糖受损(43.8%),糖尿病仅占少数(8.1%);糖尿病13例,仅4例(30.8%)空腹血糖>7.0 mmol/L,9例(69.2%)通过口服葡萄糖耐量试验筛查发现.多囊卵巢综合征组糖代谢异常的发生率随体重指数升高而升高(χ2=53.71,P<0.0001).结论多囊卵巢综合征患者为糖代谢异常的高危人群,其糖代谢异常以糖耐量受损为主,空腹血糖受损次之.多囊卵巢综合征患者(尤其是肥胖者)应行口服葡萄糖耐最试验,以早期发现其糖代谢异常.
목적 탐토다낭란소종합정환자당대사이상특점급기발생솔.방법 회고성분석2006년6월1일지2009년2월1일엄주중산대학손일선기념의원부산과수치적초진다낭란소종합정환자654례(청춘기101례,성인553례),이120명년령필배적건강지원자위대조조(청춘기40명,성인80명).병례화대조조균행구복포도당내량시험화이도소석방시험,비교병례조화대조조、성인다낭란소종합정여청춘기다낭란소종합정、불동체중지수아조중당대사이상적특점급기발생솔.결과 다낭란소종합정환자당대사이상적발생솔위24.5%(160/654),현저고우대조조적3.3%(4/120)(χ2=27.11,P<0.0001);성인병례조당대사이상적발생솔고우청춘기병례조(분별위26.6%、12.9%,χ2=8.688,P=0.003),청춘기병례조대사이상적발생솔고우청춘기대조조(분별위12.9%、0%,χ2=5.671,P=0.02).다낭란소종합정환자당대사이상주요표현위당내량수손(62.5%),기차위공복혈당수손(43.8%),당뇨병부점소수(8.1%);당뇨병13례,부4례(30.8%)공복혈당>7.0 mmol/L,9례(69.2%)통과구복포도당내량시험사사발현.다낭란소종합정조당대사이상적발생솔수체중지수승고이승고(χ2=53.71,P<0.0001).결론 다낭란소종합정환자위당대사이상적고위인군,기당대사이상이당내량수손위주,공복혈당수손차지.다낭란소종합정환자(우기시비반자)응행구복포도당내최시험,이조기발현기당대사이상.
Objective To evaluate the characteristics and prevalence of abnormal glucose metabolism in polycystic ovary syndrome (PCOS) patients. Methods A retrospective case-control study was performed in 654 PCOS patients (101 were in adolescence, 553 were adults) and 120 healthy controls (40 were in adolescence, 80 were adults). Oral glucose tolerance test (OGTT), insulin releasing test (IRT), and other biochemical testing were underwent in all patients and controls. The characteristics and prevalence of abnormal glucose metabolism were analyzed and compared. Results The prevalence of abnormal glucose metabolism, including impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetes mellitus (DM), was 24.5% in PCOS patients, which was significantly higher than that in the controls (χ2 = 27.11, P < 0.0001). The prevalence of abnormal glucose metabolism in adolescent PCOS patients was lower than that in adult PCOS patients (12.9% and 26.6%, respectively; χ2 = 8.688, P =0.003), but higher than that in age-matched adolescent controls (12.9% and 0%, respectively; χ2=5.671, P = 0.02). IGT was the most common manifestation of abnormal glucose metabolism in PCOS patients (62.5%), followed by IFG (43.8%) and DM (8.1%). In PCOS patients, 13 patients were diagnosed with DM, however, 9 of them (69.2%) were exposed by OGTT screening. In PCOS patients, the prevalence of abnormal glucose metabolism increased with body mass index(BM1) (χ2 = 53.71, P <0.0001). Conclusions PCOS patients are at a higher risk of abnormal glucose metabolism, and IGT may be the most common phenotype. It' s recommended that all PCOS patients should be screened for abnormal glucose metabolism by using 2-h OGTT.