中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
29期
2036-2039
,共4页
曲中玉%石玉华%赵冬妮%姜晶晶%马增香%陈子江
麯中玉%石玉華%趙鼕妮%薑晶晶%馬增香%陳子江
곡중옥%석옥화%조동니%강정정%마증향%진자강
多囊卵巢综合征%非酒精性脂肪性肝病%胰岛素抵抗
多囊卵巢綜閤徵%非酒精性脂肪性肝病%胰島素牴抗
다낭란소종합정%비주정성지방성간병%이도소저항
Polycystic ovary syndrome%Nonalcoholic fatty liver disease%Insulin resistance
目的 研究肥胖对多囊卵巢综合征(PCOS)患者中非酒精性脂肪性肝病(NAFLD)发病的影响.方法 对306例PCOS患者及286例对照者进行基础内分泌、口服糖耐量试验及胰岛素释放试验、肝功、血脂等检查,B超诊断脂肪肝.结果 306例PCOS患者中诊断NAFLD 94例,占30.7%,明显高于对照组发病率17.5%(P＜0.05);PCOS患者中NAFLD轻度56例(59.6%),中度34例(36.2%),重度4例(4.2%).PCOS患者中NAFLD发病率随着体重指数(BMI)、腰臀比(WHR)、甘油三酯(TG)、HOMA-IR的增加而升高,脂肪肝程度随着BMI的增加而加重.腹型肥胖的PCOS患者NAFLD发病率为43.4%,明显高于腰围正常的PCOS患者NAFLD发生率为2.2%(P＜0.05).且随着BMI的增加,PCOS患者胰岛素抵抗、代谢综合征的发生率亦随之升高.结论 PCOS患者NAFLD发病率较高,腹型肥胖和Ⅱ肥胖的PCOS患者更易发生NAFLD,其发病率和脂肪肝的程度与BMI呈正相关.PCOS患者NAFLD的发生与胰岛素抵抗、肥胖、代谢异常密切相关.肥胖的PCOS患者应加强NAFLD的诊断并及时指导其改善生活方式.
目的 研究肥胖對多囊卵巢綜閤徵(PCOS)患者中非酒精性脂肪性肝病(NAFLD)髮病的影響.方法 對306例PCOS患者及286例對照者進行基礎內分泌、口服糖耐量試驗及胰島素釋放試驗、肝功、血脂等檢查,B超診斷脂肪肝.結果 306例PCOS患者中診斷NAFLD 94例,佔30.7%,明顯高于對照組髮病率17.5%(P＜0.05);PCOS患者中NAFLD輕度56例(59.6%),中度34例(36.2%),重度4例(4.2%).PCOS患者中NAFLD髮病率隨著體重指數(BMI)、腰臀比(WHR)、甘油三酯(TG)、HOMA-IR的增加而升高,脂肪肝程度隨著BMI的增加而加重.腹型肥胖的PCOS患者NAFLD髮病率為43.4%,明顯高于腰圍正常的PCOS患者NAFLD髮生率為2.2%(P＜0.05).且隨著BMI的增加,PCOS患者胰島素牴抗、代謝綜閤徵的髮生率亦隨之升高.結論 PCOS患者NAFLD髮病率較高,腹型肥胖和Ⅱ肥胖的PCOS患者更易髮生NAFLD,其髮病率和脂肪肝的程度與BMI呈正相關.PCOS患者NAFLD的髮生與胰島素牴抗、肥胖、代謝異常密切相關.肥胖的PCOS患者應加彊NAFLD的診斷併及時指導其改善生活方式.
목적 연구비반대다낭란소종합정(PCOS)환자중비주정성지방성간병(NAFLD)발병적영향.방법 대306례PCOS환자급286례대조자진행기출내분비、구복당내량시험급이도소석방시험、간공、혈지등검사,B초진단지방간.결과 306례PCOS환자중진단NAFLD 94례,점30.7%,명현고우대조조발병솔17.5%(P＜0.05);PCOS환자중NAFLD경도56례(59.6%),중도34례(36.2%),중도4례(4.2%).PCOS환자중NAFLD발병솔수착체중지수(BMI)、요둔비(WHR)、감유삼지(TG)、HOMA-IR적증가이승고,지방간정도수착BMI적증가이가중.복형비반적PCOS환자NAFLD발병솔위43.4%,명현고우요위정상적PCOS환자NAFLD발생솔위2.2%(P＜0.05).차수착BMI적증가,PCOS환자이도소저항、대사종합정적발생솔역수지승고.결론 PCOS환자NAFLD발병솔교고,복형비반화Ⅱ비반적PCOS환자경역발생NAFLD,기발병솔화지방간적정도여BMI정정상관.PCOS환자NAFLD적발생여이도소저항、비반、대사이상밀절상관.비반적PCOS환자응가강NAFLD적진단병급시지도기개선생활방식.
Objective To investigate the effect of obesity on nonalcoholic fatty liver disease (NAFLD) in women with polycystic ovary syndrome (PCOS). Methods The patient data were acquired from 306 women with PCOS by Rotterdam consensus criteria and 286 women selected as controls. Basal endocrine, oral glucose tolerance test (OGTT), insulin release test, lipid profile, blood pressure and body mass index (BMI) were tested. The essays of liver chemistries, B-hepatitis and c-hepatitis were performed and alcoholic liver diseases excluded. Fatty liver was diagnosed by ultrasound. Results Patients with PCOS showed a higher prevalence of NAFLD than control group (30. 7% vs 17. 5% ), including 56 mild cases (59.6%), 34 moderate cases (36. 2% ) and 4 severe cases (4. 2% ). The prevalence of NAFLD in PCOS increased with BMI, waist hip ratio, triglyceride and HOMA-IR. The prevalence of NAFLD in abdominal obese PCOS patients was significantly higher than those with normal waist. In addition to the prevalence of insulin resistance, metabolic syndrome in PCOS women significantly increased with BMI. Conclusion These findings indicate that Chinese women with PCOS have a high prevalence of NAFLD, especially in abdominal and Ⅱ obese PCOS patients. The prevalence and severity of NAFLD are positively correlated with BMI. It seems that insulin resistance and metabolic abnormalities are closely associated with NAFLD in PCOS. It is essential to give a high priority to the screening and treatment of NAFLD in obese PCOS patients.
