CAJ | 학술논문

目的探讨肥胖和非肥胖型多囊卵巢综合征(PCOS)患者的糖代谢特征.方法回顾性分析2006年5月至2009年4月在山东大学附属省立医院生殖医学中心就诊的1928例PCOS患者的临床资料和糖耐量、胰岛素释放试验结果,按体质指数(BMI)分为肥胖组(BMI≥25 kg/m2)901例和非肥胖组(BMI<25 kg/m2)1027例,比较两组患者口服糖耐量试验(OGTT)结果、空腹血糖受损(IFG)、糖耐量受损(IGT)和2型糖尿病(T2DM)的发生率.结果 (1)血糖水平:空腹及服糖后30、60、120、180 min,肥胖组血糖水平分别为(5.3±1.1)、(9.0±2.4)、(9.3±4.4)、(7.5±2.8)、(5.3±1.8)mmol/L,非肥胖组分别为(5.0±0.8)、(8.4±3.5)、(8.0±4.2)、(6.5±3.2)、(4.9±1.6)mmol/L,两组各时间点血糖水平比较,差异均有统计学意义(P<0.01).(2)胰岛素水平:空腹及服糖后30、60、120 min,肥胖组胰岛素水平分别为(13±7)、(81±51)、(102±65)、(83±63)mU/L,非肥胖组胰岛素水平分别为(8±5)、(57±35)、(62±44)、(46±39)mU/L,两组各时间点比较,差异均有统计学意义(P<0.01);但服糖后180 min两组胰岛素水平比较,差异无统计学意义(P>0.05).(3)糖代谢异常发生率:IFG总发生率为4.98%(96/1928);糖耐量异常总发生率为23.08%(445/1928);肥胖组和非肥胖组IGT发生率分别为24.20%(218/901)和13.05%(134/1027),两组比较,差异有统计学意义(P<0.01);肥胖组和非肥胖组T2DM发生率分别为7.44%(67/901)和2.53%(26/1027),两组比较,差异也有统计学意义(P<0.01).结论肥胖型较非肥胖型PCOS患者更易发生糖代谢紊乱.
목적 탐토비반화비비반형다낭란소종합정(PCOS)환자적당대사특정.방법 회고성분석2006년5월지2009년4월재산동대학부속성립의원생식의학중심취진적1928례PCOS환자적림상자료화당내량、이도소석방시험결과,안체질지수(BMI)분위비반조(BMI≥25 kg/m2)901례화비비반조(BMI<25 kg/m2)1027례,비교량조환자구복당내량시험(OGTT)결과、공복혈당수손(IFG)、당내량수손(IGT)화2형당뇨병(T2DM)적발생솔.결과 (1)혈당수평:공복급복당후30、60、120、180 min,비반조혈당수평분별위(5.3±1.1)、(9.0±2.4)、(9.3±4.4)、(7.5±2.8)、(5.3±1.8)mmol/L,비비반조분별위(5.0±0.8)、(8.4±3.5)、(8.0±4.2)、(6.5±3.2)、(4.9±1.6)mmol/L,량조각시간점혈당수평비교,차이균유통계학의의(P<0.01).(2)이도소수평:공복급복당후30、60、120 min,비반조이도소수평분별위(13±7)、(81±51)、(102±65)、(83±63)mU/L,비비반조이도소수평분별위(8±5)、(57±35)、(62±44)、(46±39)mU/L,량조각시간점비교,차이균유통계학의의(P<0.01);단복당후180 min량조이도소수평비교,차이무통계학의의(P>0.05).(3)당대사이상발생솔:IFG총발생솔위4.98%(96/1928);당내량이상총발생솔위23.08%(445/1928);비반조화비비반조IGT발생솔분별위24.20%(218/901)화13.05%(134/1027),량조비교,차이유통계학의의(P<0.01);비반조화비비반조T2DM발생솔분별위7.44%(67/901)화2.53%(26/1027),량조비교,차이야유통계학의의(P<0.01).결론 비반형교비비반형PCOS환자경역발생당대사문란.
Objective To investigate characteristics of glucose metabolism of non-obese and obese women with polycystic ovary syndrome (PCOS). Methods From May 2006 to April 2009, 1928 PCOS patients treated in Reproductive Medicine Center of Shandong Provincial Hospital Affiliated to Shandong University were enrolled in this study, which were divided into 901 cases [body mass index (BMI) ≥25 kg/m2] in obese group and 1027 cases in non-obese (BMI < 25 kg/m2) group. The prevalence of type 2 diabetes mellitus (T2DM), oral glucose tolerance test, impaired fasting glucose (IFG), impaired glucose tolerance(IGT) were compared between the two groups. Results (1) Blood glucose levels: at the time of fasting, 30, 60, 120 and 180 minutes, the levels of glucose were (5. 3±1.1), (9. 0±2. 4), (9. 3±4. 4),(7.5±2.8) ,(5.3±1.8)mmol/L in obese group and (5.0±0. 8) ,(8.4±3.5),(8.0±4.2),(6.5±3.2) ,(4. 9±1.6) mmol/L in non-obese group, which all showed statistical difference at every time point (P < 0. 01). (2)The level of insulin: at the time of fasting, 30, 60, 120 min, the level of insulin were (13±7), (81±51), (102±65), (83±63) mU/L in obese group and (8±5) ,(57±35) ,(62±44),(46±39) mU/L in non-obese group, which all showed statistical differenceatevery time point (P <0. 01). However, at time point of 180 minutes, the level of insulin did not exhibit significantly difference between obese and non-obese group (P > 0. 05). (3) The prevalence of abnormal glucose metabolism: the rate of IFG was 4. 98% (96/1928). The rate of abnormal glucose tolerance was 23. 08% (445/1928). The rate of IGT were 13.05% (134/1027) in non-obese group and 24. 20% (218/901) in obese group,which also showed remarkable difference (P < 0. 01). The rate of T2DM were 2. 53% (26/1027) in nonobese group and 7.44% (67/901) in obese group, which reached significant difference (P < 0. 01).Conclusion Abnormal glucose metabolism was observed more frequently in overweight or obese PCOS women.