不同睾酮水平的多囊卵巢综合征患者胰岛素敏感性和β细胞功能特点研究

摘要

Objective To investigate the insulin sensitivity and beta cell function of polycystic ovarian syndrome ( P-COS ) patients with different testosterone levels in order to provide references for metabolic intervention of PCOS patients with normal blood glucose. Methods Blood testosterone levels were measured among 78 PCOS patients ( PCOS group ) admitted to obstetrics and gynecology department of our hospital from February 2005 to September 2007 and 20 healthy non - pregnant adult women ( control group ) . Patients in PCOS group were divided into normal androgen group and high androgen group according to blood testosterone levels. All the patients were given oral glucose tolerance test ( OGTT ) and Botnia high insulin - glucose clamp technique. Insulin sensitivity index M and DI index were used to evaluate insulin sensitivity and β -cell function respectively. Analysis of variance and SNK method were adopted in comparison between groups. Results The age, BMI and FPG among three groups showed no statistically significant differences ( P > 0. 05 ), but PPG, blood testosterone levels, M value and DI index among three groups showed statistically significant differences ( P <0. 01 ) . The PPG levels in control group, high androgen group and normal androgen group increased in turn; while the blood testosterone levels in control group, normal androgen group and high androgen group increased in turn, and showed statistically significant differences pairwise ( P <0. 01 ) . Compared with control group, the M value and DI index in normal androgen group and high androgen group decreased, and showed statistically significant difference ( P <0. 01 ) . Conclusion The PCOS patients whose blood glucose is normal and blood testosterone has not increased obviously have already had damaged insulin sensitivity and β-cell function. Early intervention should be given to them.%目的 评估不同睾酮水平的多囊卵巢综合征(PCOS)患者胰岛素敏感性和β细胞功能,为血糖正常的PCOS患者早期代谢干预提供依据.方法 选取2005年2月-2007年9月在本院妇产科就诊的78例血糖正常的PCOS患者(PCOS组)及20例体质量正常的健康非孕成年女性(对照组)按年龄匹配,测定其血睾酮水平.根据对照组血睾酮水平,将PCOS组患者分为PCOS正常雄激素组和PCOS高雄激素组.所有受试者行口服葡萄糖耐量试验(OGTT)、Botnia高胰岛素-正糖钳夹术,利用胰岛素敏感指数(M)及β细胞指数(DI指数)分别评估胰岛素敏感性和β细胞功能.组间比较采用方差分析及SNK法.结果 3组受试者的年龄、体质指数(BMI)、空腹血糖(FPG)水平比较,差异均无统计学意义(P>0.05);而3组的餐后血糖(PPG)、睾酮、M值、DI指数比较,差异均有统计学意义(P<0.01);其中对照组、PCOS高雄激素组、PCOS正常雄激素组PPG水平依次升高,对照组、PCOS正常雄激素组及高雄激素组睾酮水平依次升高,组间两两比较差异均有统计学意义(P<0.01);PCOS正常雄激素组及高雄激素组患者M值及DI指数低于对照组,组间比较差异均有统计学意义(P<0.01).结论 血糖正常且血睾酮水平未显著升高的PCOS患者已存在胰岛素敏感性和β细胞功能受损,应及早予以干预.