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目的:探讨多囊卵巢综合征(polycysticovarysyndrome,PCOS)患者胰岛素抵抗特点。方法:对62例PCOS患者行葡萄糖耐量试验、胰岛素释放试验,测定五个时点血糖、胰岛素以及C-肽浓度;测定空腹血瘦素、总睾酮浓度以及体重指数(BMI)和腰臀比例(WHR)。结果:PCOS患者糖负荷后血糖、胰岛素以及C-P浓度峰值均在服糖后30～60min。服糖后3h血糖、胰岛素以及C-P浓度显著高于空腹值(t=3.3723～5.0412,P<0.05)。肥胖组的胰岛素曲线下面积显著高于消瘦组(t=2.1263,P<0.05);两组的血糖及C-肽浓度曲线下面积无显著差异(t=0.9949～1.0692,P>0.05)。空腹、60min以及120min胰岛素浓度与肥胖有关指标(瘦素,BMI,WHR)均呈显著正相关(r>0.40,P<0.05)。结论:PCOS患者同时存在胰岛素抵抗和代谢异常。对于PCOS患者常规进行糖耐量及胰岛素释放试验是必要的。肥胖能加重PCOS患者胰岛素抵抗的程度。
Objective: To investigate the characteristics of insulin resistance in patients with polycystic ovarysyndrome (PCOS). Methods: Sixty-two PCOS patients underwent glucose tolerance test and insulin release test. Blood glucose, insulin and C-peptide concentrations were measured at five time points. Fasting blood leptin, total testosterone, body mass index (BMI) WHR). Results: The peak value of blood glucose, insulin and C-P concentration in patients with PCOS were 30-60 minutes after oral administration of sugar. Blood glucose, insulin and C-P levels at 3h after oral administration were significantly higher than fasting values (t = 3.3723 ~ 5.0412, P <0.05). The area under the curve of insulin in the obese group was significantly higher than that in the emaciated group (t = 2.1263, P <0.05). There was no significant difference between the two groups in the area under the curve of blood glucose and C-peptide concentration (t = 0.9949-1.0692, P> 0.05). The fasting, 60min and 120min insulin concentrations were significantly correlated with obesity (leptin, BMI, WHR) (r> 0.40, P <0.05). Conclusion: PCOS patients have both insulin resistance and metabolic abnormalities. Conventional glucose tolerance and insulin release tests in patients with PCOS are necessary. Obesity can aggravate the degree of insulin resistance in PCOS patients.