摘要
目的了解多囊卵巢综合征（PCOS）患者胰岛B细胞功能状况。方法对47例PCOS患者（肥胖组16例，非肥胖组31例）和年龄相当的非肥胖健康妇女20例（对照组）行口服葡萄糖耐量试验（OGTT）和Bomia葡萄糖钳夹术，该钳夹术包括静脉葡萄糖耐量试验（IVGTT，0～60min）和随后的高胰岛素-正糖钳夹术（简称正糖钳夹术，61～180min）。胰岛素敏感性（IS）用正糖钳夹术稳态阶段胰岛素介导的葡萄糖代谢率与稳态胰岛素浓度比值表示（M／I）。胰岛B细胞功能采用IVGTT第一时相胰岛素分泌量（AIR）评估。葡萄糖处置指数（DI）=ISXAIR。结果（1）3组间年龄、空腹血糖差异无统计学意义，但PCOS组腰臀比高于对照组，肥胖PCOS患者OGTT2h血糖比对照组和非肥胖PCOS组高[分别为（7．89±1．72）、（5．94±1．10）和（6．31±1．42）mmol/L，均P〈0．05]。（2）非肥胖PCOS组与肥胖PCOS组IS（分别为2．89±0．16和1．96±0．16）均低于对照组（5．76±0．16），其中肥胖PCOS组最低（均P〈0．05）。（3）3组间AIR差别无统计学意义，但PCOS患者有增高趋势，尤以肥胖者明显（P=0．08）。（4）非肥胖和肥胖PCOS组DI（分别为1．07±0．45和1．12±0．45）比对照组（1．46±0．50）降低（均P〈0．05），但前两组间差异无统计学意义。结论无论肥胖与否，PCOS患者均存在胰岛素抵抗；PCOS患者糖刺激后第一时相胰岛素分泌未降低，但其DI降低，提示胰岛β细胞对胰岛素抵抗代偿能力下降。
Objective To evaluate the islet β-cell function in women with polycystic ovary syndrome （PCOS）. Methods Forty-seven women with PCOS （31 non-obese and 16 obese subjects） and 20 age-matched healthy women （control group） underwent oral glucose tolerance tests （OGTY） and Botnia glucose clamp which was an intravenous glucose tolerance test （IVGTY） for 60 minutes followed by an euglycemic-hyperinsulinomic clamp for 2 hours. Insulin sensitivity （ IS ） was calculated as insulin-mediated glucose disposal rate of the euglycemic-hyperinsulinomic clamp divided by the mean of insulin concentrations at 150 min and 180 min （M/I）. Islet β-cell function Was reflected through acute insulin response （AIR） of IVGTY. Glucose disposition index （DI） = IS × AIR. Results （ 1 ） There was no significant difference in age and fasting plasma glucose among 3 groups, but PCOS patients had a higher waist hip ratio than the control, and 2 h plasma glucose level during OGTY in the obese PCOS women was increased in comparison with those in control and non-obese groups [ （7.89 ± 1.72） , （5.94 ±1.10） and （6.31 ± 1.42）mmol/L, respectively, both P〈0.05]. （2） IS in non-obese and obese PCOS groups （2.89 ± 0.16 and 1.96 ± 0. 16, respectively） significantly decreased as compared with control group （ 5.76 ±0.16）, and obese PCOS group had the lowest IS among 3 groups （all P〈0.05）. （3） AIR was similar in 3 groups, but there was a trend of increase in women with PCOS, especially in those with obesity （ P = 0.08）. （4） DI was lower in non-obese and obese PCOS patients （1.07 ± 0. 45 and 1.12 ± 0.45 respectively）than that in healthy women （1.46 ±0.50, beth P 〈0.05）, and no significant difference was found between the non-obese and obese PCOS groups. Conclusion Regardless of obese or not, PCOS patients have profound insulin resistance. MR in women with PCOS does not decrease, however, DI is decreased, suggesting that the compensatory ability of islet β-cell for insulin resistance is deficient.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2007年第1期40-43,共4页
Chinese Journal of Endocrinology and Metabolism
基金
重庆市卫生局科研基金资助项目（03-2-112）
