首都医科大学学报 ›› 2015, Vol. 36 ›› Issue (4): 553-558.doi: 10.3969/j.issn.1006-7795.2015.04.008

• 更年期与妇科生殖内分泌 • 上一篇    下一篇

多囊卵巢综合征患者合并代谢综合征的患病率和预测指标

武红琴1, 阮祥燕1,2, 卢永军1, 田玄玄1, 张颖1, 崔亚美1, 赵越1, 杜娟1, 李扬璐1, Diethelm Wallwiener2, Alfred O. Mueck1,2   

  1. 1. 首都医科大学附属北京妇产医院内分泌科, 北京 100026;
    2. 德国图宾根大学妇产医院内分泌与绝经中心, 图宾根 D-72076, 德国
  • 收稿日期:2015-05-22 出版日期:2015-08-21 发布日期:2015-07-17
  • 通讯作者: 阮祥燕 E-mail:ruanxiangyan@163.con
  • 基金资助:

    国家外国专家局2015年度北京市引进国外技术、管理人才项目(GDJ20151100013),北京市卫生系统高层次卫生技术人才(2014-2-016),首都医科大学附属北京妇产医院,北京妇幼保健院学科带头人项目(2013-1)。

Prevalence, characteristics and predictors of the metabolic syndrome in women with polycystic ovary syndrome

Wu Hongqin1, Ruan Xiangyan1,2, Lu Yongjun1, Tian Xuanxuan1, Zhang Ying1, Cui Yamei1, Zhao Yue1, Du Juan1, Li Yanglu1, Diethelm Wallwiener2, Alfred O. Mueck1,2   

  1. 1. Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China;
    2. Department of Endocrinology, University Women's Hospital of Tubingen, Tubingen D-72076, Germany
  • Received:2015-05-22 Online:2015-08-21 Published:2015-07-17
  • Supported by:

    This study was supported by Foreign Technical and Administrative Talent Introduction Project in 2015, State Administration of Foreign Experts Affairs, the P. R. of China(GDJ20151100013); Beijing Municipality Health Technology High-level Talent(2014-2-016); Project of Discipline Leader, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Health Care Hospital(2013-1).

摘要:

目的 探讨多囊卵巢综合征(polycystic ovarian syndrome,PCOS)患者代谢综合征(metabolic syndrome,MS)及其各组分的发病情况,评估MS各组分对预测PCOS患者合并MS的预测能力。方法 选取2013年12月至2014年7月就诊于首都医科大学附属北京妇产医院内分泌科被确诊为多囊卵巢综合征患者180例,所有患者均收集人体测量学指标、基础内分泌指标和血糖血脂等生物化学指标,评估PCOS患者MS及其各组分的发病情况,筛选对PCOS患者发生MS高风险的预测指标。结果 ① 180例PCOS患者MS的患病率为43.89%;② 不同年龄段的患病率分别为17~24岁32.14%、25~29岁39.53%、30~34岁50%、35~39岁80%;正常体质量、超质量、肥胖、重度肥胖的患病率非别为10.00%、51.16%、69.57%、85.71%;③ 合并有MS的PCOS患者的年龄和体质量指数均高于非MS的PCOS患者(29.16±3.85 vs 27.47±3.81,P=0.004;31.44±4.89 vs 24.29±4.87,P=0.000),两组患者的血总睾酮浓度差异无统计学意义(P < 0.05);④ PCOS患者发生MS最好的预测指标是高密度脂蛋白胆固醇<1.29 mmol/L(敏感度为91.14%,特异度为88.12%)。结论 PCOS患者是发生代谢综合征的高风险人群,年龄和肥胖情况是决定不同人群代谢综合征患病率的关键因素。通过高密度脂蛋白胆固醇水平可以较好的评估PCOS患者发生代谢综合征的风险。

关键词: 多囊卵巢综合征, 代谢综合征, 患病率, 预测指标

Abstract:

Objective To investigate the prevalence of metabolic syndrome(MS) and its components in women with polycystic ovary syndrome(PCOS), and analyze the ability of MS components to predict MS risk in PCOS patients. Methods A total of 180 women with PCOS participated in this study between December 2013 and July 2014. All of the subjects were examined for anthropometric, serum hormone level and biochemical parameters. We investigated the incidence of MS and its components, screening predictors for PCOS patients at high risk of MS. Results The prevalence of MS in PCOS patients was 43.89%. The prevalence in different age groups was 32.14% for 17-24 years, 39.53% for 25-29 years, 50.00% for 30-34 years and 80.00% for 35-39 years. The prevalence in different BMI groups was 10.00% for normal, 51.16% for overweight, 69.57% for obese and 85.71% for morbidly obese women. The age and BMI in PCOS patients with MS were higher than those of patients without MS(29.16±3.85 vs 27.47±3.81, P=0.004; 31.44±4.89 vs 24.29±4.87, P=0.000, respectively), the total testosterone level in two group was similar(P<0.05). The best predictors of metabolic syndrome in PCOS was HDL-C<1.29 mmol/L(sensitivity 91.14% and specificity 88.12%). Conclusion Women with PCOS have high risk for MS, age and the degree of obesity could be the main determinants of the prevalence of metabolic syndrome in different populations. The level of HDL-cholesterol could be a good predictor of the risk of MS in PCOS patients.

Key words: polycystic ovary syndrome, metabolic syndrome, prevalence, predictors

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