首都医科大学学报 ›› 2016, Vol. 37 ›› Issue (4): 424-430.doi: 10.3969/j.issn.1006-7795.2016.04.003

• 更年期与妇科内分泌 • 上一篇    下一篇

达英-35对多囊卵巢综合征患者糖脂代谢的影响

李扬璐1, 阮祥燕1,2, 赵越1, 杜娟1, 王利娟1, 崔亚美1, 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绝经内分泌中心, 图宾根 D-72076, 德国
  • 收稿日期:2016-06-15 出版日期:2016-08-21 发布日期:2016-07-18
  • 通讯作者: 阮祥燕 E-mail:ruanxiangyan@163.com
  • 基金资助:
    北京市自然科学基金(Y161011),北京市卫生系统高层次卫生技术人才(2014-2-016),国家外国专家局2016年度北京市引进国外技术、管理人才项目(高外端)(20161100031),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)。

Effects of Diane-35 on the glucose and lipid metabolism in patients with polycystic ovary syndrome

Li Yanglu1, Ruan Xiangyan1,2, Zhao Yue1, Du Juan1, Wang Lijuan1, Cui Yamei1, Alfred O. Mueck1,2   

  1. 1. Department of Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China;
    2. Section of Endocrinology and Menopause, Department of Women's Health, University of Tubingen, Tubingen D-72076, Germany
  • Received:2016-06-15 Online:2016-08-21 Published:2016-07-18
  • Supported by:
    This study was supported by Natural Science Foundation Beijing(Y161011);Beijing Municipality Health Technology High-level Talent(2014-2-016);Foreign Technical and Administrative Talent Introduction Project in 2016,State Administration of Foreign Experts Affairs,the P. R. of China(20161100031);Project of Discipline Leader,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital(2013-1).

摘要: 目的 观察达英-35治疗多囊卵巢综合征(polycystic ovary syndrome,PCOS)的疗效,探讨其对PCOS患者激素及糖脂代谢的影响。方法 将确诊为PCOS的100名患者按照国际糖尿病联盟对代谢综合征的诊断分为代谢综合征(metabolic syndrome,MS)组和非代谢综合征组(non-MS)。观察并比较两组采用达英-35治疗3个月前后的激素、糖脂代谢指标的变化。结果 治疗后MS组体质量指数显著降低,非MS组无明显改变;两组血清睾酮和黄体生成素(luteinizing hormone,LH)/测量卵泡刺激素(follicle stimulating hormone,FSH)明显下降(P<0.05);MS组总胆固醇降低,非MS组显著升高,两组间变化幅度比较,差异近似有统计学意义(P=0.054);两组三酰甘油浓度均有显著升高,MS组升高幅度较大,组间差异有统计学意义(P<0.05);MS组高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)在治疗后略有上升,而非MS组显著升高,组间比较差异无统计学意义(P<0.05);MS组LDL-C均有轻度下降,非MS组则略有上升,组间比较差异有统计学意义(P<0.05)。MS组空腹血糖显著下降,非MS组显著上升,组间比较差异有统计学意义(P<0.05)。MS组空腹胰岛素轻度下降,非MS组轻度上升,组间比较差异无统计学意义(P>0.05)。结论 达英-35能够调整月经周期,改善高雄激素状态,并不恶化PCOS的糖脂代谢。在治疗过程中,除药物治疗外,还应注意配合饮食控制和运动,以期达到更好的疗效。

关键词: 多囊卵巢综合征, 代谢综合征, 达英-35, 糖脂代谢

Abstract: Objective To observe the effects of Diane-35 on polycystic ovary syndrome (PCOS), and to investigate its influence on hormone, glucose and lipid metabolism in PCOS patients. Methods Totally 100 patients diagnosed as PCOS were divided into two groups, metabolic syndrome (MS) group (n=64) and non-MS group (n=36), according to the MS criteria formulated by International Diabetes Federation (IDF). Hormone level and parameters of glucose and lipid metabolism were detected and compared between the two groups before and after treatment by Diane-35 for 3 months. Results The body mass index decreased significantly after treatment in MS group, while no obvious change in non-MS group. The serum testosterone and LH/FSH decreased in both groups (P<0.05). The total cholesterol in MS group slightly decreased, but increased significantly in non-MS group. The triglyceride in both groups increased significantly, especially in MS group, and the difference between the groups was statistically significant. HDL-C increased in both group, but only increased significantly in non-MS group (P<0.05). LDL-C decreased in MS group and increased in non-MS group without statistical difference, but the difference of between the groups was statistically significant. Fasting glucose decreased in MS group and increased in non-MS group significantly, and the difference between the groups was statistically significant. Fasting insulin decreased in MS group and increased in non-MS group without significant difference, and the difference between the groups was not significant. Conclusion Diane-35 can modify the menstrual cycle, and improve the hyperandrogenism such as hirsutism and acne, and do not deteriorate the glucose and lipid metabolism. PCOS treatment should combine diane-35 with diet and exercise, helping PCOS patients achieving the best effect.

Key words: polycystic ovary syndrome, metabolic syndrome, Diane-35, glucose and lipid metabolism

中图分类号: