原发性卵巢功能不全对病人糖脂代谢及生物化学指标的影响

doi:10.3969/j.issn.1006-7795.2017.04.004

首都医科大学学报 ›› 2017, Vol. 38 ›› Issue (4): 504-508.doi: 10.3969/j.issn.1006-7795.2017.04.004

原发性卵巢功能不全对病人糖脂代谢及生物化学指标的影响

李雪¹, 阮祥燕^1,2, 王虎生¹, 李扬璐¹, 赵越¹, 谷牧青¹, 杜娟¹, 宋菁华¹, 金凤羽¹, Alfred O. Mueck^1,2

1. 首都医科大学附属北京妇产医院妇科内分泌科, 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:2017-06-05 出版日期:2017-07-21 发布日期:2017-07-20
通讯作者: 阮祥燕 E-mail:ruanxiangyan@163.com
基金资助:
国家外国专家局2017年度北京市引进国外技术、管理人才项目（20171100004），首都临床特色应用研究与成果推广（Z161100000516143），首都卫生发展科研专项项目（2016-2-2113），北京市医院管理局临床技术创新项目（XMLX201710），北京市卫生系统高层次卫生技术人才（学科带头人）（2014-2-016）

Effects of primary ovarian insufficiency on glucose and lipid metabolism and biochemical parameters in patients

Li Xue¹, Ruan Xiangyan^1,2, Wang Husheng¹, Li Yanglu¹, Zhao Yue¹, Gu Muqing¹, Du Juan¹, Song Jinghua¹, Jin Fengyu¹, Alfred O. Mueck^1,2

1. Department of Gynecological 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:2017-06-05 Online:2017-07-21 Published:2017-07-20
Supported by:
This study was supported by Foreign Technical and Administrative Talent Introduction Project in 2017, State Administration of Foreign Experts Affairs, the P. R. of china(20171100004);Capital Characteristic Clinic Project of China(Z161100000516143); Beijing Capital Foundation for Medical Science Development and Research(2016-2-2113); Clinical Technique Innovation Project of Beijing Municipal Administration of Hospitals(XMLX201710); Beijing Municipality Health Technology High-level Talent(2014-2-016)

摘要/Abstract

摘要： 目的比较原发性卵巢功能不全（primary ovarian insufficiency，POI）病人、绝经期妇女及正常体检女性的性激素、糖脂代谢及其他生物化学指标之间的差异，以期提高对POI病人健康状况的关注程度。方法纳入108例POI病人、114名绝经期女性、63例正常体检女性，分别测量其性激素、糖脂代谢、其他生物化学指标（相关检测试剂盒的批间误差、批内误差控制在3% ~ 5%）。结果 3组之间体质量指数（body mass index，BMI）差异无统计学意义（P>0.05），卵泡刺激素（follicle stimulating hormone，FSH）、黄体生成素（luteinizing hormone，LH）、雌二醇（estradiol，E₂）两两比较差异均有统计学意义（P<0.05）。总胆固醇（total cholesterol，TC）、空腹胰岛素［fasting insulin，FINS］、胰岛素抵抗指数（homeostasis model assessment of insulin resistance，HOMA-IR）POI组与绝经组的测量值均明显大于对照组（P<0.05）、高密度脂蛋白胆固醇（high density lipoprotein-cholesterol，HDL-C）和睾酮（testosterone，T）浓度明显低于对照组（P<0.05）。结论本研究中POI病人的TC、FINS、HOMA-IR、HDL-C已经达到绝经期女性水平（P<0.05），长期发展可能影响病人的生活质量，临床医生应及早对POI病人进行干预与治疗。

关键词: 原发性卵巢功能不全, 更年期, 糖脂代谢, 性激素

Abstract: Objective To compare the endocrine and metabolic parameters of primary ovarian insufficiency (POI) patients with menopausal women and normal control group, and to analyze the differences of the endocrine indicators, glucose and lipid metabolism indicators and other biochemical indicators between POI group, menopausal women and normal control group,in order to increase the attention to the health status of patients with POI. Methods A total of 108 patients diagnosed with POI, 114 menopausal women and 63 normal women. Sex hormones, glucose and lipid metabolism, and other biochemical indicators were compared. The error of the relevant detection kit and the batch error is less than 3% to 5%. Results There was no significant difference in body mass index (BMI) among the three groups (P>0.05). There were significant differences between follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E₂) (P< 0.05 ). The levels of total cholesterol (TC), fasting insulin (FINS) and homeostasis model assessment of insulin resistance (HOMA-IR) in the POI group were significantly higher than those of the control group (P<0.05 ), high density lipoprotein-cholesterol (HDL-C) and testosterone (T) levels were significantly lower than those of the control group (P<0.05). Conclusion In this study, TC, FINS, HOMA-IR and HDL-C of POI patients had reached menopausal women (P<0.05). The clinicians should intervene and treat POI patients as soon as possible.

Key words: primary ovarian insufficiency, menopause, metabolic of glucose and lipid, sex hormones

中图分类号:

李雪, 阮祥燕, 王虎生, 李扬璐, 赵越, 谷牧青, 杜娟, 宋菁华, 金凤羽, Alfred O. Mueck. 原发性卵巢功能不全对病人糖脂代谢及生物化学指标的影响[J]. 首都医科大学学报, 2017, 38(4): 504-508.

Li Xue, Ruan Xiangyan, Wang Husheng, Li Yanglu, Zhao Yue, Gu Muqing, Du Juan, Song Jinghua, Jin Fengyu, Alfred O. Mueck. Effects of primary ovarian insufficiency on glucose and lipid metabolism and biochemical parameters in patients[J]. Journal of Capital Medical University, 2017, 38(4): 504-508.

参考文献

[1] Luisi S, Orlandini C, Regini C,et al. Premature ovarian insufficiency: from pathogenesis to clinical management[J].J Endocrinol Invest, 2015, 38(6):597-603.
[2] Lee P A. Normal ages of pubertal events among American males and females[J]. J Adolesc Health Care, 1980, 1(1):26-29.
[3] Altuntas C Z, Johnson J M, Tuohy V K. Autoimmune targered disruption of the pituitary-ovarian axis causes premature ovarian failure[J]. J Immunol, 2006, 177(3):1996-1998.
[4] 马良坤, 林守清.卵巢早衰与卵巢不敏感综合征[J].实用妇产科杂志,2003, 19(4):198-200.
[5] Torréns J I,Sutton-Tyrrell K,Zhao X,et al.Relative androgen excess during the menopausal transition predicts incident metabolic syndrome in midlife women: study of Women's Health Across the Nation [J]. Menopause, 2009, 16(2): 257-264.
[6] 符金香,朱晓慧,高贝贝,等.雌激素对CETP 转基因小鼠糖代谢及胰岛功能影响的初步研究[J].南京医科大学学报(自然科学版),2014,34(8): 1025-1028.
[7] Pallikadavath S, Ogollah R, Singh A, et al. Natural menopause among women below 50 years in India: a population-based study[J]. Indian J Med Res, 2016, 144(3): 366-377.
[8] Lindnein S R, Presser S C, Diskoff E C, et al. A possible bimodal effect of estrogen on insulin sensitivity in postmenopausal women and the attenuating effect of added progestin[J]. Fertil Steril, 1993, 60(4):664-667.
[9] Herrington D M, Howard T D, Hawkins G A, et al. Estrogen-receptor polymorphisms and effects of estrogen replacement on high-density lipoprotein cholesterol in women with coronary disease[J].N Engl J Med,2002, 346(3):967-974.
[10] Manrique C, Lastra G, Habibi J, et al. Loss of estrogen receptor α signaling leads to insulin resistance and obesity in young and adult female mice[J]. Cardiorenal Med,2012, 2(3): 200-210.
[11] Knopp R H, Paramsothy P, Retzlaff B M, et al. Sex differences in lipoprotein metabolism and dietary response: basis in hormonal differences and implications for cardiovascular disease[J].Curr Cardiol Rep,2006, 8(6):452-459.
[12] Haverkamp F, Gasteyger C.A review of biopsychosocial strategies to prevent and overcome early-recognized poor adherence in growth hormone therapy of children [J]. J Med Econ,2011, 14(4): 448-457.
[13] Faulds M H,Zhao C,Dahlman-Wright K,et al. The diversity of sex steroid action:regulation of metabolism by estrogen signaling[J]. J Endocrinol,2012,212(1):3-12.
[14] Wolfe B M, Huff M W. Effects of combined estrogen and progestin administration on plasma lipoprotein metabolism in postmenopausal women[J].J Clin Invest, 1989, 83(1):40-45.
[15] Ates S, Yesil G, Sevket O, et al. Comparison of metabolic profile and abdominal fat distribution between karyotypically normal women with premature ovarian insufficiency and age matched controls[J].Maturitas,2014, 79(3):306-310.
[16] Arnett D K, McGovern P G, Jacobs D R Jr, et al. Fifteenyear trends in cardiovascular risk factors (1980-1982 through 1995-1997) the Minnesota Heart Survey[J]. Am J Epidemiol, 2002, 156(10): 929-935.
[17] ESHRE Capri Workshop Group. Noncontraceptive health benefits of combined oral contraception[J]. Hum Reprod Update,2005, 11(5):513-525.
[18] Gravholt C H, Naeraa R W, Nyholm B,et al. Glucose metabolism, lipid metabolism, and cardiovascular risk factors in adult Turner's syndrome.The impact of sex hormone replacement[J]. Diabetes Care,1998, 21(7):1062-1070.
[19] González C, Alonso A, Grueso N A. Role of 17beta-estradiol administration on insulin sensitivity in the rat:implications for the insulin receptor[J].Steroids,2002, 67(13-14): 993-1005.
[20] González C, Alonso A, Diaz F. Dose-and time-dependent effects of 17betaoestradiol on insulin sensitivity in insulin-dependent tissues of rat:implications of IRS-1[J]. J Endocrinol, 2003, 176(3): 367-379.
[21] Bachmann G, Bancroft J, Braunstein G, et al. Female androgen insufficiency: the Princeton consensus statement on definition, classification, and assessment. [J]. Fertil Steril,2002, 77(4):660-665.
[22] Benetti-Pinto C L, Bedone A J, Magna L A. Evaluation of serum androgen levels in women with premature ovarian failure [J].Fertil Steril,2005, 83(2):508-510.
[23] Cawood E H, Bancroft J. Steroid hormones, the menopause, sexuality and well-being of women. [J].Psychol Med,1996, 26(5):925-936.

原发性卵巢功能不全对病人糖脂代谢及生物化学指标的影响

Effects of primary ovarian insufficiency on glucose and lipid metabolism and biochemical parameters in patients

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	鞠蕊, 阮祥燕, 代荫梅, 白勇涛, 杨瑜, 许新, 程姣姣, 杨幸子, 施琰红, 孙艳华, 李瑞玲. 女性性功能障碍的影响因素研究[J]. 首都医科大学学报, 2022, 43(3): 357-363.
[2]	张凌燕, 阮祥燕, 李星明, 崔亚美, 谷牧青, 刘玉兰, 甄洁. 更年期症状全面评估量表的信度与效度评价[J]. 首都医科大学学报, 2021, 42(4): 511-520.
[3]	鞠蕊, 阮祥燕, 许新, 杨瑜, 张露平, 秦爽, 王宾红, 豆竹丽, Alfred O. Mueck. 围绝经期及绝经后女性性功能障碍状况及与更年期症状的关系分析[J]. 首都医科大学学报, 2020, 41(4): 503-507.
[4]	张露平, 阮祥燕, 鞠蕊, 秦爽, 王宾红, 许新, 杨瑜, Alfred O. Mueck. 围绝经期及绝经后女性基于腰椎定量电子计算机断层扫描测定的内脏脂肪与糖脂代谢的相关性[J]. 首都医科大学学报, 2020, 41(4): 508-513.
[5]	王宾红, 阮祥燕, 鞠蕊, 豆竹丽, 秦爽, 张露平, 许新, 杨瑜, Alfred O. Mueck. 综合干预治疗对多囊卵巢综合征患者雄激素浓度的影响[J]. 首都医科大学学报, 2020, 41(4): 520-524.
[6]	秦爽, 阮祥燕, 王宾红, 鞠蕊, 张露平, 豆竹丽, 程姣姣, 金婧. 多囊卵巢综合征患者促排卵周期中成熟卵泡性激素浓度对妊娠的影响[J]. 首都医科大学学报, 2020, 41(4): 530-535.
[7]	张怡尘, 曹曦, 杨金奎. G蛋白偶联受体MAS对肝脏糖脂代谢的影响[J]. 首都医科大学学报, 2019, 40(3): 409-416.
[8]	冯逊逊, 董晓英, 郑秀蕊. 原发性卵巢功能不全小鼠卵巢血流与性激素浓度相关性研究[J]. 首都医科大学学报, 2017, 38(6): 897-902.
[9]	金婧, 阮祥燕, 华琳, 田玄玄, 李杨璐, 王利娟, 赵越, Alfred O. Mueck. 多囊卵巢综合征合并卵巢储备功能低下病人的内分泌特征[J]. 首都医科大学学报, 2017, 38(4): 515-520.
[10]	李扬璐, 阮祥燕, 赵越, 杜娟, 王利娟, 崔亚美, Alfred O. Mueck. 达英-35对多囊卵巢综合征患者糖脂代谢的影响[J]. 首都医科大学学报, 2016, 37(4): 424-430.
[11]	崔亚美, 阮祥燕, 田玄玄, 张颖, 武红琴, 刘玉兰, 甄洁, Diethelm Wallwiener, Alfred O. Mueck. 北京妇产医院就诊妇女更年期症状发生率的调查研究[J]. 首都医科大学学报, 2014, 35(4): 392-396.
[12]	杨树琳, 阮祥燕, 蒋辉, 王迎. 口服戊酸雌二醇对自然更年期大鼠超敏C反应蛋白的影响[J]. 首都医科大学学报, 2013, 34(4): 501-505.
[13]	张俊丽, 阮祥燕, 刘玉兰, 甄洁, 殷冬梅, 王娟, 柳顺玉. 更年期激素治疗规范管理的有效性及安全性评价[J]. 首都医科大学学报, 2013, 34(4): 512-518.
[14]	阮祥燕, 闫丹, 张俊丽, 卢永军, 柳顺玉, 王娟, 殷冬梅, 刘玉兰, 甄洁. 绝经妇女代谢综合征干预措施的研究[J]. 首都医科大学学报, 2013, 34(4): 519-524.
[15]	殷冬梅, 刘真, 阮祥燕, 王娟. 激素治疗对更年期综合征患者生存质量的影响[J]. 首都医科大学学报, 2013, 34(3): 428-431.