多囊卵巢综合征患者腰臀比与糖脂代谢、胰岛素样生长因子-1及胰岛素抵抗的相关性

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摘要目的: 研究多囊卵巢综合征(polycystic ovary syndrome, PCOS)患者腰臀比与糖脂代谢、胰岛素样生长因子-1(insulinlike growth factor-1, IGF-1)、胰岛素抵抗(insulin resistance, IR)的相关性。方法: 选择2018年1月至2021年9月南京医科大学附属江苏盛泽医院收治的PCOS患者110例作为PCOS组，另选择同期健康体检者60例作为对照组。测定两组腰臀比、糖脂代谢指标、IGF-1以及稳态模式IR指数(HOMA-IR)，其中糖脂代谢指标包括空腹血糖（FPG）、餐后2 h血糖(2 h PBG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)和空腹胰岛素(FINS)。将PCOS组中腰臀比≥0.80的患者纳入腹型肥胖组，＜0.80的患者纳入非腹型肥胖组，比较两组糖脂代谢指标、IGF1及HOMAIR。采用Pearson相关分析PCOS患者腰臀比与糖脂代谢、IGF1及IR的相关性。采用ROC曲线分析腰臀比对PCOS患者糖脂代谢异常、IGF1及IR的预测价值。结果: 与对照组相比，PCOS组腰臀比、2 h PBG、LDL-C、TG、FINS、IGF-1、HOMA-IR水平均明显增高，HDL-C水平明显降低(P均＜0.05)，FPG、TC水平差异无统计学意义(P均＞0.05)。与非腹型肥胖组相比，腹型肥胖组2 h PBG、LDL-C、TG、FINS、IGF-1、HOMA-IR水平明显增高，HDL-C水平明显降低(P均＜0.05)，FPG、TC水平差异无统计学意义(P均＞0.05)。PCOS患者腰臀比与2 h PBG、TG、IGF-1、HOMAIR呈明显正相关，与HDL-C呈明显负相关(P均＜0.05)。腰臀比对PCOS患者血糖、血脂代谢异常及IR均具有较好的预测价值(AUC分别为0.821、0.793、0.782)。结论:PCOS患者尤其是腰臀比较高的患者表现为明显的糖脂代谢紊乱、IGF-1异常增高以及IR，且腰臀比对PCOS患者糖脂代谢异常、IR具有较好的预测价值。

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关键词 ：多囊卵巢综合征, 腰臀比, 胰岛素样生长因子-1, 胰岛素抵抗, 相关性

Abstract：Objective： To study the correlation of waisthip ratio with glucose and lipid metabolism, insulinlike growth factor1(IGF1) and insulin resistance(IR) in polycystic ovary syndrome（PCOS) patients. Methods： A total of 110 PCOS patients who were admitted to Jiangsu Shengze Hospital Affiliated to Nanjing Medical University from January 2018 to September 2021 were selected as the PCOS group, and 60 healthy subjects during the same period as the control group. Waisthip ratio, glucose and lipid metabolism indexes, IGF1 and homeostasis model for IR （HOMAIR) were measured in the two groups. The glucose and lipid metabolism indexes included fasting blood glucose(FPG), 2 h postprandial blood glucose （2 h PBG), total cholesterol(TC), highdensity lipoprotein cholesterol(HDLC), lowdensity lipoprotein cholesterol(LDLC), triglyceride(TG) and fasting insulin （FINS). The patients with waisthip ratio≥0.80 in the PCOS group were subgrouped into the abdominal obesity group, and the patients with waisthip ratio <0.80 into the nonabdominal obesity group, and the glucose and lipid metabolism indexes, IGF1, and HOMAIR were compared between the two groups.Pearson correlation analysis was used to evaluate the correlation between waisthip ratio and glucose and lipid metabolism, IGF1 and IR in PCOS patients. The ROC curve was used to analyze the predictive value of waisthip ratio for abnormal glucose and lipid metabolism, IGF-1 and IR in PCOS patients. Results： Compared with the control group, the PCOS group showed higher levels of the waisthip ratio, 2 h PBG, LDL-C, TG, FINS, IGF-1, HOMA-IR, and lower level of HDL-C (all P<0.05), while there was no significant difference between the levels of FPG and TC (both P>0.05). Compared with the nonabdominal obesity group, the levels of 2 h PBG, LDLC, TG, FINS, IGF-1 and HOMA-IR in the abdominal obesity group were significantly increased, and the levels of HDL-C were significantly decreased (all P<0.05), while there was no statistically significant difference between the levels of FPG and TC (both P>0.05). In PCOS patients, waisthip ratio was positively correlated with 2 h PBG, TG, IGF-1, HOMA-IR (all P<0.05), while negatively correlated with HDL-C(P<0.05). Waisthip ratio had good predictive value for abnormal blood glucose metabolism, abnormal blood lipid metabolism and IR in PCOS patients（AUC were 0.821, 0.793, 0.782, respectively). Conclusion： PCOS patients, especially those with higher waisthip ratio, showed obvious glycolipid metabolism disorders, abnormal increase of IGF1 and IR, and waisthip ratio has a good predictive value for glycolipid metabolism disorders and IR in PCOS patients.

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收稿日期: 2022-03-23

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通讯作者: 周扣兰(通讯作者)，副主任医师，E-mail:2674820596@qq.com

作者简介: 王雁(1983—)，女，江苏苏州人，硕士，主要从事妇科内分泌以及宫颈疾病研究

引用本文:

王雁，周扣兰，李熠，等.. 多囊卵巢综合征患者腰臀比与糖脂代谢、胰岛素样生长因子-1及胰岛素抵抗的相关性[J]. 江苏大学学报:医学版, 2022, 32(05): 433-438. WANG Yan, ZHOU Koulan, LI Yi, QIAN Danjuan, LI Xiaoxiao. Correlation of waisthip ratio with glucose and lipid metabolism, insulin-like growth factor1 and insulin resistance in patients with polycystic ovary syndrome. Journal of Jiangsu University(Medicine Edition), 2022, 32(05): 433-438.

链接本文:

http://zzs.ujs.edu.cn/xbyxb/CN/ 或 http://zzs.ujs.edu.cn/xbyxb/CN/Y2022/V32/I05/433

［1］EscobarMorreale HF. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment［J］. Nat Rev Endocrinol, 2018, 14(5): 270-284.
［2］Barber TM, Franks S. Obesity and polycystic ovary syndrome［J］. Clin Endocrinol（Oxf), 2021, 95(4): 531-541.
［3］Aydin Y, Hassa H, Burkankulu D, et al. What is the risk of metabolic syndrome in adolescents with normal BMI who have polycystic ovary syndrome［J］. J Pediatr Adolesc Gynecol, 2015, 28(4): 271-274.
［4］Mawaddatina T, Budihastuti UR, Rahayu D. Waist circumference, hip circumference, arm span, and waisttohip ratio high risk of polycystic ovarian syndrome［J］. Scott Med J, 2021, 66(4): 186-190.
［5］Soares ALG, Banda L, Amberbir A, et al. A comparison of the associations between adiposity and lipids in Malawi and the United Kingdom［J］. BMC Med, 2020, 18(1): 181.
［6］Wang T, Liu Y, Lv M, et al. miR3233p regulates the steroidogenesis and cell apoptosis in polycystic ovary syndrome（PCOS) by targeting IGF1［J］. Gene, 2019, 30(683): 87-100.
［7］Blum MR, Popat RA, Nagy A, et al. Using metabolic markers to identify insulin resistance in premenopausal women with and without polycystic ovary syndrome［J］. J Endocrinol Invest, 2021, 44(10): 2123-2130.
［8］Pedersen AJT, Stage TB, Glintborg D, et al. The pharmacogenetics of metformin in women with polycystic ovary syndrome: a randomized trial［J］. Basic Clin Pharmacol Toxicol, 2018, 122(2): 239-244.
［9］Setji TL, Brown AJ. Polycystic ovary syndrome: diagnosis and treatment［J］. Am J Med, 2007, 120(2): 128-132.
［10］Huxley R, Mendis S, Zheleznyakov E, et al. Body mass index, waist circumference and waist: hip ratio as predictors of cardiovascular risk—a review of the literature［J］. Eur J Clin Nutr, 2010, 64(1): 16-22.
［11］Hudecova M, Holte J, Olovsson M, et al. Diabetes and impaired glucose tolerance in patients with polycystic ovary syndrome—a long term followup［J］. Hum Reprod, 2011, 26(6): 1462-1468.
［12］Ng NYH, Jiang G, Cheung LP, et al. Progression of glucose intolerance and cardiometabolic risk factors over a decade in Chinese women with polycystic ovary syndrome: A casecontrol study［J］. PLoS Med, 2019, 16(10): e1002953.
［13］Perona JS, SchmidtRioValle J, RuedaMedina B, et al. Waist circumference shows the highest predictive value for metabolic syndrome, and waisttohip ratio for its components, in Spanish adolescents［J］. Nutr Res, 2017, 45(9): 38-45.
［14］Couto Alves A, Valcarcel B, Mkinen VP, et al. Metabolic profiling of polycystic ovary syndrome reveals interactions with abdominal obesity［J］. Int J Obes（Lond), 2017, 41(9): 1331-1340.
［15］Vrbíková J, Zamrazilová H, Sedlácková B, et al. Metabolic syndrome in adolescents with polycystic ovary syndrome［J］. Gynecol Endocrinol, 2011, 27(10): 820-822.
［16］Mu L, Zhao Y, Li R, et al. Metabolic characteristics of normal weight central obesity phenotype polycystic ovary syndrome women: a largescale national epidemiological survey［J］. Reprod Biomed Online, 2018, 37(4): 498-504.
［17］Franik G, Bizoń A, Woch S, et al. The effect of abdominal obesity in patients with polycystic ovary syndrome on metabolic parameters［J］. Eur Rev Med Pharmacol Sci, 2017, 21(21): 4755-4761.
［18］Zhou Y, Lv L, Liu Q, et al. Total flavonoids extracted from Nervilia Fordii function in polycystic ovary syndrome through IL6 mediated JAK2/STAT3 signaling pathway［J］. Biosci Rep, 2019, 9(1): BSR20181380.
［19］Lazúrová I, Lazúrová Z, Figurová J, et al. Relationship between steroid hormones and metabolic profile in women with polycystic ovary syndrome［J］. Physiol Res, 2019, 68(3): 457-465.
［20］Matsuzaki T, Tungalagsuvd A, Iwasa T, et al. Clinical outcome of various metformin treatments for women with polycystic ovary syndrome［J］. Reprod Med Biol, 2017, 16(2): 179-187.
［21］Dumesic DA, Phan JD, Leung KL, et al. Adipose insulin resistance in normalweight women with polycystic ovary syndrome［J］. J Clin Endocrinol Metab, 2019, 104(6): 2171-2183.
［22］张丽娜, 王娟, 姚雪, 等.IFNγ在多囊卵巢综合征中的表达及对卵巢颗粒细胞的影响［J］.江苏大学学报(医学版), 2020, 30(6): 480-485.
［23］Lazurova I, Figurova J, Lazurova Z, et al. Insulinlike growth factor（IGF) system and hormonalmetabolic profile in women with polycystic ovary syndrome［J］. Bratisl Lek Listy, 2021, 122(7): 469-473.
［24］Schmitz KH, Xie D, Teal V, et al. Association of IGF axis hormones with waisttohip ratio varies by physical activity［J］. In Vivo, 2011, 25(2): 245-250.
［25］Chi XX, Zhang T, Chu XL. Effect of genistein on IGF1 and IGFBP1 in young and aged female rat ovary［J］. J Anim Physiol Anim Nutr（Berl), 2019, 103(5): 1594-1601.
［26］Jiang B, Xue M, Xu D, et al. Downregulated lncRNA HOTAIR alleviates polycystic ovaries syndrome in rats by reducing expression of insulinlike growth factor 1 via microRNA130a［J］. J Cell Mol Med, 2020, 24(1): 451-464.