摘要
目的分析青春期多囊卵巢综合征(polycystic ovary syndrome,PCOS)的高危因素及内分泌代谢特征,旨在为青春期PCOS患者的早期筛查和治疗提供科学依据。方法回顾性分析咸宁市中心医院生殖中心2017年1月至2019年10月收治的300例青春期PCOS患者的临床资料,将其作为PCOS组,另选取因月经周期紊乱或出血量异常于本院进行检查的200例健康青春期女性作为非PCOS组,记录两组年龄、身高、体重等一般资料,比较两组脂代谢指标甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)和糖代谢指标空腹血糖(fasting blood glucose,FBG)、空腹胰岛素(fasting insulin,FINS)以及内分泌参数黄体生成激素(luteinizing hormone,LH)、卵泡刺激素(follicle-stimulating hormone,FSH)、催乳激素(prolactin,PRL)、雌二醇(estradiol,E2)、睾酮(testosterone,T)水平,计算体质量指数(body mass index,BMI)、腰臀比(waist-to-hip ratio,WHR)、胰岛素抵抗指数(homa insulin-resistance,HOMA-IR)、胰岛素敏感指数(insulin sensitivity index,ISI)、LH/FSH,采用多因素Logistic回归分析PCOS发生的危险因素。结果PCOS组体重、BMI、WHR和存在PCOS家族史、生活压力大、饮食不规律比例以及多毛、痤疮发生率高于非PCOS组(P<0.05);PCOS组FINS、HOMA-IR、TC、TG、HDL-C、LDL-C值及LH、LH/FSH、PRL、T水平均高于非PCOS组(P<0.05),ISI以及FSH、E2水平低于非PCOS组(P<0.05);多因素Logistic回归分析提示BMI(OR=1.642,P=0.011)、WHR(OR=1.817,P=0.014)、PCOS家族史(OR=1.627,P=0.004)、生活压力大(OR=1.696,P=0.025)、饮食不规律(OR=1.758,P=0.013)、HOMA-IR(OR=1.929,P=0.002)、ISI(OR=1.868,P=0.008)、LH(OR=1.797,P=0.000)、T(OR=1.766,P=0.002)是影响青春期PCOS的高危因素。结论BMI、WHR值过高,存在PCOS家族史,HOMA-IR、LH、T高水平,ISI低水平是影响青春期PCOS的高危因素。
Objective Analyze the high-risk factors and endocrine and metabolism characteristics of polycystic ovary syndrome(PCOS)in adolescence,aiming to provide scientific basis for early screening and treatment of adolescent PCOS patients.Methods A retrospective analysis of the clinical data of 300 adolescent PCOS patients admitted to the Reproductive Center of Xianning Central Hospital from January 2017 to October 2019 was used as the PCOS group.Another 200 patients were examined in this hospital due to menstrual cycle disorders or abnormal bleeding.The clinical data of adolescent women is regarded as the non-PCOS group,and general data such as age,height,and weight of the two groups are recorded,and the lipid metabolism indicators of the two groups are compared with triglyceride(TG),total cholesterol(TC),and high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)and glucose metabolism indicators fasting blood glucose(FBG),fasting insulin(FINS),and endocrine parameters luteinizing hormone(LH),follicle-stimulating hormone(FSH),prolactin(PRL),estradiol(E2),testosterone(T)levels,body mass index(BMI),waist-to-hip ratio(WHR),insulin resistance index(homa insulin-resistance,HOMA-IR),insulin sensitivity index(ISI),LH/FSH,using multivariate Logistic regression to analyze the risk factors of PCOS.Results The body weight,BMI,WHR,family history of PCOS,high life pressure,irregular eating rate,and the incidence of hirsutism and acne in the PCOS group were higher than those in the non-PCOS group(P<0.05);FINS,HOMA-IR,TC,TG in the PCOS group,HDL-C,LDL-C values and LH,LH/FSH,PRL,and T levels were higher than the non-PCOS group(P<0.05),ISI,FSH,and E2 levels were lower than the non-PCOS group(P<0.05);more Logistic regression analysis of factors suggested BMI(OR=1.642,P=0.011),WHR(OR=1.817,P=0.014),family history of PCOS(OR=1.627,P=0.004),high life pressure(OR=1.696,P=0.025),irregular eating(OR=1.758,P=0.013),HOMA-IR(OR=1.929,P=0.002),ISI(OR=1.868,P=0.008),LH(OR=1.797,P=0.000),T(OR=1.766,P=0.002)is a high-risk factor affecting PCOS in adolescence,and the difference is statistically significant(P<0.05).Conclusion BMI and WHR are too high,there is a family history of PCOS,HOMA-IR,LH,T are high,and ISI is low is a high-risk factor affecting PCOS in adolescence.
作者
郑波
徐岚
胡泉
欧阳丽红
范莹
ZHENG Bo;XU Lan;HU Quan;OUYANG Lihong;FAN Ying(Reproductive Center,Xianning Central Hospital(The First Affiliated Hospital of Hubei Technology College),Xianning Hubei 437000,P.R.China)
出处
《中国计划生育和妇产科》
2020年第11期78-81,共4页
Chinese Journal of Family Planning & Gynecotokology
基金
咸宁市科学技术局科技计划项目(项目编号:2018041)。
