上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

三酰甘油作为评估胰岛素抵抗的替代指标在中国多囊卵巢综合征患者中应用的可行性分析

周莉，高婧，陈晨   

  1. 上海交通大学 医学院附属瑞金医院妇产科，上海 200025
  • 出版日期:2017-01-28 发布日期:2017-01-19
  • 通讯作者: 陈晨，电子信箱：cc10736@rjh.com.cn。
  • 作者简介:周莉（1990—），女，硕士生；电子信箱：15000029086@163.com。
  • 基金资助:

    上海浦江人才计划（11PJ1406600）

Feasibility analysis of triglyceride as a surrogate marker for insulin resistance in Chinese women with polycystic ovary syndrome

ZHOU Li, GAO Jing, CHEN Chen   

  1. Department of Obstetrics and Gynecology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Online:2017-01-28 Published:2017-01-19
  • Supported by:

    Talent Project of Shanghai Pujiang，11PJ1406600

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摘要：

目的 ·探讨三酰甘油（TAG）作为胰岛素抵抗替代指标在中国多囊卵巢综合征（PCOS）患者中应用的可行性。方法 ·选择2012年5月—2015年6月在上海交通大学医学院附属瑞金医院妇产科就诊的PCOS患者171例，均符合鹿特丹标准且未经过药物治疗。分别检测其身高，体质量，血清TAG、总胆固醇（TC）、高密度脂蛋白（HDL）等指标，行口服葡萄糖耐量试验（OGTT）和胰岛素释放试验（IRT），计算体质量指数（BMI）、胰岛素抵抗稳态指数模型（HOMA-IR）等参数。按BMI将患者分为肥胖组和非肥胖组，分析探讨在2组患者中TAG作为评估胰岛素抵抗替代指标的可行性。结果 ·肥胖组PCOS患者的TAG、HDL、TC、各时相血糖和胰岛素水平均显著高于非肥胖组（均P<0.05）；肥胖组患者发生胰岛素抵抗的比例显著高于非肥胖组（P=0.000）。ROC曲线分析显示在肥胖组PCOS患者中， TAG不具有预测胰岛素抵抗的价值；在非肥胖组中受试者工作特征（ROC）曲线下面积为0.791，最佳切点为1.585 mmol/L，敏感度和特异度分别为0.484和0.979。结论 · TAG可以考虑作为中国PCOS非肥胖患者胰岛素抵抗的替代指标。

关键词: 多囊卵巢综合征, 三酰甘油, 胰岛素抵抗

Abstract:

 Objective · To analyze the feasibility of triacylglycerol (TAG) as a surrogate marker for insulin resistance in Chinese women with polycystic ovary syndrome (PCOS). Methods · Height, weight, TAG, total cholesterol (TC), high density lipoprotein (HDL), OGTT, insulin release test were measured in 171 women with PCOS according to Rotterdam consensus, who went to Department of Obstetrics and Gynecology of Ruijin Hospital from May, 2012 to June, 2015. Body mass index (BMI) and HOMA-IR were calculated. PCOS patients were divided into obese and non-obese group by BMI to analyze the feasibility of TAG as a surrogate marker for insulin resistance in two groups. Results · TAG, HDL, TC, plasma glucose and insulin levels in obese group were significantly higher than those in non-obese group (P<0.05). The proportion of patients with insulin resistance was also higher in obese group (P=0.000). The ROC curve analysis demonstrated that TAG could not predict insulin resistance in obese group. But in non-obese group the areas under the ROC curve was 0.791. The optimal cut-off point was 1.585 mmol/L with sensitivity of 0.484 and specificity of 0.979. Conclusion · TAG can be used as a surrogate marker for insulin resistance in non-obese Chinese women with PCOS.

Key words: polycystic ovary syndrome, triacylglycerol, insulin resistance