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投稿时间：2018-03-07 网络发布日期：2018-06-20
投稿时间：2018-03-07 网络发布日期：2018-06-20
中文摘要: 目的 分析多囊卵巢综合征(PCOS)合并代谢综合征(MS)患者临床生化特征,载脂蛋白B/载脂蛋白A1(ApoB/ApoA1,ApoB/A1)比值与PCOS患者代谢异常的相关性,及对PCOS患者MS的诊断价值。方法 根据2003年鹿特丹PCOS诊断标准纳入2012年6月至2016年12月门诊就诊的PCOS患者620例,参照NCEP-ATPⅢ关于MS诊断标准,PCOS合并MS患者194例,PCOS非MS患者426例；同时纳入一般MS女性124例。比较各组临床生化指标,运用相关分析及ROC曲线分析ApoB/ApoA1比值与PCOS患者代谢异常的相关性,及对PCOS患者MS的诊断价值。结果 PCOS合并MS占31.29%(194/620),其糖脂代谢异常显著高于PCOS非MS女性,其改良Ferriman-Gallwey(mF-G)多毛评分、雄激素、促黄体生成素/促卵泡生成素、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)和ApoB/A1显著高于一般MS女性。PCOS患者ApoB/A1比值与MS诊断因素、睾酮、游离雄激素指数、FINS 及HOMA-IR等存在正相关。ROC曲线分析，当截断值为0.742时,ApoB/A1比值对MS的诊断价值最大,ROC曲线下面积为0.864,敏感度0.824,特异性0.795。结论 PCOS患者MS的发生率较高,PCOS合并MS患者FINS和胰岛素抵抗显著升高为主要临床特征,ApoB/A1比值对PCOS患者MS有较好的预测和监测价值,可作为一个重要的糖脂代谢异常的评价监测指标。
中文关键词: 多囊卵巢综合征 代谢综合征 载脂蛋白B/载脂蛋白A1 胰岛素抵抗 空腹胰岛素
Abstract:Objective To analysis the clinical and biochemical features of patients with polycystic ovary syndrome (PCOS) and metabolic syndrome (MS), and to investigate the relationship between Apolipoprotein (Apo)B/ApoA1 ratio and metabolic abnormalities in PCOS patients, and to estimate the diagnostic value of ApoB/ApoA1 ratio in PCOS patients. Methods According to NCEP-ATP Ⅲ on MS diagnostic criteria, a total of 620 PCOS patients who met the 2003 Rotterdam PCOS diagnostic criteria were divided into PCOS with MS group (194 cases) and PCOS without MS group (426 cases). At the same time, 124 MS female patients without PCOS were selected. The clinical and biochemical indexed were collected and compared between three groups. Correlation analysis and ROC curve analysis were carried out between ApoB/ApoA1 ratio and metabolic abnormalities in PCOS patients. The diagnostic value of ApoB/ApoA1 ratio in MS patients was analyzed. Results The abnormal glucose and lipid metabolism in PCOS with MS patients was significantly more serious than that in PCOS without MS patients. The modified Ferriman-Gallwey (mF-G)hirsutism score, androgen, luteinizing hormone (LH), follicle-stimulating hormone (FSH), fasting insulin (FINS), homeostasis model assessment-insulin resistance index (HOMA-IR) and ApoB/ApoA1 ratio were significantly higher in PCOS with MS group than those in MS female without PCOS. The ApoB/ApoA1 ratio of PCOS patients was positively correlated with MS diagnostic factors, testosterone, free androgen index, FINS and HOMA-IR. ROC curve analysis showed that when the cut-off value was 0.742, the ApoB/ApoA1 ratio had the greatest diagnostic value for MS, and the area under the ROC curve was 0.864, the sensitivity was 0.824, and the specificity was 0.795. Conclusions The incidence of MS is higher in PCOS patients. The increased FINS and insulin resistance are the main clinical characteristics in PCOS combined with MS. The ApoB/ApoA1 ratio has a good predictive and monitoring value for MS in PCOS patients, which could be used as an important indicator of the evaluation of abnormal glucose and lipid metabolism.
keywords: Polycystic ovary syndrome Metabolic syndrome ApoB/ApoA1 ratio Insulin resistance Fasting insulin
文章编号： 中图分类号： 文献标志码：A
基金项目:陕西省中医药管理局科研课题(LCMS020)
附件
| Author Name | Affiliation |
| CAO Li-ping*, WANG Ying | *Obstetrics and Gynecology Clinic Center, Yulin Hospital of Chinese Medicine, Yulin, Shaanxi 719000, China |
引用文本：
曹利萍,王颖.ApoB/ApoA1比值对多囊卵巢综合征患者代谢综合征的诊断价值[J].中国临床研究,2018,31(6):753-756.
曹利萍,王颖.ApoB/ApoA1比值对多囊卵巢综合征患者代谢综合征的诊断价值[J].中国临床研究,2018,31(6):753-756.