PCOS患者内脏脂肪含量与其糖代谢、胰岛素抵抗的相关研究

Study on Relationship between Visceral Adipose Tissue and Glucose Metabolism and Insulin Resistance in Patients with Polycystic Ovarian Syndrome

摘要: 目的：探讨正常糖耐量组(NGT组)与糖尿病前期组(IGT组)多囊卵巢综合征(PCOS)患者内脏脂肪含量与其糖代谢、胰岛素抵抗(IR)的相关性。方法：回顾性收集2021年1月至2024年6月诊治的65例PCOS患者的临床资料，根据血糖情况分为NGT组和IGT组，其中NGT组31例，IGT组34例。比较2组临床资料、肥胖指标水平，分析比较BMI、SAT、VAT对IR的影响程度及预测价值。结果：两组的年龄、PCOS表型、月经周期、FINS、TG、LDL-C、FSH、T、SAT差异均无统计学意义(P > 0.05)。IGT组的FPG、HOMA-1R、TC、BMI、VAT均高于NGT组(P < 0.05)，NGT组的LH水平大于IGT组(P < 0.05)。曲线拟合图显示VAT与FPG、HOMA-1R在一定程度上呈正相关(P < 0.05)。Logistic回归分析结果显示VAT为PCOS患者IR风险的危险因素[OR (95% CI) = 1.054 (1.006~1.105), P < 0.05]，VAT预测IR的曲线下面积(AUC)为0.717 (95% CI 0.514~0.920)，最佳临界值为81 cm²。结论：VAT高的PCOS更容易出现糖代谢紊乱、IR，VAT对IR具有一定的预测价值。

Abstract: Objective: To investigate the correlation between visceral fat content, glucose metabolism and insulin resistance (IR) in patients with polycystic ovary syndrome (PCOS) in normal glucose tolerance group (NGT group) and impaired glucose tolerance group (IGT group). Methods: Collected the clinical data of 65 PCOS patients diagnosed and treated in Longgang District Central Hospital of Shenzhen from 2021 to 2024, and divided them into hyperglycemia PCOS group (NGT-group) 31 cases and orthoglycemic PCOS group (IGT-group) 34 cases. Compare the two groups of clinical data, obesity index level, analyze and compare the influence degree and predictive value of BMI, VAT and SAT on IR. Results: The difference of age, PCOS phenotype, menstrual cycle, FINS, TG, LDL-C, FSH, T, SAT between the two PCOS group were not statistically significant (P > 0.05). The FPG, HOMA-1R, TC, BMI, VAT of the IGT-group were significantly higher than those of NGT-group (P < 0.05), the LH of the NGT-group was significantly higher than that of IGT-group (P < 0.05). Curve fitting analysis showed that VAT was positively correlated with IR and abnormal glucose metabolism. Logistic regression analysis showed that elevated VAT was risk factor for IR in PCOS patients [OR (95% CI) = 1.054 (1.006~1.105), P < 0.05], The area under the curve (AUC) of VAT predicted IR is 0.717 (95% CI 0.514~0.920), and the best critical value is 81 cm². Conclusion: PCOS patients with high visceral fat content are more likely to have glucose metabolism disorders and insulin resistance, VAT has a certain predictive value for IR.