多囊卵巢综合征患者血清尿酸水平对糖脂代谢异常的初筛价值

Preliminary Screening Value of Serum Uric Acid Levels in Patients with Polycystic Ovary Syndrome for Abnormal Glucose and Lipid Metabolism

摘要: 目的：分析多囊卵巢综合征患者血清尿酸水平对糖脂代谢异常的初筛价值。方法：本回顾性研究连续纳入2022年1月~2023年9月于重庆医科大学附属第二医院妇产科就诊的PCOS患者124例。根据血清尿酸水平分为正常组77例及高尿酸血症(HUA)组47例。比较两组患者的基线资料、糖脂代谢指标。结果：HUA组的糖、脂代谢异常率及胰岛素抵抗率均高于正常组，差异有统计学意义(P < 0.05)。对影响PCOS患者糖脂代谢的因素进行单因素分析及多因素Logistic回归分析，发现HUA是PCOS患者发生糖代谢异常(OR = 3.406, 95% CI 1.414~8.207, P = 0.006)和脂代谢异常(OR = 3.321, 95% CI 1.231~8.963, P = 0.018)的独立预测因子。血清尿酸初步筛查PCOS患者糖、脂代谢异常的曲线下面积分别为0.652、0.709，临界筛查值分别为340.9 μmol/L、320.5 μmol/L，灵敏度分别为60.00%、73.80%，特异度分别为76.60%、68.20%。血清尿酸对PCOS患者糖、脂代谢异常的初筛准确率分别为81.45%、87.90%，精确率分别为78.46%、90.12%，召回率分别为85.00%、91.25%。结论：PCOS高尿酸血症患者糖脂代谢异常风险显著增高。血清尿酸初步筛查PCOS患者的糖脂代谢异常具有一定临床可行性，有望成为PCOS患者糖脂代谢异常的初筛指标。

Abstract: Objective: To analyze the preliminary screening value of serum uric acid levels in patients with polycystic ovary syndrome (PCOS) for abnormal glucose and lipid metabolism. Methods: Our retrospective study included 124 patients with PCOS at the Department of Obstetrics and Gynecology of the Second Hospital of Chongqing Medical University from January 2022 to September 2023. The PCOS women were divided into normal group (77 cases) and (hyperuricemia) HUA group (47 cases) based on their serum uric acid level. We further compared the baseline and the glycolipid metabolism indicators between the two groups. Results: The rates of abnormal glycolipid metabolism and insulin resistance in the HUA group were significantly higher than those in the normal group (P < 0.05). Univariate analysis and multivariate Logistic regression analysis were performed on the factors affecting glucose and lipid metabolism in PCOS patients, and HUA was found to be an independent predictor of glucose metabolism (OR = 3.406, 95% CI 1.414~8.207, P = 0.006) and lipid metabolism (OR = 3.321, 95% CI 1.231~8.963, P = 0.018) abnormalities in PCOS patients. The areas under the curve for the preliminary screening of abnormal glycolipid metabolism in PCOS patients by serum uric acid were 0.652 and 0.709. The critical screening values were 340.9 μmol/L and 320.5 μmol/L, sensitivities were 60.00% and 73.80% and specificities were 76.60% and 68.20%, respectively. The accuracy of serum uric acid for the preliminary screening of glucose and lipid metabolism abnormalities in PCOS patients were 81.45% and 87.90%, precision rates were 78.46% and 90.12%, and recall rates were 85.00% and 91.25%, respectively. Conclusion: Patients with PCOS and HUA are at significantly increased risk of abnormal glucose and lipid metabolism. The primary screening of serum uric acid in PCOS patients has clinical feasibility and is expected to become a preliminary screening indicator for abnormal glucose and lipid metabolism.