目的研究多囊卵巢综合征(PCOS)患者代谢综合征(MS)患病率,并探讨MS发生的危险因素。方法比较348例年轻的PCOS患者及113名非PCOS正常女性的MS及其组分的患病率。结果PCOS组MS的患病率为27.0%,明显高于正常对照组的10.6%(P〈0.01),除甘油三酯外,其他MS组分在PCOS组均高于正常对照组(P〈0.05或P〈0.01),但校正年龄和体重指数(BMI)后,差异就不存在统计学意义(P=0.737)。分层分析也显示PCOS非肥胖组和肥胖组的MS患病率与相应的正常对照组均无明显差异(均P〉0.05)。多元逐步回归分析显示稳态模型评估的胰岛素抵抗指数(HOMA-IR)和BMI是MS的独立预测因素(均P〈0.01)。结论肥胖和胰岛素抵抗是MS的独立危险因素,PCOS单独并不增加MS的发生风险。
Objective To study the prevalence of metabolic syndrome (MS)in women with polycystic ovary syndrome (PCOS), and to explore the risk factors of MS in young women. Methods The prevalence of MS and its components were evaluated in 348 young women with PCOS and 113 control subjects without PCOS. Results According to the 2005 modified Adult Treatment Panel Ⅲ criteria, MS was found in 27.0% of PCOS women,being significantly higher than 10.6% in the controls(P〈0.01 ). The rates of MS components,except for the triglyceride (TG) level, were all significantly higher in PCOS subjects than those in control subjects (P〈0. 05 or P〈 0.01 ). However,the difference disappeared after adjustment for age and body mass index (BMI, P〉0.05 ). The results of logistic regression analysis revealed that homeostasis model assessment insulin resistance(HOMA-IR) and BMI were the independent predictors of MS( both P〈0.01 ) , and the presence of PCOS was not the independent risk factor for MS(P〉0.05 ). Conclusions Obesity and insulin resistance are the independent predictors of MS. PCOS alone does not increase the risk of MS prevalence.