Metabolic and androgen profile in underweight women with polycystic ovary syndrome
Metabolic and androgen profile in underweight women with polycystic ovary syndrome
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DOI：
10.1007/s00404-017-4422-9
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发表时间：
2017-08-01
影响因子：
2.6
通讯作者：
Reger-Tan, Susanne
中科院分区：
文献类型：
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作者：
Anastasiou, Olympia E.;Canbay, Ali;Reger-Tan, Susanne
多囊卵巢综合征（PCOS）是一种与胰岛素抵抗和肥胖相关的疾病。本研究的目的是阐明PCOS患者体重不足的患病率，以及PCOS的代谢和雄激素谱是否因正常或低体重而不同。在杜伊斯堡-埃森大学内分泌和代谢系招募的1269名PCOS患者中，19名患者（1.5%）体重过轻，并与375名瘦型PCOS受试者（29.6%）进行了比较。评价临床和内分泌参数。通过3小时口服葡萄糖耐量试验（OGTT）评估胰岛素抵抗。2型糖尿病患病率和游离雄激素指数在两组之间没有差异。总胆固醇和低密度脂蛋白水平显着低于体重不足的患者组。虽然空腹状态下的稳态模型评估（HOMA）指数无显著差异，但在OGTT中葡萄糖摄入后2 h计算的HOMA-M120在体重过轻的患者中显著较高。低体重患者在OGTT中摄入葡萄糖后也显示出显著较高的餐后胰岛素分泌。6例体重不足的PCOS患者接受二甲双胍治疗月经过少。3例患者的月经周期得到改善，2例患者失访，1例患者因副作用而停止治疗。PCOS患者体重不足的发生率很低。PCOS患者体重不足与餐后胰岛素水平升高相关。我们的一些体重过轻的患者在二甲双胍治疗下能够实现规律的月经周期。
Polycystic ovary syndrome (PCOS) is a disorder associated with insulin resistance and obesity. Aim of our study is to clarify the prevalence of underweight in PCOS patients and whether metabolic and androgen profiles of PCOS differ depending on normal or low body weight.Out of 1269 consecutive patients with PCOS recruited from the Department of Endocrinology and Metabolism at the University of Duisburg-Essen, 19 patients (1.5%) were underweight and were compared to 375 lean PCOS subjects (29.6%). Clinical and endocrine parameters were evaluated. Insulin resistance was assessed by 3-h oral glucose tolerance test (OGTT).Prevalence of type 2 diabetes and free androgen index did not differ between the two groups. Total cholesterol and low density lipoprotein levels were significantly lower in the group of underweight patients. While no significant difference was found for the Homeostasis model assessment (HOMA) index at fasting state, the HOMA-M120, calculated 2 h after glucose intake in OGTT, was significantly higher in underweight patients. Underweight patients also showed significantly higher postprandial insulin secretion after glucose intake in OGTT. Six underweight PCOS patients received metformin treatment for oligomenorrhea. An improvement of the menstrual cycle was observed in three cases, while two patients were lost to follow up and one discontinued therapy due to side effects.The prevalence of underweight in patients with PCOS is very low. Underweight in PCOS is associated with higher postprandial insulin levels. Several of our underweight patients were able to achieve regular menstrual cycle under metformin therapy.