RISK-FACTORS FOR CORONARY-ARTERY DISEASE IN LEAN AND OBESE WOMEN WITH THE POLYCYSTIC-OVARY-SYNDROME
RISK-FACTORS FOR CORONARY-ARTERY DISEASE IN LEAN AND OBESE WOMEN WITH THE POLYCYSTIC-OVARY-SYNDROME
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DOI：
10.1111/j.1365-2265.1992.tb02295.x
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发表时间：
1992-08-01
影响因子：
3.2
通讯作者：
JACOBS, HS
中科院分区：
文献类型：
--
作者：
CONWAY, GS;AGRAWAL, R;JACOBS, HS
目的 一些患有多囊卵巢综合征 (PCOS) 的女性患有高胰岛素血症的证据使人们对她们患早期冠状动脉疾病的风险产生了疑问。我们通过测量 PCOS 女性的葡萄糖耐量、空腹血脂浓度和血压，重点关注与高胰岛素血症相关的三个心脏危险因素。设计比较瘦和肥胖的 PCOS 女性与卵巢正常女性的临床和生化测量结果。通过多元回归分析评估冠状动脉疾病危险因素的决定因素。 患者 对 102 名经超声诊断为 PCOS 的女性和 19 名卵巢正常的瘦女性进行了研究。患者是从生殖内分泌诊所招募的。 测量 在 2 小时口服葡萄糖耐量试验中测量空腹总胆固醇、甘油三酯、高密度脂蛋白 (HDL)、HDL2、葡萄糖耐量、空腹和刺激胰岛素、促性腺激素、睾酮和雄烯二酮。自动测量卧位血压。 结果 与卵巢正常的女性相比，患有 PCOS 的瘦女性存在高胰岛素血症，并且血清 HDL 和 HDL2 浓度降低；在多元回归分析中，血清胰岛素浓度与血浆葡萄糖和血压测量呈正相关。此外，肥胖 PCOS 女性的收缩压、血清甘油三酯和血浆葡萄糖浓度高于瘦身 PCOS 女性和对照组。 结论 这些结果支持这样的证据，即高胰岛素血症 PCOS 女性患心血管疾病的风险增加，因此建议对这些女性进行代谢筛查。
OBJECTIVE The evidence that some women with the polycystic ovary syndrome (PCOS) are hyperinsulinaemic has brought into question their risk of developing early coronary artery disease. We have focused on three cardiac risk factors which have been associated with hyperinsulinaemia by measuring glucose tolerance, fasting serum lipid concentrations and blood pressure in women with PCOS.DESIGN Comparison of clinical and biochemical measurements in lean and obese women with PCOS and in women with normal ovaries. Determinants of the risk factors for coronary artery disease were assessed by multiple regression analysis.PATIENTS One hundred and two women with ultrasound diagnosed PCOS and 19 lean women with normal ovaries were studied. Patients were recruited from a reproductive endocrine clinic.MEASUREMENTS Fasting total cholesterol, triglycerides, high density lipoproteins (HDL), HDL2, glucose tolerance, fasting and stimulated insulin, gonadotrophins, testosterone and androstenedione were measured during a 2-hour oral glucose tolerance test. Recumbent blood pressure was measured automatically.RESULTS Lean women with PCOS were found to be hyperinsulinaemic and have reduced serum HDL and HDL2 concentrations compared to women with normal ovaries; serum insulin concentrations correlated positively with plasma glucose and blood pressure measurements in multiple regression analysis. Obese women with PCOS were in addition found to have higher systolic blood pressure, serum triglyceride and plasma glucose concentration than lean women with PCOS and controls.CONCLUSIONS These results support the evidence that hyperinsulinaemic women with PCOS have an increased risk of developing cardiovascular disease and therefore form a population in whom metabolic screening is advisable.