The Distribution of Stroma and Antral Follicles Differs between Insulin-Resistance and Hyperandrogenism-Related Polycystic Ovarian Syndrome.
The Distribution of Stroma and Antral Follicles Differs between Insulin-Resistance and Hyperandrogenism-Related Polycystic Ovarian Syndrome.
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DOI：
10.3389/fendo.2017.00117
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发表时间：
2017
影响因子：
5.2
通讯作者：
Guerriero S
中科院分区：
文献类型：
--
作者：
Alviggi C;Conforti A;De Rosa P;Strina I;Palomba S;Vallone R;Gizzo S;Borrelli R;Andersen CY;De Placido G;Guerriero S
虽然胰岛素抵抗在多囊卵巢综合征(PCOS)中起着重要的致病作用，但超声检查PCOS模式与胰岛素抵抗之间的相关性尚未见报道。这项回顾性观察研究的目的是评估患有胰岛素抵抗的多囊卵巢综合征患者和高雄激素血症患者的卵巢超声参数是否存在差异。对符合鹿特丹多囊卵巢综合征标准的妇女进行了回顾性研究。记录人体测量、生化和临床数据。根据经阴道超声参数将女性分为两组：一半以上卵泡直径在5~9 mm之间，超声确定间质/总面积(S/A) >； 为0.34，有腔卵泡有“项链”征(A组)；一半以上有腔卵泡直径在2~4 mm之间，S/A ≤ 为0.34；B组无“项链”征，但卵泡普遍分布。这些超声模式和胰岛素抵抗的存在之间的关联也被评估。入选78例患者，其中A超声型33例，B超声型45例，后者预测PCOS患者胰岛素抵抗的敏感性为88%，特异性为78%。两组在年龄、Ferriman-Gallwey评分和血清促性腺激素或雄激素水平方面没有差异。B组的体重指数、腰臀比和稳态模型评分显著高于A组(p <； 005)。相反，A组性激素结合球蛋白水平和卵巢体积显著高于A组(p <； 0.05)。B组胰岛素抵抗发生率高于A组(36/41，87.8%对7/32，21.8%；p <； 0.05)。这些结果表明，胰岛素抵抗可能与PCOS患者的一种特定的超声模式有关。
Although insulin resistance plays an important pathogenetic role in polycystic ovary syndrome (PCOS), no correlation between ultrasound PCOS pattern and insulin resistance has yet been reported. The aim of this retrospective observational study was to assess whether the ovarian ultrasonographic parameter differed between PCOS women with insulin resistance and those with a hyperandrogenic profile. Women who fulfilled the Rotterdam criteria for PCOS were retrospectively studied. Anthropometric, biochemical, and clinical data were recorded. Women were divided into two groups based on specific transvaginal ultrasound parameters: subjects with more than half of the follicles measuring between 5 and 9 mm in diameter, an ultrasonographic determined stroma/total area (S/A) > 0.34 and a “necklace” sign of antral follicles (Group A); and subjects with more than half of the antral follicles measuring between 2 and 4 mm in diameter, an S/A ≤ 0.34; no “necklace” sign but ubiquitously distributed follicles determined by ultrasound (Group B). The association between these ultrasound patterns and the presence of insulin resistance was also evaluated. Seventy-eight patients were enrolled: 33 with ultrasound sound pattern A and 45 with pattern B. The latter pattern had a sensitivity of 88% and a specificity of 78% in predicting PCOS women with insulin resistance. There were no differences in age, Ferriman–Gallwey score, and serum gonadotropin or androgen levels between the two groups. Body mass index, the waist-to-hip ratio, and homeostasis model assessment were significantly higher in group B than in group A (p < 0.05). Conversely, sex hormone binding globulin levels and ovarian volume were significantly higher in group A (p < 0.05). Insulin resistance was more frequent in group B than in group A (36/41, 87.8% versus 7/32, 21.8%; p < 0.05). These results suggest that insulin resistance could be associated with a specific ultrasound pattern in PCOS patients.