Early metabolic abnormalities in adolescent girls with polycystic ovarian syndrome
Early metabolic abnormalities in adolescent girls with polycystic ovarian syndrome
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DOI：
10.1067/mpd.2001.109603
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发表时间：
2001-01-01
影响因子：
5.1
通讯作者：
Arslanian, S
中科院分区：
文献类型：
--
作者：
Lewy, VD;Danadian, K;Arslanian, S
目的：为探讨青春期多囊卵巢综合征（PCOS）患儿胰岛素敏感性和分泌情况，并明确早期代谢紊乱，研究设计：将12名肥胖PCOS患儿（年龄12.0 ± 0.7岁）与10名肥胖非高雄激素血症患儿（对照组）进行比较。两组在年龄、体脂百分比和腹部脂肪方面相匹配。所有受试者均接受了3小时高胰岛素（80 mu/m2/min）-正葡萄糖钳夹试验以测定体内胰岛素敏感性，并接受了2小时高葡萄糖钳夹试验（225 mg/dL）以测定胰岛素分泌。用[6，6 -6-H-2（2）]葡萄糖测定空腹肝葡萄糖的生成量。结果：两组间空腹血糖和肝葡萄糖的生成量相当，但PCOS组的空腹胰岛素高2倍。PCOS组空腹血糖与胰岛素的比值低于对照组（1.9 +/- 0.3 vs 3.1 +/- 0.3，P = 0.02）。在高胰岛素-正葡萄糖钳夹期间，多囊卵巢综合征组的胰岛素敏感性较低（1.4 +/- 0.2 vs 2.7 +/- 0.3 mg/kg/min/muu/mL，P = 0.002）。在高血糖钳夹过程中，PCOS组的胰岛素分泌明显高于对照组。胰岛素敏感性与空腹胰岛素呈负相关（r =-0.71，P = .0002），与空腹血糖胰岛素比值呈正相关（r = 0.79，P < .0001）。患有PCOS的青春期女孩在该综合征的早期发现有严重的代谢紊乱，包括（1）外周组织胰岛素敏感性降低50%，（2）肝脏胰岛素抵抗的证据，和（3）代偿性高胰岛素血症。这些观察结果可能预示PCOS青少年患2型糖尿病的风险增加。
Objective: To investigate insulin sensitivity and secretion in young adolescent girls with childhood onset polycystic ovarian syndrome (PCOS) and to identify the early metabolic derangement(s).Study design: Twelve obese girls with PCOS (age 12.0 +/- 0.7 years) were compared with 10 obese nonhyperandrogenic girls (control group). The groups were matched for age, percent body fat, and abdominal fat. All subjects underwent a 3-hour hyperinsulinemic (80 mu/m(2)/min) -euglycemic clamp to determine in vivo insulin sensitivity and a 2-hour hyperglycemic clamp (225 mg/dL) to determine insulin secretion. Fasting hepatic glucose production was determined with the use of [6,6-6-H-2(2)]glucose.Results: Fasting glucose and hepatic glucose production were comparable between the 2 groups, but fasting insulin was 2-fold higher in the PCOS group. The fasting glucose to insulin ratio was lower in the PCOS group versus the control group (1.9 +/- 0.3 vs 3.1 +/- 0.3, P = .02). During the hyper insulinemic-euglycemic clamp, insulin sensitivity was lower in the PCOS group (1.4 +/- 0.2 vs 2.7 +/- 0.3 mg/kg/min per muu/mL, P = .002). During the hyperglycemic clamp, insulin secretion was significantly higher in the PCOS group. Insulin sensitivity correlated negatively with fasting insulin (r = -0.71, P = .0002) and positively with the fasting glucose to insulin ratio (r = 0.79, P < .0001).Conclusion: Adolescent girls with PCOS have profound metabolic derangements detected early in the course of the syndrome, including (1) 50% reduction in peripheral tissue insulin sensitivity, (2) evidence of hepatic insulin resistance, and (3) compensatory hyperinsulinemia. These observations may predict an increased risk of type 2 diabetes mellitus in adolescents with PCOS.