Biochemical hyperandrogenism is associated with metabolic syndrome independently of adiposity and insulin resistance in Romanian polycystic ovary syndrome patients
Biochemical hyperandrogenism is associated with metabolic syndrome independently of adiposity and insulin resistance in Romanian polycystic ovary syndrome patients
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DOI：
10.1007/s12020-014-0340-9
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发表时间：
2015-03-01
期刊：
影响因子：
3.7
通讯作者：
Barbu, Carmen Gabriela
中科院分区：
文献类型：
--
作者：
Albu, Alice;Radian, Serban;Barbu, Carmen Gabriela
该研究的目的是确定罗马尼亚多囊卵巢综合征（PCOS）患者是否有代谢综合征（MetS）的患病率增加，并研究肥胖，胰岛素抵抗和高雄激素血症在PCOS MetS发病机制中的参与。在2006年1月至2012年12月期间，共对398名PCOS患者和126名对照进行了评估。MetS由国家胆固醇教育计划，成人治疗组III标准定义。使用主成分分析（PCA）通过将感兴趣的变量分组为几个成分来分析它们之间的相关性，保存主成分（PC）评分并将其用作逻辑回归的自变量。PCOS患者MetS的患病率（20.4%）高于对照组（11.1%），P < 0.05.在PCOS患者中，PCA从分析的变量中提取三个PC。第一个PC聚集了与肥胖和胰岛素抵抗相关的变量，因子负荷显示这些参数之间有很强的关系。第二个PC包括高雄激素血症的标志物，最好用游离雄激素指数（FAI）表示，FAI与该PC密切相关。第三个组成部分是最好的代表多毛症。Logistic回归分析显示，在PCOS患者中，第一和第二PC与MetS独立相关，而第三组分则不相关。罗马尼亚PCOS患者发生代谢综合征的风险增加;肥胖、胰岛素抵抗和高雄激素血症是代谢综合征存在的独立预测因子，但多毛症不是。我们的数据还表明，胰岛素抵抗只是继发于肥胖增加，FAI是生化高雄激素血症的一个很好的标志物，代谢成分的影响很小。
The aim of the study was to determine whether Romanian polycystic ovary syndrome (PCOS) patients have an increased prevalence of metabolic syndrome (MetS) and to study the involvement of adiposity, insulin resistance and hyperandrogenism in the pathogenesis of MetS in PCOS. A total of 398 PCOS patients and 126 controls were evaluated between January 2006 and December 2012. MetS was defined by National Cholesterol Education Program, Adult Treatment Panel III criteria. Principal component analysis (PCA) was used to analyze the correlations among variables of interest by grouping them in few components, and principal component (PCs) scores were saved and used as independent variables in logistic regression. The prevalence of MetS was higher among patients with PCOS (20.4 %) than in controls (11.1 %, p < 0.05). In PCOS patients, PCA extracted three PCs from the analyzed variables. First PC aggregated variables related to adiposity and insulin resistance, with factor loadings showing strong relationship between these parameters. The second PC included markers of hyperandrogenemia and was best represented by free androgen index (FAI) which correlated strongly and exclusively with this PC. The third component was best represented by hirsutism. Logistic regression analysis revealed that in PCOS patients, the first and the second PCs were independently associated with MetS, whereas the third component was not. Romanian PCOS patients have an increased risk for MetS; adiposity, insulin resistance and hyperandrogenemia, but not hirsutism, are independent predictors of MetS presence. Our data also suggest that insulin resistance is only secondary to increased adiposity and FAI is a good marker of biochemical hyperandrogenism with little influences from the metabolic component.