SERUM-LIPOPROTEIN LIPID PROFILE IN WOMEN WITH THE POLYCYSTIC-OVARY-SYNDROME - RELATION TO ANTHROPOMETRIC, ENDOCRINE AND METABOLIC VARIABLES
SERUM-LIPOPROTEIN LIPID PROFILE IN WOMEN WITH THE POLYCYSTIC-OVARY-SYNDROME - RELATION TO ANTHROPOMETRIC, ENDOCRINE AND METABOLIC VARIABLES
复制标题
DOI：
10.1111/j.1365-2265.1994.tb02577.x
复制
发表时间：
1994-10-01
影响因子：
3.2
通讯作者：
LITHELL, H
中科院分区：
文献类型：
--
作者：
HOLTE, J;BERGH, T;LITHELL, H
目的 虽然多囊卵巢综合征 (PCOS) 常常与胰岛素抵抗和葡萄糖耐受不良相关，但已发现多种脂蛋白异常，但考虑到肥胖程度，情况并非总是如此。因此，我们研究了一组伴有或不伴有肥胖的多囊卵巢综合征妇女的血清脂质谱。设计对患有 PCOS 的妇女和体重匹配的对照妇女中的血清脂蛋白脂质和血浆游离脂肪酸与人体测量、代谢和激素变量的关系进行横断面研究。 患者 24 名肥胖（Pob，平均 BMI +/- SD 30.6 +/- 3.3 kg/m(2)）和 25 名肥胖者患有 PCOS 的非肥胖（Pnob，22.2 +/- 2.3 kg/m(2)）女性。 20 名肥胖者（Cob，30.2 +/- 3.5 kg/m(2)）和 20 名非肥胖者（Cnob，21.4 +/- 1.5 kg/m(2)）对照。测量血浆游离脂肪酸、血清胆固醇和高密度脂蛋白（HDL）、低密度脂蛋白（LDL）和极低密度脂蛋白（VLDL）中甘油三酯的糊状浓度胰岛素敏感性指数（M/I；用正常血糖胰岛素钳夹评估）、葡萄糖耐量（k 值；静脉葡萄糖耐量试验）、基础血清激素浓度和体脂分布（皮褶和腰臀比）。 结果 Pob 组血浆游离脂肪酸浓度显着高于其他组（所有 P < 0.001）。 Pob 和 Cob 之间或非肥胖组之间的脂蛋白脂质没有差异，而两个肥胖组的血清甘油三酯浓度（总甘油三酯和 VLDL 浓度）均高于非肥胖组，而 HDL 胆固醇则低于非肥胖组。 Pob 的血清总胆固醇和低密度脂蛋白胆固醇水平也高于 Pnob。 Pob 比其他组具有更明显的皮下躯干腹部肥胖、更高的空腹胰岛素水平和更低的 M/I，并且 k 值比 Cob 更低。 Cob 的空腹胰岛素水平高于 Cnob。游离脂肪酸水平与 PCOS 女性和对照女性的 k 值（成反比）相关，并且与 PCOS 患者的 M/I（成反比）、年龄和睾酮水平相关。对总人口进行逐步回归分析，比较内分泌、人体测量和代谢解释变量，结果表明，血清 HDL 胆固醇和甘油三酯水平主要与体脂分布（两者）和空腹胰岛素水平（甘油三酯）相关，总胆固醇和 LDL 胆固醇水平与 BMI 和年龄相关。 结论 患有 PCOS 的肥胖女性血浆游离脂肪酸相关性显着增加，与较低的胰岛素敏感性和较低的糖耐量密切相关在这些女人身上。尽管存在这些严重的代谢异常，患有多囊卵巢综合症的肥胖女性的脂蛋白脂质谱并没有比体重匹配的对照者明显更异常。
OBJECTIVE Although often associated with insulin resistance and glucose intolerance, various lipoprotein abnormalities have been found in polycystic ovary syndrome (PCOS) but not invariably so when the degree of obesity is taken into account. We have therefore investigated the serum lipid profile in a group of women with polycystic ovary syndrome with and without obesity.DESIGN Cross-sectional study of serum lipoprotein lipids and plasma free fatty acids in relation to anthropometric, metabolic and hormonal variables in women with PCOS and weight-matched controls.PATIENTS Twenty-four obese (Pob, mean BMI +/- SD 30.6 +/- 3.3 kg/m(2)) and 25 non-obese (Pnob, 22.2 +/- 2.3 kg/m(2)) women with PCOS. Twenty obese (Cob, 30.2 +/- 3.5 kg/m(2)) and 20 non-obese (Cnob, 21.4 +/- 1.5 kg/m(2)) controls.MEASUREMENTS Pasting concentrations of plasma free fatty acids, serum cholesterol and triglycerides in high density lipoproteins (HDL), low density lipoproteins (LDL) and very low density lipoproteins (VLDL) in relation to insulin sensitivity index (M/I; assessed with the euglycaemic insulin clamp), glucose tolerance (k-value; intravenous glucose tolerance test), basal serum hormone concentrations, and body fat distribution (skinfolds and waist hip ratio).RESULTS Plasma concentrations of free fatty acids were markedly higher in Pob than in the other groups (all P < 0.001). The lipoprotein lipids did not differ between Pob and Cob, or between the non-obese groups, whereas both obese groups had higher serum concentrations of triglycerides, totally and in VLDL, and lower HDL-cholesterol than their non-obese counterparts. Pob also had higher serum levels of total and LDL-cholesterol than Pnob. Pob had a more pronounced subcutaneous truncal-abdominal adiposity, higher fasting insulin levels and lower M/I than the other groups, and a lower k-value than Cob. Cob had higher levels of fasting insulin than Cnob. Free fatty acid levels correlated with the k-value (inversely) in both women with PCOS and controls, and with M/I (inversely), age and testosterone levels in PCOS. Stepwise regression analysis for the total population, comparing endocrine, anthropometric and metabolic explanatory variables, showed that the serum levels of HDL cholesterol and triglycerides were mainly correlated with body fat distribution (both) and fasting insulin levels (triglycerides), and levels of total and LDL-cholesterol with BMI and age.CONCLUSIONS Plasma free fatty acid correlations were markedly increased in obese women with PCOS, closely associated with the lower insulin sensitivity and lower glucose tolerance in these women. In spite of these profound metabolic aberrations, the lipoprotein lipid profile was not significantly more abnormal in obese women with PCOS than in their weight-matched controls.