Clinical and metabolic characteristics of endometrial lesions in polycystic ovary syndrome at reproductive age.
Clinical and metabolic characteristics of endometrial lesions in polycystic ovary syndrome at reproductive age.
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DOI：
10.1186/s12905-023-02339-7
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发表时间：
2023-05-06
影响因子：
2.5
通讯作者：
Xie, Meiqing
中科院分区：
文献类型：
--
作者：
Zhong, Xiaozhu;Liu, Yang;Liang, Weiying;Hu, Qiyue;Zeng, Anqi;Ding, Miao;Chen, Dongmei;Xie, Meiqing
目的探讨不同子宫内膜病变多囊卵巢综合征（PCOS）患者的临床及代谢特点。234例经宫腔镜检查和子宫内膜活检的PCOS患者分为4组：(1)子宫内膜正常（对照组，n = 98），(2)子宫内膜息肉（EP组，n = 92），(3)子宫内膜增生（EH组，n = 33），(4)子宫内膜癌（EC组，n = 11）。测定并分析血清性激素水平、75 g口服葡萄糖耐量试验、胰岛素释放试验、空腹血脂、全血细胞计数及凝血指标。与对照组和EP组相比，EH组的体重指数和甘油三酯水平更高，平均月经周期更长。EH组性激素结合球蛋白（SHBG）和高密度脂蛋白（高密度脂蛋白）均低于对照组。EH组36%的患者提示肥胖，高于其他三组。通过多变量回归分析，游离雄激素指数bbb50的患者发生EH的风险较高（OR 5.70; 95% CI 1.05-31.01），而二甲双胍似乎是EH的保护因素（OR 0.12; 95% CI 0.02-0.80）。二甲双胍和激素（口服避孕药或孕激素）被证明是EP的保护因素（or 0.09; 95% CI 0.02-0.42; or 0.10; 95% CI 0.02-0.56）。激素治疗似乎是EC的保护因素（OR 0.05; 95% CI 0.01-0.39）。肥胖、月经周期延长、SHBG降低和血脂异常是多囊卵巢综合征患者EH的危险因素。建议口服避孕药、孕激素和二甲双胍预防和治疗PCOS患者子宫内膜病变。
We aimed to explore the clinical and metabolic characteristics in polycystic ovary syndrome (PCOS) patients with different endometrial lesions. 234 PCOS patients who underwent hysteroscopy and endometrial biopsy were categorized into four groups: (1) normal endometrium (control group, n = 98), (2) endometrial polyp (EP group, n = 92), (3) endometrial hyperplasia (EH group, n = 33), (4) endometrial cancer (EC group, n = 11). Serum sex hormone levels, 75 g oral glucose tolerance test, insulin release test, fasting plasma lipid, complete blood count and coagulation parameters were measured and analyzed. Body mass index and triglyceride level of the EH group were higher while average menstrual cycle length was longer in comparison with the control and EP group. Sex hormone-binding globulin (SHBG) and high density lipoprotein were lower in the EH group than that in the control group. 36% of the patients in the EH group suggested obesity, higher than the other three groups. Using multivariant regression analysis, patients with free androgen index > 5 had higher risk of EH (OR 5.70; 95% CI 1.05–31.01), while metformin appeared to be a protective factor for EH (OR 0.12; 95% CI 0.02–0.80). Metformin and hormones (oral contraceptives or progestogen) were shown to be protective factors for EP (OR 0.09; 95% CI 0.02–0.42; OR 0.10; 95% CI 0.02–0.56). Hormones therapy appeared to be a protective factor for EC (OR 0.05; 95% CI 0.01–0.39). Obesity, prolonged menstrual cycle, decreased SHBG, and dyslipidemia are risk factors for EH in patients with PCOS. Oral contraceptives, progestogen and metformin are recommended for prevention and treatment of endometrial lesions in PCOS patients.
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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