二甲双胍对多囊卵巢综合征患者血脂水平的影响

目的　探讨多囊卵巢综合征 (PCOS)患者胰岛素抵抗 (IR)与脂代谢的关系。方法　测定 5 1例PCOS患者及 2 3例正常妇女性激素、血脂、胰岛素 (Ins)及口服糖耐量 (OGTT)试验 ,OGTT示IR者给予二甲双胍 (1 5g·d-1)治疗 ,3月后复测上述指标。结果　PCOS患者血清Ins、胆固醇 (CHO)、甘油三酯 (TG)、载脂蛋白B(apoB)、脂蛋白 (a)〔Lp(a)〕、游离脂肪酸 (FFA)水平显著升高 ,高密度脂蛋白 (HDL)水平显著降低 ;IR组TG、FFA、Lp(a)、T水平显著高于NIR组 ,HDL低于NIR组。PCOS患者经二甲双胍治疗后血清Ins、T、CHO、TG、FFA水平显著下降 ,胰岛素敏感指数 (ISI)、HDL显著上升。结论　血脂异常是PCOS患者的临床表现之一 ;IR和高胰岛素血症(HI)是PCOS患者血脂异常的重要原因 ;二甲双胍可阻断IR对PCOS发展的促进作用 ,改善PCOS的血脂紊乱。

Serum lipid profile in women with polycystic ovary syndrome before and after treatment with metformin

Objective To study the relatioship between insulin resistance and altered lipoprotein lipids in polycystic ovary syndrome(PCOS). Methods Serum follicle stimulating hormone(FSH), luteinizing hormone(LH), estradiol(E 2), testosterone(T), lipid profile, and insulin concentration during oral glucose tolerance test were assessed in 51 women with PCOS and 23 normal women. Those women who showed insulin resistance(IR) were administered with three month metformin. After the treatment, those anthropometic measurements and endocrine profile were measured again.Results The patients with PCOS showed high levels of insulin, CHO, TG, apoB, Lp(a), FFA and low levels of HDL. Serum TG, FFA, Lp(a), and T in IR group were significantly higher and HDL was lower than those in non IR group. Serum Ins, T, CHO, TG, and FFA values decreased while ISI and HDL increased significantly after metformin treatment.Conclusion Dyslipidaemia is one of the clinical manifestations of PCOS. IR and hyperinsulinemia(HI) play an important role in lipid profiles in women with PCOS. Metformin therapy in PCOS women reduces HI and IR, but improves lipid abnormalities.