Influence of glucose metabolism level on ovarian ultrasound characteristics in patients with polycystic ovary syndrome
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摘要:
目的 观察不同糖代谢水平多囊卵巢综合征(PCOS)患者卵巢超声特征差异,分析PCOS患者糖代谢水平对卵巢超声特征的影响。 方法 选择2019年1月—2022年10月于杭州市妇产科医院妇科就诊的200例PCOS患者为研究对象,依据血糖代谢水平不同分为血糖正常(NBG)组(44例)、空腹糖耐量受损(IFG)组(61例)、糖尿病前期(PDM)组(57例)和糖尿病(DM)组(38例),所有研究对象均进行经阴道三维能量超声检查,分析各组PCOS患者年龄、体重指数、空腹胰岛素含量(FINS)、胰岛素抵抗指数(HOMA-IR)、空腹三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)和高密度脂蛋白(HDL)等,观察各组卵巢超声指标差异。 结果 各组PCOS患者年龄、BMI和HDL差异无统计学意义(均P>0.05),HOMA-IR、TC、TG和LDL等随PCOS患者糖代谢异常程度的加剧而升高,且IFG组、PDM组和DM组FINS均显著高于NBG组,而DM组FINS显著低于IFG组和PDM组(均P < 0.05)。NBG组、IFG组、PDM组、DM组卵巢体积分别为(11.53±1.49)cm2,(13.16±1.52)cm2,(14.82±1.61)cm2,(16.04±1.64)cm2,差异有统计学意义(F=14.359,P<0.001);各组血流指数(FI)、血管化指数(VI)和血管化血流指数(VFI)等超声检测数值均随PCOS患者糖代谢异常程度的加剧而增加(均P < 0.05)。 结论 PCOS患者血糖水平持续升高,会导致脂代谢功能紊乱及胰岛素抵抗程度加剧,同时导致卵巢超声特征改变,主要表现为卵巢体积增大、卵巢血液流速加快、卵巢微血管数量增多。 Abstract:Objective To observe the differences of ovarian ultrasound characteristics in polycystic ovary syndrome (PCOS) patients with different glucose metabolism levels, and to analyze the effect of glucose metabolism level on ovarian ultrasound characteristics in PCOS patients. Methods A total of 200 patients with PCOS who were treated in the Department of Obstetrics and Gynecology in Hangzhou Obstetrics and Gynecology Hospital from January 2019 to October 2022 were taken as the research objects. They were divided into normal blood glucose group (NBG, 44 cases), impaired fasting glucose tolerance group (IFG, 61 cases), pre diabetes group (PDM, 57 cases) and diabetes group (DM, 38 cases) according to the level of blood glucose metabolism. All the research objects were examined by transvaginal three-dimensional energy ultrasound. The age, body mass index (BMI), fasting insulin content (FINS), insulin resistance index (HOMA-IR), fasting triacylglycerol (TG), total cholesterol (TC), low density lipoprotein (LDL) and high density lipoprotein (HDL) of PCOS patients in each group were analyzed, and the differences of ovarian ultrasound indexes in each group were observed. Results There was no statistically significant difference in age, BMI and HDL of PCOS patients in each group (all P>0.05). HOMA-IR, TC, TG, and LDL increased with the aggravation of the abnormal degree of glucose metabolism in PCOS patients. The FINS values in IFG group, PDM group and DM group were significantly higher than that in NBG group, while the FINS values in DM group were significantly lower than those in IFG group and PDM group (all P < 0.05). The ovarian volume of NBG group, IFG group, PDM group and DM group were (11.53±1.49) cm2, (13.16±1.52) cm2, (14.82±1.61) cm2, (16.04±1.64) cm2, respectively, and the difference was statistically significant (F=14.359, P < 0.001). The values of flow index (FI), vascularity index (VI) and vascularization flow index (VFI) in each group increased with the severity of abnormal glucose metabolism in PCOS patients (all P < 0.05). Conclusion With the continuous increase of blood glucose level in PCOS patients, it will lead to lipid metabolism disorder and the intensification of insulin resistance. At the same time, it will lead to changes in ovarian ultrasound characteristics, mainly manifested as an increase in the volume of ovaries, the acceleration of ovarian blood flow, and the increase in the number of ovarian blood vessels. -
表 1 各组PCOS患者一般资料情况比较(x±s)
Table 1. Comparison of general data of PCOS patients in each group (x±s)
组别 例数 年龄(岁) BMI FINS
(mU/L)HOMA-IR TC
(mmol/L)TG
(mmol/L)LDL
(mmol/L)HDL
(mmol/L)NBG组 44 31.62±3.25 24.82±1.59 9.25±1.64 2.21±0.37 1.28±0.35 1.31±0.39 2.74±0.41 1.42±0.35 IFG组 61 31.94±3.16 25.03±1.65 23.98±2.53a 2.94±0.42a 1.36±0.37 1.42±0.42 2.85±0.46 1.39±0.33 PDM组 57 32.16±3.41 24.96±1.67 24.53±2.67a 4.37±0.51ab 1.85±0.43ab 1.82±0.41ab 3.26±0.51ab 1.49±0.32 DM组 38 31.75±3.32 25.17±1.72 18.15±2.18abc 5.09±0.64abc 2.31±0.46abc 2.26±0.47abc 3.43±0.52ab 1.51±0.37 F值 0.852 0.749 26.741 20.318 17.685 14.529 12.284 1.143 P值 0.316 0.428 <0.001 <0.001 <0.001 <0.001 <0.001 0.216 注:与NBG组比较,aP < 0.05;与IFG组比较,bP < 0.05;与PDM组比较,cP < 0.05。 表 2 各组PCOS患者卵巢三维超声指标比较(x±s)
Table 2. Comparison of ovarian three-dimensional ultrasound parameters in PCOS patients of each group (x±s)
组别 例数 卵巢体积(cm2) RI PI FI VI VFI NBG组 44 11.53±1.49 0.59±0.06 0.81±0.09 31.85±3.41 6.31±0.72 2.38±0.34 IFG组 61 13.16±1.52a 0.62±0.08 0.79±0.08 32.94±3.62a 7.79±0.87a 2.66±0.36a PDM组 57 14.82±1.61ab 0.58±0.07 0.78±0.08 37.26±3.91ab 8.62±0.93ab 2.98±0.39ab DM组 38 16.04±1.64abc 0.61±0.08 0.82±0.10 42.69±4.17abc 9.74±1.13abc 3.27±0.41abc F值 14.359 0.528 0.493 22.517 18.436 15.951 P值 <0.001 0.613 0.642 <0.001 <0.001 <0.001 注:与NBG组比较,aP < 0.05;与IFG组比较,bP < 0.05;与PDM组比较,cP < 0.05。 -
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