摘要
目的探讨均衡营养素膳食联合二甲双胍治疗对多囊卵巢综合征(PCOS)患者糖脂代谢的影响。方法为单中心非随机对照研究。选取2019年1月至2020年6月在首都医科大学附属北京朝阳医院京西院区内分泌科门诊及住院明确诊断为PCOS的患者为研究对象,对其进行6个月规范化均衡营养素膳食联合二甲双胍干预。收集患者干预前后身高、体重、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素(FINS)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇和睾酮,计算体重指数(BMI)、稳态模型评估胰岛素抵抗指数(HOMA-IR)、稳态模型评估β细胞功能指数(HOMA-β)、定量胰岛素敏感性检测指数(QUICKI)及LH/FSH比值。根据国际指南,将PCOS患者分为A型组[少排卵和(或)无排卵+临床和(或)生物化学体征高雄激素症+卵巢多囊化]、B型组[少排卵和(或)无排卵+临床和(或)生物化学体征高雄激素症]、C型组[临床和(或)生物化学体征高雄激素症+卵巢多囊化]和D型组[少排卵和(或)无排卵+卵巢多囊化]4个表型组。干预前后各指标的比较采用配对t检验或Wilcoxon符号秩检验。结果干预前共92例PCOS患者纳入研究,最终有71例患者完成6个月的均衡营养素膳食联合二甲双胍规范化治疗,其中A型组17例,B型组29例,C型组1例,D型组24例。与干预前相比,经过6个月均衡营养素膳食联合二甲双胍干预后,71例PCOS患者整体体重、BMI、TG、LDL-C、FPG、HbA1c、HOMA-IR、HOMA-β、睾酮、LH/FSH比值均降低,雌二醇、HDL-C、QUICK指数均升高(均P<0.05)。对不同表型组对规范化治疗的效果进行分析,结果显示,与干预前相比,经过6个月的干预,A、B、D型组的PCOS患者HDL-C均升高,同时A型组的LDL-C降低;B型组的体重、BMI、TG、FPG、HOMA-β均降低;D型组除�
Objective To investigate the effects of a balanced nutrient diet combined with metformin on glucose and lipid metabolism in patients with polycystic ovary syndrome(PCOS).Methods This was a single-center,non-randomized controlled study.From January 2019 to June 2020,outpatients and inpatients diagnosed with PCOS in the Department of Endocrinology,Jingxi District of Beijing Chaoyang Hospital Affiliated to Capital Medical University were enrolled as the study subjects,and they were given a 6-month standardized balanced nutrient diet combined with metformin intervention.Height,weight,triglyceride(TG),high-density lipoprotein-cholesterol(HDL-C),low-density lipoprotein-cholesterol(LDL-C),fasting insulin(FINS),fasting plasma glucose(FPG),glycated hemoglobin A1c(HbA1c),glutamic pyruvic transaminase(ALT),glutamic oxaloacetic transaminase(AST),follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol and testosterone were measured before and after the intervention.Body mass index(BMI),homeostasis model assessment of insulin resistance(HOMA-IR),homeostasis model assessment ofβ-cell function(HOMA-β),quantitative insulin sensitivity check index(QUICKI)and LH/FSH ratio were calculated.PCOS patients were divided into A group[hypoovulatory and/or anovulatory+clinical and/or biochemical signs of hyperandrogenism+ovarian polycystic],B group[hypoovulatory and/or anovulatory+clinical and/or biochemical signs of hyperandrogenism],C group[clinical and/or biochemical signs of hyperandrogenism+ovarian polycystic],and D group[hypoovulatory and(or)Anovulatory+ovarian polycystic]according to international guidelines.Paired t test or Wilcoxon signed rank test were used to compare the indexes before and after the intervention.Results A total of 92 PCOS patients were enrolled in the study before intervention,and 71 patients completed the standardized treatment of balanced nutrient diet combined with metformin for 6 months,including 17 cases in group A,29 cases in group B,1 case in group C,and 24 cases in group D.Compared with befo
作者
姚馨悦
肖燕
高珊
黎明
Yao Xinyue;Xiao Yan;Gao Shan;Li Ming(Department of Endocrinology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Endocrinology,Jingxi District of Beijing Chaoyang Hospital,Capital Medical University,Beijing 100040,China;Department of Endocrinology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Key Laboratory of Endocrinology,National Health Commission,Beijing 100730,China)
出处
《中华糖尿病杂志》
CAS
CSCD
北大核心
2024年第7期762-769,共8页
CHINESE JOURNAL OF DIABETES MELLITUS
关键词
多囊卵巢综合征
糖脂代谢
均衡营养素膳食
二甲双胍
Polycystic ovary syndrome
Glycolipid metabolism
Balanced nutrient diet
Metformin
