国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2020, Vol. 39 ›› Issue (5): 370-373.

• 论著 • 上一篇    下一篇

人体测量指标对多囊卵巢综合征患者胰岛素抵抗的预测价值

刘睿欣，薛丽，闫雅茹，武海飞，郭雪桃   

  1. 030001 太原，山西医科大学第一临床医学院（刘睿欣，薛丽，闫雅茹，武海飞）；山西医科大学第一医院妇科（郭雪桃）
  • 收稿日期:2020-03-24 修回日期:2020-05-11 出版日期:2020-09-15 发布日期:2020-09-11
  • 通讯作者: 郭雪桃，E-mail：gxt_999@163.com E-mail:1071840209@qq.com

Predictive Value of Anthropometric Indexes on Insulin Resistance in Patients with Polycystic Ovary Syndrome

LIU Rui-xin, XUE Li, YAN Ya-ru, WU Hai-fei, GUO Xue-tao   

  1. The First Clinical Medical College, Shanxi Medical University, Taiyuan 030001, China （ＬＩU Rui-xin, XUE Li, YAN Ya-ru, WU Hai-fｅｉ）; Department of Gynecology, The First Hospital of Shanxi Medical University, Taiyuan 030001, China （ＧＵO Xue-taｏ）
  • Received:2020-03-24 Revised:2020-05-11 Published:2020-09-15 Online:2020-09-11
  • Contact: GUO Xue-tao, E-mail：gxt_999@163.com E-mail:1071840209@qq.com

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摘要： 目的：比较4种人体测量指标人体质量指数（BMI）、腰围（WC）、腰臀比（WHR）、腰围身高比（WHtR）对多囊卵巢综合征（PCOS）胰岛素抵抗（IR）的预测价值。方法：回顾性分析育龄期PCOS患者754例，采用受试者工作特征曲线（ROC）、诊断性试验和二分类Logistic回归分析比较人体测量指标在PCOS合并IR中的预测价值。结果：①PCOS合并IR患者的BMI、WC、WHR、WHtR和胰岛素抵抗指数稳态模型评估指数（ＨＯＭＡ－ＩＲ）均高于非IR患者（均P＜0.05）。②BMI、WC、WHR、WHtR的ROC曲线下面积（AUC）分别为0.768、0.769、0.739和0.768；BMI、WC、WHR、WHtR对PCOS合并IR的预测最佳临界值分别为26.33 kg/m2、81.15 cm、0.85和0.53。③二分类Logistic回归分析显示，BMI、WHR是PCOS患者发生IR的危险因素，BMI≥26.33 kg/m2者发生IR的风险是BMI＜26.33 kg/m2者的5.189倍，WHR≥0.85者发生IR的风险是WHR＜0.85者的1.903倍。BMI+WHR联合预测较单一指标价值更大（AUC为0.778）。结论：人体测量指标对PCOS合并IR均有一定的预测价值。腹型肥胖PCOS可选WC或WHR预测IR，全身肥胖PCOS选BMI。BMI和WHR综合预测价值更大。当BMI≥26.33 kg/m2和（或）WHR≥0.85时，IR发病风险显著增加，肥胖型PCOS患者进行适当的体质量管理有利于改善IR。

关键词: 多囊卵巢综合征；, 人体质量指数；, 腰围；, 腰臀比；, 腰围-身高比

Abstract: Objective: To evaluate the predictive value of the four anthropometric indexes, including body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR) and waist-height ratio (WHtR), on the insulin resistance (IR) of polycystic ovary syndrome (PCOS). Methods: Retrospective analysis of 754 PCOS patients of childbearing age, receiver operating characteristic  curve (ROC), diagnostic test and binary logistic regression analysis were included in this study. Results: ①The BMI,WC,WHR，WHtR and the homeostasis model of assessment for insulin resistence index (HOMA-IR) in the PCOS with IR group were higher than those in the PCOS with non-IR group (all P＜0.05). ②The AUCs of ROC curves of BMI, WC, WHR and WHtR were 0.768, 0.769, 0.739 and 0.768. The optimal cutoff values of BMI, WC, WHR and WHtR for the prediction of IR in PCOS patients were 26.33 kg/m2, 81.15 cm, 0.85 and 0.53, respectively. ③The binary logistic regression analysis showed that BMI and WHR were risk factors of IR in PCOS patients. The risk of IR in PCOS patients with BMI≥26.33 kg/m2 was 5.189 times higher than that in PCOS patients with BMI＜26.33 kg/m2; and the risk of IR in PCOS patients with WHR≥0.85 was 1.903 times higher than that in PCOS patients with WHR＜0.85. The predictive value of BMI plus WHR was better than any one indicator (AUC of ROC curve was 0.778). Conclusions: Anthropometric indexes have predictive value for the IR of PCOS. WC or WHR can be used to predict IR in PCOS patients with abdominal obesity, and BMI can be used in PCOS patients with systemic obesity. The predictive value of BMI plus WHR is better. When BMI≥26.33 kg/m2 and/or WHR≥0.85, the risk of IR is significantly increased. The appropriate weight management in those obese PCOS patients will reduce their risk of IR.

Key words: Polycystic ovary syndrome, Body mass index;, Waist circumference, Waist-hip ratio, Waist-height ratio