[1]张熙曦*,黄桂英,王芳,等.多囊卵巢综合征患者维生素D营养状态与糖脂代谢的临床关系及对妊娠结局的影响[J].中国计划生育和妇产科,2019,(6):8-12.
　ZHANG Xi-xi*,HUANG Gui-ying,WANG Fang,et al.Relationship between vitamin D nutritional status and glycolipid metabolism in patients with polycystic ovary syndrome and its effect on pregnancy outcome[J].Chinese Journal of Family Planning & Gynecotokology,2019,(6):8-12.
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多囊卵巢综合征患者维生素D营养状态与糖脂代谢的临床关系及对妊娠结局的影响
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2019年6期
页码:
8-12
栏目:
论著与临床
出版日期:
2019-06-25

文章信息/Info

Title:
Relationship between vitamin D nutritional status and glycolipid metabolism in patients with polycystic ovary syndrome and its effect on pregnancy outcome
作者:
张熙曦*; 黄桂英; 王芳; 毛熙光
西南医科大学附属医院人类辅助生殖技术部
Author(s):
ZHANG Xi-xi*; HUANG Gui-ying; WANG Fang; MAO Xi-guang
Department of Human Assisted Reproductive Technology, Affiliated Hospital of Southwest Medical University, Luzhou Sichuan 646000，P.R.China
关键词:
多囊卵巢综合征; 维生素D; 25-羟基维生素D; 胰岛素抵抗; 妊娠率
Keywords:
polycystic ovary syndrome;  Vitamin D;  25-hydroxyl vitamin D;  insulin resistance;  pregnancy rate
分类号:
R 71175
摘要:
目的探讨多囊卵巢综合征（polycystic ovary syndrome，PCOS）患者维生素D营养状态与糖脂代谢的临床关系及对妊娠结局的影响。方法选取2015年8月至2016年8月西南医科大学附属医院收治的PCOS患者110例，检测其血清中25-羟基维生素D ［25-hydroxyvitamin D，25（OH）D］水平，观察PCOS患者在不同年龄、体质量指数、季节时维生素D营养状况，血清25（OH）D水平及维生素D与妊娠率间的关系；另选同期78例健康育龄期妇女为对照组，比较两组糖脂代谢水平，并分析25（OH）D与糖脂代谢各指标之间关系。结果年龄≥35岁患者与＜35岁患者的维生素D营养状况、血清25（OH）D水平比较，差异无统计学意义（P＞005）；体重超重患者的维生素D充足比例、血清25（OH）D水平低于体重正常患者（P＜005）；冬春季维生素D充足患者比例、血清25（OH）D水平低于夏秋季患者（P＜005）；PCOS组三酰甘油（triglycerides，TG）、总胆固醇（total cholesterol，TC）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol，LDL-C）、空腹血糖（fasting blood glucose，FBG）、胰岛素抵抗指数(homeostasis model assessment insulin resistance index，HOMA-IR)高于对照组，而高密度脂蛋白胆固醇（high-density lipoprotein cholesterol，HDL-C）、空腹胰岛素（fasting insulin，FINS）、胰岛素敏感性指数（quantitative insulin sensitivity check index，QUICKI）低于对照组，以上各项差异均有统计学意义（P＜005）。PCOS组血清25（OH）D水平与FINS、HOMA-IR、TG呈负相关，与HDL-C、QUICKI呈正相关（P＜005），与其他指标之间无相关性（P＞005）。血清25（OH）D浓度＜50 nmol/L患者的妊娠率低于血清25（OH）D浓度≥50 nmol/L患者（P＜005）。结论PCOS患者维生素D水平一般较低，其中体重超重患者的维生素D缺乏情况较为严重，同时冬春季患者也易发生维生素D缺乏现象，25（OH）D水平与FINS、HOMA-IR、TG、HDL-C、QUICKI密切相关，缺乏维生素D将降低妊娠率，故应对PCOS患者给予足量维生素D补充。
Abstract:
ObjectiveTo investigate the relationship between vitamin D nutritional status and glycolipid metabolism in patients with polycystic ovary syndrome（PCOS） and its effect on pregnancy outcome.Methods110 patients with PCOS admitted to Affiliated Hospital of Southwestern Medical University from August 2015 to August 2016 were selected.The serum levels of 25- hydroxyvitamin D ［25(OH)D］ were detected , and the relationship between vitamin D nutrition status, serum 25(OH)D level and vitamin D and pregnancy rate in PCOS patients at different ages, body mass index(BMI) and seasons was compared. Another 78 healthy women of child-bearing age in the same period were selected as the control group. The glycolipid metabolism level of the two groups was compared, and the relationship between 25(OH)D and glycolipid metabolism indexes was analyzed. ResultsThere were no significant differences in vitamin D status and serum 25(OH)D levels between patients aged ≥35 years and ＜35 years old (P>005); vitamin D adequacy ratio, the level of serum 25(OH)D in overweight patients was lower than that of normal weight patients (P<005); the proportion of patients with adequate vitamin D and serum 25(OH)D levels in winter and spring were lower than those in summer and autumn (P<005).Triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), insulin resistance index (homeostasis model assessment insulin resistance index, HOMA-IR) in PCOS group was higher than the control group, while high-density lipoprotein cholesterol (HDL-C), fasting insulin (FINS), and insulin sensitivity index (quantitative), the insulin sensitivity check index (QUICKI) was lower than the control group, and the above differences were statistically significant (P<005). Serum 25(OH)D levels in PCOS group were negatively correlated with FINS, HOMA-IR, and TG, and positively correlated with HDL-C and QUICKI (P<005). There was no correlation between serum 25(OH)D levels and other indexes (P>005). The pregnancy rate of serum 25(OH)D <50 nmol/L was lower than that of serum 25(OH)D≥50 nmol/L (P<005). ConclusionVitamin D levels in patients with PCOS are generally low, of which patients with overweight are more severe in vitamin D deficiency, and patients in winter and spring are also prone to vitamin D deficiency, 25 (OH)D levels and FINS, HOMA-IR, TG, HDL- C, QUICKI is closely related, lack of vitamin D will reduce the pregnancy rate, it should be given to patients with PCOS sufficient vitamin D supplement.

参考文献/References:

［1］林琼林．坤泰胶囊联合炔雌醇环丙孕酮片和二甲双胍治疗多囊卵巢综合征的临床研究 ［J］．现代药物与临床，2016，31（3）：338-341． ［2］Rezvan N, Moini A, Gorgani-Firuzjaee S, et al. Oral quercetin supplementation enhances adiponectin receptor transcript expression in polycystic ovary syndrome patients: a randomized Placebo-Controlled Double-Blind clinical trial ［J］. Cell J, 2018, 19(4): 627-633. ［3］李美芝，李蓉．多囊卵巢综合征诊断的金标准:鹿特丹标准?［J］．中国实用妇科与产科杂志，2007，23（9）：657-659． ［4］夏维波，李梅．维生素D缺乏的评价、预防及治疗——内分泌学会临床实践指南 ［J］．中华骨质疏松和骨矿盐疾病杂志，2011，4（2）：144-146． ［5］谢敏，李丹，赵爽．多囊卵巢综合征的病因病机及治疗研究动态［J］．世界中西医结合杂志，2018，13（1）：145-148． ［6］Coviello AD, Sam S, Legro RS, et al. High prevalence of metabolic syndrome in first-degree male relatives of women with polycystic ovary syndrome is related to high rates of obesity［J］. J Clin Endocrinol Metab, 2009, 94(11): 4361-4366. ［7］李亚芳，郑连文，谷春会．子宫内膜孕激素抵抗在多囊卵巢综合征发病机制中的研究进展 ［J］．中国妇幼保健，2018，33（4）：954-957． ［8］Joham AE, Teede HJ, Cassar S, et al. Vitamin D in polycystic ovary syndrome: Relationship to obesity and insulin resistance ［J］. Mol Nutr Food Res, 2016, 60(1): 110-118. ［9］陈咏，于月新，芦冬梅，等．维生素D受体基因多态性与多囊卵巢综合征Meta分析 ［J］．中国实用妇科与产科杂志，2018，34（1）：94-99． ［10］方锐，赵馨，蔡立义，等．不孕女性的维生素D营养状况对IUI临床妊娠率的影响［J］．生殖医学杂志，2017，26（5）：428-432． ［11］郭小芳，文希．多囊卵巢综合征患者血清维生素 D 水平与肥胖、胰岛素抵抗的相关性分析 ［J］．安徽医药，2016，20（2）：283-286． ［12］Pal L, ZHANG Heping, Williams J, et al. Vitamin D status relates to reproductive outcome in women with polycystic ovary syndrome: secondary analysis of a multicenter randomized controlled trial ［J］. J Clin Endocrinol Metab, 2016, 101(8): 3027-3035. ［13］袁俐．维生素D缺乏对多囊卵巢综合征的影响 ［J］．中国计划生育学杂志，2016，24（12）：855-857． ［14］司冬梅，祝幼荣，刘心宁．孕前,孕期维生素D水平与妊娠期糖尿病相关性研究 ［J］．现代医学，2017，45（3）：412-415． ［15］沈紫丹，程红，彭文，等.产前抑郁患者妊娠结局及其与维生素D缺乏的相关性［J］．华南国防医学杂志，2016，30（2）：96-98． ［16］Muscogiuri G, Palomba S, Caggiano MA, et al. Low 25 (OH) vitamin D levels are associated with autoimmune thyroid disease in polycystic ovary syndrome ［J］. Endocrine, 2016, 53(2): 538-542. ［17］吴桐，向菲，欧亚萍，等．孕妇血清维生素D水平与妊娠结局的相关性研究 ［J］．重庆医学，2016，45（7）：893-895． ［18］阳晓敏，李茜西．多囊卵巢综合征患者生殖内分泌紊乱与维生素D缺乏关系的研究进展 ［J］．中国妇幼保健，2017，32（10）：2263-2266．

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更新日期/Last Update: 2019-06-25