生殖医学杂志

目的通过对多囊卵巢综合征(PCOS)患者进行身体成分分析,评判患者的体型、脂肪分布及营养状况,为PCOS患者的健康管理及并发症的预防提供依据。方法收集2018年6月至2019年8月在江苏省人民医院妇科内分泌门诊就诊的PCOS患者123例为PCOS组,选择同期就诊、月经正常的女性121例为对照组。记录所有研究对象的年龄、身高、体重等参数,采用人体成分分析仪(InBody S10),以生物电阻抗法为原理进行相关指标的测定。比较两组对象一般情况及检测指标的差异,并根据BMI进一步行分层分析。结果两组对象年龄、身高、体重比较均无统计学差异(P均>0.05),PCOS组的BMI[(27.14±4.60)vs.(25.82±4.58)kg/m²]、全身脂肪含量[(26.55±8.67)vs.(24.23±8.36)kg]、内脏脂肪面积[(100.37±29.98)vs.(92.40±29.34)cm²]和体脂率[(37.03±6.69)%vs.(35.23±7.06)%]均显著高于对照组(P均<0.05)。根据BMI数值进行分层,当BMI<24kg/m²时PCOS组的全身脂肪含量[(15.86±4.71)vs.(13.13±3.39)kg]、内脏脂肪面积[(64.65±19.67)vs.(55.09±13.96)cm²]和体脂率[(29.10±5.84)%vs.(25.31±4.82)%]亦显著高于对照组(P均<0.05);两组患者细胞外水分率、骨骼肌及骨矿物质含量比较无显著性差异(P均>0.05)。当BMI≥24kg/m²时,PCOS组的全身脂肪含量[(29.85±6.73)vs.(27.89±5.91)kg]、内脏脂肪面积[(111.39±23.28)vs.(104.71±21.64)cm²]亦显著高于对照组(P均<0.05);两组患者体脂率、细胞外水分率、骨骼肌及骨矿物质含量比较无显著性差异(P均>0.05)。结论 PCOS患者中超重和肥胖,尤其是腹型肥胖的发生率较高,且无论PCOS患者体重是否正常,全身脂肪含量及内脏脂肪面积均明显高于正常女性。因此,建议对PCOS患者进行体脂及相关指标等检测,以更好地指导临床进行营养与运动管理,改善PCOS患者的体脂分布及比例,有利于改善临床症状及预防远期并发症。

Objective:To evaluate the body shape,fat distribution and nutritional status by the body composition analysis in patients with polycystic ovary syndrome(PCOS)to provide a basis for health management and prevention of complications in PCOS patients.Methods:A total of 123 PCOS patients in the Gynecological Endocrine Clinic of Jiangsu Province Hospital as PCOS group from June 2018 to August 2019 were collected as PCOS group,and 121 women with normal menstruation were selected as the control group.The age,height,weight and other parameters of all subjects were recorded.The body composition analyzer(Inbody S10)was used to measure the body composition based on the bioelectrical impedance method.The general condition and detection index were compared between the two groups,and further stratified analysis according to BMI was carried out.Results:There was no significant difference in age,height and weight between the two groups(P>0.05),but BMI[(27.14±4.60)vs.(25.82±4.58)kg/m²]and body fat content[(26.55±8.67)vs.(24.23±8.36)kg],visceral fat area[(100.37±29.98)vs.(92.40±29.34)cm²]and body fat ratio[(37.03±6.69)% vs.(35.23±7.06)%]of PCOS patients were significantly higher than those of the control group(P<0.05).Further stratified analysis according to BMI values,the PCOS patients with BMI<24 kg/m² had significantly higher body fat content[(15.86±4.71)vs.(13.13±3.39)kg],visceral fat area[(64.65±19.67)vs.(55.09±13.96)cm²]and body fat ratio[(29.10±5.84)%vs.(25.31±4.82)%]comparing with the control group(P<0.05),but there was no significant difference in extracellular water content,skeletal muscle and bone mineral content between the two groups(all P>0.05).The body fat content[(29.85±6.73)vs.(27.89±5.91)kg]and visceral fat area[(111.39±23.28)vs.(104.71±21.64)cm²]in the PCOS patients with BMI≥24 kg/m² were also significantly higher than those in control group(P<0.05).No significant difference was found in body fat ratio,extracellular water rate,skeletal muscle and bone mineral content between the two groups(P>0.05).Conclusions:PCOS patients have a higher incidence of overweight and obesity,especially abdominal obesity.Regardless of whether the weight of PCOS patients are normal or not,body fat mass and visceral fat area are significantly higher than normal women.Therefore,it is recommended that body fat index and other tests should be performed to better guide clinical nutrition and exercise management and improve body fat distribution and proportion,in order to improve clinical symptoms and prevent long-term complications in PCOS patients.