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目的:探讨高雄激素血症(HT)与多囊卵巢综合征(PCOS)患者非酒精性脂肪性肝病(NAFLD)发病的关系。方法:对306例PCOS患者进行基础内分泌、口服糖耐量试验及胰岛素释放试验、肝功能、血脂等检查,B超诊断脂肪肝。结果:306例PCOS患者中诊断出NAFLD94例,发病率为30.7%;其中NAFLD轻度56例(59.6%),中度34例(36.2%),重度4例(4.2%)。PCOS患者NAFLD的发病率与HA无明显相关性,与稳态模型评估胰岛素抵抗指数(HOMA-IR)、甘油三酯(TG)呈正相关。PCOS合并NAFLD组胰岛素抵抗(IR)发生率明显高于PCOS不合并NAFLD组,P<0.05;PCOS高雄激素血症(PCOS-HA)组IR发生率与PCOS非高雄激素血症(PCOS-NHA)组无明显差异,P>0.05。结论:PCOS患者NAFLD发病率较高,PCOS患者NAFLD的发生与IR、代谢异常密切相关,与HA无明显相关。
Objective: To investigate the relationship between hyperandrogenism (HT) and non-alcoholic fatty liver disease (NAFLD) in patients with polycystic ovary syndrome (PCOS). Methods: 306 cases of PCOS patients with endocrine, oral glucose tolerance test and insulin release test, liver function, blood lipids and other tests, B ultrasound diagnosis of fatty liver. Results: Among 306 PCOS patients, 94 cases were diagnosed with NAFLD, the incidence was 30.7%. NAFLD was mild in 56 cases (59.6%), moderate in 34 cases (36.2%) and severe cases in 4 cases (4.2%). The incidence of NAFLD in PCOS patients was not significantly correlated with HA, but positively correlated with homeostasis model assessment of insulin resistance index (HOMA-IR) and triglyceride (TG). The incidence of IR in PCOS combined with NAFLD group was significantly higher than that in PCOS without NAFLD group (P <0.05). The incidence of IR in PCOS-HA group was significantly higher than that in PCOS-non-hyperandrogenism group (PCOS-NHA) There was no significant difference between the two groups (P> 0.05). Conclusions: The incidence of NAFLD in PCOS patients is high. The incidence of NAFLD in PCOS patients is closely related to IR and metabolic abnormalities, but not to HA.