多囊卵巢综合征患者睡眠质量与代谢综合征的相关性分析

doi:10.12280/gjfckx.20220295

摘要/Abstract

摘要：

目的：探讨多囊卵巢综合征（polycystic ovary syndrome,PCOS）患者代谢综合征（metabolic syndrome,MS）的发病与睡眠障碍的关系,为临床防治提供指导。方法：选取2021年4—10月黑龙江中医药大学附属第一医院妇科门诊就诊的PCOS患者170例,按是否合并MS分为PCOS合并MS组（A组,40例）、PCOS无MS组（B组,130例）,另选取同期非PCOS但存在MS的患者（C组,30例）作为对照,对3组患者的临床特征、睡眠质量、睡眠状况与MS标志物的相关性进行回顾性分析。结果：A、B、C组睡眠障碍者分别为18例（45.00%）、44例（33.84%）和4例（13.33%）,各组睡眠障碍程度的差异有统计学意义（P<0.05）。A组睡眠状况评分、体质量、体质量指数、收缩压、舒张压、腰臀比、空腹血糖、空腹胰岛素、胰岛素抵抗指数、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、载脂蛋白B水平均高于B组（P<0.05）;A组黄体生成素、黄体生成素与卵泡刺激素比值、性激素结合球蛋白、高密度脂蛋白胆固醇水平低于B组（P<0.05）。A组在睡眠状况评分、黄体生成素、黄体生成素与卵泡刺激素比值、睾酮、硫酸脱氢表雄酮、雄烯二酮水平均高于C组（P<0.05）;A组性激素结合球蛋白水平低于C组（P<0.05）。PCOS患者早醒、睡眠不稳与三酰甘油水平呈正相关（P<0.05）。结论：PCOS患者易合并睡眠障碍,MS与PCOS患者睡眠质量存在相互影响且MS会加重PCOS患者睡眠障碍,对于PCOS患者应重视其睡眠健康。

关键词: 多囊卵巢综合征, 睡眠障碍, 睡眠呼吸暂停,阻塞性, 代谢综合征, 血脂异常

Abstract:

Objective: To investigate the relationship between metabolic syndrome (MS) and sleep disorders in patients with polycystic ovary syndrome(PCOS), and to provide guidance for clinical prevention and treatment. Methods: 170 patients with PCOS (group A: PCOS with MS, group B: PCOS without MS) and 30 MS patients without PCOS (group C) were sorted as subjects for regression analysis. These patients are collected from the gynecology clinic of The First Affiliated Hospital of Heilongjiang University of Chinese Medicine from April to October 2021. The differences of clinical characteristics, sleep quality and the correlation between sleep status and metabolic syndrome markers were retrospectively analyzed. Results：There were 18 cases of sleep disorders in group A (45.00%), 44 cases in group B (33.84%) and 4 cases in group C (13.33%). There was significant difference in the distribution of sleep disorders among the three groups (P<0.05). Compared with group B, the SRSS score, body weight, BMI, SBP, DBP, WHR, FPG, FINS, HOMA-IR, TG, TC, LDL-c and ApoB in group A were higher, while the levels of LH, LH/FSH, SHBG and HDL-c in group A were lower than those in group B (P<0.05). Compared with group C, SRSS scores, LH, LH/FSH, T, DHEAS and AND in group A were higher, while the level of SHBG in group A was lower than that in group C (P<0.05). Early awakening and sleep instability were positively correlated with TG level in patients with PCOS (P<0.05). Conclusions：PCOS patients are easy to be complicated with sleep disorders. The sleep quality of MS and PCOS patients have mutual influence on sleep quality, and MS can aggravate sleep disorders in PCOS patients, so attention should be paid to sleep health in PCOS patients.

Key words: Polycystic ovary syndrome, Sleep disorders, Sleep apnea, obstructive, Metabolic syndrome, Dyslipidemias

匡洪影, 李爽, 程显卓, 江昕桐, 侯丽辉. 多囊卵巢综合征患者睡眠质量与代谢综合征的相关性分析[J]. 国际妇产科学杂志, 2022, 49(4): 472-476.

KUANG Hong-ying, LI Shuang, CHENG Xian-zhuo, JIANG Xin-tong, HOU Li-hui. Correlation between Sleep Quality and Metabolic Syndrome in Patients with Polycystic Ovary Syndrome[J]. Journal of International Obstetrics and Gynecology, 2022, 49(4): 472-476.

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参考文献 20

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组别	n	无睡眠障碍	轻度睡眠障碍	中度睡眠障碍	重度睡眠障碍	H	P
A组	40	22（55.00）	11（27.50）	7（17.50）	0（0）	8.352	0.015
B组	130	86（66.16）	35（26.92）	9（6.92）	0（0）
C组	30	26（86.67）	4（13.33）	0（0）	0（0）

组别	n	无睡眠障碍	轻度睡眠障碍	中度睡眠障碍	重度睡眠障碍	H	P
A组	40	22（55.00）	11（27.50）	7（17.50）	0（0）	8.352	0.015
B组	130	86（66.16）	35（26.92）	9（6.92）	0（0）
C组	30	26（86.67）	4（13.33）	0（0）	0（0）

组别	n	体质量（kg）	BMI（kg/m²）	SBP（mmHg）	DBP（mmHg）	WHR
A组	40	80.00（70.00,91.75）	29.92（27.03,34.74）	132.00（118.00,138.75）	83.00（79.00,90.75）	0.87（0.84,0.92）
B组	130	64.00（55.00,72.12）^a	23.60（20.05,27.13）^a	117.00（111.00,122.00）^a	75.00（70.00,80.00）^a	0.81（0.77,0.87）^a
C组	30	78.00（60.00,85.00）^b	30.12（24.03,31.24）^b	136.00（130.00,147.00）^b	86.00（83.00,88.00）^b	0.85（0.84,0.89）
H		44.145	45.214	53.259	44.419	28.514
P		0.000	0.000	0.000	0.000	0.000

组别	n	体质量（kg）	BMI（kg/m²）	SBP（mmHg）	DBP（mmHg）	WHR
A组	40	80.00（70.00,91.75）	29.92（27.03,34.74）	132.00（118.00,138.75）	83.00（79.00,90.75）	0.87（0.84,0.92）
B组	130	64.00（55.00,72.12）^a	23.60（20.05,27.13）^a	117.00（111.00,122.00）^a	75.00（70.00,80.00）^a	0.81（0.77,0.87）^a
C组	30	78.00（60.00,85.00）^b	30.12（24.03,31.24）^b	136.00（130.00,147.00）^b	86.00（83.00,88.00）^b	0.85（0.84,0.89）
H		44.145	45.214	53.259	44.419	28.514
P		0.000	0.000	0.000	0.000	0.000

组别	n	LH （U/L）	FSH （U/L）	LH/FSH	PRL （ng/mL）	E₂ （pg/mL）	T （ng/dL）	DHEAS （μg/dL）	AND （nmol/L）	SHBG （nmol/L）
A组	40	6.92（4.26,10.16）	4.54（3.41,5.50）	1.51（1.09,2.22）	11.73（8.93,16.38）	38.50（27.00,61.37）	45.17（32.53,76.73）	274.22±119.91	8.11±3.69	27.40（18.65,41.47）
B组	130	8.97（5.50,12.62）^a	4.79（3.67,5.71）	1.95（1.35,2.69）^a	13.63（9.78,18.88）	42.43（30.00,66.75）	47.70（35.44,61.26）	289.71±102.84	7.78±2.72	36.80（22.80,65.35）^a
C组	30	4.11（2.11,6.44）^ab	4.91（2.78,6.55）	0.98（0.78,2.02）^ab	9.84（6.85,22.02）	36.00（24.00,49.00）	28.89（21.15,31.87）^ab	200.40±55.71^ab	4.56±1.91^ab	72.4（42.00,100.45）^ab
F或H		9.960	0.857	12.734	1.864	1.189	13.152	9.849	12.777	13.787
P		0.007	0.651	0.002	0.394	0.552	0.001	0.007	0.002	0.001