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目的回顾性分析限能量平衡膳食(CRD)对超重或肥胖多囊卵巢综合征(PCOS)患者体成分和代谢指标的影响。方法回顾分析南京大学医学院附属鼓楼医院收治的59例体重指数(BMI)≥24的PCOS经CRD干预前后的数据,测定了体成分、血脂、75 g口服葡萄糖耐量实验和同步胰岛素释放试验,并计算稳态模型评估胰岛素抵抗指数(HOMA-IR)。采用配对t检验和McNemar卡方检验比较分析。结果经12周干预,患者体重下降(7.21±3.76)kg(9.05%),体脂肪(BF)、体脂百分比(BFP)和内脏脂肪面积(VFA)分别下降16.15%、8.00%和12.59%,腰围(WC)减少(7.00±4.12)cm(6.96%)、腰臀比(WHR)下降3.16%(P均<0.001);总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、胰岛素0 min和120 min均显著下降(P均<0.05)。胰岛素抵抗(IR,定义为HOMA-IR≥2.69)检出率由干预前89.83%降至干预后54.55%,代谢综合征(MS)的检出率由干预前67.80%降至干预后42.37%。结论超重或肥胖PCOS患者经CRD干预可以减轻体重、BF、VFA,并改善脂代谢紊乱、IR和MS。
Objective To retrospectively analyze the effect of limiting energy balance diet (CRD) on body composition and metabolic parameters in overweight or obese patients with polycystic ovary syndrome (PCOS). Methods The data of 59 PCOS patients with body mass index (BMI) ≥ 24 admitted to Drum Tower Hospital of Nanjing University Medical College before and after CRD intervention were retrospectively analyzed. Body composition, lipids, 75 g oral glucose tolerance test and synchronous insulin release test were determined. The homeostasis model was used to assess the insulin resistance index (HOMA-IR). Paired t-test and McNemar chi-square test for comparative analysis. Results The body weight (7.21 ± 3.76) kg (9.05%), body fat (BF), body fat percentage (BFP) and visceral fat area (VFA) decreased by 16.15%, 8.00% and 12.59%, respectively, Waist circumference (WC) decreased (7.00 ± 4.12) cm (6.96%), WHR decreased 3.16% (all P <0.001); total cholesterol (TC), low density lipoprotein cholesterol The content of triglyceride (TG), insulin at 0 min and 120 min decreased significantly (all P <0.05). The detection rate of insulin resistance (IR, defined as HOMA-IR≥2.69) decreased from 89.83% before intervention to 54.55% after intervention, and the detection rate of metabolic syndrome (MS) decreased from 67.80% before intervention to 42.37% after intervention. Conclusion Overweight or obese PCOS patients with CRD can reduce body weight, BF, VFA, and improve lipid metabolism disorders, IR and MS.