基于Framingham评分的多囊卵巢综合征心血管疾病风险评估

摘要

目的:探讨多囊卵巢综合征 (PCOS) 与心血管疾病 (CVD) 危险因素的关系, 评估PCOS患者的10年CVD风险.方法:本研究选择239例PCOS患者 (PCOS组) 及年龄匹配的134例非PCOS者 (对照组) 进行回顾性分析, 收集一般资料并测定生化、糖耐量、性激素等指标, 根据年龄、收缩压 (SBP) 、血清总胆固醇 (TC) 和高密度脂蛋白胆固醇 (HDL-C) 水平以及吸烟史, 对所有患者的CVD风险进行Framingham评分 (FRS) .比较PCOS患者和非PCOS的临床特征、实验室指标及FRS, 分析FRS与与代谢指标及性激素的相关性.结果:①与对照组相比, PCOS组的SBP以及舒张压 (DBP) 显著升高, 糖脂代谢紊乱明显, 雄激素水平更高 (P＜0.05) .②PCOS组的FRS较对照组显著升高 (P＜0.01) .③血压 (BP) 、空腹血糖 (FPG) 及餐后血糖 (PBG) 、空腹胰岛素 (FIns) 及餐后胰岛素 (PIns) 、胰岛素抵抗指数 (HOMA-IR) 、TC、甘油三酯 (TG) 、低密度脂蛋白胆固醇 (LDL-C) 与FRS呈显著正相关, 而HDL-C、性激素结合球蛋白 (SHBG) 与FRS呈显著负相关 (P＜0.05) .结论:PCOS与主要CVD危险因素如血糖升高、血压升高和血脂异常相关;10年CVD发生风险较普通人群明显升高, 这种升高趋势主要与血压、糖脂代谢有关, 而与雄激素水平无关.%Objective:To investigate the association between polycystic ovary syndrome (PCOS) and cardiovascular risk factors and evaluate 10-year risk of cardiovascular disease (CVD) in women with PCOS.Methods:239 PCOS patients (PCOS group) and 134 age-matched non-PCOS participants (control) were enrolled in this retrospective study.The general data was collected and biochemical test, glucose tolerance, sex hormones were detected.The Framingham score (FRS) for all women was evaluated according to age, systolic blood pressure (SBP), serum total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and history of smoking.The clinical features, laboratory parameters and FRS of PCOS patients and non-PCOS controls were compared.The correlation between FRS and metabolic indicators and sex hormones was analyzed.Results:①Compared with those of the control group, SBP and diastolic blood pressure (DBP) significantly increased, the glucose and lipid metabolism was moredisordered, and the androgen level was higher in PCOS group (P＜0.05).② The FRS of the PCOS group was higher than that of the control women (P＜0.01).③ FRS were positively correlated with BP, FPG, PBG, FIns, PIns, HOMA-IR, TC, TG, LDL-C.FRS was negatively correlated with HDL-C and SHBG (P＜0.05).Conclusions:PCOS is correlated with major cardiovascular risk factors, such as hypertension, hyperglycemia, and hyperlipidemia.PCOS show a higher risk of 10-year CVD events than individuals without PCOS.The phenomenonis mainly related to blood pressure and glycolipid metabolism but not androgen.