胆钙化醇及其联合二甲双胍对多囊卵巢综合征女性脂质和碳水化合物状况的影响

Q4 Medicine

Problemi Endokrinnoi Patologii Pub Date : 2022-03-15 DOI:10.21856/j-pep.2022.1.01

Tetyana Arkhypkina, V. Bondarenko, L. Lyubimovа

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引用次数: 0

摘要

目标。探讨胆钙化醇、二甲双胍及其联合用药对多囊卵巢综合征(PCOS)及胰岛素抵抗(IR)患者糖脂代谢指标的影响。材料和方法。对60例PCOS合并IR的女性和30例年龄、体重相近的健康女性进行了检查。患者被分为3组:20名女性每天服用4000 IU的胆钙化醇;20名妇女接受每日两次850毫克二甲双胍治疗;20例患者服用二甲双胍850毫克，每天2次，胆钙化醇4000 IU，每天2次。测定治疗前后12周的维生素D、葡萄糖、免疫反应性胰岛素(IRI)、HOMA-IR指数、总胆固醇、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、口服糖耐量。胆骨化醇治疗可使维生素D浓度(158.9±4.7)%升高(P < 0.001)， IRI (P < 0.02)、HOMA-IR指数(P < 0.001)、总胆固醇(P < 0.01)和LDL (P < 0.05)降低，但对人体测量参数、葡萄糖、TG和HDL水平无显著影响。二甲双胍治疗伴有体重指数(BMI)下降(P < 0.01)， IRI基础水平(24.6±0.4)% (P < 0.001)， HOMA-IR指数(27.9±0.4)% (P < 0.001)，口服葡萄糖负荷血糖反应(P < 0.001)， TG (P < 0.02)和HDL水平升高(P < 0.05)。没有观察到维生素D水平的负动态变化。联合治疗组维生素D浓度升高(P < 0.001)， BMI (P < 0.001)、腰臀比(P < 0.05)、口服糖负荷血糖反应(P < 0.001)、IRI (P < 0.001)和HOMA-IR指数(P < 0.001)均显著降低，总胆固醇(P < 0.001)、TG (P < 0.001)、LDL (P < 0.001)和HDL (P < 0.001)均显著降低。胆钙化醇与二甲双胍联合应用于旨在纠正多囊卵巢综合征妇女代谢紊乱的综合治疗措施是有利的。

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EFFECT OF CHOLECALCIFEROL AND ITS COMBINATION WITH METFORMIN ON THE LIPID AND CARBOHYDRATE STATUS IN WOMEN WITH POLYCYSTIC OVARIAN SYNDROME

Objective. To investigate the effect of therapy with cholecalciferol, metformin and their combination to indicator of carbohydrate and lipid metabolism in women with polycystic ovary syndrome (PCOS) and insulin resistance (IR). Materials and methods. 60 women with PCOS and IR, 30 healthy women similar in age and body weight were examined. Patients were divided into 3 groups: 20 women receiving cholecalciferol at 4000 IU daily; 20 women receiving metformin at 850 mg twice a day; 20 patients taking metformin at 850 mg twice a day and cholecalciferol at 4000 IU daily. Vitamin D, glucose, immunoreactive insulin (IRI), HOMA-IR index, total cholesterol, triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), oral glucose tolerance test before and after 12 weeks of therapy were determined. Results. Therapy with cholecalciferol was accompanied by increasing (P < 0.001) in concentrations of vitamin D (158.9 ± 4.7)%, reducing the levels of IRI (P < 0.02), the HOMA-IR indexes (P < 0.001), total cholesterol (P < 0.01) and LDL (P < 0.05), but did not had a significant effect on anthropometric parameters, glucose, TG, and HDL levels. Therapy with metformin was accompanied by decreasing body mass index (BMI) (P < 0.01), basal levels of IRI (24.6 ± 0.4)% (P < 0.001), HOMA-IR index (27.9 ± 0.4)% (P < 0.001), glycemic responses to an oral glucose load (P < 0.001), TG (P < 0.02) and increasing levels of HDL (P < 0.05). No negative dynamics of vitamin D levels was observed. Combination therapy was accompanied by increasing in concentration of vitamin D (P < 0.001), significant decreasing of BMI (P < 0.001), waist-to-hip ratio (P < 0.05), glycemic responses to an oral glucose load (P < 0.001), levels of IRI (P < 0.001) and HOMA-IR indexes (P < 0.001), more significant decreasing in total cholesterol (P < 0.001), TG (P < 0.001), LDL (P < 0.001) and increasing in HDL (P < 0.001). Conclusion. It is expedient to use a combination of cholecalciferol with metformin in the complex of therapeutic measures aimed at the correction of metabolic disorders in women with PCOS.

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来源期刊

Problemi Endokrinnoi Patologii Medicine-Endocrinology, Diabetes and Metabolism

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0.50

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0.00%

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