Diabetes and Metabolism Journal

Korean Diabetes Association (대한당뇨병학회)
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Prevalence of Metabolic Syndrome in Young Korean Women with Polycystic Ovary Syndrome

젊은 한국인 다낭성난소증후군 환자에서 대사증후군의 유병률

Lee, Hye-jin;Oh, Jee-Young;Hong, Young-sun;Sung, Yeon-Ah;Chung, Hye-won
이혜진;오지영;홍영선;성연아;정혜원

  • Published : 2006.07.31
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Abstract

Background: Polycystic ovary syndrome (PCOS) is characterized by insulin resistance and consequent hyperinsulinemia. Insulin resistance plays an important role in the development of metabolic syndrome (MS). We conducted a cross-sectional study to determine the prevalence of the MS and whether the insulin resistance or hyperandrogenemia is related to the MS in young Korean women with PCOS. Methods: 143 women with PCOS (mean age 26 ${\pm}$ 5 years) were studied to evaluate the prevalence of MS by modified Adult Treatment Panel III. Insulin sensitivity was evaluated by euglycemic hyperinsulinemic clamp technique. Results: The prevalence of MS in women with PCOS was 11.9%, 2.8-fold higher than age matched women in Korean urban population. The most frequent component of MS was low HDL cholesterol (39.4%), and the least frequent one was high fasting serum glucose levels (6.7%). The frequency of MS was 40.7% in obese PCOS (BMI $\geq$ 25 kg/m$^2$, n = 38), 10.0% in overweight PCOS (BMI 23~24.9 kg/m$^2$, n = 13), and 0% in lean PCOS (BMI < 23 kg/m$^2$, n = 92). The frequency of MS was 26.1% in insulin resistant PCOS (insulin mediated glucose uptake, IMGU < lowest 10$^{th}$ percentile of lean controls, n = 65), whereas no one had MS in insulin sensitive PCOS (IMGU $\geq$ lowest 10$^{th}$ percentile of lean controls, n = 78). Conclusion: MS is frequent in young women with PCOS, and obesity and insulin resistance might be essential for the development of MS in this study group.

연구배경: 다낭성난소증후군은 인슐린저항성과 그와 동반된 고인슐린혈증을 특징으로 한다. 인슐린저항성은 또한 대사증후군 발생에 중요한 역할을 한다. 저자 등은 한국인 PCOS 환자에서 대사증후군의 유병률을 알아보고 대사증후군에 영향을 주는 인자를 분석하고자 하였다. 방법: 143명의 PCOS 환자를 (평균연령 26 ${\pm}$ 5세) 대상으로 NCEP modified ATP III 에 의해 정의된 대사증후군의 유병률과 각 요소의 빈도를 구하였다. 정상혈당 고인슐린 클램프 검사로 인슐린감수성을 측정하였다. 결과: 1) PCOS 환자에서 대사증후군의 유병률은 11.9%로 동일 연령대의 도시지역 거주 여성 (4.3%)에 비해 2.8배 증가되어 있었다. 대사증후군의 구성 요소 중 저 고밀도 지단백 콜레스테롤혈증이 39.4%로 가장 흔하였고, 공복 고혈당은 6.7%로 가장 적었다. 2) 비만한 PCOS 환자에서 대사증후군의 유병률은 40.7%, 과체중 환자에서 10%를 보였으며, 정상 체중군에서는 대사증후군이 존재하지 않았다. 인슐린저항성을 가진 군에서의 대사증후군의 유병률은 26.1%이었으며, 인슐린감수성군에서는 대사증후군이 없었다. 3) 대사증후군이 있는 PCOS 환자는 인슐린감수성 지표인 IMGU가 유의하게 감소되어 있었으며, 이는 BMI를 보정한 후에도 통계적으로 의미가 있었다. 유리 테스토스테론은 대사증후군을 가진 군에서 유의하게 증가되어 있었고 성호르몬결합글로불린은 감소되어 있었으나, BMI를 보정한 후에는 통계적 유의성은 없었다. 결론: 젊은 한국인 PCOS 환자에서 대사증후군의 유병률은 일반인들에 비해 높았으며, 비만과 인슐린저항성이 대사증후군 발생에 중요한 역할을 하는 것으로 생각되었다.

Keywords

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