다낭성 난포증후군 환자에서 총 경동맥의 혈관내막 두께 측정을 통한 인슐린 저항성과 잠재성 동맥경화의 관계분석
Intima Media Thickness ( IMT ) in Relation to Insulin Resistance and Subclinical Atherosclerosis in Polycystic Ovary Syndrome ( PCOS )
김정연 ; 박기현 ; 송찬호 ; 조동제 ; 배상욱 ; 안철우 ; 강경숙 ; 정경아
Korean Journal of Obstetrics and Gynecology (대한산부인과학회지), Vol.44(6) : 1178~1185, 2001
Korean Journal of Obstetrics and Gynecology (대한산부인과학회지)
Objectives: The purpose of this study was to determine whether women with PCOS have greater subclinical atherosclerosis and evaluate the relationship to risk factors for atherosclerosis. Methods: Women with PCOS(n=24) and age and body mass index(BMI)-matched cycling women(n=16) as control group underwent carotid scanning for the measurement of the IMT. We compared IMT and plaque between cases and controls, assessed some risk factors for atherosclerosis, and analyzed factors affecting IMT. Results: There was no difference between the groups in waist-hip ratio(WHR) and in the levels of total cholesterol, triglyceride(TG), LDL, Lp(a), fibrinogen, homocystein, plasminogen activator inhibitor 1. However, HDL was significantly lower, and systolic and diastolic blood pressure, fasting blood sugar or insulin concentration and IMT was significantly higher in PCOS group than control group (51.1±11.6 vs 60.4±10.0mg/dl, 119.4±12.5 vs 109.0±11.6mmHg, 79.1±11.1 vs 68.9±7.8mmHg, 93.6±11.1 vs 85.0±5.9 mg/dl, 8.9±5.2 vs 5.0±3.3pU/ml, 0.57±0.12 vs 0.49±0.11mm respectively, all p<0.05). In the analysis of correlation between the IMT and clinical characteristics, PCOS status, BMI, systolic and diastolic blood pressure, fasting blood sugar or insulin concentration, TG, HDL, fibrinogen were significantly independent variables (Coefficients of correlation were 0.358, 0.461, 0.452, 0.349, 0.405, 0.466, 0.478, -0.433, 0.349 respectively, all p<0.05). The factors affecting IMT by multivariate regression were PCOS status and fasting insulin concentration. Conclusions: We concluded that women with PCOS might have an increased risk of subclinical atherosclerosis and insulin resistance was assumed to be the main risk factor of atherosclerosis.