Ngôn ngữ sử dụng
Cách trích dẫn
Nguyễn, T. N., Hồ, N. A. V., Phạm, D. T., Nguyễn, H. N. M., Lý, Đại L., Hồ, M. T., & Vương, T. N. L. (2023). Tỷ lệ bất thường dung nạp đường ở phụ nữ hiếm muộn người Việt Nam có hội chứng buồng trứng đa nang: IGT. Tạp Chí Phụ sản, 20(2), 63-69. https://doi.org/10.46755/vjog.2022.2.1362
Tóm tắt
Mục tiêu: Khảo sát tỷ lệ bất thường dung nạp đường (IGT) và xác định các yếu tố liên quan với tình trạng IGT ở nhóm phụ nữ hiếm muộn người Việt Nam có hội chứng buồng trứng đa nang (HC BTĐN).
Đối tượng và phương pháp nghiên cứu: Phụ nữ hiếm muộn người Việt Nam có HC BTĐN chẩn đoán theo tiêu chuẩn Rotterdam được nhận vào nghiên cứu. Bệnh nhân được khai thác tiền sử, bệnh sử, khảo sát nhân trắc học, siêu âm phụ khoa, xét nghiệm nội tiết, đường huyết đói (FG) và HbA1c. Nếu FG < 125 mg/dL và HbA1c < 6,5%, bệnh nhân được thực hiện xét nghiệm dung nạp glucose đường uống với 75g đường (OGTT). Kết cục chính là tỷ lệ IGT. Dữ liệu được phân tích sử dụng phương pháp thống kê mô tả và mô hình hồi quy logistic đơn, đa biến.
Kết quả: Có 903 phụ nữ có HC BTĐN tham gia nghiên cứu từ 6/2020 đến 6/2021. Đa số trẻ tuổi, không thừa cân. 22,6% được chẩn đoán IGT; 3,7% và 5,2% có đái tháo đường (ĐTĐ) típ 2 chẩn đoán bằng FG/HbA1c và OGTT; 68,5% có chuyển hoá đường bình thường. Tình trạng tiền ĐTĐ được phát hiện ở 29,6% bệnh nhân. Tuổi và BMI là hai yếu tố liên quan độc lập của tình trạng IGT sau phân tích hồi quy đa biến.
Kết luận: Tỷ lệ IGT và các rối loạn chuyển hoá khác liên quan đường huyết ở phụ nữ hiếm muộn người Việt Nam có HC BTĐN cao, mặc dù cơ địa thừa cân - béo phì là không phổ biến.
Tài liệu tham khảo
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3. Barlampa D, Bompoula MS, Bargiota A, Kalantaridou S, Mastorakos G, Valsamakis G. Hypothalamic Inflammation as a Potential Pathophysiologic Basis for the Heterogeneity of Clinical, Hormonal, and Metabolic Presentation in PCOS. Nutrients. 2021 Feb 5;13(2):520.
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12. American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021 Jan;44(Suppl 1):S15–33.
13. Le MT, Nguyen VQH, Truong QV, Le DD, Le VNS, Cao NT. Metabolic Syndrome and Insulin Resistance Syndrome among Infertile Women with Polycystic Ovary Syndrome: A Cross-Sectional Study from Central Vietnam. Endocrinol Metab (Seoul). 2018 Dec;33(4):447–58.
14. Reyes-Muñoz E, Ortega-González C, Martínez-Cruz N, Arce-Sánchez L, Estrada-Gutierrez G, Moran C, et al. Association of obesity and overweight with the prevalence of insulin resistance, pre-diabetes and clinical-biochemical characteristics among infertile Mexican women with polycystic ovary syndrome: a cross-sectional study. BMJ Open. 2016 Jul 22;6(7):e012107.
15. Chen X, Yang D, Li L, Feng S, Wang L. Abnormal glucose tolerance in Chinese women with polycystic ovary syndrome. Human Reproduction. 2006 Aug 1;21(8):2027–32.
16. Wongwananuruk T, Rattanachaiyanont M, Indhavivadhana S, Leerasiri P, Techatraisak K, Tanmahasamut P, et al. Prevalence and clinical predictors of insulin resistance in reproductive-aged thai women with polycystic ovary syndrome. Int J Endocrinol. 2012;2012:529184.
17. Pantasri T, Vutyavanich T, Sreshthaputra O, Srisupundit K, Piromlertamorn W. Metabolic syndrome and insulin resistance in Thai women with polycystic ovary syndrome. J Med Assoc Thai. 2010 Apr;93(4):406–12.
18. Dabadghao P, Roberts BJ, Wang J, Davies MJ, Norman RJ. Glucose tolerance abnormalities in Australian women with polycystic ovary syndrome. Med J Aust. 2007 Sep 17;187(6):328–31.
19. Gambineri A, Pelusi C, Manicardi E, Vicennati V, Cacciari M, Morselli-Labate AM, et al. Glucose intolerance in a large cohort of mediterranean women with polycystic ovary syndrome: phenotype and associated factors. Diabetes. 2004 Sep;53(9):2353–8.
20. Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care. 1999 Jan 1;22(1):141–6.
21. Sharma S, Majumdar A. Prevalence of metabolic syndrome in relation to body mass index and polycystic ovarian syndrome in Indian women. J Hum Reprod Sci. 2015 Dec;8(4):202–8.
22. Zhao X, Zhong J, Mo Y, Chen X, Chen Y, Yang D. Association of biochemical hyperandrogenism with type 2 diabetes and obesity in Chinese women with polycystic ovary syndrome. Int J Gynaecol Obstet. 2010 Feb;108(2):148–51.
23. Zhao L, Zhu Z, Lou H, Zhu G, Huang W, Zhang S, et al. Polycystic ovary syndrome (PCOS) and the risk of coronary heart disease (CHD): a meta-analysis. Oncotarget. 2016 Jun 7;7(23):33715–21.
24. Mani H, Davies MJ, Bodicoat DH, Levy MJ, Gray LJ, Howlett TA, et al. Clinical characteristics of polycystic ovary syndrome: investigating differences in White and South Asian women. Clin Endocrinol (Oxf). 2015 Oct;83(4):542–9.
25. Oh J-Y, Barrett-Connor E, Wedick NM, Wingard DL, Rancho Bernardo Study. Endogenous sex hormones and the development of type 2 diabetes in older men and women: the Rancho Bernardo study. Diabetes Care. 2002 Jan;25(1):55–60.
26. Muka T, Nano J, Jaspers L, Meun C, Bramer WM, Hofman A, et al. Associations of Steroid Sex Hormones and Sex Hormone-Binding Globulin With the Risk of Type 2 Diabetes in Women: A Population-Based Cohort Study and Meta-analysis. Diabetes. 2017 Mar;66(3):577–86.
27. Legro RS, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, Pasquali R, et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013 Dec;98(12):4565–92.
28. Patel SA, Deepa M, Shivashankar R, Ali MK, Kapoor D, Gupta R, et al. Comparison of multiple obesity indices for cardiovascular disease risk classification in South Asian adults: The CARRS Study. PLoS One. 2017;12(4):e0174251.
29. Dunaif A, Xia J, Book CB, Schenker E, Tang Z. Excessive insulin receptor serine phosphorylation in cultured fibroblasts and in skeletal muscle. A potential mechanism for insulin resistance in the polycystic ovary syndrome. J Clin Invest. 1995 Aug;96(2):801–10.
30. Belani M, Deo A, Shah P, Banker M, Singal P, Gupta S. Differential insulin and steroidogenic signaling in insulin resistant and non-insulin resistant human luteinized granulosa cells-A study in PCOS patients. J Steroid Biochem Mol Biol. 2018 Apr;178:283–92.
31. Unluhizarci K, Karaca Z, Kelestimur F. Role of insulin and insulin resistance in androgen excess disorders. World J Diabetes. 2021 May 15;12(5):616–29.
32. Lee H, Oh J-Y, Sung Y-A, Chung H, Cho WY. The prevalence and risk factors for glucose intolerance in young Korean women with polycystic ovary syndrome. Endocrine. 2009 Oct;36(2):326–32.
33. Livadas S, Bothou C, Kuliczkowska-Płaksej J, Robeva R, Vryonidou A, Macut JB, et al. Can dysglycemia in OGTT be predicted by baseline parameters in patients with PCOS? Endocr Connect. 2022 Mar 1;EC-21-0358.
34. Alberti KGMM, Zimmet P, Shaw J. International Diabetes Federation: a consensus on Type 2 diabetes prevention. Diabet Med. 2007 May;24(5):451–63.
2. Melo AS, Vieira CS, Barbieri MA, Rosa-E-Silva ACJS, Silva A a. M, Cardoso VC, et al. High prevalence of polycystic ovary syndrome in women born small for gestational age. Hum Reprod. 2010 Aug;25(8):2124–31.
3. Barlampa D, Bompoula MS, Bargiota A, Kalantaridou S, Mastorakos G, Valsamakis G. Hypothalamic Inflammation as a Potential Pathophysiologic Basis for the Heterogeneity of Clinical, Hormonal, and Metabolic Presentation in PCOS. Nutrients. 2021 Feb 5;13(2):520.
4. Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocr Rev. 2012 Dec;33(6):981–1030.
5. Stepto NK, Cassar S, Joham AE, Hutchison SK, Harrison CL, Goldstein RF, et al. Women with polycystic ovary syndrome have intrinsic insulin resistance on euglycaemic-hyperinsulaemic clamp. Hum Reprod. 2013 Mar;28(3):777–84.
6. Bil E, Dilbaz B, Cirik DA, Ozelci R, Ozkaya E, Dilbaz S. Metabolic syndrome and metabolic risk profile according to polycystic ovary syndrome phenotype. J Obstet Gynaecol Res. 2016 Jul;42(7):837–43.
7. Rubin KH, Glintborg D, Nybo M, Abrahamsen B, Andersen M. Development and Risk Factors of Type 2 Diabetes in a Nationwide Population of Women With Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2017 Oct 1;102(10):3848–57.
8. Joham AE, Ranasinha S, Zoungas S, Moran L, Teede HJ. Gestational diabetes and type 2 diabetes in reproductive-aged women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2014 Mar;99(3):E447-452.
9. Kakoly NS, Khomami MB, Joham AE, Cooray SD, Misso ML, Norman RJ, et al. Ethnicity, obesity and the prevalence of impaired glucose tolerance and type 2 diabetes in PCOS: a systematic review and meta-regression. Hum Reprod Update. 2018 Jul 1;24(4):455–67.
10. Morales AJ, Laughlin GA, Bützow T, Maheshwari H, Baumann G, Yen SS. Insulin, somatotropic, and luteinizing hormone axes in lean and obese women with polycystic ovary syndrome: common and distinct features. J Clin Endocrinol Metab. 1996 Aug;81(8):2854–64.
11. Kim JJ, Choi YM. Phenotype and genotype of polycystic ovary syndrome in Asia: Ethnic differences. J Obstet Gynaecol Res. 2019 Dec;45(12):2330–7.
12. American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021 Jan;44(Suppl 1):S15–33.
13. Le MT, Nguyen VQH, Truong QV, Le DD, Le VNS, Cao NT. Metabolic Syndrome and Insulin Resistance Syndrome among Infertile Women with Polycystic Ovary Syndrome: A Cross-Sectional Study from Central Vietnam. Endocrinol Metab (Seoul). 2018 Dec;33(4):447–58.
14. Reyes-Muñoz E, Ortega-González C, Martínez-Cruz N, Arce-Sánchez L, Estrada-Gutierrez G, Moran C, et al. Association of obesity and overweight with the prevalence of insulin resistance, pre-diabetes and clinical-biochemical characteristics among infertile Mexican women with polycystic ovary syndrome: a cross-sectional study. BMJ Open. 2016 Jul 22;6(7):e012107.
15. Chen X, Yang D, Li L, Feng S, Wang L. Abnormal glucose tolerance in Chinese women with polycystic ovary syndrome. Human Reproduction. 2006 Aug 1;21(8):2027–32.
16. Wongwananuruk T, Rattanachaiyanont M, Indhavivadhana S, Leerasiri P, Techatraisak K, Tanmahasamut P, et al. Prevalence and clinical predictors of insulin resistance in reproductive-aged thai women with polycystic ovary syndrome. Int J Endocrinol. 2012;2012:529184.
17. Pantasri T, Vutyavanich T, Sreshthaputra O, Srisupundit K, Piromlertamorn W. Metabolic syndrome and insulin resistance in Thai women with polycystic ovary syndrome. J Med Assoc Thai. 2010 Apr;93(4):406–12.
18. Dabadghao P, Roberts BJ, Wang J, Davies MJ, Norman RJ. Glucose tolerance abnormalities in Australian women with polycystic ovary syndrome. Med J Aust. 2007 Sep 17;187(6):328–31.
19. Gambineri A, Pelusi C, Manicardi E, Vicennati V, Cacciari M, Morselli-Labate AM, et al. Glucose intolerance in a large cohort of mediterranean women with polycystic ovary syndrome: phenotype and associated factors. Diabetes. 2004 Sep;53(9):2353–8.
20. Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care. 1999 Jan 1;22(1):141–6.
21. Sharma S, Majumdar A. Prevalence of metabolic syndrome in relation to body mass index and polycystic ovarian syndrome in Indian women. J Hum Reprod Sci. 2015 Dec;8(4):202–8.
22. Zhao X, Zhong J, Mo Y, Chen X, Chen Y, Yang D. Association of biochemical hyperandrogenism with type 2 diabetes and obesity in Chinese women with polycystic ovary syndrome. Int J Gynaecol Obstet. 2010 Feb;108(2):148–51.
23. Zhao L, Zhu Z, Lou H, Zhu G, Huang W, Zhang S, et al. Polycystic ovary syndrome (PCOS) and the risk of coronary heart disease (CHD): a meta-analysis. Oncotarget. 2016 Jun 7;7(23):33715–21.
24. Mani H, Davies MJ, Bodicoat DH, Levy MJ, Gray LJ, Howlett TA, et al. Clinical characteristics of polycystic ovary syndrome: investigating differences in White and South Asian women. Clin Endocrinol (Oxf). 2015 Oct;83(4):542–9.
25. Oh J-Y, Barrett-Connor E, Wedick NM, Wingard DL, Rancho Bernardo Study. Endogenous sex hormones and the development of type 2 diabetes in older men and women: the Rancho Bernardo study. Diabetes Care. 2002 Jan;25(1):55–60.
26. Muka T, Nano J, Jaspers L, Meun C, Bramer WM, Hofman A, et al. Associations of Steroid Sex Hormones and Sex Hormone-Binding Globulin With the Risk of Type 2 Diabetes in Women: A Population-Based Cohort Study and Meta-analysis. Diabetes. 2017 Mar;66(3):577–86.
27. Legro RS, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, Pasquali R, et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013 Dec;98(12):4565–92.
28. Patel SA, Deepa M, Shivashankar R, Ali MK, Kapoor D, Gupta R, et al. Comparison of multiple obesity indices for cardiovascular disease risk classification in South Asian adults: The CARRS Study. PLoS One. 2017;12(4):e0174251.
29. Dunaif A, Xia J, Book CB, Schenker E, Tang Z. Excessive insulin receptor serine phosphorylation in cultured fibroblasts and in skeletal muscle. A potential mechanism for insulin resistance in the polycystic ovary syndrome. J Clin Invest. 1995 Aug;96(2):801–10.
30. Belani M, Deo A, Shah P, Banker M, Singal P, Gupta S. Differential insulin and steroidogenic signaling in insulin resistant and non-insulin resistant human luteinized granulosa cells-A study in PCOS patients. J Steroid Biochem Mol Biol. 2018 Apr;178:283–92.
31. Unluhizarci K, Karaca Z, Kelestimur F. Role of insulin and insulin resistance in androgen excess disorders. World J Diabetes. 2021 May 15;12(5):616–29.
32. Lee H, Oh J-Y, Sung Y-A, Chung H, Cho WY. The prevalence and risk factors for glucose intolerance in young Korean women with polycystic ovary syndrome. Endocrine. 2009 Oct;36(2):326–32.
33. Livadas S, Bothou C, Kuliczkowska-Płaksej J, Robeva R, Vryonidou A, Macut JB, et al. Can dysglycemia in OGTT be predicted by baseline parameters in patients with PCOS? Endocr Connect. 2022 Mar 1;EC-21-0358.
34. Alberti KGMM, Zimmet P, Shaw J. International Diabetes Federation: a consensus on Type 2 diabetes prevention. Diabet Med. 2007 May;24(5):451–63.
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