2026 年第 9 期 第 21 卷

相关指数与多囊卵巢综合征患者胰岛素抵抗和预后的关系研究

Study on the relationship between related indices and insulin resistance as well as prognosis in patients with polycystic ovary syndrome

作者：王婧1陈华英2韩莉莉1

英文作者：Wang Jing1 Chen Huaying2 Han Lili1

单位：1新疆维吾尔自治区人民医院妇科，乌鲁木齐830000；2新疆维吾尔自治区伊犁哈萨克自治州妇幼保健院妇科，伊宁835000

英文单位：1Department of Gynecology People′s Hospital of Xinjiang Uygur Autonomous Region Urumqi 830000 China; 2Department of Gynecology Maternity and Child Healthcare Hospital of Ili Kazakh Autonomous Prefecture Xinjiang Uygur Autonomous Region Yining 835000 China

关键词：多囊卵巢综合征；C反应蛋白-甘油三酯-葡萄糖指数；炎症负担指数；胰岛素抵抗

英文关键词：Polycysticovarysyndrome;C-reactiveprotein-triglyceride-glucoseindex;Inflammatoryburdenindex;Insulinresistance

• 摘要：

• 目的 探讨C反应蛋白-甘油三酯-葡萄糖指数（CTI）、炎症负担指数（IBI）与多囊卵巢综合征（PCOS）患者胰岛素抵抗（IR）和预后的关系。方法 回顾性分析2023年1月至2024年5月在新疆维吾尔自治区人民医院治疗的171例PCOS患者（PCOS组）的资料，另收集同期体检健康女性171例（对照组）资料。计算CTI、IBI和稳态模型IR指数（HOMA-IR），Spearman相关分析PCOS患者CTI、IBI与HOMA-IR的相关性。依据随访12个月患者预后情况分为预后良好组（107例）和预后不良组（64例）。分析PCOS患者预后的影响因素及CTI、IBI对预后的预测效能。结果 PCOS组CTI、IBI、HOMA-IR均高于对照组（均P＜0.001）。PCOS患者CTI、IBI与HOMA-IR均呈正相关（rs＝0.695、0.579，均P＜0.001）。预后不良组黄体生成素与促卵泡生成素比值、睾酮、抗米勒管激素（AMH）、HOMA-IR、CTI、IBI均高于预后良好组（均P＜0.05）。多因素Logistic回归分析显示睾酮升高、AMH升高、HOMA-IR升高、CTI升高、IBI升高均为PCOS患者预后不良的独立危险因素（比值比=1.711、2.821、1.976、1.680、1.031，均P＜0.05）。CTI、IBI及二者联合预测PCOS患者预后的曲线下面积分别为0.818、0.795、0.890，二者联合预测的效能大于CTI、IBI单独预测（均P<0.05）。结论 PCOS患者CTI、IBI升高，与IR加重及预后不良密切相关，CTI、IBI联合对预后的预测效能较高，有助于PCOS患者预后评估。

• Objective To investigate the relationships of C-reactive protein-triglyceride-glucose index (CTI) and inflammatory burden index (IBI) with insulin resistance (IR) and prognosis in patients with polycystic ovary syndrome (PCOS). Methods Clinical data of 171 PCOS patients (PCOS group) treated in People′s Hospital of Xinjiang Uygur Autonomous Region from January 2023 to May 2024 were retrospectively analyzed, and data of 171 healthy women receiving physical examination during the same period were collected as control group. CTI, IBI and homeostatic model assessment for insulin resistance (HOMA-IR) were calculated. Spearman correlation analysis was performed to analyze the correlations of CTI and IBI with HOMA-IR in PCOS patients. According to the 12-month follow-up outcomes, PCOS patients were divided into good prognosis group (107 cases) and poor prognosis group (64 cases). Influencing factors for prognosis of PCOS patients and the predictive efficacy of CTI and IBI on prognosis were analyzed. Results CTI, IBI and HOMA-IR in the PCOS group were all higher than those in the control group (all P＜0.001). CTI and IBI were positively correlated with HOMA-IR in PCOS patients (rs=0.695, 0.579, both P＜0.001). The luteinizing hormone/follicle-stimulating hormone ratio, testosterone, anti-Müllerian hormone (AMH), HOMA-IR, CTI and IBI in the poor prognosis group were higher than those in the good prognosis group (all P＜0.05). Multivariate Logistic regression analysis showed that elevated testosterone, elevated AMH, elevated HOMA-IR, elevated CTI and elevated IBI were independent risk factors for poor prognosis in PCOS patients (odds ratio=1.711, 2.821, 1.976, 1.680, 1.031, all P＜0.05). The area under the curve of CTI, IBI and their combination for predicting the prognosis of PCOS patients were 0.818, 0.795 and 0.890 respectively, and the predictive efficacy of combined detection was superior to that of single CTI or IBI detection (both P<0.05). Conclusions Increased CTI and IBI are closely associated with aggravated IR and poor prognosis in PCOS patients. The combined detection of CTI and IBI presents high predictive efficacy, which facilitates prognostic assessment for PCOS patients.