超18万人研究发现:避孕药或降低多囊卵巢综合征女性患 2 型糖尿病的风险

2021-10-19 K.K MedSci原创

每10名妇女中就有一名患有多囊卵巢综合症,这是一种终身的代谢紊乱疾病,找到减少其相关健康风险的方法是极其重要的。

多囊卵巢综合症影响着世界上10%的妇女,从长远来看还与其他一些疾病有关,如子宫内膜癌、血管疾病和非酒精相关脂肪肝(NAFLD)。

多囊卵巢综合症的症状包括月经不调或无月经,可能会导致生育问题,许多人遭受"多毛症",脱发以及油性皮肤或痤疮,这些症状是由血液中高水平的雄激素引起的。

患有多囊卵巢综合症的妇女还经常与体重增加作斗争,她们体内的细胞对胰岛素的反应往往较差,其中胰岛素是使身体吸收葡萄糖进入人体细胞以获得能量的激素。对胰岛素反应的减少可能导致血糖水平升高,并导致身体制造更多的胰岛素,这反过来又导致身体产生更多的雄激素。

近日,伯明翰大学领导的一项研究首次揭示,避孕药可以将患有多囊卵巢综合症(PCOS)的妇女患2型糖尿病的风险降低四分之一以上。研究发表在《Diabetes Care 》上。研究结果还显示,患有多囊卵巢综合症的妇女患2型糖尿病或血糖异常的风险是正常人的两倍。

Balachandran Kumarendran et al, Polycystic Ovary Syndrome, Combined Oral Contraceptives, and the Risk of Dysglycemia: A Population-Based Cohort Study With a Nested Pharmacoepidemiological Case-Control Study, Diabetes Care (2021). DOI: 10.2337/dc21-0437

科学家进行了两项研究,首先是确定患有多囊卵巢综合症的妇女患2型糖尿病和糖尿病前期的风险,其次是研究联合使用口服避孕药对多囊卵巢综合症妇女患2型糖尿病、糖尿病前期风险的影响。研究人员纳入英国64051名患有多囊卵巢综合症妇女和123545名无多囊卵巢综合症的妇女,进行了一项基于大型队列研究,分析了2型糖尿病和糖尿病前期的风险。

他们发现,与没有多囊卵巢综合症的妇女相比,多囊卵巢综合症的妇女患2型糖尿病或糖尿病前期的风险是其2倍。而多毛症、雄激素高是2型糖尿病和糖尿病前期的一个重要风险因素。

为了研究避孕药对2型糖尿病或糖尿病前期的影响,研究人员对4814名患有多囊卵巢综合症的妇女进行了进一步病例对照研究。科学家们发现,使用联合口服避孕药能使患有多囊卵巢综合症的妇女患2型糖尿病和糖尿病前期的几率降低26%。

伯明翰大学研究所所长Wiebke Arlt教授说:"我们已经从过去的小型研究中得知,患有多囊卵巢综合症的妇女患2型糖尿病的风险增加。现在,我们已经能够从一个非常大的人口研究中提供新的证据,首次表明我们有一个潜在的治疗选择,联合口服避孕药来预防这种非常严重的健康风险。"

健康科学大学临床副教授Michael O'Reilly博士补充说:"我们假设,避孕药通过抑制雄激素来降低患糖尿病的风险。这种作用如何?该药片含有雌激素,能增加血液中一种叫做性激素结合球蛋白(SHBG)的蛋白质。SHBG与雄激素结合,使其失去活性。因此,如果服用避孕药,SHBG会增加,这减少了活性雄激素的数量,降低了患疾病风险。”

伯明翰大学第一作者Anuradhaa Subramanian补充说:"每10名妇女中就有一名患有多囊卵巢综合症,这是一种终身的代谢紊乱疾病,找到减少其相关健康风险的方法是极其重要的。"

伯明翰大学应用健康研究所教授Krish Nirantharakumar补充说:"数据还强调,多囊卵巢综合症的正常体重女性也面临2型糖尿病和糖尿病前期的风险增加。这与之前发现的患有多囊卵巢综合症的正常体重妇女的非酒精性脂肪肝风险增加相类似,进一步挑战了多囊卵巢综合症相关的代谢并发症只与肥胖有关的观点。这些数据表明,肥胖可能是多囊卵巢综合症的特定因素。"

参考资料:

Balachandran Kumarendran et al, Polycystic Ovary Syndrome, Combined Oral Contraceptives, and the Risk of Dysglycemia: A Population-Based Cohort Study With a Nested Pharmacoepidemiological Case-Control Study, Diabetes Care (2021). DOI: 10.2337/dc21-0437

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    2022-01-13 尹乔

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    0

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    2021-10-19 14665f9am03暂无昵称

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    2021-10-19 谭桂峰

    希望有针对性药物研发

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1753614, encodeId=2c8b1e53614f3, content=<a href='/topic/show?id=6a57e33772b' target=_blank style='color:#2F92EE;'>#研究发现#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73377, encryptionId=6a57e33772b, topicName=研究发现)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7e1736602208, createdName=hanhaisha2020, createdTime=Sun May 01 02:47:03 CST 2022, time=2022-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1183892, encodeId=e334118389237, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/07/28/dc0a622c5c75f55fb8c848c04ece3cdc.jpg, createdBy=916d2333311, createdName=尹乔, createdTime=Thu Jan 13 15:11:53 CST 2022, time=2022-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1718451, encodeId=15a71e1845123, content=<a href='/topic/show?id=5ce04315043' target=_blank style='color:#2F92EE;'>#多囊卵巢#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43150, encryptionId=5ce04315043, topicName=多囊卵巢)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Fri Mar 11 21:47:03 CST 2022, time=2022-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1432166, encodeId=6de614321666b, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Wed Oct 20 05:47:03 CST 2021, time=2021-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061848, encodeId=0ce910618484f, content=学习到, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/07/06/95275c4ca065065e4f37aad1bc1e360b.jpg, createdBy=0d2a5135634, createdName=14665f9am03暂无昵称, createdTime=Tue Oct 19 15:20:29 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061795, encodeId=9a6e1061e9519, content=希望有针对性药物研发, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=谭桂峰, createdTime=Tue Oct 19 12:20:36 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061554, encodeId=5e8a10615549b, content=<a href='/topic/show?id=800d4315123' target=_blank style='color:#2F92EE;'>#多囊卵巢综合征#</a>,<a href='/topic/show?id=ce9d239823b' target=_blank style='color:#2F92EE;'>#二甲双胍#</a>是不错的选择,避孕药也可以考虑。, beContent=null, objectType=article, channel=null, level=null, likeNumber=198, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43151, encryptionId=800d4315123, topicName=多囊卵巢综合征), TopicDto(id=23982, encryptionId=ce9d239823b, topicName=二甲双胍)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=医者仁者, createdTime=Mon Oct 18 18:08:39 CST 2021, time=2021-10-18, status=1, ipAttribution=)]
    2021-10-18 医者仁者

    #多囊卵巢综合征##二甲双胍#是不错的选择,避孕药也可以考虑。

    0

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