【摘要】 目的 探讨青年女性痤疮患者并发胰岛素抵抗的临床、生化特征及诊断价值。方法连续收集65例并发胰岛素抵抗的患者（胰岛素抵抗组），130例单纯痤疮患者，50例健康对照者。对所有受试者进行详细的体格、代谢和性激素检查。结果 胰岛素抵抗组患者的痤疮严重程度显著高于单纯痤疮组，胸背部皮损显著加重（P <0.05）。胰岛素抵抗组患者的糖尿病家族史（56.9%）显著高于单纯痤疮组患者（27.7%），且体重、体质指数、腰围、三酰甘油、三酰甘油/高密度脂蛋白比值、三酰甘油葡萄糖指数、垂体泌乳素均显著高于其他两组（P <0.05）。腰围和三酰甘油是胰岛素抵抗的独立相关因素，三酰甘油葡萄糖指数对女性痤疮患者中胰岛素抵抗的诊断价值最高。结论 并发胰岛素抵抗的青年女性痤疮患者皮损有加重倾向，尤其是胸背部皮损较重。中心型肥胖，糖尿病家族史，糖、脂代谢异常等特征对早期识别痤疮患者中的胰岛素抵抗具有重要意义。更多还原

【Abstract】 Objective To explore the clinical, metabolic and endocrine characteristics and evaluate the diagnostic value of acne patients with insulin resistance(IR). Methods 65 acne patients with IR(the IR group), 130 simple acne patients and 50 age-matched healthy individuals consecutively were recruited. Physical, biochemical and endocrinological examinations were conducted on all the subjects.Results We found that acne patients with IR tended to have severer acne especially severer lesions on chest/upper back compared with simple acne patients(P< 0.05). A higher prevalence of family diabetes history(56.9%) was seen in acne patients with IR than simple acne patients(27.7%). Besides, higher levels of weight, body mass index(BMI), waist circumference(WC), triglycerides(TG), TG/HDL-C ratio,triglycerides glucose(TyG) index and plasma prolactin were also seen in female acne patients with IR compared with the other two groups.WC and TG were independent factors correlating to IR(P<0.05). ROC analysis shows that TyG index had the best diagnostic value for IR in female acne patients. Conclusion Female acne patients with IR have the characteristics of severer acne especially on chest/upper back,central obesity, positive family diabetes history and glucose/lipid metabolic abnormalities, which are useful for the early diagnosis of acne patients with IR.更多还原