与代谢异常相关的异子宫出血修改代谢紊乱是身体的一种状态是机体对物质的消化、吸收、排泄出现病理性、不协调的供需不平衡的状态可以表现为一种物质也可以表现为多种物质的紊乱高血糖症与糖尿病9某大学妇产科医院就诊的314例患者，包括56例子宫内膜无序增殖（DPE），194例子宫内膜增生（EH），25例I型子宫内膜癌（ⅠEC）表1各组子宫内膜病理改变子宫内膜癌存在胰岛素受体的过度表达及活化、胰岛素受体底物-1的过度活化，并与不良临床病理特征相关胰岛素样生长因子1（IGF-1）有很强的刺激子宫内膜增殖的作用张艳芳，韩玉良等多囊卵巢综合征子宫内膜病变与胰岛素PI3K/AKT、MAPK了ERK信号通路的相关研究，肥胖是导致胰岛素抵抗最主要的原因，尤其是中心性肥胖表1各组子宫内膜病理改变妇科恶性肿瘤保留生育功能临床诊治指南蛋白激酶C、糖原合成酶激酶-3糖代谢异常主要为胰岛素抵抗（IR）及高胰岛素血症长期高血糖、高游离脂肪酸血症、某些药物如糖皮质激素、某些微量元素缺乏如铬和钒缺乏、妊娠和体内胰岛素拮抗激素增多等CancerEpidemiolBiomarkersPrev,,17(4):921-929.多囊卵巢综合症与子宫内膜病变糖代谢紊乱：高血糖症与糖尿病低血糖症酮症半乳糖血症```````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````什么是胰岛素抵抗与高胰岛素血症？胰岛素抵抗是指各种原因使胰岛素促进葡萄糖摄取和利用的效率下降，机体代偿性的分泌过多胰岛素产生高胰岛素血症，以维持血糖的稳定。胰岛素抵抗易导致代谢综合征和2型糖尿病全国糖尿病防治组测算的胰岛素抵抗指数判定为胰岛素抵抗（HOMA-IR=空腹胰岛素×空腹血糖／22.5）高胰岛素血症：空腹胰岛素≥85pmol/Lpmol/L胰岛素异常子宫出血（AUB）月经出血超过正常的频率、规律性、持续时间与出血量称为异常子宫出血（即月经失调）FIGOAUB病因PALM—COEIN系统研究表明与代谢异常相关的妇科疾病多囊卵巢综合症（PCOS）与代谢异常多囊卵巢综合症与子宫内膜病变PCOS中IR与子宫内膜病理改变PCOS高发内膜病变的因素胰岛素抵抗(重要原因)胰岛素样生长因子参与内膜病变雌激素的长期作用病变内膜上基因表达异常肥胖(仅次于胰岛素抵抗)子宫内膜癌与胰岛素抵抗姜艳华，孙立新，陈咏健，等F胰岛素及其受体与人类子宫内膜异常增生的关系22例分析中国实用妇科与产科杂志多囊卵巢综合症（PCOS）与代谢异常[11]刘雪，付译漫等多囊卵巢综合征与子宫内膜病变相关性探讨其他方法：GnRH-i；华绍芳，薛凤霞教授胰岛素/PI3K/Aki信号传导通路与子宫内膜癌发生关系的研究肥胖是导致胰岛素抵抗最主要的原因，尤其是中心性肥胖半乳糖血症单伟伟，罗雪珍等代谢异常与子宫内膜增生性病变的关系子宫内膜癌存在胰岛素受体的过度表达及活化、胰岛素受体底物-1的过度活化，并与不良临床病理特征相关血脂改变主要有甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白-胆固醇(LDL-C)极低密度脂蛋白-胆固醇(VLDL-C)和载脂蛋白（apoB）升高；Burzawa等对99例子宫内膜癌患者进行了前瞻性研究Prosp