不孕妇女性激素水平与胰岛素水平关系

目的 研究血清性激素、胰岛素水平与不孕的关系。方法 筛选120名不孕妇女，其中多囊卵巢综合征（PCOS）48例，非PCOS不孕妇女72例为实验组，测定血清黄体激素（LH），睾硐（T）卵泡刺激素（FSH），雌二醇（E2），空腹胰岛素（FINS），空腹血糖（FBG），并计算出胰岛素抵抗指数（HOMA-IR）。另设50名正常生育妇女作对照组。结果 （1）不孕组血清LH、T、FINS及HOMA-IR明显增高，FSH、E2和ISI明显下降（P〈0．01）；（2）与非PCOS组比较，PCOS组FINS、LH和T明显增高，E2、ISI明显下降（P〈0．01）；LH／FSH比值也明显高于非PCOS组（P〈0．01）；（3）不孕组的血清T水平与INS，HOMA-IR及呈正相关，与ISI呈负相关（P〈0．05），E2水平与INS、HOMA-IR呈负相关，与ISI呈正相关（P〈0．05）。结论 不孕妇女血清性激素水平异常，胰岛素抵抗尤其是PCOS患者表现为高胰岛素血症，高雄激素血症。

Observation on Relationship Between Levels of Serum Sex Hormones and Insulin in Women with Infertility

Objective To understand the relationship between serum sex hormones and insulin levels in women with infertility. Methods One hundred and twenty women with infertility, including 48 cases of polycystic ovary syndrome (PCOS)and 72 cases without PCOS were enrolled in the study. The serum luteinizing hormone (LH), testosterone (T), follicular stimulating hormone (FSH), estradiol (E2), fasting insulin (FINS), and fasting blood glucose (FBG) levels were determined by enzyme linked immunoassay and glucose oxidase methods respectively, and the insulin resistance index (HOMA-IR) calculated. Additional 50 normal fertility women were served as control. Results (1) Levels of serum LH, T, FINS and HOMA-IR in infertility group were significantly increased VS. that of the control (P<0.01), but levels of serum FSH, E2 and ISI were significantly decreased. (2) When compared with non-PCOS infertility women, serum FINS, LH and T values were significntly higher in the PCOS group, levels serum E2, ISI were significantly lower (P<0.01); LH/FSH ratio was remarkably increased as compared with non-PCOS group (P<0.01). (3) In the infertility group serum T level was positive correlated with INS, HOMA-IR values, and negative correlated with ISI value (P<0.05); while serum E2 level was negative correlated with INS, HOMA-IR values, and positive correlated with ISI value (P<0.05). Conclusions The infertility women have sex hermone disturbances and insulin resistance, particularly among those with POCS accompanied with hyperinsulinemia and hyperandrogenemia that are related to infertility of POCS.