多囊卵巢综合征高雄激素血症特性研究

目的 探讨多囊卵巢综合征(PCOS)患者多项雄激素检测指标的意义及各生化参数间的相关性.方法 按ESHRE/ASRM诊断标准,选择40例PCOS为研究组,研究组依据体重指数分为肥胖组和非肥胖组,胰岛素敏感指数分为胰岛素抵抗和非胰岛素抵抗,40例正常育龄妇女为对照组,检测FSH、LH、PRL、E2、T、A4、DHEAS、FG、FIN、SHBG等指标,计算Homa-IR、ISI、FAI.结果 ①研究组中LH、LH/FSH、T、A4、FAI、FIN,Homa-IR均较对照组高,FSH、SHBG、ISI均较对照组低,P<0.05.两组间值FG、PRL、E2、DHEAS比较,P>0.05.②两组中T、FAI、A4值增高例数比较,P>0.05,DHEAS增高例数比较P<0.05.③多毛组和无多毛组T、FAI、A4值比较差异有统计学意义,P<0.05.④PCOS肥胖组与非肥胖组T、A4、DHEAS比较,P<0.05;PCOS肥胖组的FAI、Homa-IR比非肥胖组高;PCOS肥胖组的SHBG、ISI、LH/FSH明显低于非肥胖组.⑤高雄激素组胰岛素抵抗例数高于低雄激素组.⑥A4、DHEAS在PCOS胰岛素抵抗组和非胰岛素抵抗组间比较,P<0.05,FAI、T在胰岛素抵抗组较非胰岛素抵抗组高.⑦PCOS组FAI与BMI、Homa-IR统计值呈正相关,BMI与LH/FSH统计值呈负相关.结论 FAI比T、A4、DHEAS诊断PCOS敏感性更高.肥胖型PCOS患者较非肥胖型PCOS患者存在更严重的内分泌及代谢紊乱.高雄激素血症与胰岛素抵抗密切相关.

Hyperandrogenism characteristics in polycystic ovary syndrome

Objective To investigate various sex hormones and the their relation in patients with polycystic ovary syndrome (PCOS).Methods 40 patients with PCOS were matched with 40 age matched healthy women,study group was divided into the obese group and non-obese groups based on body mass index,insulin resistance and non-insulin-resistance based on insulin sensitivity index. The level of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E2), testosterone (T), androstene dione (A4), sulfal-dehydroepiandrosterone (DHEAS), sex hormone-binding globulin (SHBG), fasting glucose(FG), fasting insulin (FIN) was measured in both group. Homeostasis model assessment insulin resistance (HOMA-IR), insulin sensitivity index (ISI) and free androgen index (FAI) were caulculated. Results ①In the PCOS group,LH, LH/FSH, T, A4, FAI, FIN and Homa-IR were significantly higher compared to the control,while FSH, SHBG, ISI were significantly lower (P<0.05),PRL, FG, E2, DHEAS level did not show difference (P>0.05). ②There were significant differences in T, FAI, A4, but not in DHEAS between the PCOS group and the control one. ③There were significant differences between the hirsute group and the non-hirsute group in T, FAI, A4 (P<0.05). ④In the obese PCOS group compared to the non-obese PCOS group, T, A4, DHEAS were not significantly different, but FAI and Homa-IR were significantly higher, SHBG, ISI, LH/FSH were significantly lower. ⑤The quantity of insulin resistance in the increased T group was significantly higher compared to the common T group. ⑥In the insulin resistance group compared to the non insulin resistance group, there were not significant differences of A4、DHEAS,T and FAI was significantly higher.⑦In PCOS group,there were significant positive correlation between FAI useful parameter compared to T, A4, DHEAS for the diagnosis of PCOS. Obese PCOS women have more severe and BMI,FAI and Homa-IR;BMI and LH/FSH were significant inverse correlation. Conclusions FAI is more endocrine secretion and metabolic disturbance than non PCOS women. Hyperandrogenism and insulin resistance are consanguineous correlation.