多囊性卵巢综合征患者AMH水平与内分泌代谢异常的相关性研究

目的分析抗苗勒管激素(AMH)水平在多囊卵巢综合征(PCOS)患者中与内分泌代谢异常之间的关系。方法选取2014年1月至2015年12月临床上确诊为PCOS的200例患者为试验组,以及同期因输卵管因素不孕的180例患者作为对照组,试验组据AMH水平分为高AHM组(AMH≥10ng/mL,n=98)和低AMH组(AMH10ng/mL,n=102);将根据稳态模型胰岛素抵抗指数(HOMA-IR)分为高HOMA-IR组(HOMA-IR≥2.97,n=108)和低HOMA-IR组(HOMA-IR2.97,n=92)。测定各组卵泡刺激素(FSH)、AMH、雌二醇(E2)、黄体生成素(LH)、空腹血糖(FPG)、空腹胰岛素(INS)、睾酮(T)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL),计算HOMA-IR,比较各组内分泌代谢指标差异,分析AMH水平的影响因素。结果对照组AMH、HOMA-IR、LH、T均显著低于试验组(P0.05),体质量指数(BMI)高于试验组(P0.05)。高AMH组BMI、HOMA-IR均显著低于低AMH组(P0.05)。高HOMA-IR组与低HOMA-IR组间LH和T水平差异均无统计学意义(P0.05),高HOMA-IR组AMH、INS、BMI水平均显著高于低HOMA-IR组,差异有统计学意义(P0.05)。结论 PCOS患者AMH显著升高,且AMH与BMI、HOMA-IR负相关,与T呈正相关。

Study on the relationship between AMH level and abnormal endocrine metabolism in patients with polycystic ovary syndrome

Objective To analyze the relationship between anti Mullerian hormone (AMH) levels and abnormal endocrine metab-olism in patients with polycystic ovary syndrome (PCOS) .Methods From January 2014 to December 2015 ,a total of 200 PCOS pa-tients were recruited into experimental group ,180 infertility patients causing by tubal disorder were selected into the control group . According to the level of AMH ,PCOS patients were divided into high AHM group(AMH=10 ng/mL ,98 cases) and low AMH group (AMH<10 ng/mL ,102 cases) .According to the index of insulin resistance(HOMA) ,PCOS patients were divided into high HOMA group(HOMA index=2 .97 ,108 cases) ,and low HOMA group (HOMA index <2 .97 ,92 cases) .Follicle stimulating hor-mone(FSH) ,serum AMH ,estradiol ,luteinizing hormone(LH) ,fasting blood glucose and fasting insulin ,testosterone(T) ,high den-sity lipoprotein(HDL) ,low density lipoprotein(LDL) were detected ,the level of insulin resistance(factor HOMA-IR were calculat-ed ,then internal secretion metabolic differences and the effect of AMH were analyzed .Results The AMH ,HOMA-IR ,LH ,T in the control group were significantly lower than those in the experimental group(P<0 .05) ,body mass index(BMI) in the control group was significantly higher than that in the experimental group(P<0 .05) .BMI ,HOMA-IR in the high AMH group were sig-nificantly lower than those in the low AMH group(P<0 .05) .There were no significant differences on LH and T between the high AMH group and low AMH group (P>0 .05) .AMH ,INS ,BMI in the high AMH group were higher than those in the low AMH group(P<0 .05) .Conclusion AMH in patients with PCOS increased significantly ,and AMH was negatively correlated with BMI and HOMA-IR ,and positively correlated with testosterone .