PCOS患者治疗前后性激素的变化及其与胰岛素抵抗、肥胖的关系

目的探究多囊卵巢综合征(PCOS)患者治疗前后性激素的变化及其与胰岛素抵抗(IR)、肥胖的关系。方法回顾性选取2020年1～12月山西省儿童医院(山西省妇幼保健院)妇产科及生殖医学中心接收的80例PCOS患者作为实验组,另收集正常育龄妇女75名为对照组。其中实验组给予饮食、锻炼指导及盐酸二甲双胍和炔雌醇环丙孕酮片等基础治疗,比较实验组治疗前后与对照组相关性激素卵泡刺激素(FSH)、睾酮(T)、黄体生成素(LH)]的变化。并根据IR将实验组分为PCOS-IR组(n=49)与PCOS-非IR组(n=31),根据体重指数(BMI)将实验组分为PCOS肥胖组(BMI≥25 kg/m²,n=50)与PCOS非肥胖组(BMI≥25 kg/m²,n=30),分析性激素与IR、肥胖的关系。结果实验组治疗前FSH水平为(7.63±3.64) IU/L,显著低于对照组(10.21±5.01) IU/L],而T、LH水平为(3.18±2.01)nmol/L、(19.13±9.96) IU/L,显著高于对照组(1.05±0.55) nmol/L、(11.38±...

Changes of sex hormones in patients with PCOS before and after treatment and their relationship with insulin resistance and obesity

Objective To explore the changes of sex hormones in patients with polycystic ovary syndrome( PCOS) before and after treatment,and their relationship with insulin resistance( IR) and obesity. Methods A Total of 80 patients with PCOS admitted to the Gynecological Clinic and Reproductive Medicine Centre of Shanxi Children’s Hospital( Shanxi Maternity and Child Health Care Hospital) between January and December 2020 were selected as the experimental group. Meanwhile,75 normal women of childbearing age were retrospectively selected as the control group. Patients enrolled were given diet and exercise guidance as well as basic treatments of metformin hydrochloride and ethinylestradiol and cyproterone acetate tablets. The changes of related sex hormones follicle stimulating hormone( FSH),testosterone( T),luteinizing hormone( LH) ]in the experimental group and the control group were compared before and after treatment. According to IR,the patients were divided into PCOS-IR group( n = 49) and PCOS-non-IR group( n = 31). According to body mass index( BMI),they were divided into PCOS with obesity group( BMI≥25 kg/m²)( n = 50) and PCOS without obesity group( BMI < 25 kg/m²)( n = 30). The relationship of sex hormones with IR and obesity was analyzed. Results The level of FSH in the experimental group before treatment was( 7. 63 ± 3. 64) IU/L,which was significantly lower than that in the control group ( 10. 21 ± 5. 01) IU/L],the levels of T and LH were( 3. 18 ± 2. 01) nmol/L,( 19. 13 ± 9. 96) IU/L,which were significantly higher than those in the control group ( 1. 05 ± 0. 55) nmol/L,( 11. 38 ± 5. 57) IU/L],the differences were statistically significant( P < 0. 05). The level of FSH in the the experimental group after treatment was( 9. 65 ± 3. 84) IU/L,which was significantly higher than that before treatment,and the levels of T and LH were( 1. 62 ± 0. 98) nmol/L and( 14. 55 ± 6. 02) IU/L,which were significantly lower than before treatment,the differences were statistically significant( P < 0. 05). The level of FSH in the PCOS-IR group was( 6. 51 ± 3. 44)IU/L,which was lower than that in the PCOS-non-IR group ( 8. 22 ± 2. 25) IU/L],the levels of T and LH were( 3. 87 ± 1. 60) nmol/L,( 20. 38 ± 10. 05) IU/L,which were higher than those in the PCOS-non-IR group ( 2. 15 ± 1. 01) nmol/L,( 16. 08 ± 8. 04) IU/L],the differences were statistically significant( P < 0. 05). The level of FSH in the PCOS obese group was( 6. 74 ± 4. 01) IU/L,which was lower than that in the PCOS non-obese group ( 8. 48 ± 3. 18) IU/L],the levels of s T and LH were( 3. 18 ± 1. 79) nmol/L,( 19. 05 ± 8. 97) IU/L,which were slightly higher than those in the PCOS non-obese group ( 2. 71 ± 1. 04) nmol/L,( 17. 21 ± 8. 02) IU/L],the difference was not statistically significant( P > 0. 05). Pearson correlation analysis showed that FSH,T and LH were significantly correlated with IR( r =-1. 413,1. 550,2. 318,P < 0. 05). There was no significant correlation between T,LH and obesity( r = 0. 508,0. 613,P > 0. 05),while FSH was negatively correlated with obesity( r =-2. 305,P < 0. 05). Conclusion Patients with PCOS have more disordered sex hormones than normal people,which indicates that sex hormone disorder may be involved in the occurrence and development of PCOS. Correlation analysis finds that sex hormone levels are significantly related to obesity and IR,which indicates that assessing IR and BMI can help related treatments.