多囊卵巢综合征患者促甲状腺激素水平与代谢综合征相关性探讨

目的:探讨多囊卵巢综合征(PCOS)患者促甲状腺激素(TSH)水平及代谢综合征(MS)各项指标的相关性。方法:回顾性分析育龄期PCOS患者512例,分析TSH水平为0~7 mU/L的MS检出率及TSH与MS各项指标[腰围(WC)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、胰岛素抵抗指数(HOMA-IR)]的相关性,应用ROC曲线寻找预测MS的TSH临界值,并以此为截断值分两组,对MS的各项指标进行比较。结果:①随着P-COS患者的TSH水平(0~7 mU/L)升高,其MS发生率增加。②PCOS患者的TSH水平与WC、SBP、DBP、FPG、HOMA-IR、TG均呈正相关(r>0,P<0.05),与HDL-C呈负相关(r<0,P<0.05);其中TSH水平与WC及HDL-C为线性相关;合并MS的PCOS患者中,TSH水平仅与HDL-C呈负相关(r=-0.128,P<0.05)。③以TSH=2.43 mU/L为截断值时,预测MS的灵敏度和特异度最高,分别为77.7%和64.1%。④TSH≥2.43 mU/L组的WC、FPG、HOME-IR、SBP、DBP水平与TSH<2.43 mU/L组比较,差异有统计学意义(P<0.05)。结论:PCOS患者的TSH水平与MS各项指标均有相关性,合并MS的PCOS患者HDL-C的相关性更高,TSH并不能作为预测PCOS患者是否合并MS的独立因素,但临床医生应更加关注TSH超过2.43 mU/L的PCOS患者。

The Relationship between TSH Level and Metabolic Syndrome in Patients with PCOS

Objective:To investigate the correlation between thyroid stimulating hormone(TSH)level and metabolic syndrome(MS)in patients with polycystic ovary syndrome(PCOS).Methods:A retrospective analysis of 512 patients with PCOS at reproductive age was performed.The detection rate of MS with TSH level between 0-7mU/L was calculated.The relationship between TSH and MS indicators including waist circumference(WC),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FPG),high-density lipopro-tein cholesterol(HDL-C),triglyceride(TG),insulin resistance index(HOMA-IR)were analyzed.The TSH thresh-old for prediction of MS was determined using the ROC curve.Two groups were divided according to the cutoff value and the indicators of MS were compared.Results:①The incidence of MS increased with the increase of TSH level(0-7mU/L)in patients with PCOS;②The TSH level of patients with PCOS was positively correlated with WC,SBP,DBP,FPG,HOMA-IR and TG(r>0,P<0.05),and negatively correlated with HDL-C(r<0,P<0.05).Linear correlation was observed between WC,HDL-C and TSH level.TSH levels were only negatively correlated with HDL-C in patients with PCOS and MS(r=-0.128,P<0.05).③When TSH=2.43 mU/L was used as the cut-off point,the sensitivity and specificity of MS prediction were 77.7%and 64.1%,respectively.④The levels of WC,FPG,HOME-IR,SBP and DBP in TSH≥2.43 mU/L group were higher than those in TSH<2.43 mU/L group(P<0.05).Conclusions:The TSH level of patients with PCOS is correlated with the parameters of MS.The correlation of HDL-C in PCOS patients with MS is higher.TSH could not be used as an independent factor to predict MS in patients with PCOS.Still,clinicians should pay more attention to PCOS patients with TSH level over 2.43 mU/L.