联合LC-MS和化学发光免疫法分析不同类型PCOS的雄激素水平

目的:利用液相色谱-质谱联用(LC-MS)方法和化学发光免疫分析法测定不同临床类型PCOS患者的血清雄激素水平,分析中国PCOS女性的高雄激素血症的生化特点。方法:纳入有排卵障碍和多囊卵巢的PCOS患者149例,根据血清睾酮(T)和硫酸脱氢表雄酮(DHEAS)值及F-G多毛评分情况分为两组:高雄组55例,非高雄组94例。同期选取输卵管性不孕患者82例作为对照组。化学发光法测定性激素结合球蛋白(SHBG)水平,计算游离雄激素指数(FTI)。LC-MS法测定各组血清睾酮、雄烯二酮(AD)和脱氢表雄酮(DHEA)。结果:高雄组的血清T水平及FTI值显著高于非高雄组及对照组(P0.05),非高雄组高于对照组(P0.05);高雄组、非高雄组的DHEAS及AD水平均高于对照组(P0.05);3组的DHEA水平比较,差异均无统计学意义。结论:血清T、AD、DHEAS及FTI均为诊断PCOS高雄激素血症的敏感指标;T及FTI是PCOS分型(高雄及非高雄)的主要依据;LC-MS和化学发光免疫分析法对PCOS高雄激素血症的诊断具有一致性。

Analysis of androgen levels in different types of PCOS by combined LC-MS and chemi-luminescence immunoassay

Objective:A chemiluminescent immunoassay( CI) in combination with liq-uid chromatography mass spectrometry ( LC-MS ) was used for analysis of serum androgens of women with various clinical types of polycystic ovary syndrome ( PCOS ) , and analyze the bio-chemical characteristics of hyperandrogenism in PCOS women. Methods:One hundred forty-nine PCOS patients with ovulation disorder and polycystic ovaries were recruited. According to their serum Testosterone ( T ) and dehydroepiandrosterone sulfate ( DHEAS ) determined by chemiluminescent assay and their F-G hirsutism score, the subjects were then divided into 2 subgroups:55 hyperandrogenism patients and 94 patients without hyperandrogenism. A control group was composed of 82 patients with tubal infertility. Sex hormone-binding globulin ( SHBG) levels was measured by chemiluminescent immunoassay and then free testosterone index ( FTI) was calculated. LC-MS was used to measure the levels of T, androstenedione ( AD ) and de-hydroepiandrosterone ( DHEA) . Results:Serum T and FTI in hyperandrogenic group were sig-nificantly higher than those in non-hyperandrogenic group and the control ( P<0 . 05 ) . T and FTI in non-hyperandrogenic group were significantly higher than control group ( P<0 . 05 ) . The average levels of DHEAS and AD in both PCOS group were higher than those control group ( P<0. 05). However,the DHEA levels among the 3 groups did not show any significant differ-ences. Conclusions:Based on these results,the levels of T,AD,DHEAS,and FTI in serum were specific parameters for the diagnosis of hyperandrogenism in PCOS patients. Among those pa-rameters,the T level and FTI value were important factors for subtyping of PCOS patients ( hy-perandrogenic or non-hyperandrogenic type) . The LC-MS based method showed agreement with chemiluminescent immunoassay on the diagnosis of hyperandrogenism in PCOS patients.