多囊卵巢综合征患者促甲状腺激素浓度与血脂关系的研究

目的研究不同浓度血清促甲状腺激素（thyroid-stimulating hormone,TSH）的多囊卵巢综合征（polycystic ovary syndrome,PCOS）患者临床特征及内分泌代谢指标之间的差异。方法选择110例多囊卵巢综合征患者,测量身高、体质量、腰围、臀围;应用化学发光法分析测定血清TSH、总胆固醇（total cholesterol,TC）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol,LDL-C）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol,HDL-C）、三酰甘油（triglycerides,TG）、空腹血糖（fasting blood glucose,FBG）、空腹胰岛素（fasting serum insulin,INS）、卵泡刺激素（follicle stimulating hormone,FSH）、黄体生成素（luteinizing hormone,LH）、睾酮（testosterone,T）、催乳素（prolactin,PRL）、雌二醇（estrogen,E2）;计算体质量指数（body mass index,BMI）、腰臀比（waist hip ratio,WHR）、黄体生成素与卵泡刺激素的比值（LH-to-FSH ratio,LH/FSH）;采用稳态模型评估的胰岛素抵抗指数（homeostasis model assessment insulin resistance,HOMA-IR）,按血清TSH浓度将其分为2组：A组71例,TSH0.05）。结论 TSH与脂代谢指标有相关性,TSH≥2.5 mIu/L的PCOS患者,脂代谢发生了显著的变化。

Association between thyroid-stimulating hormone and serum lipid in patients with polycystic ovary syndrome

Objective To investigate the differences in clinical features , endocrine metabolic parameters of polycystic ovary syndrome patients with different levels of serum thyroid-stimulating hormone .Methods One hundred and ten PCOS patients were enrolled . Height , weight , waist circumference , hip circumferences were measured . Chemiluminescence was applied for measuring thyroid-stimulating hormone（TSH）, total cholesterol（TC）, low density lipoprotein（LDL）, high density lipoprotein（HDL）, triglyceride（TG）, fasting blood-glucose（FBG）, fasting insulin（INS）, follicle-stimulating hormone（FSH）, luteinizing hormone（LH）, testosterone（T）, prolactin（PRL） and estradiol（E2）;Body mass index（BMI）, waist-to-hip circumference ratio（WHR）, LH-to-FSH ratio（LH/FSH） were calculated;The insulin resistance index evaluated by steady-state model （ HOMA-IR）;all patients were divided into two groups according to serum thyroid-stimulating hormone：group A had 71 cases with TSH〈2.5 mIu/L, as group B of 39 cases with TSH≥2.5 mIu/L; all the hormone parameters mentioned above were compared between group A and B , and the correlation with TSH .Results The WHR and LDL in group B（TSH≥2.5 mIu/L） is significantly higher than that of the patients in group A （TSH〈2.5 mIu/L）.The increase of TSH concentration positively correlates to an increase of WHR , TC, LDL-C and PRL.No significant differences are shown in other clinical and＆amp;nbsp;metabolic indicators.Conclusion There was a significant correlation between TSH and lipid metabolic parameters .Women with polycystic ovary syndrome and with thyroid-stimulating hormone≥2.5 mIu/L had significantly endocrine and metabolic changes .