年龄联合腰臀比在肥胖PCOS患者合并SCH筛查的价值分析

目的研究肥胖伴多囊卵巢综合征（PCOS）患者合并亚临床甲状腺功能减退（SCH）的危险因素，并评估其筛查价值。 方法回顾性分析2021年1月1日至2021年7月1日在安徽医科大学第二附属医院减重代谢外科就诊的肥胖患者的临床资料，根据PCOS患病情况分为PCOS组和对照组，比较两组SCH患病率差异。进一步将PCOS组患者分为合并SCH组和不合并SCH组，分析患者的一般测量资料、性激素、甲状腺功能、生化等指标。 结果共纳入患者172例，其中单纯肥胖患者104例，PCOS患者68例，PCOS组中SCH的发生率显著高于对照组（36.76% vs. 17.31%；P=0.004，χ²=8.302）。多因素分析结果显示两个亚组间的年龄、腰臀比（P=0.016，OR=1.144；P=0.044，OR=10.387）具有统计学意义。受试者工作特征曲线（ROC）分析显示联合使用年龄、腰臀比可提高曲线下面积（AUC），诊断SCH的灵敏度和特异度分别为55.8%、88.0%。 结论肥胖伴PCOS患者并发SCH的风险较高，且年龄、腰臀比是独立危险因素。对于此类患者，年龄联合腰臀比监测具有较好的灵敏度与特异度，可用于肥胖合并PCOS患者并发SCH的筛查。

Analysis of the value of age combined with waist-to-hip ratio in screening obese PCOS patients with SCH.

ObjectiveTo study the risk factors of obesity and polycystic ovary syndrome (PCOS) patients with subclinical hypothyroidism (SCH), and evaluate its screening value. MethodsThe clinical data of obese patients who attended the Department of Weight Loss and Metabolism in the Second Affiliated Hospital of Anhui Medical University from January 1, 2021 to July 1, 2021 were retrospectively analyzed, according to the prevalence of PCOS, they were divided into PCOS group and control group, the differences in the prevalence of SCH between the two groups were compared. The PCOS group was further divided into combined SCH group and uncombined SCH group, and the general measurement data, sex hormones, thyroid function, biochemical indicators of all patients were analyzed. ResultsA total of 172 patients were enrolled, including 104 patients with simple obesity and 68 obese patients with PCOS. The incidence of SCH in the PCOS group was significantly higher than that in the control group (36.76% vs. 17.31%; P=0.004, χ²=8.302). The results of multivariate analysis showed that age and waist-to-hip ratio (P=0.016, OR=1.144; P=0.044, OR=10.387) were statistically significant between the two subgroups. Receiver operating characteristic curve (ROC) analysis showed that the combined use of age and waist-to-hip ratio could increase the area under the curve (AUC), and the sensitivity and specificity of diagnosing SCHwere 55.8% and 88.0%, respectively. ConclusionsObesity combined with PCOS had a higher risk of SCH, and age and waist-to-hip ratio were independent risk factors. For such patients, age combined with waist-to-hip ratio monitoring had good sensitivity and specificity, and could be used to screen obese PCOS patients with SCH.