性激素结合球蛋白在多囊卵巢综合征患者中的变化及与其他指标的关系

目的: 探讨性激素结合球蛋白（SHBG）在多囊卵巢综合征（PCOS）患者血清中的变化及与其他内分泌指标的关系。方法: 选择58例PCOS患者分为PCOS-IR组30例、PCOS-NIR组28例，30例健康育龄期妇女为对照组。比较PCOS-IR组、PCOS-NIR组患者SHBG、空腹血糖（FPG）、空腹胰岛素（FINS）、睾酮（T）、雌二醇（E2）、泌乳素（PRL）、卵泡刺激素（FSH）、黄体生成素（LH）水平以及HOMA-IR、LH/FSH、FTI的值与对照组的差异，并用Spearman相关分析法分别分析SHBG与其他指标的相关性。结果:PCOS-IR组及PCOS-NIR组患者的SHBG、FINS、HOMA-IR、 LH、T、LH/FSH及FTI与对照组比较差异有统计学意义（P<0.01）；PCOS-IR组及PCOS-NIR组患者的FPG与对照组比较无统计学意义（P>0.05）。PCOS-IR组与PCOS-NIR组患者相比SHBG、FINS、HOMA-IR及FTI差异有统计学意义（P<0.01），PCOS-IR组与PCOS-NIR组患者相比各项性激素指标比较无统计学意义（P>0.05）。SHBG与FINS、T、FTI、HOMA-IR呈负相关(r值分别为: -0.519、-0.513、-0.592、-0.588，均P<0.01)，而SHBG与FPG、LH/FSH(r=-0.292，P>0.05)、LH/FSH(r=-0.124，P>0.05)并无相关性。结论: PCOS患者与对照组相比SHBG降低，FINS、T、FTI、HOMA-IR、LH、LH/FSH升高；且SHBG与FINS、T、FTI、HOMA-IR呈负相关，提示低水平SHBG是预防和治疗PCOS的重要实验指标。

Changes of SHBG in patients with polycystic ovary syndrome and their relationship with other indicators

Objective : To investigate the changes of serum sex hormone binding globulin （SHBG ）and its correlation with other endocrine parameters in patients with polycystic ovary syndrome (PCOS). Methods: Fifty-eight patients with PCOS were selected and divided into PCOS-IR group 30 cases, PCOS-NIR group 28 cases and 30 cases of healthy women as control group. The levels of SHBG, FPG, FINS, T, E2, PRL, FSH, LH in serum and the value of HOMA-IR and LH/FSH were compared between PCOS-IR, PCOS-NIR and normal control, the correlation between SHBG and FPG, FINS, T, HOMA-IR, LH/FSH were analyzed by Spearman correlation. Results: The levels of serum SHBG, FINS, T, FTI, LH and the value of HOMA-IR, LH/FSH and FTI for the PCOS-IR group and PCOS-NIR group had significant difference from those for the control group(P all<0.01). Levels of serum FPG, E2, PRL, FSH were not higher in the PCOS-IR group and PCOS-NIR group than that in the control group (P>0.05). The levels of SHBG, FINS, HOMA-IR and FTI for the PCOS-IR group had significant difference from those for the PCOS-NIR group (P all<0.01). Compared with the PCOS-NIR group, all sex hormone indexes of PCOS-IR group had no statistical significance (P>0.05). There were negative correlations between SHBG and FINS, T, FTI and HOMA-IR in the PCOS group(r=-0.519，-0.513，0.592，-0.588，P all<0.01). But there was no correlation between SHBG and FPG, LH/FSH(r=-0.292，-0.124，P all>0.05). Conclusion: Patients who have diagnosed with PCOS show lower level of serum SHBG and higher levels of FINS, T, FTI, HOMA-IR, LH, LH/FSH than the control group. SHBG may have negative correlation with FINS, T, FTI and HOMA-IR in the PCOS group. The low level of SHBG may be an important experiment basis to predict and treat PCOS.