多囊卵巢综合征伴和不伴高雄激素血症的患者临床表型及内分泌代谢指标比较  

Clinical phenotype and endocrine metabolic parameters in polycystic ovary syndrome patients with and without hyperandrogenemia

作　　者：刘巧蕊[1] 洪洁[1] 迟贞旎[1] 顾卫琼[1] 张翼飞[1] 晏群[1] 张豫文[1] 苏玉霞[1] 李小英[1] 宁光[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院内分泌科上海市内分泌代谢病临床中心,上海200025

出　　处：《诊断学理论与实践》2009年第3期264-268,共5页Journal of Diagnostics Concepts & Practice

摘　　要：目的:总结分析多囊卵巢综合征(PCOS)患者的内分泌代谢特征,并比较PCOS伴高雄激素血症(PCOS/HA)患者与PCOS不伴高雄激素血症(PCOS/NHA)患者间的临床表型、内分泌代谢差异。方法:选择未经治疗的PCOS患者241例和正常女性对照者50例,测定其身高、体重、体脂含量、腰围、臀围、血压、血脂、血糖、血清胰岛素及性激素水平,并行卵巢超声检查,采用稳态模型法评估胰岛素抵抗指数(HOMA-IR)及胰岛β细胞功能(HOMA-β)。结果:①PCOS患者较正常女性对照者有更高的体质指数(BMI)、体脂含量、血糖、胰岛素、HOMA-IR、HOMA-β、血脂水平及性激素紊乱(P<0.05)。②PCOS/HA组患者的血清黄体生成素(LH)、总睾酮(T)、硫酸脱氢表雄酮(DHEA-S)水平较PCOS/NHA组显著升高,而其卵泡刺激素(FSH)则显著降低,差异有统计学意义(P<0.05)。③体重正常的PCOS/NHA患者的空腹胰岛素(FINS)水平、HOMA-IR、HOMA-β较体重正常的PCOS/HA患者显著升高[7.2(6.0～21.1)mU/L比6.3(3.9～9.6)mU/L,P<0.05;1.5(1.2～5.1)比1.4(0.8～2.0),P<0.05;130.0(102.8～304.0)比97.0(63.7～168.0),P<0.05]。结论:相比正常女性对照者,PCOS患者表现为有显著升高的血糖、血清胰岛素、血脂水平及性激素代谢紊乱、胰岛素抵抗(IR)。体重正常的PCOS/NHA患者较体重正常的PCOS/HA患者IR更严重,其胰岛β细胞功能也较体重正常的PCOS/HA患者低。Objective To analyze the endocrine and metabolic characteristics of polycystic ovary syndrome（PCOS） and compare the clinical phenotype and endocrine metabolic parameters between PCOS patients with hyperandrogemia （PCOS/HA） and without hyperandrogemia （PCOS/NHA）. Methods Two hundred and forty-one patients with PCOS who had not been treated and fifty healthy controls were enrolled. Height, weight, fat content （fat %）, blood pressure, waist circumferences and hip circumferences were measured and recorded. Fasting blood samples were collected for measuring serum lipids, blood glucose, serum insulin and sex hormones. Homeostasis model of insulin resistance （HOMA-IR） and pancreatic β cell function （HOMA-β） were also assessed. Results Body mass index （BMI）, fat content, blood glucose, insulin, lipid in PCOS patients were significantly higher than that in controls. Luteinizing hormone （LH）, total testosterone （T） dehydroepiandrosterone sulfate （DHEA-S） and disturbance of sex hormone in PCOS/HA patients were significantly higher than that in PCOS/NHA patients, whereas follicular-stimulating hormone （FSH） was significantly lower （P〈0.05）. Normal body weight PCOS/NHA patients had higher fasting insulin [7.2（6.0-21.1） vs 6.3（3.9-9.6） mU/L, P〈0.05], HOMA-IR [1.5（1.2-5.1） vs 1.4（0.8-2.0）, P〈0.05] and HOMA-β [130.0（102.8-304.0） vs 97.0（63.7-168.0）, P〈0.05] than normal body weight PCOS/ HA patients. Conclusions PCOS patients have significantly higher body mass index and blood glucose, serum lipids profile, insulin resistance and disturbance of sex hormone than the control group. Normal body weight PCOS/NHA patients have more severe insulin resistance and impaired islet β cell function than normal body weight PCOS/HA patients.

关 键 词：多囊卵巢综合征 高雄激素血症 胰岛素抵抗 

分 类 号：R587[医药卫生—内分泌]