多囊卵巢综合征患者血清抗苗勒管激素与胰岛素抵抗水平的关系  

Relationship between serum anti-Müllerian hormone and insulin resistance of patients with polycystic ovarian syndrome

作　　者：徐玲[1,2] 牛志宏[1] 李雁[1] 程美玉[1] 冯云 

机构地区：[1]上海交通大学医学院附属瑞金医院生殖医学中心,上海200025 [2]上海交通大学医学院附属仁济医院嘉定分院妇产科,上海201800

出　　处：《上海交通大学学报（医学版）》2014年第6期859-863,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海交通大学医学院附属仁济医院嘉定分院院级课题(YYKYXM 2012-12-01)~~

摘　　要：目的探讨多囊卵巢综合征(PCOS)患者血清抗苗勒管激素(AMH)与胰岛素抵抗(IR)程度的相关性。方法选择PCOS患者49例为实验组,以月经周期规则的输卵管性不孕患者50例作为对照组。在PCOS组内,以稳态模型胰岛素抵抗指数(HOMA-IR)的中位数(2.97)为标准,将PCOS患者分为高HOMA-IR组(n=25)和低HOMA-IR组(n=24);另按体质量指数(BMI)将PCOS患者分为超重组(BMI≥23 kg/m2,n=25)和非超重组(BMI<23 kg/m2,n=24)。测定患者血清AMH、生殖激素及糖代谢指标水平,并进行组间比较;分析AMH水平与HOMA-IR的关系。结果 PCOS组患者的血清AMH、黄体化激素(LH)、LH/促卵泡激素(FSH)、睾丸素(T)、空腹胰岛素(INS)及HOMA-IR均显著高于对照组,差异有统计学意义(P<0.05)。高HOMA-IR组患者的血清AMH水平高于低HOMA-IR组,差异有统计学意义(P<0.05);PCOS组患者的HOMA-IR与血清AMH水平呈正相关(r=0.53,P<0.01);超重组的HOMA-IR和血清T水平均显著高于非超重组,差异有统计学意义(P<0.05)。结论 PCOS患者的血清AMH水平升高,其升高与体质量无关,与IR水平正相关。Objective To investigate the correlation between the serum anti-Müllerian hormone （AMH） and the insulin resistance （IR） for patients with polycystic ovarian syndrome （PCOS）. Methods Forty-nine patients who were diagnosed as PCOS were selected as the experimental group and 50 patients with tubal infertility and regular menstruation were selected as the control group. Patients with PCOS were divided into the high HOMA-IR group （n=25） and low HOMA-IR group （n=24） based on the median of homeostasis model assessment insulin resistance （HOMA-IR）index. Patients with PCOS were also divided into the overweight group （n=25, BMI≥23 kg/m2） and non-overweight group （n=24, BMI〈23 kg/m2） based on the body mass index （BMI）. Levels of serum AMH, reproductive hormones, and sugar metabolism indicators of patients were measured and comparisons among groups were conducted. The relationship between the level of AMH and HOMAIR was analyzed. Results The levels of serum AMH, luteinizing hormone （LH）, LH/follicle-stimulating hormone （FSH）, testosterone （T）, INS, and HOMA-IR of the experimental group were significantly higher than those of the control group. The differences were statistically significant （P〈0.05）. The levels of serum AMH of the high HOMA-IR group were higher than those of the low HOMA-IR group. The differences were statistically significant （P〈0.05）. The HOMA-IR and the level of serum AMH of the experimental group were positively correlated （r=0.53, P〈0.01）. The HOMA-IR and the level of serum T of the overweight group were significantly higher than those of the non-overweight group. The differences were statistically significant （P〈0.05）. Conclusion The level of serum AMH of patients with PCOS significantly increases. The increase is irrelevant to BMI and is positively correlated to the level of IR.

关 键 词：多囊卵巢综合征 抗苗勒管激素 胰岛素抵抗 

分 类 号：R711.75[医药卫生—妇产科学]