多囊卵巢综合征患者血清雄烯二酮水平与其代谢特征的关系  

Relationship between serum androstendione level of patients with PCOS and its metabolic characteristics

作　　者：王全先[1] 刘军杰[1] 孙鑫涛 宋作哲 WANG Quan-xian, LIU Jun-jie, SUN Xin-tao, SONG Zuo-zhe(Department of Human Sperm Bank, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou , Henan 450052, Chin)

机构地区：[1]郑州大学第三附属医院人类精子库,河南郑州450052

出　　处：《热带医学杂志》2018年第3期371-376,共6页Journal of Tropical Medicine

基　　金：河南省医学科技攻关计划项目(201503046)

摘　　要：目的探讨多囊卵巢综合征(PCOS)患者血清雄烯二酮(A2)水平与其代谢特征之间的相关性。方法选取2016年2月至2017年2月本院收治的76例符合鹿特丹诊断标准的PCOS患者为研究对象,以3.8 ng/m L为A2参考阳性临界值,将76例患者分为低A2组(A2≤3.8 ng/m L)(31例),高A2组(A2>3.8 ng/m L)(45例),同期选取68例月经规律健康女性作为正常对照组,应用全自动生化分析仪检测两组血糖、血脂指标,应用放射免疫分析法检测空腹胰岛素(FINS)水平,采用胰岛素稳态模型评估法(HOMA)计算胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(HOMA-ISI),应用化学发光免疫分析法检测血清A2、促卵泡刺激素(FSH)、黄体生成素(LH)、催乳素(PRL)、总睾酮(TT)、雄激素结合球蛋白(SHBG)、硫酸脱氢表雄酮(DHEAS),计算游离睾酮指数(FAI)。结果 PCOS组与对照组年龄、收缩压(SBP)、舒张压(DBP)、体质指数(BMI)比较,差异无统计学意义(P>0.05)。PCOS组与对照组空腹血糖(FPG)、餐后2h血糖(2h PG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、HOMA-ISI水平比较,差异无统计学意义(P>0.05);PCOS组甘油三酯(TG)、总胆固醇(TC)、FINS、HOMA-IR明显高于对照组,差异有统计学意义(P<0.05);PCOS组A2、LH/FSH、PRL、TT、DHEAS、FAI水平明显高于对照组(P<0.05),SHBG水平明显低于对照组(P<0.05)。高A2组与低A2组年龄、SBP、DBP、BMI、FPG、2h PG、TC、LDL-C、LH/FSH、DHEAS水平比较,差异无统计学意义(P>0.05);高A2组FINS、HOMA-IR、TG、PRL、TT、A2、FAI明显高于低A2组,HDL-C、SHBG、HOMA-ISI明显低于低A2组,差异均有统计学意义(P<0.05)。相关性分析结果显示,A2与POCS患者FINS、TT、FAI呈明显正相关(r=0.312、0.523、0.354,P<0.05),与HDL-C、SHBG呈明显负相关(r=-0.341、-0.216,P<0.05);多因素回归分析结果显示,FINS、FAI、HDL-C是PCOS血清A2的独立影响因素。结论 A2表达与PCOS患者内分泌及代谢紊乱密切相关,早期诊Objective To investigate the correlation between serum androstenedione （A2） levels and metabolic characteristics in patients with polycystie ovary syndrome （PCOS）. Methods 76 cases of patients with PCOS met Rotterdam diagnostic criteria were selected as the subjects. With 3,8 ng/mL as the A2 reference positive critical value, 76 cases of patients were divided into low A2 group （A2≤3.8 ng/mL） （31 cases） and high A2 group （A2〉3.8 ng/mL） （45 cases ）. 68 cases of healthy women in menstrual patterns in the same period were selected as the normal control group. Blood glucose and blood lipids indicators were detected by using automatic biochemical analyzer; fasting insulin （FINS） level was tested by using radioimmunoassay ; insulin resistance index （ HOMA-IR ） and insulin sensitivity index （ HOMA- ISI ） were calculated by using insulin homeostasis model assessment （HOMA）. Serum A2, follicle stimulating hormone （FSH）, luteinizing hormone （LH）, prolactin （PRL）, total testosterone （TT）, androgen binding globulin （SHBG） and dehydroepiandrosterone sulfate （DHEAS） were detected by using chemiluminescence immunoassay, and free testosterone index （FAI） were calculated. Results There was no significant difference in age, systolic blood pressure （SBP）, diastolicblood pressure （DBP） and body mass index （BMI） between PCOS group and control group （P〉0.05）. There was no statistically significant difference in fasting plasma glucose （FPG）, 2 hours postprandial plasma glucose （2hPG）, high density lipoprotein cholesterol （HDL-C）, Low density lipoprotein cholesterol （LDL-C）, HOMA-ISI levels between PCOS group and control group （P〉0.05）. Triglyceride （TG）, total cholesterol （TC）, FINS, HOMA-IR levels in PCOS group were significantly higher than those in the control group （P〈0.05）. A2, LH/FSH, PRL, TT, DHEAS and FAI levels of PCOS group were obviously higher than those of the control group （P〈0.05）, and SHBG l

关 键 词：多囊卵巢综合征 雄烯二酮 内分泌 代谢特征 

分 类 号：R711.75[医药卫生—妇产科学]