多囊卵巢综合征与自身免疫性甲状腺炎内分泌代谢特征的相关性  

Correlation between polycystic ovary syndrome and endocrine and metabolic characteristics of autoimmune thyroiditis

作　　者：刘桂治[1] 赵红莉[2] 周旋[1] 李明友[1] 林茂锐[1] 曹东林[1] LIU Gui-zhi;ZHAO Hong-li;ZHOU Xuan;LI Ming-you;LIN Mao-rui;CAO Dong-lin(Department of Laboratory, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong 510317, China)

机构地区：[1]广东省第二人民医院检验科,广东广州510317 [2]广东省第二人民医院内分泌科,广东广州510317

出　　处：《中国临床研究》2019年第7期889-892,897,共5页Chinese Journal of Clinical Research

基　　金：广东省科学技术厅省科技计划项目(2017ZC0284)~~

摘　　要：目的研究多囊卵巢综合征(PCOS)与自身免疫性甲状腺炎(AIT)甲状腺功能、糖脂代谢、性激素等内分泌特征的相关性。方法选取2015年1月至2018年4月就诊的PCOS患者67例为对照组,选取同期PCOS伴AIT患者67例为观察组,检测两组相关指标。(1)甲状腺功能及免疫指标:血清促甲状腺激素(TSH)、总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)及甲状腺过氧化物酶抗体(Tpo-Ab)、甲状腺球蛋白抗体(Tg-Ab);(2)性激素指标:卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、催乳素(PRL)及睾酮(T);(3)脂类代谢指标:血清总胆固醇(TC)、三酰甘油(TG)、载脂蛋白A(apoA)、载脂蛋白B(apoB)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C);(4)糖代谢指标:空腹血糖(FBG)、血清空腹胰岛素(FINS)并计算稳态模型胰岛素抵抗指数(HOMA-IR);并比较两组各指标的差异。结果 PCOS伴AIT患者的血清LH、LH/FSH及PRL水平均明显高于PCOS患者,T明显低于PCOS患者(P均<0.01);而体质指数(BMI)、腰臀比(WHR)、FSH及E2水平两组间无统计学差异(P均>0.05)。PCOS伴AIT患者的TSH水平及Tpo-Ab、Tg-Ab阳性率明显高于PCOS患者(P均<0.01),而TT4和FT4水平明显低于PCOS患者(P均<0.01);TT3、FT3两组间无统计学差异(P均>0.05)。PCOS患者中Tpo-Ab阳性11例(16.42%)及Tg-Ab阳性患者8例(11.94%)。PCOS伴AIT组患者的FBG、FINS、HOMA-IR、TG、apoA及apoA/apoB水平明显高于PCOS患者(P均<0.01);TC、apoB、HDL-C及LDL-C水平两组间无统计学差异(P均>0.05);两组HOMA-IR均高于正常值。线性相关分析显示,TSH与E2、PRL、TG呈正相关关系(P均<0.01),与HDL-C呈负相关(P<0.01)。结论自身免疫性甲状腺疾病影响PCOS患者的内分泌代谢,两者关系密切,但具体机制尚需进一步深入研究。Objective To investigate the relationship between polycystic ovary syndrome ( PCOS) and endocrine and metabolic characteristics ( such as thyroid function, glucose and lipid metabolism, sex hormone and so on) of autoimmune thyroiditis ( AIT). Methods Sixty-seven patients with PCOS from January 2015 to April 2018 were selected as the control group, and 67 patients with PCOS and AIT during the same period were selected as the experimental group. The related indexes of two groups were detected.(1)Thyroid function and immune indexes:serum thyroid stimulating hormone (TSH), total triiodothyronine (TT3),total thyroxine (TT4),free triiodothyronine ( FT3),free thyroxine ( FT4),thyroid peroxidase antibody ( Tpo-Ab), thyroglobulin antibody ( Tg-Ab);( 2 ) Sex hormone indexes: follicle stimulating hormone ( FSH ), luteinizing hormone ( LH),estradiol ( E2),prolactin ( PRL) and testosterone ( T);(3 ) Lipid metabolic indicators: serum total cholesterol (TC), triglyceride ( TG), apolipoprotein A ( apoA ), apolipoprotein B ( apoB ), low density lipoprotein cholesterol ( LDL-C) and high density lipoprotein cholesterol ( HDL-C);(4) Glucose metabolic indicators:fasting glucose (FBG),fasting insulin ( FINS) and homeostasis model insulin resistance index ( HOMA-IR) were calculated. And the differences of each index were compared between two groups. Results Serum levels of LH, LH/FSH and PRL in PC OS patients with AIT were significantly higher than those in PCOS patients, while T was significantly lower than that in PCOS patients ( all P <0. 01 ). And there were no significant differences in BMI, WHR,FSH and E2 between two groups ( all P > 0. 05). The level of TSH and positive rate of Tpo-Ab and Tg-Ab in PCOS patients with AIT were significantly higher than those in PCOS patients ( all P <0. 01 ), while TT4 and FT4 were significantly lower than those in PCOS patients ( all P < 0. 01 );there were no significant differences in TT3 and FT3 between two groups ( all P > 0. 05). Among PCOS patients, 11 (16. 42%) were Tpo-Ab positive and 8 (1

关 键 词：多囊卵巢综合征 自身免疫性甲状腺疾病 甲状腺功能 性激素 糖代谢 脂类代谢 

分 类 号：R58[医药卫生—内分泌]