广东地区育龄期女性游离睾酮指数正常参考值建立  

Determing the cutoff value of free androgen index for the diagnosis of hyperandrogenemia

作　　者：赵晓苗[1] 叶扬 杨亚波[1] 谭旻 黄佳[1] 陈晓莉[1] 李琳[1] 杨冬梓[1] Zhao Xiaomiao;Ye Yang;Yang Yabo;Tan Min;Huang Jia;Chen Xiaoli;Li Lin;Yang Dongzi(Center for Reproductive Medicine,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院生殖中心,广州510120

出　　处：《中华生殖与避孕杂志》2019年第7期539-544,共6页Chinese Journal of Reproduction and Contraception

基　　金：国家自然科学基金面上项目(81771545,81471425);广东省中医药管理局重大科技项目(粤中医办函[2017]19号);2014年中山大学5010项目(2014005)。

摘　　要：目的探讨广东地区育龄期女性中高雄激素血症(HA)的游离睾酮指数(FAI)诊断界值.方法通过多级系统整群随机抽样方法,在2个城区和2个郊区的16个群体中抽出3009名在20~45岁间的女性,再通过随机方法,在抽出的样本抽取约一半的对象(n=1526).对再抽取的对象在剔除可能影响雄激素水平的因素后作为参照组(n=444)进行临床和实验室的检查.收集研究对象的临床资料,计算FAI值.用K-means聚类分析方法(K=2)和第5位及第95位百分位数确定FAI的界值.结果在参照组人群中,FAI的参考范围按第5位及第95位百分位数计算,为0.7~6.4.在总体人群中,聚类分析方法将6.1作为划分HA的界值.通过聚类分析和百分位数法观察到,FAI的诊断界值随年龄增加而下降.FAI值与年龄负相关(r=-0.185,P<0.0001),与调整年龄后的体质量指数(BMI)呈正相关(r=0.250,P<0.0001).结论FAI的参考范围为0.7~6.4,HA的FAI诊断界值为6.1.按照该界值诊断HA,伴HA的女性发生合并代谢紊乱的发病率明显增加.Objective To determine the normative cutoff value of free androgen index(FAI)among reproductive-age women in China.Methods A multistage systematic cluster random sampling was conducted by which a total sample of 3009 women aged 20-45 years were randomly selected from 16 communities in two urban and two rural regions,and about half of them(n=1526)were selected by random sampling.Among these women,444 subjects without known factors affecting androgen levels were selected as the reference group to undergo clinical and laboratory tests.Clinical data of subjects were collected and the FAI was calculated according to the following equation.The normative cutoff value of the FAI was computed based on the 5th-95th percentiles and K-means cluster analysis(K=2).Results A reference range of 0.7-6.4 of FAI was recommended by the 5th and 95th percentiles for the reference group.K-means cluster analysis identifed 6.1 as the cutovalue of FAI for the total population.The means of FAI decreased with age increasing among the total population,either evaluated by K-means or percentile analysis.The FAI value was negatively correlated with age(r=-0.185,P<0.000 1),and positively correlated with BMI(r=0.250,P<0.000 1),after the adjustment of age.Conclusion A reference range of FAI was 0.7-6.4,and the cutovalue of FAI for HA was 6.1.According to this cutoff value,the hyperandrogenic women present with higher risks for metabolic disorders.

关 键 词：高雄激素血症 游离睾酮指数 总睾酮 性激素结合球蛋白 K-means聚类分析 

分 类 号：R68[医药卫生—骨科学]