不同年龄多囊卵巢综合征患者性激素结合球蛋白与激素指标、血脂指标的相关性  

Correlation of sex hormone binding globulin with hormone indicators and blood lipid indicators in patients of different ages with polycystic ovary syndrome

作　　者：王鑫[1,2] 张晓冬[1,2] 赵丽娟 邹洋[1] 杨文荣[2,3] 高选 温红玲[2] WANG Xin;ZHANG Xiaodong;ZHAO Lijuan;ZOU Yang;YANG Wenrong;GAO Xuan;WEN Hongling(Center for Research in Reproductive Medicine of Shandong University/National Engineering Research Center for Assisted Reproduction and Eugenics/Ministry of Education Key Laboratory of Reproductive Endocrinology(Shandong University),Jinan,Shandong 250001,China;School of Public Health,Shandong University,Jinan,Shandong 250012,China;Department of Clinical Nutrition,Tai′an Central Hospital,Tai′an,Shandong 271000,China)

机构地区：[1]山东大学生殖医学研究中心/国家辅助生殖与优生工程技术研究中心/生殖内分泌教育部重点实验室(山东大学),山东济南250001 [2]山东大学公共卫生学院,山东济南250012 [3]泰安市中心医院临床营养科,山东泰安271000

出　　处：《检验医学与临床》2021年第4期454-458,共5页Laboratory Medicine and Clinic

基　　金：山东省医药卫生科技发展计划项目(2017WS206)。

摘　　要：目的分年龄阶段探讨多囊卵巢综合征(PCOS)患者血清性激素结合球蛋白(SHBG)与空腹胰岛素(FINS)、硫酸脱氢表雄酮(DHEA-S)及血脂指标的相关性。方法回顾性分析2017年1月1日至2019年8月30日在山东大学生殖医学研究中心就诊的3349例PCOS患者的FINS、性激素和血脂指标,按照SHBG的参考值下限(32.4 nmol/L)分为SHBG低值组(SHBG<32.4 nmol/L,n=1780)和SHBG高值组(SHBG≥32.4 nmol/L,n=1569),并且分别对每组进行年龄分层(<25岁、25~<30岁、30~<35岁、≥35岁)研究,分析其血清SHBG、FINS、DHEA-S及血脂指标特征。结果在<25岁、25~<30岁、30~<35岁几个年龄阶段PCOS患者中,SHBG低值组患者FINS、DHEA-S水平明显高于SHBG高值组患者,差异有统计学意义(P<0.05);且随着年龄的增长,SHBG低值组中FINS及两组中DHEA-S呈现递减趋势(P<0.05)。在<25岁、25~<30岁、30~<35岁几个年龄阶段PCOS患者中,SHBG低值组患者总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDLC)水平明显高于SHBG高值组患者,差异有统计学意义(P<0.05);SHBG低值组患者高密度脂蛋白胆固醇(HDLC)水平明显低于SHBG高值组患者,差异有统计学意义(P<0.05);且两组TC、TG、LDLC随着年龄的增长呈现递增趋势(P<0.05)。<25岁、25~<30岁和30~<35岁PCOS患者血清SHBG水平与HDLC呈正相关(P<0.05),而与FINS、DHEA-S、TC、TG、LDLC呈负相关(P<0.05)。结论PCOS患者SHBG与FINS、DHEA-S及血脂指标关系密切,SHBG水平的变化也可以作为FINS、DHEA-S和血脂变化的提示指标,为临床提早诊断及及时治疗PCOS提供重要的参考依据。Objective To investigate the correlation between serum sex hormone binding globulin(SHBG)and fasting insulin(FINS),dehydroepiandrosterone sulfate(DHEA-S)and blood lipid indicators in woman with polycystic ovary syndrome(PCOS)at different ages.Methods Retrospective analysis was performed on the data of sex hormones and blood lipid of 3349 PCOS patients treated at the Center for Research in Reproductive Medicine of Shandong University from January 1,2017 to August 30,2019.According to the lower limit of the reference value of SHBG concentration(32.4 nmol/L),the patients were divided into SHBG low-level group(SHBG<32.4 nmol/L,n=1780)and SHBG high-level group(SHBG≥32.4 nmol/L,n=1569),and each group was stratified by age(<25 years old,25—<30 years old,30—<35 years old,≥35 years old),the serum SHBG,FINS,DHEA-S and blood lipid indicators were detected and statistically analyzed.Results In the age range<25 years old,25-<30 years old,30-<35 years old,the FINS and DHEA-S concentrations in SHBG low-level group were significantly higher than those in SHBG high-level group(P<0.05),there was a decreasing trend with age on FINS in SHBG low-level group,on DHEA-S in the two groups(P<0.05).In the age range<25 years old,25-<30 years old,30-<35 years old,the concentrations of total cholesterol(TC),triacylglycerol(TG)and low density lipoprotein cholesterol(LDLC)in SHBG low-level group were significantly higher than those in SHBG high-level group(P<0.05).High density lipoprotein cholesterol(HDLC)level in SHBG low-level group was significantly lower than that in SHBG high-level group(P<0.05),the TC,TG,LDLC in the two groups showed an increasing trend with age(P<0.05).Correlation analysis showed that in the age range<25 years old,25-<30 years old,30-<35 year old,serum SHBG level positively correlated with HDLC level,and negatively correlated with FINS,DHEA-S,TC,TG and LDLC levels(P<0.05).Conclusion The level of SHBG in PCOS patients closely related to the levels of FINS and DHEA-S,and it also related to blood lipid indicators,ch

关 键 词：多囊卵巢综合征 性激素结合球蛋白 空腹胰岛素 硫酸脱氢表雄酮 血脂 年龄 

分 类 号：R446.1[医药卫生—诊断学]