血清睾酮、性激素结合球蛋白预测多囊卵巢综合征并发妊娠期糖尿病的价值分析  

Analysis of the value of serum testosterone and sex hormone binding globulin in predicting polycystic ovary syndrome complicated with gestational diabetes mellitus

作　　者：李文静 钟群[2] LI Wenjing;ZHONG Qun(Department of Laboratory Medicine,Beijing Shunyi Maternal and Child Health Hospital(Shunyi Women’s and Chidren’s Hospital of Beijing Chidren’s Hospital),Beijing 101300,China;Department of Laboratory Medicine,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京市顺义区妇幼保健院(北京儿童医院顺义妇儿医院)检验科,北京101300 [2]北京大学第三医院检验科,北京100191

出　　处：《中国性科学》2021年第6期104-107,共4页Chinese Journal of Human Sexuality

摘　　要：目的探究血清睾酮(T)、性激素结合球蛋白(SHBG)对多囊卵巢综合征(PCOS)并发妊娠期糖尿病(GDM)的预测价值。方法选取2016年6月至2019年6月北京市顺义区妇幼保健院妇产科诊断为PCOS,经后续规范化治疗后妊娠并分娩的162例孕妇作为研究对象。其中并发GDM孕妇纳入GDM组(n=80),未并发GDM孕妇纳入非GDM组(n=82)。分别检测血清T、空腹胰岛素(FINS)、空腹血糖(FBG)、SHBG水平,利用稳态模型(HOMA)计算胰岛素抵抗指数(IR)。采用受试者操作特征(ROC)曲线评估血清T、SHBG对PCOS合并GDM患者的预测价值。结果 GDM组患者孕期增加体重高于非GDM组(P<0.05);与非GDM组比较,GDM组血清T、HOMA-IR水平均升高(P<0.05),SHBG水平降低(P<0.05);ROC曲线显示,血清T、SHBG诊断PCOS合并GDM的曲线下面积(AUC)分别为0.742、0.904,两者联合诊断的AUC为0.931。Logistic回归分析显示,孕期增加体重、HOMA-IR、T和SHBG水平是影响PCOS患者妊娠期并发GDM的危险因素。结论血清T水平升高、SHBG水平降低与PCOS患者妊娠期并发GDM有关,血清T、SHBG对PCOS并发GDM孕妇均有一定的诊断价值,且两者联用诊断价值更高。Objective To explore the predictive value of serum testosterone(T) and sex hormone binding globulin(SHBG) for polycystic ovary syndrome(PCOS) complicated with gestational diabetes mellitus(GDM). Methods From June 2016 to June 2019, 162 pregnant women who were diagnosed with PCOS in the Department of Obstetrics and Gynecology, Beijing Shunyi Maternal and Child Health Hospital, and who became pregnant and gave birth after follow-up standardized treatment were selected as the research objects. Among them, pregnant women with complicated GDM were included in the GDM group(n=80), and pregnant women without GDM were included in the non-GDM group(n=82). The levels of serum T, fasting insulin(FINS), fasting blood glucose(FBG), and SHBG were measured, and the insulin resistance index(IR) was calculated with homeostasis model(HOMA). The value of serum T and SHBG in patients with PCOS complicated with GDM was predicted with receiver operating characteristic curve(ROC). Results The gestational weight gain in GDM group was higher than that in non GDM group(P<0.05). Compared with those in non GDM group, the levels of serum T and HOMA-IR in GDM group were higher(P<0.05), and the level of SHBG was lower(P<0.05). ROC results showed that the area under the curve(AUC) of serum T and SHBG in diagnosing PCOS complicated with GDM was 0.742 and 0.904, the AUC of the combined diagnosis was 0.931. Logistic regression analysis showed that gestational weight gain, HOMA-IR, T and SHBG levels were risk factors for GDM in PCOS patients during pregnancy. Conclusions The increase of serum T level and the decrease of SHBG level are related to GDM in PCOS patients. Serum T and SHBG have certain diagnostic value for pregnant women with PCOS complicated with GDM, and the combination of the two has a higher diagnostic value.

关 键 词：睾酮 性激素结合球蛋白 多囊卵巢综合征 妊娠期糖尿病 

分 类 号：R711[医药卫生—妇产科学]