PCOS患者AMH水平与性激素及胰岛素抵抗的相关性研究  

Correlation of AMH level with sex hormones and insulin resistance in patients with PCOS

作　　者：周杨[1] 王晓琳 贺永艳 曹杨 吕淑兰[2] ZHOU Yang;WANG Xiaolin;HE Yongyan;CAO Yang;LYU Shulan(Department of Gynaecology,Affiliated Hospital of Northwestern Polytechnical University,Shaanxi Xi'an 710072,China;Department of Obstetrics and Gynaecology,The First Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Xi'an 710061,China)

机构地区：[1]西北工业大学医院妇科,陕西西安710072 [2]西安交通大学第一附属医院妇产科,陕西西安710061

出　　处：《中国妇幼健康研究》2022年第1期49-54,共6页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨多囊卵巢综合征(PCOS)患者血清抗苗勒管激素(AMH)水平与性激素及胰岛素抵抗(IR)的相关性。方法选取2019年1月至12月在西安交通大学第一附属医院妇科内分泌门诊及西北工业大学医院妇科确诊的PCOS患者109例,测定患者血清AMH、性激素水平,应用稳态模型评估胰岛素抵抗指数(HOMA-IR),分析PCOS患者不同AMH水平的性激素及IR值的差异,以及性激素、IR对AMH的影响。结果对PCOS患者,根据血清AMH检测值按百分位(<25%,25%~75%,>75%)进行分层,随着AMH百分位逐渐升高,体质量指数(BMI)、HOMA-IR值均降低(F值分别为3.354、3.712,P<0.05),同时黄体生成素(LH)、睾酮(T)值均升高(F值分别为3.355、3.317,P<0.05)。相关性分析显示,血清AMH水平与BMI、HOMA-IR均呈显著负相关(r分别为-0.228、-0.214,P<0.05),与LH、T均呈显著正相关(r分别为0.344、0.327,P<0.01)。进一步多元回归分析显示,在控制BMI后,LH及T对AMH存在显著正向影响(β=0.258,P<0.05;β=0.291,P<0.01)。结论PCOS患者血清AMH水平与LH、T均呈正相关,其与HOMA-IR的负相关关系可以由BMI解释。Objective To investigate the correlation between serum anti-Müllerian hormone(AMH) and sex hormones and insulin resistance(IR) in patients with polycystic ovary syndrome(PCOS).Methods A total of 109 patients, who were diagnosed as PCOS in the Gynecological Endocrinology Clinic of the First Affiliated Hospital of Xi′an Jiaotong Universityand the Department of Gynaecology of the Affiliated Hospital of Northwestern Polytechnical University from January to December 2019,were selected.Serum AMH and sex hormones levels of patients were measured and the homeostatic model assessment for insulin resistance(HOMA-IR) was applied.The differences of sex hormones and IR values in different AMH levels of PCOS patients were analyzed, as well as the effects of sex hormones and IR on AMH.Results Patients with PCOS were stratified according to the AMH percentiles(<25%,25%-75% and>75%).As the AMH percentiles gradually increased, body mass idex(BMI) and HOMA-IR values decreased(F=3.354 and 3.712,respectively, P<0.05),while luteinizing hormone(LH) and testosterone(T) values increased(F=3.355 and 3.317,respectively, P<0.05).Correlation analysis showed significant negative correlations between AMH and BMI and HOMA-IR(r=-0.228 and-0.214,respectively, P<0.05) and significant positive correlations with LH and T(r=0.344 and 0.327,respectively, P<0.01).Further multivariate regression analysis showed significant positive effects of LH and T on AMH after controlling the BMI(β=0.258,P<0.05;β=0.291,P<0.01).Conclusion The level of serum AMH in patients with PCOS is positively correlated with LH and T,and the negative correlation between AMH and HOMA-IR could be explained by BMI.

关 键 词：多囊卵巢综合征 抗苗勒管激素 性激素 胰岛素抵抗 体质量指数 

分 类 号：R711[医药卫生—妇产科学]