PCOS患者抗苗勒管激素与胰岛素代谢指标的相关性研究  

Correlations of serum anti-Müllerian hormone and insulin metabolic indexes in patients with polycystic ovary syndrome

作　　者：唐雪原 周冬梅 马雁南 朱骞 黄艳红 TANG Xueyuan;ZHOU Dongmei;MA Yannan;ZHU Qian;HUANG Yanhong(Department of Reproductive Endocrinology,Xi′an International Medical Center Hospital,Xi′an,Shaanxi 710001,China)

机构地区：[1]西安国际医学中心医院生殖内分泌科,西安710001

出　　处：《重庆医学》2022年第10期1679-1682,共4页Chongqing medicine

基　　金：陕西省重点产业创新链资助项目(2020ZDLSF03-01);西安国际医学中心医院青年课题(2021QN021)。

摘　　要：目的研究不同体重指数(BMI)的多囊卵巢综合征(PCOS)患者抗苗勒管激素(AMH)与胰岛素代谢指标的相关性。方法比较126例PCOS患者与40例同年龄段的备孕女性(对照组)血清AMH水平及其他性激素水平的差异;并根据体重指数(BMI)将PCOS患者分为非超重组(BMI<23 kg/m2)和超重组(BMI≥23 kg/m2),计量资料采用独立样本t检验,连续性数值变量间的关系应用Pearson相关分析,用多因素logistic回归分析预测胰岛素抵抗的影响因素。结果PCOS组患者的血清AMH、黄体生成素(LH)、雌二醇(E2)、睾酮(T)水平显著高于对照组,差异有统计学意义。非超重组PCOS患者的血清AMH、LH水平显著高于超重组,而血清T水平、空腹血糖、空腹胰岛素、稳态模型胰岛素抵抗指数(HOMA-IR)显著低于超重组,差异有统计学意义。Pearson相关分析显示:BMI与AMH呈负相关(r=-0.414,P<0.01),AMH与LH(r=0.346,P<0.01)、T(r=0.310,P<0.01)呈正相关,BMI与空腹血糖(r=0.431,P<0.01)、空腹胰岛素(r=0.646,P<0.01)、HOMA-IR(r=0.682,P<0.01)呈正相关。多因素logistic回归分析示:高水平的血清硫酸脱氢表雄酮(DHEAS)和高HOMA-IR是胰岛素抵抗发生的独立危险因素(OR>1,P<0.05)。结论随着PCOS患者BMI的增加胰岛素抵抗水平相应增强,血清AMH水平反而降低,而BMI并非PCOS患者胰岛素抵抗发生的独立危险因素,部分非超重型的PCOS患者也伴有胰岛素抵抗。Objective To analyze the correlations of anti-muller hormone(AMH)and insulin metabolism in the different body mass index(BMI)of the patients with polycystic ovary syndrome(PCOS).Methods The levels of serum AMH and other sex hormones were compared between 126 cases of PCOS and 40 females preparing for pregnancy in the same age group(control group).Based on BMI,the PCOS patients were divided into non-overweight group(BMI<23 kg/m2)and overweight group(BMI≥23 kg/m2).The measurement data adopted the independent ample t test,and the relationship of continuous numerical variables used the Pearson correlation analysis.The multivariate Logistic regression was used to predict the influence factors of insulin resistance.Results The levels of serum AMH,luteinizing hormone(LH),estradiol(E2)and testosterone(T)in the PCOS group were significantly higher than those in the control group,and the differences were statistically significant.The levels of serum AMH and LH in the non-overweight group were significantly higher than those in the overweight group,while the level of serum T,fasting glucose,fasting insulin,homeostasis model assessment insulin resistance index(HOMA-IR)were significantly lower than those in the overweight group,and the differences were statistically significant.The Pearson correlation analysis showed that BMI was negatively correlated with serum AMH level(r=-0.414,P<0.01),the serum AMH level was positively correlated with LH(r=0.346,P<0.01)and T(r=0.31,P<0.01),BMI was positively correlated with fasting blood glucose(r=0.431,P<0.01),fasting insulin(r=0.646,P<0.01)and HOMA-IR(r=0.682,P<0.01).The multivariate logistic regression analysis showed that the high level of serum DHEAS and high HOMA-IR were the independent risk factors for the occurrence of insulin resistance(OR>1,P<0.05).Conclusion With the BMI increase in PCOS patients,the insulin resistance level is correspondingly increased,while serum AMH level is decreased.Whereas BMI is not an independent risk factor for the occurrence of insulin resistance in

关 键 词：多囊卵巢综合征 体重指数 抗苗勒管激素 胰岛素抵抗 

分 类 号：R711.59[医药卫生—妇产科学]