多囊卵巢综合征患者游离睾酮指数水平与临床指标的相关性分析  

Correlation Analysis between Different Free Testosterone Index Levels and Clinical Characteristics of Patients with Polycystic Ovary Syndrome

作　　者：冯晓玲[1] 尹文卿 王颖[1] 侯丽辉[1] FENG Xiaoling;YIN Wenqing;WANG Ying;HOU Lihui(First Affiliated Hospital,Heilongjiang University of Chinese Medicine,Harbin 150040,China;Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学附属第一医院,黑龙江省哈尔滨市150040 [2]黑龙江中医药大学,黑龙江省哈尔滨市150040

出　　处：《中国全科医学》2023年第24期3005-3009,共5页Chinese General Practice

基　　金：国家自然科学基金青年科学基金项目(81904235);黑龙江省普通高校青年创新人才培养计划项目(UNPYSCT-2018227);黑龙江中医药大学“优秀创新人才支持计划”科研项目(2018RCQ03);黑龙江省自然科学基金资助项目(LH2022H078)。

摘　　要：背景多囊卵巢综合征(PCOS)是一种常见的生殖代谢紊乱疾病,其中高雄激素血症是POCS患者的主要临床特征,游离睾酮指数(FAI)不仅在诊断高雄激素血症中具有重要意义,并且与PCOS患者糖脂代谢等临床指标密切相关。目的探究PCOS患者FAI水平与临床指标的相关性。方法回顾性分析2019年10月—2021年6月就诊于黑龙江中医药大学附属第一医院妇科门诊的PCOS患者468例,根据FAI水平三分位数分为低FAI水平(LFAI)组(FAI≤2.57,n=156)、中水平FAI(MFAL)组(2.57<FAI≤6.70,n=156)、高水平FAI(HFAI)组(FAI>6.70,n=156);收集3组患者一般情况、性激素、糖脂代谢指标、甲状腺激素及尿酸水平的资料;采用Pearson相关分析探究3组患者FAI水平与临床特征的相关性。结果在HFAI组中,FAI与体质量(r=0.301)、BMI(r=0.318)、腰围(r=0.362)、臀围(r=0.307)、腰臀比(r=0.280)、睾酮(r=0.581)、雄烯二酮(r=0.407)、60 min葡萄糖(r=0.298)、120 min葡萄糖(r=0.279)、180 min葡萄糖(r=0.281)、空腹胰岛素(r=0.415)、60 min胰岛素(r=0.320)、120 min胰岛素(r=0.362)、180 min胰岛素(r=0.447)、稳态模型胰岛素抵抗指数(r=0.446)、尿酸(r=0.265)呈正相关(P<0.05),与性激素结合球蛋白(r=-0.486)呈负相关(P<0.05)。结论FAI水平与PCOS患者葡萄糖水平、胰岛素水平、稳态模型胰岛素抵抗指数关系密切,针对高水平FAI的PCOS患者应提高对糖脂代谢等临床指标的筛查与重视。Background Polycystic ovary syndrome(PCOS)is a common reproductive and metabolic disorder,mainly characterized by hyperandrogenemia.Free testosterone index(FAI)is not only important in the diagnosis of hyperandrogenemia but also closely associated with clinical parameters,such as glucose and lipid metabolism indexes in PCOS patients.Objective To investigate the association between different levels of FAI and the clinical characteristics of PCOS patients.Methods A total of 468 patients with PCOS who were admitted to the gynecology outpatient of the First Affiliated Hospital,Heilongjiang University of Chinese Medicine from October 2019 to June 2021 were included in the retrospective analysis and divided into the low FAI level(LFAI)group(FAI≤2.57,n=156),medium level FAI(MFAL)group(2.57<FAI≤6.70,n=156),and high level FAI(HFAI)group(FAI>6.70,n=156)according to the tertile of FAI levels.The general information,sex hormone levels,glucose and lipid metabolism levels,thyroid hormone and uric acid levels of patients in 3 groups were collected.Pearson correlation analysis was used to analyze the correlation between FAI level and clinical parameters of the patients in the three groups.Results In the HFAI group,FAI was positively correlated with body mass(r=0.301),BMI(r=0.318),waist circumference(r=0.362),hip circumference(r=0.307),WHR(r=0.280),AND(r=0.407),glucose at 60 minutes(r=0.298),glucose at 120 minutes(r=0.279),glucose at 180 minutes(r=0.281),FINS(r=0.415),insulin at 60 minutes(r=0.320),insulin at 120 minutes(r=0.362),insulin at 180 minutes(r=0.447),homeostatic model assessment of insulin resistance(HOMA-IR)(r=0.446),uric acid(r=0.265)(P<0.05),and negatively correlated with sex hormone-binding globulin(SHBG)(r=-0.486)(P<0.05).Conclusion The levels of FAI are closely related to glucose and lipid metabolism indexes in PCOS patients.Therefore,it is crucial to enhance the screening and attention to clinical parameters in PCOS patients with high FAI levels such as glucose and lipid metabolism indexes.

关 键 词：多囊卵巢综合征 睾酮 雄激素类 游离睾酮指数 甲状腺激素类 尿酸 

分 类 号：R711.75[医药卫生—妇产科学]