多囊卵巢综合征患者胆汁酸代谢、性激素水平分析  

Analysis on bile acid metabolism and sex hormone levels of patients with polycystic ovary syndrome

作　　者：尹馨 缑灵山 顾茂胜 廖明明 YIN Xin;GOU Lingshan;GU Maosheng;LIAO Mingming(Department of Medical Genetics and Prenatal Diagnosis,Xuzhou Maternal and Child Health Hospital Affiliated to Xuzhou Medical University,Xuzhou 221009,China)

机构地区：[1]徐州医科大学附属徐州妇幼保健院医学遗传与产前诊断科,221009

出　　处：《浙江医学》2024年第15期1613-1617,I0004,共6页Zhejiang Medical Journal

基　　金：徐州市科技局基础研究计划面上项目(KC21061);徐州医科大学附属医院发展基金资助项目(XYFY202325);徐州市医学重点人才项目(XWRCHT20220060)。

摘　　要：目的分析多囊卵巢综合征(PCOS)患者胆汁酸代谢特征,并探讨其与性激素水平的关系。方法回顾性选取2023年1至6月在徐州市妇幼保健院进行健康检查的PCOS患者54例(PCOS组),另择同期来院进行健康检查的正常对照女性53名为对照组。研究对象于月经第2~5天,留取上午空腹肘静脉血检测性激素、胆汁酸代谢物水平。比较两组血清性激素、胆汁酸代谢物水平,并通过建立正交偏最小二乘判别分析(OPLS-DA)模型,寻找两组差异性胆汁酸;分析差异性胆汁酸与性激素的相关性。结果PCOS组患者血清抗米勒管激素、促黄体生成素、促黄体生成素/卵泡生成素、雄激素睾酮(T)和脱氢表雄酮硫酸酯(DHEAS)水平均高于对照组(均P<0.05)。与对照组比较,PCOS组患者血清初级游离胆汁酸鹅脱氧胆酸水平增加(P<0.05),次级结合胆汁酸甘氨脱氧胆酸(GDCA)和甘氨石胆酸水平均降低(均P<0.05)。通过OPLS-DA模型找到两组差异性最强的胆汁酸为GDCA,相关性分析显示GDCA与T、DHEAS均呈负相关(rs=-0.363、-0.342,均P<0.05)。结论PCOS患者存在胆汁酸代谢紊乱和性激素水平异常,且GDCA与PCOS高雄激素症状密切相关。Objective To analyze the characteristics of bile acid metabolism in patients with polycystic ovary syndrome(PCOS)and explore its relationship with sex hormone levels.Methods Fifty-four PCOS patients(PCOS group)who underwent health examination in Xuzhou Maternal and Child Health Hospital from January to June 2023 were selected,while another 53 healthy females who underwent health examination during the same period were selected as the control group.On the 2-5 days of menstruation,fasting elbow venous blood was collected in the morning to detect the levels of sex hormones and bile acid metabolites.The levels of serum sex hormones and bile acid metabolites were compared between the two groups,and the difference of bile acids between the two groups was detected by establishing an orthogonal partial least squares discriminant analysis(OPLS-DA)model.The correlation between the difference of bile acids and sex hormones was analyzed.Results The levels of serum anti-mullerian hormone,luteinizing hormone,luteinizing hormone/follicle-stimulating hormone,testosterone(T)and dehydroepiandrosterone sulfate(DHEAS)in the PCOS group were higher than those of the control group(all P<0.05).Compared with the control group,the levels of serum primary free bile acid chenodeoxycholic acid in PCOS group were increased(P<0.05),while the levels of secondary conjugated bile acids glycodeoxycholic acid(GDCA)and glycolithocholic acid in PCOS group were decreased(both P<0.05).The difference of bile acids between the two groups was found by OPLS-DA model as GDCA,and the correlation analysis showed that GDCA was negatively correlated with T and DHEAS(rs=-0.363,-0.342,respectively,both P<0.05).Conclusion Patients with PCOS have bile acid metabolism disorder and abnormal sex hormone levels,and GDCA is closely related to hyperandrogenic symptoms of PCOS.

关 键 词：多囊卵巢综合征 胆汁酸 高雄激素 甘氨脱氧胆酸 

分 类 号：R711.75[医药卫生—妇产科学]