游离睾酮指数与伴高雄激素血症的多囊卵巢综合征的相关性研究

Correlation of free androgen index and polycentric ovary syndrome with hyperandrogenism

目的探讨多囊卵巢综合征(polycentric ovary syndrome,PCOS)患者雄激素指标总睾酮(testos-terone,T)、游离睾酮(free testosterone,FT)、游离睾酮指数(free androgen index,FAI)诊断PCOS患者高雄激素血症的敏感性和准确性,分析雄激素指标与多毛、痤疮的相关性。方法选择符合鹿特丹标准、未经治疗的PCOS患者120例,采用改良Ferriman Gallwey(mFG)多毛评分方法和痤疮综合分级系统(global acne grading system,GAGS)进行多毛、痤疮评分,测定身高、体重、性激素、性激素结合球蛋白(sex hormone-binding globulin,SHBG)和游离睾酮,计算游离睾酮指数。结果 FAI诊断高雄激素血症比T、FT敏感(74.7%和32.7%、22.2%),FAI与多毛的符合率显著高于T、FT(68%和40.8%、45.6%),mFG总分与T存在显著相关性(r=0.182,P=0.027);GAGS总分与各雄激素指标均无显著相关性。结论 FAI可作为诊断PCOS高雄激素血症的敏感及准确性指标,此检测方法比较简单、快速,适合在临床推广。

Objective To explore the value of total testosterone（T）,free testosterone（FT） and free androgen index（FAI） for the diagnosis of hyperandrogenism in polycentric ovary syndrome（PCOS） patients and analyse the correlation of sexual hormones,hirsutism and acne.Methods Height,weight,sexual hormones,sex hormone-binding globulin（SHBG） and free testosterone（FT） were collected from 120 patients with untreated PCOS according to Rotterdam PCOS consensus.Hirsutism was evaluated according to global acne grading system（GAGS） and acne was evaluated according to Ferriman Gallwey（mFG）.T,FT and FAI were counted and used to assess the sensitivity of hyperandrogenemia.Results Compared with T and FT,FAI was more sensitive for the diagnosis of hyperandrogenemia（74.7% vs 32.7%,22.2%） and hirsutism（68% vs 40.8%,45.6%）.The analysis results of mFG and T indicated that both correlated significantly（r=0.182,P=0.027）,but there was no significant correlation between GAGS and sexual hormones.Conclusion FAI is accuracy and sensitivity for the diagnosis of hyperandrogenism in PCOS patients,and it is deserved to be used in clinical diagnosis.