多囊卵巢综合征患者高雄激素的相关性研究

Correlation of hyperandrogenism with insulin resistance and serum luteinizing hormone in the patients with polycystic ovary syndrome

目的研究多囊卵巢综合征(Polycystic ovary syndrome,PCOS)患者高雄激素临床表现及其与胰岛素抵抗(IR)、高黄体生成素(LH)血症的相关关系及其意义。方法 100例PCOS患者以空腹胰岛素水平≥15 mIU/L为高胰岛素血症(hy-perinsulinemia,HI)标准,按年龄、体重指数配对原则将其分为HI-PCOS组和non-HI-PCOS组各50例,分别进行多毛评分并测定卵泡早期血清性激素水平、空腹葡萄糖及胰岛素水平,计算胰岛素抵抗指数(HOMA-IR),对2组患者血生化参数进行比较并进行相关性分析。结果 HI-PCOS组患者多毛评分与血清T水平与LH/FSH及HOMA-IR呈正相关(r=0.925,r=0.731,r=0.721,P<0.05);non-HI-PCOS组患者多毛评分与血清T水平及LH/FSH呈正相关(r=0.899,r=0.814,P<0.05),与HOMA-IR无相关性;两组LH/FSH与HOMA-IR均无相关性。结论 PCOS的HI及LH血症均与高雄激素关系密切,PCOS患者中LH/FSH与IR无相关关系,提示高LH/FSH与IR在PCOS患者中可能是相互独立存在的。

Objective The aim of this study was to explore the relationship and significance ol hyperandrogenlsm with inSUlin resistance and serum luteinizing hormone in patients with polycystic ovary syndrome （PCOS）. Methods One hundred patients with P- COS were classified as HI-PCOS （ n = 50 ） or non-HI-PCOS （ n = 50） based on the present or absent of HI （ fasting insulin level 〉 15 mIU/ L） , age-and body index-matched. Crinosity score and serum levels of gonadotropins, ovarian steroids, glucose and insulin were deter- mined. Insulin resistance index （HOMA-IR） was calculated. The association of serum androgen levels with HOMA-IR and LH/FSH were analyzed in the two groups,respectively. Results The Crinosity score and serum testosterone were positively correlated with LH/FSH and HOMA-IR in the HI-PCOS group. Crinosity score and serum testosterone was positively correlated with LI4/FSH but not correlated with HOMA-IR in the non-HI-PCOS group. There was no correlation between LH/FSH and HOMA-IR in either HI-PCOS group or non- HI-PCOS group. Conclusion Hyperandrogenism is associated with both hyperinsulinemia and raised LH level in PCOS patients. Since there is no correlation between LH/FSH and HOMA-IR suggesting that hyperinsulinemia and LH are perhaps taking effect independently in PCOS patient.