多囊卵巢综合征患者胰岛素抵抗与高雄激素血症的分析研究

Research of insulin resistance and hyperandrogenism of polycystic ovarian syndrome

目的探讨多囊卵巢综合征(PCOS)患者胰岛素抵抗与雄激素水平增高的实验室检查最优指标以及两者的相关性分析。方法选择49例PCOS患者为研究组,22例健康育龄妇女为对照组,检测睾酮(T)、性激素结合球蛋白(SHBG)、硫酸脱氢表雄酮(DHEA-S),进行口服糖耐量试验(OGTT)及胰岛素释放试验,计算胰岛素抵抗指数(HOMA-IR)、游离雄激素指数(FAI)。结果 (1)PCOS组与对照组之间,DHEA-S比较差异无统计学意义(P>0.05),T及FAI指数PCOS组高于对照组(P<0.05),SHBG值PCOS组低于对照组(P<0.05)。(2)PCOS组中按FAI≥3.32和FAI<3.32分两组,在30、60、120min时两组胰岛素水平的差异有统计学意义(P<0.05)。(3)PCOS组HOMA-IR和FAI均与服糖后的时间呈正相关(P<0.05)。结论 FAI作为PCOS的诊断指标具有更高的灵敏度;HOMA-IR联合120min胰岛素水平评估PCOS患者胰岛素抵抗更简便、省时;胰岛素抵抗与高雄激素血症密切相关。

Objective To explore the relevance between the insulin resistence and the high level of androgen in patients with polycystic ovary syndrome（PCOS）and to explore the best index of the laboratory examination of them.Methods 49 patients with PCOS were considered as study group and 22 normal women of child-bearing age were considered as control group.Testosterone（T）,sex-hormone-binding globulin（SHBG）,dehydro-epiandrosterone sulfate（DHEA-S）,oral glucose tolerance test and insulin secretion test,homeostasis model assessment of insulin resistance（HOMA-IR）,free androgen index（FAI）were determined.Results（1）There was no significant difference in the level of DHEA-S between study group and control group （P＆gt;0.05）.The levels of T and FAI of study group were significantly higher than those of control group （P＆lt;0.05）.Serum SHBG was lower in study group compared with control group（P＆lt;0.05）.（2） The patients with PCOS are divided into two groups,group of FAI lower than 3.32 and group of FAI higher than 3.32,and are compared with the insulin of 30 min,60 min,120 min.The difference between the two groups had statistical significance.（P＆lt;0.05）.（3）HOMA-IR and serum insulin levels in 30,60,120,180 min for correlation analysis in PCOS （P＆lt;0.05）.In the same way,to analyze the relationship between FAI and serum insulin levels（P＆lt;0.05）.Conclusion Compared with T and DHEA-S,FAI has higher degree of sensitivity as a diagnostic index PCOS.The level of insulin of 120 min is more convenient and time saving in the laboratory examination to evaluate the insulin resistence of the patients with PCOS.The insulin resistence is closely related to the hyperandrogenism.