多囊卵巢综合征患者促甲状腺激素浓度与血脂关系的研究

Association between thyroid-stimulating hormone and serum lipid in patients with polycystic ovary syndrome

目的研究不同浓度血清促甲状腺激素(thyroid-stimulating hormone,TSH)的多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者临床特征及内分泌代谢指标之间的差异。方法选择110例多囊卵巢综合征患者,测量身高、体质量、腰围、臀围;应用化学发光法分析测定血清TSH、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、三酰甘油(triglycerides,TG)、空腹血糖(fasting blood glucose,FBG)、空腹胰岛素(fasting serum insulin,INS)、卵泡刺激素(follicle stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)、睾酮(testosterone,T)、催乳素(prolactin,PRL)、雌二醇(estrogen,E2);计算体质量指数(body mass index,BMI)、腰臀比(waist hip ratio,WHR)、黄体生成素与卵泡刺激素的比值(LH-to-FSH ratio,LH/FSH);采用稳态模型评估的胰岛素抵抗指数(homeostasis model assessment insulin resistance,HOMA-IR),按血清TSH浓度将其分为2组:A组71例,TSH<2.5mIu/L;B组39例TSH≥2.5 mIu/L;比较2组上述各项指标的差异及TSH与各项指标间的相关性。结果 B组(TSH≥2.5 mIu/L)PCOS患者的WHR及LDL高于A组(TSH<2.5 mIu/L),差异有统计学意义(P<0.05)。TSH浓度的升高与腰臀比、血清总胆固醇、低密度脂蛋白胆固醇、PRL浓度呈正相关。2组间其他临床、代谢指标相比无统计学意义(P>0.05)。结论 TSH与脂代谢指标有相关性,TSH≥2.5 mIu/L的PCOS患者,脂代谢发生了显著的变化。

Objective To investigate the differences in clinical features , endocrine metabolic parameters of polycystic ovary syndrome patients with different levels of serum thyroid-stimulating hormone .Methods One hundred and ten PCOS patients were enrolled . Height , weight , waist circumference , hip circumferences were measured . Chemiluminescence was applied for measuring thyroid-stimulating hormone（TSH）, total cholesterol（TC）, low density lipoprotein（LDL）, high density lipoprotein（HDL）, triglyceride（TG）, fasting blood-glucose（FBG）, fasting insulin（INS）, follicle-stimulating hormone（FSH）, luteinizing hormone（LH）, testosterone（T）, prolactin（PRL） and estradiol（E2）;Body mass index（BMI）, waist-to-hip circumference ratio（WHR）, LH-to-FSH ratio（LH/FSH） were calculated;The insulin resistance index evaluated by steady-state model （ HOMA-IR）;all patients were divided into two groups according to serum thyroid-stimulating hormone：group A had 71 cases with TSH〈2.5 mIu/L, as group B of 39 cases with TSH≥2.5 mIu/L; all the hormone parameters mentioned above were compared between group A and B , and the correlation with TSH .Results The WHR and LDL in group B（TSH≥2.5 mIu/L） is significantly higher than that of the patients in group A （TSH〈2.5 mIu/L）.The increase of TSH concentration positively correlates to an increase of WHR , TC, LDL-C and PRL.No significant differences are shown in other clinical and＆amp;nbsp;metabolic indicators.Conclusion There was a significant correlation between TSH and lipid metabolic parameters .Women with polycystic ovary syndrome and with thyroid-stimulating hormone≥2.5 mIu/L had significantly endocrine and metabolic changes .