性激素结合球蛋白对PCOS患者糖代谢异常及胰岛素抵抗的评估价值

Sex Hormone Binding Globulin in Evaluating Abnormal Glucose Metabolism and Insulin Resistance in Patients with Polycystic Ovary Syndrome

[目的]探讨性激素结合球蛋白（SHBG）对多囊卵巢综合征（PCOS）患者糖代谢异常、胰岛素抵抗（IR）的评估价值。[方法]150例PCOS患者根据SHBG水平分为两组：低SHBG（SHBG〈18nmol／L）组（n=70），正常SHBG（sHBG≥18nmol／L）组（n=80），另选同期体检的健康者95例作为对照组。检测所有受试者血清SHBG、黄体生成激素（LH）、LH／卵泡刺激素（FSH）、空腹血糖（FPG）、空腹胰岛素（FINS）等激素、糖代谢及胰岛素抵抗（IR）指标水平，并分析SHBG与糖代谢异常、IR的相关性。[结果]低SHBG组、正常SHBG组SH—BG水平显著低于对照组（P〈0．05），雌二醇（E2）、睾酮（T）、LH、LH／FSH水平显著高于对照组（P〈0．05）；正常SHBG组、低SHBG组SHBG、E2、T、LH、LH／FSH水平比较差异有统计学意义（P〈0．05）。低SHBG组、正常SHBG组FINS、甘油三酯（TG）、胆固醇（TC）水平显著高于对照组（P〈0．05）；而与正常SHBG组相比，低SHBG组胰岛素抵抗指数（HOMA-IR）、PFG、FINS、TG、TC水平明显增高，胰岛素敏感性指数（ISI）水平显著较低（P〈0．05）。相关性分析显示SHBG与HOMA—IR、FINS、PFG、LH／FSH、LH、T、TG呈负相关（PG0．05），与ISI呈正相关（PG0．05）。[结论]低SHBG水平的PCOS患者各项性激素、糖代谢及IR相关指标更易发生失衡或紊乱，故SHBG可作为评估PCOS患者糖代谢异常及IR的重要方法。

[Objective] To investigate the value of sex hormone binding globulin （SHBG） in evaluating ab- normal glucose metabolism and insulin resistance （IR） in patients with polycystic ovary syndrome （PCOS）. [Methods]A total of 150 patients with PCOS were divided into the low SHBG （SHBG 〈 18nmol / L） group （ n =70） and normal SHBG （SHBG ≥ 18 nmol / L） group （ n =80）. Simultaneously, 95 healthy people were selected as the control group. The levels of serum SHBG, luteinizing hormone （LH）, follicle stimulating hormone （FSH）, fasting plasma glucose （FPG）, fasting insulin （FINS）, glucose metabolism, and IR in all groups were detected, and the correlation between SHt3G and glucose metabolism, IR was analyzed. [Results] SHBG levels of PCOS patients （including the low SHBG group and normal SHBG group） were significantly lower than that of control group （ P〈0.05）, while the levels of estradiol （Ez）, testosterone （T）, LH, and LH/FSH in PCOS patients were significantly higher than those in the control group. The levels of FINS, tri- glyceride （TG） and cholesterol （TC） in the low SHBG group and normal SHBG group of PCOS patients were significantly higher than those in the control group （ P 〈0.05）. Compared to the normal SHBG group, the in- sulin resistance index （HOMA-IR）, PFG, FINS, TG and TC levels in the low SHBG group were significantly higher （ P 〈0.05）, while the insulin sensitivity index （ISI） was significantly lower （ P 〈0.05）. Correlation analysis showed that SHBG was negatively correlated with H OMA-IR, FINS, PFG, L H/FSH, LH, T, and TG （ P〈0.05） whereas it was positively correlated with ISI （ P 〈0.05）. [Conclusion] PCOS patients with low SHBG level are prone to imbalance of and disorders relating to sex hormones, glucose metabolism, and I- related indicators. Therefore, SHBG can be used as an important method to evaluate glucose metabolism and IR in patients with PCOS.