不同体质量指数多囊卵巢不孕患者性激素、SHBG、胰岛素、血脂水平对比分析

Analysis of sex hormone,SHBG,fasting insulin,blood lipid in polycystic ovary syndrome infertile patients with different body mass index

目的:探讨多囊卵巢综合征(PCOS)不孕患者体重指数与性激素、性激素结合球蛋白(SHBG)、空腹血糖、胰岛素、血脂水平的相关性。方法:120例PCOS不孕患者按体重指数(BMI)分为非肥胖组(BMI<25kg/m2)和超重/肥胖组(BMI≥25kg/m2)各60例。比较两组患者基础血性激素、性激素结合球蛋白、空腹血糖、胰岛素和血脂情况。结果:超重/肥胖组PCOS患者的黄体生成素(LH)、性激素结合球蛋白显著低于非肥胖组(P<0.01),其它性激素比较差异无统计学意义(P>0.05);超重/肥胖组PCOS患者的胰岛素(INS)、甘油三酯(TG)显著高于非肥胖组(P<0.01),低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(apo B)高于非肥胖组差异均有统计学意义(P<0.05),其它糖脂代谢指标比较差异无统计学意义(P>0.05)。结论:不同体重指数PCOS不孕患者性激素、性激素结合球蛋白、胰岛素、血脂代谢有高度异质性,超重/肥胖PCOS患者发生心血管疾病和糖尿病、代谢综合征风险显著增加,孕前应加强健康指导。

Objectives： To explore the correlation about sex hormone,sex hormone binding globulin（ SHBG）,fasting plasma glucose（ GLU）,insulin（ INS） and blood lipid in polycystic ovary syndrome infertility patients with different body mass index（ BMI）. Methods： The 120 infertile patients with polycystic ovary syndrome were divided into two groups according to body mass index： normal group（ BMI 25 kg/m2） and overweight or obese group（ BMI≥25 kg/m2）. There were 60 patients in each group. The sex hormone,SHBG,GLU,INS and blood lipid were compared between the two groups. Results： The levels of luteotropic hormone（ LH） and SHBG in overweight or obese group were significantly lower than those in normal group（ P 0. 01）. Other sex hormones had no significant difference between two groups（ P 0. 05）. The levels of INS and triglyceride（ TG） increased more significantly in overweight or obese group than those in normal group（ P 0. 01）,but the levels of low density lipoprotein cholesterol（ LDL-C） and apolipoprotein B（ apo B） were very significantly higher than those in normal group（ P 0. 05）. Other levels of fasting plasma glucose and blood lipid had no significant difference between two groups（ P 0. 05）. Conclusion： There are highly differences in PCOS infertile patients with different BMI in the aspect of sex hormone,SHBG,GLU,INS and blood lipid. The risk of cardiovascular disease,diabetes and metabolic syndrome is significantly increased in overweight or obese patients. These PCOS patients should have more health directions before pregnancy.