血清抗苗勒管激素与多囊卵巢综合征相关激素和糖代谢指标的临床研究

Clinical study of serum anti-Mullerian hormone and polycystic ovary syndrome related hormones and glucose metabolism indicators

目的探讨多囊卵巢综合征（PCOS）患者抗苗勒管激素与相关激素和糖代谢指标的关系。方法选取2016年5月至2017年8月于本院诊断为PCOS的患者共123例为观察组，选取同期就诊的输卵管性不孕患者68例为对照组。观察组依据HOMA—IR指数的中位数分为高HOMA—IR组和低HOMA—IR组。分析和比较观察组和对照组、不同HOMA—IR分组相关血清学指标。结果观察组AMH、T、LH、LH／FSH、INS、HOMA—IR均高于对照组（均P〈0．05）。AMH与T、LH在观察组和对照组中均呈正相关（均P〈0．05），与E2呈负相关（P〈0．05）。AMH与HOMA—IR在观察组存在正相关（P〈0．05），而在对照组两者无明显相关性（P〉0．05）。高HOMA—IR组AMH、T、INS和HOMA—IR显著升高（均P〈0．05），AMH与T、INS、HOMA—IR在两HOMA—IR组间均呈正相关（均P〈0．05）。结论PCOS患者体内AMH显著升高，与胰岛素抵抗呈正相关。胰岛素抵抗、高雄激素血症和高胰岛素血症是PCOS患者特征性激素表现。

Objective To investigate the relationship between anti-Mullerian hormone, related hormones, and glucose metabolism in patients with PCOS. Methods A total of 123 patients diagnosed with polycystic ovary syndrome at our hospital from May, 2016 to August, 2017 were selected as an observation group and 68 patients with tubal infertility a control group. The observation group was divided into a high HOMA-IR group and a low HOMA-IR group according to the median of HOMA-IR index. The related serological indicators in the observation group, the control group, and different HOMA-IR groups were analyzed and compared. Results The levels of AMH, T, LH, LH/FSH, INS, and HOMA-IR were higher in the observation group than in the control group （all P 〈 0.05）. There was a positive correlation between AMH, T, and LH in the observation group and the control group （all P 〈 0.05） and negative in E2 （P 〈 0.05）. There was a positive correlation between AMH and HOMA-1R in the observation group （P 〈 0.05）, but no in the control group （P〉0.05）. The levels of AMH, T, INS, and HOMA-IR in the high HOMA-IR group were significantly increased （all P 〈 0.05）; and there was a positive correlation between AMH and T, INS and HOMA-IR in the two HOMA-IR groups （all P 〈 0.05）. Conclusion AMH increases significantly in patients with PCOS and positively correlates with insulin resistance. Insulin resistance, Kaohsiung hormone, and hyperinsulinemia are characteristic hormone manifestations in patients with PCOS.