多囊卵巢综合征患者性激素结合球蛋白的诊断价值

Diagnostic value of sex hormone binding globulin in patients with polycystic ovary syndrome

目的分析多囊卵巢综合征(PCOS)患者的性激素结合球蛋白(SHBG)对胰岛素抵抗及代谢综合征(MS)的诊断价值。方法回顾性分析2017年1月1日至2019年6月30日在山东大学生殖医学研究中心就诊的1150例PCOS患者,根据SHBG界值将PCOS患者分为SHBG低值组609例(SHBG<32.4 nmol/L)和SHBG高值组541例(SHBG≥32.4 nmol/L),测量各组身高、体质量、血压,检测其胰岛素、生化指标,计算体质量指数(BMI)、稳态模型评估胰岛素抵抗指数(HOMA-IR)并进行统计学分析,以及绘制受试者工作特征曲线(ROC曲线)确定其灵敏度、特异度、约登指数等。结果两组年龄和身高比较差异无统计学意义(P>0.05),SHBG低值组体质量、BMI、收缩压、舒张压均高于SHBG高值组,差异有统计学意义(P<0.05)。SHBG低值组空腹血糖、2 h葡萄糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、载脂蛋白B水平高于SHBG高值组,差异有统计学意义(P<0.05);SHBG低值组高密度脂蛋白胆固醇、载脂蛋白A水平低于SHBG高值组,差异有统计学意义(P<0.05)。SHBG低值组胰岛素抵抗、超体质量和(或)肥胖、高血糖、高血压、血脂紊乱、代谢综合征患病率均高于SHBG高值组,差异有统计学意义(P<0.05)。结论血清SHBG水平对PCOS患者胰岛素抵抗、代谢综合征均具有一定的诊断价值。

Objective To analyze the diagnostic value of sex hormone binding globulin(SHBG)in patients with polycystic ovary syndrome(PCOS)for insulin resistance and metabolic syndrome(MS).Methods A retrospective analysis of 1150 PCOS patients who were admitted to the Center for Research in Reproductive Medicine of Shandong University from January 1,2017 to June 30,2019,and divided PCOS patients into SHBG low value group(SHBG<32.4 nmol/L,n=609)and SHBG high value group(SHBG≥32.4 nmol/L,n=541),height,body weight,blood pressure of each group were measured,insulin,biochemical indicators,calculate body mass index(BMI),homeostasis model assessment for insulin resistance(HOMA-IR)were detected and analyzed statistically,and receiver operating characteristic curve(ROC curve)was used to determine its sensitivity,specificity,Youden index and so on.Results There was no significant difference in age and height between the two groups(P>0.05).Body weight,BMI,systolic blood pressure and diastolic blood pressure in the SHBG low value group were higher than those in the SHBG high value group,the difference was statistically significant(P<0.05).SHBG low value group FPG,2 h glucose,total cholesterol,triglyceride,low density lipoprotein cholesterol and apolipoprotein B level were higher than those in SHBG high value group,the difference was statistically significant(P<0.05).High density lipoprotein cholesterol and apolipoprotein A level in the SHBG low value group were lower than those in the SHBG high value group,the difference was statistically significant(P<0.05).The prevalence of insulin resistance,overweight and/or obesity,hyperglycemia,hypertension,dyslipidemia and metabolic syndrome in the SHBG low value group were higher than those in the SHBG high value group,with statistical significance(P<0.05).Conclusion Serum SHBG level has certain diagnostic value for insulin resistance and metabolic syndrome in PCOS patients.