多囊卵巢综合征患者血清DHEAS、TEST、sOB-R水平及临床意义

Clinical significance of serum DHEAS,TEST and sOB-R levels in patients with polycystic ovary syndrome

目的分析多囊卵巢综合征(PCOS)患者血清硫酸脱氢表雄酮(DHEAS)、总睾酮(TEST)及可溶性瘦素受体(sOB-R)水平及临床意义。方法选取2017年1月至2020年4月复旦大学附属中山医院吴淞医院收治的PCOS患者180例(PCOS组),其中稀发或无排卵(OA)+高雄激素血症(HA)+卵巢多囊样改变(PCO)患者89例,OA+HA患者61例,OA+PCO患者30例;另择体检健康女性180例作为对照组。检测研究对象血清DHEAS、TEST、sOB-R水平及胰岛素抵抗指数(HOMA-IR)。结果PCOS组患者血清DHEAS、TEST水平及HOMA-IR分别为(7.55±1.21)μmol/L、(1.60±0.43)nmol/L和2.03±0.82,均高于对照组(均P<0.05),而sOB-R为(22.32±3.11)ng/ml,低于对照组(P<0.05)。PCOS组OA+HA+PCO患者血清DHEAS水平为(8.54±1.02)μmol/L,明显高于OA+HA患者和OA+PCO患者(均P<0.05);OA+HA患者血清DHEAS水平为(7.32±1.07)μmol/L,高于OA+PCO患者(P<0.05);OA+PCO患者血清TEST水平和HOMA-IR分别为(1.10±0.33)nmol/L和1.75±0.66,明显低于OA+HA+PCO患者和OA+HA患者(均P<0.05),而sOB-R为(24.43±2.77)ng/ml,明显高于OA+HA+PCO患者和OA+HA患者(均P<0.05)。PCOS组患者治疗后血清DHEAS、TEST水平及HOMA-IR分别为(6.10±1.19)μmol/L、(1.42±0.29)nmol/L和1.34±0.27,均低于治疗前(均P<0.05),而sOB-R为(25.51±2.88)ng/ml,高于治疗前(P<0.05)。PCOS组患者血清DHEAS、TEST水平与HOMA-IR均呈正相关(r=0.455、0.412,均P<0.05),而sOB-R与HOMA-IR呈负相关(r=-0.389,P<0.05)。结论PCOS患者血清DHEAS、TEST水平升高,而sOB-R水平降低,3者与PCOS表型、胰岛素抵抗有一定关系。

Objective To explore the clinical significance of serum dehydroepiandrosterone sulfate(DHEAS),testosterone(TEST)and soluble leptin receptor(sOB-R)levels in patients with polycystic ovary syndrome(PCOS).Methods One hundred and eighty PCOS patients(PCOS group)treated in Wusong Campus of Zhongshan Hospital Affiliated to Fudan University from Ja-nuary 2017 to April 2020 were enrolled,including 89 cases of sporadic or anovulatory(OA)+hyperandrogenemia(HA)+polycystic ovarian change(PCO),61 cases of OA+HA,30 cases of OA+PCO.One hundred and eighty healthy women were selected as the control group.Serum DHEAS,TEST,SOB-R and insulin resistance index(HOMA-IR)were measured and compared among groups.Results The levels of DHEAS,TEST and HOMA-IR in PCOS group were(7.55±1.21)μmol/L,(1.60±0.43)nmol/L and(2.03±0.82),which were significantly higher than those in control group(P<0.05).While sOB-R was(22.32±3.11)ng/ml,which was significantly lower than that in control group(P<0.05).The serum DHEAS in OA+HA+PCO group of PCOS patients was(8.54±1.02)μmol/L,which was significantly higher than that in OA+HA and OA+PCO groups(P<0.05).The serum TEST and HOMA-IR in OA+PCO group of patients were(1.10±0.33)nmol/L and(1.75±0.66),which were significantly lower than those in OA+HA+PCO and OA+HA groups(P<0.05),while the sOB-R was(24.43±2.77)ng/ml,which was significantly higher than hat in OA+HA+PCO and OA+HA groups(P<0.05).After treatment,serum DHEAS,TEST and HOMA-IR in PCOS group were(6.10±1.19)μmol/L,(1.42±0.29)nmol/L and(1.34±0.27),which were significantly lower than those before treatment(P<0.05),and sOB-R was(25.51±2.88)ng/ml,which was significantly higher than that before treatment(P<0.05).DHEAS and TEST were positively correlated with HOMA-IR(r=0.455 and 0.412,P<0.05),while sOB-R was negatively correlated with HOMA-IR(r=-0.389,P<0.05).Conclusion Serum levels of DHEAS and TEST in PCOS patients are increased,but serum sOB-R level is decreased,and these indicators are related to PCOS phenotype and insulin resistance.