多囊卵巢综合征不同亚型患者血清AMH表达及与糖脂代谢指标相关性

The expression level of serum anti-Müllerian hormone of the women with different subtypes of polycystic ovary syndrome and its correlation with their glucose and lipid metabolism indexes

目的:探究多囊卵巢综合征(PCOS)不同亚型患者血清抗苗勒管激素(AMH)水平及与糖脂代谢指标相关性。方法:回顾性分析本院2020年2月-2021年2月收治的PCOS患者184例临床资料,依据PCOS不同亚型标准分为无排卵或稀发排卵(OA)+多囊卵巢(PCO)(A组,39例)、OA+高雄激素的临床表现(如多毛、痤疮)和(或)高雄激素血症(HA)(B组,50例)、OA+PCO+HA(C组,51例)、PCO+HA(D组,44例),健康体检健康妇女58例作为对照组,对比不同组一般资料、血清AMH、空腹胰岛素(FINS)、空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)差异,Person相关性分析AMH与各指标相关性。结果:A、B、C、D组血清AMH水平无差异但均高于对照组,D组糖代谢指标FBG、FINS、HOMA-IR水平高于A、B、C组,C组脂代谢指标TC、TG水平高于A、B、D组及对照组,LDL-C水平高于B、D组及对照组(均P<0.05);血清AMH与糖脂代谢指标均呈中等相关性(r=0.565、0.514、0.483、0.470、0.523),与TC、LDL-C水平呈弱相关性(r=0.338、0.328)(均P<0.05)。结论:PCOS患者血清AMH水平异常升高,且与糖脂代谢指标相关;不同分型PCOS患者糖脂代谢指标异常程度不同,了解其代谢变化有助于进行针对性分类治疗。

Objective:To explore the expression level of serum anti-Müllerian hormone(AMH)of the women with different subtypes of polycystic ovary syndrome(PCOS),and to study its correlation with the glucose and lipid metabolism indexes of the women.Methods:The clinical data of 184 women with PCOS from February 2020 to February 2021 were analyzed retrospectively.These women were included in study group,and were divided into group A(39 cases with anovulatory or sparse ovulation(OA)and polycystic ovary(PCO)),group B(50 cases with clinical manifestations of OA and high androgen,such as hirsutism and acne,and/or hyperandrogenism(HA)),group C(51 cases with OA,PCO,and HA),and group D(44 cases with PCO and HA).58 healthy women were selected in control group.The general data,the levels of serum AMH,the glucose metabolism index,such as the levels of fasting insulin(FINS)and fasting blood glucose(FPG),and the resistance index(HOMA-IR)value,and the differences of lipid metabolism levels,such as triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C),of the women were compared among these groups.Person correlation analysis was used to analyze the correlation between the AMH level of the women and their various indicators.Results:The serum AMH level of the women in group A,group B,group C,or group D was significantly higher than that of the women in the control group,while the levels of FBG and FINS,and the HOMA-IR value of the women in group D were significantly higher than those of the women in group A,B,and C,the levels of lipid metabolism indexes,such as TC and TG of the women in group C were significantly higher than those of the women in group A,group B,group D,or the control group.The LDL-C level of the women in group D was significantly higher than that of the women in group B,group D,or the control group(all P<0.05).The serum AMH level of the women with PCOS was moderately correlated with their glucose and lipid metabolism indexes levels(r=0.565,0.514,0.483,0.470,and 0.523),and which was weakly correlated with their TC and LDL-C levels(r=0.338,0.328)(all P<0.05).Conclusion:The serum AMH level of the women with PCOS elevates abnormally,which is related to their glucose and lipid metabolism indexes.The women with different types of PCOS have different degrees of abnormal glucose and lipid metabolism,so understanding the changes of the glucose and lipid metabolism indexes of the women with PCOS is helpful for targeted treatment.