血清性激素结合球蛋白与PCOS患者糖代谢水平关系及对妊娠影响

Relationship between serum sex hormone binding globulin and glucose metabolism in patients with PCOS and its effect on pregnancy

目的:探究血清性激素结合球蛋白(sHBG)与多囊卵巢综合征(PCOS)患者糖代谢水平关系及对妊娠影响。方法:选取2018年3月-2020年2月医院收治的多囊卵巢综合征(PCOS)患者80例,为研究组,根据妊娠结局分为良好组(n=43)和不良组(n=37),另纳入同期在医院体检的健康者30例,为对照组,分别检测以上各组受试对象的血清sHBG水平和糖代谢指标[空腹血糖(FPG)、餐后2h血糖(27hPG)、糖化血红蛋白(HbA1c)]水平,并统计所有受试者的妊娠结局及记录研究组的病情程度,对比良好组和不良组患者的血清sHBG水平和血浆FPG、2hPG、HbA1c水平,采用Logistic回归分析和Pearson相关性分析明确sHBG水平变化与PCOS患者糖代谢水平变化及母婴结局的关系。结果:相较对照组,研究组血浆FPG、27h7PG、HbA1c水平均偏高,血清sHBG水平偏低(P<0.05);不良组血浆FPG、27h7PG、HbA1c水平均显著高于良好组,血清sHBG低于良好组(P<0.05);经Logistic回归分析结果显示,低sHBG水平、高FPG、27h7PG、HbA1c水平是影响PCOS患者母婴结局的危险因素(P<0.05);经Pearson相关性分析PCOS患者血浆FPG、27h7PG、HbA1c水平均与血清sHBG水平变化呈负相关(P<0.05)。结论:血清sHBG水平变化与PCOS患者的糖代谢水平变化、病情发展密切相关,可作为预测其妊娠结局的有效临床指标。

Objective:To explore the relationship between serum sex hormone binding globulin(SHBG)and glucose metabolism in patients with polycystic ovary syndrome(PCOS)and its effect on pregnancy.Methods:80 patients with polycystic ovary syndrome(PCOS)admitted to the hospital from March 2018 to February 2020 were selected as the study group.According to the pregnancy outcome,they were divided into a good group(n=43)and a bad group(n=37).In addition,30 healthy people who underwent physical examination in the hospital during the same period were included as the control group,Serum SHBG levels and glucose metabolism indexes[fasting blood glucose(FPG),2 h postprandial blood glucose(2 h PG),and glycated hemoglobin(HbA1 c)]levels of the subjects in the above groups were measured respectively,and pregnancy outcomes of all subj ects were counted and the severity of the disease in the study group was recorded.The serum SHBG levels and plasma FPG,2 h PG,and HbA1c levels of the patients in the good group and the poor group were compared,Logistic regression analysis and Pearson correlation analysis were used to clarify the relationship between the changes of SHBG level and the changes of glucose metabolism level and maternal and infant outcomes in PCOS patients.Results:Compared with the control group,the plasma FPG,2 h PG and HbA1c levels in the study group were higher,while the serum SHBG levels were lower(PV0.05);The plasma FPG,2 h PG and HbA1c levels in the poor group were significantly higher than those in the good group,and the serum SHBG was lower than those in the good group(P<0.05);The results of logistic regression analysis showed that low SHBG level,high FPG,2 h PG and HbA1 c level were the risk factors affecting the maternal and infant outcomes of PCOS patients(P<0.05);According to Pearson correlation analysis,plasma FPG,2 h PG and HbA1c levels in PCOS patients were negatively correlated with serum SHBG levels(P<0.05).Conclusi on:The change of serum SHBG level is closely related to the change of glucose metabolism level and the development of the disease in PCOS patients,and can be used as an effective clinical index to predict the pregnancy outcome.