PCOS患者月经模式与性激素、糖脂代谢关系

Correlation between the menstrual pattern of patients with polycystic ovary syndrome and their sex hormones levels and glucolipid metabolism

目的:探究多囊卵巢综合征(PCOS)患者月经模式与性激素、糖脂代谢的关系。方法:回顾性选取2021年5月-2022年5月本院收治的PCOS患者126例临床资料,依据月经模式分为月经规律组和月经不规律组(细分为月经频发组、月经稀少组、闭经组)。比较各组血清睾酮(T)、促黄体生成素(LH)、促卵泡生成激素(FSH)、雌二醇(E_(2))、游离雄激素指数(FAI)、泌乳素(PRL)、抗苗勒管激素(AMH)、空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),分析月经模式与PCOS患者性激素、糖脂代谢的关系。结果:月经不规律组T、LH/FSH、E_(2)、AMH、HOMA-IR、TC、TG水平高于月经规律组;月经不规律患者中,闭经、月经稀发、月经频发患者血清T、LH/FSH、AMH、FAI、HOMA-IR、TG、LDLC、HDLC水平有差异,其中闭经组性激素和糖脂代谢指标异常变化较其他组更明显;随着月经稀发程度加重,PCOS患者血清T、LH/FSH、AMH、FAI、HOMA-IR水平逐渐升高(均P<0.05)。结论:不同月经模式PCOS患者血清性激素、糖脂代谢有差异,月经稀发严重程度加重时性激素和糖脂代谢指标异常增加,提示临床上需注意不同月经模式PCOS患者性激素水平和糖代谢水平,进行个体化治疗。

Objective:To investigate the correlation between the menstrual pattern of patients with polycystic ovary syndrome(PCOS)and their sex hormones levels and glucolipid metabolism.Methods:A total of 126 patients with PCOS from May 2021 to May 2022 were selected in this study retrospectively.According to the menstrual pattern,these patients were divided into group A(patients with regular menstruation)and group B(patients with irregular menstruation,including frequent menstruation,infrequent menstruation,and amenorrhea).The levels of serum testosterone(T),luteinizing hormone(LH),follicle stimulating hormone(FSH),estradiol(E_2),free androgen index(FAI),prolactin(PRL),anti-Müllerian hormone(AMH),fasting plasma glucose(FPG),homeostatic model assessment for insulin resistance(HOMA-IR),total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)of the patients were compared between these groups.The correlation between the menstrual pattern of the patients with PCOS and their sex hormones levels and glucolipid metabolism was analyzed.Results:The levels of T,E_(2),AMH,TC,and TG,and the values of LH/FSH and HOMA-IR of the patients in group B were significantly higher than those of the patients in group A.In group B,there were significant differences in the levels of serum T,AMH,FAI,TG,LDLC,and HDLC,and the values of LH/FSH and HOMA-IR among the patients with amenorrhea,the patients with oligomenorrhea,and the patients with frequent menstruation.The abnormal changes of sex hormones levels and glucose and lipid metabolism indexes values of the patients with amenorrhea were significantly more obvious than those of the other patients.The levels of serum T,AMH,and FAI,and the values of LH/FSH and HOMA-IR of the patients with PCOS had increased gradually with the severity of their oligomenorrhea(all P<0.05).Conclusion:There are differences in the serum sex hormones and glucose and lipid metabolism levels among the PCOS patients with different menstrual patterns.The abnormal sex hormones and glucose metabolism indexes increase of the patients with the severity of their oligomenorrhea,and which suggests that the levels of sex hormones and glucose metabolism of the PCOS patients with different menstrual patterns should be paid attention to in clinic,and the individual treatment for these patients should be carried out.