论文部分内容阅读
目的:探讨多囊卵巢综合征(PCOS)患者的雄激素表现及其与内分泌和代谢改变之间的关系。方法:分析100例PCOS患者及100例对照女性的临床和生化雄激素(A)指标及其与内分泌和代谢参数间的关系。结果:PCOS患者多毛评分高于对照组,但症状程度较轻(中位数=2)。生化雄激素指标中,硫酸脱氢表雄酮(DHEAS)和双氢睾酮(DHT)在组间无统计学差异(P>0.05),而PCOS组患者睾酮(T,1.46 nmol/L vs 0.90 nmol/L)、雄烯二酮(A4,8.24 nmol/L vs 4.96 nmol/L)和游离雄激素指数(FAI,3.70 vs 1.54)显著高于对照组(P<0.05),性激素结合球蛋白(SHBG,35.84 nmol/L vs56.08 nmol/L)则明显低于对照组(P<0.05)。相关分析表明,与对照组相比PCOS组各雄激素指标间相关性明显减低。雄激素指标与内分泌和代谢参数的相关性在组间也存在统计学差异(P<0.05)。对照组中FAI、A4、T、DHEAS与FSH呈负相关,而在PCOS组中FSH相关性消失,而是与LH呈正相关;对照组雄激素指标与糖脂代谢参数的相关性不明显,但在PCOS组中FAI、A4、T均与代谢指标明显呈正相关。结论:对于中国PCOS患者来说,生化雄激素指标较临床指标更为显著;FAI和A4在评价生化高雄激素时更有意义。PCOS中特异存在的雄激素代谢和作用过程改变可能是疾病病因机制的关键。
Objective: To investigate the androgen expression in patients with polycystic ovary syndrome (PCOS) and its relationship with endocrine and metabolic changes. METHODS: Clinical and biochemical androgenic (A) indices in 100 PCOS patients and 100 control women were analyzed and their relationships with endocrine and metabolic parameters were analyzed. Results: The hirsutism score was higher in PCOS patients than in controls, but the symptoms were mild (median = 2). DHEAS and DHT showed no significant difference between the two groups (P> 0.05), but the serum levels of testosterone (T, 1.46 nmol / L vs 0.90 nmol / L), androstenedione (A4, 8.24 nmol / L vs 4.96 nmol / L) and free androgen index (FAI, 3.70 vs 1.54) were significantly higher than those of the control group , 35.84 nmol / L vs 56.08 nmol / L) was significantly lower than that of the control group (P <0.05). Correlation analysis showed that compared with the control group, the correlation between each androgen index in PCOS group was significantly reduced. There was also a significant difference between androgen and endocrine and metabolic parameters in the groups (P <0.05). In the control group, FAI, A4, T and DHEAS were negatively correlated with FSH, but no correlation with FSH was found in the PCOS group, but positively correlated with LH. There was no significant correlation between androgen and glucose and lipid metabolism parameters in the control group FAI, A4, T in PCOS group were positively correlated with the metabolic index. Conclusion: The biochemical androgenic indexes are more significant than the clinical ones in Chinese patients with PCOS. FAI and A4 are more useful in the evaluation of biochemical androgen. Specific androgen metabolism in PCOS and changes in the role of the process may be the key mechanism of disease etiology.