摘要
目的探讨多囊卵巢综合征(polycystic ovary syndrome,POCS)合并亚临床甲状腺功能减低(subclinical hypothyroidism,SCH)患者激素水平和糖脂指标变化。方法选择POCS患者216例和年龄匹配的正常对照87例,另依据TSH是否>4 m IU/L,将POCS患者分为合并亚甲减组(SCH)61例和不合并亚甲减组(NSCH)155例,分别对以上各组测量身高、体重、腰围、臀围,测定促黄体生成激素(LH)、促卵泡刺激素(FSH)、雌二醇(E2)、催乳素(PRL)、睾酮(TES)、促甲状腺素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)。并对SCH组和NSCH组测定空腹血糖(FPG)、甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、空腹胰岛素(FINS)。计算体重指数(BMI)、腰臀比(WHR)、LH/FSH比值、胰岛素β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)。采用独立样本t检验和相关分析比较上述各组指标的差异及相关性。结果 1与对照组相比较,POCS组BMI、WHR、LH、LH/FSH、PRL、TES和TSH均升高,差异均有统计学意义(均P<0.01),而年龄、E2、FSH、FT3、FT4,两组比较差异均无统计学意义(均P>0.05)。2SCH组与NSCH组相比较,PRL、TSH、FINS、HOMA-β、HOMA-IR、TG均升高,而E2、FT3、FT4均降低,差异均有统计学意义(均P<0.05),而年龄、BMI、WHR、LH、FSH、LH/FSH、TES、FPG、TC、HDL-C、LDL-C的差异均无统计学意义(均P>0.05);POCS患者合并亚甲减的比例为28.2%。3相关分析显示:TSH与TG(г=0.371,P=0.000)、FINS(г=0.445,P=0.000)呈正相关,而TSH与其他指标,如年龄、BMI、WHR、E2、PRL、LH、FSH等均无相关性。结论 POCS合并SCH患者可能存在更严重的胰岛素抵抗和血脂异常;并且合并SCH患者催乳素显著上升,而E2、FT3和FT4显著下降。
Objective To investigate the changes of hormone and glycolipid levels in patients with polycystic ovary syndrome（POCS） combined with subclinical hypothyroidism（SCH）. Methods A total of 216 patients with PCOS were enrolled as PCOS group and 87 aged-matched heahhy women at the corresponding period were chosen as control group in the study. According to thyroid stimulating hormone （TSH）, POCS patients were divided into two groups ： SCH group （TSH 〉 4 mIU/L, n = 61 ） and NSCH group（ TSH ≤4 mIU/L, n = 155 ）. Height, body weight, waist circumference, hip circumference, luteinizing hormone （ LH ）, follicle stimulating hormone （ FSH ）, estradiol （ E2 ）, prolactin （ PRL）, testosterone （ TES ）, TSH, free triiodothyrouine （ FT3 ）, free thyroxine （ FT4 ） were measured in all subjects. Fasting blood glucose （ FPG）, triglyceride （ TG ）, cholesterol （ TC ）, high density lipoprotein （ HDL-C ）, low density lipopro- tcin （LDL-C）, fasting insulin （FINS） were measured in SCH and NSCH groups. The body mass index （BMI）, waist hip ratio （WHR）, the ratio of LH/FSH,the islet β cell function index（HOMA-beta） ,insulin resistance index（HOMA-IR） were calculated. Independent- samples t-test and correlation analysis were used for the statistics analysis. Results ①The levels of BMI, WHR, LH, LH/FSH, PRL, TES and TSH in POCS group increased compared with control group（ P 〈 0.01 ）. There was no significant difference in age and the E2, FSH,Fβ,FT4 levels between the two groups（P 〉 0.05 ）. ②Compared with NSCH group, the levels of PRL, TSH, FINS, HOMA-β, HOMA-IR,TG in SCH group increased, and E2, FT3, FT4 decreased （P 〈 0.05 ）. There was no significant difference in age, BMI, WHR and LH, FSH, LH/FSH, TES, FPG,TC, HDL-C levels between the two groups （ P 〉 0.05 ）. SCH patients accounted for 28.2%. ③TSH was positively correlated with TG （ r = 0.371, P = 0.000 ）, FINS （ r = 0. 445, P = 0.000 ）, but not with age, BMI, WHR, E2, PRL, LH, FSH. Conclusion PCOS plus SCH patients may be more prone to serious insulin resistance and lipid abnormality. The level of prolactin in SCH patients increases significantly, while the E2,FT3 and FT4 decreases significantly.
出处
《山西医科大学学报》
CAS
2015年第9期920-923,共4页
Journal of Shanxi Medical University
