摘要
目的通过测定多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者不同的雄激素指标,比较其与体脂、血脂、胰岛素抵抗和β细胞分泌指数的关系。方法收集PCOS患者211例,按体重指数(body mass index,BMI)将其分为正常体重组、超重组和肥胖组,测体脂分布指标、常规生化和性激素水平,计算并比较各组间血脂、胰岛素抵抗指数和β细胞分泌指数的变化并观察不同高雄激素指标与体脂分布、血脂和胰岛素敏感度的关系。结果肥胖和超重的PCOS患者存在更严重的脂代谢紊乱和糖代谢异常,游离指数(FAI)与BMI、腰围(waist)、腰臀比(WHR)、TG、胆固醇(TC)、HDL、低密度脂蛋白(LDL)、HOMA-IR、QUICKI和HOMA-β均呈显著正相关,与HDL呈负相关。而总睾酮(testosterone,T)只与HOMA-IR、LH、LH/FSH呈正相关,和QUICKI呈负相关,雄烯二酮(androstenedione,A_2)与LH、LH/FSH间呈正相关,而DHEAS未见显著相关。结论 FAI与体脂、血脂和胰岛素抵抗等均密切相关,是反映PCOS代谢异常的重要指标,优于总睾酮。对于PCOS患者,应测定性激素结合球蛋白(SHBG)以便获得FAI。
Objective To assess the relationship between different androgens and body fat distribution, blood lipids, insulin resist- ance and β cell seeretion index by measuring the levels of different androgens of the subjects suffering polyeystic ovary syndrome（PCOS）. Methods Totally 211 eases of PCOS patients were enrolled and divided into three groups according to body mass index （BMI） ： the nor- mal body weight group（n =81, BMI 〈24kg/m2） ; the overweight group（n =81, 24 BMI 〈28kg/m2） ; the obese group （n =85, BMI 28kg/me）. We obtained the value of body fat distribution index, routine biochemical indicators and sexual hormone profile; calculated blood lipid levels, insulin resistence index and eell secretion index of every group. After comparing every observation index between each group, the association between body fat, blood lipid, insulin sensitivity and different elevated androgens was analyzed. Results The o- verweight and obese group showed more severe glucose and lipid metabolism disorder compared with the normal group. The correlation a- nalysis suggested that dehydroepiandrosterone （DHEAS） sulfate had a negative - e correlation with triglyeeride（TG） , a positive correla- tion with high density lipoprotein （HDL）. Free androgen index （FAI）had a significant eorrelation with BMI, waist circumference, waist hip ratio （WHR）, TG, total cholesterol（TCH） , HDL, low densit- y lipoprotein（LDL） , the homeostasis model assessment for insulin resistance （HOMA- IR）, the quantitative insulin sensitivity check index （QUICKI）, homeostasis model assessment of β -cell function （HOMA - β）. But total testosterone was only correlated to TCH. A2, not DHEAS was correlated with luteinizing hormone（LH） and LH/ FSH. Conclusion FAI, correlating closely with body fat composition, blood lipid and insulin resistance, is a superior indicator for meta- bolic disorder of PCOS to total testosterone. As for PCOS patients, sex hormone -bindinlobulin （SHBG） detection should be eonsidered.
作者
邹建平
陈颖
李圣贤
刘伟
Zou Jianping Chen Ying Li Shengxian et al(Zhejiang Quhua Hospital Department of Endocrinology, Zhejiang 324002, Chin)
出处
《医学研究杂志》
2017年第9期171-174,共4页
Journal of Medical Research
关键词
多囊卵巢综合征
胰岛素抵抗
雄激素
血脂
体脂分布
Polycystic ovary syndrome
Insulin resistance
Androgen
Blood lipid
Body fat distribution
