【摘要】 目的 探讨多囊卵巢综合征(PCOS)患者胰岛素水平的变化及对雄激素的影响。 方法 选择新诊断PCOS患者46例和对照(Con)组30名，测定糖脂代谢指标、基础性激素、硫酸脱氢表雄酮(DHEAS)、性激素结合球蛋白(SHBG)，计算游离雄激素指数(FAI)。根据BMI和胰岛素抵抗指数(HOMA-IR)进行分组,比较各组间生化指标的差异。 结果 总体PCOS组、Ob-PCOS组和IR-PCOS组BMI、FIns、HOMA-IR、FPG、血脂、睾酮(T)、DHEAS、FAI、黄体生成素(LH)均高于Con组(P均<0.05)，SHBG低于Con组(P<0.01)。Ob-PCOS组和IR-PCOS组BMI、FIns、HOMA-IR、FAI分别高于Nob-PCOS组和NIR-PCOS组(P<0.05)。BMI与FIns、HOMA-IR呈正相关(P<0.01);BMI、FIns与T、DHEAS、FAI呈正相关(P<0.05)，且BMI与SHBG呈负相关(P<0.01)。 结论 肥胖PCOS患者存在明显的高胰岛素血症和IR，肥胖、高胰岛素血症与PCOS患者高雄激素血症密切相关。
Correlation of obesity, hyper-insulinemia, and hyperandrogenemia in the patients with polycystic ovary syndrome SHI Zhaoming, WU Daoai, ZHANG Shirong, et al. Department of Endocrinology, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
【Abstract】 Objective To explore the change of plasma insulin levels and its effect on androgenic hormones in patients with polycystic ovary syndrome (PCOS). Methods Glucose and lipid metabolism indices, basal sexual hormones, dehydroepiandrosterone (DHEAS) sulfate and sex hormone binding globulin (SHBG) were measured in 46 women initially diagnosed with PCOS and 30 normal controls. Free androgen index (FAI) was calculated. The PCOS patients and normal controls were divided into groups according to their body mass index (BMI) and homeostasis model assessment-insulin resistance (HOMA-IR), and the differences in the biochemical indices of all the groups were compared for observation. Results Compared with the control group, the total PCOS group, obese PCOS group, and IR PCOS group showed an increase in the levels of BMI, fasting insulin (FIns), HOMA-IR, fasting plasma glucose (FPG), blood lipids, testosterone (T), DHEAS, FAI, and luteinizing hormone (LH) (P<0.05), but a decrease in the level of SHBG (P<0.01). The obese PCOS group and IR PCOS group had higher levels of BMI, FIns, HOMA-IR, and FAI than the Non-obese PCOS group and Non-IR PCOS group respectively (P<0.05). BMI was positively correlated with FIns and HOMA-IR (P<0.01). BMI and FIns were positively correlated with T, DHEAS and FAI (P<0.05). BMI was negatively correlated with SHBG (P<0.01). Conclusion The obese PCOS patients have significantly a higher level of plasma insulin and IR. Hyperandrogenemia in the PCOS patients is closely associated with obesity and hyperinsulinemia.
【Key words】Polycystic ovary syndrome; Hyperinsulinemia; Obesity; Hyperandrogenemia