Cupisti S, Kajaia N, Dittrich R, Duezenli H, W Beckmann M, Mueller A
Department of Obstetrics and Gynecology, Erlangen University Hospital, Universitaetsstrasse 21-23, D-91054 Erlangen, Germany.
Eur J Endocrinol. 2008 May;158(5):711-9. doi: 10.1530/EJE-07-0515.
The aim of this study was to evaluate associations of clinical features, such as hirsutism, polycystic ovaries (PCOs), ovulatory dysfunction, and body mass index (BMI) > or =25 kg/m(2), with metabolic abnormalities in hyperandrogenic women.
Hirsutism was based on the modified Ferriman-Gallwey score. Ovulatory function was classified as eumenorrhea, oligomenorrhea and amenorrhea, and PCOs were assessed using the ultrasound criteria recommended in the Rotterdam definition. An oral glucose tolerance test was performed. Different insulin resistance (IR) indices were calculated.
Hirsute women had significantly higher BMI, DHEA sulfate (DHEAS) and free androgen index (FAI), and significantly lower values for sex hormone-binding globulin (SHBG). Women with amenorrhea were younger in comparison to women with eumenorrhea and had significantly higher values for fasting insulin (FI) and 1- and 2-h insulin levels; lower values for glucose to insulin ratio (GIR), quantitative insulin sensitivity check index (QUICKI), and SHBG. Women with PCO had significantly higher levels of LH and low-density lipoprotein (LDL), whereas high-density lipoprotein (HDL) levels were significantly lower. Women with a BMI > or =25 kg/m(2) had significantly higher values for age, fasting plasma glucose, FI, and 1- and 2-h glucose and insulin levels, homeostatic model for assessment of IR (HOMA-IR), homeostatic model for assessment of B-cell function (HOMA-B), and FAI, whereas their GIR, insulin sensitivity index, QUICKI, SHBG, and HDL were significantly lower.
In women with hyperandrogenic syndrome, BMI> or =25 kg/m(2) and amenorrhea appear to be associated with severe endocrine and metabolic abnormalities.
本研究旨在评估多毛症、多囊卵巢(PCO)、排卵功能障碍和体重指数(BMI)≥25kg/m²等临床特征与高雄激素血症女性代谢异常之间的关联。
多毛症采用改良的费里曼-盖尔维评分法。排卵功能分为月经正常、月经过少和闭经,PCO根据鹿特丹定义推荐的超声标准进行评估。进行口服葡萄糖耐量试验。计算不同的胰岛素抵抗(IR)指数。
多毛女性的BMI、硫酸脱氢表雄酮(DHEAS)和游离雄激素指数(FAI)显著更高,而性激素结合球蛋白(SHBG)的值显著更低。与月经正常的女性相比,闭经女性更年轻,空腹胰岛素(FI)、1小时和2小时胰岛素水平显著更高;葡萄糖与胰岛素比值(GIR)、定量胰岛素敏感性检查指数(QUICKI)和SHBG的值更低。患有PCO的女性促黄体生成素(LH)和低密度脂蛋白(LDL)水平显著更高,而高密度脂蛋白(HDL)水平显著更低。BMI≥25kg/m²的女性年龄、空腹血糖、FI、1小时和2小时血糖及胰岛素水平、评估IR的稳态模型(HOMA-IR)、评估B细胞功能的稳态模型(HOMA-B)和FAI的值显著更高,而其GIR、胰岛素敏感性指数、QUICKI、SHBG和HDL显著更低。
在高雄激素血症综合征女性中,BMI≥25kg/m²和闭经似乎与严重的内分泌和代谢异常有关。