[促黄体生成素与促卵泡生成素比值对多囊卵巢综合征患者抗苗勒管激素分泌及卵泡发生的影响]

[Effect of luteinizing hormone vs follicular stimulating hormone ratio on anti-Müllerian hormone secretion and folliculogenesis in patients with polycystic ovarian syndrome].

作者信息

Li Yi, Wei Li-na, Xiong Yong-lao, Liang Xiao-yan

机构信息

Reproductive Center, Second Affiliated Hospital of Sun Yat-sen University, Guangzhou 510120, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2010 Aug;45(8):567-70.

PMID:21029609

Abstract

OBJECTIVE

To investigate characteristics of anti-Müllerian hormone (AMH) secretion and mechanism of aberrant folliculogenesis by the ratio of luteinizing hormone (LH)/follicle-stimulating hormone (FSH) in polycystic ovarian syndrome (PCOS) patients.

METHODS

Base on the ratio of LH/FSH, total 95 patients with PCOS were divided into two groups, including 49 cases in higher ratio group (LH/FSH ≥ 2) and 46 cases in normal ratio group (LH/FSH < 2) matched with 62 infertile cases with tubal factor and regular menstruation as control group. Body mass index (BMI) were calculated in all objectives. The serum AMH were detected by enzyme linked immunosorbent assay (ELISA). Ovarian sexual hormones, fasting blood glucose, insulin and lipid were measured by chemiluminescence method. The correlation between AMH and metabolic index was analyzed by multilinear regression.

RESULTS

(1) AMH: the serum level of AMH were (7.2 ± 4.3) µg/L in higher LH/FSH group, (5.2 ± 3.8) µg/L in normal LH/FSH group and (3.7 ± 2.2) µg/L in control group, which all reached significant difference among those 3 groups (P < 0.01). (2) The correlation between AMH and biological metabolic index: estradiol (E(2)) was negatively correlated with serum level of AMH in higher LH/FSH ratio group (r = -0.318). The serum level of AMH were positively correlated with BMI, fasting glucose, homeostasis model assessment insulin resistance index (HOMA-IR) in normal LH/FSH ratio group (r = 0.493, 0.362, 0.303). After controlling affect factors, serum levels of AMH were positively correlated with LH/FSH in higher LH/FSH ratio group (r = 0.301), but negatively correlated with E₂ (r = -0.429). However, in normal LH/FSH group, serum level of AMH was only positively correlated with BMI (r = 0.428).

CONCLUSION

The PCOS patients with higher LH/FSH ratio are primarily caused by hypothalamic-pituitary dysfunction, while the PCOS patients with normal LH/FSH ratio are mainly caused by metabolic disorders.

摘要

目的

通过多囊卵巢综合征（PCOS）患者促黄体生成素（LH）/促卵泡生成素（FSH）的比值，研究抗苗勒管激素（AMH）分泌特征及卵泡发生异常机制。

方法

根据LH/FSH比值，将95例PCOS患者分为两组，其中高比值组（LH/FSH≥2）49例，正常比值组（LH/FSH<2）46例，并选取62例输卵管因素不孕且月经规律的患者作为对照组。计算所有研究对象的体重指数（BMI）。采用酶联免疫吸附测定（ELISA）法检测血清AMH。采用化学发光法测定卵巢性激素、空腹血糖、胰岛素和血脂。通过多线性回归分析AMH与代谢指标之间的相关性。

结果

（1）AMH：LH/FSH高比值组血清AMH水平为（7.2±4.3）μg/L，LH/FSH正常比值组为（5.2±3.8）μg/L，对照组为（3.7±2.2）μg/L，三组间差异均有统计学意义（P<0.01）。（2）AMH与生物代谢指标的相关性：在LH/FSH高比值组中，雌二醇（E₂）与血清AMH水平呈负相关（r=-0.318）。在LH/FSH正常比值组中，血清AMH水平与BMI、空腹血糖、稳态模型评估胰岛素抵抗指数（HOMA-IR）呈正相关（r=0.493、0.362、0.303）。在控制影响因素后，LH/FSH高比值组血清AMH水平与LH/FSH呈正相关（r=0.301），但与E₂呈负相关（r=-0.429）。然而，在LH/FSH正常比值组中，血清AMH水平仅与BMI呈正相关（r=0.428）。