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[多毛年轻女性临床体征与激素参数之间的相关性]

[Correlations between clinical signs and hormonal parameters in young women with hirsutism].

作者信息

Kristesashvili J, Chanukvadze D

机构信息

Javakhishvili Tbilisi State University, Department of Gynecology, Obstetrics and Reproductology, Medical faculty, Georgia.

出版信息

Georgian Med News. 2011 Nov;11(200):30-5.

Abstract

Hyperandrogenism is the pathological condition, which clinical signs are "androgendependent dermopathies" (seborrhea, acne, hirsutism, alopecia) and not in every cases evidence with hyperandrogenemia. Free testosterone is the most frequent marker of hyperandrogenism, but its determination routinely not feasible in all laboratories. Therefore, some models for calculating free and bioavailable testosterone have been developed. In women the testosterone sources are not only ovaries and adrenal glands, but also abdominal and peripheral fat. There are many investigations to definite correlations between body mass index, androgens and sex hormone binding globulin. The aim of this study was to define the correlations between clinical, biochemical markers of hyperandrogenism and body mass index, with regard of abdominal obesity in young women with hirsutism. 83 female adolescents (14-20 year) with hirsutism and 20 female adolescents in control group were included. C-peptide, estradiol, total testosterone, sex hormone binding globulin (SHBG) were measured. Free androgen index (FAI), free (cFT) and bioavailable (Bio-T) testosterone were calculated. The levels of C-peptide and glucose were used to compute Homa-IR (homeostasis model assessment for insulin resistance). There were detected significant high levels by all hormonal parameters of hyperandrogenism in women with hirsutism, than in control group. In patients with abdominal obesity were also found significant high levels by all calculated parameters of hyperandrogenism and significant low level of steroid-bind globulin, than in patients with central obesity. In two groups by hirsutism degree were not detected any differences between androgen markers. The findigs of this research suggest, that android obesity in female adolescents with hirsutism can cause harder hyperandrogenism and elevate free androgen index, free and bioavailable testosterone levels. The prophylactic reduction of body mass index may prevent complications.

摘要

高雄激素血症是一种病理状态,其临床体征为“雄激素依赖的皮肤病”(脂溢性皮炎、痤疮、多毛症、脱发),但并非在所有情况下都有高雄激素血症的证据。游离睾酮是高雄激素血症最常见的标志物,但并非所有实验室都能常规检测。因此,已经开发了一些计算游离睾酮和生物可利用睾酮的模型。在女性中,睾酮的来源不仅是卵巢和肾上腺,还有腹部和外周脂肪。有许多研究确定了体重指数、雄激素和性激素结合球蛋白之间的相关性。本研究的目的是确定高雄激素血症的临床、生化标志物与体重指数之间的相关性,同时考虑多毛年轻女性的腹部肥胖情况。研究纳入了83名患有多毛症的女性青少年(14 - 20岁)和20名作为对照组的女性青少年。检测了C肽、雌二醇、总睾酮、性激素结合球蛋白(SHBG)。计算了游离雄激素指数(FAI)、游离(cFT)和生物可利用(Bio - T)睾酮。使用C肽和葡萄糖水平计算胰岛素抵抗的稳态模型评估(Homa - IR)。与对照组相比,多毛症女性中所有高雄激素血症的激素参数水平均显著升高。与中心性肥胖患者相比,腹部肥胖患者中所有计算出的高雄激素血症参数水平也显著升高,而类固醇结合球蛋白水平显著降低。根据多毛症程度分组,两组之间的雄激素标志物未检测到任何差异。本研究结果表明,患有多毛症的女性青少年的腹型肥胖可导致更严重的高雄激素血症,并提高游离雄激素指数、游离和生物可利用睾酮水平。预防性降低体重指数可能预防并发症。

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