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绝经后卵巢雄激素分泌肿瘤妇女手术纠正高雄激素血症对代谢无影响。

No metabolic impact of surgical normalization of hyperandrogenism in postmenopausal women with ovarian androgen-secreting tumours.

机构信息

Division of Endocrinology, S. Orsola-Malpighi Hospital, University Alma Mater Studiorum, Bologna, Italy.

出版信息

Clin Endocrinol (Oxf). 2013 Apr;78(4):533-8. doi: 10.1111/j.1365-2265.2012.04438.x.

DOI:10.1111/j.1365-2265.2012.04438.x
PMID:22583337
Abstract

AIM

To examine the impact of surgical normalization of testosterone on body weight and on glucose and lipid metabolism and insulin sensitivity in a group of hyperandrogenic women with ovarian androgen-secreting tumours (OAST).

METHODS

Five consecutive postmenopausal hyperandrogenic patients (aged 63 ± 5 years) with a diagnosis of OAST were prospectively evaluated. Clinical signs, symptoms and metabolic and hormonal parameters were collected at the time of the diagnosis and at follow-up, 12 months after surgical oophorectomy. A group of 15 age-matched and body mass index-matched postmenopausal control women served as a reference group.

RESULTS

At baseline, patients with OAST had very high testosterone levels and inappropriately low gonadotrophin levels for their menopausal status. All the women were overweight or obese, and one had a history of polycystic ovary syndrome and Type 2 diabetes. Twelve months after surgical oophorectomy, testosterone and gonadotrophin levels returned to appropriate values for menopausal status in all patients; however, no change in body weight was found. Fasting glucose levels slightly increased (P < 0·05) without any significant change in other metabolic parameters. In the woman with diabetes, a moderate decrease in haemoglobin A1c occurred. Red blood cell count and haematocrit values were normalized (P < 0·05, respectively).

CONCLUSION

Normalization of androgen levels achieved after surgical oophorectomy did not cause any significant change in body weight and insulin sensitivity. These findings may offer a different perspective on the impact of hyperandrogenaemia on metabolism.

摘要

目的

研究一组患有卵巢雄激素分泌肿瘤(OAST)的高雄激素血症妇女,手术使睾酮正常化对体重以及葡萄糖和脂质代谢及胰岛素敏感性的影响。

方法

前瞻性评估 5 例连续绝经后高雄激素血症患者(年龄 63±5 岁),诊断为 OAST。在诊断时和随访时(手术切除卵巢后 12 个月)收集临床体征、症状以及代谢和激素参数。一组 15 例年龄匹配和体重指数匹配的绝经后对照妇女作为参考组。

结果

基线时,OAST 患者的睾酮水平非常高,且促性腺激素水平与绝经状态不相符。所有女性均超重或肥胖,其中 1 例有多囊卵巢综合征和 2 型糖尿病病史。手术切除卵巢 12 个月后,所有患者的睾酮和促性腺激素水平均恢复到绝经状态的适当水平,但体重未发生变化。空腹血糖水平略有升高(P<0.05),但其他代谢参数无明显变化。在患有糖尿病的女性中,HbA1c 中度降低。红细胞计数和红细胞压积值正常化(分别为 P<0.05)。

结论

手术切除卵巢后雄激素水平正常化并未导致体重和胰岛素敏感性发生任何显著变化。这些发现可能为高雄激素血症对代谢的影响提供了不同的视角。

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