Moran Carlos, Arriaga Monica, Arechavaleta-Velasco Fabian, Moran Segundo
Research Unit of Reproductive Medicine (C.M., F.A.-V.), Health Research Council, Mexican Institute of Social Security, Mexico City, Mexico; Medical Unit of High Specialty (M.A.), Gynecology and Obstetrics Hospital No. 4 Luis Castelazo Ayala, Mexican Institute of Social Security, Mexico City, Mexico; and Research Unit of Clinical Epidemiology (S.M.), Health Research Council, Mexican Institute of Social Security, Mexico City, Mexico.
J Clin Endocrinol Metab. 2015 Mar;100(3):942-50. doi: 10.1210/jc.2014-2569. Epub 2014 Dec 16.
Adrenal hyperandrogenism affects approximately 25% of polycystic ovary syndrome (PCOS) patients but its relation to obesity is not totally understood.
This study aimed to assess dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) levels in relation to body mass index (BMI) in PCOS.
This was a prospective observational study at an institutional practice at an obstetrics/gynecology hospital.
The study included 136 PCOS patients, 20-35 years old, and 42 age-matched control women. The participants were classified with the BMI cutoff value of 27 kg/m(2) as follows: 1) high-BMI PCOS patients; 2) low-BMI PCOS patients; 3) high-BMI control women; and 4) low-BMI control women. The data were reanalyzed with the BMI cutoff value of 30 kg/m(2) to corroborate the findings in obese and nonobese patients.
MAIN OUTCOME MEASURE(S): Blood samples were taken and LH, FSH, insulin, T, androstenedione (A4), DHEA, DHEAS, and glucose levels were determined. Homeostatic model assessment was calculated. Pelvic and abdominal ultrasound for ovarian morphology and adipose tissue, respectively, were performed.
Obese PCOS patients presented significantly more insulin resistance than nonobese PCOS patients. The LH levels and LH/FSH ratio were significantly higher in low-BMI than in high-BMI PCOS patients. The A4 and DHEAS levels were significantly higher in nonobese than in obese PCOS patients. A significant correlation between LH and A4 in nonobese PCOS patients was observed. The frequency of hyperandrogenism by increased A4, and DHEA along with DHEAS was significantly higher in low-BMI PCOS patients compared with high-BMI PCOS patients. Some findings observed with the BMI cutoff value of 27 kg/m(2) changed with the cutoff value of 30 kg/m(2).
Low BMI more so than high BMI is associated with increased LH, high A4, DHEA, and DHEAS levels in PCOS patients. The BMI cutoff value of 27 kg/m(2) classified better than 30 kg/m(2) for hormonal and metabolic characteristics.
肾上腺雄激素过多症影响约25%的多囊卵巢综合征（PCOS）患者，但其与肥胖的关系尚未完全明确。
本研究旨在评估PCOS患者中脱氢表雄酮（DHEA）和硫酸脱氢表雄酮（DHEAS）水平与体重指数（BMI）的关系。
这是一项在妇产科医院机构实践中进行的前瞻性观察研究。
研究纳入了136例年龄在20 - 35岁的PCOS患者和42例年龄匹配的对照女性。参与者根据BMI临界值27kg/m²分为以下几类：1）高BMI的PCOS患者；2）低BMI的PCOS患者；3）高BMI的对照女性；4）低BMI的对照女性。数据以BMI临界值30kg/m²重新分析，以证实肥胖和非肥胖患者的研究结果。
采集血样并测定促黄体生成素（LH）、促卵泡生成素（FSH）、胰岛素、睾酮（T）、雄烯二酮（A4）、DHEA、DHEAS和葡萄糖水平。计算稳态模型评估值。分别进行盆腔和腹部超声检查以观察卵巢形态和脂肪组织。
肥胖的PCOS患者比非肥胖的PCOS患者表现出更明显的胰岛素抵抗。低BMI的PCOS患者的LH水平和LH/FSH比值显著高于高BMI的PCOS患者。非肥胖的PCOS患者的A4和DHEAS水平显著高于肥胖的PCOS患者。在非肥胖的PCOS患者中观察到LH与A4之间存在显著相关性。与高BMI的PCOS患者相比，低BMI的PCOS患者中因A4、DHEA和DHEAS升高导致的高雄激素血症发生率显著更高。一些以27kg/m²为BMI临界值观察到的结果在以30kg/m²为临界值时发生了变化。
在PCOS患者中，低BMI比高BMI更易导致LH升高、A4、DHEA和DHEAS水平升高。对于激素和代谢特征，27kg/m²的BMI临界值比30kg/m²分类效果更好。
