Suresh S, Vijayakumar T
Department of Biochemistry, School of Medical Education, Mahatma Gandhi University, Gandhinagar-P.O, Kottayam, 686006 Kerala India.
Educare Institute of Dental Sciences, Kiliamannil Campus, Chattiparamba-P.O, Malappuram, Kerala India.
Indian J Clin Biochem. 2015 Jul;30(3):345-50. doi: 10.1007/s12291-014-0447-z. Epub 2014 Jun 1.
Functional ovarian hyperandrogenism (FOH) is a form of polycystic ovary syndrome (PCOS) characterized by elevated circulating levels of androgens derived from the ovary. Insulin resistance (IR) is the most common etiological factor in women with FOH. IR causes the generation of increased oxidative stress (OS) and diminished antioxidant status. OS is directly correlated with both IR and testosterone levels, which consequently contribute to endocrine and biochemical alterations in FOH women. In the current study, elevations in total testosterone, free testosterone and luteinizing hormone (LH) levels accompanied by a decrease in follicle stimulating hormone (FSH) level leading to higher LH:FSH ratio were the prominent endocrine changes observed in women with FOH. A significant increase in fasting blood levels of glucose and insulin, as well as an elevated IR were also seen in FOH women, as compared to their age matched controls. Women with FOH have higher pro-oxidant and lower anti-oxidant levels in blood than their age matched controls. In FOH women, elevations in LH:FSH ratio and OS are correlated more with hyperandrogenemia than with IR. Of the androgens, free rather than total testosterone has better positive correlations with elevated LH:FSH ratio and OS, and hence, the former is a better predictive marker for the development of biochemical PCOS in women with FOH.
功能性卵巢雄激素过多症（FOH）是多囊卵巢综合征（PCOS）的一种形式，其特征是源自卵巢的循环雄激素水平升高。胰岛素抵抗（IR）是FOH女性中最常见的病因。IR导致氧化应激（OS）增加和抗氧化状态降低。OS与IR和睾酮水平直接相关，因此导致FOH女性出现内分泌和生化改变。在本研究中，总睾酮、游离睾酮和黄体生成素（LH）水平升高，同时促卵泡生成素（FSH）水平降低，导致LH:FSH比值升高，这是在FOH女性中观察到的主要内分泌变化。与年龄匹配的对照组相比，FOH女性空腹血糖和胰岛素水平也显著升高，IR也升高。与年龄匹配的对照组相比，FOH女性血液中的促氧化剂水平更高，抗氧化剂水平更低。在FOH女性中，LH:FSH比值和OS的升高与高雄激素血症的相关性比与IR的相关性更大。在雄激素中，游离睾酮而非总睾酮与升高的LH:FSH比值和OS具有更好的正相关性，因此，前者是FOH女性生化性PCOS发展的更好预测指标。
