Lin X F, Wu R R, Du J, Liao Y C, Du Y, Ye Y, Wang Y, Zhang X B, Wu C, Chen A
Clin Exp Obstet Gynecol. 2015;42(3):315-20.
To explore whether sex hormone-binding globulin (SHBG) and free androgen index (FAI) can be seen as therapeutic effect indexes of women with polycystic ovarian syndrome (PCOS).
The body mass index (BMI), basal sexual hormones, SHBG, fasting blood glucose (FBG), and fasting insulin (FINS) were collected from 579 women with PCOS, were divided into two groups according to BMI: obese group (n = 145) and non-obese group (n = 434), according to homeostasis model assessment of insulin status (HOMA-IR). Patients were then divided into four groups: A: non-obese without insulin resistance (n = 174), B: non-obese with insulin resistance (n = 260), C: obese without insulin resistance (n = 34), D: obese with insulin resistance (n = 111). A and B groups received Diane-35 alone, C and D groups received Diane-35 plus metformin for three months. Then clomiphene citrate and HMAG were used to induce ovulation then compared ovulation rate and pregnancy outcome.
FAI decreased significantly and SHBG increased significantly in all groups. In A group FINS and HOMA-IR increased significantly (p < 0.05), but in B and D groups FINS and HOMA-IR decreased significantly (p < 0.05). After treatment the ovulation rate in non-obese group was higher than obese group (p < 0.01). Compared with non-ovulation patients, SHBG increased significantly and FAI decreased significantly in the patient with ovulation. Regarding the pregnancy outcome, FAI decreased significantly in delivery patients than spontaneous abortion patients. Furthermore, SHBG increased significantly.
It was important to check SHBG and FAI during the treatment of PCOS patient. They could be used to assess whether the treatment was effective and as a guidance of clinical medication.
探讨性激素结合球蛋白（SHBG）和游离雄激素指数（FAI）是否可作为多囊卵巢综合征（PCOS）女性的治疗效果指标。
收集579例PCOS女性的体重指数（BMI）、基础性激素、SHBG、空腹血糖（FBG）和空腹胰岛素（FINS），根据BMI分为两组：肥胖组（n = 145）和非肥胖组（n = 434），根据胰岛素状态的稳态模型评估（HOMA-IR）。然后将患者分为四组：A：非肥胖无胰岛素抵抗（n = 174），B：非肥胖有胰岛素抵抗（n = 260），C：肥胖无胰岛素抵抗（n = 34），D：肥胖有胰岛素抵抗（n = 111）。A组和B组单独使用达英-35，C组和D组使用达英-35加二甲双胍治疗三个月。然后使用枸橼酸氯米芬和人绝经期促性腺激素诱导排卵，比较排卵率和妊娠结局。
所有组的FAI均显著降低，SHBG均显著升高。A组的FINS和HOMA-IR显著升高（p < 0.05），但B组和D组的FINS和HOMA-IR显著降低（p < 0.05）。治疗后，非肥胖组的排卵率高于肥胖组（p < 0.01）。与未排卵患者相比，排卵患者的SHBG显著升高，FAI显著降低。关于妊娠结局，分娩患者的FAI比自然流产患者显著降低。此外，SHBG显著升高。
在PCOS患者治疗期间检查SHBG和FAI很重要。它们可用于评估治疗是否有效，并作为临床用药的指导。
