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[促黄体生成素与促卵泡生成素比值和多囊卵巢综合征:一项被遗忘的检测?]

[LH-FSH ratio and Polycystic Ovary Syndrome: A forgotten test?].

作者信息

Saucedo de la Llata E, Moraga-Sánchez M R, Romeu-Sarrió A, Carmona-Ruiz I O

出版信息

Ginecol Obstet Mex. 2016 Feb;84(2):84-94.

Abstract

OBJECTIVE

To identify the predictive value of LH-FSH ratio in the Polycystic Ovary Syndrome diagnosis and to evaluate its role according PCOS phenotypes.

MATERIAL AND METHOD

A descriptive, comparative, observational, prospective study of PCOS patients and its controls. All participants received a questionnaire and underwent a physical and transvaginal ultrasound examination. Blood samples were also collected for analysis of metabolic markers and hormones. PCOS was diagnosed according to Rotterdam criteria.

RESULTS

A total of 267 women were included into the study. PCOS was diagnosed in 162 patients. There was statistical difference in: HOMA, 1.43 ± 1.06, 2.09 ± 1.96; Total Testosterone, 0.31 ± 0.14, 0.41 ± 0.19; and free Androgen index, 1.17 ± 1.30, 1.69 ± 1.18; for control and PCOS group, respectively. FSH, 6.55 ± 2.43 in controls and 5.30 ± 1.66 in PCOS patients (p = 0.001); LH, 4.34 ± 2.12 controls, 6.36 ± 4.61 PCOS patients (p = 0.001). LH-FSH ratio was 0.71 ± 0.39 for control group and 1.25 ± 0.85 in PCOS group, p = 0.001. A correlation was observed between LH-FSH ratio and total antral follicle count (p < 0.001) and with insulin resistance (p = 0.022).

CONCLUSION

LH-FSH ratio, although it is a valuable test, it is not diagnostic of PCOS. A correlation was found with LH-FSH ratio and insulin resistance but we must not forget about its association with hyperandrogenism.

摘要

目的

确定促黄体生成素与促卵泡生成素比值(LH-FSH比值)在多囊卵巢综合征诊断中的预测价值,并根据多囊卵巢综合征的表型评估其作用。

材料与方法

一项对多囊卵巢综合征患者及其对照进行的描述性、比较性、观察性、前瞻性研究。所有参与者均接受问卷调查,并进行体格检查和经阴道超声检查。还采集血样以分析代谢标志物和激素。根据鹿特丹标准诊断多囊卵巢综合征。

结果

共有267名女性纳入研究。162例患者被诊断为多囊卵巢综合征。对照组和多囊卵巢综合征组在以下指标上存在统计学差异:稳态模型评估的胰岛素抵抗指数(HOMA),分别为1.43±1.06、2.09±1.96;总睾酮,分别为0.31±0.14、0.41±0.19;游离雄激素指数,分别为1.17±1.30、1.69±1.18。促卵泡生成素(FSH),对照组为6.55±2.43,多囊卵巢综合征患者为5.30±1.66(p = 0.001);促黄体生成素(LH),对照组为4.34±2.12,多囊卵巢综合征患者为6.36±4.61(p = 0.001)。LH-FSH比值对照组为0.71±0.39,多囊卵巢综合征组为1.25±0.85,p = 0.001。观察到LH-FSH比值与窦卵泡总数(p < 0.001)以及胰岛素抵抗(p = 0.022)之间存在相关性。

结论

LH-FSH比值虽然是一项有价值的检测指标,但不能用于诊断多囊卵巢综合征。发现LH-FSH比值与胰岛素抵抗存在相关性,但我们不能忽视其与高雄激素血症的关联。

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