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多囊卵巢综合征女性的高雄激素血症:患病率、特征及其与体重指数的关联

Hyperandrogenemia in women with polycystic ovary syndrome: prevalence, characteristics and association with body mass index.

作者信息

Alexiou Eleni, Hatziagelaki Erifili, Pergialiotis Vasilios, Chrelias Charalampos, Kassanos Dimitrios, Siristatidis Charalampos, Kyrkou Giannoula, Kreatsa Maria, Trakakis Eftihios

出版信息

Horm Mol Biol Clin Investig. 2017 Mar 1;29(3):105-111. doi: 10.1515/hmbci-2016-0047.

Abstract

BACKGROUND

Hyperandrogenemia is one of the major diagnostic features for the diagnosis of polycystic ovary syndrome (PCOS). The aim of this study was to estimate the prevalence and the characteristics of hyperandrogenemia in women with PCOS and to investigate the association of clinical and biochemical characteristics with body mass index (BMI) according to the presence of hyperandrogenemia.

MATERIALS AND METHODS

We studied 266 women diagnosed with PCOS. Hyperandrogenemia was defined by testosterone (T) and/or free testosterone (FT) and/or ∆4 androstenedione (Δ4-A) higher than 75% of the upper limits of each hormone. Patients were stratified in two groups according to a BMI threshold of 25 kg/m2.

RESULTS

Hyperandrogenemia was present in 78.2% of the patients. Elevated levels of T were found in 58.4%, while elevated levels of FT and Δ4-A were found in 42.5% and 34.1% of patients. In normal weight women (BMI≤25 kg/m2) with hyperandrogenemia lower values of hip circumference and HOMA-IR and increased levels of T, FT, Δ4-A, 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone sulfate (DHEAS), white blood cells (WBC) and neutrophils were observed compared to women without hyperandrogenemia. Also, in overweight women higher levels of T, FT, Δ4-A, 17-OHP, DHEAS and cortisol were measured, while lower thyroid-stimulating hormone (TSH) levels were comparable to women without hyperandrogenemia.

CONCLUSION

This study showed high prevalence of hyperandrogenemia in PCOS women. Women with BMI≤25 kg/m2 have significant differences in androgens, WBC, neutrophils and HOMA-IR and women with BMI≥25 kg/m2 in androgens, TSH and cortisol according to the presence or not of hyperandrogenemia.

摘要

背景

高雄激素血症是多囊卵巢综合征(PCOS)诊断的主要特征之一。本研究旨在评估PCOS女性高雄激素血症的患病率及特征,并根据高雄激素血症的存在情况,探讨临床和生化特征与体重指数(BMI)之间的关联。

材料与方法

我们研究了266例诊断为PCOS的女性。高雄激素血症定义为睾酮(T)和/或游离睾酮(FT)和/或Δ4雄烯二酮(Δ4-A)高于各激素上限的75%。根据BMI阈值25kg/m²将患者分为两组。

结果

78.2%的患者存在高雄激素血症。58.4%的患者T水平升高,42.5%的患者FT水平升高,34.1%的患者Δ4-A水平升高。与无高雄激素血症的女性相比,体重正常(BMI≤25kg/m²)且有高雄激素血症的女性臀围和胰岛素抵抗稳态模型评估(HOMA-IR)值较低,而T、FT、Δ4-A、17-羟孕酮(17-OHP)、硫酸脱氢表雄酮(DHEAS)、白细胞(WBC)和中性粒细胞水平升高。此外,超重女性的T、FT、Δ4-A、17-OHP、DHEAS和皮质醇水平较高,而促甲状腺激素(TSH)水平较低,与无高雄激素血症的女性相当。

结论

本研究显示PCOS女性中高雄激素血症的患病率较高。根据是否存在高雄激素血症,BMI≤25kg/m²的女性在雄激素、WBC、中性粒细胞和HOMA-IR方面存在显著差异,而BMI≥25kg/m²的女性在雄激素、TSH和皮质醇方面存在显著差异。

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