Zhang Duojia, Gao Jingshu, Liu Xuekui, Qin Huichao, Wu Xiaoke
Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, People's Republic of China.
Department of Endocrinology, Xuzhou Central Hospital, Xuzhou, China.
Reprod Sci. 2021 Mar;28(3):775-784. doi: 10.1007/s43032-020-00316-1. Epub 2020 Sep 28.
This work sought to evaluate the effects of three androgen indexes of free testosterone (FT), total testosterone (TT), and free-androgen index (FAI) on clinical phenotype, endocrine metabolic disorders, and fertility outcomes in women with polycystic ovary syndrome. The data in this study came from a large, multicenter, randomized double-blind controlled clinical trial involving 1000 infertile PCOS patients. Baseline phenotypic, endocrine, and metabolic parameters and fertility outcomes undergoing ovulation induction were collected. FAI is superior to FT, and FT is superior to TT in terms of their correlation with anthropometric parameters and metabolic profile. FT and TT were significantly positively correlated with LH/FSH. FAI and FT were significantly correlated with the incidence of metabolic syndrome. FAI, FT, and TT were significantly positively correlated with polycystic ovary morphology and menstrual period. FAI was significantly related ovulations per cycle, pregnancy, conception, and live birth rates. After adjusting for age, the increased FT level was significantly related to the decreased rates of ovulations per cycle, conception, and pregnancy. FAI is superior to FT and FT is superior to TT in terms of their correlation with phenotypic and metabolic parameters in PCOS patients. FAI and FT are important factors related to the fertility outcomes of infertile PCOS patients. Clinical trial registration number: NCT01573858.
本研究旨在评估游离睾酮（FT）、总睾酮（TT）和游离雄激素指数（FAI）这三种雄激素指标对多囊卵巢综合征女性的临床表型、内分泌代谢紊乱及生育结局的影响。本研究数据来自一项大型、多中心、随机双盲对照临床试验，该试验纳入了1000例不孕的多囊卵巢综合征患者。收集了基线时的表型、内分泌和代谢参数以及接受促排卵治疗后的生育结局。就与人体测量参数和代谢特征的相关性而言，游离雄激素指数优于游离睾酮，游离睾酮优于总睾酮。游离睾酮和总睾酮与促黄体生成素/促卵泡生成素显著正相关。游离雄激素指数和游离睾酮与代谢综合征的发生率显著相关。游离雄激素指数、游离睾酮和总睾酮与多囊卵巢形态和月经周期显著正相关。游离雄激素指数与每个周期的排卵次数、妊娠、受孕及活产率显著相关。在调整年龄后，游离睾酮水平升高与每个周期的排卵次数、受孕及妊娠率降低显著相关。就与多囊卵巢综合征患者的表型和代谢参数的相关性而言，游离雄激素指数优于游离睾酮，游离睾酮优于总睾酮。游离雄激素指数和游离睾酮是与不孕多囊卵巢综合征患者生育结局相关的重要因素。临床试验注册号：NCT01573858。
