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生殖年龄多囊卵巢综合征 (PCOS) 女性的内分泌和代谢参数的异质性与高雄激素血症的严重程度有关-对综合征发病机制的新认识。

Heterogeneity of Endocrinologic and Metabolic Parameters in Reproductive Age Polycystic Ovary Syndrome (PCOS) Women Concerning the Severity of Hyperandrogenemia-A New Insight on Syndrome Pathogenesis.

机构信息

Department of Infertility and Reproductive Endocrinology, Poznan University of Medical Sciences, 60-535 Poznań, Poland.

出版信息

Int J Environ Res Public Health. 2020 Dec 11;17(24):9291. doi: 10.3390/ijerph17249291.

Abstract

BACKGROUND

Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, anovulation, infertility, obesity, and insulin resistance, which results in increased concentrations of testosterone (T), which disturbs follicular growth and ovulation. This study aimed to assess PCOS women's clinical, endocrinological, and metabolic parameters concerning hyperandrogenism severity.

RESULTS

314 women (mean age 27.3 ± 4.6; mean body mass index (BMI) 25.7 ± 5.6) with PCOS, were divided into terciles according to T concentrations: <0.64 ng/mL (group 1), 0.64 to 0.84 ng/mL (Group 2) and >0.84 ng/mL (group 3). The mean concentration of T in all women was 0.59 ng/mL and correlated negatively with the number of menstrual cycles per year (MPY) (r = -0.36; p < 0.0001) and positively with Ferriman-Gallway score (FG) (r = 0.33; p < 0.0001), luteinizing hormone (LH) (r = 0.19; p < 0.0001) and dehydroepiandrosterone sulfate (DHEAS) (r = 0.52; p < 0.0001). Positive correlation between BMI and hirsutism (r = 0.16; p < 0.0001), total cholesterol (TC) (r = 0.18; p < 0.0001), low-density lipoprotein (LDL) (r = 0.29; p < 0.0001), and triglycerides (TG) (r = 0.40; p < 0.0001) was demonstrated. The division into subgroups confirmed the lowest MPY, highest LH, and hirsutism in group 3. BMI, insulin sensitivity indices, and lipid profile parameters were not different between the three T subgroups.

CONCLUSIONS

We found no correlation between testosterone levels and insulin sensitivity or dyslipidemia in women with PCOS. Metabolic abnormalities may contribute more significantly than hyperandrogenemia to PCOS development.

摘要

背景

多囊卵巢综合征(PCOS)的特点是高雄激素血症、排卵障碍、不孕、肥胖和胰岛素抵抗,这会导致睾酮(T)浓度升高,扰乱卵泡生长和排卵。本研究旨在评估多囊卵巢综合征患者高雄激素血症严重程度的临床、内分泌和代谢参数。

结果

根据 T 浓度将 314 名(平均年龄 27.3 ± 4.6;平均体重指数(BMI)25.7 ± 5.6)多囊卵巢综合征妇女分为三组:<0.64ng/ml(第 1 组)、0.64-0.84ng/ml(第 2 组)和>0.84ng/ml(第 3 组)。所有妇女的 T 平均浓度为 0.59ng/ml,与每年月经周期数(MPY)呈负相关(r=-0.36;p<0.0001),与 Ferraiman-Gallway 评分(FG)(r=0.33;p<0.0001)、黄体生成素(LH)(r=0.19;p<0.0001)和脱氢表雄酮硫酸盐(DHEAS)(r=0.52;p<0.0001)呈正相关。BMI 与多毛症(r=0.16;p<0.0001)、总胆固醇(TC)(r=0.18;p<0.0001)、低密度脂蛋白(LDL)(r=0.29;p<0.0001)和甘油三酯(TG)(r=0.40;p<0.0001)呈正相关。分组证实第 3 组的 MPY 最低、LH 最高、多毛症最严重。三组间 BMI、胰岛素敏感性指数和血脂参数无差异。

结论

我们发现多囊卵巢综合征妇女的睾酮水平与胰岛素敏感性或血脂异常无关。代谢异常对多囊卵巢综合征的发展可能比高雄激素血症更为重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/027a/7763600/cde10fd962db/ijerph-17-09291-g001a.jpg

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