Department of Gynecology and obstetrics, The Sixth People's Hospital of KunShan, Kunshan, Jiangsu, China.
Department of Gynecology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu, China.
J Obstet Gynaecol Res. 2021 Apr;47(4):1221-1231. doi: 10.1111/jog.14681. Epub 2021 Feb 8.
It is found that there is a significant difference in serum-free androgen index (FAI) between patients with polycystic ovary syndrome (PCOS) and healthy people, and the selection of appropriate cutoff value has a certain diagnostic value for PCOS. However, the current research conclusions on the diagnostic value of FAI for PCOS are not consistent. The purpose of this study is to explore the diagnostic value of FAI in PCOS, in order to provide reference for clinicians to select appropriate diagnostic indicators in the future.
Cochrane Library, Medline, Excerpta Medica Database, China National Knowledge Infrastructure, and China Wanfang database were searched until July 2020. A comprehensive collection of FAI studies on the diagnosis of PCOS was conducted. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (+LR), and negative likelihood ratio (-LR) were analyzed by Stata15.0 software, and the receiver operating characteristic (ROC) curves of the subjects were drawn.
A total of seven high-quality clinical studies were included. The results of meta-analysis showed that the pooled sensitivity = 0.76 (95% confidence interval [CI]: 0.69 ~ 0.82), specificity = 0.82 (95%CI: 0.69 ~ 0.90), +LR = 4.12 (95%CI: 2.12 ~ 4.03), -LR = 0.29 (95%CI: 0.22 ~ 0.38), DOR = 14.08 (95%CI: 7.13 ~ 27.83), and the area under ROC was 0.84.
FAI has a moderate diagnostic value for PCOS. It may be possible to add new experimental designs to find the best cut-off value for FAI diagnosis to improve the diagnostic efficacy.
研究发现多囊卵巢综合征（PCOS）患者与健康人群的血清游离雄激素指数（FAI）存在显著差异，且合适截断值的选择对 PCOS 具有一定的诊断价值。但目前关于 FAI 对 PCOS 的诊断价值的研究结论尚不一致。本研究旨在探讨 FAI 对 PCOS 的诊断价值，为临床医生今后选择合适的诊断指标提供参考。
计算机检索 Cochrane Library、Medline、Embase、中国知网、万方数据库，搜集关于 FAI 诊断 PCOS 的研究，检索时限均从建库至 2020 年 7 月。采用 Stata15.0 软件进行 Meta 分析，计算合并敏感度、特异度、诊断比值比（DOR）、阳性似然比（+LR）、阴性似然比（-LR），绘制受试者工作特征（ROC）曲线。
共纳入 7 项高质量临床研究。Meta 分析结果显示，FAI 诊断 PCOS 的合并敏感度=0.76（95%CI：0.690.82），特异度=0.82（95%CI：0.690.90），+LR=4.12（95%CI：2.124.03），-LR=0.29（95%CI：0.220.38），DOR=14.08（95%CI：7.13~27.83），ROC 曲线下面积为 0.84。
FAI 对 PCOS 具有中等诊断价值，可尝试增加新的实验设计寻找最佳截断值，以提高诊断效能。
