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硫酸脱氢表雄酮(DHEAS)水平在多囊卵巢综合征(PCOS)中的变化。

Dehydroepiandrosterone Sulfate (DHEAS) Levels in Polycystic Ovarian Syndrome (PCOS).

机构信息

Department of Pathology, PNS Hafeez, Naval Hospital, Islamabad, Pakistan.

Department of Medicine, PNS Hafeez, Naval Hospital, Islamabad, Pakistan.

出版信息

J Coll Physicians Surg Pak. 2021 Mar;31(3):253-257. doi: 10.29271/jcpsp.2021.03.253.

Abstract

OBJECTIVE

To compare DHEAS levels among subjects with and without PCOS, evaluating differences between lean-PCOS or obese-PCOS phenotype for insulin resistance, anthropometric indices, glycemic and lipid parameters.

STUDY DESIGN

Descriptive study. Study Place and Duration of Study: PNS Hafeez Naval Hospital, Islamabad, Pakistan, from January 2018 to August 2019.

METHODOLOGY

Three hundred and twenty-eight subjects were included in the study for evaluation. PCOS was defined as per Rotterdam criteria, while insulin resistance, anthropometric measurements, various hormonal and biochemical analyses were carried out as per standard protocols. Hirsutism was calculated as per modified Ferrimen Gallwey score and free androgen index (FAI) was calculated using formula as: FAI = [(Total testosterone/Sex hormone binding globulin (SHBG)] x100. These subjects underwent clinical biochemical evaluation and were segregated into 2 groups: lean-PCOS and obese-PCOS.   Results: DHEAS levels were higher in subjects with PCOS [(171.50) (111.75-244.25) ug/dl], n=164] than in subjects without PCOS [(130.50) (78.95-189.75) ug/dl, n=164, p<0.001]. Area under curve (AUC) in diagnosing PCOS was highest for modified FG score [0.802, p<0.001], followed by FAI [0.785, p<0.001]. Total testosterone [0.743, p<0.001] and DHEAS [0.637, p<0.001]. DHEAS levels were found to be inversely related to age, anthropometric indices, glycemia, dyslipidemia, nephropathy and reproductive hormones. The DHEAS in lean-PCOS was higher than obese female subjects with or without PCOS.

CONCLUSION

DHEAS levels were high in lean-PCOS in comparison to obese-PCOS and non-PCOS females. However, receiver operating curve (ROC) analysis showed DHEAS as a weaker marker for diagnosing PCOS than FAI and modified FG score. Key Words: DHEAS, Polycystic ovarian syndrome (PCOS), Homeostasis model assessment for insulin resistance (HOMAIR), Rotterdam criteria, Free androgen index.

摘要

目的

比较多囊卵巢综合征(PCOS)患者和非 PCOS 患者的 DHEAS 水平,评估瘦型 PCOS 或肥胖型 PCOS 表型的胰岛素抵抗、人体测量学指标、血糖和血脂参数的差异。

研究设计

描述性研究。研究地点和时间:巴基斯坦伊斯兰堡 PNS Hafeez Naval 医院,2018 年 1 月至 2019 年 8 月。

方法

共纳入 328 例研究对象进行评估。PCOS 按 Rotterdam 标准定义,胰岛素抵抗、人体测量学测量、各种激素和生化分析均按标准方案进行。多毛症按改良 Ferriman-Gallwey 评分计算,游离雄激素指数(FAI)按公式计算:FAI = [(总睾酮/性激素结合球蛋白(SHBG)] x100。这些患者接受了临床生化评估,并分为 2 组:瘦型 PCOS 和肥胖型 PCOS。结果:PCOS 组 DHEAS 水平高于非 PCOS 组[171.50(111.75-244.25)μg/dl,n=164] [130.50(78.95-189.75)μg/dl,n=164,p<0.001]。诊断 PCOS 的曲线下面积(AUC)以改良 FG 评分最高[0.802,p<0.001],其次是 FAI[0.785,p<0.001]。总睾酮[0.743,p<0.001]和 DHEAS[0.637,p<0.001]。DHEAS 水平与年龄、人体测量学指标、血糖、血脂异常、肾病和生殖激素呈负相关。瘦型 PCOS 患者的 DHEAS 水平高于肥胖型 PCOS 和非 PCOS 女性。结论:与肥胖型 PCOS 和非 PCOS 女性相比,瘦型 PCOS 患者的 DHEAS 水平较高。然而,受试者工作特征曲线(ROC)分析显示,DHEAS 作为诊断 PCOS 的标志物不如 FAI 和改良 FG 评分强。关键词:DHEAS、多囊卵巢综合征(PCOS)、胰岛素抵抗稳态模型评估(HOMAIR)、 Rotterdam 标准、游离雄激素指数。

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