Tűű László, Nas Katalin, Török Marianna, Várbíró Szabolcs
EndoCare Institute, Endocrinology Center, 1095 Budapest, Hungary.
School of PhD Studies, Semmelweis University, 1085 Budapest, Hungary.
J Clin Med. 2024 Feb 1;13(3):838. doi: 10.3390/jcm13030838.
There are several phenotypes of polycystic ovarian syndrome (PCOS), and the different phenotypes may differ metabolically. In the present retrospective study, women with PCOS having normal fasting insulin sensitivity ( = 88) were compared with women with PCOS showing impaired insulin sensitivity ( = 46) using the HPCOS (Hungarian Polycystic ovarian syndrome) database. The impaired insulin sensitivity group has significantly higher body mass index (BMI) and HOMA index than the normal fasting insulin sensitivity group (BMI (kg/m): 22.0 vs. 28.1, < 0.0001, HOMA index: 0.96 vs. 2.38, < 0.0001). The sex hormone binding globulin (SHBG) level was significantly lower, and the free androgen index proved itself significantly higher in the impaired insulin sensitivity group ( < 0.05). Linear regression analysis showed a negative association of BMI with SHBG levels in both groups, while BMI had a positive correlation with insulin concentrations in both groups. However, the SHBG levels were negatively associated with insulin concentrations in the impaired insulin sensitivity group, but this inverse association could not be observed in the normal fasting insulin sensitivity group. The inverse linear correlation of SHBG with HOMA index and serum insulin level is not evident in all PCO syndrome phenotypes, thus SHBG has limited applicability for characterizing carbohydrate metabolism and serum insulin sensitivity.
多囊卵巢综合征（PCOS）有多种表型，不同表型在代谢方面可能存在差异。在本回顾性研究中，利用匈牙利多囊卵巢综合征（HPCOS）数据库，将空腹胰岛素敏感性正常的PCOS女性（n = 88）与胰岛素敏感性受损的PCOS女性（n = 46）进行了比较。胰岛素敏感性受损组的体重指数（BMI）和稳态模型评估胰岛素抵抗指数（HOMA指数）显著高于空腹胰岛素敏感性正常组（BMI（kg/m²）：22.0对28.1，P < 0.0001；HOMA指数：0.96对2.38，P < 0.0001）。胰岛素敏感性受损组的性激素结合球蛋白（SHBG）水平显著较低，而游离雄激素指数则显著较高（P < 0.05）。线性回归分析显示，两组中BMI与SHBG水平均呈负相关，而两组中BMI与胰岛素浓度均呈正相关。然而，在胰岛素敏感性受损组中，SHBG水平与胰岛素浓度呈负相关，但在空腹胰岛素敏感性正常组中未观察到这种负相关。SHBG与HOMA指数和血清胰岛素水平的负线性相关性在所有PCO综合征表型中并不明显，因此SHBG在表征碳水化合物代谢和血清胰岛素敏感性方面的适用性有限。
