多囊卵巢综合征患者的高雄激素血症与人体测量学参数。
Hyperandrogenism and anthropometric parameters in women with polycystic ovary syndrome.
机构信息
Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
出版信息
BMC Endocr Disord. 2024 Sep 27;24(1):201. doi: 10.1186/s12902-024-01733-y.
OBJECTIVE
One of the main features of polycystic ovary syndrome (PCOS) is increased adipose tissue, which can result in hormonal disturbances. In the present study, we aimed to investigate which indicator of obesity could better associate with hormonal disturbances in PCOS women.
METHODS
In this cross-sectional analysis, women with PCOS were included according to the Rotterdam criteria. Fasting blood samples were analyzed for biochemical, metabolic, and hormonal parameters. Anthropometric measures comprised body composition indices (assessed by bioelectric impedance analysis [BIA]), waist circumference, body mass index (BMI), and waist-to-height ratio (WHtR). Linear regression modeling was used to assess the association between anthropometric indices and hormonal imbalance, adjusted for age, mensuration status, and the homeostasis model assessment-estimated insulin resistance (HOMA-IR). Receiver operating characteristics (ROC) curves were utilized to ascertain the sensitivity, specificity, and optimal cut-off points of various anthropometric indices in identifying hyperandrogenism.
RESULTS
A total of 129 PCOS women with a median (interquartile range [IQR]) age of 32.0 (23.0-32.0) years and a median BMI of 26.3 (23.00-29.70) kg/m were enrolled. In the adjusted linear regression model, BMI (β = 0.053, P < 0.001), waist circumference (β = 0.021, P = 0.001), WHtR (β = 3.325, P = 0.002), total fat mass (β = 0.021, P = 0.002), trunk fat mass (β = 0.038, P = 0.006), and leg fat mass (β = 0.045, P = 0.004) were positively associated with free androgen index (FAI). In addition, BMI (β=-0.017, P = 0.003), waist circumference (β=-0.008, P = 0.002), WHtR (β=-1.167, P = 0.004), total fat mass (β=-0.008, P=0.003), trunk fat mass (β=-0.017, P=0.001), and leg fat mass (β=-0.018, P=0.004) were negatively associated with the serum level of sex hormone binding globulin (SHBG). WHtR showed the greatest area under the curve (AUC) value (AUC = 0.676, P = 0.001) for identifying hyperandrogenism (FAI ≥ 4.97 or total testosterone ≥ 0.7 ng/mL) in PCOS women with corresponding sensitivity of 87.30% and specificity of 39.70%.
CONCLUSIONS
WHtR is related to hyperandrogenism in PCOS better than other anthropometric measures.
目的
多囊卵巢综合征（PCOS）的主要特征之一是脂肪组织增加，这可能导致激素紊乱。本研究旨在探讨哪种肥胖指标能更好地与 PCOS 女性的激素紊乱相关。
方法
本横断面分析纳入了符合鹿特丹标准的 PCOS 患者。采集空腹血样进行生化、代谢和激素参数分析。人体测量指标包括身体成分指数（通过生物电阻抗分析[BIA]评估）、腰围、体重指数（BMI）和腰高比（WHtR）。采用线性回归模型，在校正年龄、测量状态和稳态模型评估的胰岛素抵抗（HOMA-IR）后，评估各种人体测量指标与激素失衡之间的关联。利用受试者工作特征（ROC）曲线确定各种人体测量指标识别高雄激素血症的灵敏度、特异性和最佳截断值。
结果
共纳入 129 名年龄中位数（四分位距[IQR]）为 32.0（23.0-32.0）岁、BMI 中位数（IQR）为 26.3（23.00-29.70）kg/m2的 PCOS 女性。在调整后的线性回归模型中，BMI（β=0.053，P<0.001）、腰围（β=0.021，P=0.001）、WHtR（β=3.325，P=0.002）、总脂肪量（β=0.021，P=0.002）、躯干脂肪量（β=0.038，P=0.006）和腿部脂肪量（β=0.045，P=0.004）与游离雄激素指数（FAI）呈正相关。此外，BMI（β=-0.017，P=0.003）、腰围（β=-0.008，P=0.002）、WHtR（β=-1.167，P=0.004）、总脂肪量（β=-0.008，P=0.003）、躯干脂肪量（β=-0.017，P=0.001）和腿部脂肪量（β=-0.018，P=0.004）与血清性激素结合球蛋白（SHBG）水平呈负相关。WHtR 在识别 PCOS 女性高雄激素血症（FAI≥4.97 或总睾酮≥0.7ng/mL）方面的曲线下面积（AUC）值最大（AUC=0.676，P=0.001），相应的灵敏度为 87.30%，特异性为 39.70%。
结论
与其他人体测量指标相比，WHtR 与 PCOS 患者的高雄激素血症相关性更好。
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