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[黑色素集中激素与多囊卵巢综合征及其雄激素水平的相关性]

[Correlation between melanin-concentrating hormone and polycystic ovary syndrome and its androgen levels].

作者信息

Deng Y, Ba Y C, Wang Q Q, Hong X Y, Tan Z Y, Huang Q, Wang Q, Zhang L, Yuan X Y, Liao X

机构信息

Department of Endocrinology and Metabolic Diseases, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China.

Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2025 Sep 1;64(9):838-844. doi: 10.3760/cma.j.cn112138-20250505-00255.

Abstract

To investigate the changes in and correlations between melanin-concentrating hormone (MCH) and androgen levels in the serum of patients with polycystic ovary syndrome (PCOS), aiming to provide a novel research perspective for its diagnosis. A cross-sectional study. A total of 307 subjects were enrolled from the physical examination center and endocrinology clinic of the Affiliated Hospital of Zunyi Medical University from June 2023 to June 2024. The cohort comprised 114 healthy controls and 193 patients with PCOS, diagnosed according to the Rotterdam criteria. The patients were grouped into four phenotypes: Phenotype A (hyperandrogenemia [HA]+ovulatory dysfunction [OA]+polycystic ovarian morphology [PCOM], =44), Phenotype B (HA+OA, =50), Phenotype C (HA+PCOM, =46), and Phenotype D (OA+PCOM, =53). Clinical data were collected for all subjects. Serum MCH levels were determined by enzyme-linked immunosorbent assay. The relationship between MCH and androgen-related risk factors for PCOS was analyzed using Spearman partial correlation analysis and stepwise multiple linear hierarchical regression. Binary logistic regression was used to analyze factors influencing PCOS onset. The diagnostic value of MCH for PCOS was evaluated using a receiver operating characteristic (ROC) curve. There were no significant differences in age and height between the healthy control group and the PCOS phenotypic groups (both >0.05). MCH levels [17.63 (12.69, 22.00), 17.31 (11.05, 20.09), 17.82 (11.47, 19.40), 16.50 (11.14, 19.41) μg/L vs. 12.14 (9.78, 15.05) μg/L], homeostatic model assessment of insulin resistance, fasting plasma glucose, fasting serum lisulin, body mass index, and weight were significantly higher across all four PCOS phenotypes (A, B, C, and D) than in healthy controls (all <0.05), whereas sex hormone-binding globulin (SHBG) contents were significantly lower (<0.05). Free androgen index (FAI), total testosterone (TES) and dehydroepiandrosterone (DHEA) levels were significantly higher in PCOS phenotypes A, B, and C than in the control group and PCOS phenotype D (all <0.05). Spearman partial correlation analysis revealed no significant correlation between MCH and TES, DHEA, or FAI in healthy controls and patients with non-HA PCOS (all >0.05). However, in PCOS patients with HA, MCH showed a significant positive correlation with TES and DHEA (=0.227 and 0.196, respectively; both <0.05), but not FAI (>0.05). Stepwise multiple linear hierarchical regression analysis showed that MCH was positively correlated with TES, DHEA and luteinizing hormone and negatively correlated with SHBG (all <0.05). Binary logistic regression indicated that an increase in MCH may be a potential risk factor for PCOS occurrence (1.113, 95% 1.012-1.224, 0.028). ROC analysis showed that MCH has diagnostic value for PCOS (<0.05), with an area under the curve of 0.713. Serum MCH is closely related to FAI, TES, and DHEA levels in PCOS patients and may play an important role in the etiology and progression of the syndrome.

摘要

为探讨多囊卵巢综合征(PCOS)患者血清中黑色素浓缩激素(MCH)与雄激素水平的变化及其相关性,旨在为其诊断提供新的研究视角。采用横断面研究。2023年6月至2024年6月,从遵义医科大学附属医院体检中心和内分泌科门诊纳入307名受试者。该队列包括114名健康对照者和193名PCOS患者,根据鹿特丹标准进行诊断。患者分为四种表型:A表型(高雄激素血症[HA]+排卵功能障碍[OA]+多囊卵巢形态[PCOM],n = 44)、B表型(HA+OA,n = 50)、C表型(HA+PCOM,n = 46)和D表型(OA+PCOM,n = 53)。收集所有受试者的临床资料。采用酶联免疫吸附测定法测定血清MCH水平。采用Spearman偏相关分析和逐步多元线性分层回归分析MCH与PCOS雄激素相关危险因素的关系。采用二元logistic回归分析影响PCOS发病的因素。采用受试者工作特征(ROC)曲线评估MCH对PCOS的诊断价值。健康对照组与PCOS表型组之间的年龄和身高无显著差异(均>0.05)。所有四种PCOS表型(A、B、C和D)的MCH水平[17.63(12.69,22.00)、17.31(11.05,20.09)、17.82(11.47,19.40)、16.50(11.14,19.41)μg/L vs. 12.14(9.78,15.05)μg/L]、胰岛素抵抗稳态模型评估、空腹血糖、空腹血清胰岛素、体重指数和体重均显著高于健康对照组(均<0.05),而性激素结合球蛋白(SHBG)含量显著降低(<0.05)。PCOS表型A、B和C的游离雄激素指数(FAI)、总睾酮(TES)和脱氢表雄酮(DHEA)水平显著高于对照组和PCOS表型D(均<0.05)。Spearman偏相关分析显示,健康对照组和非HA PCOS患者中MCH与TES、DHEA或FAI之间无显著相关性(均>0.05)。然而,在HA的PCOS患者中,MCH与TES和DHEA呈显著正相关(分别为r = 0.227和0.196;均<0.05),但与FAI无相关性(>0.05)。逐步多元线性分层回归分析显示,MCH与TES、DHEA和黄体生成素呈正相关,与SHBG呈负相关(均<0.05)。二元logistic回归表明,MCH升高可能是PCOS发生的潜在危险因素(OR = 1.113,95%CI 1.012 - 1.224,P = 0.028)。ROC分析显示,MCH对PCOS具有诊断价值(<0.05),曲线下面积为0.713。血清MCH与PCOS患者的FAI、TES和DHEA水平密切相关,可能在该综合征的病因和进展中起重要作用。

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