Wild R A, Umstot E S, Andersen R N, Ranney G B, Givens J R
Am J Obstet Gynecol. 1983 Jul 15;146(6):602-6. doi: 10.1016/0002-9378(83)90998-5.
The first objective of this study was to determine which plasma androgen assay or combination of assays would be the most useful in documenting hyperandrogenism in women with hirsutism, acne, oligomenorrhea, or unexplained infertility. Plasma levels of androstenedione (A), total testosterone (T), and dehydroepiandrosterone sulfate (DHEAS) were measured and free T (FTc) was calculated from the measured total T and T-estradiol-binding globulin binding capacity (TeBG-BC) in 138 consecutive women referred to our clinic for hirsutism, acne, oligomenorrhea, and/or unexplained infertility. FTc was elevated in 82% and was most frequently elevated parameter. DHEAS was elevated in 59% of the women, and 93% were noted to have hyperandrogenemia on the basis of a combination of FTc and DHEAS levels. The second objective of this study was to determine whether there was significant correlation between the androgen parameters and any of the clinical features. Body weight was significantly negatively correlated with DHEAS and TeBG-BC in those women with a normal DHEAS level but not in those with an elevated level. A strong positive correlation (simple and partial) was noted between body weight and plasma T levels in the whole group of patients, as well as in those with a normal or an elevated DHEAS level. It is suggested that the relationship between T and body weight is multifaceted. Conceivably, T could influence body mass by effects on food intake or through alterations in intermediary metabolism.
本研究的首要目标是确定哪种血浆雄激素检测方法或检测方法组合,对于记录患有多毛症、痤疮、月经过少或不明原因不孕症的女性的高雄激素血症最为有用。对138名因多毛症、痤疮、月经过少和/或不明原因不孕症转诊至我们诊所的连续女性,测量了血浆雄烯二酮(A)、总睾酮(T)和硫酸脱氢表雄酮(DHEAS)水平,并根据测得的总T和T-雌二醇结合球蛋白结合能力(TeBG-BC)计算游离T(FTc)。82%的患者FTc升高,且是最常升高的参数。59%的女性DHEAS升高,93%的女性根据FTc和DHEAS水平的组合被诊断为高雄激素血症。本研究的第二个目标是确定雄激素参数与任何临床特征之间是否存在显著相关性。在DHEAS水平正常的女性中,体重与DHEAS和TeBG-BC显著负相关,但在DHEAS水平升高的女性中则不然。在整个患者组以及DHEAS水平正常或升高的患者中,体重与血浆T水平之间均存在强正相关(简单相关和偏相关)。提示T与体重之间的关系是多方面的。可以想象,T可能通过影响食物摄入或通过改变中间代谢来影响体重。