雄激素对胰岛素抵抗的影响。

The influence of androgens on insulin resistance.

作者信息

Shoupe D, Lobo R A

出版信息

Fertil Steril. 1984 Mar;41(3):385-8.

Abstract

Insulin resistance (IR) in polycystic ovary syndrome (PCO) has been linked to hyperandrogenism and elevated luteinizing hormone (LH) levels. Fourteen patients with idiopathic hirsutism (IH), 13 with PCO, and 6 control subjects were investigated for assessment of the effects of serum LH, peripheral tissue androgens, and sex hormone-binding globulin (SHBG) on fasting immunoreactive insulin (IRI) levels. Serum LH, dehydroepiandrosterone sulfate, dihydrotestosterone, and 3 alpha-androstanediol, SHBG, and unbound testosterone (uT) were measured. Serum testosterone (T) showed a positive correlation with IRI (P less than 0.05), and SHBG showed a negative correlation (P less than 0.02). Unbound T showed a highly significant positive correlation (P less than 0.001), whereas dehydroepiandrosterone sulfate, dihydrotestosterone, and 3 alpha-androstanediol did not correlate. Gonadotropin-releasing hormone, administered to patients with IH, raised LH levels but did not change IRI levels. Spironolactone did not affect T or IRI in patients with IH but significantly lowered T and IRI in patients with PCO. It is suggested that IR is not related to LH or peripheral androgen metabolism but highly correlated with uT and SHBG, thus coupling two important factors in IR, obesity and the androgen level.

摘要

多囊卵巢综合征（PCO）中的胰岛素抵抗（IR）与高雄激素血症及黄体生成素（LH）水平升高有关。对14例特发性多毛症（IH）患者、13例PCO患者及6例对照受试者进行了研究，以评估血清LH、外周组织雄激素及性激素结合球蛋白（SHBG）对空腹免疫反应性胰岛素（IRI）水平的影响。检测了血清LH、硫酸脱氢表雄酮、双氢睾酮、3α - 雄烷二醇、SHBG及游离睾酮（uT）。血清睾酮（T）与IRI呈正相关（P < 0.05），SHBG呈负相关（P < 0.02）。游离T呈高度显著正相关（P < 0.001），而硫酸脱氢表雄酮、双氢睾酮及3α - 雄烷二醇无相关性。对IH患者给予促性腺激素释放激素可使LH水平升高，但不改变IRI水平。螺内酯对IH患者的T或IRI无影响，但可使PCO患者的T及IRI显著降低。提示IR与LH或外周雄激素代谢无关，而与游离T及SHBG高度相关，从而将IR中的两个重要因素——肥胖和雄激素水平联系起来。