不同月经稀发程度多囊卵巢综合征患者AMH、FSH、LH、E2水平观察

Observation of AMH, FSH, LH and E2 levels in PCOS patients with different degrees of menstrual thinning

摘要:

目的 探究不同月经稀发程度多囊卵巢综合征（PCOS）患者血清抗米勒管激素（AMH）、卵泡刺激素（FSH）、促黄体生成素（LH）、雌二醇（E₂）水平变化及其临床意义。方法 选取2018年1月—2022年5月安徽医科大学附属滁州医院收治的240例PCOS患者，根据患者月经不同稀发程度分为A组（月经周期36～90 d）150例、B组（月经周期91～180 d）56例和C组（月经周期> 180 d）34例。比较3组基线资料、代谢指标［胰岛素抵抗指数（HOMA-IR）、总胆固醇（TC）、甘油三酯（TG）、血尿酸（UA）］、性激素指标［AMH、FSH、LH、E₂、睾酮（T）、泌乳素（PRL）、游离雄激素指数（FAI）］，采用Spearman相关性分析评价PCOS患者月经稀发程度与代谢和性激素指标的相关性。结果 A组体质量指数（BMI）低于B组和C组（P <0.05），B组BMI低于C组（P <0.05）；3组年龄、腰臀比、多毛占比比较，差异均无统计学意义（P >0.05）。A组HOMA-IR、TG、UA均低于B组和C组（P <0.05），B组HOMA-IR、TG、UA均低于C组（P <0.05）；3组TC比较，差异无统计学意义（P >0.05）。A组LH、T、FAI均低于B组和C组（P <0.05），B组LH、T、FAI均低于C组（P <0.05）；3组AMH、FSH、E₂、PRL比较，差异无统计学意义（P >0.05）。Spearman相关分析结果显示，PCOS患者月经稀发程度与HOMA-IR、TG、UA、LH、T和FAI均呈正相关（r_s =0.764、0.560、0.558、0.650、0.512和0.678，P <0.05）。结论 PCOS患者月经稀发程度与糖脂代谢和性激素水平密切相关，月经稀发程度越严重，糖脂代谢及性激素异常程度越高。

Abstract:

Objective To investigate the changes of serum anti-müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E₂) levels in patients with polycystic ovary syndrome (PCOS) with different degrees of menstrual insufficiency and their possible clinical significance.Methods Two hundred and forty PCOS patients admitted to our hospital from January 2018 to May 2022 were selected, according to the degree of menstrual thinning, the patients were divided into group A (menstrual cycle 36-90 d), group B (menstrual cycle 91 to 180 d), 56 (menstrual cycle > 180 d) and group C (menstrual cycle > 180 d). Baseline data, sex hormone indexes [AMH, FSH, LH, E2, testosterone (T), prolactin (PRL), free androgen index (FAI)], metabolic indexes [homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), triglyceride (TG), uric acid (UA) ] were compared among the three groups. Spearman correlation analysis was used to evaluate the correlation between the degree of menstrual thinning and metabolic and sex hormone indexes in PCOS patients.Results Body mass index (BMI) of group A was lower than that of group B and C (P < 0.05), and BMI of group B was lower than that of group C (P < 0.05); there were no significant differences in age, waist-hip ratio and hirsutism among the three groups (P > 0.05). The LH, T and FAI of group A were lower than those of group B and C (P < 0.05), and those of group B were lower than those of group C (P < 0.05); there were no statistical differences in AMH, FSH, E₂ and PRL among the three groups (P > 0.05). HOMA-IR, TG and UA in group A were lower than those in group B and C (P < 0.05), and HOMA-IR, TG and UA in group B were lower than those in group C (P < 0.05); there was no statistical difference in TC among the three groups (P > 0.05). Spearman correlation analysis showed that the degree of oligomenorrhea in PCOS patients was positively correlated with HOMA-IR, TG, UA, LH, T and FAI (r_s = 0.764, 0.560, 0.558, 0.650, 0.512 and 0.678, all P <0.05）.Conclusion The degree of sparse menstruation in PCOS patients is closely related to glucolipid metabolism and sex hormone levels. The more severe the degree of sparse menstruation, the higher the degree of abnormal glucolipid metabolism and sex hormone levels.