游离睾酮指数与肥胖型多囊卵巢综合征伴胰岛素抵抗患者性激素及糖脂代谢的关系分析

Relationship between free androgen index and sex hormones/glycolipid metabolism in obese polycystic ovary syndrome patients with insulin resistance

摘要:

目的 分析游离睾酮指数（FAI）与肥胖型多囊卵巢综合征（PCOS）伴胰岛素抵抗（IR）患者性激素及糖脂代谢的关系。方法 回顾性分析2021年3月—2024年1月西北妇女儿童医院145例PCOS伴IR患者的病历资料，根据体质量指数（BMI）分为非肥胖组（78例，BMI<28 kg/m²）与肥胖组（67例，BMI≥28 kg/m²）。对比两组一般资料、FAI、性激素指标［睾酮（T）、卵泡刺激素（FSH）、雌二醇（E2）、促黄体生成素（LH）、催乳素］、糖脂代谢指标［糖化血红蛋白（HbA1c）、空腹血糖（FPG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）］，分析FAI与肥胖型PCOS伴IR患者性激素及糖脂代谢的相关性。结果 肥胖组E2和FSH水平较非肥胖组低（P <0.05），LH、FAI和T水平较非肥胖组高（P <0.05）。肥胖组HbA1c和FPG水平较非肥胖组高（P <0.05）。肥胖组TC、LDL-C和TG水平较非肥胖组高（P <0.05）。肥胖组HDL-C水平较非肥胖组低（P <0.05）。FAI与肥胖型PCOS伴IR患者T、LH、HbA1c、FPG、TC、LDL-C、TG均呈正相关（r =0.573、0.475、0.625、0.579、0.482、0.498和0.429，P <0.05）；FAI与肥胖型PCOS伴IR患者FSH、E2、HDL-C均呈负相关（r =-0.584、-0.617、-0.581，P <0.05）均呈负相关。结论 肥胖型PCOS伴IR患者FAI水平升高，FAI水平与患者性激素、糖脂代谢关系密切。

Abstract:

Objective To analyze the relationship between free androgen index (FAI) and sex hormones/glycolipid metabolism in obese polycystic ovary syndrome (PCOS) patients with insulin resistance (IR).Methods Medical records of 145 PCOS patients with IR (March 2021-January 2024) were retrospectively analyzed. Patients were divided into non-obese group (BMI < 28 kg/m2, n = 78) and obese group (BMI ≥ 28 kg/m2, n = 67). General data, FAI, sex hormones [testosterone (T), follicle-stimulating hormone (FSH), estradiol (E2), luteinizing hormone (LH), prolactin], and glycolipid metabolism indicators [glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C)] were compared. Correlation between FAI and these parameters was analyzed.Results The obese group showed lower E? and FSH levels but higher LH, FAI, and T levels versus non-obese group (P < 0.05). HbA1c and FPG levels were higher in obese group (P < 0.05). TC, LDL-C, and TG levels were higher while HDL-C was lower in obese group (P < 0.05). FAI positively correlated with T (r = 0.573), LH (r = 0.475), HbA1c (r = 0.625), FPG (r = 0.579), TC (r = 0.482), LDL-C (r = 0.498), and TG (r = 0.429) in obese PCOS/IR patients (all P < 0.05). FAI negatively correlated with FSH (r = -0.584), E2 (r = -0.617), and HDL-C (r = -0.581) (all P < 0.05).Conclusion Elevated FAI levels in obese PCOS/IR patients exhibit significant correlations with sex hormone profiles and glycolipid metabolism parameters.