摘要
目的探究青春期多囊卵巢综合症(polycystic ovary syndrome,PCOS)患者甲状腺激素水平与胰岛素抵抗的相关性。方法选取从2014年11月—2015年10月在宁波市中医院妇科门诊就诊的13~19岁多囊卵巢综合征患者92例设为研究组(PCOS组),另选取同龄段60例健康人设为对照组。比较2组腰臀比(WHR)、血糖、血脂及甲状腺激素水平差异。以促甲状腺激素(thyroid stimulating hormone,TSH)=2.5 m IU/L为临界,将青春期PCOS患者分成TSH≥2.5 m IU/L组及TSH<2.5 m IU/L组,并比较2组青春期PCOS患者人群相关检测指标。控制WHR影响因素,采用Partial相关方法分析TSH、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)与HOMA-IR、血脂、血糖的相关性。结果 1PCOS组与对照组WHR、空腹血糖(FBG)、空腹胰岛素(FINS)、HOMA-IR及TSH均增高,差异有统计学意义(P<0.05)。2TSH≥2.5 m IU/L组PCOS患者的WHR、FBG、FINS、HOMA-IR及TSH均大于TSH<2.5 m IU/L组,差异有统计学意义(P<0.05)。3控制WHR影响因素后,TSH≥2.5 m IU/L组PCOS患者中TSH与FINS、HOMA-IR存在正相关(P<0.05),FT4与TG、FBG存在正相关(P<0.05),与FINS、HOMAIR存在负相关(P<0.05)。而TSH<2.5 m IU/L组患者指标无此相关性。结论 TSH≥2.5 m IU/L的青春期PCOS患者存在明显的胰岛素抵抗、更高的腰臀比值,且TSH与胰岛素抵抗的关系可能独立于腰臀比值增高所提示的肥胖因素。
Objective To investigate the correlation of thyroid hormone levels and the insulin resistance in adolescents with polycystic ovary syndrome（PCOS）. Methods Ninety-two girls with PCOS and sixty age-matched controls underwent clinical, biochemical, hormonal evaluation. Waist-to-hip ratio （ WHR）, blood glucose, insulin and lipid levels were com- pared between the two groups. The relative indicators in patients with TSH ≥2.5 mIU/L and TSH 〈 2.5 mIU/L were also observed. Due to WHR influence factors, the partial correlation analysis was made between TSH, FT3, FT4 and HOMA- IR, blood lipid and blood sugar. Results （1）PCOS had elevated fasting plasma glucose, insulin, HOMA IR and thyroid- stimulating hormone（P 〈0.05） ;（2）PCOS with TSH ≥2.5 mIU/L had significant differences in plasma glucose, insulin, HOMA IR and thyroid-stimulating hormone as compared with another group （ TSH 〈 2.5 mIU/L）, P 〈 0.05 ;（3）Controlling the WHR influence factors, TSH was closely associated with FBI and HOMA-IR in the group TSH ≥2.5 mlU/L, while FT4 had obviously positive correlation with TG and FBG（P 〈 0.05 ）. Nevertheless, negative correlation was illustrated in the area of FBI and HOMA-IR （ P 〈 0.05 ）, however, another group （ TSH 〈 2.5 mIU/L） showed less close correlation. Conclusion Adolescent PCOS girls with TSH≥2.5 mIU/L have more obvious insulin resistance and higher WHR. How- ever this effect of TSH on IR may be independent of WHR. resistance ; Thyroid stimulating hormone
作者
殷一红
赵珊琼
YIN Yi-hong ZHA O Shan-qiong.(Department of Endocrinology, TCM Hospital of Ningbo , Ningbo , Zhejiang 315000, China)
出处
《中华全科医学》
2017年第1期60-62,102,共4页
Chinese Journal of General Practice
基金
浙江省中医管理局资助项目(2015ZA189)
