多囊卵巢综合征患者亚临床甲状腺功能减退与其内分泌代谢特征的关系

发布时间：2018-03-26 00:10

本文选题：多囊卵巢综合征　切入点：亚临床甲状腺功能减退　出处：《中南大学学报(医学版)》2017年08期

【摘要】：目的:研究多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者中亚临床甲状腺功能减退(subclinical hypothyroidism,SCH)与其内分泌代谢特征之间的关系。方法:采用2003年鹿特丹PCOS诊断标准,共收集321例新诊断PCOS患者的临床资料。甲状腺功能以化学发光法测定。分别以促甲状腺激素(thyroid stimulating hormone,TSH)值4.2 m U/L和2.5 m U/L为SCH诊断截点,将PCOS患者分为SCH组和甲状腺功能正常组,比较两组间内分泌代谢特征的差异。结果:1)以TSH值4.2 m U/L为SCH诊断截点,SCH组泌乳素及黄体生成素与卵泡刺激素的比值显著升高,空腹血糖显著降低,内脏脂肪指数显著升高(均P0.05),血三酰甘油有升高趋势(P=0.085),高密度脂蛋白胆固醇有下降趋势(P=0.060);2)以TSH值2.5 m U/L为SCH诊断截点,SCH组雌二醇、泌乳素显著升高,血三酰甘油显著升高,高密度脂蛋白胆固醇显著下降,内脏脂肪指数显著升高(均P0.05)。结论:PCOS合并SCH组其内分泌激素紊乱、血脂异常及内脏脂肪增多较甲状腺功能正常组更严重;以TSH值2.5 m U/L为PCOS患者SCH诊断截点,其SCH组较甲状腺功能正常组内分泌代谢特征差异更为显著,提示临床可以TSH值2.5 m U/L为SCH截点对PCOS患者进行分组评估、优化诊治。
[Abstract]:Objective: to study the relationship between subclinical hypothyroidism and endocrine metabolic characteristics in patients with polycystic ovary syndrome (PCOS). The clinical data of 321 newly diagnosed PCOS patients were collected. Thyroid function was measured by chemiluminescence method. Thyroid stimulating hormone thyroid stimulating hormoneTSHS (4.2mU / L and 2.5mU / L) were used as diagnostic cutoff points of SCH. The patients with PCOS were divided into SCH group and normal thyroid function group. Results the ratio of prolactin and luteinizing hormone to follicle stimulating hormone (FSH) in SCH group was significantly higher than that in Sch group, and fasting blood glucose was significantly decreased. The visceral fat index was significantly increased (all P0.05U, triacylglycerol, high density lipoprotein cholesterol decreased). Estradiol, prolactin and triacylglycerol were significantly increased in Sch group with TSH value of 2.5 m UL as diagnostic cut-off point, and serum triglyceride level was significantly increased in Sch group. High density lipoprotein cholesterol decreased significantly and visceral fat index increased significantly (all P0.050.Conclusion the endocrine hormone disturbance, dyslipidemia and visceral fat increase in SCH group were more serious than those in normal thyroid function group. The difference of endocrine metabolic characteristics in SCH group was more significant than that in normal thyroid function group, which suggested that the TSH value of 2.5 MU / L as SCH cut-off point could be used to evaluate PCOS patients and optimize the diagnosis and treatment.
【作者单位】：中南大学湘雅医院内分泌科;中信湘雅生殖和遗传专科医院;
【基金】：国家自然科学基金(81670788)~~
【分类号】：R581.2;R711.75

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