PCOS患者血清FAI与IR的关系及诊断性能评价

发布时间：2018-05-02 02:41

本文选题：多囊卵巢综合征 + 游离睾酮指数　；参考：《重庆医科大学》2017年硕士论文

【摘要】：目的:探讨多囊卵巢综合征(polycystic ovarian syndrome,PCOS)患者体内游离睾酮指数(free androgen index,FAI)与胰岛素抵抗(insulin resistance,IR)的关系并对FAI诊断PCOS患者IR的诊断性能进行评价。方法:选择139例PCOS患者作为病例组和100例健康女性作为对照组,所有受试者进行了OGTT试验和测定了人体基本测量指标,酶法分析了血糖、血脂等指标,化学发光免疫法测定了激素水平,HOMA-IR评估了IR程度。两样本t检验分析了两组之间的血清FAI与HOMA-IR的差异,Pearson线性相关与多元逐步回归研究了FAI与IR的相关性,并用二甲双胍干预评价了FAI的改善状况,ROC曲线上选取了FAI诊断IR的最佳临界点并评价了FAI的诊断性能,卡方检验评价了FAI与HOMA-IR诊断IR的一致性。结果:PCOS组的血清FAI与HOMA-IR升高(P=0.00);匹配BMI后,PCOS超重组的血清FAI和HOMA-IR水平更高(P=0.01);Pearson相关分析显示,PCOS患者血清FAI与BMI(r=0.42,P=0.001)、HOMA-IR(r=0.46,P=0.00)、FAT(r=0.25,P=0.00)呈正相关,多元逐步回归分析,PCOS组HOMA-IR和BMI是影响血清FAI水平的独立危险因素;经二甲双胍治疗6个月之后,PCOS患者HOMA-IR改善(P=0.00),FAI也改善(P=0.00);对于PCOS患者IR的诊断性能,FAI检测灵敏度为72.04%,特异度为65.22%,ROC曲线下面积为0.6891,95%CI为0.5941~0.7841;FAI与HMOA-IR的诊断一致率为71.22%(99/139),McNemarχ2检验结果分析FAI与HOMA-IR之间差异无统计学意义(χ2=1.6,P=0.268)。结论:PCOS患者体内FAI与IR存在正相关关系,FAI对于IR有一定的诊断价值。
[Abstract]:Objective: to investigate the relationship between free androgen index (FAI) and insulin resistance (IR) in patients with polycystic ovarian syndrome (PCOS) and to evaluate the diagnostic performance of FAI in the diagnosis of PCOS. Methods: 139 patients with PCOS were selected as the case group and 100 healthy women as the control group. All the subjects were tested by OGTT test and the basic human body measurement indexes were measured. The blood glucose, blood lipid and other indexes were analyzed by enzymatic method. The hormone level was determined by chemiluminescence immunoassay and the degree of IR was evaluated by HOMA-IR. The difference of serum FAI and HOMA-IR between the two groups was analyzed by t-test. Pearson linear correlation and multivariate stepwise regression were used to study the correlation between FAI and IR. Metformin intervention was used to evaluate the improvement of FAI. The best critical point of FAI diagnosis was selected and the diagnostic performance of FAI was evaluated on the curve of FAI. Chi-square test was used to evaluate the consistency between FAI and HOMA-IR in the diagnosis of IR. Results the levels of serum FAI and HOMA-IR were significantly higher than those in the control group, and the levels of serum FAI and HOMA-IR were higher in patients with hyperrecombination of BMI. The correlation analysis showed that there was a positive correlation between serum FAI and HOMA-IRR0.46P0.006P0. 25P0. 00in the patients with PCOS (P < 0. 01), and the levels of serum FAI and HOMA-IR were higher than those in patients with BMI (P < 0. 01), and the correlation analysis showed that there was a positive correlation between the levels of serum FAI and BMI-IRR 0. 46P0. 00P = 0. 25p. Multiple stepwise regression analysis showed that HOMA-IR and BMI were independent risk factors for serum FAI level in PCOS group. After 6 months of metformin treatment, the improvement of HOMA-IR in patients with PCOS was also improved. The diagnostic performance of IR in patients with PCOS was 72.04 and the specificity was 65.222.The area under the ROC curve was 0.6841 0.7841 CI was 0.5941 0.7841. The consistent rate of diagnosis between FAI and HMOA-IR was 71.220.999p / 139mr 蠂 ~ (2) and the result of McNemar 蠂 ~ (2) test showed that the diagnostic accuracy of HMOA-IR was 0.59410.7841%, and the diagnostic accuracy of HMOA-IR was 0.59410.7841.The diagnostic performance of PCOS patients was 72.04%, and the specificity was 65.22% (CI = 0.59410.7841 CI). There was no significant difference between FAI and HOMA-IR (蠂 ~ 2 / 1. 6 P = 0.268). Conclusion there is a positive correlation between FAI and IR in patients with FAI.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R711.75

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