CAJ | 학술논문

目的：研究不同浓度血清促甲状腺激素（ thyroid-stimulating hormone ， TSH ）的多囊卵巢综合征（ polycystic ovary syndrome，PCOS）患者临床特征及内分泌代谢指标之间的差异。方法选择110例多囊卵巢综合征患者，测量身高、体质量、腰围、臀围；应用化学发光法分析测定血清 TSH、总胆固醇（ total cholesterol ， TC ）、低密度脂蛋白胆固醇（ low-density lipoprotein cholesterol，LDL-C）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol，HDL-C）、三酰甘油（triglycerides，TG）、空腹血糖（fasting blood glucose，FBG）、空腹胰岛素（fasting serum insulin，INS）、卵泡刺激素（follicle stimulating hormone，FSH）、黄体生成素（luteinizing hormone，LH）、睾酮（testosterone，T）、催乳素（prolactin，PRL）、雌二醇（estrogen，E2）；计算体质量指数（body mass index，BMI）、腰臀比（waist hip ratio，WHR）、黄体生成素与卵泡刺激素的比值（LH-to-FSH ratio，LH/FSH）；采用稳态模型评估的胰岛素抵抗指数（homeostasis model assessment insulin resistance ，HOMA-IR），按血清TSH浓度将其分为2组：A组71例，TSH＜2．5 mIu/L；B组39例TSH≥2．5 mIu/L；比较2组上述各项指标的差异及TSH与各项指标间的相关性。结果 B组（ TSH≥2．5 mIu/L）PCOS患者的WHR及LDL高于A组（TSH＜2．5 mIu/L），差异有统计学意义（P＜0．05）。 TSH浓度的升高与腰臀比、血清总胆固醇、低密度脂蛋白胆固醇、PRL浓度呈正相关。2组间其他临床、代谢指标相比无统计学意义（P＞0．05）。结论 TSH与脂代谢指标有相关性，TSH≥2．5 mIu/L的PCOS患者，脂代谢发生了显著的变化。
목적：연구불동농도혈청촉갑상선격소（ thyroid-stimulating hormone ， TSH ）적다낭란소종합정（ polycystic ovary syndrome，PCOS）환자림상특정급내분비대사지표지간적차이。방법선택110례다낭란소종합정환자，측량신고、체질량、요위、둔위；응용화학발광법분석측정혈청 TSH、총담고순（ total cholesterol ， TC ）、저밀도지단백담고순（ low-density lipoprotein cholesterol，LDL-C）、고밀도지단백담고순（high-density lipoprotein cholesterol，HDL-C）、삼선감유（triglycerides，TG）、공복혈당（fasting blood glucose，FBG）、공복이도소（fasting serum insulin，INS）、란포자격소（follicle stimulating hormone，FSH）、황체생성소（luteinizing hormone，LH）、고동（testosterone，T）、최유소（prolactin，PRL）、자이순（estrogen，E2）；계산체질량지수（body mass index，BMI）、요둔비（waist hip ratio，WHR）、황체생성소여란포자격소적비치（LH-to-FSH ratio，LH/FSH）；채용은태모형평고적이도소저항지수（homeostasis model assessment insulin resistance ，HOMA-IR），안혈청TSH농도장기분위2조：A조71례，TSH＜2．5 mIu/L；B조39례TSH≥2．5 mIu/L；비교2조상술각항지표적차이급TSH여각항지표간적상관성。결과 B조（ TSH≥2．5 mIu/L）PCOS환자적WHR급LDL고우A조（TSH＜2．5 mIu/L），차이유통계학의의（P＜0．05）。 TSH농도적승고여요둔비、혈청총담고순、저밀도지단백담고순、PRL농도정정상관。2조간기타림상、대사지표상비무통계학의의（P＞0．05）。결론 TSH여지대사지표유상관성，TSH≥2．5 mIu/L적PCOS환자，지대사발생료현저적변화。
Objective To investigate the differences in clinical features , endocrine metabolic parameters of polycystic ovary syndrome patients with different levels of serum thyroid-stimulating hormone .Methods One hundred and ten PCOS patients were enrolled . Height , weight , waist circumference , hip circumferences were measured . Chemiluminescence was applied for measuring thyroid-stimulating hormone(TSH), total cholesterol(TC), low density lipoprotein(LDL), high density lipoprotein(HDL), triglyceride(TG), fasting blood-glucose(FBG), fasting insulin(INS), follicle-stimulating hormone(FSH), luteinizing hormone(LH), testosterone(T), prolactin(PRL) and estradiol(E2);Body mass index(BMI), waist-to-hip circumference ratio(WHR), LH-to-FSH ratio(LH/FSH) were calculated;The insulin resistance index evaluated by steady-state model ( HOMA-IR);all patients were divided into two groups according to serum thyroid-stimulating hormone:group A had 71 cases with TSH<2.5 mIu/L, as group B of 39 cases with TSH≥2.5 mIu/L; all the hormone parameters mentioned above were compared between group A and B , and the correlation with TSH .Results The WHR and LDL in group B(TSH≥2.5 mIu/L) is significantly higher than that of the patients in group A (TSH<2.5 mIu/L).The increase of TSH concentration positively correlates to an increase of WHR , TC, LDL-C and PRL.No significant differences are shown in other clinical and metabolic indicators.Conclusion There was a significant correlation between TSH and lipid metabolic parameters .Women with polycystic ovary syndrome and with thyroid-stimulating hormone≥2.5 mIu/L had significantly endocrine and metabolic changes .