生殖医学杂志

目的探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者雄激素指标总睾酮(total testosterone,TT)和游离睾酮(free testosterone,FT)诊断PCOS患者高雄激素血症的敏感性和准确性,并分析雄激素指标与胰岛素抵抗(Insulin resistance,IR)的相关性。方法纳入符合鹿特丹标准、未经治疗的PCOS患者365例,测定身高、体重、基础生殖内分泌激素、FT,空腹血糖(FPG)和空腹胰岛素(FINS)。比较TT和FT的相关性和差异性,并对比TT和FT与IR的相关性。结果 FT与TT存在线性相关,(r=0.660,r2=0.448,P<0.001);TT和FT的诊断率分别是14.61%和22.75%,且差异具有统计学意义(P<0.05);与TT相比,FT和体重指数(BMI)、IR的相关性更大。结论 FT在PCOS诊断高雄激素血症上有较高的检出率,减少漏诊率,而且更能反映PCOS患者IR的水平,指导临床治疗。

Objective: To explore the diagnosis sensitivity and accuracy of total testosterone(TT)and free testosterone(FT)for hyperandrogenism in polycystic ovary syndrome(PCOS)patients,and analyze the correlation between androgen index and insulin resistance(IR).Methods: A total of 365 patients with PCOS diagnosed by Rotterdam consensus.The patients' height,weight,basal sexual hormones and free testosterone(FT),fasting glucose(FPG)and fasting insulin(FINS)were collected.The correlation and diversity between TT and FT were analyzed,as well as the correlation between TT& FT and BMI&IR.Results: Serum FT had a linear correlation with serum TT(r=0.660,r2=0.448,P<0.001).The diagnosis rate of TT and FT was 14.61% and 22.75% respectively.FT was significantly more sensitive than TT for diagnosis of hyperandrogenemia(P<0.05).The FT was significantly correlated with BMI &insulin resistance compared with TT.Conclusions: FT is more sensitive for diagnosis of hyperandrogenism in PCOS patients,and it is an ideal biochemical indicator for predicting insulin resistance as well.