多囊卵巢综合征合并卵巢储备功能低下病人的内分泌特征

doi:10.3969/j.issn.1006-7795.2017.04.006

首都医科大学学报 ›› 2017, Vol. 38 ›› Issue (4): 515-520.doi: 10.3969/j.issn.1006-7795.2017.04.006

多囊卵巢综合征合并卵巢储备功能低下病人的内分泌特征

金婧¹, 阮祥燕^1,2, 华琳³, 田玄玄¹, 李杨璐¹, 王利娟¹, 赵越¹, Alfred O. Mueck^1,2

1. 首都医科大学附属北京妇产医院内分泌科, 北京 100026;
2. 德国图宾根大学妇女医院妇女保健科, 图宾根 D-72076, 德国;
3. 首都医科大学生物信息学教研室, 北京 100069

收稿日期:2017-06-05 出版日期:2017-07-21 发布日期:2017-07-20
通讯作者: 阮祥燕 E-mail:ruanxiangyan@163.com
基金资助:
北京市属医院科研培育计划（PX2017053），北京妇产医院中青年学科骨干培养专项（fcyy201427），首都临床特色应用研究与成果推广（Z161100000516143），北京市医院管理局临床技术创新项目（扬帆项目XMLX201710）

Endocrine characteristics of diminished ovarian reserve in Chinese women with polycystic ovary syndrome

Jin Jing¹, Ruan Xiangyan^1,2, Hua Lin³, Tian Xuanxuan¹, Li Yanglu¹, Wang Lijuan¹, Zhao Yue¹, Alfred O. Mueck^1,2

1. Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China;
2. Department of Women's Health, University Women's Hospital of Tuebingen, Tuebingen D-72076, Germany;
3. Department of Bioinformatics, Capital Medical University, Beijing 100069, China

Received:2017-06-05 Online:2017-07-21 Published:2017-07-20
Supported by:
This study was supported by Beijing Municipal Administration of Hospitals Incubating Program(PX2017053); Beijing Obstetrics and Gynecology Hospital;Capital Medical University(fcyy201427); Beijing Municipal Science and Technology Commission(Z161100000516143); Beijing Municipal Administration of Hospitals Clinical medicine Development of special funding support(XMLX201710)

摘要/Abstract

摘要： 目的了解中国多囊卵巢综合征（polycystic ovary syndrome，PCOS）合并卵巢储备功能低下（diminished ovarian reserve，DOR）病人的发生率及内分泌特征。方法选取2015年1月至2017年1月就诊的多囊卵巢综合征病人338例及同期就诊的单纯DOR病人68例，记录所有研究对象的年龄、月经情况，测量其身高、体质量、腰围、臀围，测定基础血清卵泡刺激素（follicle stimulation hormone，FSH）、黄体生成素（luteinizing hormone，LH）、雌二醇（estradiol，E₂）、睾酮（testosterone，T）、抗苗勒管激素（anti-Müllerian hormone，AMH）及基础窦卵泡数（baseline antral follicle count，bAFC）。对PCOS合并DOR病人、单纯PCOS及单纯DOR病人的各指标进行方差分析。结果 1）PCOS合并DOR的病人发生率为16.9%。2）在PCOS合并DOR病人中，基础FSH>10IU/L且<40IU/L、FSH/LH>3、基础E₂>80pg/mL、bAFC≤4的发生率分别为38.6%、35.1%、35.1%及36.8%。3）PCOS合并DOR病人基础FSH及睾酮浓度与单纯PCOS及单纯DOR病人之间的差异均具有统计学意义（P<0.05），PCOS合并DOR病人基础E₂、FSH/LH、AMH与单纯PCOS之间的差异有统计学意义（P<0.05），而与单纯DOR之间的差异无统计学意义（P>0.05）。4）在单纯PCOS组，AMH与睾酮呈正相关（P<0.01）。在PCOS合并DOR组，AMH与FSH呈负相关，与LH呈正相关（P<0.01）。在单纯DOR组，AMH与年龄、FSH、LH、FSH/LH均呈负相关（P<0.01）。结论 PCOS合并DOR病人的内分泌特征既不同于单纯PCOS组，也不同于单纯DOR病人。

关键词: 多囊卵巢综合征, 卵巢储备功能低下, 性激素, 抗苗勒管激素

Abstract: Objective To assess the prevalence of diminished ovarian reserve (DOR) in patients with polycystic ovary syndrome (PCOS) in China, and to investigate the endocrine characteristics of these patients.Methods Totally 338 PCOS women and 68 simple DOR women, who came to Department of Gynecological Endocrinology in Beijing Obstetrics and Gynecology Hospital between January 2015 and January 2017 were recruited.Age and menstruation of these patients were recorded. Body height, body weight, waist circumference, hip circumference, basal follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E₂), testosterone(T),anti-Müllerian hormone (AMH) and baseline antral follicle count (bAFC) of these patients were measured. The differences of indices between PCOS with DOR,simple PCOS and simple DOR were analyzed with analysis of variance. Results (1) The prevalence of DOR in our Chinese PCOS patients was 16.9%.(2)In PCOS with DOR patients, the prevalence of basal FSH value>10IU/L, FSH/LH ratio>3,basal estradiol (E₂)>80 pg/mL and baseline antral follicle count (bAFC) fewer than four were 38.6%,35.1%,35.1% and 36.8%,respectively. The basal FSH and testosterone in PCOS with DOR patients were different from both simple PCOS and simple DOR patients(P<0.05). The basal estradiol, FSH/LH ratio,AMH in PCOS with DOR patients had significant differences from simple PCOS patients(P<0.05),while had no difference from simple DOR patients. (4)In simple PCOS patients,AMH had a positive correlation with testosterone(P<0.01).In PCOS with DOR patients, AMH had a negative correlation with FSH(P<0.01),while had a positive correlation with LH(P<0.01).In simple DOR patients, AMH had a negative correlation with age,FSH,LH and FSH/LH ratio(P<0.01).Conclusion The endocrine characteristics of PCOS with DOR patients are different from simple PCOS patients as well as simple DOR patients.

Key words: polycystic ovary syndrome, diminished ovarian reserve, sex hormones, anti-Müllerian hormone

中图分类号:

R711.75

金婧, 阮祥燕, 华琳, 田玄玄, 李杨璐, 王利娟, 赵越, Alfred O. Mueck. 多囊卵巢综合征合并卵巢储备功能低下病人的内分泌特征[J]. 首都医科大学学报, 2017, 38(4): 515-520.

Jin Jing, Ruan Xiangyan, Hua Lin, Tian Xuanxuan, Li Yanglu, Wang Lijuan, Zhao Yue, Alfred O. Mueck. Endocrine characteristics of diminished ovarian reserve in Chinese women with polycystic ovary syndrome[J]. Journal of Capital Medical University, 2017, 38(4): 515-520.

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多囊卵巢综合征合并卵巢储备功能低下病人的内分泌特征

Endocrine characteristics of diminished ovarian reserve in Chinese women with polycystic ovary syndrome

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