育龄期多囊卵巢综合征患者糖代谢与性激素及子宫内膜容受性的关系

Relationships of glucose metabolism with sex hormones and endometrial receptivity in patients with polycystic ovary syndrome at childbearing age

  • 摘要:
    目的 探讨育龄期多囊卵巢综合征(PCOS)患者糖代谢与性激素及子宫内膜容受性的关系。
    方法 检测90例育龄期PCOS患者(研究组)和90例育龄期健康体检者(对照组)的糖代谢指标、性激素指标、子宫内膜容受性相关指标。根据PCOS患者子宫内膜容受性情况将其分为容受性不良组(n=28)和容受性良好组(n=62), 分析PCOS患者子宫内膜容受性的影响因素。采用Pearson法分析糖代谢指标与性激素、子宫内膜容受性相关指标的关系。
    结果 研究组体质量指数(BMI)、空腹血糖(FPG)、空腹胰岛素(FINS)、稳态模型胰岛素抵抗指数(HOMA-IR)、黄体生成素(LH)、睾酮(T)、孕酮(P)、雌二醇(E2)水平、子宫内膜螺旋动脉搏动指数(PI)及阻力指数(RI)均高于对照组,差异有统计学意义(P<0.05); 研究组子宫内膜厚度低于对照组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,T(OR=2.593)、FINS(OR=2.898)、HOMA-IR(OR=3.277)、P(OR=4.362)、E2(OR=2.392)、子宫内膜厚度(OR=0.485)均是PCOS患者子宫内膜容受性不良的影响因素(P<0.05)。FINS、HOMA-IR与LH、T以及子宫内膜螺旋动脉PI、RI呈显著正相关(P<0.05),与子宫内膜厚度呈显著负相关(P<0.05)。
    结论 PCOS患者存在糖代谢、性激素紊乱以及子宫内膜容受性受损的情况,FINS、HOMA-IR与性激素、子宫内膜容受性相关指标密切相关。

     

    Abstract:
    Objective To investigate the relationships of glucose metabolism with sex hormones and endometrial receptivity in patients with polycystic ovary syndrome (PCOS) at childbearing age.
    Methods Glucose metabolism indexes, sex hormone indexes and endometrial receptivity related indexes were detected in 90 PCOS patients (study group) at childbearing age and 90 healthy people (control group) at childbearing age. According to condition of endometrial receptivity, the PCOS patients were divided into poor receptivity group (n=28) and good receptivity group (n=62), and the influencing factors of endometrial receptivity in PCOS patients were analyzed. Pearson method was used to analyze the relationships of glucose metabolism indexes with sex hormone indexes and endometrial receptivity related indexes.
    Results In the study group, body mass index (BMI), fasting plasma glucose (FPG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), luteinizing hormone (LH), testosterone (T), progesterone (P), estradiol (E2), pulsatility index (PI) and resistance index (RI) of endometrial spiral artery were significantly higher than those in the control group (P < 0.05); the endometrial thickness of the study group was significantly lower than that of the control group (P < 0.05). Multivariate Logistic regression analysis revealed that T (OR=2.593), FINS (OR=2.898), HOMA-IR (OR=3.277), P (OR=4.362), E2 (OR=2.392) and endometrial thickness (OR=0.485) were the factors of poor endometrial receptivity in patients with PCOS (P < 0.05). FINS and HOMA-IR showed significant positive correlations with LH, T as well as PI and RI of the endometrial spiral artery (P < 0.05), and a significant negative correlation with endometrial thickness (P < 0.05).
    Conclusion PCOS patients have glucose metabolism and sex hormones disorders as well as impaired endometrial receptivity, and FINS and HOMA-IR are closely related to sex hormones and endometrial receptivity related indicators.

     

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