本文選題：多囊卵巢綜合征　切入點(diǎn)：亞臨床甲狀腺功能減退　出處：《中南大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年08期

【摘要】：目的:研究多囊卵巢綜合征(polycystic ovary syndrome,PCOS)患者中亞臨床甲狀腺功能減退(subclinical hypothyroidism,SCH)與其內(nèi)分泌代謝特征之間的關(guān)系。方法:采用2003年鹿特丹PCOS診斷標(biāo)準(zhǔn),共收集321例新診斷PCOS患者的臨床資料。甲狀腺功能以化學(xué)發(fā)光法測(cè)定。分別以促甲狀腺激素(thyroid stimulating hormone,TSH)值4.2 m U/L和2.5 m U/L為SCH診斷截點(diǎn),將PCOS患者分為SCH組和甲狀腺功能正常組,比較兩組間內(nèi)分泌代謝特征的差異。結(jié)果:1)以TSH值4.2 m U/L為SCH診斷截點(diǎn),SCH組泌乳素及黃體生成素與卵泡刺激素的比值顯著升高,空腹血糖顯著降低,內(nèi)臟脂肪指數(shù)顯著升高(均P0.05),血三酰甘油有升高趨勢(shì)(P=0.085),高密度脂蛋白膽固醇有下降趨勢(shì)(P=0.060);2)以TSH值2.5 m U/L為SCH診斷截點(diǎn),SCH組雌二醇、泌乳素顯著升高,血三酰甘油顯著升高,高密度脂蛋白膽固醇顯著下降,內(nèi)臟脂肪指數(shù)顯著升高(均P0.05)。結(jié)論:PCOS合并SCH組其內(nèi)分泌激素紊亂、血脂異常及內(nèi)臟脂肪增多較甲狀腺功能正常組更嚴(yán)重;以TSH值2.5 m U/L為PCOS患者SCH診斷截點(diǎn),其SCH組較甲狀腺功能正常組內(nèi)分泌代謝特征差異更為顯著,提示臨床可以TSH值2.5 m U/L為SCH截點(diǎn)對(duì)PCOS患者進(jìn)行分組評(píng)估、優(yōu)化診治。
[Abstract]:Objective: to study the relationship between subclinical hypothyroidism and endocrine metabolic characteristics in patients with polycystic ovary syndrome (PCOS). The clinical data of 321 newly diagnosed PCOS patients were collected. Thyroid function was measured by chemiluminescence method. Thyroid stimulating hormone thyroid stimulating hormoneTSHS (4.2mU / L and 2.5mU / L) were used as diagnostic cutoff points of SCH. The patients with PCOS were divided into SCH group and normal thyroid function group. Results the ratio of prolactin and luteinizing hormone to follicle stimulating hormone (FSH) in SCH group was significantly higher than that in Sch group, and fasting blood glucose was significantly decreased. The visceral fat index was significantly increased (all P0.05U, triacylglycerol, high density lipoprotein cholesterol decreased). Estradiol, prolactin and triacylglycerol were significantly increased in Sch group with TSH value of 2.5 m UL as diagnostic cut-off point, and serum triglyceride level was significantly increased in Sch group. High density lipoprotein cholesterol decreased significantly and visceral fat index increased significantly (all P0.050.Conclusion the endocrine hormone disturbance, dyslipidemia and visceral fat increase in SCH group were more serious than those in normal thyroid function group. The difference of endocrine metabolic characteristics in SCH group was more significant than that in normal thyroid function group, which suggested that the TSH value of 2.5 MU / L as SCH cut-off point could be used to evaluate PCOS patients and optimize the diagnosis and treatment.
【作者單位】： 中南大學(xué)湘雅醫(yī)院內(nèi)分泌科;中信湘雅生殖和遺傳專科醫(yī)院;
【基金】：國(guó)家自然科學(xué)基金(81670788)~~
【分類號(hào)】：R581.2;R711.75

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