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山东大学学报（医学版） ›› 2017, Vol. 55 ›› Issue (1): 80-84.doi: 10.6040/j.issn.1671-7554.0.2016.1114

• 临床医学 • 上一篇    下一篇

多囊卵巢综合征患者促甲状腺激素对血糖、血脂的影响

张琳,李敬,王泽,张江涛,马增香,石玉华   

  1. 山东大学附属生殖医院 国家辅助生殖与优生工程技术研究中心 生殖内分泌教育部重点实验室 山东省生殖医学重点实验室, 山东 济南 250001
  • 收稿日期:2016-09-04 出版日期:2017-01-10 发布日期:2017-01-10
  • 通讯作者: 石玉华. E-mail:shiyuhua2003@126.com E-mail:shiyuhua2003@126.com
  • 基金资助:
    国家科技支撑计划(2012BAI32B04);国家自然基金面上项目(81471428,81200423);山东大学附属生殖医院自主创新项目(20141103)

Impact of thyroid-stimulating hormone on blood glucose and serum lipids in patients with polycystic ovary syndrome

ZHANG Lin, LI Jing, WANG Ze, ZHANG Jiangtao, MA Zengxiang, SHI Yuhua   

  1. Center for Reproductive Medicine, Shandong University;
    National Research Center for Assisted Reproductive Technology and Reproductive Genetics;
    Key Laboratory for Reproductive Endocrinology(Shandong University), Ministry of Education;
    Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan 250001, Shandong, China
  • Received:2016-09-04 Online:2017-01-10 Published:2017-01-10

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摘要： 目的 分析多囊卵巢综合征(PCOS)患者的促甲状腺激素(TSH)对血糖、血脂的影响。 方法 选择无甲状腺疾病治疗史的PCOS患者1 034例,测量其身高、体质量、腰围、臀围、血压等,实验室检测包括TSH、性激素、血糖、胰岛素、血脂总胆固醇(TC)、三酰甘油TG)、低密度脂蛋白胆固醇(LDL-C)等指标,计算体质量指数(BMI)、腰臀比,稳态模型评估胰岛素抵抗指数(HOMA-IR)。并根据TSH界值将PCOS患者分为TSH正常组(0.27 μIU/mL≤TSH≤4.2 μIU/mL)和TSH升高组(TSH>4.2 μIU/mL),比较两组间各项生化指标的差异。 结果 1 034例PCOS患者中有163例(15.76%)TSH升高。TSH升高组和TSH正常组的患者比较体质量(P=0.015)、BMI(P=0.021)、臀围(P=0.023)、收缩压(P=0.006)、舒张压(P=0.001),差异有统计学意义,且TSH升高组的肥胖患者占比明显高于TSH正常组。两组间的2 h血糖、空腹胰岛素、2 h胰岛素以及HOMA-IR差异均无统计学意义(P>0.05),但PCOS伴TSH升高组相比TSH正常组有升高趋势。TSH升高组PCOS患者TC(P=0.027)、TG(P=0.022)及LDL-C(P=0.049)高于TSH正常组。相关性分析结果显示,TSH与臀围、收缩压、舒张压、空腹胰岛素、2 h胰岛素、HOMA-IR、TC、TG、LDL-C呈正相关性(P均<0.05)。 结论 TSH升高的PCOS患者更容易发生肥胖,导致血脂代谢紊乱,同时糖代谢异常和胰岛素抵抗有加剧的趋势,建议PCOS患者常规检查TSH。

关键词: 多囊卵巢综合征, 血脂, 促甲状腺激素, 血糖

Abstract: Objective To analyze the effect of thyroid stimulating hormone(TSH)on blood glucose and serum lipids in patients with polycystic ovary syndrome(PCOS). Methods A total of 1 034 PCOS patients without thyroid disease history were collected. Their height, weight, waist circumference(WC), hip circumference(HC), blood pressure, TSH, sex hormones, blood glucose, insulin, serum lipids were measured; body mass index(BMI), waist hip ratio, and homeostasis model assessment of insulin resistance(HOMA-IR)were calculated. Based on the normal TSH cut-off adopted in our hospital, the PCOS patients were divided into two groups: normal TSH group(0.27 μIU/mL≤TSH≤4.2 μIU/mL)and elevated TSH group(TSH>4.2 μIU/mL). The biochemical indicators of the two groups were compared. Results 山 东 大 学 学 报 (医 学 版)55卷1期 -张琳,等.多囊卵巢综合征患者促甲状腺激素对血糖、血脂的影响 \=-Of all patients, 163(15.76%)had elevated TSH level. There were significant differences between the elevated and normal TSH groups in body weight(P=0.015), BMI(P=0.021), WC(P=0.023), systolic pressure(P=0.006), and diastolic pressure(P=0.001). The prevalence of obesity was significantly higher in elevated TSH group than in normal TSH group. There are no significant differences between the two groups in 2 h blood glucose, FINS, 2 h insulin, and HOMA-IR(all P>0.05), but there was a rising trend in the elevated TSH group. The elevated TSH group had higher TC(P=0.027), TG(P=0.022)and LDL-C(P=0.049)than those of the normal TSH group. TSH was positively correlated to hip circumference, systolic pressure, diastolic blood pressure, FINS, 2 h insulin, HOMA-IR, TC, TG and LDL-C(all P<0.05). Conclusion PCOS patients with TSH elevated are prone to obesity, dyslipidemia, glucose metabolism disorder and insulin resistance. Therefore, such patients are suggested to have TSH level screened.

Key words: Thyroid stimulating hormone, Serum lipids, Blood glucose, Polycystic ovary syndrome

中图分类号: 

  • R711.75
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