多囊卵巢综合征诊断指标与雌激素代谢的关系

探讨多囊卵巢综合征(PCOS)Rotterdam标准的不同诊断指标与我国患者雌激素合成以及糖代谢之间的关系.对8例对照、PCOS患者的17例多囊组(PCO组)、14例高雄组(OHA组)和21例复合组(PCOS组)妇女行卵巢兴奋试验(hMGl50IU hCG 5000IU),分别观察睾酮和雌二醇的血浓度变化,并计算芳香化酶功能指标和代谢指标.与对照组比较,PCOS三组均有雌二醇合成亢进,但程度有差异,芳香化酶状态以OHA组最高.三组患者的雌激素水平较正常对照组高,而且hMG刺激后均升高,但不同组的患者hMG刺激后雌激素升高的程度不同.雌激素过多升高导致FSH下降可能是PCOS卵泡发育停滞不排卵的一个因素.

Estrogen Synthesis and Glucose Metabolism in Women with Polycystic Ovary Syndrome

This paper assessed the differences in estrogen and carbohydrate metabolisms among women with various aspects of polycystic ovary syndrome(PCOS).Serum testosterone(T) and estradiol(E_2) responses,as well as glucose,insulin and c-peptide(C-P) responses were evaluated during ovarian stimulation test by iv hMG(150 lU) plus hCG(5 000 IU) and during oral glucose(75 g) tolerance test,respectively in women of controls(n=8),PCOS with main features of polycystic ovary(Group 1,n=17),hyperandrogenism(Group 2,n=14) and both(Group 3,(n=)22).The ratios of E_2 to T,insulin to glucose and C-P to insulin at all time points during individual test were used as the functional index of ovary aromatase,peripheral insulin resistance and hepatic insulin clearance.Amplified estrogenic potentials were observed in three groups of women with PCOS,with normal aromatase activity.In contrast,comparable levels of insulin resistance and hyperinsulinemia existed among women from PCOS three groups and control.Chinese women with different features of PCOS show various estrogenic capacities,indicating involvement of insulin resistance in different compartments of follicular structure.