1 新疆医科大学第二附属医院妇产科，乌鲁木齐 830028
|| 新疆维吾尔自治区自然科学基金 (2017D01C241)。
目的：研究新疆维吾尔族与汉族多囊卵巢综合征(polyc ystic ovarian syndrome，PCOS)患者中抗苗勒氏管激素(ant i-Mül ler ian hormone，AMH)的表达水平与分布特征，分析AMH与临床代谢及激素指标的相关性。方法：选择156例在新疆医科大学第二附属医院就诊的PCOS患者，按民族及体重指数(BMI)分为：维吾尔族肥胖组40例，BMI≥25 kg/m2；维吾尔族非肥胖组36例， BMI<25 kg/m2；汉族肥胖组38例，BMI≥25 kg/m2；汉族非肥胖组42例，BMI<25 kg/m2；另选正常人群80例为对照组，维吾尔族与汉族均40例。测定并比较各组的外周血清AMH、卵泡刺激素(follicle-stimulating hormone，FSH)、黄体生成素(luteinizing hormone，LH)、雌二醇(estradiol， E2)、睾酮水平；检测并各组的空腹血糖(fasting plasma glucose，FPG)和空腹血清胰岛素(ser um insulin，INS)，同时计算各组的稳态模型胰岛素抵抗指数(homeostasis model assessment of insulin re s i st ance，HOMA-IR)。采用Pea r s on相关分析血清AMH水平与上述临床各指标间的相关性。 结果：维吾尔族肥胖组及汉族肥胖组血清FSH，LH，E2均低于维吾尔族非肥胖组及汉族非肥胖组(均P<0.05)，而血清FPG，INS及HOMA-IR均高于维吾尔族非肥胖组及汉族非肥胖组(均P<0.05)；维吾尔族患者血清AMH均高于汉族患者(均P<0.05)，而维吾尔族患者与汉族患者血清FSH，LH， E2，FPG，INS及HOMA-IR指标均无显著差异(均P>0.05)；4组PCOS患者上述指标均高于对照组(均P<0.05)。维吾尔族及汉族PCOS患者AMH与LH、睾酮、FPG、INS及HOMA-IR均呈正相关，与FSH，E2均呈负相关(均P<0.05)。结论：PCOS患者血清AMH显著升高，其升高与民族和BMI无关，与下丘脑-腺垂体功能障碍和糖代谢紊乱有关。
Correlation between plasma levels of anti-Müllerian hormone and clinical indexes in Uyghur and Han ethnic women with polycystic ovary syndrome
This work was supported by the Xinjiang Uygur Autonomous Region Natural Science Foundation, China (2017D01C241).
Objective: To analyze the relationship of the plasma levels of anti-Müllerian hormone (AMH) and clinical indexes between Uyghur and Han ethnic women with polycystic ovary syndrome (PCOS). Methods: The 156 patients diagnosed to PCOS in our hospital were collected and divided into four groups according to the ethnic and the body mass index (BMI), which were Uyghur obesity group (40 cases, Uyghur ethnic women with BMI ≥25 kg/m2), Uyghur non-obesity group (36 cases, Uyghur ethnic women with BMI <25 kg/m2), Han obesity group (38 cases, Han ethnic women with BMI ≥25 kg/m2) and Han non-obesity group (42 cases, Han ethnic women with BMI <25 kg/m2). The 80 cases of healthy examinee were chosen to control group and the Uyghur and Han ethnic women were 40 cases respectively. The plasma levels of AMH, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone, fasting blood-glucose (FPG), fasting insulin (INS) and homeostasis model of assessment for insulin resistance index (HOMA-IR) were detected and compared among five groups respectively. The correlations of plasma levels of AMH to FSH, LH, E2, testosterone, FPG, INS and HOMA-IR were confirmed by Pearson linear correlation analysis. Results: The plasma levels of FSH, LH, E2 in Uyghur obesity group and Han obesity group were lower than those in Uyghur non-obesity group and Han non-obesity group (all P<0.05), but the plasma levels of FPG, INS and HOMA-IR were higher than those in Uyghur non-obesity group and Han non-obesity group (all P<0.05). The plasma levels of AMH in Uyghur group were higher than in Han group (all P<0.05). But the plasma levels of FSH, LH, E2, FPG, INS and HOMA-IR were no different between Uyghur group and Han group (all P>0.05). The above indexes in the four groups were higher than those in the control group (all P<0.05). The positive correlations of AMH to LH, testosterone, FPG, INS and HOMA-IR were confirmed by Pearson linear correlation analysis (all P<0.05), and the negative correlations of AMH to FSH and E2 were also confirmed (all P<0.05). Conclusion: The plasma levels of AMH in patients with PCOS are significant increase. And the plasma levels of AMH are not associated with BMI, which may have correlation with hormone imbalance and metabolic disorders.
ethnic characteristic; polycystic ovary syndrome; anti-Müllerian hormone; gonadal hormone; homeostasis model of assessment for insulin resistance index