Lower Sex hormone-binding Globulin is a Potential Marker for the Insulin Resistance in non-obese Untreated Taiwanese Women with Polycystic Ovary Syndrome

較低之性荷爾蒙結合球蛋白可能作為臺灣非肥胖且未治療之多囊性卵巢症候群患者胰島素抗性之參考指標

楊曉萍(Hsiao-Ping Yang) ； 蘇秀悅(Hsiu-Yueh Su) ； 蔡雅惠(Ya-Hui Tsai) ； 黃士懿(Shih-Yi Huang)

《臺灣營養學會雜誌》 34卷3期 (2009/09) Pp. 103-113

https://doi.org/10.6691/NSJ.200909_34(3).0004

摘要

多囊性卵巢症候群得到代謝症候群的機會上升，對於非肥胖之患者，需要可利用指標幫助早期發現健康是否惡化。本研究目的為探討非肥胖患者生化與荷爾蒙指標之變化，與其間相關性。研究對象為30名育齡非肥胖之臺灣多囊性卵巢症候群女性患者，並以15名健康、育齡非肥胖婦女為對照組，比較兩組體組成、生化與荷爾蒙指標之差異，並作迴歸分析。結果發現相對於對照組，多囊性卵巢症候群組具有較低之性荷爾蒙結合球蛋白與高密度脂蛋白膽固醇，而其高敏感性C反應蛋白較高。經以年齡與身體質量指數校正，可發現多囊性卵巢症候群組性荷爾蒙結合球蛋白與男性荷爾蒙指標、高密度脂蛋白膽固醇、三酸甘油酯、體組成明顯相關；高密度脂蛋白膽固醇血中濃度與腰圍、腰臀比成反比；性荷爾蒙結合球蛋白與空腹胰島素、胰島素阻抗指標、2小時血糖值成反比。較低之性荷爾蒙結合球蛋白應有潛力成為台灣非肥胖患者胰島素抗性的臨床參考。

關鍵字

多囊性卵巢症候群 ； 性荷爾蒙結合球蛋白 ； 高密度脂蛋白膽固醇 ； 腰圍

並列摘要

Background: Polycystic ovary syndrome (PCOS) is considered to share similar features with metabolic syndrome (MBS). Useful clinical diagnostics is necessary to evaluate the early manifestations of worsening health illustrated in non-obese women with PCOS. Objective: We investigated the association of serum biochemical and hormonal factors of non-obese patients with PCOS. Methods: Thirty qualified premenopausal, non-obese Taiwanese women with PCOS were enrolled in this study while another 15 non-obese premenopausal women were enrolled and served as controls. Anthropometric measures and select essential biochemical and hormonal measures were measured. The regressions between selected biochemical measures and the anthropometric measures were assessed between these groups. Results: When the PCOS group was compared with the control, the levels of high-density lipoprotein cholesterol (HDL-C and sex hormone-binding globulin SHBG) levels were significantly lower (56.3 ± 13.3 mg/dL and 49.9 ± 22.9 nmol/L, respectively, p＜0.05) and while high-sensitivity C-reactive protein (hs-CRP) was significantly higher 0.18 ± 0.21 mg/L). SHBG was significantly correlated with androgen profiles, HDL-C and triglycerides levels after being adjusted for age and BMI, hormone levels and anthropometric variables. HDL-C is highly inversely associated with waist circumference (WC) and waist-to-hip ratio (WHR). The fasting insulin, homeostasis model assessment (HOMA) of insulin resistance and results from 2-h glucose challenge test significantly but negatively correlated with SHBG levels after being adjusting for age and BMI in the PCOS group. Conclusion: Lower SHBG is a useful clinical marker to help detecting the insulin resistance in patients of non-obese Taiwanese women with PCOS.

並列關鍵字

Sex-hormone binding globulin ； High-density lipoprotein cholesterol ； Polycystic ovary syndrome ； Waist circumference