多囊卵巢综合征患者甲状腺自身抗体表达与血清雌二醇 及雌二醇/孕酮比值相关性研究

Expression of thyroid autoimmune antibodies and its correlation with serum estradiol level and estradiol-to-progesterone ratio in patients with polycystic ovary syndrome

摘要:

目的：探讨合并自身免疫性甲状腺病（autoimmune thyroiditis，AIT）的多囊卵巢综合征（polycystic ovary syndrome，PCOS）患者的临床特点。方法：收集51例PCOS患者的临床资料，包括年龄、体质指数、甲状腺功能及甲状腺自身抗体、生化及激素水平和卵巢超声形态等并进行统计分析。结果：①甲状腺自身抗体阳性的PCOS患者与甲状腺自身抗体阴性者相比，血清雌二醇E2[193.00（144.00~251.00） vs. 148.00（94.80~193.25）]升高，雌二醇（estradiol，E2）/孕酮（progesterone，PRG）比值[155.17（69.17~319.72） vs. 112.91（79.18~141.55）]升高（均P<0.05）。②无卵巢多囊表现的PCOS患者与存在卵巢多囊者相比，血清E2[201.0（149.0~350.0） vs. 174.0（105.3~196.0）]升高，E2/PRG比值[209.38（105.19~341.11） vs. 116.86（83.74~153.75）]升高（均P<0.05），血清甲状腺自身抗体阳性率明显升高（P<0.05）。PCOS患者血清甲状腺自身抗体水平与E2、E2/PRG呈显著正相关（P<0.05）。结论：PCOS患者中无卵巢多囊表现者更倾向于发展为AIT。甲状腺自身抗体的产生可能与血清E2和E2/PRG升高有关。

Abstract:

Objective：To investigate the clinical features of patients with polycystic ovary syndrome（PCOS） and autoimmune thyroiditis（AIT）. Methods：The clinical data of 51 patients with PCOS were collected，including age，body mass index，thyroid function，thyroid autoimmune antibodies，biochemical parameters，hormone levels，and ovarian morphology on ultrasound，and a statistical analysis was performed. Results：The PCOS patients with positive thyroid autoimmune antibodies had significantly higher serum estradiol level and estradiol-to-progesterone ratio than those with negative thyroid autoimmune antibodies [serum estradiol level：193（144-251） vs. 148 （94.8-193.25），P <0.05；estradiol-to-progesterone ratio：155.17（69.17-319.72） vs. 112.91（79.18-141.55），P <0.05]. Compared with those with polycystic ovaries，the PCOS patients without such manifestation had significant increases in serum estradiol level[201 （149-350） vs. 174 （105.3-196），P <0.05]，estradiol-to-progesterone ratio[209.38（105.19-341.11） vs. 116.86 （83.74-153.75），P <0.05]，and positive rate of thyroid autoimmune antibodies（P <0.05）. In the PCOS patients，the serum level of thyroid autoimmune an－tibodies was positively correlated with serum estradiol level and estradiol-to-progesterone ratio（P <0.05）. Conclusion：The PCOS pa－tients without polycystic ovaries tend to develop AIT. The pro－duction of thyroid autoimmune antibodies may be associated with the increases in serum estradiol level and estradiol-to-pro－gesterone ratio.