目的:该研究的目的是调查患有功能性下丘脑闭经(FHA)和多囊卵巢形态学(PCOM)的女性的血清促黄体生成素(LH)水平是否仍然与体重指数(BMI)和/或使用更多FHA的血清胰岛素和/或抗苗勒氏激素(AMH)水平有关。
方法:回顾性观察研究(2006-2020)。
方法:本研究使用来自62名FHA患者的数据,使用严格的标准来定义它们。
方法:血清LH,FSH,17-羟基孕酮(17-OHP),硫酸脱氢表雄酮(DHEA-S),雄烯二酮,总睾酮,催乳素,通过免疫测定测量性激素结合球蛋白(SHBG)和AMH水平。为了均匀化AMH值,我们转换了2015年后获得的。我们以严格的标准定义了PCOM:每个卵巢的卵泡数(FNPO)≥12或≥20,取决于进行评估的日期和超声设备。
结果:我们的FHA人口中有42%患有PCOM。PCOM组的BMI(p=.024)和血清AMH水平(p=.0001)明显较高,血清FSH水平(p=.002)明显较低。在PCOM组,LH仅与空腹胰岛素(p=.011)和AMH(p=.035)呈正相关,而与BMI无关。两组LH与FSH呈正相关。
结论:我们的研究表明,PCOM患者的GnRH功能不全揭示了LH调节的一些机制,这些机制在文献中记录很少,可能涉及直接的垂体作用。正如我们的血清胰岛素和AMH水平的结果表明。
The aim of the study was to investigate whether serum Luteinizing Hormone (LH) levels in women with Functional Hypothalamic Amenorrhoea (FHA) and Polycystic Ovarian Morphology (PCOM) are still associated to Body Mass Index (BMI) and/or serum insulin and/or Anti-Müllerian Hormone (AMH) levels using a larger population of FHA.
Retrospective observational study (2006-2020).
Data from 62 FHA patients were used for this study using strict criteria to define them.
Serum LH, FSH, 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone sulphate (DHEA-S), androstenedione, total testosterone, prolactin, Sex Hormone Binding Globulin (SHBG) and AMH levels were measured by immunoassay. To homogenize the AMH values, we converted those obtained after 2015. We defined PCOM with strict criteria: a follicle number per ovary (FNPO) ≥12 or ≥20 per ovary, depending on the date on which the assessment was carried out and the ultrasound device.
Forty-two percentage of our FHA population had PCOM. The PCOM+ group had significantly higher ranks of BMI (p = .024) and serum AMH levels (p = .0001) and significantly lower ranks of serum FSH levels (p = .002). LH was positively correlated with fasting insulin (p = .011) and with AMH (p = .035) in the PCOM+ group only but not with BMI. There was a positive correlation between LH and FSH in both groups.
Our study suggests that GnRH insufficiency in women with PCOM unravels some mechanisms of LH regulation that are poorly documented in the literature and may involve a direct pituitary effect, as suggested by our results with serum insulin and AMH levels.