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| 多囊卵巢综合征是否有任何敏感且特异的甾体类性激素标志物？ |
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| Are There Any Sensitive and Specific Sex Steroid Markers for Polycystic Ovary Syndrome? |
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| Stener-Victorin E, Holm G, Labrie F 2010/6/30 19:21:13 |
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| J Clin Endocrinol Metab, 2010, |
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| View at Publisher |
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Context:
Despite the high prevalence of hyperandrogenemia, the principal biochemical abnormality in women with polycystic ovary syndrome (PCOS), a definitive endocrine marker for PCOS has so far not been identified.
Objective:
To identify a tentative diagnostic marker for PCOS, we compared serum levels of sex steroids, their precursors, and main metabolites in women with PCOS and controls.
Design and Methods:
In this cross-sectional study of 74 women with PCOS and 31 controls, we used gas and liquid chromatography/mass spectrometry to analyze serum sex steroid precursors, estrogens, androgens, and glucuronidated androgen metabolites; performed immunoassays of SHBG, LH, and FSH; and calculated the LH/FSH ratio.
Results:
Androgens and estrogens, sex steroid precursors, and glucuronidated androgen metabolites were higher in women with PCOS than in controls. In multivariate logistic regression analyses, estrone and free testosterone were independently associated with PCOS. The odds ratios per SD increase were 24.2 for estrone [95% confidence interval (CI), 4.0–144.7] and 12.8 for free testosterone (95% CI, 3.1–53.4). In receiver operating characteristic analyses, the area under curve was 0.93 for estrone (95% CI, 0.88–0.98) and 0.91 for free testosterone (95% CI, 0.86–0.97), indicating high sensitivity and specificity.
Conclusion:
Women with PCOS have elevated levels of sex steroid precursors, estrogens, androgens, and glucuronidated androgen metabolites as measured with a specific and sensitive mass spectrometry-based technique. The combination of elevated estrone (>50pg/ml) and free testosterone (>3.3pg/ml) appeared to discriminate with high sensitivity and specificity between women with and without PCOS. |
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 疾病资源中心
病例分析 [栏目介绍]
王燕燕 王曙
上海交通大学附属瑞金医院内分泌科
患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。
医学数据库
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