多囊卵巢综合征不同表型不孕患者AFC、AMH、性激素和糖脂代谢特点及其临床意义

doi:10.13481/j.1671-587X.20250320

Abstract

Abstract:

Objective To discuss the characteristics of age， antral follicle count （AFC）， anti-Müllerian hormone （AMH）， sex hormones， and glycolipid metabolism in the infertile patients with different phenotypes of polycystic ovarian syndrome （PCOS）， and to improve the outcomes of assisted reproductive technology （ART）. Methods A total of 11 660 infertile female patients treated in our hospital were selected as the research subjects， including 3 110 PCOS patients and 8 550 non-PCOS patients. According to the Rotterdam criteria and inclusion/exclusion criteria， the subjects were divided into PCOS group （2 261 PCOS patients） and control group （1 871 non-PCOS patients）. The PCOS group was further divided into four phenotypes： type A （345 cases， oligo-ovulation or anovulation （OA）+hyperandrogenemia or clinical hyperandrogenism （HA）+polycystic ovary morphology （PCO））， type B （204 cases， OA+HA）， type C （102 cases， HA+PCO）， and type D （1 610 cases， OA+PCO）. Chemiluminescent immunoassay was used to detect the serum AMH levels of the subjects in various groups； glucose oxidase method and biochemical method were used to detect the serum levels of triglycerides （TG）， total cholesterol （TCHO）， fasting blood glucose （FBG）， and fasting insulin （FINS） of the subjects in various groups； chemiluminescence method was used to detect the serum basal sex hormone levels of the subjects in various groups； transvaginal ultrasound was used to detect the AFC of the subjects in various groups. Results Compared with control group， the age and serum basal follicle-stimulating hormone （bFSH） levels of the subjects in different PCOS phenotype groups were significantly decreased （P<0.01）， while AFC and serum levels of AMH， total testosterone （TESTO）， and basal luteinizing hormone （bLH） of the subjects were significantly increased （P<0.01）. Compared with type A PCOS group， the AFC and serum levels of AMH and bLH of the subjects in type B， C， and D PCOS groups were significantly decreased （P<0.01）. Compared with control group， the serum levels of TG， TCHO， FBG， and FINS， as well as homeostasis model assessment of insulin resistance （HOMA-IR） of the subjects in type A and D PCOS groups were significantly increased （P<0.01）； the serum levels of FBG and FINS， as well as HOMA-IR of the subjects in type B PCOS group were significantly increased （P<0.01）； the serum TG level of the subjects in type C PCOS group was significantly increased （P<0.01）. Compared with type A PCOS group， the serum levels of TG and FINS， as well as HOMA-IR of the subjects in type B， C， and D PCOS groups were significantly decreased （P<0.01）. Conclusion The patients with different PCOS phenotypes exhibit distinct basal sex hormone levels and glycolipid metabolism characteristics. Phenotypic classification of PCOS infertile patients helps predict disease severity， and personalized pretreatment should be performed for different PCOS phenotypes before ART.

Key words: Polycystic ovarian syndrome, Anti-Müllerian hormone, Antral follicle count, Glycolipid metabolism, Assisted reproductive technology

CLC Number:

R711.6

Yaping YE,Longmei WANG,Ping LI. AFC, AMH，sex hormone, and characteristics of glucose lipid metabolism in infertility patients with different phenotypes of polycystic ovatrian syndrome and their clinical significances[J].Journal of Jilin University(Medicine Edition), 2025, 51(3): 757-762.

Figures/Tables 2

References 27

[1]	陈凯，赵越. 多囊卵巢综合征表型跨代遗传相关研究进展［J］. 现代妇产科进展， 2022， 31（6）： 473-477.
[2]	HOUDA MIMOUNI NEL， PAIVA I， BARBOTIN A L， et al. Polycystic ovary syndrome is transmitted via a transgenerational epigenetic process［J］. Cell Metab， 2021， 33（3）： 513-530.e8.
[3]	VAN KEIZERSWAARD J， DIETZ DE LOOS A L P， LOUWERS Y V， et al. Changes in individual polycystic ovary syndrome phenotypical characteristics over time： a long-term follow-up study［J］. Fertil Steril， 2022， 117（5）： 1059-1066.
[4]	WIWEKO B， HANDAYANI L K， HARZIF A K， et al. Correlation of anti-Müllerian hormone levels with metabolic syndrome events in polycystic ovary syndrome： a cross-sectional study［J］. Int J Reprod Biomed， 2020， 18（3）： 187-192.
[5]	VAGIOS S， JAMES K E， SACHA C R， et al. A patient-specific model combining antimüllerian hormone and body mass index as a predictor of polycystic ovary syndrome and other oligo-anovulation disorders［J］. Fertil Steril， 2021， 115（1）： 229-237.
[6]	ROTTERDAM ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome［J］. Fertil Steril， 2004， 81（1）： 19-25.
[7]	NORMAN R J， DEWAILLY D， LEGRO R S，et al.Polycystic ovary syndrome［J］. The Lancet， 2007， 370（9588）：685-697．
[8]	GAO J S， MA H L， WANG Y， et al. Hospital-based phenotypic features and treatment outcomes of Chinese women with polycystic ovary syndrome： the effect of body mass index and geographic distribution［J］. Engineering， 2021， 7（2）： 170-177.
[9]	YANG Z W， ZHOU W Z， ZHOU C L， et al. Steroid metabolome profiling of follicular fluid in normo- and hyperandrogenic women with polycystic ovary syndrome［J］. J Steroid Biochem Mol Biol， 2021， 206： 105806.
[10]	杨欣，曹金龙，李晓凤，等. 基于代谢组学的多囊卵巢综合征研究进展［J］. 生殖医学杂志， 2021， 30（1）： 120-124.
[11]	WANG L， ZHOU J， GOBER H J， et al. Alterations in the intestinal microbiome associated with PCOS affect the clinical phenotype［J］. Biomed Pharmacother， 2021， 133： 110958.
[12]	ARYA S， HANSEN K R， PECK J D， et al. Metabolic syndrome in obesity： treatment success and adverse pregnancy outcomes with ovulation induction in polycystic ovary syndrome［J］. Am J Obstet Gynecol， 2021， 225（3）： 280.e1-280280.e11.
[13]	MACKENS S， PAREYN S， DRAKOPOULOS P， et al. Outcome of in-vitro oocyte maturation in patients with PCOS： does phenotype have an impact？［J］. Hum Reprod， 2020， 35（10）： 2272-2279.
[14]	LENTSCHER J A， SLOCUM B， TORREALDAY S. Polycystic ovarian syndrome and fertility［J］. Clin Obstet Gynecol， 2021， 64（1）： 65-75.
[15]	BAHADUR A， MUNDHRA R， KASHIBHATLA J， et al. Prevalence of metabolic syndrome among women with different PCOS phenotypes-a prospective study［J］. Gynecol Endocrinol， 2021， 37（1）： 21-25.
[16]	KAUR R， KAUR M， SURI V. Phenotypic presentation of PCOS with respect to BMI in a north Indian population［J］. Clin Ter， 2021， 172（5）： 435-437.
[17]	叶生琴，薛原，赵晨宇，等. 广东地区不同表型多囊卵巢综合征患者临床特点及代谢特征分析［J］. 中国实用妇科与产科杂志， 2022， 38（10）： 1020-1023.
[18]	EZEH U， EZEH C， PISARSKA M D， et al. Menstrual dysfunction in polycystic ovary syndrome： association with dynamic state insulin resistance rather than hyperandrogenism［J］. Fertil Steril， 2021， 115（6）： 1557-1568.
[19]	钟兴明，苗竹林，崔蓉，等. 肥胖与多囊卵巢综合征患者临床特征的相关性分析［J］. 中国妇幼保健， 2020， 35（5）： 895-899.
[20]	王晓林，贺永艳，曹杨，等. 不同表型PCOS患者AMH与BMI、IR的相关性分析［J］. 中国计划生育和妇产科， 2022， 14（10）： 81-85.
[21]	PAPADAKIS G， KANDARAKI E A， GARIDOU A， et al. Tailoring treatment for PCOS phenotypes［J］. Expert Rev Endocrinol Metab， 2021， 16（1）： 9-18.
[22]	EZEH U， PISARSKA M D， AZZIZ R. Association of severity of menstrual dysfunction with hyperinsulinemia and dysglycemia in polycystic ovary syndrome［J］. Hum Reprod， 2022， 37（3）： 553-564.
[23]	RUDNICKA E， SUCHTA K， GRYMOWICZ M， et al. Chronic low grade inflammation in pathogenesis of PCOS［J］. Int J Mol Sci， 2021， 22（7）： 3789.
[24]	DADACHANJI R， PATIL A， JOSHI B， et al. Elucidating the impact of obesity on hormonal and metabolic perturbations in polycystic ovary syndrome phenotypes in Indian women［J］. PLoS One， 2021， 16（2）： e0246862.
[25]	TOSI F， VILLANI M， MIGAZZI M， et al. Insulin-mediated substrate use in women with different phenotypes of PCOS： the role of androgens［J］. J Clin Endocrinol Metab， 2021， 106（9）： e3414-e3425.
[26]	钟兴明，顾恒，苗竹林，等. PCOS不同临床表型的关系分析［J］. 中国妇幼健康研究， 2020， 31（10）： 1400-1404.
[27]	乔杰，齐新宇，徐雅兰，等. 关注影响女性健康的重要生殖内分泌疾病多囊卵巢综合征［J］. 中国实用妇科与产科杂志， 2020， 36（1）： 1-9.

Gruop	n	Age (year)	AFC	AMH [ρ_B/(μg·L^-1)]	TESTO [ρ_B/(μg·L^-1)]	bFSH [λ_B/(IU·L^-1)]	bLH [λ_B/(IU·L^-1)]
Control	1 871	32.07±4.24	10.77±4.58	3.59±2.75	0.41±0.15	7.90±2.07	4.38±1.87
PCOS Type A	345	28.40±3.49^*	34.09±13.59^*	11.54±4.99^*	0.93±0.21^*	6.45±1.51^*	8.71±4.57^*
Type B	204	30.90±4.05^*	12.42±4.79^*△	4.50±3.25^*△	0.91±0.22^*	7.61±2.14^*	5.30±2.87^*△
Type C	102	28.90±3.59^*	28.25±11.60^*△	9.38±5.09^*△	0.90±0.20^*	6.71±1.65^*	6.83±4.14^*△
Type D	1 610	29.20±3.45^*	28.32±8.63^*△	9.46±4.55^*△	0.49±0.15^*	6.57±1.56^*	6.71±3.87^*△

Group	n	TG [c_B/(mmol·L^-1)]	TCHO [c_B/(mmol·L^-1)]	FBG [c_B/(mmol·L^-1)]	FINS [λ_B/(mIU·L^-1)]	HOMA-IR (mIU·L^-1×mmol·L^-1)
Control	1 871	0.82±0.36	4.64±0.72	5.12±0.44	6.84±6.73	1.57±1.58
PCOS
Type A	345	1.08±0.46^*	4.76±0.72^*	5.23±0.42^*	11.16±9.45^*	2.60±2.16^*
Type B	204	0.88±0.41^△	4.65±0.65	5.29±0.44^*	8.80±9.06^*△	2.11±2.34^*△
Type C	102	0.93±0.41^*△	4.65±0.71	5.18±0.43	7.11±4.11^△	1.66±1.02^△
Type D	1 610	0.96±0.43^*△	4.70±0.67^*	5.19±0.42^*	8.99±7.26^*△	2.10±1.75^*△

AFC, AMH，sex hormone, and characteristics of glucose lipid metabolism in infertility patients with different phenotypes of polycystic ovatrian syndrome and their clinical significances

RichHTML

PDF (PC)

Like

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 2

References 27

Related Articles 3

Metrics

Comments

Recommended 0

[1]	Hong GAO,Xiaohong YAN,Li LIN,Lulu REN,Youzhu LI. Analysis of risk factors of late spontaneous abortion after assisted reproductive technology-assisted pregnancy [J]. Journal of Jilin University(Medicine Edition), 2022, 48(5): 1298-1304.
[2]	Yuanyuan YE,Xiaohong YAN,Youzhu LI. Analysis on related factors of pregnancy outcome after fresh embryo transfer in in-vitro fertilization/ intra-cytoplasmic sperm injection [J]. Journal of Jilin University(Medicine Edition), 2022, 48(2): 454-461.
[3]	GUO Hong-sheng, AN Chang-xin, CHEN Dong. Expression of FSH receptor in ovary tissue of rats withletrozole-induced polycystic ovary syndrome [J]. J4, 2009, 35(6): 1048-1051.