【摘要】 目的观察多囊卵巢综合征(PCOS)患者血皮质醇(8:00)及清晨唾液皮质醇浓度和其升高值,探讨PCOS患者下丘脑-垂体-肾上腺轴(HPA轴)功能状态。方法对24例PCOS患者(PCOS组)和25例月经正常的非肥胖健康妇女(对照组)测定8:00血皮质醇。在任意一个工作日,收集清醒即刻及清醒后15min的唾液,测定唾液皮质醇浓度并计算其升高值(用2次浓度之差表示)。比较两组清晨皮质醇水平(唾液和血)及唾液皮质醇升高值。结果(1)PCOS组体重指数(BMI)、腰臀比(WHR)高于对照组,差异有统计学意义(P<0.01)。(2)PCOS组的8:00血皮质醇,清醒即刻、清醒后15min的唾液皮质醇均低于对照组(P<0.01)。相关分析示PCOS组的血皮质醇与BMI、WHR呈负相关。两组的清晨唾液皮质醇升高值无差别。(3)剔除肥胖患者后,非肥胖的PCOS组仍有着高的WHR(P<0.01),清醒即刻、清醒后15min的唾液皮质醇仍低于对照(P<0.05)。结论PCOS患者存在HPA轴紊乱,清晨皮质醇降低,腹型肥胖可能是重要原因。更多还原

【Abstract】 Objective To assess the hypothalamic-pituitary-adrenal axis function in polycystic ovary syndrome(PCOS) patients by measuring the concentration of morning cortisol and morning salivary cortisol response to awakening.Methods Morning serum cortisol at 8 am was determined in 24 PCOS patients(PCOS group) and 25 non-obese healthy women(control group).On an ordinary working day,salivary cortisol samples were collected immediately at awakening and 15min thereafter.The 15min salivary cortisol level minus the salivary cortisol at awakening calculated the morning cortisol response.Results(1) PCOS group had higher BMI and WHR(P<0.01).(2) Both salivary cortisol at different points and serum cortisol were significantly lower in PCOS group(P<0.01).BMI and WHR were negatively correlated with serum cortisol in PCOS group.There was no significant difference in morning salivary cortisol response between the two groups.(3) After adjustment the influence of obesity,the non-obese PCOS group still had higher WHR(P<0.01)and lower salivary cortisol concentration at different points(P<0.05).Conclusion PCOS patients show some abnormalities of hypothalamic-pituitary-adrenal-axis function with lower morning cortisol level,and abdominal obesity may play an important role in this situation.更多还原