Serum levels of sex hormone binding globulin, androgen and insulin in polycystic ovarian syndrome women during pregnancy / 中华围产医学杂志

ABSTRACT

Objective To investigate the changes of serum levels of sex hormone binding globulin (SHBG),free testosterone index (FTI) and insulin resistance; and to investigate the relationship among them and prevalence of gestational diabetes mellitus (GDM) and hypertensive disorder complicating pregnancy (HDP) in polycystic ovarian syndrome (PCOS) women during pregnancy. Methods Serum samples of 32 PCOS women and 32 non-PCOS women were collected during their gestational age from 12 to16 weeks.Serum levels of total testosterone,SHBG and insulin were detected.Free testosterone index (FTI) and homeostasis model assessment for insulin resistance (HOMA-IR) were calculated.Risk factors of GDM and HDP were analyzed by stepwise logistic regression.Data of two groups were compared with t test or Chi square test. Results Serum fasting insulin [(8.0±1.5) mU/L vs (7.1±1.5) mU/L,t=2.32,P＜0.05],FTI [0.96 (0.52-1.41) vs 0.61 (0.40-0.79),t=3.02,P＜0.05],HOMA-IR levels [1.53±0.32 vs 1.36±0.36,t=2.04,P＜0.05] and total testosterone [2.95 (1.61-4.40) nmol/L vs 2.15 (1.50-2.80) nmol/L,t=2.55,P＜0.05] were higher in PCOS group than in control group; and SHBG level [325 (312-355) nmol/L vs 360 (347-373) nmol/L,t=4.13,P＜0.05] was lower in PCOS group than in control group.Cesarean section rate (84％ vs 50％,x2 =8.58,P＜0.01) and HDP incidence (25％ vs 3％,x2=4.65,P＜0.05) were higher in PCOS group than in control group. SHBG level [(293 ±42) nmol/L] of PCOS women who complicated with GDM (n=6) was significantly lower than that [(333±40) nmol/L] of those who did not (n=26),t=2.22,P＜0.05.Serum total testosterone [(4.34±1.29)vs (2.49±1.44) nmol/L,t=3.23,P＜0.05] and FTI [1.42±0.52 vs 0.81±0.59,t=2.61,P＜0.05] were significantly higher in PCOS women complicated with HDP (n=8) than those of the PCOS women who did not (n=24).Stepwise logistic regression analysis showed that SHBG was the risk factor of GDM (OR=0.98,95％CI0.96～1.00,P＜0.05); FTI was the risk factor of HDP in PCOS women (OR=5.53,95％CI1.20～25.61,P＜0.05). Conclusions FTI and SHBG levels could be predictors for GDM and HDP in PCOS women during their pregnancies.