The Study Of Correlation Between Androstendione,Dehydroepiandrosterone Sulfate,Sex Hormone Binding Protein And Insomnia Symptoms In Perimenopause

BackgroundThe incidence of chronic insomnia is high in China,but the treatment rate is low.Among them,the prevalence of chronic insomnia in elderly women is significantly higher than that in men^[1].The transition from regular menstrual period to perimenopausal period greatly increases the incidence of sleep disorders in women from 36%to 51%^[2].Therefore,perimenopause is particularly important as a special period for women to transition from middle age to old age.The mechanism of perimenopausal insomnia has not been fully revealed.Insomnia symptoms in perimenopausal women have been shown to be related to estrogen,but its correlation with androgens,especially other androgens except testosterone and sex hormone binding protein（SHBG）is still less studied.In men,sex hormone-binding protein（SHBG）is negatively correlated with sleep restriction^[3],and dehydroepiandrosterone sulfate（DHEA-S）is positively correlated with subjective sleep quality^[4].A cross-sectional observational study showed that dehydroepiandrosterone sulfate was positively associated with post-sleep arousal in the general female population^[5].The aim of this study was to investigate the association of insomnia and other perimenopausalsymptomswithserumandrostenedione（ASD）,dehydroepiandrosterone sulfate（DHEA-S）and sex hormone-binding protein（SHPR）levels in perimenopausal women.ObjectiveTo investigate the relationship between insomnia symptoms and serum androstenedione,dehydroepiandrosterone sulfate,sex hormone binding protein in perimenopausal women.MethodsAccording to The inclusion criteria and exclusion criteria,44 perimenopausal women in the Department of Neurology,the Second Affiliated Hospital of Guangzhou Medical University,Panyu from September 2022 to March 2023 were selected.PSQI)and Insomnia Severity Index（ISI）were used to evaluate the subjects’insomnia symptoms,and the modified Kupperman score was used to evaluate the subjects’perimenopausal symptoms.They were divided into the control group with a total score of 7 or less and the insomnia group with a total score of 7 or more.Serum androstenedione,dehydroepiandrosterone sulfate and sex hormone binding protein were detected.Results（1）General information:there were no significant differences in gender,age and education level between the two groups（P>0.05）（2）Sleep status:independent sample t test showed that the PSQI score,ISI score and modified Kupperman score of the insomnia group were higher than those of the control group（P<0.001;P<0.001;P<0.05）.There was no significant difference in serum ASD,DHEA-S and SHBG between the insomnia group and the control group.According to correlation analysis,serum ASD,DHEA-S and SHBG were not correlated with PSQI and ISI scores in correlation analysis（P>0.05）.In the analysis of PSQI scale factors and test results,androstenedione level was negatively correlated with habitual sleep efficiency score（P<0.05）,but not correlated with subjective sleep quality,sleep latency,sleep duration,sleep disturbance and daytime dysfunction scores（P>0.05）.Serum sex hormone binding protein level was positively correlated with sleep latency score（P<0.05）.Serum interleukin-6 level was associated with PSQI total score（P<0.05）,ISI（P<0.05）were negatively correlated with PSQI score,but not correlated with PSQI score except total score（P>0.05）,and androstenedione（P<0.05）,sex hormone binding protein（P<0.05）had a negative correlation.25-hydroxyvitamin D3 level was negatively correlated with PSQI total score（r=-0.230,P=0.040）,but not with ISI（P>0.05）.ConclusionHigher androstenedione levels were associated with higher sleep efficiency in perimenopausal women.The higher the serum sex hormone binding protein level,the longer the sleep latency.