| Objective:To study the correlation between dehydroepiandrostrone-sulphate(DHEAS)and the metabolic abnormality of polycystic ovary syndrome(PCOS),and to provide a new idea for the diagnosis and treatment of PCOS.Methods:To analyze the clinical data of the patients who were first diagnosed with PCOS in the First Affiliated Hospital of Xiamen University from December 01,2017 to December 31,2020.Measure height and weight and record the following indexes:DHEAS,androstenedione(A2),follicle stimulating hormone(FSH),luteinizing hormone(LH),progesterone(PRGE),estradiol(E2),total testosterone(TT),prolactin(PRL),fasting insulin(FINS),fasting plasma glucose(FPG),total cholesterol(TC),triglyceride(TG),high-density lipoprotein(HDL-C),low-density lipoprotein(LDL-C).Calculate the body mass index(BMI).Patients were divided into insulin resistance(IR)group(HOMA-IR≥2.69,n=38)and non-IR group(HOMA-IR<2.69,n=92)according to insulin resistance index(HOMA-IR).According to the median age of 27 years,the subjects were stratified.According to DHEAS,patients in the age<27 years old group were divided into high level DHEAS group(DHEAS≥233,n=38)and low level DHEAS group(DHEAS<233,n=26).According to DHEAS,patients in the age ≥27 years old group were divided into high level DHEAS group(DHEAS≥233,n=27)and low level DHEAS group(DHEAS<233,n=39).SPSS 26.0 software was used for analysis.The correlation between DHEAS and indexes was analyzed by Pearson and Spearman correlation;the correlation heat map was drawn by R language;independent sample t-test and rank sum test were used to compare the differences among different groups;ROC curve was constructed to predict the diagnostic ability of androgen markers for hyperandrogenemia in PCOS.Results:1.Correlation analysis between DHEAS and clinical data of patients showed that DHEAS was negatively correlated with age and E2,while DHEAS was positively correlated with A2,TT,FINS,HOMA-IR and PRGE,with statistical significance(P<0.05).2.After adjusting for age group,the correlation between DHEAS and clinical data of patients was analyzed again.The results were as follows: in the age group<27years old,TT and A2 in the high level DHEAS group were higher than those in the low level DHEAS group,with statistical significance(P<0.05).In the age≥27 years old group,A2 and FINS in the high level DHEAS group were higher than those in the low level DHEAS group(P<0.05);HDL-C in the high level DHEAS group was higher than that in the low level DHEAS group,but the difference was not statistically significant(P=0.05).3.DHEAS,BMI,FPG,FINS,TG and LDL-C in IR group were higher than those in non-IR group,while LH and HDL-C in IR group were lower than those in non-IR group,the difference was statistically significant(P<0.05).4.The area under ROC curve of DHEAS and A2 were 0.610 and 0.686,respectively,with statistical significance(P<0.05),and the cut-off values of DHEAS and A2 were 244 and 3.55,respectively.Conclusion:1.Before adjusting for age,DHEAS was positively correlated with HOMA-IR.However,due to the close relationship between DHEAS and age,there was no statistical difference in HOMA-IR between different levels of DHEAS in PCOS patients aged<27 years after stratification by age group.There was no statistical difference in HOMA-IR among PCOS patients aged≥27 years with different levels of DHEAS,but A2 and FINS in the high level DHEAS group were higher than those in the low level DHEAS group,suggesting that DHEAS and IR were not affected by each other in PCOS patients,DHEAS did not aggravate the degree of insulin resistance,and fasting insulin can promote the synthesis of DHEAS.2.DHEAS has no effect on obesity in PCOS patients.3.DHEAS does not increase the risk of dyslipidemia in PCOS patients,so it is particularly important to identify the source of androgen in the assessment and management of metabolic risk in PCOS patients.4.DHEAS and A2 have certain value in the diagnosis of PCOS hyperandrogenemia. |
