Diagnostic Value Of Different Androgen Indexes Ofhyperandrogenism In Polycystic Ovary Syndrome

Objective: To investigate the diagnostic value and clinical significance of different androgen indicators in patients with polycystic ovary syndrome(PCOS).And to analyze the clinical manifestations and biochemical indexes of the sensitivity of individual androgen indicator and combined and multiple androgen indicators to PCOS patients.To evaluate the more sensitive androgen test indicators to reduce the missed diagnosis rate,to guide the clinical rational treatment.Methods: 1 Object and groups:Selection in October 2014 to June 2016 in the First Affiliated Hospital of Zhengzhou University and diagnosed with PCOS patients 300 cases,and at the same time selecting 120 infertility patients because of fallopian tube obstruction or the man factors of normal menstruation and ovulation as control group.Then divided the PCOS group into four subgroups:normal T group(154 cases)and high T group(146 cases);high androgen symptoms(HAS)and non-high androgen symptoms(NHAS);obesity(OB)and non-obesity(NOB);insulin resistance(IR)and non-insulin resistance group(NIR).2 Detection Indicator:Measuring their height,weight,body mass index(BMI),and hairy,acne,to detect the follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),progesterone(P),prolactin(PRL),total testosterone(T),sex hormone-binding globulin(SHBG),dehydroepiandrosterone sulfate(DHEA-S)and androstenedione(AND)in the patients,and calculate the free androgen indexes(FAI).Then to detect the fasting blood-glucose(FBG)and fasting insulin(FINS),using the steady-state model method evaluation indexes of insulin resistance(HOMA-IR),determination of total cholesterol(TC)and triglyceride(TG).3 Comparative analysis:Comparison the clinical manifestations and biochemical androgen indexes in PCOS patients and control group,and comparison of the two groups of clinical and biochemical indicators of the difference between the positive rate.Then divided the PCOS group into four subgroups: high androgen symptoms(HAS)and non-androgen symptoms(NHAS),obesity(OB)and non-obesity(NOB),insulin resistance(IR)and non-insulin resistance group(NIR).And the positive rate of biochemical androgen index between the two groups was compared.And then in each group T,AND,FAI and the three indicators of parallel detection of positive rate were compared.4 Statistical methods: Data entry EXCEL database,using SPSS 16.0 statistical software for statistics.The data were used to test the positive variables of each group,and the mean ± standard deviation(x±s)was used to satisfy the normal distribution.The measured data of the skewed distribution were measured by the median(M),quarter Bit spacing(Q),the count is expressed by n(%),the rate of comparison using X2 test,age comparison with the t test.P<0.05 for the difference was statistically significant.Results: 1.The scores of LH,T,AND,DHEA-S,FAI,BMI,FBG,FINS,TC,TG,m-FG and acne were significantly higher in the PCOS group than those in the control group(P<0.05),then SHBG was significantly lower than that in normal group(P<0.05).There was no significant difference between FSH,P,E2 and PRL(P>0.05).2.The positive rate of biochemical androgen indicators such as T,SHBG,DHEA-S,AND,FAI was significantly higher than that of the control group(P<0.05),and the positive rate of BMI,hirsutism and acne was significantly higher than that of the control group Control group(P<0.05).The positive rate of FBG,FINS,TC and TG in PCOS patients was also statistically significant(P<0.05).3.In the high T group,AND,DHEA-S and FAI were significantly higher than those in the normal T group,and in the normal T group,AND,DHEA-S and FAI were increased in different degrees.4.The positive rate of FAI,AND and T in HAS group,OB group and IR group was significantly higher than that in control group(P<0.05).There was no significant difference in DHEA-S between HAS group and OB group(P>0.05),SHBG between HAS group was no significant difference(P>0.05).5.The positive rate of FAI and AND in PCOS group was significantly higher than that in T(P<0.05).The positive rate of these three indicators was significantly higher than that of single index(P<0.05).Conclusions: 1.PCOS patients with elevated T ratio is low,can not accurately reflect the PCOS patients with hyperandrogenism,easily lead to missed diagnosis.2.PCOS patients with higher FAI and AND than the ratio of T,can better reflect the patient’s hyperandrogenism,can improve the clinical diagnosis.3.Combined with T,AND and FAI for PCOS patients with the highest positive rate of hyperthyroidism,can better guide the clinical diagnosis and treatment.