Serum levels of sex hormone binding globulin, androgen and insulin in polycystic ovarian syndrome women during pregnancy

( views:170, downloads:0 )
Author:
TAO Jun(Department of Obstetrics and Gynecology, the International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China)
GU Jin-ping(Department of Obstetrics and Gynecology, the International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China)
FAN Jian-xia(Department of Obstetrics and Gynecology, the International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China)
Journal Title:
Chinese Journal of Perinatal Medicine
Issue:
Volume 15, Issue 03, 2012
DOI:
10.3760/cma.j.issn.1007-9408.2012.03.005
Key Word:
Polycystic ovarian syndrome;Pregnancy complications;Pregnancy trimester,second;Sex hormone-binding globulin;Androgens;Insulin

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%CI:0.96~1.00,P<0.05); FTI was the risk factor of HDP in PCOS women (OR=5.53,95%CI:1.20~25.61,P<0.05). Conclusions FTI and SHBG levels could be predictors for GDM and HDP in PCOS women during their pregnancies.

  • [1]Vanky E,Stridsklev S, Skogφy K, et al. PCOS:what matters in early pregnancy? data from a cross-sectional,multicenter study. Acta Obstet Gynecol Scand,2011,90:398-404.
  • [2]Ding EL,Song Y,Manson JE,et al.Sex hormone-binding globulin and risk of type 2 diabetes in women and men.N Engl J Med,2009,361:1152-1163.
  • [3]Nanda S,Savvidou M,Syngelaki A,et al. Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks.Prenat Diagn,2011,31:135-141.
  • [4]潘颖,张文颖,李东盛,等.孕早期性激素结合球蛋白与妊娠期糖尿病的相关性.吉林大学学报(医学版),2007,33:890-893.
  • [5]Karakas SE,Kim K,Duleba AJ.Determinants of impaired fasting glucose versus glucose intolerance in polycystic ovary syndrome.Diabetes Care,2010,33:887-893.
  • [6]Hammond GI,Bocchinfuso WP. Sex hormone binding globulin:gene organization and structure/function analyses.Horm Res,1996,45:197-201.
  • [7]Spencer K,Yu CK,Rembouskos G,et al.First trimester sex hormone-binding globulin and subsequent development of preeclampsia or other adverse pregnancy outcomes.Hypertens Pregnancy,2005,24:303-311.
  • [8]Kienitz T,Quinkler M. Testosterone and blood pressure regulation.Kidney Blood Press Res,2008,31:71-79.
  • [9]Troisi R,Vatten L,Hoover RN,et al. Maternal androgen and estrogen concentrations are not associated with blood pressure changes in uncomplicated pregnancies. Cancer Epidemiol Biomarkers Prev,2006,15:2013-2015.
  • [10]Gerulewicz-Vannini D, Camero Y, Salas J,et al. High plasmatic androgen levels in women affected with pregnancy-induced hypertension.Rev Invest Clin,2006,58:228-233.
  • [11]李光辉,范玲,张为远.多囊卵巢综合征对围产结局影响的研究进展.中华围产医学杂志,2011,14:562 566.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn