目的 探讨多囊卵巢综合征(polycystic ovarian syndrome,PCOS)患者不同临床表型性功能及其与临床和性激素特征的相关性.方法 使用女性性功能指数(Female Sexual Function Index,FSFI)调查问卷对首都医科大学附属北京妇产医院内分泌科2020 年 10 月至 2021 年 12 月就诊的PCOS患者和对照女性进行研究.根据鹿特丹标准将PCOS分为四个临床表型组,A组:排卵功能障碍(oligo-ovulation or anovulation,OA)+雄激素过多(hyperandrogenism,HA)+多囊卵巢(polycystic ovaries,PCO);B组:OA+HA;C组:HA+PCO;D组:OA+PCO.收集可能影响性功能的临床资料并测定性激素水平,包括人体测量指标、血清促卵泡激素、促黄体生成素、催乳素和总睾酮.结果 910 例PCOS患者和402 例参数完整的对照女性纳入研究.A组FSFI总分最低(23.69±3.20)(P<0.05),B组、C组和D组呈顺序增加的趋势.对照组FSFI总分最高(24.96±3.79)(P<0.05).与对照组相比,A组性功能障碍(female sexual dysfunction,FSD)风险百分比最高,为 87.5%(P<0.05),其次分别为B组、C组、D组.A组FSD风险高于C组和D组(P<0.05),B组FSD风险高于D组(P<0.05).多元线性回归分析显示总睾酮、年龄、腰围、体脂分布与女性性功能呈负相关.结论 与对照组相比,PCOS患者FSD风险较高,且与PCOS临床表型相关.同时符合PCOS三个诊断特征的经典表型FSD风险最高.总睾酮、年龄、腰围、体脂分布与PCOS患者的FSD风险相关.
Analysis of sexual function of patients with polycystic ovary syndrome with different clinical phenotypes
Objective To investigate the sexual function of different clinical phenotypes in patients with polycystic ovarian syndrome(PCOS)and its correlation with clinical and sex hormonal characteristics.Methods The study evaluated sexual function on PCOS patients and control women in the Department of Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University from October 2020 to December 2021,via the Chinese version of Female Sexual Function Index(FSFI).PCOS were divided into four clinical phenotype groups according to the Rotterdam criteria,A:oligo-ovulation or anovulation(OA)+hyperandrogenism(HA)+polycystic ovaries(PCO);B:OA+HA;C:HA+PCO;D:OA+PCO.The clinical data that may affect sexual function were collected and sex hormone levels were measured,including anthropometric markers,serum follicle-stimulating hormone,luteinizing hormone,prolactin and total testosterone.Results A total of 910 PCOS women and 402 control women with complete parameters were included in the study.Phenotype A had the lowest total FSFI mean score(23.69±3.20)(P<0.05);phenotype B,C and D showed a trend of sequential increase.Control group had the highest total FSFI mean score(24.96±3.79)(P<0.05).Compared with the control group,Group A had the highest risk percentage of female sexual dysfunction(FSD)at 87.5%(P<0.05),followed by Group B,Group C,and Group D.The control group had the lowest FSD risk percentage,which was 62.19%(P<0.05).The FSD risk in Group A was higher than that in Group C and Group D(P<0.05),while the FSD risk in Group B was higher than that in Group D(P<0.05).Multivariate linear regression analysis demonstrated that total testosterone(TT),age,waist circumference,and body fat distribution were negatively correlated with female sexual function.Conclusions Compared with the control group,PCOS patients have a higher risk of FSD and are associated with the clinical phenotype of PCOS.The classic phenotype that simultaneously meets the three diagnostic characteristics of PCOS has the highest risk of FSD.TT,age,waist circumference,and body fat distribution are associated with FSD risk in PCOS women.
NETL
NSTL
万方数据
