多囊卵巢综合征合并代谢综合征患者血清AMH、TyG指数和LAP表达特点及诊断意义

楼春华; 陆月红; 陈惠娟; 林红梅

doi:10.16766/j.cnki.issn.1674-4152.004252

多囊卵巢综合征合并代谢综合征患者血清AMH、TyG指数和LAP表达特点及诊断意义

doi: 10.16766/j.cnki.issn.1674-4152.004252

1.
绍兴市妇幼保健院妇女保健科，浙江绍兴 312000
2.
绍兴市妇幼保健院生殖健康科
3.
绍兴市妇幼保健院妇科

基金项目:

浙江省医药卫生科技计划项目 2023KY368

详细信息

通讯作者:
林红梅，E-mail: Linhongmei2015@163.com

中图分类号: R711.51 R446
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出版历程
- 收稿日期: 2025-02-25
- 网络出版日期: 2026-01-07

Expression characteristics and diagnostic significance of serum AMH, TyG index and LAP in patients with polycystic ovary syndrome complicated with metabolic syndrome

1.
Women's Health Care Department, Shaoxing Maternal and Child Health Hospital, Shaoxing, Zhejiang 312000, China

摘要

摘要: 目的多囊卵巢综合征(PCOS)人群易发生代谢综合征(MS)，本研究旨在探讨血清抗米勒管激素(AMH)、甘油三酯葡萄糖(TyG)指数和脂质蓄积指数(LAP)对PCOS合并MS的诊断价值。方法选取2023年1月—2024年12月绍兴市妇幼保健院收治的159例PCOS患者，依据是否合并MS分成PCOS组(97例)和PCOS合并MS组(62例)。比较2组MS组分阳性率和血清AMH、TyG指数、LAP，采用多因素logistic回归分析研究PCOS患者合并MS的影响因素，ROC曲线评价血清AMH、TyG指数、LAP对PCOS合并MS的诊断效能。结果 PCOS合并MS组甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、高血糖阳性率和不孕比例、BMI、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)均高于PCOS组(P＜0.05)，血清AMH[(15.23±3.27)ng/mL vs.(5.86±1.70)ng/mL]、TyG指数(9.15±0.48 vs.8.32±0.45)、LAP(85.26±21.14 vs.30.84±9.73)均高于PCOS组(P＜0.05)。HOMA-IR、AMH、TyG指数、LAP均是PCOS合并MS的独立影响因素(P＜0.05)，血清AMH、TyG指数、LAP三者联合诊断PCOS合并MS的AUC均高于单独预测(P＜0.05)。结论 PCOS合并MS患者血清AMH、TyG指数、LAP异常升高，三者联合检测可为临床评估MS发生风险和诊断提供依据。
- 多囊卵巢综合征 /
- 代谢综合征 /
- 抗米勒管激素 /
- 甘油三酯葡萄糖指数 /
- 脂质蓄积指数
Abstract: Objective People with polycystic ovary syndrome (PCOS) are prone to metabolic syndrome (MS). This study explores the diagnostic and evaluation value of serum anti-Miller's hormone (AMH), triglyceride-glucose (TyG) index and lipid accumulation index (LAP) for PCOS combined with MS. Methods A total of 159 patients with PCOS admitted to Shaoxing Maternal and Child Health Hospital from January 2023 to December 2024 were selected and divided into the PCOS group and the PCOS combined with MS group based on whether they were combined with MS, with 97 and 62 cases respectively. The general data, positive rate of MS components, serum AMH, TyG index, and LAP of the two groups were compared. Multivariate logistic regression was used to analyze the influencing factors of PCOS patients complicated with MS. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of serum AMH, TyG index and LAP for PCOS complicated with MS. Results The positive rates of triglycerides (TG), high-density lipoprotein (HDL-C), hyperglycemia, the proportion of infertility, BMI, fasting insulin (FINS), and insulin resistance (HOMA-IR) in the PCOS combined with MS group were all higher than those in the PCOS group (P < 0.05). The serum AMH [(15.23±3.27) ng/mL vs. (5.86±1.70)ng/mL], TyG index (9.15±0.48 vs. 8.32±0.45), and LAP (85.26±21.14 vs. 30.84±9.73) were all higher than those in the PCOS group (P < 0.05). HOMA-IR, AMH, TyG index and LAP were independent influencing factors for PCOS combined with MS (P < 0.05). The AUC of the combined diagnosis of PCOS combined with MS by AMH, TyG index and LAP was all higher than the AUC of the individual indicators (P < 0.05). Conclusion The serum AMH, TyG index and LAP of patients with PCOS combined with MS are abnormally elevated. The combined detection of the three provides a basis for the clinical assessment of the risk of MS occurrence and diagnosis.
- Polycystic ovary syndrome /
- Metabolic syndrome /
- Anti-millerian hormone /
- Triglyceride-glucose index /
- Lipid accumulation index

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图 1 血清AMH、TyG指数、LAP单独及联合诊断PCOS合并MS的ROC曲线

Figure 1. ROC curves of serum AMH, the TyG index, LAP, and their combined model for diagnosing PCOS with concurrent MS

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表 1 2组PCOS患者MS各组分阳性率比较[例(%)]

Table 1. Comparison of the positive rates of each component of MS between the two groups of PCOS patients [case(%)]

组别	例数	WC	TG	HDL-C	高血压	高血糖
PCOS组	97	52(53.61)	51(52.58)	47(48.45)	21(21.65)	50(51.55)
PCOS合并MS组	62	41(66.13)	46(74.19)	41(66.13)	20(32.26)	45(72.58)
χ²值		2.664	7.430	4.781	2.224	6.958
P值		0.103	0.006	0.029	0.136	0.008

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表 2 2组PCOS患者一般资料比较

Table 2. Comparison of general Data of two groups of PCOS patients

组别	例数	年龄 (x±s，岁)	初潮年龄 (x±s，岁)	不孕 [例(%)]	PCOS病程 (x±s，月)	BMI (x±s)	LH (x±s，IU/L)	FSH (x±s，IU/L)	T (x±s，nmol/L)	FINS (x±s，mU/L)	HOMA-IR (x±s)
PCOS组	97	29.06±4.32	13.78±1.25	64(65.98)	16.83±4.21	25.62±3.10	9.78±2.12	5.17±1.40	3.45±0.76	15.87±4.12	4.35±0.74
PCOS合并MS组	62	29.18±4.50	13.61±1.31	50(80.65)	17.19±4.65	26.71±3.18	10.23±2.40	5.36±1.48	3.62±0.84	17.95±4.27	5.62±0.85
统计量		0.168^a	0.821^a	4.009^b	0.505^a	2.141^a	1.239^a	0.816^a	1.320^a	3.061^a	9.955^a
P值		0.867	0.413	0.045	0.614	0.034	0.217	0.416	0.189	0.003	＜0.001
注：^a为t值，^b为χ²值。

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表 3 2组PCOS患者血清AMH、TyG、LAP比较(x±s)

Table 3. Comparison of Serum AMH, TyG and LAP between Two Groups of PCOS Patients (x±s)

组别	例数	AMH (ng/mL)	TyG指数	LAP
PCOS组	97	5.86±1.70	8.32±0.45	30.84±9.73
PCOS合并MS组	62	15.23±3.27	9.15±0.48	85.26±21.14
t值		23.681	8.462	21.996
P值		＜0.001	＜0.001	＜0.001

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表 4 PCOS合并MS影响因素的多因素logistic分析

Table 4. Multivariate logistic analysis of PCOS combined with MS

变量	B	SE	Waldχ²	P值	OR值	95% CI
不孕	0.033	0.021	2.469	0.358	1.034	0.831~1.576
BMI	0.188	0.116	2.627	0.279	1.207	0.958~2.034
HOMA-IR	0.840	0.325	6.680	＜0.001	2.317	1.367~4.128
AMH	0.601	0.284	4.478	＜0.001	1.823	1.107~3.206
TyG指数	0.307	0.129	5.664	＜0.001	1.359	1.028~2.273
LAP	0.436	0.215	4.112	0.006	1.547	1.054~2.840

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表 5 血清AMH、TyG指数、LAP及三者联合对PCOS合并MS的诊断效能

Table 5. The diagnostic efficacy of serum AMH, TyG index, LAP and their combination for PCOS combined with MS

诊断指标	AUC	标准误	截断值	P值	AUC的95% CI
AMH	0.853	0.051	7.36 ng/mL	＜0.001	0.753~0.954
TyG指数	0.779	0.059	8.68	＜0.001	0.662~0.895
LAP	0.824	0.053	44.51	＜0.001	0.721~0.927
联合	0.917	0.031		＜0.001	0.856~0.978

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