目的：探究多囊卵巢综合征（PCOS）患者血清尿酸（SUA）水平与性激素水平之间的关系，为PCOS患者性激素代谢异常以及不孕的改善提供综合管理新思路。方法：选取2016年6月至2017年9月就诊于南京医科大学附属鼓楼医院内分泌科及体重管理门诊的276例PCOS患者及同时期就诊的年龄、BMI匹配的140名正常育龄期女性作为正常对照组（NC组）。比较PCOS患者和正常育龄期女性的内分泌代谢指标及性激素水平间的差异以及PCOS患者不同SUA水平者一般资料、糖代谢指标、性激素等多项代谢指标的差异，进行相关性分析。结果：PCOS患者SUA水平明显高于NC组女性（P<0.05）。根据SUA浓度，PCOS患者按三分位间距分为3组：L-SUA组（SUA水平≤ 337 μmol·L^-1）、M-SUA组（337 μmol·L^-1-1）、H-SUA（SUA水平>414 μmol·L^-1）。PCOS患者H-SUA组的0.5 h胰岛素、1 h胰岛素、2 h胰岛素、硫酸脱氢表雄酮（DHEAS）水平明显高于L-SUA组（P<0.05），性激素结合球蛋白（SHBG）水平明显低于L-SUA组（P<0.05）；Pearson相关性分析显示，DHEAS水平与SUA水平呈正相关，SHBG水平与SUA水平呈负相关。结论：PCOS患者的SUA水平高于年龄、BMI匹配的正常育龄期女性，且随着SUA水平的升高，PCOS患者高雄激素血症风险增加。

[1] CONWAY G,DEWAILLY D,DIAMANTI-KANDARAKIS E,et al.The polycystic ovary syndrome:a position statement from the European Society of Endocrinology[J].Eur J Endocrinol,2014,171(4):1-29.
[2] 邵莎莎,殷惠蓉,徐友娣.青春期多囊卵巢综合征诊断的研究进展[J].东南大学学报(医学版),2014,33(6):808-810.
[3] LI R,ZHANG Q,YANG D,et al.Prevalence of polycystic ovary syndrome in women in China:a large community-based study[J].Hum Reprod,2013,28(9):2562-2569.
[4] LUQUE-RAMIREZ M,ALVAREZ-BLASCO F,URIOL,et al.Serum uric acid concentration as non-classic cardiovascular risk factor in women with polycystic ovary syndrome:effect of treatment with ethinyl-estradiol plus cyproterone acetate versus metformin[J].Hum Reprod,2008,23(7):1594-1601.
[5] MACUT D,SIMIC T,LISSOUNOV A,et al.Insulin resistance in non-obese women with polycystic ovary syndrome:relation to byproducts of oxidative stress[J].Exp Clin Endocrinol Diabetes,2011,119(7):451-455.
[6] GOZUKARA I O,GOZUKARA K H,KUCUR S K,et al.Association of glomerular filtration rate with inflammation in polycystic ovary syndrome[J].Int J Fertil Steril,2015,9(2):176-182.
[7] RUTKOWSKA A Z,DIAMANTI-KANDARAKIS E.Polycystic ovary syndrome and environmental toxins[J].Fertil Steril,2016,106(4):948-958.
[8] BOZDAG G,MUMUSOGLU S,ZENGIN D,et al.The prevalence and phenotypic features of polycystic ovary syndrome:a systematic review and meta-analysis[J].Hum Reprod,2016,31(12):2841-2855.
[9] ANTTILA L,ROURU J,PENTTILA T,et al.Normal serum uric acid concentrations in women with polycystic ovary syndrome[J].Hum Reprod,1996,11(11):2405-2407.
[10] MACUT D,SIMIC T,LISSOUNOV A,et al.Insulin resistance in non-obese women with polycystic ovary syndrome:relation to byproducts of oxidative stress[J].Exp Clin Endocrinol Diabetes,2011,119(7):451-455.
[11] CAO W,ZHENG R D,XU S H,et al.Association between sex hormone and blood uric acid in male patients with type 2 diabetes[J].Int J Endocrinol,2017,2017:4375253.
[12] KURAHASHI H,WATANABE M,SUGIMOTO M,et al.Testosterone replacement elevates the serum uric acid levels in patients with female to male gender identity disorder[J].Endocr J,2013,60(12):1321-1327.
[13] YAHYAOUI R,ESTEVA I,HARO-MORA J J,et al.Effect of long-term administration of cross-sex hormone therapy on serum and urinary uric acid in transsexual persons[J].J Clin Endocrinol Metab,2008,93(6):2230-2233.
[14] YAHYAOUI R,ESTEVA I,HARO-MORA J J,et al.Effect of long-term administration of cross-sex hormone therapy on serum and urinary uric acid in transsexual persons[J].J Clin Endocrinol Metab,2008,93(6):2230-2233.
[15] PUI K,WADDELL C,DALBETH N.Early onset of hyperuricaemia and gout following treatment for female to male gender reassignment[J].Rheumatology,2008,47(12):1840-1841.
[16] HOSOYAMADA M,TAKIUE Y,SHIBASAKI T,et al.The effect of testosterone upon the urate reabsorptive transport system in mouse kidney[J].Nucleosides Nucleotides Nucleic Acids,2010,29(7):574-579.
[17] ROSENFIELD R L,EHRMANN D A.The pathogenesis of polycystic ovary syndrome(PCOS):the hypothesis of PCOS as functional ovarian hyperandrogenism revisited[J].Endocr Rev,2016,37(5):467-520.
[18] PETER A,KANTARTZIS K,MACHANN J,et al.Relationships of circulating sex hormone-binding globulin with metabolic traits in humans[J].Diabetes,2010,59(12):3167-3173.
[19] TONG G,HUA X,ZHONG Y,et al.Intensive insulin therapy increases sex hormone-binding globulin in newly diagnosed type 2 diabetic patients[J].Eur J Endocrinol,2014,170(2):237-245.
[20] LIZNEVA D,GAVRILOVA-JORDAN L,WALKER W,et al.Androgen excess:Investigations and management[J].Best Pract Res Clin Obstet Gynaecol,2016,37:98-118.
[21] AZZIZ R.Polycystic ovary syndrome[J].Obstet Gynecol,2018,132(2):321-336.
[22] MITROU P,PETSIOU E,PAPAKONSTANTINOU E,et al.The role of acetic acid on glucose uptake and blood flow rates in the skeletal muscle in humans with impaired glucose tolerance[J].Eur J Clin Nutr,2015,69(6):734-739.
[23] FABBRINI E,SERAFINI M,KLEIN S,et al.Effect of plasma uric acid on antioxidant capacity, oxidative stress, and insulin sensitivity in obese subjects[J].Diabetes,2014,63(9):976-981.
[24] NAKAGAWA T,HU H,ZHARIKOV S,et al.A causal role for uric acid in fructose-induced metabolic syndrome[J].Am J Physiol Renal Physiol,2006,290(3):F625-F631.
[25] KODAMAN P H,DULEBA A J.Statins in the treatment of polycystic ovary syndrome[J].Semin Reprod Med,2008,26(1):127-138.
[26] PETER A,KANTARTZIS K,MACHANN J,et al.Relationships of circulating sex hormone-binding globulin with metabolic traits in humans[J].Diabetes,2010,59(12):3167-3173.
[27] LIVADAS S,PAPPAS C,KARACHALIOS A,et al.Prevalence and impact of hyperandrogenemia in 1,218 women with polycystic ovary syndrome[J].Endocrine,2014,47(2):631-638.