摘要
目的探讨多囊卵巢综合征(PCOS)患者血清脂联素(APN)水平与胰岛素抵抗的关系。方法采用酶联免疫吸附法(ELISA)测定40例PCOS患者[PCOS组,根据体重指数(BMI)分为肥胖者(BMI≥25kg/m2)19例,非肥胖者(BMI<25kg/m2)21例]及15例健康志愿者和10例非PCOS不孕患者(对照组,其中肥胖者9例,非肥胖者16例)的APN水平,化学发光法、葡萄糖氧化酶法、放射免疫法分别测定空腹胰岛素、空腹血糖、肿瘤坏死因子α(TNF-α)水平。计算两组患者胰岛素敏感指数(ISI),评价胰岛素抵抗程度。结果(1)PCOS组肥胖者APN水平为(1·6±0·5)mg/L,PCOS组非肥胖者为(3·0±0·6)mg/L,对照组肥胖者为(3·2±0·3)mg/L,非肥胖者为(4·9±0·5)mg/L,两组分别比较,差异均有统计学意义(P<0·05)。(2)PCOS组肥胖者胰岛素水平为(17±6)mU/L,非肥胖者为(14±6)mU/L,对照组肥胖者为(10±3)mU/L,非肥胖者为(7±3)mU/L,两组分别比较,差异有统计学意义(P<0·05)。(3)PCOS组肥胖者空腹血糖为(5·2±0·7)mmol/L,非肥胖者为(5·1±0·6)mmol/L,对照组肥胖者为(5·4±0·5)mmol/L,非肥胖者为(4·8±0·6)mmol/L,两组分别比较,差异无统计学意义(P>0·05)。(4)PCOS组肥胖者TNF-α水平为(1·32±0·14)μg/L,非肥胖者为(1·02±0·12)μg/L,对照组肥胖者为(0·93±0·15)μg/L,非肥胖者为(0·63±0·18)μg/L,两组分别比较,差异有统计学意义(P<0·05)。(5)PCOS组肥胖者ISI为-4·5±0·3,非肥胖者为-4·1±0·4,对照组肥胖者为-3·6±0·3,非肥胖者为-3·1±0·4,两组分别比较,差异也有统计学意义(P<0·05)。PCOS组患者APN水平与BMI呈显著负相关关系(r=-0·56,P<0·05),与ISI呈显著正相关关系(r=0·49,P<0·05)。结论PCOS患者APN水平降低,并以PCOS肥胖者降低更明显;PCOS患者APN水平下降与胰岛素敏感性及胰岛素抵抗相关。
Objective To study the relationship between serum adiponectin and insulin resistance in women with polycystic ovary syndrome （PCOS）. Methods Forty women with PCOS and twenty five healthy women were divided into PCOS obese group [body weight index（BMI） ~〉25kg/m2], PCOS non- obese group（ BMI 〈 25 kg/m2） and control group. There are 19 cases in PCOS obese group and 21 cases in PCOS non-obese group , 9 cases in obese control group and 16 in non-obese control group. Serum adiponectin levels of the four groups were detected by enzyme linked immunosorbent assay （ELISA） method, insulin by electrochemiluminescence immunoassay method, blood sugar by glucose oxidation enzyme method, tumor necrosis factor-or （TNF-ct） by radioimmunoassay. Insulin sensitivity index （ISI） was calculated. Results （ 1 ） Serum adiponectin levels of PCOS obese group was （ 1.6±0. 5 ） rag/L, of PCOS non-obese group was （3.0±0. 6） mg/L. Their values were lower than obese control group （ 3.2± 0. 3 ） mg/L, and non-obese control group （4. 9±0. 5） mg/L （P 〈 0.05）. （2）Fasting insulin levels of PCOS obese group was （17±6） mU/L, PCOS non-obese group was （14±6） mU/L. They were higher than obese control group（ 10±3） mU/L, and non-obese control group （7±3 ） mU/L （ P 〈 0.05 ）. （ 3 ） Fasting blood sugar level was （5. 2±0. 7） mmoL/L in PCOS obese group, in PCOS non-obese group was（5. 1±0. 6）mmol/L, in obese control group was （ 5.4±0. 5 ） mmol/L, and non-obese control group （ 4. 8±0. 6 ） mmol/L, without marked difference among four groups. （4）TNF-α levels of PCOS obese group was （1.32±0.14）μg/L, of PCOS non-obese group was （1.02±0.12） μg/L. They were higher than obese control group（0.93±0. 15）μg/L, and non-obese control group （0.63±0. 18）μg/L （P 〈0.05）. （5） ISI of PCOS obese group was -4.5±0.3, PCOS non-obese group was -4.1± 0.4. Their values were lower than obese control group -3.6±0.3, and non-obese control group （ -3.1±0.4） （P 〈0.05）. Serum adiponectin levels of the women with PCOS were correlated negatively with BMI（ r=-0. 56, P 〈 0.05 ）, and correlated positively with ISI （r=0.49,P〈0. 05）. Conclusion Serum adiponectin levels of women with PCOS is decreased compared with healthy women, particularly in obese women with PCOS. The decrease is correlated with ISI.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2006年第4期261-263,共3页
Chinese Journal of Obstetrics and Gynecology
基金
河南省科技攻关项目(324410030)
