中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2009年
37期
2607-2610
,共4页
李昕%李希%黄海艳%马端%朱铭伟%林金芳
李昕%李希%黃海豔%馬耑%硃銘偉%林金芳
리흔%리희%황해염%마단%주명위%림금방
多囊卵巢综合征%脂肪细胞因子%脂联素%肿瘤坏死因子-α%胰岛素抵抗
多囊卵巢綜閤徵%脂肪細胞因子%脂聯素%腫瘤壞死因子-α%胰島素牴抗
다낭란소종합정%지방세포인자%지련소%종류배사인자-α%이도소저항
PCOS%Adipocytokine%Adiponectin%Tumor necrosis factor-α%Insulinresistance
目的 探讨PCOS患者血清脂肪细胞因子与胰岛素敏感性的相关性.方法 将PCOS患者60例分为肥胖组PCOS36例、非肥胖组PCOS24例,将同期就诊的男方因素不孕症患者(正常体重)26例作对照组.进行内分泌代谢指标测定,采用空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)评估胰岛素敏感性;并应用酶联免疫吸附法测定血清游离脂肪酸(FFA)、瘦素及C反应蛋白(CRP),放射免疫法测定血清脂联素(APN)、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6.结果 (1)肥胖组PCOS的血清APN为(10±7)mg/L,低于非肥胖组PCOSE(17±9)mg/L]和对照组,均P＜0.01;FFA为(548±105)μmol/L,高于非肥胖组PCOS[(427±67)μmoL/L]和对照组,P＜0.01;血清瘦素水平为(42±21)μg/L,高于非肥胖组PCOS[(24±13)μg/L]和对照组,均P＜0.01.非肥胖组PCOS与对照组间APN、FFA和瘦素差异无统计学意义.血清IL-6肥胖组PCOS[(173 4-184)ng/L]和非肥胖组PCOS[(184±44)ng/L]均高于对照组(P＜0.05、P＜0.01);血清TNF-α非肥胖组PCOS[(0.97±0.33)μg/L]和肥胖组PCOS[(0.82 4-0.21)μg/L]均高于对照组(P＜0.01,P＜0.05);非肥胖组PCOS TNF-α高于肥胖组(P＜0.05).非肥胖组和肥胖组的PCOS患者血清中CRP高于对照组,但差异无统计学意义(P＞0.05).(2)瘦素与人体质量指数(BMI)、腰臀比及HOMA-IR呈正相关(P＜0.01),APN与BMI、腰臀比及HOMA-IR呈负相关(P＜0.01).(3)BMI和TNF-α是FINS的独立影响因素,APN是除FINS、空腹血葡萄糖、BMI外,对HOMA-IR的独立影响因素.结论 炎性因子可能参与了非肥胖型PCOS患者IR的发生;而肥胖型PCOS IR的进一步加重可能与其脂肪组织分泌瘦素、FFA增多及分泌APN减少相关.
目的 探討PCOS患者血清脂肪細胞因子與胰島素敏感性的相關性.方法 將PCOS患者60例分為肥胖組PCOS36例、非肥胖組PCOS24例,將同期就診的男方因素不孕癥患者(正常體重)26例作對照組.進行內分泌代謝指標測定,採用空腹胰島素(FINS)、胰島素牴抗指數(HOMA-IR)評估胰島素敏感性;併應用酶聯免疫吸附法測定血清遊離脂肪痠(FFA)、瘦素及C反應蛋白(CRP),放射免疫法測定血清脂聯素(APN)、腫瘤壞死因子(TNF)-α、白細胞介素(IL)-6.結果 (1)肥胖組PCOS的血清APN為(10±7)mg/L,低于非肥胖組PCOSE(17±9)mg/L]和對照組,均P＜0.01;FFA為(548±105)μmol/L,高于非肥胖組PCOS[(427±67)μmoL/L]和對照組,P＜0.01;血清瘦素水平為(42±21)μg/L,高于非肥胖組PCOS[(24±13)μg/L]和對照組,均P＜0.01.非肥胖組PCOS與對照組間APN、FFA和瘦素差異無統計學意義.血清IL-6肥胖組PCOS[(173 4-184)ng/L]和非肥胖組PCOS[(184±44)ng/L]均高于對照組(P＜0.05、P＜0.01);血清TNF-α非肥胖組PCOS[(0.97±0.33)μg/L]和肥胖組PCOS[(0.82 4-0.21)μg/L]均高于對照組(P＜0.01,P＜0.05);非肥胖組PCOS TNF-α高于肥胖組(P＜0.05).非肥胖組和肥胖組的PCOS患者血清中CRP高于對照組,但差異無統計學意義(P＞0.05).(2)瘦素與人體質量指數(BMI)、腰臀比及HOMA-IR呈正相關(P＜0.01),APN與BMI、腰臀比及HOMA-IR呈負相關(P＜0.01).(3)BMI和TNF-α是FINS的獨立影響因素,APN是除FINS、空腹血葡萄糖、BMI外,對HOMA-IR的獨立影響因素.結論 炎性因子可能參與瞭非肥胖型PCOS患者IR的髮生;而肥胖型PCOS IR的進一步加重可能與其脂肪組織分泌瘦素、FFA增多及分泌APN減少相關.
목적 탐토PCOS환자혈청지방세포인자여이도소민감성적상관성.방법 장PCOS환자60례분위비반조PCOS36례、비비반조PCOS24례,장동기취진적남방인소불잉증환자(정상체중)26례작대조조.진행내분비대사지표측정,채용공복이도소(FINS)、이도소저항지수(HOMA-IR)평고이도소민감성;병응용매련면역흡부법측정혈청유리지방산(FFA)、수소급C반응단백(CRP),방사면역법측정혈청지련소(APN)、종류배사인자(TNF)-α、백세포개소(IL)-6.결과 (1)비반조PCOS적혈청APN위(10±7)mg/L,저우비비반조PCOSE(17±9)mg/L]화대조조,균P＜0.01;FFA위(548±105)μmol/L,고우비비반조PCOS[(427±67)μmoL/L]화대조조,P＜0.01;혈청수소수평위(42±21)μg/L,고우비비반조PCOS[(24±13)μg/L]화대조조,균P＜0.01.비비반조PCOS여대조조간APN、FFA화수소차이무통계학의의.혈청IL-6비반조PCOS[(173 4-184)ng/L]화비비반조PCOS[(184±44)ng/L]균고우대조조(P＜0.05、P＜0.01);혈청TNF-α비비반조PCOS[(0.97±0.33)μg/L]화비반조PCOS[(0.82 4-0.21)μg/L]균고우대조조(P＜0.01,P＜0.05);비비반조PCOS TNF-α고우비반조(P＜0.05).비비반조화비반조적PCOS환자혈청중CRP고우대조조,단차이무통계학의의(P＞0.05).(2)수소여인체질량지수(BMI)、요둔비급HOMA-IR정정상관(P＜0.01),APN여BMI、요둔비급HOMA-IR정부상관(P＜0.01).(3)BMI화TNF-α시FINS적독립영향인소,APN시제FINS、공복혈포도당、BMI외,대HOMA-IR적독립영향인소.결론 염성인자가능삼여료비비반형PCOS환자IR적발생;이비반형PCOS IR적진일보가중가능여기지방조직분비수소、FFA증다급분비APN감소상관.
Objective To investigate the correlations between adipocytokines and insulin resistance in women with polycystic ovary syndrome.Methods Sixty women with polycystic ovary syndrome aged 19-34years old were divided into 2 groups:group A[n=36,BMI≥25 kg/m~(-2) or WHR(waist height ratio)＞0.85]and group B(n=24,BMI＜25 kg/m~(-2) and WHR≤0.85).Twenty-six healthy infertile women with amean age of 26 4-8 years old served as controls and they were named as group C(n=26,BMI＜25kg/m~(-2) and WHR≤0.85).Anthropometric measurements,hormonal profiles and metabolic profiles were compared between three groups.Plasma leptin,CRP and free fatty acid were measured by enzyme-linked immunosorbent assay(ELISA).Adiponectin.interleukin-6(IL-6)and tumor necrosis factor-alpha(TNF-α)were measured by radioimmunoassay.Insulin resistance was estimated by homeostasis model assessment (HOMA).Results(1)Adiponectin and TNF-α levels were significantly higher in group B(17±9)mg/Land(1.0 4±0.3)mg/L respectively than in group A(10±7)mg/L and(0.8±0.2)mg/L respectively.Leptin was lower in group B(24±13)μg/L and group C than in group A(42 ±21)μg/L(all P＜0.01).IL-6 was higher in group A(173±184)ng/L and group B(184±44)ng/L than in group C(P＜0.05 and P＜0.01 respectively).No significant difference of circulating level of CRP was found between these 3groups.(2)Leptin was positively correlated with BMI,WHR and HOMA-IR(all P＜0.01)whereas adiponectin was negatively correlated with BMI.WHR and HOMA-IR(P＜0.01;P＜0.01,P＜0.05 respectively).Mulivariate regression showed that adiponectin was the most significant predictor of HOMA-IR and it explained 16.5% of variance.Conclusion The higher levels of leptin and TNF-α,the lower level of adiponectin in obese PCOS and the higher Ievel of TNF-αtand IL-6 in non-obese PCOS suggested different adipocytokines play different roles of insulin resistance in PCOs.
