中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2010年
1期
30-34
,共5页
万德花%范平%白怀%宋琪%刘宏伟
萬德花%範平%白懷%宋琪%劉宏偉
만덕화%범평%백부%송기%류굉위
多囊卵巢综合征%1-烷基-2-乙酰甘油磷酸胆碱酯酶%胰岛素抗药性
多囊卵巢綜閤徵%1-烷基-2-乙酰甘油燐痠膽堿酯酶%胰島素抗藥性
다낭란소종합정%1-완기-2-을선감유린산담감지매%이도소항약성
Polycystic ovary syndrome%1-Alkyl-2-acetylglycerophosphocholine esterase%Insulin resistance
目的 探讨多囊卵巢综合征(PCOS)患者血浆中不同结合状态的血小板活化因子乙酰水解酶(PAF-AH)活性与胰岛素抵抗(IR)的关系.方法 选择2006年10月-2008年1月在四川大学华西第二医院妇产科就诊的105例PCOS患者,其中稳态模型胰岛素抵抗指数(HOMA-IR)≥2.77者53例(IR-PCOS组),<2.77者52例(非IR-PCOS组).选择同期因输卵管因素或男性因素于本院就诊的53例不孕患者作为对照组.检测并比较3组患者的血浆PAF-AH、高密度脂蛋白结合PAF-AH(H-PAF-AH)、低密度脂蛋白结合PAF-AH(L-PAF-AH)活性及L-PAF-AH/H-PAF-AH活性比值.采用Pearson相关分析法及多重线性回归法分析PCOS患者血浆中L-PAF-AH/H-PAF-AH活性比值与生殖激素水平、糖脂代谢水平之间的相关性.结果 (1)IR-PCOS组患者血浆PAF-AH活性[(0.055±0.012)mmol·L~(-1)·min~(-1)]、L-PAF-AH活性[(0.052±0.012)mmol·L~(-1)·min~(-1)]及L-PAF-AH/H-PAF-AH活性比值(23±6)均分别高于对照组[(0.050±0.009)mmol·L~(-1)·min~(-1)、(0.047±0.009) mmol·L~(-1)·min~(-1)及18±4]与非IR-PCOS组[(0.050±0.012)mmol·L~(-1)·min~(-1)、(0.048±0.012)mmol·L~(-1)·min~(-1)及(18±5)],差异均有统计学意义(P<0.05);在校正体质指数后,IR-PCOS组血浆L-PAF-AH/H-PAF-AH活性比值仍然高于对照组和非IR-PCOS组,差异均有统计学意义(P<0.01).(2)相关性分析结果显示,PCOS患者血浆中L-PAF-AH/H-PAF-AH活性比值分别与动脉硬化指数、年龄、体质指数、腰围臀围比值、HOMA-IR及甘油三酯、空腹胰岛素、空腹血糖、低密度脂蛋白胆固醇、总胆固醇水平呈正相关关系(r=0.644、0.247、0.296、0.212、0.356、0.587、0.377、0.375、0.292、0.199,P<0.05),与高密度脂蛋白胆固醇(HDL-C)呈负相关关系(r=-0.510,P<0.01).多重线形回归法分析显示,动脉硬化指数和甘油三酯水平是L-PAF-PAH/H-PAF-AH活性比值有意义的预测因子[标准化系数(β)分别为0.515和0.201,P<0.05].结论 PCOS患者血浆中L-PAF-AH活性升高可能与IR相关,L-PAF-AH/H-PAF-AH活性比值增加可能成为IR-PCOS患者慢性炎症状态的一个新指标.
目的 探討多囊卵巢綜閤徵(PCOS)患者血漿中不同結閤狀態的血小闆活化因子乙酰水解酶(PAF-AH)活性與胰島素牴抗(IR)的關繫.方法 選擇2006年10月-2008年1月在四川大學華西第二醫院婦產科就診的105例PCOS患者,其中穩態模型胰島素牴抗指數(HOMA-IR)≥2.77者53例(IR-PCOS組),<2.77者52例(非IR-PCOS組).選擇同期因輸卵管因素或男性因素于本院就診的53例不孕患者作為對照組.檢測併比較3組患者的血漿PAF-AH、高密度脂蛋白結閤PAF-AH(H-PAF-AH)、低密度脂蛋白結閤PAF-AH(L-PAF-AH)活性及L-PAF-AH/H-PAF-AH活性比值.採用Pearson相關分析法及多重線性迴歸法分析PCOS患者血漿中L-PAF-AH/H-PAF-AH活性比值與生殖激素水平、糖脂代謝水平之間的相關性.結果 (1)IR-PCOS組患者血漿PAF-AH活性[(0.055±0.012)mmol·L~(-1)·min~(-1)]、L-PAF-AH活性[(0.052±0.012)mmol·L~(-1)·min~(-1)]及L-PAF-AH/H-PAF-AH活性比值(23±6)均分彆高于對照組[(0.050±0.009)mmol·L~(-1)·min~(-1)、(0.047±0.009) mmol·L~(-1)·min~(-1)及18±4]與非IR-PCOS組[(0.050±0.012)mmol·L~(-1)·min~(-1)、(0.048±0.012)mmol·L~(-1)·min~(-1)及(18±5)],差異均有統計學意義(P<0.05);在校正體質指數後,IR-PCOS組血漿L-PAF-AH/H-PAF-AH活性比值仍然高于對照組和非IR-PCOS組,差異均有統計學意義(P<0.01).(2)相關性分析結果顯示,PCOS患者血漿中L-PAF-AH/H-PAF-AH活性比值分彆與動脈硬化指數、年齡、體質指數、腰圍臀圍比值、HOMA-IR及甘油三酯、空腹胰島素、空腹血糖、低密度脂蛋白膽固醇、總膽固醇水平呈正相關關繫(r=0.644、0.247、0.296、0.212、0.356、0.587、0.377、0.375、0.292、0.199,P<0.05),與高密度脂蛋白膽固醇(HDL-C)呈負相關關繫(r=-0.510,P<0.01).多重線形迴歸法分析顯示,動脈硬化指數和甘油三酯水平是L-PAF-PAH/H-PAF-AH活性比值有意義的預測因子[標準化繫數(β)分彆為0.515和0.201,P<0.05].結論 PCOS患者血漿中L-PAF-AH活性升高可能與IR相關,L-PAF-AH/H-PAF-AH活性比值增加可能成為IR-PCOS患者慢性炎癥狀態的一箇新指標.
목적 탐토다낭란소종합정(PCOS)환자혈장중불동결합상태적혈소판활화인자을선수해매(PAF-AH)활성여이도소저항(IR)적관계.방법 선택2006년10월-2008년1월재사천대학화서제이의원부산과취진적105례PCOS환자,기중은태모형이도소저항지수(HOMA-IR)≥2.77자53례(IR-PCOS조),<2.77자52례(비IR-PCOS조).선택동기인수란관인소혹남성인소우본원취진적53례불잉환자작위대조조.검측병비교3조환자적혈장PAF-AH、고밀도지단백결합PAF-AH(H-PAF-AH)、저밀도지단백결합PAF-AH(L-PAF-AH)활성급L-PAF-AH/H-PAF-AH활성비치.채용Pearson상관분석법급다중선성회귀법분석PCOS환자혈장중L-PAF-AH/H-PAF-AH활성비치여생식격소수평、당지대사수평지간적상관성.결과 (1)IR-PCOS조환자혈장PAF-AH활성[(0.055±0.012)mmol·L~(-1)·min~(-1)]、L-PAF-AH활성[(0.052±0.012)mmol·L~(-1)·min~(-1)]급L-PAF-AH/H-PAF-AH활성비치(23±6)균분별고우대조조[(0.050±0.009)mmol·L~(-1)·min~(-1)、(0.047±0.009) mmol·L~(-1)·min~(-1)급18±4]여비IR-PCOS조[(0.050±0.012)mmol·L~(-1)·min~(-1)、(0.048±0.012)mmol·L~(-1)·min~(-1)급(18±5)],차이균유통계학의의(P<0.05);재교정체질지수후,IR-PCOS조혈장L-PAF-AH/H-PAF-AH활성비치잉연고우대조조화비IR-PCOS조,차이균유통계학의의(P<0.01).(2)상관성분석결과현시,PCOS환자혈장중L-PAF-AH/H-PAF-AH활성비치분별여동맥경화지수、년령、체질지수、요위둔위비치、HOMA-IR급감유삼지、공복이도소、공복혈당、저밀도지단백담고순、총담고순수평정정상관관계(r=0.644、0.247、0.296、0.212、0.356、0.587、0.377、0.375、0.292、0.199,P<0.05),여고밀도지단백담고순(HDL-C)정부상관관계(r=-0.510,P<0.01).다중선형회귀법분석현시,동맥경화지수화감유삼지수평시L-PAF-PAH/H-PAF-AH활성비치유의의적예측인자[표준화계수(β)분별위0.515화0.201,P<0.05].결론 PCOS환자혈장중L-PAF-AH활성승고가능여IR상관,L-PAF-AH/H-PAF-AH활성비치증가가능성위IR-PCOS환자만성염증상태적일개신지표.
Objective To investigate the relationship between activity of plasma platelet-activating factor acetylhydrolase (PAF-AH)and insulin resistance (IR) in patients with polycystic ovary syndrome (PCOS). Methods From Oct. 2006 to Jan. 2008, 105 PCOS patients undergoing treatment in Department of Obstetrics and Gynecology of Second Hospital affiliated to West China University were enrolled in the study, among 53 cases with homeostatic model assessment IR (HOMA-IR) exceed or equal 2.77 as IR-PCOS group and 52 cases with HOMA-IR less than 2.77 as non IR-PCOS group. In the mean time, 53 infertile women due to fallopian tube or husband factors were chosen as control group. Plasma PAF-AH activity, high-density lipoprotein-associated PAF-AH (H-PAF-AH) activity, low-density lipoprotein-associated PAF-AH (L-PAF-AH) activity, the ratio of L-PAF-AH to H-PAF-AH activity were measured and compared among three groups. The method of Pearson correlation analysis and stepwise multiple regression analysis were used to study the relationship between the ratio of L-PAF-AH to H-PAF-AH activities and hormonal and metabolic parameters. Results (1) Plasma PAF-AH activity [ (0.055±0.012) mmol· L~(-1)·min~(-1)], L-PAF-AH activity [(0.052±0.012) mmol·L~(-1)·min~(-1)], and the ratio of L-PAF-AH to H-PAF-AH activity (23±6) in the IR-PCOS group were significantly higher than those at control group [(0.050±0.009) mmol·L~(-1) ·min~(-1), (0.047±0.009) mmol·L~(-1)·min~(-1) and (18±4)] and non-IR-PCOS group [(0.050±0.0012) mmol·L~(-1) ·min~(-1), (0.048±0.012) mmol·L~(-1)·min~(-1) and (18± 5 ), P <0.05 ]. The ratio of L-PAF-AH to H-PAF-AH activities at IR-PCOS group was also significantly higher than those at Non IR-PCOS and control group after correction for body mass index (P<0.01). (2) Pearson correlation analysis showed that the ratio of L-PAF-AH to H-PAF-AH in PCOS patients was positively correlated with atherogenic index, age, body mass index, waist-to-hip ratio, HOMA-IR, triglyceride levels, fasting insulin levels, fasting glucose levels, low density lipoprotein cholesterol and total cholesterol (r=0.644, 0.247, 0.296, 0.212, 0.356, 0.587, 0.377, 0.375, 0.292 and 0.199, respectively, P<0.05), and negatively correlated with high density lipoprotein cholesterol (r=-0.510, P<0.05). The multiple stepwise regression analysis showed that atherogenic index and triglyceride were significant variables for the ratio of L-PAF-AH to H-PAF-AH activity (standardized coefficient, β=0.515 and 0.201, respectively, P<0.05). Conclusion The elvated L-PAF-AH activity may be associated with IR in PCOS patients, and the increased ratio of L-PAF-AH to H-PAF-AH activities may be a potential marker of inflammation in the patients.
