CAJ | 학술논문

　　目的：通过研究肥胖型多囊卵巢综合征（PCOS）纤溶酶原激活物抑制因子1（PAI-1）基因启动子区4G/5G多态性的分布及其与胰岛素敏感性、PAI-1水平的相互关系，以期找到治疗肥胖型PCOS的新方法。方法：选取135例PCOS患者和124例正常对照者，计算体重指数（BMI）和腰臀比（WHR）；PCOS组又根据体质指数（BMI值）分出肥胖型与非肥胖型两组。用PCR方法测定PAI-1基因启动子区4G/5G基因多态性分布；ELISA法检测血浆PAI-1水平、空腹胰岛素（INS）、空腹血糖（G），并计算胰岛素抵抗指数（Homa-IR）、胰岛素敏感指数（ISI）。结果：4G/5G基因多态性分布在PCOS组和正常对照组间有显著差异，PCOS组中4G/4G基因型频率47.41%高于正常对照组的16.13%，比较差异有统计学意义（P<0.05）。PCOS组PAI-1水平高于对照组，肥胖型PCOS组PAI-1水平、WHR、空腹INS、Homa-IR均高于非肥胖组，比较差异均有统计学意义（P<0.05），但两组间4G/5G基因型分布无显著性差异。结论：PCOS尤其是肥胖型PCOS有较高的PAI-1水平。PAI-1基因启动子区4G等位基因可增加血浆PAI-1水平。PAI-1基因启动子区4G基因型频率高可能和PCOS发病有关，但与PCOS肥胖发病无关。抗PAI-1的研究可能提供一个新的治疗肥胖型PCOS的方法。
　　목적：통과연구비반형다낭란소종합정（PCOS）섬용매원격활물억제인자1（PAI-1）기인계동자구4G/5G다태성적분포급기여이도소민감성、PAI-1수평적상호관계，이기조도치료비반형PCOS적신방법。방법：선취135례PCOS환자화124례정상대조자，계산체중지수（BMI）화요둔비（WHR）；PCOS조우근거체질지수（BMI치）분출비반형여비비반형량조。용PCR방법측정PAI-1기인계동자구4G/5G기인다태성분포；ELISA법검측혈장PAI-1수평、공복이도소（INS）、공복혈당（G），병계산이도소저항지수（Homa-IR）、이도소민감지수（ISI）。결과：4G/5G기인다태성분포재PCOS조화정상대조조간유현저차이，PCOS조중4G/4G기인형빈솔47.41%고우정상대조조적16.13%，비교차이유통계학의의（P<0.05）。PCOS조PAI-1수평고우대조조，비반형PCOS조PAI-1수평、WHR、공복INS、Homa-IR균고우비비반조，비교차이균유통계학의의（P<0.05），단량조간4G/5G기인형분포무현저성차이。결론：PCOS우기시비반형PCOS유교고적PAI-1수평。PAI-1기인계동자구4G등위기인가증가혈장PAI-1수평。PAI-1기인계동자구4G기인형빈솔고가능화PCOS발병유관，단여PCOS비반발병무관。항PAI-1적연구가능제공일개신적치료비반형PCOS적방법。
Objective:To investigate the prevalence of 4G/5G polymorphism of plasminogen activator inhibitor-1(PAI-1)gene in obese polycystic ovary syndrome(PCOS)and their relationships between insulin sensitivity and plasma fibrinolysis function,to find a new way to prevent obesity and insulin resistance of obese PCOS.Method:135 patients and 124 controls were selected.Body mass index(BMI)and waist-to-hip(WHR) ratio were determined.Based on the BMI,the PCOS patients were divided into two groups:74 patients without obesity and 61 patients with obesity.Blood samples were obtained for DNA analysis.PAI-1 plasma levels,fasting insulin and fasting glucose were measured by the ELISA in all subjects.The 4G/5G polymorphic site of the PAI-1 gene promoter region was amplified by the polymerase chain reaction(PCR).We evaluate insulin resistance with Homa-IR and measure insulin sensitivityindex(ISI).Result:Comparison of the clinical data:BMI,WHR,fasting insulin,Homa-IR in patients with obesity were significant greater than those in patients without obesity,the difference was statistically significant between the groups(P<0.05);The PCOS group had significantly higher 4G/4G than the control group,whereas there were significantly less 5G/5G.PCOS women have higher levels of PAI-1 compared with the control group(P<0.05).There was no statistical difference of genotype distribution between patients with obesity and patients without obesity, whereas there was a statistically significant difference in the PAI-1 levels among the groups(P<0.05).Conclusion:The presence of the 4G allele in PAI-1 promoter region of the gene further increases the PAI-1 levels.PAI-1 gene polymorphism 4G genetype may be correlated with PCOS in Chinese women.PAI-1 gene polymorphism 4G genetype may be not correlated with obesity of PCOS in Chinese women.Anti-PAI-1 study may be a new way to prevent obesity and insulin resistance of obese PCOS.