CAJ | 학술논문

目的观察多囊卵巢综合征( PCOS )患者空腹血清Orexin A( OXA)水平的变化,探讨其在PCOS发生和发展中的意义。方法选取57例PCOS患者( PCOS组)和56例月经正常的健康女性(对照组)作为研究对象,按照身体质量指数( BMI)≥24 kg/m2或<24 kg/m2分别将PCOS组和对照组分为超重/肥胖( PCOS-OW/OB, Control-OW/OB)亚组和正常体重( PCOS-NW, Control-NW)亚组。检测各组血三酰甘油( TG)、胆固醇( TC)、高密度脂蛋白( HDL)、低密度脂蛋白(LDL)、空腹血糖(FBG)、餐后2 h血糖(P2hBG)、空腹胰岛素(FINS)、餐后2 h胰岛素(P2hINS)、黄体生成素(LH)、卵泡刺激素( FSH)、睾酮( T)以及血清OXA水平；测量身高、体重、腰围( WC )、臀围；并计算 BMI、腰臀比( WHR )、LH/FSH及稳态模型胰岛素抵抗指数( HOMA-IR)。结果PCOS组空腹血清OXA水平明显低于对照组( P<0.01)；PCOS和对照组中, OW/OB 亚组 OXA 水平均低于 NW 亚组( P <0.05)。 PCOS组中血清 OXA 水平与 BMI、WC、WHR、LH、LH/FSH、FBG、P2hBG、FINS、HOMA-IR 呈负相关( P <0.05或P<0.01)。校正年龄和BMI后,血清OXA水平仍与LH、LH/FSH、FBG、P2hBG、HOMA-IR呈负相关( P<0.05或P<0.01)。多元逐步回归分析显示：HOMA-IR、LH和P2hBG是影响OXA水平的重要因素。二分类Logistic回归分析提示, OXA是PCOS发生的保护因素。结论OXA可能参与了P-COS的发生和发展。
목적관찰다낭란소종합정( PCOS )환자공복혈청Orexin A( OXA)수평적변화,탐토기재PCOS발생화발전중적의의。방법선취57례PCOS환자( PCOS조)화56례월경정상적건강녀성(대조조)작위연구대상,안조신체질량지수( BMI)≥24 kg/m2혹<24 kg/m2분별장PCOS조화대조조분위초중/비반( PCOS-OW/OB, Control-OW/OB)아조화정상체중( PCOS-NW, Control-NW)아조。검측각조혈삼선감유( TG)、담고순( TC)、고밀도지단백( HDL)、저밀도지단백(LDL)、공복혈당(FBG)、찬후2 h혈당(P2hBG)、공복이도소(FINS)、찬후2 h이도소(P2hINS)、황체생성소(LH)、란포자격소( FSH)、고동( T)이급혈청OXA수평；측량신고、체중、요위( WC )、둔위；병계산 BMI、요둔비( WHR )、LH/FSH급은태모형이도소저항지수( HOMA-IR)。결과PCOS조공복혈청OXA수평명현저우대조조( P<0.01)；PCOS화대조조중, OW/OB 아조 OXA 수평균저우 NW 아조( P <0.05)。 PCOS조중혈청 OXA 수평여 BMI、WC、WHR、LH、LH/FSH、FBG、P2hBG、FINS、HOMA-IR 정부상관( P <0.05혹P<0.01)。교정년령화BMI후,혈청OXA수평잉여LH、LH/FSH、FBG、P2hBG、HOMA-IR정부상관( P<0.05혹P<0.01)。다원축보회귀분석현시：HOMA-IR、LH화P2hBG시영향OXA수평적중요인소。이분류Logistic회귀분석제시, OXA시PCOS발생적보호인소。결론OXA가능삼여료P-COS적발생화발전。
Objective To investigate the variation of fasting serum Orexin A ( OXA) levels and their roles in pa-tients with polycystic ovarian syndrome ( PCOS ) . Methods The subjects were divided into two groups: PCOS group(n=57) and healthy control group(n=56). According to the body mass index(BMI)≥24 kg/m2 or<24 kg/m2 , both groups were divided into overweight/obese subgroup ( PCOS-OW/OB, Control-OW/OB) and normal weight subgroup( PCOS-NW, Control-NW) . Serum triglyceride( TG) , total cholesterol( TC) , high-density lipopro-tein ( HDL) , low-density lipoprotein ( LDL) ,fasting blood glucose( FBG) , fasting insulin( FINS) , postprandial 2 h insulin (P2hINS),luteinizing hormone(LH),follicle stimulating hormone(FSH),testosterone(T) and OXA level were measured. Height, body mass, waist circumstance ( WC) and hip circumference were also measured. BMI, waist-hip ratio( WHR) ,LH/FSH and HOMA-IR( homeostasis model assessment of insulin resistance) were calcu-lated. Results Fasting serum OXA levels in PCOS group were significantly lower than those in controls ( P <0.01);Fasting serum OXA levels in PCOS-OW/OB were lower than those in PCOS-NW(P<0.05);Fasting ser-um OXA levels in Control-OW/OB were significantly lower than those in Control-NW ( P<0.01 ) . After age and BMI adjustment, fasting serum OXA was correlated negatively with LH,LH/FSH,FBG,P2hBG and HOMA-IR( P<0.05 or P<0.01). Multiple stepwise regression analysis showed that HOMA-IR,LH and P2hBG were the influ-encing factors of serum OXA level. Binary logistic regression demonstrated that OXA was the protective factor of P-COS. Conclusion The decreased serum OXA level may play a very important role in the development of PCOS.