CAJ | 학술논문

目的了解多囊卵巢综合征(PCOS)患者血浆超长链脂肪酸(VLCFAs)的变化,并分析各种脂肪酸与肥胖、胰岛素抵抗的关系.方法收集符合2003年鹿特丹会议诊断标准的18 ～40岁PCOS患者205例,另选择年龄匹配的同期因输卵管因素或男方因素所致不孕的女性117例作为正常对照组.检测血清激素水平,并用气相色谱质谱联用仪(GC-MS)检测血浆10种VLCFAs水平.两组间比较采用f检验,计量资料的多因素分析采用多元逐步回归分析.结果与正常对照组相比,PCOS患者血浆中存在多种超长链脂肪酸代谢紊乱,包括花生四烯酸(C20:4n-6)/二十碳三烯酸(C20:3n-6)较正常对照组降低,而花生烯酸(C20:ln-9)、二十碳五烯酸(C20:5n-3)、w-3二十二碳五烯酸(C22:5n-3)、二十二碳六烯酸(C22:6n-3)、C20:3n-6、二十二碳四烯酸(C22:4n-6)、二十碳二烯酸(C20:2n-7)均较正常对照组升高(t=0.539 ～6.155,均P＜0.05).在PCOS患者中,与非肥胖组相比,肥胖组C20:0升高,C20:3n-6、C20:2n-7均下降(t=-0.927、2.452、0.767,均P＜0.05).与非胰岛素抵抗(IR)组比较,IR组C20:0升高,C20:2n-7及C22:5n-3均降低(t=2.064、2.195、2.183,均P＜0.05).多元逐步回归分析结果显示C20:2n-7是肥胖的独立危险因素,而C20:0是胰岛素抵抗的独立危险因素.结论 PCOS患者存在超长链脂肪酸代谢紊乱.C20:2n-7的下降可能是PCOS患者肥胖的影响因素,而C20:0的升高则可能是PCOS患者胰岛素抵抗的影响因素.
목적 료해다낭란소종합정(PCOS)환자혈장초장련지방산(VLCFAs)적변화,병분석각충지방산여비반、이도소저항적관계.방법 수집부합2003년록특단회의진단표준적18 ～40세PCOS환자205례,령선택년령필배적동기인수란관인소혹남방인소소치불잉적녀성117례작위정상대조조.검측혈청격소수평,병용기상색보질보련용의(GC-MS)검측혈장10충VLCFAs수평.량조간비교채용f검험,계량자료적다인소분석채용다원축보회귀분석.결과 여정상대조조상비,PCOS환자혈장중존재다충초장련지방산대사문란,포괄화생사희산(C20:4n-6)/이십탄삼희산(C20:3n-6)교정상대조조강저,이화생희산(C20:ln-9)、이십탄오희산(C20:5n-3)、w-3이십이탄오희산(C22:5n-3)、이십이탄륙희산(C22:6n-3)、C20:3n-6、이십이탄사희산(C22:4n-6)、이십탄이희산(C20:2n-7)균교정상대조조승고(t=0.539 ～6.155,균P＜0.05).재PCOS환자중,여비비반조상비,비반조C20:0승고,C20:3n-6、C20:2n-7균하강(t=-0.927、2.452、0.767,균P＜0.05).여비이도소저항(IR)조비교,IR조C20:0승고,C20:2n-7급C22:5n-3균강저(t=2.064、2.195、2.183,균P＜0.05).다원축보회귀분석결과현시C20:2n-7시비반적독립위험인소,이C20:0시이도소저항적독립위험인소.결론 PCOS환자존재초장련지방산대사문란.C20:2n-7적하강가능시PCOS환자비반적영향인소,이C20:0적승고칙가능시PCOS환자이도소저항적영향인소.
Objective To investigate the changes in plasma very long chain fatty acids (VLCFAs) in polycystic ovary syndrome (PCOS) patients,and further to explore its relationship with obesity and insulin resistance.Methods Two hundred and five PCOS patients were screened out according to the diagnostic criteria of Rotterdam conference (2003),aged 18-40 years.A group of 117 healthy infertile women of corresponding period was taken as control.These women were chosen randomly from reproductive center due to the problems of uterine tube or males.The plasma hormone levels were examined.Ten kinds of plasma VLCFAs were detected by gas chromatography-mass spectrometry (GC-MS).Data between two groups analysis was performed by t test.Multiple stepwise regression analysis was used to analysize multiple factors of measurement data.Results Compared with normal individuals,plasma VLCFAs levels was disorder in PCOS patients.There is a lower C20:4n-6/C20:3n-6 in VLCFAs of PCOS patients,and a higher C20:1n-9,C20:2n-7,C20:3n-6,C22:4n-6,C20:5n-3,C22:5n-3 and C22:6n-3,compared with the control group(t =0.539-6.155,all P ＜ 0.05).In the PCOS group,compared with non-obese patients,obese patients had a higher C20:0,and lower C20:3n-6 and C20:2n-7 (t =-0.927,2.452,0.767,both P ＜ 0.05).Compared with non insulin resistance group,patients with insulin resistance had a higher C20:0 and lower C20:2n-7 and C22:5n-3 levels (t =-2.064,2.195,2.183,both P＜0.05).Multiple stepwise regression analysis showed that C20:2n-7 and C20:0 were independent risk factors of obesity and insulin resistance,respectively.Conclusions Disturbance metabolism of VLCFA existed in the PCOS patients.The decrease of C20:2n-7 was probably an influence factor of obesity in PCOS patients and the increase of C20:0 was probably an influence factor of insulin resistance in PCOS patients.