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目的探讨多囊卵巢综合征(PCOS)患者血清脂联素(APN)水平与胰岛素抵抗的关系。方法采用酶联免疫吸附法(ELISA)测定40例PCOS患者[PCOS组,根据体重指数(BMI)分为肥胖者(BMI≥25kg/m2)19例,非肥胖者(BMI<25kg/m2)21例]及15例健康志愿者和10例非PCOS不孕患者(对照组,其中肥胖者9例,非肥胖者16例)的APN水平,化学发光法、葡萄糖氧化酶法、放射免疫法分别测定空腹胰岛素、空腹血糖、肿瘤坏死因子α(TNF-α)水平。计算两组患者胰岛素敏感指数(ISI),评价胰岛素抵抗程度。结果(1)PCOS组肥胖者APN水平为(1·6±0·5)mg/L,PCOS组非肥胖者为(3·0±0·6)mg/L,对照组肥胖者为(3·2±0·3)mg/L,非肥胖者为(4·9±0·5)mg/L,两组分别比较,差异均有统计学意义(P<0·05)。(2)PCOS组肥胖者胰岛素水平为(17±6)mU/L,非肥胖者为(14±6)mU/L,对照组肥胖者为(10±3)mU/L,非肥胖者为(7±3)mU/L,两组分别比较,差异有统计学意义(P<0·05)。(3)PCOS组肥胖者空腹血糖为(5·2±0·7)mmol/L,非肥胖者为(5·1±0·6)mmol/L,对照组肥胖者为(5·4±0·5)mmol/L,非肥胖者为(4·8±0·6)mmol/L,两组分别比较,差异无统计学意义(P>0·05)。(4)PCOS组肥胖者TNF-α水平为(1·32±0·14)μg/L,非肥胖者为(1·02±0·12)μg/L,对照组肥胖者为(0·93±0·15)μg/L,非肥胖者为(0·63±0·18)μg/L,两组分别比较,差异有统计学意义(P<0·05)。(5)PCOS组肥胖者ISI为-4·5±0·3,非肥胖者为-4·1±0·4,对照组肥胖者为-3·6±0·3,非肥胖者为-3·1±0·4,两组分别比较,差异也有统计学意义(P<0·05)。PCOS组患者APN水平与BMI呈显著负相关关系(r=-0·56,P<0·05),与ISI呈显著正相关关系(r=0·49,P<0·05)。结论PCOS患者APN水平降低,并以PCOS肥胖者降低更明显;PCOS患者APN水平下降与胰岛素敏感性及胰岛素抵抗相关。
Objective To investigate the relationship between serum adiponectin (APN) levels and insulin resistance in patients with polycystic ovary syndrome (PCOS). Methods Forty PCOS patients (PCOS group) were divided into obese group (BMI≥25kg / m2) and non-obese group (BMI <25kg / m2) by enzyme linked immunosorbent assay (ELISA) Cases] and 15 healthy volunteers and 10 cases of non-PCOS infertility patients (control group, 9 cases of obesity, non-obese in 16 cases) APN levels, chemiluminescence, glucose oxidase method, radioimmunoassay were determined Fasting insulin, fasting blood glucose, tumor necrosis factor alpha (TNF-α) levels. Insulin sensitivity index (ISI) was calculated in both groups to evaluate the degree of insulin resistance. Results (1) The APN level in obese patients in PCOS group was (1.6 ± 0.5) mg / L, that in PCOS group was (3.0 ± 0.6) mg / L, and that in obese group was (3 · 2 ± 0 · 3) mg / L and (4 · 9 ± 0 · 5) mg / L respectively. There were significant differences between the two groups (P <0.05). (2) The insulin level of obese people in PCOS group was (17 ± 6) mU / L, (14 ± 6) mU / L in non-obese group, (10 ± 3) mU / L in obese group and (7 ± 3) mU / L, respectively. There was significant difference between the two groups (P <0.05). (3) The fasting blood glucose in PCOS group was (5.2 ± 0.7) mmol / L and that in non-obese group was (5.1 ± 0.6) mmol / L, and that in control group was (5.4 ± 0.05) mmol / L, and non-obese persons were (4.8 ± 0.6) mmol / L. There was no significant difference between the two groups (P> 0.05). (4) The levels of TNF-α in obese patients in PCOS group were (1.32 ± 0.14) μg / L and those in non-obese patients were (1.02 ± 0.12) μg / L and those in obese group were 93 ± 0. 15) μg / L, and non-obese (0 · 63 ± 0 · 18) μg / L respectively. There was significant difference between the two groups (P <0.05). (5) The ISI of PCOS group was -4.5 ± 0.3, that of non-obese group was -4.1 ± 0.4, that of control group was -3.6 ± 0.3, and that of non-obese group was - 3 · 1 ± 0 · 4, the difference between the two groups was also statistically significant (P <0 · 05). There was a significant negative correlation between APN level and BMI in patients with PCOS (r = -0.56, P <0.05), and positively correlated with ISI (r = 0.49, P <0.05). Conclusions The level of APN in PCOS patients is lower than that in PCOS patients. The decrease of APN levels in PCOS patients is associated with insulin sensitivity and insulin resistance.