PCOS患者PAF-AH活性及其与糖脂代谢相关性的研究  

The Activity of Platelet Activating Factor Acetylhydrolase and Its Metabolic Profile in Patients with Polycystic Ovary Syndrome

作　　者：李游[1,2] 范平[3] 白怀[3] 万德花[1] 刘宏伟[1] 

机构地区：[1]四川大学华西第二医院妇产科,成都610041 [2]江西省妇幼保健院 [3]四川大学华西第二医院遗传代谢性疾病及围生医学实验室

出　　处：《四川大学学报（医学版）》2009年第6期1066-1070,共5页Journal of Sichuan University(Medical Sciences)

基　　金：教育部回国人员启动基金(20071108-18-3);四川省科学研究基金(2008SZ0029);四川大学华西第二医院科研启动基金资助

摘　　要：目的探讨多囊卵巢综合征(PCOS)患者血小板活化因子乙酰水解酶(PAF-AH)活性及其与糖脂代谢的关系。方法按照鹿特丹标准筛选PCOS患者87例,同时选取年龄匹配的健康妇女83名作为对照。①用化学发光法检测血清雌二醇(E2)、总睾酮(TT)、黄体生成素(LH)、促卵泡激素(FSH)、空腹胰岛素(FINS);②用酶法试剂盒测定空腹血糖(FGLU)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C);③用[3H-acelty]PAF示踪三氯醋酸沉淀法检测血浆PAF-AH活性。结果①PCOS组体重指数(BMI)、腰臀比(WHR)、F-G评分、血清TT水平、LH/FSH比值高于对照组(P<0.01)。②PCOS组血清FINS、胰岛素抵抗指数(HOMA-IR)、TG、TC、LDL-C、非高密度脂蛋白胆固醇(non-HDL-C)和致动脉粥样硬化指数(AI)高于对照组(P<0.01),而HDL-C水平低于对照组(P<0.01)。但血浆PAF-AH活性两组间差异无统计学意义(P>0.05)。③非肥胖PCOS患者(BMI<25 kg/m2)FINS、HOMA-IR、LDL-C、non-HDL-C、AI高于非肥胖对照妇女(P<0.05)。肥胖PCOS患者(BMI≥25 kg/m2)除了更严重的上述代谢异常外,FGLU、TG、TC、BMI、WHR、收缩压(SBP)、舒张压(DBP)也明显升高(P<0.05),HDL-C水平明显降低(P<0.05)。然而非肥胖对照、非肥胖PCOS与肥胖PCOS三亚组间血浆PAF-AH活性差异无统计学意义(P>0.05)。④Person相关分析表明:PCOS组血浆PAF-AH活性分别与non-HDL-C、LDL-C、AI、TG、TG、WHR呈正相关,与HDL-C呈负相关(P<0.05)。多重线性回归表明:non-HDL-C与SBP是PCOS组血浆PAF-AH活性有意义的预测因子(P<0.05)。结论PCOS组血浆PAF-AH活性与对照组比较无明显改变,血脂特别是胆固醇与血浆PAF-AH活性相关联。肥胖PCOS患者比非肥胖PCOS患者表现出更严重的脂代谢异常与胰岛素抵抗。Objective To investigate the association between plasma platelet activating factor（PAF）-acetylhydrolase（PAF-AH） activity and polycystic ovary syndrome（PCOS）.Methods A total of 87 patients with PCOS were recruited in this study.Eighty three age-matched women with healthy ovulation served as controls.Plasma PAF-AH activity was measured by the trichloroacetic acid precipitation procedure using [ 3H-acetyl] PAF as a substrate.Fasting insulin（FINS）,estradiol（E 2）,total testosterone（TT）,luteinizing hormone（LH）,and follicle stimulating hormone（FSH） were determined by chemiluminescent method.The metabolic profile was investigated by measuring FINS,fasting glucose（FGLU）,total cholesterol（TC）,triglycerides（TG）,high density lipoprotein cholesterol（HDL-C）,and low density lipoprotein cholesterol（LDL-C）.Results The patients with PCOS had higher BMI,WHR,F-G score,serum TT and LH/FSH radio than the controls（P〈0.05）.The patients with PCSO had higher serum FINS,HOMA-IR,TG,TC, LDL-C,non-HDL-C and atherogenic index（AI）,and lower HDL-C level than the controls（P〈0.05）.No significant difference in plasma PAF-AH activity was found between the patients with PCOS and the controls（P〈0.05）.A progressive increase in FINS,HOMA-IR,TC,LDL-C,non-HDL-C and AI,and decrease in HDL-C level were found from non-obese healthy women（BMI〈25 kg/m 2） to nonobese patients,and to obese patients（BMI≥25 kg/m 2） with PCOS（P〈0.05）. In addition,the obese patients with PCOS had higher BMI,WHR,SBP,DBP than the controls and the non-obese patients with PCOS.But no significant difference in plasma PAF-AH activity was found between the three groups of women（P〈0.05）.The plasma PAF-AH activity was positively correlated with AI,non-HDL-C,LDL-C,TC,TG,and WHR,and negatively correlated with HDL-C level（P〈0.05）.Non-HDL-C and SBP were predictors for plasma PAF-AH activity in patients with PCOS.Conclusions Patients with PCOS have similar total plasma PAF-AH activity as health

关 键 词：多囊卵巢综合征 血小板活化因子乙酰水解酶 血脂 胰岛素抵抗 

分 类 号：R711.75[医药卫生—妇产科学]