多囊卵巢综合征患者脂联素水平的变化及意义  

Significance and changes of serum adiponectin levels in patients with polycystic ovarian sydrome

作　　者：毛秀英[1] 陶弢[1] 李圣贤[1] 刘伟[1] 

机构地区：[1]上海交通大学医学院附属仁济医院,200127

出　　处：《山西医药杂志（上半月）》2010年第3期202-205,共4页Shanxi Medical Journal

基　　金：上海市科学技术委员会科研项目(08411953000)

摘　　要：目的研究多囊卵巢综合征(PCOS)患者血清脂联素水平的变化,探讨其参与PCOS发生发展的可能机制。方法①按照体质量指数(BMI)<24kg/m2,24kg/m2≤BMI<28kg/m2,BMI≥28kg/m2分别将初诊P-COS患者170例,分为正常体质量组(P1组69例)、超重组(P2组44例)、肥胖组(P3组57例);年龄和BMI相匹配的正常对照者143名分为正常体质量组(C1组102例)、超重组(C2组20例)、肥胖组(C3组21例)。②于月经第3～5天早8:00抽取空腹血,测定性激素、血脂、脂联素等指标;实施标准口服葡萄糖耐量试验(OGTT)、胰岛素激发试验;同时测量身高、体质量、腰围、臀围等。③基础与糖负荷后胰岛素分泌功能及胰岛素抵抗,按HOMA模型计算。结果①脂联素水平的变化:PCOS患者脂联素水平低于年龄和体质量指数相匹配的健康对照者(P1<C1,P<0.05;P2<C2、P3<C3,P<0.01,差异均有统计学意义),PCOS患者和健康对照者脂联素水平随BMI的增加显著降低(C3<C2<C1,P3<P2<P1,P<0.01,差异均有统计学意义)。②相关分析:PCOS患者脂联素水平与BMI、腰围、臀围、腰臀比(WHR)、甘油三酯(TG)、高密度脂蛋白(HDL)、空腹胰岛素(Fins)、餐后120min胰岛素(Ins120)、空腹血糖(FBG)、HOMA胰岛素抵抗指数(HOMA-IR)、HOMA-IS、黄体生成素/卵泡刺激素(LH/FSH)均具有相关性,而正常对照组脂联素水平只与BMI、腰围、臀围、WHR、Fins、HOMA-IR、HOMA-IS具有相关性。结论PCOS患者脂联素水平低于年龄和BMI相匹配的健康对照者,可能通过影响其代谢和下丘脑-垂体-性腺轴的调节参与P-COS的发生发展。Objective To investigate the serum adiponectin level and its role in the polycystic ovary syndrome （PCOS）. Methods （1）One hundred and seventy women with PCOS （group P）and 143 controls（group C） who were age-and weight-matched were enrolled. Both were divided into three subgroups according to the BMI ： group P1 and C1（BMI〈24 kg/m^2 ） ; group P2 and C2（24≤BMI〈28 kg/m^2 ） ; group P3 and C3（BMI≥28 kg/m^2 ）. （2）Blood samples were collected at 8：00 am, after an overnight fast in one of the third to fifth days of the menstrual cycle. Serum levels of sex hormones, lipids,glueose, insulin, adiponeetin, luteinizing hormone （LH） and follicle-stimulating hormone （FSH） were estimated. Then all subjects underwent 75 g oral glucose tolerance test and insulin challenge test. At the same time,height,weight, waist eireumference（WC） and hip circumference（HC） were also measured. （3）Indicators of insulin secretion and insulin resistance： homeostasis model assessment. Results （1） The change of serum adiponectin levels., serum adiponectin levels were decreased with the increase of BMI both in the PCOS patients and controls（P1〉P2〉P3, C1〉C2〉C3,P〈0. 01）; Serum adiponectin levels in the PCOS patients were lower than those in the control groups （P1〈C1 ,P〈0. 05~P2〈C2, P3〈C3, P〈0. 01）. （2）Correlation analysis： In PCOS patients there were correlations between adiponectin and BMI, WC, HC, WHR, TG, HDL, Fins, Ins120,FBG, HOMA-IR, HOMA-IS and LH/FSH. Conclusion The serum adiponectin level decreases in the PCOS patients and have a relationship with the metabolism and hypothalamus-pituitary-gonadal （HPG） axis regulation and therefore participates the development of PCOS.

关 键 词：多囊卵巢综合征 肥胖 脂联素 

分 类 号：R711.75[医药卫生—妇产科学]