多囊卵巢综合征患者血清对氧磷酯酶1活性、氧化应激与胰岛素抵抗的关系  

The correlation of serum paraoxonase-l and oxidative stress with insulin resistance in patients with polycystic ovary syndrome

作　　者：李昌林[1] 张木勋[2] 喻晶[2] 帅红霞[2] 刘永健[2] 桂书彦[2] 

机构地区：[1]湖北省天门市第一人民医院内分泌科,431700 [2]华中科技大学同济医学院附属同济医院内分泌科

出　　处：《中国糖尿病杂志》2011年第2期97-100,共4页Chinese Journal of Diabetes

摘　　要：目的探讨对氧磷酯酶1(PON-1)活性、氧化应激在多囊卵巢综合征(PCOS)患者发生胰岛素抵抗(IR)中的作用。方法 41例PCOS患者分为肥胖组17例和非肥胖组24例,另有20名健康女性纳入正常对照组。所有研究对象均行口服糖耐量试验(OGTT)和胰岛素释放试验,使用稳态模型评价IR及胰岛β细胞分泌功能,空腹静脉取血检测丙二醛(MDA)、超氧化物歧化酶(SOD)活性及PON-1活性。结果 (1)PCOS非肥胖组和PCOS肥胖组的空腹胰岛素、餐后2小时血糖及胰岛素、HOMA-IR及HOMA-β均高于正常组(P<0.05),且PCOS肥胖组的空腹胰岛素、餐后2小时血糖及胰岛素、HOMA-IR均高于PCOS非肥胖组(P<0.05)。(2)PCOS非肥胖组和PCOS肥胖组的MDA、SOD及PON-1与正常组比较差异有统计学意义(P<0.05);PCOS肥胖组的SOD显著低于PCOS非肥胖组(P<0.01),而MDA及PON-1两组之间差异无统计学意义(P>0.05)。(3)相关分析显示:在PCOS非肥胖组,SOD与PON-1正相关(r=0.417,P<0.05),SOD与IR负相关(r=-0.492,P<0.05)。结论 PCOS患者无论肥胖与否,均存在餐后血糖升高、PON-1活性降低、氧化应激、IR,且肥胖患者更为严重;PCOS患者的氧化应激与IR相关。Objective To observe the role of paraoxonase-1 and oxidative stress in pathogenesis of insulin resistance in patients with polycystic ovary syndrome （PCOS）. Methods 41 PCOS patients divided into obese group and non-obese group with 20 healthy volunteers as a control. The 75g oral glucose tolerance test （OGTT） and insulin releasing test （IRT） were performed. The insulin resistance and β-eell function were estimated with homeostasis model assessment （HOMA）. The fasting serum concentration of malondialdehyde （MDA）, and the activities of superoxide dismutase （SOD） and paraoxonase-1 （PON-1） were assayed. Results （1） The levels of fasting plasma insulin, 2 hour plasma glucose and insulin, the index of insulin resistance （HOMA-IR） and β-cell function （HOMA-β） were significantly higher in PCOS patients of both non-obese group and obese group than in healthy controls（all P〈0.05）. HOMA-β was not different between non-obese group and obese group in PCOS patients（P〉0.05）, while the the levels of BMI, 2hPG, Fins, 2hIns, and HOMA-IR were significantly higher in obese group than in non-obese group（all P〈0. 05）. （2）The PCOS patients in both non-obese group and obese group showed higher MDA and lower SOD and PON-1 than in healthy controls（P〈0.05）. The serum concentration of MDA and the activity PON-1 showed no differences between non-obese group and obese group in PCOS patients （both, P^0.05）, but The activity of SOD was significantly lower in obese group than in non-obese group （P〈0. 01）. （3） SOD had a positive correlation with PON-I（r=0. 417, P=0.043）, and a negative correlation with HOMA IR（r=0. 492, P=0. 015）in non-obese PCOS group. Conclusion The PCOS patients has an increased postprandial plasma glucose, impared PON-1 activity, oxidative stress, insulin resistance, and high level of plasma insulin in non-obese and especially in obese subgroup. Insulin resistance is related to oxidative stress in patients with PCOS.

关 键 词：多囊卵巢综合征 胰岛素抵抗 氧化应激 对氧磷酯酶1 

分 类 号：R711.75[医药卫生—妇产科学] R587[医药卫生—临床医学]