apo B/apo AⅠ与多囊卵巢综合征患者胰岛素抵抗的相关性研究  

Correlation of apo B/apo AⅠ ratio with insulin resistance in women with polycystic ovary syndrome

作　　者：张玉洪[1] 杨淑敏[2] 赵长虹[2] 李启富[2] 罗梅[2] 张莉萍[1] 

机构地区：[1]重庆医科大学附属第一医院检验科,重庆400016 [2]重庆医科大学附属第一医院内分泌科,重庆400016

出　　处：《临床检验杂志》2012年第6期430-432,共3页Chinese Journal of Clinical Laboratory Science

摘　　要：目的探讨多囊卵巢综合征(PCOS)患者载脂蛋白B(apo B)/载脂蛋白AⅠ(apo AⅠ)比值与胰岛素抵抗(IR)的关系。方法选择137例PCOS患者和116例健康女性,测量血脂并计算apo B/apo AⅠ比值,行75 g口服葡萄糖耐量试验,计算稳态模型胰岛素抵抗指数(HOMA2-IR);对其中101例PCOS患者及20例健康女性行高胰岛素-正葡萄糖钳夹术,以稳态期葡萄糖代谢率(M值)评估其胰岛素敏感性。根据健康人对照组M值下四分位数(P25)和apo B/apo AⅠ比值的四分位数将PCOS患者进行分组,用logistic回归分析apo B/apo AⅠ比值与IR发生风险的关系。结果 PCOS患者中,与非IR患者相比,IR患者的HOMA2-IR水平及apo B/apo AⅠ比值均显著增高,而M值水平降低(P<0.05);PCOS患者apo B/apo AⅠ比值与BMI、FPG、2 h PG、FINS、HOMA2-IR呈正相关(P均<0.05),与M值呈负相关;随apo B/apo AⅠ比值增高,M值逐渐降低(P<0.05)。apo B/apo AⅠ比值最高组发生IR的风险是最低组的5.42倍(P<0.05)。结论 PCOS患者中,apo B/apo AⅠ比值与IR密切相关,apo B/apo AⅠ比值增高是发生IR的重要标志。Objective To investigate the correlation between apo B/apo AI ratio and insulin resistance （IR） in patients with polycystic ovary syndrome （PCOS）. Methods Oral glucose tolerance test was carried out on 137 patients with PCOS and 116 healthy women. Serum lipid was simultaneously determined and apo B/apo AI ratio was calculated. Homeostasis model assessment 2-insulin resistance （HOMA2-1R） was completed for all the subjects. Hyperinsulinemic euglycemic clamp was performed in 101 patients with PCOS and 20 healthy women, and the insulin sensitivity was assessed by homeostasis glucose metabolism rate （M value）. The subjects were divided into four groups according to the quartiles of M value for the controls and the quartiles of apo B/apo AI ratio for the patients with PCOS. Logistic regression was used to estimate the relationship between the apo B/apo AI ratio and the risk of IR. Results The level of HOMA2-IR and the apo B/apo AI ratio of the patients with IR were significantly higher than those of the patients without IR, but the reverse was true for M value （P 〈 0.05 ）. The apo B/apo AI ratio was positively correlated with the levels of body mass index （BMI）, fasting plasma glucose （FPG） , 2-hour post-load plasma glucose （2h-PPG） , fasting serum insulin （FINS） and HOMA2-IR, but nega- tively with M value （ P 〈 0.05 ） in the patients with PCOS. The risk producing IR in the group with the highest quartile of the apo B/apo AI ratio was 5.42 times higher than that with the lowest quartile of the apo B/apo AI ratio （ P 〈 0.05 ）. Conclusion The apo B/apo AI ratio is closely related to the development of IR in the patients with PCOS, and high apo B/apo AI ratio is a potential bio- marker for predicting the development of IR.

关 键 词：多囊卵巢综合征 载脂蛋白B/载脂蛋白AⅠ比值 胰岛素抵抗 

分 类 号：R446.5[医药卫生—诊断学]