多囊卵巢综合征患者血清Orexin A水平变化及意义  

Changes and significance of fasting serum Orexin A levels in patients with polycystic ovarian syndrome

作　　者：宣蓉[1] 胡红琳[1] 方朝晖[2] 代芳[1] 丁璐[1] 杜娟[1] 王长江[1] 

机构地区：[1]安徽医科大学第一附属医院内分泌科,合肥230022 [2]安徽中医药大学第一附属医院内分泌科,合肥230038

出　　处：《安徽医科大学学报》2014年第2期218-221,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽中医学院中医药管理局重点学科-中医内分泌学科开放基金(编号:2011nfmxk004)

摘　　要：目的观察多囊卵巢综合征(PCOS)患者空腹血清Orexin A(OXA)水平的变化,探讨其在PCOS发生和发展中的意义。方法选取57例PCOS患者(PCOS组)和56例月经正常的健康女性(对照组)作为研究对象,按照身体质量指数(BMI)≥24 kg/m2或<24 kg/m2分别将PCOS组和对照组分为超重/肥胖(PCOS-OW/OB,Control-OW/OB)亚组和正常体重(PCOS-NW,Control-NW)亚组。检测各组血三酰甘油(TG)、胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、空腹血糖(FBG)、餐后2 h血糖(P2hBG)、空腹胰岛素(FINS)、餐后2 h胰岛素(P2hINS)、黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)以及血清OXA水平;测量身高、体重、腰围(WC)、臀围;并计算BMI、腰臀比(WHR)、LH/FSH及稳态模型胰岛素抵抗指数(HOMA-IR)。结果 PCOS组空腹血清OXA水平明显低于对照组(P<0.01);PCOS和对照组中,OW/OB亚组OXA水平均低于NW亚组(P<0.05)。PCOS组中血清OXA水平与BMI、WC、WHR、LH、LH/FSH、FBG、P2hBG、FINS、HOMA-IR呈负相关(P<0.05或P<0.01)。校正年龄和BMI后,血清OXA水平仍与LH、LH/FSH、FBG、P2hBG、HOMA-IR呈负相关(P<0.05或P<0.01)。多元逐步回归分析显示:HOMA-IR、LH和P2hBG是影响OXA水平的重要因素。二分类Logistic回归分析提示,OXA是PCOS发生的保护因素。结论 OXA可能参与了PCOS的发生和发展。Objective To investigate the variation of fasting serum Orexin A （ OXA） levels and their roles in pa-tients with polycystic ovarian syndrome （ PCOS ） . Methods The subjects were divided into two groups： PCOS group（n=57） and healthy control group（n=56）. According to the body mass index（BMI）≥24 kg/m2 or＆lt;24 kg/m^2 , both groups were divided into overweight/obese subgroup （ PCOS-OW/OB, Control-OW/OB） and normal weight subgroup（ PCOS-NW, Control-NW） . Serum triglyceride（ TG） , total cholesterol（ TC） , high-density lipopro-tein （ HDL） , low-density lipoprotein （ LDL） ,fasting blood glucose（ FBG） , fasting insulin（ FINS） , postprandial 2 h insulin （P2hINS）,luteinizing hormone（LH）,follicle stimulating hormone（FSH）,testosterone（T） and OXA level were measured. Height, body mass, waist circumstance （ WC） and hip circumference were also measured. BMI, waist-hip ratio（ WHR） ,LH/FSH and HOMA-IR（ homeostasis model assessment of insulin resistance） were calcu-lated. Results Fasting serum OXA levels in PCOS group were significantly lower than those in controls （ P ＆lt;0.01）;Fasting serum OXA levels in PCOS-OW/OB were lower than those in PCOS-NW（P＆lt;0.05）;Fasting ser-um OXA levels in Control-OW/OB were significantly lower than those in Control-NW （ P＆lt;0.01 ） . After age and BMI adjustment, fasting serum OXA was correlated negatively with LH,LH/FSH,FBG,P2hBG and HOMA-IR（ P＆lt;0.05 or P＆lt;0.01）. Multiple stepwise regression analysis showed that HOMA-IR,LH and P2hBG were the influ-encing factors of serum OXA level. Binary logistic regression demonstrated that OXA was the protective factor of P-COS. Conclusion The decreased serum OXA level may play a very important role in the development of PCOS.

关 键 词：多囊卵巢综合征 肥胖 胰岛素抵抗 

分 类 号：R711.75[医药卫生—妇产科学]