多囊卵巢综合征患者超长链脂肪酸的变化及其与肥胖、胰岛素抵抗的关系  

Plasma very long chain fatty acids levels and its relationship with obesity, insulin resistance in polycystic ovary syndrome women

作　　者：刘玲娇[1] 吴静[1] 张婉[2] 粱逸珍 王珊[2] 吴良燕[1] 汶倩[1] 

机构地区：[1]中南大学湘雅医院内分泌科,长沙410008 [2]中南大学化工学院

出　　处：《中华糖尿病杂志》2014年第4期249-254,共6页CHINESE JOURNAL OF DIABETES MELLITUS

摘　　要：目的 了解多囊卵巢综合征（PCOS）患者血浆超长链脂肪酸（VLCFAs）的变化,并分析各种脂肪酸与肥胖、胰岛素抵抗的关系.方法 收集符合2003年鹿特丹会议诊断标准的18 ～40岁PCOS患者205例,另选择年龄匹配的同期因输卵管因素或男方因素所致不孕的女性117例作为正常对照组.检测血清激素水平,并用气相色谱质谱联用仪（GC-MS）检测血浆10种VLCFAs水平.两组间比较采用f检验,计量资料的多因素分析采用多元逐步回归分析.结果 与正常对照组相比,PCOS患者血浆中存在多种超长链脂肪酸代谢紊乱,包括花生四烯酸（C20：4n-6）/二十碳三烯酸（C20：3n-6）较正常对照组降低,而花生烯酸（C20：ln-9）、二十碳五烯酸（C20：5n-3）、w-3二十二碳五烯酸（C22：5n-3）、二十二碳六烯酸（C22：6n-3）、C20：3n-6、二十二碳四烯酸（C22：4n-6）、二十碳二烯酸（C20：2n-7）均较正常对照组升高（t=0.539 ～6.155,均P＜0.05）.在PCOS患者中,与非肥胖组相比,肥胖组C20：0升高,C20：3n-6、C20：2n-7均下降（t=-0.927、2.452、0.767,均P＜0.05）.与非胰岛素抵抗（IR）组比较,IR组C20：0升高,C20：2n-7及C22：5n-3均降低（t=2.064、2.195、2.183,均P＜0.05）.多元逐步回归分析结果显示C20：2n-7是肥胖的独立危险因素,而C20：0是胰岛素抵抗的独立危险因素.结论 PCOS患者存在超长链脂肪酸代谢紊乱.C20：2n-7的下降可能是PCOS患者肥胖的影响因素,而C20：0的升高则可能是PCOS患者胰岛素抵抗的影响因素.Objective To investigate the changes in plasma very long chain fatty acids （VLCFAs） in polycystic ovary syndrome （PCOS） patients,and further to explore its relationship with obesity and insulin resistance.Methods Two hundred and five PCOS patients were screened out according to the diagnostic criteria of Rotterdam conference （2003）,aged 18-40 years.A group of 117 healthy infertile women of corresponding period was taken as control.These women were chosen randomly from reproductive center due to the problems of uterine tube or males.The plasma hormone levels were examined.Ten kinds of plasma VLCFAs were detected by gas chromatography-mass spectrometry （GC-MS）.Data between two groups analysis was performed by t test.Multiple stepwise regression analysis was used to analysize multiple factors of measurement data.Results Compared with normal individuals,plasma VLCFAs levels was disorder in PCOS patients.There is a lower C20：4n-6/C20：3n-6 in VLCFAs of PCOS patients,and a higher C20：1n-9,C20：2n-7,C20：3n-6,C22：4n-6,C20：5n-3,C22：5n-3 and C22：6n-3,compared with the control group（t =0.539-6.155,all P ＜ 0.05）.In the PCOS group,compared with non-obese patients,obese patients had a higher C20：0,and lower C20：3n-6 and C20：2n-7 （t =-0.927,2.452,0.767,both P ＜ 0.05）.Compared with non insulin resistance group,patients with insulin resistance had a higher C20：0 and lower C20：2n-7 and C22：5n-3 levels （t =-2.064,2.195,2.183,both P＜0.05）.Multiple stepwise regression analysis showed that C20：2n-7 and C20：0 were independent risk factors of obesity and insulin resistance,respectively.Conclusions Disturbance metabolism of VLCFA existed in the PCOS patients.The decrease of C20：2n-7 was probably an influence factor of obesity in PCOS patients and the increase of C20：0 was probably an influence factor of insulin resistance in PCOS patients.

关 键 词：多囊卵巢综合征 肥胖 胰岛素抵抗 超长链脂肪酸 

分 类 号：R711.75[医药卫生—妇产科学]