卵巢局部IGF-I系统与多囊卵巢综合征胰岛素抵抗的相关性研究  

Study of the relationship between the IGF-I system in ovary and the polycystic ovary syndrome combined with insulin resistance

作　　者：李晓林[1] 毕淑娜[1] 孙颖 孙宝治[1] 范俊[1] 孟莉 袁文娟[1] 

机构地区：[1]青岛大学医学院附属青岛市市立医院东院区妇科,青岛266071 [2]山东省青岛市市南区妇幼保健所,青岛266071 [3]山东省青岛市第五人民医院妇科,青岛266021

出　　处：《中国优生与遗传杂志》2014年第6期17-19,61,F0002,共5页Chinese Journal of Birth Health & Heredity

摘　　要：目的:研究卵巢局部胰岛素样生长因子-I系统(IGF-I系统)在伴有胰岛素抵抗多囊卵巢综合征中的作用机制。方法选择30例合并胰岛素抵抗的PCOS(polycystic ovary syndrome)患者为试验组,30例患有卵巢良性肿瘤需手术探查的患者为对照组。检测并对比血清、小卵泡液中IGF-I、胰岛素样生长因子结合球蛋白-1(IGFBP-1)与各项性激素,FI,2hI,ISI,QUICK I,卵巢超声指标,研究其与各种指标间的相关性。结果试验组小卵泡液IGF-I高于对照组(P<0.01),小卵泡液及血清IGFBP-1低于对照组(P<0.05,P<0.01)。试验组小卵泡液IGF-I水平高于血清(P<0.01),小卵泡液IGFBP-1水平低于血清(P<0.05)。试验组小卵泡液IGF-I与T0、E2及卵巢体积(OV),卵巢总面积(TA),卵泡数(FN),空腹胰岛素(FI),服糖后2h胰岛素(2hI)呈正相关(P<0.05);血清IGF-I与胰岛素敏感指数(ISI),体重指数(BMI),腰臀比(WHR)呈正相关(P<0.05),与定量胰岛素敏感指数(QUICK I)呈负相关(P<0.05);试验组小卵泡液及血清IGFBP-1与FI,2hI呈负相关(P<0.05)。结论 IR可能通过影响卵巢局部IGF-I系统,刺激卵巢分泌雄激素,引发排卵障碍,在PCOS的发病机制中起到重要作用。Objective：To study effects of ovarian insulin-like growth factor-I（IGF-I）system on PCOS with insulin resistance（IR）. Methods：30 insulin-resistant PCOS patients and 30 patients with gynecology benign disease were enrolled. IGF-I and insulin-like growth factor binding protein-1（IGFBP-1）in follicular fluid and serum,reproductive hormones,insulin sensitivity indexs,ovarian ultrasound parameters were measured and compared between two groups.Correlation of IGF-I system with other parameters were analysed. Results：Follicular fluid IGF-I in PCOS group was significantly lower than in control group（P0.01）. Both serum and follicular fluid level of IGFBP-1 in PCOS group were all markedly lower than in control group（P0.05,P0.01）. In PCOS group,IGF-I in follicular fluid was significantly higher than in serum（P0.01）,and IGFBP-1 in follicular fluid was significantly lower than in serum（P0.05）.In PCOS group,follicular fluid IGF-I positively correlated with T0,E2,ovary volume（OV）,total area（TA）,follicle number（FN）,free insulin（FI）,2hI（P0.05）. Serum IGF-I positively correlated with insulin sensitivity index（ISI）,body mass index（BMI）,waist/hip ratio（WHR）（P0.05）,negatively correlated with QUICK I（P0.05）.Both follicular fluid and serum IGFBP-1 negatively correlated with FINS,2hI（P0.05）. Conclusion：These results raise the possibility that IR likely contributes to hyperandrogenism and anovulatiaon in PCOS by effecting ovarian IGF-I system.

关 键 词：多囊卵巢综合征 胰岛素抵抗 胰岛素样生长因子-I 胰岛素样生长因子结合球蛋白-1 

分 类 号：R711.75[医药卫生—妇产科学]