多囊卵巢综合征患者高糖负荷后胰高血糖素样肽1的变化  

Glucagon-like peptide-1 levels in patients with polycystic ovary syndrome after glucose load

作　　者：岳峰[1] 许娟[1] 李秀莲[1] 高云[1] 张铁[1] 

机构地区：[1]山东省泰安市中心医院内分泌一科,271000

出　　处：《中华糖尿病杂志》2016年第2期108-112,共5页CHINESE JOURNAL OF DIABETES MELLITUS

摘　　要：目的探讨多囊卵巢综合征（PCOS）患者糖负荷后胰高血糖素样肽1（GLP-1）的变化。方法2013年6月至2014年8月选择33例PCOS患者及30例年龄、体质指数相匹配的健康志愿者作为研究对象，行75g口服葡萄糖耐量试验，观察血糖、胰岛素及GLP-1变化。计算稳态模型胰岛素抵抗指数（HOMA-IR），血糖曲线下面积（AUCGLU）、胰岛素曲线下面积（AUCINS）、GLP-1曲线下面积（AUCGLP）、糖负荷后30min葡萄糖净增值（△GLU30）、胰岛素净增值（AINS30）和GLP-1净增值（△GLP30）。组间均数比较采用t检验，计量资料的多因素分析采用多元逐步回归分析。结果两组间年龄、体质指数差异无统计学意义（t=0．280、1．375，均P〉0．05）。PCOS组空腹及糖负荷后1h血糖及胰岛素水平均显著高于对照组f血糖0 h：（5．3±0．6）比（5．0±0．5）mmol／L，1h：（7．8±2．0）比（7．0±1．0）mmol／L；胰岛素0h：（20±14）对（13±6）mU／L，1h：（144±56）比（114±50）mU/L；t=2．709、2．079、2．457、2．283，均P〈0．05]；而空腹GLP-1水平较对照组显著降低[（5．0±2．4）比（6．6±3．0）pmol／L，t=-2．309，P〈0．051。PCOS组HOMA-IR、糖负荷后GLUAUC及AGLP30均明显高于对照组（t=2．712、2．290、2．557，均P〈0．05）。PCOS患者空腹GLP-1水平与空腹血糖及胰岛素均呈负相关（r=-0．355、-0．552，均P〈0．05）。多元逐步回归分析显示空腹GLP-1与睾酮水平独立相关（B=0．191，P=0．027）。结论PCOS患者存在GLP-1分泌缺陷，主要是空腹GLP-1分泌不足，与胰岛素抵抗及糖代谢紊乱的发生相关，与睾酮水平间有重要联系。Objective To explore the levels of glucagon-like peptide-1（GLP-1） after oral glucose tolerance test （OGTT） in patients with polycystic ovary syndrome （PCOS）. Methods From June 2013 to August 2014, 33 cases of PCOS patients and 30 healthy women with matched age and body mass index （BMI） were enrolled in this study. The levels of glucose, insulin and GLP- 1 were evaluated, the values of homeostasis model assessment for insulin resistance （HOMA-IR）, glucose area under cnrve（AUCGLU）, insulin area under curve（AUCINS）, GLP-1 area under curve（AUCGLP）, early phase glucose change（ A GLU30）, insulin change（AINS30） and GLP- 1 change（AGLP30） were calculated by OGTY in all the subjects. Data were compared with t test between the two groups. Multiple stepwise regression analysis was used to analysize multiple factors of measurement data. Results There was no significant difference in age and BMI between the two groups（t=0.280, 1.375, both P〉0.05）. The fasting glucose and insulin and the levels of 1 hour after OGTY were significantly higher in PCOS group than those in control （GLU 0 h：（5.3±0.6） vs （5.0±0.5） mmol/L, 1 h： （7.8±2.0） vs （7.0±1.0） mmol/L; INS 0 h： （20±14） vs （13±6） mU/L, 1 h： （144±56） vs （114±50） mU/L; t= 2.709, 2.079, 2.457, 2.283, all P〈0.05）, while, the fasting GLP- 1 levels of PCOS group was significantly lower than that in control （（5.0±2.4） vs （6.6±3.0） pmol/L, t=-2.309, P〈0.05）. There was no significant difference in GLP-1 levels after OGTT between the two groups. The values of HOMA-IR and AUCGLU, A GLP30 after glucose load were all significantly higher in PCOS group than those in the control（t=2.712, 2.290, 2.557, all P〈0.05）. The fasting GLP-1 was positively correlated with fasting glucose and insulin （r=-0.355, -0.552, P〈0.05）. Multiple regression analysis suggested that the fasting GLP-1 was an important influencing factor of testosterone level（β=0.191, P=-0.027）. Conclu

关 键 词：多囊卵巢综合征 胰高血糖素样肽1 口服葡萄糖耐量试验 

分 类 号：R711.75[医药卫生—妇产科学]