PCOS合并糖代谢异常患者内脏脂肪与脂联素及肿瘤坏死因子-α的相关性研究  

Correlations between Visceral Fat Area and APN and TNF-α in Women with Polycystic Ovary Syndrome

作　　者：余劲明[1] 黄建皓[1] 玉颜庆[1] 何萍[1] 张文娇[1] 颜晓东[1] 

机构地区：[1]广西壮族自治区人民医院内分泌科,广西南宁530021

出　　处：《实用妇产科杂志》2016年第5期362-365,共4页Journal of Practical Obstetrics and Gynecology

基　　金：广西壮族自治区卫生厅重点项目(编号:2012108)

摘　　要：目的:探讨多囊卵巢综合征(PCOS)合并糖代谢异常患者内脏脂肪与血清脂肪因子脂联素(APN)、肿瘤坏死因子α(TNF-α)的相关性。方法:选择在我院门诊确诊PCOS患者37例,其中合并糖代谢异常患者20例(P-IGT组),糖代谢正常患者17例(P-NGT组),另选18例健康同龄女性作为正常对照组,检测其空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、血清胰岛素(FINS)、APN、TNF-α、白介素6(IL-6)水平等;按稳态模型计算胰岛素抵抗指数(HOMA-IR);采用双能X线骨密度仪检测全身脂肪含量及内脏脂肪面积(VATA)。结果:1P-IGT组血清FINS及HOMA-IR水平明显高于P-NGT组及正常对照组(P<0.01);P-IGT组APN水平明显低于P-NGT组及正常对照组(P<0.01);P-IGT组TNF-α明显高于P-NGT组及正常对照组(P<0.05,P<0.01);IL-6在3组之间差异无统计学意义(P>0.05)。2P-IGT组的全身脂肪含量明显高于P-NGT组及正常对照组(P<0.01);P-IGT组与P-NGT组VATA均显著高于正常对照组(均P<0.01)。APN与FINS、体质量指数(BMI)、腰臀比(WHR)、HOMA-IR、全身脂肪含量、VATA呈负相关(r=-0.306,-0.617,-0.356,-0.343,-0.520,-0.405,均P<0.05);TNF-α与FINS、BMI、HOMA-IR、TG、全身脂肪含量、VATA呈正相关(r=0.309,0.351,0.255,0.268,0.465,0.362,均P<0.05)。APN、TNF-α是VATA的重要影响因素。结论:PCOS患者无论有否糖代谢异常均出现VATA明显增加,而合并糖代谢异常者全身脂肪含量及VATA均增加。PCOS患者合并糖代谢异常与内脏脂肪组织分泌肿瘤坏死因子-α增多及APN分泌减少有关。Objective：To investigate the correlations between visceral fat area and adipocytokines（APN and TNF-a） in women with polycystic ovary syndrome（PCOS）. Methods：Thirty-seven women with polycystic ovary syndrome were divided into 2 groups：group P-IGT （ n = 20, PCOS with impaired glucose tolerance, P-IGT） and group P-NGT（ n = 17, PCOS with normal glucose tolerance, P-NGT）. Eighteen healthy infertile women served as controls. The levels of serum FINS,APN,TNF-α and IL-6 were detected. Total body fat percentage and visceral adipose tissue area（VATA）were assessed using dual emission X-ray absorptiometry. Results：①The level of ser- um FINS and HOMA-IR were significantly higher in group P-IGT than in group P-NGT and control group （ P 〈 0. 01 ）. The level of APN in group P-IGT was significantly lower in group P-IGT than in group P-NGT and control group （P〈0.01）. TNF-α level was significantly higher in group P-IGT than in group P-NGT and control group （ P 〈0.05, P 〈0. 01 ）. No significant difference of serum IL-6 was found among 3 groups（ P 〉0.05）. ②Total body fat percentage in group P-IGT was higher than group P-NGT and control group （ P 〈 0. 01 ）. No difference was found in total body fat percentage between group P-NGT and control group. Visceral adipose tissue area in group P-IGT was higher than in group P-NGT（ P 〈0.01 ）. ③APN was negatively correlated with FINS,BMI,WHR,HO-MA-IR ,VATA and total body fat percentage （ r = - 0. 306, - 0. 617, - 0. 356, - 0. 343, - 0. 520, - 0. 405, P 〈 0.05） whereas TNF-α was positively correlated with FINS、BMI、HOMA-IR、TG and total body fat percentage（r= 0. 309,0. 351,0. 255,0. 268,0. 465,0. 362, P 〈 0.05 ）. Multivariate regression analysis showed that APN and TNF-α may be two independent factors affecting VATA. Conclusions..VATA was significantly increased in PCOS patients who were suffered impaired glucose tolerance or not. While both body fat percentage and VATA were sig- nificantly higher in those

关 键 词：多囊卵巢综合征 糖代谢异常 脂肪因子 内脏脂肪面积 

分 类 号：R711.75[医药卫生—妇产科学]