血浆瘦素水平与子宫内膜病变风险相关性研究  

Plasma leptin and risk of endometrial lesion

作　　者：冯宗昊 刘林枝[1] 张岩[1] FENG Zong-hao;LIU Lin-zhi;ZHANG Yan.(Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China)

机构地区：[1]北京大学第一医院妇产科,北京100034

出　　处：《中国实用妇科与产科杂志》2018年第6期662-665,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家自然科学基金(81272870)

摘　　要：目的探讨血浆瘦素水平与子宫内膜不典型增生(EAH)及内膜癌风险的相关性。方法回顾性分析北京大学第一医院2014年7月至2017年8月收治的EAH组患者28例,Ⅰ型子宫内膜癌(EC)组患者86例,Ⅱ型EC组患者24例;选择同期子宫内膜良性疾病患者44例为对照组。利用酶联免疫吸附法检测血浆瘦素水平,分析瘦素水平与子宫内膜病变临床特点之间的关系。结果与对照组相比,Ⅰ型、Ⅱ型EC组糖代谢异常状态、胰岛素抵抗者比例显著增加。EAH组、Ⅰ型EC组的血浆瘦素水平(18.63μg/L、16.52μg/L)明显高于对照组(12.45μg/L),差异有统计学意义(P<0.01);且血浆瘦素水平与胰岛素抵抗相关。多因素Logistic回归分析发现,在排除年龄、绝经、高血压、糖耐量状态、肥胖等混杂因素后,瘦素水平的升高是Ⅰ型EC发病的独立危险因素(P=0.038)。结论 EAH、Ⅰ型EC患者血浆瘦素水平明显升高,并且高血浆瘦素水平是Ⅰ型EC发病的独立危险因素。Objective To explore the relationships of the plasma concentrations of leptin with the risk of endometrial lesion.Methods We enrolled 28 female subjects with endometrial atypical hyperplasia、86 with type I endometrial cancer、24 with type Ⅱ endometrial cancer and 44 with benign endometrium. The plasma levels of the leptin were measured by ELISA,and the associations of leptin level with the clinical features of endometrial lesions were analyzed.Results In the patients with endometrial cancer,ratio of impaired glucose metabolism and insulin resistance was significantly higher,compared with the control subjects. In the patients with endometrial atypical hyperplasia and type I endometrial cancer,the plasma leptin level was significantly higher,compared with the control subjects（18.63μg/L vs.12.45μg/L,P=0.001;16.52μg/L vs. 12.45μg/L,P=0.002）. In the patients with endometrial atypical hyperplasia and type I endometrial cancer,the plasma leptin was related to insulin resistance.Multi-factor Logistic repression analysis showed that higher leptin level was the independent risk factor of type I endometrial cancer（P=0.038）after adjusting for the age,menopause,hypertension,glucose tolerance status and obesity.Conclusion Leptin levels in patients with endometrial atypical hyperplasia and type I endometrial cancer increase significantly,and high leptin level is an independent risk factor of type I endometrial cancer.

关 键 词：瘦素 子宫内膜不典型增生 子宫内膜癌 脂肪因子 胰岛素抵抗 

分 类 号：R737.33[医药卫生—肿瘤]