多囊卵巢综合征与血清维生素D和维生素D受体基因多态性的关系研究  

Study on the relationship between polycystic ovary syndrome and polymorphism of serum vitamin D and polymorphism of Vitamin D receptor gene

作　　者：潘小红 杨春燕[1] 王小红[1] 李采霞 吴开玲 PAN Xiao-hong;YANG Chun-yan;WANG Xiao-hong(Department of Obstetrics and Gynecology,The Chinese People's Liberation Army of the 904th Hospital,Wuxi Jiangsu 214000,China)

机构地区：[1]中国人民解放军联勤保障部队第904医院妇产科

出　　处：《临床和实验医学杂志》2019年第15期1634-1638,共5页Journal of Clinical and Experimental Medicine

基　　金：原南京军区面上项目(编号:14MS012);解放军第一〇一医院院级科研课题(编号:15YG11)

摘　　要：目的分析多囊卵巢综合征(PCOS)与血清维生素D和维生素D受体基因多态性的关系。方法采用回顾性研究的方法,选取2016年2月至2018年8月中国人民解放军联勤保障部队第904医院收治的PCOS患者60例作为观察组,此外选取同期健康体检者60例作为对照组。根据25(OH)D水平将PCOS患者分为25(OH)D<10 g/L组和25(OH)D≥10 g/L组,分别有患者26例、24例。所有研究对象均记录身体质量指数(BMI)、舒张压(DBP)、收缩压(SBP)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、总胆固醇(TC)水平和空腹胰岛素(FSI)、胰岛素抵抗指数(HOMA-IR),胰岛β细胞功能指数(HOMA-β)。比较25(OH)D<10 g/L组和25(OH)D≥10 g/L组患者的一般资料和代谢指标,分析血清25(OH)D与PCOS患者其他代谢指标的关系。比较观察组与对照组不同酶切点位各基因型分布情况。结果①与对照组相比,观察组BMI更高,HDL-C、LDL-C、TC、TG、HOMA-IR、HOMA-β均更高,25(OH)D水平更低,差异具有统计学意义(P<0.05)。两组患者的血压、年龄比较,差异无统计学意义(P>0.05)。②与25(0H)D≥10 g/L组相比,血清25(OH)D<10 g/L组BMI更大,LDL-C、FSI、HOMA-IR更高,HOMA-β更低,差异具有统计学意义(P<0.05)。PCOS患者血清25-(OH)D与BMI、LDL-C、FSI、HOMA-IR呈负相关(r分别为-0.3 82、-0.473、-0.512、-0.601),与HOMA-β呈正相关(r=0.318)。③观察组等位基因b、a及基因型bb频率(30.00%)、aa频率(33.33%)较对照组高,等位基因T和基因型TT频率高于对照组,差异具有统计学意义(P<0.05)。结论多囊卵巢综合征患者血清维生素D水平低或不足与HOMA-IR、HOMA-β、BMI相关,甚至直接影响代谢综合征发生;维生素D受体基因Bsm I、Taq I、Apa I位点的多态性与PCOS易感性相关。Objective To analyze the relationship between polycystic ovary syndrome and polymorphism of Vitanmpn D receptor on serum Vitamin D.Methods A retrospective study was conducted during February 2016 to August 2018,60 patients with PCOS were enrolled in their hospital.In addition,60 healthy persons were selected as control group.Patients with PCOS were divided into 25(OH)D<10 g/L group and≥10 g/L group according to 25(OH)D level respectively,there were 26 patients and 24 patients respectively in each group.All these patients were examined with BMI,DBP,SBP and blood levels of HDL-C,LDL-C,TG,TC,FSI,HOMA-IR and HOMA-β.The relationship between serum 25(OH)D and other metabolic indicators in PCOS patients were analyzed by comparing the general data and metabolic indicators in 25(OH)D<10 g/L group and≥10 g/L group.The distribution of genotypes at different restriction sites was compared between observation group and control group.Results①In comparison with control group,the BMI in observation group was higher,HDL-C,LDL-C,TC,TG,HOMA-IR and HOMA-βwere also higher,and 25(OH)D level was lower,P<0.05.There was no significant difference in blood pressure and age range between these two groups(P>0.05).②In comparison with the group of 25(OH)D≥10 g/L,the serum 25(OH)D<10 g/L group had higher BMI,LDL-C,FSI and HOMA-IR and lower HOMA-β,(P<0.05).Serum level of 25-(OH)D was negatively correlated with BMI,LDL-C,FSI,and HOMA-IR in patients with PCOS,r=-0.382,r=-0.473,r=-0.512,r=-0.601,and HOMA-β,with positive correlation(r=0.318).③The frequency of allele b,a and genotype bb,aa in observation group was higher than that of control group,and the frequency of allele T and genotype TT was higher than that of control group,(P<0.05).Conclusion The low or insufficient serum Vitamin D level in patients with polycystic ovary syndrome is related to insulin resistance,isletβcell function and body mass index,and even directly affects the occurrence of metabolic syndrome.Polymorphism of vitamin D receptor gene BsmI,TaqI and ApaI sites

关 键 词：多囊卵巢综合征 维生素D 维生素D受体 基因多态性 

分 类 号：R711.75[医药卫生—妇产科学]