雌激素依赖性子宫病变中脂联素及炎性因子的表达  

Expression of Adiponectin and Inflammatory Factors in Estrogen-Dependent Uterine Lesions

作　　者：孟凡萍[1] 郝坡[2] MENG Fan-ping;HAO Po(Chongqing Three Gorges Central Hospital,Chongqing Three Gorges Medical College,Chongqing 404000,China)

机构地区：[1]重庆三峡中心医院检验科,重庆404000 [2]重庆三峡医药高等专科学校医学技术学院,重庆404020

出　　处：《广东医学》2020年第1期51-55,共5页Guangdong Medical Journal

基　　金：重庆市万州区科研项目(201203061);重庆三峡医药高等专科学校课题(2014mpxz18)

摘　　要：目的探讨雌激素依赖性子宫病变--子宫内膜癌、子宫内膜异位症、子宫肌瘤患者的体质指数(body mass index,BMI)、胰岛素抵抗指数(HOMA-IR)、脂联素(adiponectin,APN)及炎性因子C反应蛋白(CRP)、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、γ干扰素(IFN-γ)表达水平的变化。方法选取新发子宫内膜癌40例(EMC组)、子宫内膜异位症30例(EMS组)、子宫肌瘤40例(EM组)患者分别作为观察组,另以30例同期体检的健康妇女作为对照组,观察4组研究对象的BMI、空腹血糖(fasting glucose,FG)、空腹胰岛素(fasting insulin)、APN及炎性因子CRP、TNF-α、IL-6、IFN-γ水平。并用稳态模型评估法计算HOMA-IR,Pearson相关分析BMI、IR与APN、炎性因子的相关性。结果观察组患者HOMA-IR、CRP、TNF-α、IL-6及IFN-γ水平均明显高于对照组(P<0.05),而3个观察组的APN则明显低于对照组(P<0.05)。其中EMC组患者BMI、HOMA-IR及血清炎症因子水平较EMS组、UM患者均显著增加,而APN则显著降低(P<0.05)。Pearson相关分析结果显示,EMS组患者BMI与APN呈正相关但无统计学意义(r=0.632,P=0.091),而另两个观察组合并后BMI与APN则呈负相关(r=-0.569,P=0.025),3组BMI、HOMA-IR与CRP、TNF-α、IL-6和IFN-γ均呈正相关,HOMA-IR与APN呈负相关。结论雌激素依赖性子宫病变致使机体炎症因子升高,而增高的炎症因子又加重胰岛素抵抗,形成恶性循环,是此类疾病发病的重要因素。APN在此类疾病中处于低水平,上调APN可能会缓解雌激素依赖性子宫病变的胰岛素抵抗状态。Objective To investigate the body mass index(BMI), insulin resistance index(HOMA-IR), IL-6 and IFN-γ in patients with estrogen-dependent uterine lesions-endometrial carcinoma and endometriosis. Methods 40 new cases of endometrial carcinoma, 30 cases of endometriosis and 40 cases of uterine myoma were taken as observation groups, and 30 healthy women were taken as control group during the same period. The levels of BMI, fasting glucose(FG), fasting insulin, APN, and inflammatory factors, including CRP, TNF-α, IL-6 and IFN-γ were recorded. Using steady state model evaluation method to calculate the insulin resistance index(HOMA-IR). Pearson correlation analysis as applied for the correlation analysis of BMI, IR, APN and inflammatory factors. Results BMI, HOMA-IR, CRP, TNF-α, IL-6 and IFN-γ were significantly higher in observation groups than the control group(P<0.05). The APNs of the three observation groups were significantly lower than that of the control group(P<0.05). Among the patients with endometrial carcinoma, the levels of BMI, IR and serum inflammatory factors were significantly increased compared with those of endometriosis and uterine myoma, while APN was significantly reduced(P<0.05). Pearson-related analysis showed that in EMS group BMI was positively correlated with APN(r=0.632, P=0.091);while in EMC group and UM group BMI were negatively correlated with APN(r=-0.569, P=0.025). In the 3 observation groups, BMI and HOMA-IR were positively correlated with CRP, TNF-α, IL-6, and IFN-γ;and HOMA-IR were negatively correlated with APN. Conclusion Metabolism, inflammation and other factors lead to the emergence of IR in the body, which is an important factor in estrogen-dependent uterine lesions and even malignant changes. APN plays an important role in this pathogenesis.

关 键 词：子宫内膜癌 子宫内膜异位症 子宫肌瘤 胰岛素抵抗指数 脂联素 炎性因子 

分 类 号：R446.1[医药卫生—诊断学] R717.7[医药卫生—临床医学]