多囊卵巢综合征患者胰岛素抵抗与性激素和脂类以及超敏C反应蛋白的相关性研究  

Study on the correlation of insulin resistance with sex hormones,lipids and hypertensive C reactive protein in patients with polycystic ovary syndrome

作　　者：杨淑娴 陈颖 娄鉴芳 Yang Shuxian;Chen Ying;Lou Jianfang(Department of Laboratory Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China)

机构地区：[1]南京医科大学第一附属医院检验学部,江苏南京210029

出　　处：《感染．炎症．修复》2020年第4期220-223,共4页Infection Inflammation Repair

摘　　要：目的:研究多囊卵巢综合征(PCOS)患者胰岛素抵抗与性激素、脂类以及超敏C反应蛋白(hs-CRP)的关系。方法:选取2018年7月-2019年5月在南京医科大学第一附属医院就诊的PCOS患者160例,检测其血清空腹胰岛素(FIN)、空腹血糖、超敏C反应蛋白(hs-CRP)、性激素结合蛋白(SHBG),脂代谢指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)]、性激素指标[卵泡刺激素(FSH)、黄体生成素(LH)、泌乳素(PRL)、睾酮(Testo)、雌二醇(E2)、孕酮(Prog)、硫酸脱氢表雄酮(DHEA)]和生长激素(GH),通过稳态模式评估法(HOMA)计算纳入研究对象的胰岛素抵抗指数(HOMA-IR),并对其与上述指标的关系进行统计分析。结果:51.88%(83/160例)的PCOS患者存在胰岛素抵抗,以胰岛素抵抗指数(HOMA-IR)>2.69即为胰岛素抵抗为标准,将患者分为胰岛素抵抗组(83例)和非胰岛素抵抗组(77例),两组年龄差异无显著性(P>0.05)。Pearson检验显示,血清FIN(r=0.9874)、空腹血糖(r=0.5442)、TG(r=0.3932)、DHEA(r=0.1977)、LDL-C(r=0.2473)、hs-CRP(r=0.5076)与HOMA-IR呈正相关(P<0.05);SHBG(r=-0.6173)、PRL(r=-0.2965)、E2(r=-0.2633)、Prog(r=-0.2908)、GH(r=-0.3690)与HOMA-IR呈负相关(P<0.05)。胰岛素抵抗组PRL、E2、Prog、GH、SHBG水平明显低于非胰岛素抵抗组(P<0.05),TG、LDL-C、hs-CRP水平明显高于非胰岛素抵抗组(P<0.05)。结论:PCOS患者存在胰岛素抵抗现象,血清FIN、空腹血糖、DHEA水平随HOMA-IR增高而增高,SHBG反之,血清PRL、E2、Prog、GH水平随HOMA-IR增高而降低。伴胰岛素抵抗的PCOS患者血清hs-CRP、TG、LDL-C水平明显增高,这3个指标与心血管事件相关,临床治疗中需要密切监测其水平变化以便更好地预防和治疗。Objective:To investigate the correlation of insulin resistance with sex hormones,lipids and hypersensitive C-reactive protein(hs-CRP)in patients with polycystic ovary syndrome(PCOS).Methods:One hundred and sixty patients with PCOS admitted from July 2018 to May 2019 in the First Affiliated Hospital of Nanjing Medical University were involved in the study.Levels of serum fasting insulin(FIN),fasting blood glucose(FBG),hs-CRP,sex hormone binding protein(SHBG),lipid metabolism index including total cholesterol(TC),triglyceride(TG)and low density lipoprotein-cholesterol(LDL-C)and sex hormone related parameters including follicle stimulating hormone(FSH),luteinizing hormone(LH),prolactin(PRL),testosterone(Testo),estradiol(E2),progesterone(Prog),dehydroepiandrosterone sulfate(DHEA),growth hormone(GH)were measured.Homeostasis model assessment-insulin resistance(HOMA-IR)was calculated by steady-state model assessment method and its relationships with the above indicators were analyzed,respectively.Results:Of 160 PCOS patients,51.88%(83/160 cases)had insulin resistance.According to HOMA-IR,they were divided into insulin resistance(IR)group(HOMA-IR>2.69)and non-IR group(HOMA-IR<2.69),with no difference in age between the two groups(P>0.05).Pearson analysis results showed that HOMA-IR was positively correlated with serum FIN(r=0.9874),FBG(r=0.5442),TG(r=0.3932),DHEA(r=0.1977),LDL-C(r=0.2473),hs-CRP(r=0.5076)and negatively correlated with SHBG(r=-0.6173),PRL(r=-0.2965),E2(r=-0.2633),Prog(r=-0.2908)and GH(r=-0.3690)with significant difference(P<0.05).The levels of PRL,E2,Prog,GH and SHBG were lower but TG,LDL-C,hs-CRP were higher in PCOS with IR group than in PCOS without IR group(P<0.05).Conclusions:Insulin resistance exists in a considerable part of PCOS patients.Leves of serum FIN,FBG and DHEA increase with HOMA-IR while SHBG,PRL,E2,Prog and GH levels decrease with the increase of HOMA-IR.The serum levels of hs-CRP,TG and LDL-C are higher in PCOS patients with IR,they need to be monitored in clinic because of the close cor

关 键 词：胰岛素抵抗 脂类 性激素 超敏C反应蛋白 性激素结合蛋白 生长激素 

分 类 号：R711[医药卫生—妇产科学]