多囊卵巢综合征患者中胰岛素抵抗与子宫内膜局部炎症因子及葡萄糖转运蛋白-4表达的相关性  

Correlation between insulin resistance and expressions of local inflammatory factors and glucose transporter protein type-4 in the endometrium of patients with polycystic ovary syndrome

作　　者：哈灵侠[1,2] 殷婷 吴阳阳 黎维霞 杜玉冬 HA Lingxia;YIN Ting;WU Yangyang;LI Weixia;DU Yudong(Center for Reproductive Medicine,General Hospital of Ningxia Medical University,Yinchuan 750004,Ningxia,China;Key Laboratory of Fertility Preservation and Maintenance,Ministry of Education,Ningxia Medical University,Yinchuan 750004,Ningxia,China)

机构地区：[1]宁夏医科大学总医院生殖医学中心,宁夏银川750004 [2]宁夏医科大学生育力保持教育部重点实验室,宁夏银川750004

出　　处：《山东大学学报（医学版）》2021年第11期41-47,共7页Journal of Shandong University:Health Sciences

基　　金：宁夏自然科学基金(2019AAC03190)。

摘　　要：目的探讨子宫内膜局部炎症因子及葡萄糖转运蛋白-4(GLUT-4)在多囊卵巢综合征(PCOS)患者子宫内膜上的表达,分析PCOS患者胰岛素抵抗与子宫内膜炎症因子及GLUT-4表达的相关性。方法选取2018年6月至2020年7月就诊的60例PCOS患者,根据胰岛素抵抗指数(HOMA-IR)分为PCOS胰岛素抵抗组(A组,n=30)和PCOS非胰岛素抵抗组(B组,n=30);选取同期的60例非PCOS患者作为对照,分为胰岛素抵抗组(C组,n=30)和正常对照组(D组,n=30)。检测血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))、睾酮(T)、泌乳素(PRL)、抗苗勒氏管激素(AMH)、空腹血糖及胰岛素水平。采用免疫组化法检测4组患者子宫内膜肿瘤坏死因子-α(TNF-α)、核因子-κB(NF-κB)p65、GLUT-4的表达。结果 (1)4组患者间BMI、AMH、LH、T比较,差异有统计学意义(F值分别为57.35、29.54、16.77、21.20,P<0.001))。其中,与B组相比,A组患者BMI升高;与D组相比,C组患者BMI升高。与C、D组相比,A、B两组患者血清中AMH、LH升高。A组患者血清中T高于B组;(2)4组患者间子宫内膜中NF-κB p65、TNF-α及GLUT-4的表达差异均有统计学意义(F值分别为76.90、 45.13、47.75,P<0.001)。其中,与B组相比,A组患者子宫内膜中NF-κBp65、TNF-α表达升高,而GLUT-4的表达降低。与D组相比,C组患者子宫内膜中NF-κBp65、TNF-α表达升高,而GLUT-4表达降低;(3)Logistic回归分析结果显示,在PCOS及非PCOS患者中,HOMA-IR与NF-κBp65呈正相关(P<0.05),与GLUT-4呈负相关(P<0.05)。在非PCOS患者中,HOMA-IR与BMI呈正相关(P<0.05)。结论 PCOS患者胰岛素抵抗与NF-κBp65及GLUT-4相关,可能会导致子宫内膜局部炎症因子表达增加,GLUT-4表达降低。Objective To explore the expressions of local inflammatory factors and glucose transporter protein type-4(GLUT-4) in the endometrium of patients with polycystic ovary syndrome(PCOS),and to analyze the correlation between insulin resistance(IR) and the expressions of inflammatory factors and GLUT-4.Methods A total of 60 PCOS patients treated during June 2018 and July 2020 were enrolled.Based on the homeostasis model assessment for insulin resistance index(HOMA-IR),the patients were divided into IR PCOS group(n=30) and non-IR PCOS group(n=30).Meanwhile,60 non-PCOS patients were collected and divided into IR group(n=30) and normal control group(n=30).Follicle stimulating hormone(FSH),luteining hormone(LH),estradiol(E_(2)),testosterone(T),prolactin(PRL) and anti-Mullerian hormone(AMH) were detected.The expressions of tumor necrosis factor alpha(TNF-α),nuclear factor-kappa B(NF-κB) and GLUT-4 in the endometrium were detected with immunohistochemistry.Results(1) There were significant differences in body mass index(BMI),AMH,LH and T among the 4 groups(F=57.35,29.54,16.77,21.20,P<0.001).Group A had higher BMI than group B;group C had higher BMI than group D.Groups A and B had higher levels of AMH and LH than groups C and D.Group A had higher T than group B.(2) There were significant differences in expressions of TNF-α,NF-κBp65 and GLUT-4 among the 4 groups(F=76.90,45.13,47.75,P<0.001).Group A had higher expressions of TNF-α and NF-κBp65 but lower GLUT-4 than group B.Group C had higher expressions of TNF-α and NF-κBp65 but lower expression of GLUT-4 than group D.(3)The results of multivariate Logistic regression analysis showed that HOMA-IR was positively correlated with the expression of NF-κBp65 but negatively correlated with the expression of GLUT-4 in PCOS and non-PCOS patients(P<0.05);HOMA-IR was positively correlated with BMI in non-PCOS patients(P<0.05).Conclusion Insulin resistance is associated with NF-κBp65 and GLUT-4 in PCOS patients.It may increase the expressions of local inflammatory factors and d

关 键 词：多囊卵巢综合征 胰岛素抵抗 核因子-ΚB 肿瘤坏死因子-Α 葡萄糖转运蛋白-4 

分 类 号：R711.71[医药卫生—妇产科学]