PCOS患者胰岛素释放试验峰值后移与胰岛素分泌总量及敏感性的特征分析  

Analysis of the Relationship between the Peak Shift of Insulin Release Test and Total Insulin Secretion and Sensitivity in Patients with PCOS

作　　者：朱琳[1] 林延润 杨发达[1] 陈跃瑜[1] 谢煜楠[1] ZHU Lin;LIN Yan-run;YANG Fa-da;CHEN Yue-yu;XIE Yu-nan(Department of Clinical Laboratory,Nanhai District Maternal and Child Health Hospital of Foshan City,Guangdong Foshan 528200,China)

机构地区：[1]佛山市南海区妇幼保健院检验科,广东佛山528200

出　　处：《现代检验医学杂志》2022年第5期154-158,共5页Journal of Modern Laboratory Medicine

基　　金：2020年佛山市自筹经费类科技计划项目(医学类科技攻关项目):多囊卵巢综合征患者性激素水平与胰岛素释放峰值后移的相关性研究;项目管理单位:佛山市科学技术局;编号:2020001004478。

摘　　要：目的分析胰岛素释放试验(insulin release test,IRT)峰值后移的多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者的胰岛素分泌特征,探讨胰岛素峰值后移对胰岛素敏感度的影响。方法回顾性分析2019年11月~2021年12月在佛山市南海区妇幼保健院妇科就诊的PCOS患者120例。首次就诊时行空腹血糖(fasting plasma glucose,FPG)和IRT检测,根据IRT的峰值时间进行分组,峰值时间在30min为I_(30)组(n=30),在60min为I_(60)组(n=30),在120min为I_(120)组(n=30)和在180min为I_(180)组(n=30)。比较四组FPG和IRT各时间点血浆胰岛素水平的差异,通过公式计算出胰岛素敏感指数(insulin sensitivity index,ISI)、胰岛素抵抗指数(insulin resistance index,IRI)和胰岛素曲线下面积(area under the curve,AUC),比较这三个指标以及峰值的血浆胰岛素水平在四组的差异,通过Pearson相关性分析探讨峰值后移与胰岛素分泌总量和胰岛素敏感度指标的相关性。结果①单因素方差分析显示四组的FPG和30min的胰岛素水平差异无统计学意义(F=1.795,1.780,均P>0.05),但达峰时间影响空腹和60,120,180min的胰岛素分泌量,差异均有统计学意义(F=9.355~24.170,均P<0.05)。②四组ISI和AUC差异无统计学意义(F=1.906,0.492,均P>0.05),而IRI和峰值的胰岛素值从I_(30)组到I_(180)组均呈递增趋势,差异有统计学意义(F=10.360,5.140,均P<0.05)。③Pearson相关性分析表明ISI,AUC与峰值后移无相关性(r=-0.077,-0.014,均P>0.05),IRI和峰值的胰岛素水平与峰值后移呈显著正相关(r=0.359,0.335,均P=0.000)。结论PCOS患者胰岛素峰值后移对空腹和60,120,180min的胰岛素分泌量有影响;随着胰岛素峰值后移,峰值的胰岛素水平和胰岛素抵抗程度增加,但胰岛素敏感性和胰岛素分泌总量变化不明显。Objective To analyze the characteristics of total insulin secretion in patients with polycystic ovary syndrome(PCOS)with peak value shifted backward in insulin release test(IRT)and to explore the effect of Insulin peak shift on insulin sensitivity.Methods A retrospective analysis was made of 120 women with PCOS were enrolled from November 2019 to December 2021 at Nanhai District Maternal and Child Health Hospital in Foshan.Fasting plasma glucose(FPG)and IRT were performed at the first visit.According to the peak time of insulin release test,the peak value appeared at 30min in I_(30) group(n=30),at 60min in I_(60) group(n=30),at 120min in I_(120) group(n=30),and the peak value at 180min was I_(180) group(n=30).The differences of FPG and plasma insulin level at each time point of IRT in four groups were analyzed and Insulin Sensitivity Index(ISI),Insulin Resistance Index(IRI),area under curve(AUC)of insulin and the peak insulin values were calculated,and the differences of these four indexes among the four groups were compared.Pearson correlation analysis was used to investigate the correlation between peak shift and total insulin secretion and sensitivity.Results①Univariate analysis of variance showed that there was no significant difference in FPG and plasma insulin level at 30min(F=1.795,1.780,all P>0.05),but the peak time of insulin secretion affected insulin levels at fasting and 60,120,180min,and there were significantly different among the four groups(F=10.740~24.170,all P<0.05).②ISI and AUC were not significantly different(F=1.906,0.492,all P>0.05).However,IRI and peak insulin values increased from I_(30) group to I_(180) group,the difference was statistically significant(F=10.360,5.140,all P<0.05).③Pearson correlation analysis showed that there was no correlation between ISI,AUC and Insulin Peak Shift(r=-0.077,-0.014,all P>0.05),IRI and insulin peak shift were positively correlated(r=0.359,0.335,all P<0.000).Conclusion The backward shift of insulin peak in patients with PCOS has an effect on fasting

关 键 词：多囊卵巢综合征 胰岛素 胰岛素释放试验 峰值后移 

分 类 号：R711.75[医药卫生—妇产科学] R446.112[医药卫生—临床医学]