多囊卵巢综合征患者血清25-羟维生素D3水平与慢性炎性反应、胰岛素抵抗的相关性  

Correlation of serum 25-hydroxyvitamin D3 with chronic inflammation and insulin resistance in polycystic ovarian syndrome patients

作　　者：黄兴全 侯凤香[2] 谢小谢 姜兰叶[1] 安阳 Huang Xingquan;Hou Fengxiang;Xie Xiaoxie;Jiang Lanye;An Yang(Department of Endocrinology,Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,China;Department of Pediatrics,Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,China)

机构地区：[1]河北北方学院附属第二医院内分泌科,张家口075100 [2]河北北方学院附属第二医院儿科,张家口075100

出　　处：《中国医师进修杂志》2023年第6期512-516,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨多囊卵巢综合征(PCOS)患者血清25-羟维生素D3[25(OH)D3]水平与慢性炎性反应、胰岛素抵抗的相关性。方法回顾性选择河北北方学院附属第二医院2018年1月至2020年1月诊治的124例PCOS患者,依据体质量指数(BMI)分为PCOS 1组(BMI<25 kg/m^(2),64例)和PCOS 2组(BMI≥25 kg/m^(2),60例),同时选取60例单纯性肥胖患者(肥胖组)和58例健康体检者(对照组),测量各组人体学指标、性激素指标、血清25(OH)D3水平、胰岛素抵抗(IR)相关指标及慢性炎性因子水平,分析血清25(OH)D3水平与各指标的相关性。结果四组BMI、腰臀比、睾酮(T)、黄体生成素(LH)/卵泡刺激素(FSH)、游离雄激素指数(FAI)、空腹胰岛素(FINS)、空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)比较差异有统计学意义(P<0.05);PCOS 2组25(OH)D3水平低于PCOS 1组[(1.14±0.36)nmol/L比(1.83±0.25)nmol/L](P<0.05);PCOS 2组FINS、HOMA-IR高于PCOS 1组、肥胖组及对照组[(13.26±2.61)mg/L比(5.58±1.03)、(6.63±1.42)、(4.66±0.85)mg/L,1.49±0.37比1.15±0.20、1.12±0.22、0.96±0.11](P<0.05),ISI低于PCOS1组、肥胖组及对照组(-4.19±0.78比-3.52±0.74、-3.23±0.53、-3.06±0.54)(P<0.05)。四组白细胞介素6(IL-6)、转化生长因子-β(TGF-β)、肿瘤坏死因子-α(TNF-α)比较差异有统计学意义(P<0.05);PCOS2组IL-6水平高于PCOS1组[(18.15±4.93)ng/L比(14.77±4.58)ng/L](P<0.05)。Pearson相关分析结果表明,血清25(OH)D3水平与IL-6、BMI、腰臀比、T、FINS、ISI、TGF-β及TNF-α呈负相关(r=-0.582、-0.242、-0.371、-0.203、-0.208、-0.267、-0.723、-0.617,P<0.05)。结论PCOS患者血清25(OH)D3水平变化与慢性炎性反应、IR相关,并可能参与PCOS的发生及发展。Objective To discuss the correlation of serum 25-hydroxyvitamin D3[25(OH)D3]with chronic inflammation and insulin resistance(IR)in polycystic ovarian syndrome(PCOS)patients.Methods One hundred and twenty-four PCOS patients registered from January 2018 to January 2020 in the Second Affiliated Hospital of Hebei North University were selected retrospectively.According to the difference of body mass index(BMI),the patients were divided into PCOS 1 group(BMI<25 kg/m^(2),64 cases)and PCOS 2 group(BMI≥25 kg/m^(2),60 cases).At the same time,60 patients with simple obesity were selected as the obesity group and 58 healthy subjects were selected as the control group.The somatology indicators,gonadal hormone,serum 25(OH)D3,insulin resistance(IR)related index and chronic inflammation factors were measured,the correlations of serum 25(OH)D3 with relevant indicators were analyzed by Pearson correlation analysis.Results The BMI,waist hip ratio,testosterone(T),luteinizing hormone(LH)/follicle-stimulating hormone(FSH),free androgen index(FAI),fasting insulin(FINS),fasting plasma glucose(FPG),insulin resistance index(HOMA-IR),insulin sensitivity index(ISI)in the four groups had significant differences(P<0.05);the level of 25(OH)D3 in the PCOS 1 group was lower than that in the PCOS 2 group:(1.14±0.36)nmol/L vs.(1.83±0.25)nmol/L,P<0.05;the levels of FINS,HOMA-IR in the PCOS 2 group were higher than those in the PCOS 1 group,obesity group and control group:(13.26±2.61)mg/L vs.(5.58±1.03),(6.63±1.42),(4.66±0.85)mg/L,1.49±0.37 vs.1.15±0.20,1.12±0.22,0.96±0.11,P<0.05;the level of ISI in the PCOS 2 group was lower than that in the PCOS1 group,obesity group and control group:-4.19±0.78 vs.-3.52±0.74,-3.23±0.53,-3.06±0.54,P<0.05.The levels of interleukin-6(IL-6),transforming growth factor-β(TGF-β),tumor necrosis factor-α(TNF-α)in the four groups had significant differences(P<0.05);the level of IL-6 in the PCOS 2 group was higher than that in the PCOS 1 group:(18.15±4.93)ng/L vs.(14.77±4.58)ng/L,P<0.05.The results of

关 键 词：慢性炎性反应 单纯性肥胖 腰臀比 睾酮(T) 人体学 Pearson相关分析 白细胞介素6 河北北方学院 

分 类 号：R711.75[医药卫生—妇产科学]