多囊卵巢综合征患者血清、卵泡液固醇调节元件结合蛋白1c、富含亮氨酸的α-2-糖蛋白1水平的变化及与胰岛素抵抗的相关性研究  

Correlation of serum and follicular fluid SREBP1c and LRG1 levels with insulin resistance in PCOS patients

作　　者：贵小婷 黄琦 袁晓英 巴亚超 李昱 张习莹 王茜 张琳 张晗 章莹 廖鑫 Gui Xiaoting;Huang Qi;Yuan Xiaoying;Ba Yachao;Li Yu;Zhang Xiying;Wang Qian;Zhang Lin;Zhang Han;Zhang Ying;Liao Xin(Department of Endocrinology and Metabolism,Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China;Nuclear Medicine Department,Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China;Department of Endocrinology,Jinsha People′s Hospital,Bijie 551800,China)

机构地区：[1]遵义医科大学附属医院内分泌与代谢病科,遵义563000 [2]遵义医科大学附属医院核医学科,遵义563000 [3]毕节市金沙县人民医院内分泌科,毕节551800

出　　处：《中华内分泌代谢杂志》2023年第11期937-943,共7页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金资助项目(82060273);贵州省科技计划项目(黔科合基础-ZK(2021)一般407);贵州省卫健委科学技术基金(gzwkj2022-007)。

摘　　要：目的探究非卵巢病因不孕患者、多囊卵巢综合征(PCOS)伴或不伴胰岛素抵抗(IR)患者血清、卵泡液中固醇调节元件结合蛋白1c(SREBP1c)、富含亮氨酸的α-2-糖蛋白1(LRG1)水平浓度及与IR的相关性。方法回顾性收集PCOS患者49例及同期非卵巢病因不孕患者66例,采用稳态模型评估的胰岛素抵抗指数(HOMA-IR)评估IR程度,分为对照组(非PCOS及IR组,n=36)、IR组(n=30)、单纯PCOS组(PCOS未合并IR组,n=28)及PCOS-IR组(PCOS合并IR组,n=21)。比较各组血清、卵泡液LRG1、SREBP1c水平差异并分析其与相关激素、糖脂代谢指标的相关性。结果与对照组相比,IR组、单纯PCOS组及PCOS-IR组的血清、卵泡液LRG1、SREBP1c水平均明显升高;PCOS-IR组血清、卵泡液LRG1、SREBP1c水平升高更明显(P<0.05)。相关性分析显示,血清、卵泡液LRG1与体重指数、空腹血糖、空腹胰岛素、三酰甘油、HOMA-IR呈正相关(P<0.05);血清、卵泡液SREBP1c与体重指数、LH、总睾酮、硫酸脱氢表雄酮、游离雄激素指数、空腹血糖、空腹胰岛素、三酰甘油、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、HOMA-IR呈正相关(P<0.05)。二元logistic回归分析显示,血清SREBP1c是PCOS的危险因素(P<0.05)。结论PCOS患者尤其是合并IR的PCOS患者的血清、卵泡液LRG1、SREBP1c水平均升高。血清、卵泡液LRG1、SREBP1c水平升高可能与PCOS患者IR及糖脂代谢异常相关。血清LRG1、SREBP1c水平可能作为预测PCOS患者IR,早期诊断及干预PCOS的新指标。Objective To investigate the serum and follicular fluid levels of sterol regulatory element-binding protein 1c(SREBP-1c),leucine-richα-2-glycoprotein 1(LRG1)and the correlation with insulin resistance(IR)in non-ovarian etiology infertility patients and polycystic ovary syndrome(PCOS)patients with or without IR.Methods Forty-nine PCOS patients and 66 infertility patients with non-ovarian etiology were collected in this retrospective study,homeostasis model assessment for insulin resistance(HOMA-IR)was used to evaluate IR,and were divided into control group(n=36),IR group(n=30),PCOS alone group(n=28)and PCOS-IR group(PCOS with IR group,n=21).The concentrations of serum,follicular fluid LRG1 and SREBP1c levels in each group were compared,and their correlation with relevant hormones and glycolipid metabolism were analyzed.Results The levels of serum,follicular fluid LRG1 and SREBP1c in IR group,PCOS alone group and PCOS-IR group were significantly higher than those in control group;The PCOS-IR group showed a more significant increase in the levels of serum,follicular fluid LRG1 and SREBP1c(P<0.05).Correlation analysis showed that serum,follicular fluid LRG1 was positively correlated with body mass index,fasting plasma glucose(FPG),fasting insulin(FINS),triglycerides(TG),and HOMA-IR(P<0.05).Serum,follicular fluid SREBP1c was positively correlated with body mass index,FPG,FINS,TG,total cholesterol,LDL-C,LH,total teststerone,DHEAS,FAI,and HOMA-IR(P<0.05).Binary logistic regression analysis showed that serum SREBP1c was a risk factor for PCOS(P<0.05).Conclusion The serum and follicular fluid levels of LRG1 and SREBP-1c were elevated in PCOS patients,especially in those with IR.The elevated levels of serum and follicular fluid LRG1 and SREBP-1c may be associated with IR and glucose-lipid metabolism abnormalities in PCOS patients.Serum LRG1 and SREBP-1c levels may serve as new indicators for predicting IR,early diagnosis,and intervention in PCOS patients.

关 键 词：多囊卵巢综合征 胰岛素抵抗 固醇调节元件结合蛋白1C 富含亮氨酸的α-2-糖蛋白1 

分 类 号：R711.75[医药卫生—妇产科学]