多囊卵巢综合征血清中vaspin、KLK7表达水平及其与胰岛素抵抗相关性分析  

Analysis of vaspin and KLK7 expression levels and their correlation with insulin resistance in polycystic ovary syndrome

作　　者：于京京 高彩虹[1] 郝晓莹[2] Yu Jingjing;Gao Caihong;Hao Xiaoying(Shanxi Medical University,Second Hospital of Shanxi Medical University,Taiyuan Shanxi 030001,P.R.China;Department of Obstetrics and Gynecology,Second Hospital of Shanxi Medical University,Taiyuan Shanxi 030001,P.R.China)

机构地区：[1]山西医科大学,山西太原030001 [2]山西医科大学第二医院妇产科,山西太原030001

出　　处：《中国计划生育和妇产科》2024年第5期51-55,60,I0001,共7页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的检测多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者血清中人内脏脂肪特异性丝氨酸蛋白酶抑制剂(vaspin)和人组织激肽释放酶7(human kallikrein related petidase,KLK7)表达水平,比较PCOS患者与非PCOS患者血清中两者的表达差异,并分析两者与胰岛素抵抗(insulin resistance,IR)之间的相关性。方法选取2021年4月至2022年8月就诊于山西医科大学第二医院且符合2003年鹿特丹诊断标准的18~35岁PCOS患者94例纳入PCOS组,将年龄相匹配的健康体检女性和(或)由于男方因素和(或)女方单纯因输卵管原因导致不孕的31例患者纳入NC组。根据胰岛素抵抗指数(HOMA-IR)分为IR组和NIR组,PCOS患者分为PCOS伴IR组(PCOS+IR组)和PCOS不伴IR组(PCOS+NIR组)。比较各组间vaspin、KLK7的表达水平,并分析两者与HOMA-IR之间的关系。结果①PCOS组中vaspin、KLK7、HOMA-IR、FINS水平高于NC组,差异有统计学意义(P<0.05)。②与NIR组比较,IR组中FBG、PBG、FINS、HOMA-IR、vaspin、KLK7水平升高,差异有统计学意义(P<0.05)。③PCOS+IR组中FBG、PBG、FINS、HOMA-IR、vaspin、KLK7显著高于PCOS+NIR组,差异有统计学意义(P<0.05)。④Vaspin与PBG、FINS、HOMA-IR、TG、LDL-C、KLK7呈正相关,与HDL-C呈负相关(P<0.05);KLK7与LH、T、PBG、FINS、HOMA-IR、vaspin呈正相关,且与HDL-C呈负相关(P<0.05)。⑤矫正其他变量之后行二元Logistic回归分析得出KLK7、LH是PCOS的独立危险因素(PKLK7=0.01、PLH=0.003)。⑥通过ROC曲线分析,KLK7和LH在诊断PCOS方面有一定的价值,二者联合具有更高的诊断价值。结论PCOS患者血清中vaspin、KLK7不同程度升高,且vaspin、KLK7与HOMA-IR呈正相关,提示vaspin、KLK7高表达参与了PCOS中IR发生发展;升高的vaspin与KLK7具有相关性;KLK7还可能具有预测PCOS的价值,联合LH预测价值更高。Objective The expression levels of adipokine human visceral fat-specific serine protease inhibitor(vaspin)and human kallikrein related peptidase 7(KLK7)in the patients with polycystic ovary syndrome(PCOS)were examined.Compared the differential expression of vaspin and KLK7 in the serum between PCOS patients and non-PCOS patients,and the correlation between vaspin and KLK7 and insulin resistance(IR)was analyzed.Methods Selected 94 PCOS patients aged 18~35 years from April 2021 to August 2022 in the Second Hospital of Shanxi Medical University who met the 2003 diagnostic criteria for Rotterdam as PCOS group,randomly selected 31 patients age-matched physical examination of healthy women and(or)due to male factors and(or)female infertility as NC group.All subjects were divided into IR group and NIR group according to the insulin resistance index(HOMAIR),and PCOS patients were divided into PCOS with IR(PCOS+IR)and PCOS without IR(PCOS+NIR).The expression of vaspin,KLK7 was compared among different groups and analyzed the relationship with HOMA-IR.Results①The levels of vaspin,KLK7,HOMA-IR and FINS in PCOS group were higher than in NC group,which were statistically significant(P<0.05).②Compared with the NIR group,the FBG,PBG,FINS,HOMA-IR,vaspin,and KLK7 levels were higher in the IR group,which were statistically significant differences(P<0.05).③FBG,PBG,FINS,HOMA-IR,vaspin,and KLK7 in PCOS+IR group were significantly higher than in PCOS+NIR group,which were statistically significant differences(P<0.05).④Vaspin was positively correlated with PBG,FINS,HOMA-IR,TG,LDL-C,and KLK7,and was negative correlation with HDL-C(P<0.05);KLK7 was positively correlated with LH,T,PBG,FINS,HOMA-IR,and vaspin(P<0.05).And showed a negative correlation with HDL-C(P<0.05).⑤After correction of other variables,the results with a binary Logistic regression analysis prompted that KLK7 and LH were independent risk factors for PCOS(PKLK7=0.01,PLH=0.003).⑥Through the ROC curve analysis,KLK7 and LH have certain value in the diagnosis of PC

关 键 词：多囊卵巢综合征 胰岛素抵抗 人内脏脂肪特异性丝氨酸蛋白酶抑制剂 人组织激肽释放酶7 

分 类 号：R711.75[医药卫生—妇产科学]