PTX-3和COX-2在多囊卵巢综合征患者中的表达及其与胰岛素抵抗的关系  

Expression of PTX-3 and COX-2 in patients with polycystic ovary syndrome and their relationship with insulin resistance

作　　者：宋阳阳[1] 高洁凡[1] 黄晓 张丹 王东晖[1] Song Yangyang;Gao Jiefan;Huang Xiao;Zhang Dan;Wang Donghui(Department of Reproductive Medicine,Cangzhou Central Hospital,Cangzhou 061000,China)

机构地区：[1]沧州市中心医院生殖医学科,沧州061000

出　　处：《中华内分泌外科杂志（中英文）》2024年第6期812-817,共6页Chinese Journal of Endocrine Surgery

基　　金：河北省2022年度医学科学研究课题计划项目(20220341)。

摘　　要：目的分析正五聚蛋白-3(PTX3)和环氧化酶-2(COX-2)在多囊卵巢综合征(PCOS)患者中的表达及其与胰岛素抵抗的关系。方法选取2020年12月至2023年3月在沧州市中心医院诊治的150例PCOS患者作为研究对象,根据胰岛素抵抗指数(HOMA-IR)分为胰岛素抵抗组68例,非胰岛素抵抗组82例,另选取同期健康体检者150例作为对照组;采用酶联免疫吸附法(ELISA)检测血清PTX-3和COX-2水平;采用Pearson法分析血清PTX-3和COX-2水平相关性及二者与一般资料的相关性;采用Logistic回归分析PCOS患者胰岛素抵抗的影响因素;受试者工作特征(ROC)曲线来分析血清PTX-3和COX-2对PCOS患者胰岛素抵抗的诊断价值。结果胰岛素抵抗组和非胰岛素抵抗组空腹血糖(FBG)、空腹胰岛素(FINS)、HOMA-IR、睾酮(T)、雌二醇(E2)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、PTX-3和COX-2水平显著高于对照组(P<0.05),高密度脂蛋白胆固醇(HDL-C显著低于对照组(P<0.05),且胰岛素抵抗组FBG、FINS、HOMA-IR、T、E2、TC、TG、LDL-C、PTX-3和COX-2水平显著高于非胰岛素抵抗组(P<0.05),HDL-C显著低于非胰岛素抵抗组(P<0.05)。根据Pearson相关性分析得知,血清PTX-3和COX-2水平呈正相关(r=0.587,P<0.05),二者均与FBG、FINS、HOMA-IR、E2、T、TC、TG和LDL-C呈正相关,与HDL-C呈负相关。根据Logistic回归分析得知,PTX-3、COX-2、FBG、FINS、HOMA-IR升高是影响PCOS患者胰岛素抵抗的危险因素(P<0.05)。根据ROC曲线得知,二者联合诊断PCOS患者胰岛素抵抗的AUC优于PTX-3和COX-2各自单独诊断(Z_(联合vs PTX-3)=2.205、Z_(联合vs COX-2)=2.703,P均<0.05)。结论PTX-3和COX-2在PCOS患者血清中表达水平显著升高,二者与胰岛素抵抗密切相关,二者联合可提高PCOS患者胰岛素抵抗的诊断价值。ObjectiveTo analyze the expression of pentraxin-3(PTX-3)and cyclooxygenase-2(COX-2)in patients with polycystic ovary syndrome(PCOS)and their relationship with insulin resistance.Methods:A total of 150 PCOS patients diagnosed and treated in our hospital from Dec.2020 to Mar.2023 were collected as the study subjects.According to the insulin resistance index(HOMA-IR),68 cases were in the insulin resistance group and 82 cases in the non insulin resistance group.150 healthy individuals who underwent physical examination were included into the control group;Enzyme linked immunosorbent assay(ELISA)was applied to detect serum levels of PTX-3 and COX-2;Pearson method was applied to analyze the correlation between serum PTX-3 and COX-2 levels,and their correlation with general data;Logistic regression was applied to analyze the influencing factors of insulin resistance in PCOS patients;Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum PTX-3 and COX-2 for insulin resistance in PCOS patients.Results:Fasting blood sugar(FBG)[(5.46±1.12),(4.71±1.03)mmol/L]in insulin-resistant and non-insulin-resistant groups,fasting insulin(FINS),HOMA-IR,testosterone(T),estradiol(E2),total cholesterol(TC),triglycerides(TG),LDL cholesterol(LDL-C),PTX-3,and COX-2 were significantly higher than those in the control group(P<0.05),HDL cholesterol(HDL-C)were significantly lower than those in the control group(P<0.05),and the insulin-resistant group FBG,FINS,HOMA-IR,T,E2,TC,TG,LDL-C,PTX-3 and COX-2 levels were significantly higher than those in the non-insulin-resistant group(P<0.05),and HDL-C levels were significantly lower than those in the non-insulin-resistant group(P<0.05).According to Pearson correlation analysis,serum PTX-3 and COX-2 levels were positively correlated(r=0.587,P<0.05),both of which were positively correlated with FBG,FINS,HOMA-IR,E2,T,TC,TG and LDL-C,and negatively correlated with HDL-C.According to Logistic regression analysis,the elevated levels of PTX-3,COX-2,FBG,FINS,and HOMA-

关 键 词：正五聚蛋白-3 环氧化酶-2 多囊卵巢综合征 胰岛素抵抗 

分 类 号：R711.75[医药卫生—妇产科学]