多囊卵巢综合征患者血清内脂素、脂联素、瘦素的变化及临床意义

Clinical significance and changes of serum visfatin,adiponectin and leptin levels in patients with polycystic ovarian syndrome

目的：研究多囊卵巢综合征（polycystic ovarian syndrome，PCOS）患者血清中内脂素、脂联素、瘦素水平，为阐明PCOS的发病机制提供基础。方法：设POCS组和健康对照组，采用酶联免疫吸附法（enzyme-linked immunosorbentassay，ELISA）和放射免疫法（radioimmunoassay，RIA），检测73例PCOS患者组以及75例年龄和体重指数（body mass index，BMI）相匹配的健康对照组血清内脂素、脂联素、瘦素、性激素水平以及内分泌代谢指标。结果：PCOS组空腹胰岛素（fasting insulin，Fins）、胰岛素抵抗指数（homeostatic model assessment for insulin resistance，HOMA-IR）、睾酮（testosterone，T）、黄体生成素（luteinizing hormone，LH）以及泌乳素（prolactin，PRL）水平高于健康对照组（均P〈0．05），而卵泡刺激素（follicle-stimulating hormone，FSH）水平低于健康对照组（P〈0．001）。PCOS组血清的内脂素和瘦素水平显著高于健康对照组[PCOS组内脂素和瘦素分别为（95．30±31．90）和（11．10±3．87）μg／L，健康对照组分别为（73．20±20．30）和（7．21±2．47）μg／L，均P〈0．001]，而脂联素水平显著低于健康对照组[PCOS组为（4．21±1．17）mg／L，健康对照组为（6．39±1．53）mg／L，P〈0．001]。PCOS纽和健康对照组血清内脂素水平与脂联素呈负相关（分别为r=-0．452和-0．378，均P〈0．01），而两组内脂素水平与瘦素、HOMA-IR呈正相关（r=0．379～0．556，均P〈0．01）。在控制BMI影响后，PCOS组血清内脂素水平与HOMA-IR呈正相关（r=0．462，P〈0．01）。结论：PCOS患者存在高内脂素、高瘦素和低脂联素水平，且内脂素水平与胰岛素抵抗相关联。

Objective To examine the serum visfatin, adiponectin and leptin levels in patients with polycystic ovarian syndrome （PCOS） , and to explore the basis of the pathogenesis of PCOS. Methods A PCOS group （n = 73 ） and a healthy control group （n = 75 ） were included in the study, which were matched in age and body mass index （BMI）. Serum visfatin, adiponectin, leptin, sex hormone levels, and metabolic parameters were measured by enzyme-linked immunosorbent assay （ ELISA ） or radioimmunoassay （ RIA ）. Results Serum levels of fasting insulin （ Fins ） , homeostatic model assessment for insulin resistance （ HOMA-IR ） , testosterone （ T ） , luteinizing hormone （LH）, and prolactin （PRL） in the PCOS group were significantly higher than those in the healthy group（ all P 〈 0. 05 ）, and follicle-stimulating hormone （FSH） level was significantly decreased in the PCOS group. The visfatin and leptin levels in the PCOS group increased significantly than those in the healthy group [PCOS group： （95.30±31.90） and （11. 10±3.87） μg/L; healthy group ： （ 73.20 ± 20.30） and （ 7.21 ± 2.47 ） μg/L, P 〈 0. 001 ]. The adiponectin level was significantly lower than that in the healthy group [ PCOS group： （4.21 ± 1.17） mg/L; healthy group ： （ 6.39 ± 1.53 ） mg/L, P 〈 0.001 ]. Pearson correlation analysis showed that visfatin level was negatively related to adiponectin levels（ r = -0. 452 and -0. 378, P 〈 0.01 ） , but positively related to leptin and HOMA-IR levels in both the PCOS group and the healthy group （ r = 0. 379 - 0. 556, all P 〈 0.01 ）. The correlation remained between the visfatin and HOMA-IR levels in the P- COS group after correcting the influence of BMI. Conclusion Patients with PCOS have high visfatin and leptin levels but low adiponectin levels. Visfatin levels are positively related to insulin resistance.