多囊卵巢综合征患者胰高血糖素水平及临床意义

Glucagon level and its clinical significance in patients with polycystic ovary syndrome

目的探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者胰高血糖素(glucagon,GCG)水平变化及临床意义。方法选取2018年1月至2020年8月因月经异常或不孕症就诊于湖北医药学院附属东风医院内分泌科或妇科门诊的186例PCOS患者作为研究对象,按稳态模型胰岛素抵抗指数(insulin homeostasis model index,HOMA-IR)分为胰岛素抵抗组(IR组)、非胰岛素抵抗组(NIR组),比较两组患者肥胖、性激素水平以及糖代谢水平,分析GCG与各项指标之间的相关性。结果IR组肥胖率、体质量指数(body mass index,BMI)、硫酸脱氢表雄酮(dehydroepiandrosterone sulfate,DHEAS)、雄烯二酮(androstenedione,AND)、餐后2 h血糖(2 h postprandial blood glucose,2hPG)、餐后2 h胰岛素(2 h postprandial insulin,2hINS)及餐后2 h胰高血糖素(2 h postprandial glucagon,2hGCG)、HOMA-IR、胰岛β细胞功能指数(isletβcell function index,HOMA-β)均高于NIR组,黄体生成素(luteinizing hormone,LH)、LH/促卵泡生成素(follicle stimulating hormone,FSH)、胰岛素敏感指数(insulin sensitivity index,ISI)均低于NIR组,差异均有统计学意义(P<0.05)。Pearson相关分析显示,PCOS患者空腹胰高血糖素(fasting glucagon,FGCG)与空腹血糖(fasting blood glucose,FBG)及性激素无明显相关性,差异无统计学意义(P>0.05);与空腹胰岛素(fasting insulin,FINS)、BMI、HOMA-IR、HOMA-β均呈明显的正相关,与ISI呈明显的负相关,差异有统计学意义(P<0.01)。结论GCG与PCOS患者肥胖及糖代谢紊乱相关。

Objective To investigate the changes and clinical significance of glucagon(GCG)level in patients with polycystic ovary syndrome(PCOS).Methods According to the insulin homeostasis model index(HOMA-IR),186 patients with PCOS were divided into insulin resistance group(IR group)and non-insulin resistance group(NIR group).The differences in obesity,sex hormones and glucose metabolism between the two groups were compared,and the correlation between glucagon and various indexes was analyzed.Results The obesity rate,body mass index(BMI),dehydroepiandrosterone sulfate(DHEAS),androstenedione(AND),2 h postprandial glucose(2 hPG),2 h postprandial insulin(2 hINS)and 2 h postprandial glucagon(2 hGCG),HOMA-IR and isletβcell function index(HOMA-β)in IR group were all higher than those in NIR group,while luteinizing hormone(LH),luteinizing hormone/follicle stimulating hormone(LH/FSH)and insulin sensitivity index(ISI)were significantly lower than those in NIR group(P<0.05).Pearson correlation analysis showed that fasting glucagon(FGCG)was not significantly correlated with fasting blood glucose(FBG)or sex hormones,but positively correlated with fasting insulin(FINS),BMI,HOMA-IR and HOMA-β,and negatively correlated with ISI in patients with PCOS(P<0.01).Conclusion GCG is related to obesity and glucose metabolism disorder in PCOS patients.