瘦素、神经肽Y在多囊卵巢综合征胰岛素抵抗中的作用

The Effect of Leptin and Neuropeptide Y on Insulin Resistance of Polycystic Ovary Syndrome

目的探讨瘦素和神经肽Y(NPY)在多囊卵巢综合征(PCOS)发病中的作用。方法采用放射免疫法测定163例PCOS妇女及100例对照组血浆中的瘦素、NPY水平,采用Logistic回归分析法评价瘦素、NPY在PCOS致胰岛素抵抗(IR)作用,线性相关分析瘦素、NPY与胰岛素(Ins)、黄体生成素(LH)、体质量指数(BMI)、游离睾酮(FT)的相互关系。结果(1)PCOS妇女瘦素和NPY水平[分别为(17.1±3.5)μg/L和(76.66±8.73)pmol/L]明显高于对照组[分别为(8.2±1.7)μg/L和(50.54±7.61)pmol/L];(2)PCOS胰岛素抵抗组瘦素、NPY明显高于非胰岛素抵抗组,分别为(20.52±3.41)μg/L和(81.87±7.88)pmol/L,(15.89±2.26)μg/L和(71.99±7.76)pmol/L;(3)瘦素、NPY致PCOS胰岛素抵抗的相对危险度(OR值)分别为1.8581和1.1156。瘦素和NPY、Ins、HOMA IR均呈正相关(r分别为0.837,0.679,0.661,P<0.01)。结论瘦素、NPY是PCOS胰岛素抵抗的风险因子。PCOS妇女瘦素、NPY水平较高,且与FT、LH、胰岛素分泌异常升高有关。

Objective To observe whether abnormal leptin and nearopeptide Y（NPY） production were present in the patients with polycystic ovary syndrome（PCOS）, and whether there were correlation between these hormones and plasma glucose, insulin, HOMA IR. Methods Leptin and NPY concentrations in plasma were determined by immunoradiometric assay and radioimmunoassay respectively in 163 patients with PCOS and 100 cases of control group. Serum levels of FSH, LH, DHEAS, A2, SHBG, PRL and E2 were measured by immunochemiluminometric assay. Results There were significant higher leptin and NPY levels in the patients with PCOS[ （17.1±3.5）gg/L and （76.66 ± 8.73）pmol/L] when compared with that in control group[（8.2±1.7）μ g/L and （50.54±7.61）pmol/L]. The relative risk of leptin and NPY were 1.8581 and 1.1156 respectively. The correlative coefficients between leptin and NPY, Fins, HOMA IR were 0.837, 0.679, 0.661, respectively（P〈0.01）. Conclusion Leptin and NPY were the risk factors of insulin resis- tance in PCOS.