PAI-1基因4G/5G多态性与PCOS糖代谢、肥胖的相关性研究

4G/5G Polymorphism of Plasminogen Activator Inhibitor-1(PAI-1) Gene in Polycystic Ovarian Syndrome and its Correlation with Glucose Metabolism and Obese Status

目的:探讨纤溶酶原激活物抑制因子-1(PAI-1)基因启动子4G/5G多态性与多囊卵巢综合征(PCOS)糖代谢、肥胖的关系。方法:PCR-RFLP法检测42例正常育龄妇女,101例PCOS患者[根据糖代谢情况分为A、B、C组;根据体重指数(BMI)分为肥胖、非肥胖组]PAI-1基因启动子4G/5G位点插入或缺失多态性,比较组间多态基因型分布及体重指数(BMI)、胰岛素抵抗指数(Homa-IR)、胰岛素敏感指数(ISI)。结果:①BMI、Homa-IR指标PCOS糖代谢C组>B组>A组、肥胖PCOS组>非肥胖PCOS组,ISI则相反,差异均有显著性(P<0.05)。②PCOS组不同糖代谢组PAI-1基因4G/5G多态基因型分布无差异,但PCOS组、PCOS糖代谢异常C组与对照组、PCOS非肥胖组与肥胖组之间比较有统计学差异(χ2=4.439、4.018、4.151;P均<0.05);4G型(4G/4G基因型)PCOS组、PCOS糖代谢异常C组与非肥胖PCOS组分布显著高于相应对照组与肥胖PCOS组;5G型(4G/5G+5G/5G基因型)分布相反。结论:①PCOS患者高PAI-1 4G/4G多态基因型,可能是其高PAI-1活性现象的重要遗传基础。②PAI-1基因启动子4G/5G多态性可能与PCOS患者糖代谢异常、非肥胖PCOS发病、病情进展有关。

Objective; To investigate the correlation of 4G/SG polymorphism of plasminocjen activator inhibitor-1 （PAl-l） gene with the glucose metabolism and obese status of polycystic ovary syndrome （PCOS）. Methods：4G/ 5G polymorphism of PAI-1 gene was detected by PCR-RFLP method in 42 controls and 101 PCOS patients who were divided into three groups：normal glucose tolerance without or with hypednsulinemia （group A and B） and abnormal glucose tolerance group （ group C）. Body Mass Index （BMI）, insulin resistance （Homa-IR） and insulin sensitivity indices （ISI） are compared between the groups. Results： In PCOS patients, BMI, Homa-IR were significantly higher in group C than those of group B and group A. BMI and Homa-IR were higher in obese PCOS than those in non-obese PCOS, while I Sl is just the opposite. （ P 〈 0.05）. The distribution of PAl-1 gene genotype between PCOS and control, C subgroup and control and between non-obese and obese PCOS group are different （X^2 =4.439; 4.018;4.012; P〈0.05）：4G genetype （4G/4G genotype） is higher and 5G genetype （5G/5G and 4G/5G genotype ） were lower in PCOS group,PCOS subgroup C and non-obese PCOS group than that of each control group. Conclusions ： High expression of 4G/4G genotype in PAI-1 gene 4G/5G polymorphism may play an important genetic role in the increased PAI-1 levels in PCOS patients. It may also be correlated with abnormal glucose metabolism in PCOS patients and the development of PCOS especially in non-obese patients.