多囊卵巢综合征患者血清单核细胞趋化蛋白-1水平与血脂代谢的相关性

Monocyte chemoattractant protein-1 and its correlation with lipoprotein inpolycystic ovary syndrome

目的:探讨多囊卵巢综合征(PCOS)患者血清中单核细胞趋化蛋白-1(MCP-1)的变化与血脂代谢的关系。方法:应用ELISA方法检测65例PCOS患者及20例体重指数(BMI)<25kg/m2的正常对照组血清中MCP-1水平,用化学发光法检测血清中泌乳素(PRL)、促黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)和睾酮(T)水平,用放射免疫法检测血清中雄烯二酮(A)水平;同时检测血脂:甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)、脂蛋白(a)LP(a)。根据BMI将PCOS患者分为:肥胖组27例(BMI≥25kg/m2),非肥胖组38例(BMI<25kg/m2)。结果:PCOS组MCP-1(P=0.001)及ApoB(P=0.018)水平明显高于正常对照组,而ApoA/ApoB的比值明显低于正常对照组(P=0.015)。肥胖PCOS患者血清MCP-1水平明显高于非肥胖PCOS患者(P=0.012),非肥胖PCOS患者MCP-1水平明显高于正常对照组(P=0.03)。单因素相关分析显示,MCP-1与BMI(r=0.366,P=0.001),LH(r=0.262,P=0.016),TG(r=0.480,P=0.000)及ApoB(r=0.289,P=0.008)呈正相关,与ApoA/ApoB的比值呈负相关(r=-0.282,P=0.009);控制BMI的偏相关分析显示,MCP-1与LH(r=0.2577,P=0.020)及TG(r=0.4611,P=0.000)呈正相关。多元回归分析显示TG和BMI是影响MCP-1的主要因素,而且TG的影响更大。结论:肥胖与非肥胖PCOS患者血清MCP-1水平均明显升高;MCP-1的升高与BMI,LH,TG,ApoB及ApoA/ApoB的比值有关;TG和BMI是影响PCOS患者血清MCP-1改变的主要因素,而且TG的影响更大;MCP-1可能参与了PCOS的病理生理过程以及PCOS患者远期并发症的发生。

Objective： To measure serum monocyte chemoattractant protein-1 （MCP-1） levels and study its associations with lipoproteins in patients with polycystic ovary syndrome （PCOS）. Methods： Sixty-five PCOS women and 20 ovulating normal women with body mass index （BMI） 〈 25 kg/m^2 as controls were recruited. PCOS women were divided to two groups ： 27 BMI ≥25 kg/m^2 patients as obese group ; 38 BMI 〈 25 kg/m^2 as non-obese group. Serum MCP-1 was assayed by enzyme-linked immunosorbent assays （ELISA）. Serum prolactin （ PRL）, follicle stimulating hormone （ FSH ）, luteinizing （ LH）, estradiol（ E2 ）and testosterone （T） were assayed by chemoluminescence method. Serum androstenedione （A） was assayed by radioimmunity method in patients. And triglycefides （TG）, total cholesterol（TC）, apoprotein A （ ApoA ）, apoprotein B （ ApoB ） , lipoprotein （a） [ LP （a） ], high density lipoprotein （HDL） and low density lipoprotein （LDL） cholesterol （HDL-C and LDL-C） were measured. Results： MCP-1 （P = 0.001 ） and ApoB （P = 0. 018） levels were found to be significantly increased in PCOS groups compared with that of controls, but the ratio of ApoA/ApoB was significantly decreased in groups PCOS（P =0. 015）. PCOS obese group had markedly higher MCP-1 serum levels than non-obese group （P = 0. 012）, and MCP-1 serum levels in PCOS non-obese group higher than controls （P = 0.03 ）. Univariate analysis revealed that serum MCP-1 levels were significantly and positively correlated with BMI （r =0.350, P=0.001）, LH（r=0.262, P=0.016）,TG（r=0.480,P=0.000） and ApoB （r=0.289, P = 0.008 ） ; but significantly and negtively correlated with the ratio of ApoA/ApoB （ r = - 0. 282, P = 0. 009）. Partial correlation showed that serum MCP-1 levels were correlation with LH （ r = 0. 2577, P =0. 020） and TG（ r = 0. 4611, P = 0. 000）. Multiple regression analysis showed that MCP-1 levels was influecenced by BMI and TG. Furthermore, TG showed more effect on MCP-1 levels. Conclusion： PCOS obese and non-obese patients had higher serum MCP-1 levels than controls. MCP-1 was correlated with BMI,LH ,TG, ApoB and the ratio of ApoA/ApoB. BMI and TG were two major determining factors of MCP-1 in patients with PCOS. Furthermore, TG had more effect on MCP-1 levels. Based on the above findings, we presume that MCP-1 is likely to participate in the pathophysiology and long-term complication of PCOS.