瘦素、胰岛素样生长因子-1与多囊卵巢综合征高胰岛素血症的关系

The Relationship Between Leptin, Insulin-like Growth Factor-1 (IGF-1) and Hyperinsulinemia of Patients with Polycystic Ovarian Syndrome

目的了解瘦素、胰岛素样生长因子-1(IGF-1)与多囊卵巢综合征(PCOS)高胰岛素血症间的关系,探讨相关发病机制。方法采用病例-对照的方法,实验分为PCOS组(92例)和对照组(92例),其中PCOS组又分为PCOS-高胰岛素血症组(46例)和PCOS-非高胰岛素血症组(46例)。通过放免法检测血清瘦素、胰岛素样生长因子-1、睾酮、双氢睾酮、脱氢表雄酮、硫酸脱氢表雄酮等的水平,葡萄糖氧化酶法检测血糖水平。结果PCOS组瘦素(16.8±9.8ng/mL)、IGF-1水平(214.8±131.6ng/mL)明显高于对照组(分别为11.6±6.8ng/mL、118.0±82.9ng/mL)(P<0.05)。PCOS患者中高胰岛素组瘦素水平(19.2±10.2ng/mL)明显高于正常胰岛素组(12.5±7.6ng/mL)(P<0.05),IGF-1及空腹血糖在两组间差异无统计学意义。多元逻辑回归结果显示,在调整了体重指数、睾酮、黄体生成素/卵泡刺激素比值、双氢睾酮、脱氢表雄酮、硫酸脱氢表雄酮等因素后,瘦素、IGF-1均是PCOS的危险因素,但均不是高胰岛素血症的危险因素。结论瘦素、IGF-1可能与PCOS的发病机制有关,但与高胰岛素血症的关系有待进一步探讨。

Objective To identify the effect of IGF-1 and leptin on the hyperinsulinemia （HI） of patients with polycystic ovarian syndrome （PCOS）. Methods The case-control compared method was applied to the study. Ninety-two PCOS and 92 control subjects were involved in the study. The group of PCOS was further divided into two subgroups of 46 PCOS-HI and 46 PCOS-NHI. The leptin, IGF-1 and other hormones such as serum testosterone, DHT, DHEA, DHEA-S were measured by RIA method. Results Leptin and IGF-1 were higher in PCOS group （16.8±9.8 ng/mL, 214.8±131.6 ng/mL） than those in control group （11.6± 6.8 ng/ mL, 118. 0±82.9 ng/mL respectively, P〈0. 05）. Serum leptin level was higher in hyperinsulinemia group （9.2± 10.2 ng/mL） than that in normal insulin group （12. 5±7.6 ng/mL,P〈0. 05）. IGF-1 （208. 7±109.7 ng/mL vs. 151.7±120. 0 ng/mL, P=0. 66）and fasting glucose （5.1±0. 5 mmol/L vs. 4.9±0.4 retool/L, P=0. 15） had no significant difference between two groups. Multiple logistic regression showed that after the body mass index （BMI） adjusted, the testosterone, LH/FSH, DHT, DHEA, and DHEA-S, leptin and IGF-1 showed to be the independent risk factor for PCOS, but not to be for hyperinsulinemia in patients with PCOS. Conclusion The leptin and IGF-1 may contribute to the pathogenesis of PCOS, but the relationship between leptin, IGF-1 and hyperinsulinemia needs more researches to confirm.