多囊卵巢综合征患者血浆酰化刺激蛋白和瘦素与胰岛素抵抗的关系

Association of plasma acylation stimulating protein and leptin with insulin resistance in patients with polycystic ovary syndrome

目的探讨多囊卵巢综合征(PCOS)患者血浆酰化刺激蛋白(ASP)和瘦素水平的变化及其与胰岛素抵抗(IR)的关系。方法将39例PCOS患者分为肥胖PCOS组和非肥胖PCOS组,42名健康孕龄妇女分为单纯肥胖组和正常体重对照组。测定血浆ASP、瘦素、空腹血糖(FPG)、空腹胰岛素(FIns)水平,并计算胰岛素抵抗指数(HOMA-IR)。结果①与正常体重对照组相比,其余三组ASP水平显著升高(P<0.01);单纯肥胖组和肥胖PCOS组的血浆瘦素水平显著高于正常体重对照组(P<0.05;P<0.01),而非肥胖PCOS组与正常体重对照组无显著性差异(P>0.05);与正常体重对照组相比,非肥胖PCOS组和肥胖PCOS组的HOMA-IR显著升高(P<0.05;P<0.01)。②在PCOS患者中,ASP与FIns、HOMA-IR成正相关(r=0.284,P=0.04;r=0.297,P=0.03);瘦素与BMI、FIns、HOMA-IR成正相关(r=0.677,P<0.01;r=0.609,P<0.01;r=0.588,P<0.01);ASP与瘦素不相关(r=-0.043)。结论PCOS患者存在胰岛素抵抗,其血浆ASP水平显著升高;ASP、瘦素可能与PCOS的胰岛素抵抗有关。

Objective To investigate the levels of plasma acylation stimulating protein （ASP） and leptin and elucidate the correlations among ASP, leptin, HOMA-IR in patients with polycystic ovary syndrome（PCOS）. Methods Thirty-nine women with PCOS were divided into obese PCOS group and nonobese PCOS group and forty-two healthy menstrual age women were divided into obese group and normal weight group. Plasma ASP and leptin were respectively measured by ELASA and RIA. Plasma glucose was determined by glucose oxidase technique and insulin by electrochemiluminescence immunoassay. HOMA-IR was calculated. Results ①Compared with normal weight controls, the concentrations of plasma ASP were significantly higher in the other three groups （P 〈 0.01 ） ;the levels of leptin were significantly higher in both obese and obese PCOS groups than in normoweight controls （ P 〈 0.05 ; P 〈 0.01 ）, but not in nonobese PCOS group（ P 〉 0.05 ） ; compared with normal weight controls, HOMA-IR was significantly higher in nonobese and obese PCOS groups （P 〈 0.05;P 〈 0.01 ）.②In PCOS, ASP correlated positively with Fins and HOMA-IR （ r = 0. 284, P = 0.04 ; r = 0. 297, P = 0.03 ） ; leptin correlated positively with BMI, Fins and HOMA-IR （ r = 0. 677, P 〈 0.01 ; r = 0. 609, P 〈 0.01 ; r = 0. 588, P 〈 0.01 ） ; no correlation between ASP and leptin was found （ r = - 0. 043 ）. Conclusions Insulin resistance exists and plasma ASP level elevates in patients with PCOS. ASP and leptin may both relate with insulin resistance in PCOS.