多囊卵巢综合征及高雄激素血症患者血中ghrelin水平的变化

Plasma ghrelin levels in women with polycystic ovary syndrome and in hyperandrogenic women

目的:目前,在国内尚无关于多囊卵巢综合征(PCOS)患者中ghrelin水平的研究报道,文中检测PCOS患者、高雄激素血症者血中ghrelin的水平变化;并研究ghrelin与PCOS患者的体质指数(BMI)、胰岛素(INS)、胰岛素抵抗(IR)、雄激素的关系。方法:临床收集40例正常对照者(正常对照组)、15例高雄激素血症者(高雄组)、60例PCOS患者(PCOS组)的血清标本,分别测定其体质指数(BMI)、腰臀比(WHR)、空腹血糖(FBG)、空腹胰岛素(FINS)、促性腺激素、雄性激素、性激素结合球蛋白(SHBG)、ghrelin的水平、计算胰岛素抵抗指数(HOMA-IR)。结果:①3组相比,PCOS组的WHR、LH、胰岛素(insulin)水平较其他2组升高(P<0.05),SHBG降低(P<0.05);高雄激素血症组ghrelin水平最低,但与其他2组比较差异均无统计学意义(P>0.05)。②PCOS组ghrelin水平与BMI、WHR、insulin、HOMA-IR呈负相关,与SHBG呈正相关(P<0.05)。结论:在PCOS患者中,ghrelin水平降低,与BMI、IR、SHBG密切相关,表明ghrelin可能参与其能量平衡、肥胖、IR的形成,但是其形成原因仍需进一步研究。

Objective：（i） to compare plasma ghrelin levels between women with PCOS and women presented only with hyperandrogenaemia; （ii）to investigate the relationship between circulating ghrelin and BMI.insulin level, insulin resistance, and Androgen levels in PCOS. Methods：Blood samples from sixty women with PCOS, 15 women with only hyperandrogenaemia and 40 controls were collected, the basal levels of gonadotrophin, androgens, prolaetin, sex hormone-binding globulin, glucose, insulin and ghrelin were measured. Results ： （ 1 ） Comparing with PCOS and Controls, women with only hy- perandrogenaemia had the lowest ghrelin levels;women with PCOS had lower ghrelin levels comparing with controls, but they were not significant. （2）Ghrelin levels were negatively correlated with BMI, WHR, Insulin levels and Insulin Resistance, positively correlated with sex hormone-binding globulin lev- els. Conclusion：In PCOS, circulating ghrelin and BMI,Insulin Resistance,SHBG levels were inverse- ly related,indicating that Gbrelin might be associated with energy balance, obesity, and Insulin Resist- ance. However, further investigation was needed to clarify whether low ghrelin was a cause or the conse- quence of obesity and Insulin Resistance awaits.