PCOS患者C-反应蛋白与颈动脉内膜中层厚度、内皮依赖性舒张功能的相关性研究

Correlation of C-Reactive Protein with Carotid Intima-Media wall Thickness and Flow Nediated Dilatation in Women with Polycystic Ovary Syndrome

目的:观察多囊卵巢综合征(PCOS)患者血清C-反应蛋白(CRP)浓度与颈动脉内膜中层厚度(IMT)、内皮依赖性舒张功能(FMD)的变化及其关系,探讨PCOS患者是否存在早期动脉粥样硬化。方法:对51例PCOS患者(PCOS组)和50例同期就诊的输卵管性不孕症患者(对照组)采用超声检测IMT、FMD,免疫浊度法测定CRP浓度。按体重指数(BMI)≥25kg/m2或<25kg/m2分为PCOS肥胖组(25例)、PCOS非肥胖组(26例)。结果:PCOS肥胖组及非肥胖组颈动脉IMT、血清CRP浓度均高于对照组(P<0.05),PCOS肥胖组IMT、血清CRP浓度高于非肥胖组,差异有统计学意义(P<0.05)。FMD在PCOS肥胖组及非肥胖组较对照组低(P<0.05)。PCOS肥胖组及非肥胖组出现内膜形态改变的比率均明显高于对照组(P<0.01)。直线相关分析显示CRP与IMT具有显著的正相关(r=0.30,P<0.05);CRP与FMD具有显著的负相关(r=-0.59,P<0.01)。多元回归分析显示HOMA-IR、CRP对IMT有显著影响。结论:PCOS患者尤其伴有肥胖者可能存在血管内皮损伤、早期动脉粥样硬化,炎症反应可能参与了PCOS患者血管内皮损伤的发生发展。纠正胰岛素抵抗,可能减少PCOS远期并发症的发生。

Objective： To investigate the changes and relationship among C- reactive protein （CRP）, carotid intima- media thickness （IMT）and flow mediated dilatation （FMD）, and to evaluate whether the premature subclinical atherosclerosis in women with polycystic ovary syndrome （PCOS） is present.Methods：50 controls and 51 PCOS women who were divided into obese （25 cases） and non-obese group（26 cases） according to body mass index （BMI ≥ 25 kg/m^2 or BMI 〈 25 kg/m^2） were recruited. Carotid IMT and low mediated dilatation were detected by uitrasound, and C-reactive protein level was measured by immune turbidimetry.Results：Women with PCOS presented significantly higher IMT and CRP concentration than that in controls （ P 〈 0.05）. IMT and CRP concentration were higher in obese group than that in non-obese group （ P〈0.05） .FMD was significantly lower in PCOS patients than that in controls （ P〈 0.05）.The ratio of impaired arterial intima in obese and non-obese PCOS group was significantly higher than that in controls（ P 〈 0.01）. Linear correlation analysis showed that CRP was positively correlated with IMT（ r=0.30, P〈0.05 ） ,whereas FMD was negatively correlated with CRP（ r= -0.59, P〈 0.01 ） .Multiple linear regression analysis showed that IMT was positively affected by HOMA-IR and CRP. Conclusions： These data suggest that women with PCOS especially obese may have endothelial impairment and early atherosclerosis. Inflammation may be associated with the occurrence and development of vascular endothelium injury in PCOS patients. Correcting insulin resistance may contribute to preventing the long-term complications of PCOS.