多囊卵巢综合征患者血清瘦素水平的变化及临床意义

Changes and clinical significance of serum leptin levels in patients with polycystic ovarian syndrome

目的研究多囊卵巢综合征(PCOS)患者血清瘦素水平变化及其临床意义。方法初次诊断为PCOS的170例患者根据体质量指数(BMI)分为正常体质量组(P1组,n=69)、超重组(P2组,n=44)和肥胖组(P3组,n=57)。酶联免疫吸附法检测血清瘦素水平,分析BMI、腰臀比及血糖、胰岛素和血脂水平以及胰岛素抵抗指数(HOMA-IR)和胰岛B细胞分泌功能指数(HOMA-IS)与血清瘦素水平的相关性。以年龄和体质量指数(BMI)相匹配的143名健康志愿者作为正常对照,且同样分为正常体质量组(C1组,n=102)、超重组(C2组,n=20)和肥胖组(C3组,n=21)。结果血清瘦素水平检测和分析结果显示,P1组与C1组比较差异无统计学意义;但P2组>C2组,P3组>C3组,差异均有统计学意义(P<0.01)。Spearman相关分析显示,PCOS患者血清瘦素水平与BMI、腰臀比以及血清三酰甘油、高密度脂蛋白胆固醇、空腹及餐后2 h血胰岛素、空腹及餐后2 h血糖、HOMA-IR、HOMA-IS相关;进一步的多元逐步回归分析结果表明,PCOS患者血清瘦素水平与BMI和HOMA-IR独立相关。结论PCOS的发生和发展可能与血清瘦素水平升高导致糖脂代谢异常有关。

Objective To investigate the changes and clinical significance of serum leptin levels in patients with polycystic ovary syndrome （PCOS）. Methods One hundred and seventy women initially diagnosed with PCOS were divided into normal body weight group （ P1 group, n = 69）, overweight group （ P2 group, n = 44） and obesity group （P3 group, n = 57） according to body mass index （BMI）. Serum leptin levels were detected by enzyme linked immunosorbent assay, and the relationship between serum leptin level and BMI, waist to hip ratio, blood glucose, blood insulin, blood lipid, insulin resistance index （HOMA-IR） and pancreatic island B cell secretion function index （HOMA-IS） was explored. One hundred and forty-three age- and BMl-matched healthy volunteers were served as normal controls, and were also divided into normal body weight group （ C1 group, n = 102）, overweight group （C2 group, n = ：20） and obesity group （C3 group, n = 21）. Results The detection and analysis of serum leptin levels indicated that there was no significant difference between P1 group and C1 group, while P2 group was significantly higher than C2 group （P 〈 0.01）, and P3 group was significantly higher than C3 group （P 〈0.01）. Spearman correlation analysis revealed that serum leptin level was related to BMI, waist to hip ratio, serum triglyceride, high density lipoprotein-cholesterol, fasting and 2 h post-prandial blood glucose, fasting and 2 h post-prandial blood insulin, HOMA-IR and HOMA-IS. Multiple regression analysis demonstrated that serum leptin was independently related to BMI and HOMA-IR. Conclusion The increase of serum leptin may lead to abnormal glucolipid metabolism, which may contribute to the development of PCOS.