多囊卵巢综合征子宫内膜局部胰岛素抵抗的研究

Study of the insulin resistance in localy endometria with polycystic ovary syndrome

目的探讨多囊卵巢综合征(PCOS)患者子宫内膜是否存在局部胰岛素抵抗(IR)。方法分离28例PCOS患者(PCOS组)和32例不孕症患者(对照组)的子宫内膜上皮和间质细胞并体外培养;采用葡萄糖氧化酶法测定PCOS子宫内膜细胞对葡萄糖的摄取量;应用免疫组化法检测胰岛素(Ins)、胰岛素受体(InsR)和葡萄糖转运蛋白4(GLUT4)在PCOS患者子宫内膜的表达。结果 PCOS组子宫内膜细胞葡萄糖摄取量与对照组比较,差异无统计学意义(P>0.05);加入1×10-7mmol/L胰岛素后,PCOS组葡萄糖摄取量低于对照组(P<0.05);PCOS肥胖及IR组葡萄糖摄取量低于非肥胖及非IR组(P<0.05)。PCOS组子宫内膜Ins表达与对照组比较,差异无统计学意义(P>0.05),但InsR及GLUT4表达低于对照组(P<0.05);PCOS肥胖和IR组子宫内膜InsR及GLUT4表达低于非肥胖和非IR组,但差异无统计学意义(P>0.05)。结论 P-COS患者子宫内膜存在局部IR,肥胖及全身IR加重子宫内膜局部IR。

Objective To investigate whether insulin resistance exists in endometria of PCOS patients.Methods Endometrial glandular and stromal cells were isolated and cultured in vitro.The capability of Absorbing glucose of the endometria in PCOS patients（PCOS group）,and infertility patients（control group）were evaluate by glucose oxidase method;expression of Ins,InsR and GLUT4 in endometria of PCOS were determined by immunohistochemistry.Results There were no significant difference in the amount of the endometria Absorbing glucose between groups（P〉0.05）,while significant difference was found after the stimulation of insulin（P〈0.05）.The amount was lower in obese and IR PCOS patients than in PCOS with normal BMI,non-IR and control group（P〉0.05）.There was no significant difference of the expression of Ins in endometria between PCOS and control group（P〉0.05）.But the expression of InsR and GLUT4 were lower in PCOS group than in control group（P〉0.05）.Conclusions IR exists in the endometria of PCOS.Obesity and IR could aggravate the endometria IR of PCOS.（P〉0.05）.