多囊卵巢综合征患者血清Apelin水平变化及相关因素分析

Changes of the level of serum apelin and its relative factors in patients with polycystic ovarian syndrome

目的测定多囊卵巢综合征(PCOS)患者的血清Apelin水平,并探讨其与FIns、HOMA-IR、BMI等的相关性。方法 69例PCOS患者和31名对照,按BMI≥25kg/m2或<25kg/m2又各自分为超重/肥胖与正常体重亚组,采用放免法检测空腹血清Apelin水平,同时检测FPG、FIns、性激素水平,计算BMI、WHR及HOMA-IR。结果 (1)PCOS组FIns、HOMA-IR和血清Apelin水平明显高于对照组[FIns:(45.12±55.59)vs(7.31±5.72)mU/L;HDMA-IR:(10.19±12.63)vs(1.62±1.23);Apelin:(229.37±19.38)vs(218.58±15.95)ng/L,P均<0.01]。按BMI分为超重/肥胖和正常体重亚组后,PCOS两亚组的FIns和HOMA-IR均高于相应对照亚组,PCOS组的超重/肥胖亚组Apelin水平显著高于相应对照亚组。(2)空腹血清Apelin水平与BMI、腰围、FIns和HOMA-IR呈正相关(r值分别为0.705、0.558、0.435、0.429,P<0.01)。(3)多元逐步回归分析发现,BMI是影响血清Apelin水平的独立相关因素。结论血清Apelin水平变化与BMI、胰岛素抵抗有关,并可能在PCOS的发生发展中起一定的作用。

Objective To survey the changes of blood apelin in PCOS and the correlation of apelin with fasting insulin,homeostasis model assessment-insulin resistance（HOMA-IR） index and body mass index（BMI）. Methods 69 patients with PCOS and 31 controls were selected and each group was divided into overweight/obese and non-obese subgroups according to body mass index（BMI）≥25 kg/m^2 or25 kg/m^2.The level of fasting serum apelin was assayed by radioimmunoassay.Meanwhile,fasting levels of plasma glucose（FPG）,insulin（FIns） and gonadal hormone were also measured.BMI and waist-to-hip ratio were calculated and insulin sensitivity was assessed by HOMA-IR. Results（1） FIns,HOMA-IR and serum apelin levels were significantly increased in PCOS as compared with controls（45.12±55.59 vs 7.31±5.72mU/L;10.19±12.63 vs 1.62±1.23;229.37±19.38 vs 218.58±15.95ng/L,all P0.01）.In addition,the difference in serum apelin level existed between PCOS and control group with BMI≥25 overweight/obese subgroups.（2） Fasting serum apelin levels correlated positively with BMI,waist circle,FINS and HOMA-IR（r was 0.705,0.558,0.435,0.429,P〈0.01 respectively）.（3）Multiple stepwise regression analysis showed that BMI was the independent influencing factor for of serum apelin.Conclusion The changes of serum apelin are associated with obesity and insulin resistance,and they may contribute,in part,to the pathogenesis of PCOS.