多囊卵巢综合征患者视黄醇结合蛋白-4的水平变化及意义

The significance and the change of retinol-binding protein-4 level in cases with polycystic ovary syndrome

目的探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者视黄醇结合蛋白-4(retinol binding protein4,RBP-4)及其与各项代谢指标和性激素指标的相关性研究。方法将中山市博爱医院收治的PCOS患者36例设为观察组,正常妇女30例为对照组进行对比观察。于月经期第三天抽取空腹静脉血去血清,血浆送检验科测定血脂,其中包括总胆固醇(total cholesterol,TC),甘油三酯(triglyceride,TG),低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)和高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C);测定空腹胰岛素(insulin)及空腹血糖(fasting blood glucose,FBG)水平;测定空腹及服糖后2小时的胰岛素及血糖水平;稳态模型评估法测定的胰岛素抵抗指数(homeostasismodel of assessment for insulin resistence index,HOMA-IRI)=(空腹血糖×空腹胰岛素)/22.5。血总睾酮(total testosterone,TT)、硫酸脱氢表雄酮(dehydroepiandrosterone sulfate,DHEAS)、促黄体生成素(luteinizinghormone,LH)、卵泡生成素(follicle stimulating hormone,FSH)和雌二醇(eatradiol,E2)采用电化学发光免疫法测定。空腹血浆RBP-4浓度采用夹心酶联免疫分析法(enzyme-linked immunosorbent assay,ELISA)的方法测定。结果 PCOS组患者血清RBP-4的水平明显高于对照组(P<0.05);PCOS组患者胰岛素、FBG和HOMA-IRI的水平明显高于对照组(P<0.05),而血HDL-C的水平明显低于对照组(P<0.05);TT、DHEAS、LH/FSH和E2水平明显高于对照组(P<0.05)。PCOS组患者RBP-4水平与血清体质量指数(bodymass index,BMI)、Insulin、FBG和HOMA-IRI呈正相关,r值依次为0.32、0.27、0.25和0.31(P<0.05);PCOS组患者血清RBP-4水平与血清TT、DHEAS、LH/FSH水平有明显的正相关,r值依次为0.43、0.35和0.38(P<0.05);与E2呈负相关,r值为-0.26(P<0.05)。结论 PCOS患者血浆RBP-4水平显著升高,且血清RBP-4与BMI、FBG、insulin、HOMA-IRI,与TT、DHEAS、LH/FSH水平均有显著正相关,提示RBP-4在PCOS中具有重要意义。

Objective To analyze potential interactions of retinol - binding protein 4 （ RBP - 4 ） levels with body mass, metabolic and hormonal status in cases with polycystic ovary syndrome （PCOS）. Methods Totally 36 patients with PCOS and 30 normal women （NGT group ） were enrolled in the study. Fasting blood samples were drawn from the vein on the third day of the menstrual cyele. Plasma RBF -4 levels were measured by the enzyme -linked immunosorbent assay（ELISA） of patients in PCOS Group and in control group. The data of Body mass index （BMI）, fasting blood glucose（ FBG）, Insulin, homeostasis model of assessment for insulin resistence index（ HOMA - IRI） and Total testosterone （ TI＇）, dehydroepiandrosterone sulfate （ DHEAS）, luteinizing hormone/follicle stimulating hormone （LI-I/FSH） and estradiol （ E2 ） were detected. Lipid metabolism [ total cholesterol （ TC）, triglyceride （ TG）, low - density lipoprotein cholesterol （ LDL - C ）, high - density lipoproteiu cholesterol （ HDL - C ） ] were also detected. Results The study results showed the levels of RBP - 4, insulin and glucose and HOMA - IRI in PCOS patients were higher than those of healthy women（ P 〈 0. 05）. A positive correlation was demonstrated between RBP -4 and FBG, HOMA - IR1, insulin and the value of r was 0. 32,0. 27,0. 25 and 0. 31 respectively（P 〈0. 05）. RBP -4 level also showed a positive correlation with TI＇, DHEAS, LH/FSH and the value of r was 0. 43,0. 35 and 0. 38 respectively （P 〈 0. 05 ）. While inverse correlation was showed between RBP - 4 and E2 and the value of r was - 0. 26. Conclusion Blood RBP - 4 levels have been observed increasing significantly of patients in PCOS group and have positive correlation with FBG, HOMA -IRI, insulin, TT, DHEAS, LH/FSH. So RBP -4 may be the significant marker of PCOS.