吡格列酮对肥胖型多囊卵巢综合征患者脂肪细胞因子的影响

Effects of pioglitazone on adipokine in obese women with polycystic ovary syndrome

目的探讨胰岛素增敏剂吡格列酮在治疗肥胖型多囊卵巢综合征(PCOS)时脂肪细胞因子的影响。方法吡格列酮治疗肥胖型PCOS 34例12周,监测治疗前后患者的临床指标,并用酶联免疫吸附法和放射免疫法检测治疗前后患者血清内脂素、瘦素、脂联素的水平,并检测空腹血糖、空腹血清胰岛素、黄体生成激素(LH)、卵泡刺激素(FSH)和睾酮(T)水平和血脂情况。结果 34例患者治疗后F-G评分比治疗前下降(P<0.05),卵泡总数及卵巢体积亦显著降低(P<0.01);体重指数、腰臀比有下降趋势,但无显著性差异(P>0.05);治疗后LH和T水平显著下降(P<0.05),FSH水平无明显变化(P>0.05);空腹血清胰岛素和HOMA-IR较治疗前显著下降(P<0.01),空腹血糖在治疗后有显著下降(P<0.05);治疗后总胆固醇、甘油三脂和低密度脂蛋白较治疗前显著下降(P<0.05,P<0.01),高密度脂蛋白较治疗前显著升高(P<0.05);内脂素、瘦素较治疗前显著下降(P<0.01),脂联素较治疗前显著升高(P<0.05)。结论吡格列酮可有效改善肥胖型PCOS的生殖状况、胰岛素抵抗和糖、脂代谢紊乱程度;吡格列酮可能通过改善血清内脂素、瘦素和脂联素水平而发挥其治疗PCOS、改善胰岛素抵抗的目的。

Objective To investigate the effects of pioglitazone on serum visfatin（ADP）,leptin（LEP）,adiponectin（ADP） in obese patients with polycystic ovary syndrome（PCOS）.Methods Pioglitazone was given for 12 weeks in 34 obese women with PCOS.Clinical parameters of patients with PCOS were monitored.The changes of fasting plasma glucose（FPG）,fasting serum insulin（FINS）,serum levels of visfatin,leptin,adiponectin,follicle-stimulating hormone （FSH）,luteinizing hormone （LH）,testosterone （T）,blood fat were examined at the baseline and after the treatment by enzyme-linked immunosorbent assay（ELISA） and radioimmunoassay （RIA）.Results After treatment,the volumes and follicle numbers of bilateral ovaries were significantly decreased （P ＜ 0.01）,the score of Ferriman-Gallwey was also significantly decreased （P ＜ 0.05）,and WHR and BMI were declined,but there was no significant difference （P ＞ 0.05）.The levels of LH,T,FPG,FINS,HOMA-IR,total cholesterol （TC）,triglyceride （TG）,and low density lipoprotein-cholesterol（LDL-C） were significantly decreased （P ＜ 0.05 or P ＜ 0.01） after treatment,high density lipoprotein-cholesterol （HDL-C） were significantly increased （P ＜ 0.05）,while there was no significant change in FSH （P ＞ 0.05）.The level of serum visfatin and leptin was decreased after treatment （P ＜ 0.01）,while the level of serum adiponectin was increased （P ＜ 0.05）.Conclusion Pioglitazone can effectively improve their reproductive status,insulin resistance,glucose and lipid metabolism of obese women with PCOS.Pioglitazone can decrease plasma glucose level,and improve the insulin resistance partly through improving the profiles of visfatin,leptin and adiponectin.