多囊卵巢综合征胰岛素抵抗与瘦素关系的探讨

Study on the relationship between leptin and insulin resistance in women with polycystic ovary syndrome

目的 探讨多囊卵巢综合征 (PCOS)妇女血清瘦素 (leptin)水平与胰岛素抵抗 (IR)的关系 ,为研究PCOS的发病机制和治疗新途径提供理论依据。方法 5 1例PCOS患者及 2 3例正常妇女均测定体重指数(BMI)、腰臀比 (WHR)、血清生殖激素及leptin水平 ,同期行口服糖耐量 (OGTT)及胰岛素 (Ins)释放试验 ,OGTT示IR者给予二甲双胍 (1 5 g/d)治疗 3个月后复测上述指标。 结果 PCOS患者血清leptin水平高于相应对照组 ,且IR组显著高于NIR组 ;PCOS患者经二甲双胍治疗后血清Ins水平显著下降 ,胰岛素敏感指数 (ISI)显著上升 ,同时leptin水平下降。相关分析表明 ,PCOS患者血清leptin与BMI、WHR及T显著正相关 ,与ISI负相关 (r=0 6 7,P <0 0 1) ,多元回归显示leptin中有BMI、ISI引入。结论 PCOS患者血清leptin水平升高与胰岛素敏感性相关 ;二甲双胍治疗PCOS患者可提高其胰岛素敏感性 ,降低血清leptin水平。

Objective To study the relationship between blood leptin and insulin resistance in women with polycystic ovary syndrome(PCOS).Methods Body mass index(BMI), waist to hip ratio(WHR),serum leptin, luteinizing hormone, follicle stimulating hormone , estradiol,testosterone, insulin concentration during oral glucose tolerance test were assessed in 51 PCOS women and 23 normal women. The above-intentioned measurement was perfomed again in those women who showed insulin resistance (IR) after being administrated three months of metformin.Results The PCOS patients showed high levels of leptin, which was significantly higher in IR group than that in NIR group. Serum leptin, insulin values decreased and ISI increased significantly after the treatment of metformin. Significantly positive correlation was found between serum leptin and BMI, WHR,T. A negative correlation was found between leptin and ISI(r=0.67,P<0.01).Conclusion High level of leptin in PCOS women is associated with insulin sensitivity.Serum leptin concentration can be decreased and the sensitivity of insulin can be increased after metformin therapy.