多囊卵巢综合征痰湿证患者脂联素及其受体mRNA表达与体外受精结局的相关性研究

Expressions of Adiponectin and Its Receptors' mRNA and Correlation with Outcomes of IVF-ET in Polycystic Ovary Syndrome with Phlegm-dampness

目的:探讨脂联素、脂联素受体与多囊卵巢综合征(PCOS)痰湿证的关系,以及其与体外受精(IVF)结局的相关性。方法:选择行体外受精-胚胎移植(IVF-ET)的PCOS患者共43例(痰湿证20例、非痰湿证23例)及对照组30例,化学发光法检测3组患者血清胰岛素(FIN)水平;取卵日留取外周血及卵泡液,并提取黄素化颗粒细胞,酶联免疫吸附法(ELISA)测定血清和卵泡液中脂联素(APN)水平,实时定量PCR(RT-PCR)法测定黄素化颗粒细胞脂联素、脂联素受体m RNA的表达水平。结果:1)PCOS痰湿组BMI及FIN明显高于其余两组(P<0.01),且PCOS非痰湿组也高于对照组(P<0.05)。2)PCOS痰湿组血清及卵泡液APN水平、Adipo R1、Adipo R2m RNA表达水平均显著低于其余两组(P<0.05);各组颗粒细胞均无脂联素m RNA的表达。3)血清APN、卵泡液APN、Adipo R1、Adipo R2m RNA与BMI及FIN分别呈负相关;BMI与FIN呈正相关。4)妊娠妇女血清脂联素含量明显高于未妊娠妇女(P<0.05)。结论:PCOS痰湿证患者具有明显的胰岛素抵抗特征;其胰岛素抵抗(IR)可能与卵巢局部脂联素受体m RNA的表达下降有关;采卵日血清中高水平的脂联素可预示良好的IVF结局。

Objective： To explore the correlation of phlegm - dampness syndrome with adiponectin and its re- ceptor in PCOS, and the correlation with outcome of IVF - ET. Methods： Selecting 43 PCOS patients under treat- ment of vitro fertilisation and embryo transplantation（ IVF -ET） （20 cases in phlegm -dampness group ,23 cases in non - phlegm - dampness group） and 30 infertility patients （ control group）, using chemical light method to de- tect the level of fasting insulin（FIN） in three groups;at the day of oocytes retrieval selecting the peripheral blood and follocular fluid and extracting ovarian luteinizing granulose cells, using enzyme - linked immunosorbent assay （ELISA） to detect the level of adiponeetin in serum and follicular fluid, using real- time polymerase chain reac- tion（ RT- PCR）to detect the level of the expressions of adiponectin mRNA and AdipoR1、AdipoR2 mRNA in o- varian luteinizing granulose cells. Results： 1 ） BMI and FIN of phlegm - dampness group of PCOS was significant- ly higher（ P 〈 0. 01 ） ;compared with the control group. 2 ）The level of APN in serum and follicular fluid and the level of the expression of AdipoRi ,AdipoR2 mRNA of phlegm - dampness group of PCOS was lower than the oth- er two groups （ P 〈 0. 05 ） ; in ovarian hrteinizing granulose cells of each group adiponectin mRNA was not ex- pressed. 3 ）APN in serum, APN in follicular fluid, AdipoRl ,AdipoR2 mRNA in ovarian luteinizing granulose ceils and BMI and FIN were respectively in negtive correlation ; BMI and FIN were positively correlated. 4 ） Serum adi- ponectin level of pregnant women were significantly higher than the level of those who were not pregnant （ P 〈 0. 05 ）. Conclusion： PCOS with phlegm - dampness has distinct characteristics of insulin resistance ; insulin re- sistance（ IR）of phlegm- dampness group of PCOS may be related with the decreasinge of the expression of adi- ponectin receptor mRNA in ovarian luteinizing granulose ceils. Adiponectin may be a useful marker, especially inobese women, for early prediction of good IVF outcome.