叶酸对肥胖型多囊卵巢综合征患者炎症因子及糖脂代谢的影响

Effect of Folic Acid on Inflammatory Factor and Blood Glucose and Lipid Metabolism in Patients with Obese Polycystic Ovary Syndrome

目的:研究叶酸对肥胖型多囊卵巢综合征(PCOS)患者炎症因子及糖脂代谢的影响。方法:选择2012年1月-2014年1月于本院就诊的肥胖型PCOS患者80例为研究对象,根据口服药物剂量的不同将患者分为1 mg组(口服叶酸1 mg/d)和5 mg组(口服叶酸5 mg/d),每组40例,研究两组患者治疗前后炎症因子及糖脂代谢变化。结果:两组患者治疗后高敏C反应蛋白(hs-CRP)、白细胞总数、中性粒细胞、淋巴细胞、单核细胞和嗜酸性粒细胞水平与治疗前比较均明显降低,差异均有统计学意义(P<0.05)。1 mg组治疗后稳态模型胰岛素抵抗指数(homa-IR)为(2.01±0.96),低于治疗前的(2.38±0.75),比较差异有统计学意义(P<0.05);5 mg组治疗后空腹胰岛素和homa-IR指数分别为(9.57±4.62)和(2.00±0.68),低于治疗前的(13.15±4.59)和(2.40±0.83),比较差异均有统计学意义(P<0.05)。5 mg组治疗后LDL和TC水平下降至(2.25±0.78)mmol/L和(3.45±1.08)mmol/L,低于治疗前的(3.10±0.94)mmol/L和(4.28±1.45)mmol/L及1 mg组治疗后的(2.94±0.93)mmol/L和(4.25±1.37)mmol/L,比较差异均有统计学意义(P<0.05)。结论:短期口服叶酸治疗,可以减轻PCOS患者的亚临床炎症和胰岛素抵抗,增加胰岛素敏感性,改善循环中血脂水平,对PCOS患者的亚临床炎症及糖脂代谢改善有一定的价值。

Objective： To study the effect of folic acid on inflammatory factor and blood glucose and lipid metabolism in patients with obese polycystic ovary syndrome.Method： 80 patients with obese PCOS admitted to our hospital from 2012 January to 2014 January were chosen as the study objects and divided into 1 mg group （ oral folic acid 1 mg/d ） and 5 mg group （ oral folic acid 5 mg/d ） according to the different dosage, 40 cases in each group, compared and analysed the changes of inflammatory cytokines and glucose and lipid metabolism before and after treatment in the two groups.Result： The level of hs-CRP, the total number of leukocytes, neutrophils, lymphocytes, monocytes and eosinophils after treatment in both two groups were significantly lower than which before treatment, the difference was statistically significant （ P〈0.05 ） .The index of homa-IR in 1 mg group was （ 2.01 ±0.96 ）, lower than （ 2.38 ± 0.75 ） before treatment, the difference was statistically significant （ P〈0.05 ） . Fasting insulin and the index of homa-IR in 5 mg group after treatment was （ 9.57 ± 4.62 ） and （ 2.00 ± 0.68 ）, lower than （13.15 ±4.59 ） and （2.40±0.83） before treatment, the difference there was statistically significant （ P〈0.05 ） . In 5 mg group, the level of LDL and TC after treatment decreased significandy to （ 2.25 ± 0.78 ） mmol/L and （ 3.45 ± 1.08 ） mmol/L, lower than either （ 3.10 ± 0.94 ） mmol/L and （ 4.28 ± 1.45 ） mmol/L that before treatment or （ 2.94 ± 0.93 ） mmol/L and （ 4.25± 1.37 ） mmol/L of 1 mg group after treatment, the difference was statistic significant （ P〈0.05 ） .Conclusion： Short-term oral folic acid treatment can reduce subclinical inflammation and insulin resistance in PCOS patients, increase their insulin sensitivity and improve the blood lipid levels in the circulation. It shows a certain value for the sub clinical inflammation and glucose and lipid metabolism in PCOS patients.