多囊卵巢综合征患者血清骨钙素水平的变化

The changes of serum osteocalcin levels in women with polycystic ovary syndrome

目的骨钙素(osteocalcin,OC)不仅参与骨代谢,而且还与生殖功能密切相关。文中旨在探讨多囊卵巢综合征(polycystic ovarian syndrome,PCOS)患者血清OC水平的变化。方法连续收集2013年8月至2015年5月间在苏州大学附属第三医院就诊的PCOS患者59例(PCOS组)及年龄相匹配的健康女性46例(对照组),分别测定血清OC、羧化不全骨钙素(under-carboxylated osteocalcin,uc OC)、空腹血糖(fasting glucose,FBG)、空腹胰岛素(fasting insulin,FINS)、总睾酮(total testosterone,TT)、雌二醇(E2)、黄体生成素(luteinizing hormone,LH)、卵泡刺激素(follicle-stimulating hormone,FSH)、泌乳素(PRL)、血脂等,计算体重指数(BMI)及胰岛素抵抗指数(HOMA-IR),并进行相关统计学分析。结果 PCOS组血清OC水平明显低于对照组[(13.12±6.20)ng/m L vs(17.09±4.54)ng/m L],而uc OC水平明显高于对照组[(0.443±0.096)ng/m L vs(0.404±0.097)ng/m L],差异均有统计学意义(P<0.05)。相关分析结果显示,OC与BMI、FINS、HOMA-IR呈显著负相关,与LH、LH/FSH呈显著正相关;uc OC与TT、LH、LH/FSH呈显著正相关。多元回归分析表明,HOMA-IR及TT分别是影响血清OC及uc OC水平的独立相关因素。结论 PCOS患者的血清OC水平偏低,而uc OC水平偏高,并且与胰岛素抵抗、高雄激素血症密切相关。

Objective Osteocalcin （OC） not only participates in the bone metabolism, but also plays a role in the reproductive function. The aim of this study is to investigate the changes of serum osteocalcin levels in women with polycystic ovarian syndrome （PCOS）. Methods Fifty nine PCOS patients from August 2013 to May 2015 and forty six healthy female individuals matched for age were included in the study. A blood sample was obtained to test serum levels of osteocalcin （OC）, under-carboxylatedosteocalcin （ucOC）, fasting glucose （FBG）, fasting insulin （FINS）, total testosterone （TT）, estradiol （E2）, luteinizing hormone （LH）, folli- cle-stimulating hormone （FSH）, prolactin （PRL） and serum lipid. The body mass index （BMI） and the homeostasis model assessment of insulin resistance （HOMA-IR） were calculated. The correlation analysis was also performed. Results Serum osteocalcin was lower in the PCOS patients than the controls [ （13.12 ±6.20） vs （17.09 ±4.54） ng/mL, P〈0.05]. However, serum ucOC was higher in the PCOS patients than the controls [ （0.443 ± 0. 096） vs （0. 404 ± 0. 097 ） ng/mL, P 〈 0. 05 ]. The correlation analysis results showed that serum osteocalcin was negatively correlated with BMI, FINS and HOMA-IR. In the meantime, it was positively corre- lated with LH and LH/FSH. Serum ucOC was positively correlated with TT, LH and LH/FSH. Regression analysis showed that HOMA-IR and TT were the independent risk factors of serum osteocalcin and ucOC separately. Conclusion The serum OC level was low and ueOC was high in PCOS patients, and it was closely correlated with insulin resistance and hyperandrogcnemia.