多囊卵巢综合征患者血清Irisin和25（OH）维生素D3及其他代谢指标的相关性被引量：8

Association of serum Irisin with 25 （ OH） VD3 and other metabolic indicators in patients with polycystic ovarian syndrome

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摘要目的通过检测多囊卵巢综合征（PCOS）患者体内Irisin的水平并分析其与25（OH）维生素D3及其他代谢指标的相关性,进一步探讨Irisin在PCOS中的作用,为PCOS的诊断及治疗提供新的方向.方法收集2015年4月至2016年1月在山西医科大学附属第一医院生殖不孕不育中心门诊就诊的PCOS患者67例,同时选择72例在体检中心进行体检的育龄期妇女作为对照组.测量两组人群的身高、体质量、腹围、腰围、臀围、血压,计算体质量指数（BMI）和腰臀比（WHR）.检测所有个体血清中Irisin、25（OH）维生素D3、三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹血糖（FPG）、空腹胰岛素（FINS）、卵泡刺激素（FSH）、黄体生成素（LH）、睾酮（TES）等生化指标,计算胰岛素抵抗指数（HOMA-IR）.结果 PCOS患者体质量[（66.074±12.952）kg比（57.671±8.806）kg,P=0.000]、BMI[（25.340±4.149）kg/m^2比（22.201±3.585）kg/m^2,P=0.003]、腰围[（88.829±12.212）cm比（80.550±10.343）cm,P=0.007]、臀围[（100.805±8.614）cm比（92.007±9.325）cm,P=0.000]、WHR（1.279±0.082比0.857±0.071,P=0.000）、舒张压[（78.548±8.936）mmHg比（73.071±10.614）mmHg,P=0.036]、TG[（2.263±1.142）mmol/L比（1.330±1.329）mmol/L,P=0.019]、FPG[（5.128±0.392）mmol/L比（4.809±0.394）mmol/L,P=0.008]、FINS[（13.319±8.122）mU/L比（4.921±2.028）mU/L,P=0.000]、LH[（8.153±2.271）IU/L比（3.811±2.607）IU/L,P=0.000]、TES[（63.068±25.704）ng/dl比（34.811±11.827）ng/dl,P=0.000]、HOMA-IR（2.245±0.853比1.021±0.153,P=0.000）增加,血清Irisin水平[（831.542±98.484）ng/ml比（612.345±86.308）ng/ml,P=0.006]明显升高,HDL-C[（1.278±0.345）mmol/L比（2.493±0.262）mmol/L,P=0.011]、25（OH）维生素D3水平[（17.181±5.078）nmol/L比（20.823±5.305）nmol/L,P=0.009]显著降低;PCOS患者Irisin与体质量（r=0.396,P=0.028）、BMI（r=0.712,P=0.000）、腰围（r=0.462,P=0.021）、臀围（r=0.478,P=0.006）、WHR（r=0.686,P=0.002）、TG（r=0.397,P=0.036）、HOMA-IR（r=0.467,P=0.019）呈正相关,与25（OH）维生素D3（r=-0.654,P=0.004）呈负相关;多重回归分析在PCOS患者中以Irisin为因变量,其他体测及生化指标为自变量,发现血清Irisin水平与BMI（β=0.822,P〈0.001）、TG（β=0.076,P=0.035）、25（OH）维生素D3（β=-0.242,P=0.027）有线性回归关系.结论 PCOS患者血清Irisin水平显著升高,且与25（OH）维生素D3、BMI、HOMA-IR、TG存在相关性.Irisin为PCOS的诊断及治疗提供新的思路. Objective To investigate the level of Irisin in polycystic ovarian syndrome （ PCOS） patients and analyze its potential correlation with 25 （OH） vitamin D3 and other metabolic indicators , with an attempt to explore the role of Irisin in PCOS and thus inform the diagnosis and treatment of this condition .Methods Totally 67 PCOS patients presenting in the reproductive infertility center of the First Hospital of Shanxi Medical University from April 2015 to January 2016 were enrolled as the PCOS group;meanwhile, 72 women of child-bearing age from the health check-up center were included as the control group .We measured the height , body mass, waist circumference, abdominal girth, hip circumference, and blood pressure and calculated their body mass index （BMI） and waist-to-hip ratio （WHR）.The serum biochemical indicators including Irisin , 25（OH） vitamin D3, total cholesterol （TC）, triglycerides （TG）, high-density lipoprotein cholesterol （HDL-C）, low-density lipoprotein cholesterol （ LDL-C ） , fasting plasma glucose （ FPG ） , fasting insulin （ FINS ） , follicle-stimulating hormone （FSH）, luteinizing hormone （LH）, total testosterone （TES） , and Homeostatic Model Assessment of Insulin Resistance （ HOMA-IR ） were measured .Results The body mass [ （ 66.074 ± 12.952） kg vs.（57.671 ±8.806） kg, P =0.000], BMI [ （25.340 ±4.149） kg/m^2 vs.（22.201 ± 3.585 ） kg/m^2 , P=0.003 ] , waist circumference [ （ 88.829 ±12.212 ） cm vs.（ 80.550 ±10.343 ） cm, P=0.007], hip circumference [ （100.805 ±8.614 ） cm vs.（92.007 ±9.325 ） cm, P=0.000], WHR （1.279 ±0.082 vs.0.857 ±0.071, P=0.000）, diastolic blood pressure [ （78.548 ±8.936） mmHg vs. （73.071 ±10.614） mmHg, P=0.036], TG [ （2.263 ±1.142） mmol/L vs.（1.330 ±1.329） mmol/L, P=0.019], FPG [ （5.128 ±0.392） mmol/L vs.（4.809 ±0.394） mmol/L, P=0.008], FINS [ （13.319 ± 8.122） mU/L vs.（4.921 ±2.028） mU/L, P=0.000], LH [ （8.153 ±2.271） IU/L vs.（3.811 ±2.607） IU/L, P=0.000], TES [ （63.068 ±25.704） ng/dl vs.（34.811 ±11.827） ng/dl, P=0.000] and, HOMA-IR （2.245 ±0.853 vs.1.021 ±0.153, P=0.000） in PCOS group were higher than those in the normal control group.Serum irisin level in PCOS group was significantly elevated when compared with control group [ （831.542 ± 98.484） ng/ml vs.（612.345 ±86.308） ng/ml, P=0.006], while HDL-C [ （1.278 ±0.345） mmol/L vs. （2.493 ±0.262） mmol/L, P=0.011], and 25 （OH） VD3 concentrations [ （17.181 ±5.078） nmol/L vs. （20.823 ±5.305） nmol/L, P=0.009] were decreased significantly .Linear regression analysis showed that irisin was positively associated with body mass （r=0.396, P=0.028）, BMI （r=0.712, P=0.000）, waist circ-umference （r=0.462, P =0.021）, hip circumference （r =0.478, P =0.006）, WHR （r =0.686, P =0.002）, TG （r=0.397, P=0.036） and HOMA-IR （r=0.467, P=0.019） in the PCOS patients and there was a negative correlation between irisin and 25 （OH） VD3 （r=-0.654, P=0.004）.Multiple regression analysis in PCOS group with irisin as dependent variable and other anthropometric and biochemical indicators as independent variables revealed that there was linear regression relationship between serum irisin and BMI （β=0.822, P〈0.001）, TG （β=0.076, P=0.035）, and 25 （OH） VD3 levels （β=-0.242, P=0.027）. Conclusions Serum Irisin level is increased in PCOS patients and it is correlated with 25 （ OH） vitamin D3 , BMI, HOMA-IR, and TG.Irisin provides a new method for the diagnosis and treatment of PCOS .