多囊卵巢综合征患者外周血Ang-(1-7)、AngⅡ/Ang-(1-7)比值与胰岛素抵抗及脂代谢的相关性研究

Correlation among Ang-(1-7), AngⅡ/Ang-(1-7), insulin resistance and lipid metabolism in peripheral blood of polycystic ovary syndrome patients

目的探讨多囊卵巢综合征(PCOS)患者中肾素血管紧张素系统(renin angiotensin system,RAS)与胰岛素抵抗(IR)及脂代谢的关系。方法 PCOS患者根据胰岛素抵抗指数(HOMA-IR)分为IR组(HOMA-IR≥2.69,n=80)与非IR组(NIR组,HOMA-IR<2.69,n=67),另以25例正常月经周期女性作为对照组。采用酶联免疫法(ELISA)测定外周血血管紧张素Ⅱ(AngⅡ)、血管紧张素1-7[Ang-(1-7)]的水平,化学发光法测定血清性激素、空腹胰岛素(FINS)、血脂水平。结果 (1)IR组与NIR组外周血中AngⅡ和Ang-(1-7)水平均高于对照组(P<0.05),IR组与NIR组间AngⅡ水平无统计学差异(P>0.05),但Ang-(1-7)水平IR组低于NIR组(P<0.05);(2)IR组外周血中AngⅡ/Ang-(1-7)比值高于NIR组及对照组(P<0.05),NIR组AngⅡ/Ang-(1-7)比值较对照组无统计学差异(P>0.05);(3)Pearson相关分析显示,IR组外周血中Ang-(1-7)与FINS、HOMA-IR、体质量指数(BMI)呈负相关,与卵泡刺激素(FSH)呈正相关(P<0.05);NIR组外周血中Ang-(1-7)与甘油三酯(TG)呈负相关,与高密度脂蛋白(HDL)呈正相关(P<0.05)。结论 PCOS患者外周血存在AngⅡ、Ang-(1-7)亢进现象;AngⅡ/Ang-(1-7)比值失衡与PCOS患者的IR及代谢紊乱有关,Ang-(1-7)水平的提高可能改善IR及代谢紊乱。

Objective To investigate the correlation among renin angiotensin system （RAS）, insulin resistance （IR） and lipid metabolism in polycystic ovary syndrome （PCOS） patients.Methods According to homeostasis model assessment （HOMA）-IR, PCOS patients were divided into IR group （HOMA-IR≥2.69, n=80） and non-IR （NIR） group （HOMA-IR〈2.69, n=67）, 25 women with normal menstrual cycle were selected as the control. The levels of plasma AngⅡand Ang-（1-7） were examined by enzyme-linked immunosorbent assay （ELISA）; serum sexual hormone, fasting insulin （FINS）, serum glucose and lipid were examined by chemiluminescence method.Results 1） The levels of AngⅡand Ang-（1-7） in IR and NIR group were all higher than those in the control （P〈0.05）. The level of AngⅡ in IR group was not significantly different from NIR group （P〉0.05）, but the level of Ang-（1-7） was lower in IR group than in NIR group （P〈0.05）. 2） The AngⅡ/Ang-（1-7） ratio was higher in IR group than in other two groups （P〈0.05）. No statistical differences were found between NIR group and control group （P〉0.05）. 3） Pearson correlation analysis showed that Ang-（1-7） was negatively correlated with FINS, HOMA-IR, and body mass index （BMI） in IR group, and showed a positive correlation with follicle stimulating hormone （FSH） （P〈0.05）; Ang-（1-7） in NIR group was negatively correlated with triglyceride （TG）, and had a positive correlation with high density lipoprotein （HDL） （P〈0.05）. Conclusion A hyperthyroidism phenomenon of AngⅡ and Ang-（1-7） levels exists in PCOS women as compared with the control. The imbalance of Ang Ⅱ/ Ang-（1-7） is associated with IR and metabolic disorders in PCOS patients. IR and metabolic disorders may be improved by improving Ang-（1-7） level.