血清骨钙素在多囊卵巢综合征患者中的水平及临床意义

Clinical effect of serum osteocalcin on patients with polycystic ovarian syndrome

目的探讨血清骨钙素(OC)在多囊卵巢综合征(PCOS)患者中的水平及对PCOS诊疗的临床意义。方法选取2015年1月至2015年6月检查不孕不育且被确诊为PCOS患者60例,设为观察组;同时选取经检查确定为健康女性60例,设为对照组,入选标准为女性排卵功能正常,且雄激素指标较低,符合健康水平。对两组对象的雌二醇(E2)、黄体生成素(LH)、睾酮(T)、卵泡刺激素(FSH)、垂体泌乳素(PRL)等性激素指标和空腹胰岛素(FINS)、空腹血糖(FBG)等代谢指标水平进行检测,并测算其体质量指数(BMI)、稳态模型胰岛素抵抗指数(HOMA-IR)以及LH/FSH比值。通过酶免疫荧光法(Pharmacia CAP系统)测定两组对象的血清骨钙表达水平。结果观察组FSH、LH/FSH比值、FINS、FBG和HOMA-IR水平均高于对照组(P<0.05),E2、LH、T和PRL水平则明显低于对照组,差异有统计学意义(P<0.05);PCOS患者骨钙素水平与睾酮浓度呈正相关,与稳态模型胰岛素抵抗指数呈负相关。结论 PCOS患者骨钙素表达较低,是影响高雄激素血症和胰岛素抵抗的重要因素,推测其可能参与PCOS疾病发展。

Objective To analyze the effect of osteocalcin on paitients with polycystic ovary syndrome（ PCOS）.Methods From January 2015 to July 2015,60 patients with PCOS were selected as observed group and 60 healthy women without any evidence of androgen excess or ovulatory dysfunction were selected as control group. The levels of estradiol（ E2）,luteinizing hormone（ LH）,testosterone（ T）,follicle-stimulating hormone（ FSH）,pituitary prolactin（ PRL）,fasting serum lisulin（ FINS） and fasting blood glucose（ FBG） were calculated. The body mass index（ BMI）,homeostasis model assessment of insulin resistance（ HOMA-IR） and LH/FSH were calculated. The expression of osteocalcin were measured by Pharmacia. Results The levels of E2,LH,T and PRL were significantly lower in the observation group than those in the control group（ P〈0. 05）; the levels of FSH,LH/FSH,FINS,FBG and HOMA-IR in the observation group were significantly higher than those in the control group（ P〈0. 05）. There was positive correlation of osteocalcin level with testosterone concentration in PCOS patients, and negative correlation with insulin resistance index in steady state model.Conclusion The expression of osteocalcin is low in PCOS patients, which is an important factor influencing hyperandrogenism and insulin resistance. It is speculated that it may be involved in PCOS.