二甲双胍对PCOS并糖代谢异常患者血清脂联素、总氧化态及胰岛素抵抗的影响

The Influence of Metformin in Adiponectin, Total Oxidation and Insulin Resistance in Patients with PCOS and Abnormal Glucose Metabolism

目的观察二甲双胍对多囊卵巢综合征(PCOS)并糖代谢异常患者血清脂联素、总氧化态及胰岛素抵抗的影响。方法将112例PCOS并糖代谢异常患者,随机分为观察组和对照组,两组均给予去氧孕稀炔雌醇片治疗,观察组在此基础上加用盐酸二甲双胍片治疗,观察比较治疗前后两组患者血清脂联素(APN)水平、胰岛素指数及一氧化氮(NO)、总抗氧能力(TAC)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平。结果治疗后,两组患者血清APN水平较治疗前均有升高,但对照组较治疗前差异无统计学意义(P>0.05),且观察组较对照组APN水平升高更显著,差异有统计学意义(P<0.05)。治疗后,对照组HOMA-IR较治疗前无显著变化(P>0.05),但观察组较治疗前HOMA-IR明显减小,且与对照组比亦明显减小,差异均有统计学意义(P<0.05)。治疗后,对照组较治疗前上述四个指标均无显著变化(P>0.05);而观察组较治疗前NO、MDA水平均明显降低,TAC、SOD水平明显升高,差异有统计学意义(P<0.05)。结论二甲双胍可升高PCOS并糖代谢异常患者血清APN水平,改善胰岛素抵抗及总氧化态,促进病情缓解。

Objective To observe the influence of Metformin in adiponectin, total oxidation and insulin resistance of patients with PCOS and abnormal glucose metabolism. Methods A total of 112 cases of patients with PCOS and abnormal glucose metabolism were divided into observation group and contrast group randomly with each group 56 cases. Patients in both groups were given desogestrel and ethinylestradiol tablets treatment. Meantime, patients in the observation group were given Metformin based on desogestrel and ethinylestradiol tablets treatment. Observe and compare the APN level, insulin index as well as the levels of NO, TAC, MDA and SOD between both groups. Results The APN levels of after treatment in both groups were more raised than those of before treatment. In the contrast group, the difference of APN levels of before and after treatment showed no statistical significance （P〉0.05）. The APN levels in the observation group were more significantly raised than those in the contrast group. The difference showed s statistical significance （P〈0.05）. In the contrast group, the HOMA-IR of after treatment was not significantly different with that of before treatment. The difference showed s statistical significance （P〈0.05）. In the contrast group, the levels of NO, TAC, MDA and SOD of after treatment were not significantly different with those of before treatment （P〉0,05）. While in the observation group, the levels of NO and MDA were significantly more decreased and the levels of TAC and SOD were significantly more increased. The difference showed s statistical significance（P〈0.05）. Conclusion Metformin can increase the APN level of the patients with PCOS and abnormal glucose metabolism, improve the insulin resistance and total oxidation, and then promote to relieve the patients＇ state of illness.