Kisspeptin对PCOS的发生及能量代谢的影响

Effect of kisspeptin on pathogenesis and energy metabolism of polycystic ovary syndrome

目的:探讨血清Kisspeptin在多囊卵巢综合征(PCOS)的表达及发生及代谢异常的关系。方法:收集73例PCOS患者及63例同期就诊输卵管因素不孕症(对照组)患者详细病例资料,检测血清中Kisspeptin、胰岛素及性激素水平并进行分析。结果:PCOS组Kisspeptin水平(265.8±214.7pg/ml)高于对照组(219.1±165.7pg/ml)(P<0.05),其中PCOS正常体重组(350.5±240.3pg/ml)高于PCOS超重组(219.0±185.6pg/ml)、对照超重肥胖组(216.7±124.7pg/ml)、对照正常体重组(219.7±175.9pg/ml)(P<0.05)。血清Kisspeptin水平与促黄体生成素(LH)水平呈正相关(r=0.23,P<0.05),PCOS组血清Kisspeptin水平与血糖曲线下面积及胰岛素曲线下面积均呈负相关(r=-0.26、-0.24,P<0.05),与甘油三酯水平呈负相关(r=-0.24,P<0.05)。结论:血清Kisspeptin在PCOS正常体重组升高,与LH水平正相关,其可能通过调控LH水平,在PCOS患者发生排卵障碍的过程中发挥作用。在PCOS肥胖超重患者中Kisspeptin水平降低,与血糖及胰岛素释放异常及血脂异常相关,对PCOS代谢异常发生有一定作用,其对肥胖与非肥胖患者的影响不同。

Objective： To investigate the expression of serum kisspeptin in women with polycystic ovary syndrome （P- COS）, and to explore the relationship between kisspeptin and the pathogenesis or abnormal metabolism of women with PCOS. Methods：73 women diagnosed as PCOS were included in the PCOS group, and the control group included 63 women who were treated for infertility because of tubal factors at the same time. The related detail information of all included women was recorded. The levels of Kisspeptin were detected by ELISA, levels of sex hormone in serum were analyzed by electrochemiluminescence, and the insulin release experiments were conducted by glucose oxidase method. The results were further analyzed. Results：The level of Kisspeptin of women in PCOS group （265.8±214.7） was sig- nificant higher than that of women in control group （219.1±165.7） （P 〈10.05）. The level of Kisspeptin of normal weight women in PCOS group （350.5±240.3） had increased most obviously, which was significant higher than that of overweight or obesity women in PCOS group （219.0±185.6）, and also was significant higher than that of overweight or obesity women （216.7±124.7） and normal weight women（219.7±175.9） in control group（P〈0.05）. The level of serum Kisspeptin of women was positively correlated with level of luteinizing hormone （r = 0.23, P〈0.05）, and was negatively correlated with the area under the curve of glucose and insulin（r=-0.26 and r=-0.24, respectively）, and al- so was negatively correlated with level of triglyceride （r = 0.24）. Conclusion：The level of serum Kisspeptin of normal weight women with PCOS increases, and is positively correlated with level of LH, which may play an important role in ovulation disorder of patients with PCOS by regulating the level of luteinizing hormone. The level of Kisspeptin of obese or over weigh women with PCOS reduces, and is negatively correlated with level of abnormal glucose, insulin and dyslipidemia. Kisspeptin play a role in abnormal metabolic, and the effects are different between overweight or obese women with PCOS and normal weight women with PCOS.