多囊卵巢综合征合并代谢综合征患者血清ApoB／ApoA1比值测定的临床意义

Clinical significance of apolipoprotein B/apolipoprotein A1 ratio detection for patients with polycystic ovary syndrome combined with metabolic syndrome

目的检测多囊卵巢综合征（polycystic ovariansyndrome，PCOS）合并代谢综合征（metabolic syn-drome，MS）患者的载脂蛋白B（ApoB）和载脂蛋白A1（ApoA1）血清水平，探讨其临床意义。方法选择2014年1月至2015年12月期间在浙江温州医科大学附属第三医院妇产科及内分泌科就诊的PCOS患者160例，根据MS诊断标准将入选的PCOS患者分为MS组和非MS组，测定2组的体格测量指标、基础内分泌指标和糖脂代谢指标，比较2组各观察指标的差异，分析ApoB/ApoA1比值与MS各组分的相关性，及其与MS组分异常项数的关系。结果MS组患者血清ApoB和ApoA1水平分别为（1.01±0.34）g/L和（1.15±0.29）g/L，与非MS组比，差异有统计学意义（P〈0.05）；ApoB/ApoA1比值为（1.15±0.29），明显高于非MS组（P〈0.05）。ApoB/ApoA1比值与体质量指数（BMI）、腰围（WC）、收缩压（SBP）、舒张压（DBP）、空腹血糖（FPG）、胰岛素抵抗指数（HOMA-IR）、甘油三脂（TG）、及低密度脂蛋白（LDL-C）均呈显著正相关（P〈0.05），与高密度脂蛋白（HDL-C）呈显著负相关（P〈0.05），而与年龄、空腹胰岛素（FINS）和总胆固醇（TC）相关性不明显（P〉0.05）。ApoB/ApoA1比值随MS组分异常项数增多而增大（P〈0.05）。结论ApoB/ApoA1比值与MS组分密切相关，该值的测定对预测及诊断PCOS合并MS、预防PCOS远期并发症具有重要意义。

ObjectiveTo study the clinical significance of apolipoprotein B and apolipoprotein A1 ratio （ApoB/ApoA1） in patients with polycystic ovary syndrome （PCOS） combined metabolic syndrome （MS） , by detecting the level of ApoB and ApoA1 in patients’ serum.Methods160 patients with PCOS were selected in our hospital from Jan. 2014 to Dec. 2015, and they were divided into MS group and non-MS group according to the diagnostic criteria of MS. The anthropometric measurements, endocrine markers, glucose and lipid metabolism indexes of patients in the two groups were measured and compared. Correlation of ApoB/ApoA1 ratio and components of MS were analyzed, respectively. Relationship between ApoB/ApoA1 ratio and the number of abnormal components in MS were also investigated.ResultsSignificant difference was found in the levels of ApoB （ （1.01±0.34） g/L） and ApoA1 （ （1.15±0.29） g/L） between MS group and non-MS group （P〈0.05） , and ApoB/ApoA1 ratio in MS group was obviously higher than that in non-MS group （P〈0.05） . ApoB/ApoA1 ratio was positively correlated with BMI, waist circumference （WC） , systolic blood pressure （SBP） , diastolic blood pressure （DBP） , fasting plasma glucose （FPG） , insulin resistance index （HOMA-IR） , high triglycerides （TG） and low density lipoprotein （LDL-C） , respectively, and it was negatively correlated with high density lipoprotein （HDL-C） （P〈0.05） . However, there was no significant correlation between ApoB/ApoA1 ratio and the age, fasting insulin （FINS） , as well as the total cholesterol （TC） （P〉0.05） . Moreover, ApoB/ApoA1 ratio increased with increase in the number of abnormal components （P〈0.05） .ConclusionApoB/ApoA1 ratio is closely related to the components of MS, and it may have important clinical significance for diagnosis of PCOS combined MS and preventing long-term complications of PCOS.