多囊卵巢综合征患者血浆半乳糖凝集素-3与慢性炎症和胰岛素抵抗的相关性研究

Relation of plasma galectin-3 level with parameters of chronic inflammation and insulin resistance in the patients with polycystic ovary syndrome

从本院门诊一共收集纳入受试者108例，其中健康受试者为对照组（21名），将多囊卵巢综合征（PCOS）患者体重指数（BMI）〈25 kg/m2者作为非肥胖型PCOS组（PCOS1组，34例），BMI≥25 kg/m2者为肥胖型PCOS组（PCOS2组，32例），与肥胖型PCOS年龄和BMI相匹配者为单纯肥胖组（21例）。测量BMI、腰臀比、空腹血糖（FPG）、餐后2 h血糖（2hPG）、HbA1C、空腹胰岛素（FINS）、2h胰岛素（2hINS）、性激素和血脂等指标，胰岛素敏感性采用稳态模型评估的胰岛素抵抗指数（HOMA-IR）及胰岛素敏感性指数（ISI）评价，ELISA法检测血浆半乳糖凝集素-3（Galectin-3）和白细胞介素6（IL-6）水平，分析Galectin-3与各指标的关系。结果显示，PCOS组的血浆Galectin-3水平显著高于对照组和单纯肥胖组，且血浆Galectin-3在单纯肥胖组高于对照组，PCOS2组也显著高于PCOS1组（均P〈0.05）。偏相关分析显示，血浆Galectin-3水平经年龄、BMI和腰臀比校正后与FPG、2hPG、FINS、HOMA-IR、超敏C反应蛋白和IL-6呈正相关关系，与ISI呈负相关关系（P〈0.05）。多元逐步回归分析显示IL-6、HOMA-IR和BMI是Galectin-3的独立预测因子（P〈0.05）。这些结果提示Galectin-3水平变化与糖代谢、慢性炎症及胰岛素抵抗相关，可能参与PCOS的发生。

A total of 108 subjects were enrolled in this study, including 21 healthy subjects（control group）, 34 non-obese patients with polycystic ovary syndrome [PCOS1 group, body mass index（BMI）〈25 kg/m2], 32 obese patients with PCOS（PCOS2 group, BMI≥25 kg/m2）, and 21 simple obese patients whose age and BMI matched with PCOS2（OB group）. BMI, waist-hip ratio（WHR）, fasting plasma glucose（FPG）, postprandial 2h plasma glucose（2hPG）, HbA1C, fasting insulin（FINS）, postprandial 2h insulin（2hINS）, sex hormones, and lipid parameters were determined. The status of insulin resistance was assessed by homeostasis model assessment for insulin resistant index（HOMA-IR）and insulin sensitivity index（ISI）. Levels of plasma galectin-3 and interleukin-6（IL-6）were detected by ELISA. The results showed that the plasma level of galectin-3 was significantly higher in PCOS group than those in control and OB groups（all P〈0.05）. Moreover, the level of galectin-3 was also higher in OB group compared with control group, while galectin-3 level in PCOS2 group was higher than that in PCOS1 group（all P〈0.05）. After adjusted by age, BMI, and WHR, correlation analysis showed that the level of galectin-3 was positively correlated with FPG, 2hPG, FINS, HOMA-IR, highly-sensitive C-reactive protein, and IL-6, while negatively correlated with ISI. A multiple linear regression analysis revealed that the plasma galectin-3 concentration was independently associated with IL-6, HOMA-IR, and BMI（all P〈0.05）. These data suggest that plasma galectin-3 is closely associated with glucose metabolism, chronic inflammation, and insulin resistance, which may be involved in the pathogenesis of PCOS.