丙二醛、视黄醇与多囊卵巢综合征发病机制关系的探索

Exploration of relationship between malondialdehyde,retinol and pathogenesis of polycystic ovary syndrome

目的研究氧化应激指标丙二醛(malondialdehyde,MDA)、视黄醇(retinol,RET)与多囊卵巢综合征(polycystic ovary syndrome,PCOS)发病机制的关系。方法选取2017年7月至10月就诊于首都医科大学附属北京妇产医院内分泌科的PCOS患者65例作为研究组,同时选取因女方输卵管因素或男方因素而不孕或正常体检的健康育龄女性24例作为对照组。测量所有参与者的人体测量学指标、内分泌代谢指标及各氧化应激指标,比较PCOS患者与对照组各氧化应激指标特点。结果 PCOS组MDA、超氧化物歧化酶(superoxide dismutase,SOD)均显著高于对照组(P<0.05),血清RET浓度低于对照组(P<0.05)。PCOS组氧化型谷胱甘肽(oxidized glutathione,Glut oxyd,)、总抗氧化活性(total antioxidant activity,TAA)、维生素C(vitamin C,VC)、维生素E(vitamin E,VE)与对照组相比差异无统计学意义(P>0.05)。MDA与抗苗勒管激素(anti-Müllerian hormone,AMH)呈明显正相关(r=0.208,P=0.05),与睾酮(testosterone,TT)、空腹胰岛素(fasting insulin,FINS)、稳态胰岛素指数(homeostasis model assessment insulin resistance,HOMA-IR)无明显相关性(P>0.05);RET与AMH呈明显负相关(r=-0.232,P<0.05),与TT、FINS、HOMA-IR无明显相关性(P>0.05)。结论多个氧化应激指标显示PCOS患者体内MDA代表的氧化应激水平增高,RET代表的抗氧化水平降低,深入研究氧化应激与PCOS的关系可能有助于阐明PCOS的发病机制。

Objective The global prevalence of polycystic ovary syndrome （PCOS） is as high as 6%-21%. It is the most common cause of anovulatory infertility in women of childbearing age. The inherent characteristics of the ovary is the increase in the follicle number and the failure of dominant follicle selection. Although previous studies showed that oxidative stress was detected in patients with PCOS, which will destroy the normal structure and function of follicle, the specific pathogenesis is unclear currently. This study aims to investigate the relationship between oxidative stress indicators malondialdehyde （MDA）, retinol （RET） and the pathogenesis of polycystic ovary syndrome（PCOS）. Methods From July to October 2017, 65 cases of PCOS patients in Endocrinology Department of Beijing Gynecology Hospital, Capital Medical University were selected as study group and 24 healthy women who were infertile because of fallopian tube factor or male factor or normal physical examination were selected as control group at the same time. The anthropometric indexes, endocrine indexes, metabolic and oxidative stress indexes of all participants were measured. The characteristics of oxidative stress indicators were compared between PCOS patients and control group. Results Both MDA and superoxide dismutase （SOD） were significantly higher in PCOS group than those in control group （ P 〈0.05）, but the RET in PCOS group was significantly lower than that in control group （ P 〈0.05）. There was no significant difference in oxidized glutathione （Glut oxyd）, total antioxidant activity （TAA）, vitamin C （VC）, vitamin E （VE） in the two groups （ P 〉0.05）. There was a positive correlation between MDA and anti-Müllerian hormone （AMH） （ r = 0.208, P = 0.05） and there was no significant correlation between MDA and testosterone（TT）, fasting insulin （FINS）, and homeostasis model assessment insulin resistance （HOMA-IR） （ P 〉0.05）. There was a negative correlation between RET and AMH （ r =-0.232, P 〈0.05）, and there was no significant correlation between RET and TT, FINS, and HOMA-IR （ P 〉0.05）. Conclusion The study on multiple oxidative stress markers revealed that the oxidative stress level represented by MDA was increased and the antioxidant level represented by RET was decreased in PCOS patients. Further study of the relationship between oxidative stress and PCOS might be helpful to clarify the pathogenesis of PCOS.