多囊卵巢综合征患者血管生成素样蛋白4水平变化及临床意义

Expression of Serum Angiopoietin Like Protein 4 in Patients with Polycystic Ovary Syndrome

目的:分析多囊卵巢综合征(PCOS)患者血管生成素样蛋白4(Angptl 4)表达水平及临床诊断价值。方法:检测本院确诊的93例PCOS患者(PCOS组)以及112例月经规律且基础激素水平正常者(对照组)的一般资料及实验室指标,包括:身高、体重指数(BMI)、腰围、腰围臀围比、皮下脂肪组织面积(VAT)及内脏脂肪组织面积(SAT)、空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)、Angptl4、胰岛素抵抗指数(HOMA-IR),比较两组各项指标的差异,采用Spearman等级相关分析,Angptl 4与其它指标的相关性采用Logistic回归分析PCOS的危险因素。结果:PCOS组患者BMI、腰围、FPG、HDL-C、LDL-C、TG、TC、hs-CRP、TNF-α、SAT和VAT均高于对照组,而HDL-C低于对照组;PCOS组患者Angptl 4浓度均明显低于对照组(24.23±3.89vs 37.23±5.78ng/ml;P=0.000);Logistic回归分析表明Angptl 4是PCOS的保护因素Or=0.612以及95%CI(0.312—0.945,P=0.039)。Spearman's等级相关分析显示:Angptl 4与胰岛素抵抗[HOMA-IR(r=-0.382,P=0.000)]及炎症指标[hs-CRP(r=-0.167,P=0.000),TNF-α(r=-0.189,P=0.041)]均相关。结论:Angptl 4在PCOS发生发展中发挥着重要作用,或可作为诊断PCOS的新指标。

Objective:To detect the expression level of angiopoietin like protein 4(Angptl 4)in patients with polycystic ovary syndrome(PCOS)and to explore its clinical value.Method:Including 93 PCOS patients diagnosed in our hospital and 112 healthy patients with general information and laboratory indexes:height,weight,waist circumference,waist hip ratio,subcutaneous adipose tissue area(VAT)and visceral adipose tissue area(SAT),fasting blood glucose(FPG),three glycerol ester(tTG),total cholesterol(TC),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),the level of high sensitivity C-reactive protein(hs-CRP),tumor necrosis factor alpha(TNF-alpha),Angptl 4 and insulin resistance index(HOMA-IR),the difference between the two groups of indicators,using Spearman rank correlation analysis and Logistic regression analysis of each index difference.Results:The PCOS patients with BMI,waist circumference,FPG,HDL-C,LDL-C,TG,TC,hs-CRP,TNF-α,SAT and VAT alpha were higher than the control group,and HDL-C was lower than that of the normal group;Angptl4 concentrations in PCOS group were significantly lower than the control group(24.23±3.89 vs 37.23±5.78ng/ml;P=0.000).Spearman's rank correlation analysis showed that Angptl 4 insulin resistance[HOMA-IR(r=-0.382,