二甲双胍对多囊卵巢综合征患者疗效及其对患者脂肪组织miR-25水平的影响

Effects of metformin on patients with polycystic ovary syndrome and its effect on adipose tissue miR-25 level

目的:分析二甲双胍对多囊卵巢综合征(PCOS)患者疗效及其对患者脂肪组织miR-25水平的影响。方法:选取2018年3月至2019年1月本院内分泌科及妇科门诊就诊PCOS患者76例,简单随机化法分为两组,各38例,对照组给予炔雌醇环丙孕酮片治疗,观察组在此基础上给予二甲双胍治疗,比较两组治疗6个疗程后总有效率、性激素结合蛋白(SHBG)、黄体生成素(LH)、睾酮(T)、卵泡刺激素(FSH)、雌二醇(E2)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、腰臀比(WHR)、体质量指数(BMI)、脂肪组织miR-25mRNA水平。结果:治疗6个疗程后总有效率,观察组(94.74%)较对照组(76.32%)高(P<0.05);治疗6个疗程后,观察组SHBG较对照组升高更加显著,LH、T、FINS、HOMA-IR、WHR、BMI较对照组下降更加显著(P<0.05);两组治疗6个疗程后FSH、E2比较无显著差异(P>0.05);治疗6个疗程后,观察组miR-25mRNA较对照组下降更加显著(P<0.05)。结论:二甲双胍治疗PCOS可改善患者性激素水平与中心型肥胖状态,纠正内分泌异常现象,增加胰岛素敏感性,疗效显著,其机制可能与抑制脂肪组织中miR-25表达有关,miR-25靶向抑制剂可能是治疗PCOS的新思路。

AIM : To analyze the effect of metformin on patients with polycystic ovary syndrome (PCOS) and its effect on adipose tissue miR-25 level. METHODS : From March 2018 to January 2019,76 patients with PCOS were enrolled in the department of endocrinology and gynecology in our hospital.The simple randomization method was used to divide them into two groups,38 cases in each group.The control group was given ethinyl estradiol progesterone tablets.The observation group was given metformin on the basis of this,and the total effective rate,sex hormone binding protein (SHBG),luteinizing hormone (LH),testosterone (T),follicle stimulating hormone (FSH),and female two were compared after treatment for 6 courses.Alcohol (E 2),fasting insulin (FINS),insulin resistance index (HOMA-IR),waist-to-hip ratio (WHR),body mass index (BMI),adipose tissue miR-25 mRNA level were counted. RESULTS :After treatment for 6 courses,the total effective rate was 94.74% higher than that of the control group ( 76.32%)( P < 0.05 ).After 6 courses of treatment,SHBG in the observation group increased more significantly than that in the control group,while LH,T,FINS,HOMA-IR,WHR and BMI decreased more significantly than that in the control group ( P < 0.05 ).There was no significant difference in FSH and E 2 between the two groups after 6 courses of treatment ( P > 0.05 );after 6 courses of treatment,the expression of microRNA-25 in the observation group decreased more significantly than that in the control group ( P < 0.05 ). CONCLUSION :Metformin treatment of PCOS can improve the level of sex hormones and central obesity,correct endocrine abnormalities and increase insulin sensitivity.The mechanism may be related to the inhibition of miR-25 expression in adipose tissue.miR-25 targeting inhibitor provides new idea for treating PCOS.