多囊卵巢综合征患者血清内脂素水平及其与心血管疾病危险因素的相关性

Correlation between serum visfatin level and cardiovascular disease risk factors in patient with polycystic ovary syndrome

目的探讨多囊卵巢综合征(PCOS)患者血清内脂素水平与心血管疾病危险因素的相关性。方法选择2016年7月至2018年7月武汉普仁医院100例POCS患者和50例健康妇女分别作为PCOS组和对照组,再将PCOS患者按照体质量指数(BMI)分为肥胖组57例(BMI≥25 kg/m2)和非肥胖组43例(BMI<25 kg/m2)。采用酶联免疫吸附测定法检测各组研究对象血清内脂素水平,分析PCOS患者内脂素与卵泡生成激素(FSH)、黄体生成激素(LH)、睾酮(T)、高敏C-反应蛋白(hs-CRP)、血脂、血糖等指标的相关性。结果与对照组比较,PCOS组内脂素、BMI、舒张压、腰臀比、多毛症F-G评分、FSH、LH、T、三酰甘油(TG)、空腹胰岛素(FINS)、稳态模型评估的胰岛素抵抗指数(HOMA-IR)明显升高[(103.20±19.15)μg/L比(29.56±4.41)μg/L(25.81±4.17)kg/m2比(21.29±3.74)kg/m2、(81.91±10.32)mmHg(1 mmHg=0.133 kPa)比(68.29±7.57)mmHg、0.91±0.14比0.82±0.13、(13.41±2.91)分比(5.98±1.01)分、(12.78±1.98)U/L比(11.95±1.51)U/L、(15.84±3.16)U/L比(12.94±1.53)U/L、(2.98±0.32)nmol/L比(1.17±0.20)nmol/L、(1.89±0.43)mmol/L比(1.21±0.11)mmol/L、(18.40±2.98)mU/L比(11.23±2.10)mU/L、4.25±0.86比2.51±0.55],HDL-C、ISI明显降低[(1.46±0.23)mmol/L比(1.55±0.27)mmol/L、0.011±0.002比0.019±0.005],差异有统计学意义(P<0.01或<0.05)。肥胖组血清内脂素、BMI、舒张压、多毛症F-G评分、FSH、LH、T、hs-CRP、TG明显高于非肥胖组,高密度脂蛋白胆固醇(HDL-C)明显低于非肥胖组,差异有统计学意义(P<0.01或<0.05)。PCOS患者血清内脂素与BMI、舒张压、多毛症F-G评分、FSH、LH、T、hs-CRP、TG呈正相关,与HDL-C呈负相关(P<0.05)。回归分析显示,舒张压和TG升高是PCOS患者血清内脂素增加的独立危险因素(P<0.05)。结论PCOS患者血清内脂素水平明显升高,血清内脂素与心血管病危险因素呈正相关。

Objective To explore the correlation between serum visfatin level and cardiovascular disease risk factors in patient with polycystic ovary syndrome(PCOS).Methods A total of 100 PCOS patients(PCOS group)and 50 healthy women(control group)in Wuhan Puren Hospital from July 2016 to July 2018 were selected.In addition,according to the body mass index(BMI),the PCOS patients were divided into obese group(BMI≥25 kg/m2,57 cases)and non-obese group(BMI<25 kg/m2,43 cases).Serum level of visfatin was measured by enzyme-linked immunosorbent assay(ELISA)method,and the correlation between serum visfatin and follicle-stimulating hormone(FSH),luteinizing hormone(LH),testesterone(T),high sensitivity C-reactive protein(hs-CRP),blood lipids and blood glucose was analyzed.Results Compared with those in control group,the visfatin,BMI,diastolic blood pressure,waist and hip rate,hirsutism F-G score,FSH,LH,T,triglyeride(TG),fasting insulin(FINS),homeostasis model of assessment for insulin resistance index(HOMA-IR)in PCOS group were significantly increased:(103.20±19.15)μg/L vs.(29.56±4.14)μg/L,(25.81±4.17)kg/m2 vs.(21.29±3.74)kg/m2,(81.91±10.32)mmHg(1 mmHg=0.133 kPa)vs.(68.29±7.57)mmHg,0.91±0.14 vs.0.82±0.13,(13.41±2.91)scores vs.(5.98±1.01)scores,(12.78±1.98)U/L vs.(11.95±1.51)U/L,(15.84±3.16)U/L vs.(12.94±1.53)U/L,(2.98±0.32)nmol/L vs.(1.17±0.20)nmol/L,(1.89±0.43)mmol/L vs.(1.21±0.11)mmol/L,(18.40±2.98)mU/L vs.(11.23±2.10)mU/L,4.25±0.86 vs.2.51±0.55;the high density lipoprotein-cholesterol(HDL-C)and ISI were significantly decreased:(1.46±0.23)mmol/L vs.(1.55±0.27)mmol/L and 0.011±0.002 vs.0.019±0.005,and there were statistical differences(P<0.01 or<0.05).In addition,compared with those in non-obese group,the visfatin,BMI,diastolic blood pressure,hirsutism F-G score,FSH,LH,T,hs-CRP and TG in obese group were significantly higher,the HDL-C in obese group were significantly lower,and there were statistical differences(P<0.01 or<0.05).In PCOS group,serum visfatin level was positively correlated with BMI,diastolic blood pressure,hirsutism F-G score,FSH,LH,T,hs-CRP and TG,and serum visfatin level was negatively correlated with HDL-C(P<0.05).Stepwise multiple linear regression analysis showed that diastolic blood pressure and TG increased were the main predictors of increased visfatin level in patients with PCOS(P<0.05).Conclusions Serum visfatin is increased in the patients with PCOS,and serum visfatin is positively related with the cardiovascular risk factors.