循环内皮祖细胞对围绝经期多囊卵巢综合征胰岛素抵抗的影响

Effects of circulating endothelial progenitor cells on insulin resistance in perimenopause polycystic ovary syndrome

目的分析围绝经期多囊卵巢综合征(PCOS)患者循环内皮祖细胞(EPCs)的变化与胰岛素抵抗(IR)的关系。方法选择临床围绝经期PCOS患者79例,分为肥胖组(n=43)与非肥胖组(n=36);同期健康女性体检者30例为对照组。比较3组糖代谢、内分泌水平,流式细胞术分析CD45+CD34+CD133+占单个核细胞百分比。体外培养内皮祖细胞(EPCs)并计数内皮祖细胞集落形成单位。酶联免疫吸附试验(ELISA)检测研究对象的血清血管内皮生长因子(VEGF)、C反应蛋白(CRP)、白细胞介素(IL)-6的水平。结果肥胖组空腹血糖(FPG)、餐后2小时血糖(2 hPG)、胰岛素抵抗指数(HOMA-IR)和胰岛素抵抗(IR)发生率明显高于非肥胖组及对照组,差异有统计学意义(P<0.05);肥胖组与非肥胖组黄体生成素(LH)分泌均明显高于对照组,差异有统计学意义(P<0.05)。肥胖组EPCs数量、集落形成单位明显低于非肥胖组和对照组,差异有统计学意义(P<0.05)。肥胖组CRP、VEGF、IL-6水平明显高于非肥胖组和对照组,差异有统计学意义(P<0.05)。循环EPCs数量与HOMA-IR呈负相关(r=-0.582,P<0.05)。结论肥胖的围绝经期PCOS患者较非肥胖患者及健康人群IR发病率明显升高,循环EPCs可能与肥胖PCOS患者的IR发生有关。

Objective To analyze the relationship between changes in circulating endothelial progenitor cells(EPCs)and insulin resistance(IR)in patients with perimenopause polycystic ovary syndrome.Methods Seventy-nine patients with perimenopause polycystic ovary syndrome were divided into obese and non-obese groups.During the same period,30 healthy female physical examination subjects were served as the control group.The levels of endocrine and glucose metabolism were compared among three groups.The percentage of CD45+CD34+CD133+in mononuclear cell was analyzed by flow cytometry.EPCs were cultured in vitro and the colony forming units of EPCs were counted.The expressions of VEGF,CRP and IL-6 were detected by ELISA.Results The FPG,2 hPG,HOMA-IR and incidence of IR in the obese group were significantly higher than those of the non-obese group and the control group.The secretion of LH in both PCOS groups was lower than that of the control group.The number of EPCs and colony forming units of obese group were significantly lower than those of non-obese group and control group.The expressions of CRP,VEGF and IL-6 in the obese group were higher than those of the non-obese group and the control group.The number of circulating EPCs was negatively correlated with HOMA-IR(r=-0.582,P<0.05).Conclusions The incidence of IR in obese perimenopause PCOS patients is significantly higher than that of non-obese patients and healthy control group,and circulating EPCs might be related to the occurrence of IR in obese PCOS patients.