基于代谢组学探索多囊卵巢综合征合并非酒精性脂肪性肝病的病因学研究

Etiological study on polycystic ovary syndrome combined with non-alcoholic fatty liver disease based on metabonomics

目的探讨多囊卵巢综合征(PCOS)合并非酒精性脂肪性肝病(NAFLD)患者与单纯PCOS患者血清代谢物的差异,为PCOS合并NAFLD代谢组学研究提供依据。方法分别纳入PCOS合并NAFLD 24例及单纯性PCOS患者9例。采用超高液相色谱-质谱连用技术筛选两组研究对象的血清代谢组学差异物。结果两组血清代谢谱得到明显分离,筛选并鉴定了18种代谢差异物,包括游离脂肪酸(FFA) 5种、鞘磷脂(SM) 3种、单酰基甘油1种、磷脂酰胆碱(PC) 4种、硫化固醇3种、胆汁酸1种、苯甲酸类1种。与非NAFLD组相比,合并NAFLD的PCOS患者SM及1-花生四烯酸甘油水平升高,而FFA、PC、硫化固醇、甘氨胆酸(GCA)及马尿酸水平降低。结论与单纯性PCOS患者相比,PCOS+NAFLD患者存在更为严重的脂代谢异常,这可能是PCOS患者伴发NAFLD的重要原因。同时,受脂代谢影响,PCOS+NAFLD患者甾体类激素代谢亦出现异常。

Objective To explore the differences of serum metabolites between patients with polycystic ovary syndrome( PCOS) combined with non-alcoholic fatty liver disease( NAFLD) and patients with PCOS,provide a basis for metabonomic studies of PCOS combined with NAFLD. Methods Twenty-four patients with PCOS combined with NAFLD and nine patients with PCOS were selected,ultra-high liquid chromatography-mass spectrometry technology was used to screen the differences of serum metabonomics in the two groups. Results In the two groups,metabolic spectrums were isolated significantly,18 serum metabolites were screened out and identified,including five kinds of free fatty acid( FFA),three kinds of sphingomyelin( SM),one kind of monoacylglycerol,four kinds of phosphatidylcholine,three kinds of dihydro testosterone sulfate,one kind of bile acid,and one kind of benzoic acid. Compared with non-NAFLD group,the levels of SM and1-arachidonoyl glycbrol in NAFLD+PCOS group increased,the levels of dihydro testosterone sulfate,glycocholic acid,and hippuric acid decreased. Conclusion Compared with PCOS patients,more severe lipid metabolism abnormality is observed in patients with PCOS and NAFLD,which may be one of the important causes of PCOS complicated with NAFLD. At the same time,due to the influence of lipid metabolism,steroid hormone metabolism in patients with PCOS and NAFLD is abnormal.