多囊卵巢综合征患者血清网膜素、C1q/肿瘤坏死因子相关蛋白9、内脏脂肪组织来源的丝氨酸蛋白酶抑制剂水平与病情的相关性和诊断价值的研究

Serum Omentin,CTRP9,Vaspin levels in PCOS patients and their correlation with disease and diagnostic value

目的探讨多囊卵巢综合征(PCOS)患者血清网膜素(Omentin)、C1q/肿瘤坏死因子相关蛋白9(CTRP9)、内脏脂肪组织来源的丝氨酸蛋白酶抑制剂(Vaspin)水平与患者病情的相关性及其对PCOS的诊断价值。方法选取2015年10月至2021年3月邯郸市中心医院收治的106例PCOS患者作为观察组,根据PCOS分型标准将其分为1型组(n=36)、2型组(n=28)、3型组(n=24)、4型组(n=18)4个亚组;选取同期64例健康女性体检者作为对照组。检测两组血清Omentin、CTRP9、Vaspin水平,观察组患者行经阴道超声检查,统计卵巢体积和卵巢直径<9mm的卵泡数目。采用Pearson相关性分析评价血清Omentin、CTRP9、Vaspin水平与病情的相关性,采用受试者工作特征(ROC)曲线评价血清Omentin、CTRP9、Vaspin水平对PCOS的诊断价值。结果观察组血清Omentin、CTRP9水平低于对照组,Vaspin水平高于对照组(P<0.05)。与1型组比较,4型组、3型组、2型组血清Omentin、CTRP9水平降低,且4型组<3型组<2型组(P<0.05)。与1型组比较,4型组、3型组、2型组血清Vaspin水平升高,且4型组>3型组>2型组(P<0.05)。Pearson相关性分析显示,血清Omentin水平与卵巢体积、卵泡数目均呈负相关(r=-0.458、-0.469,P<0.05),血清CTRP9水平与卵巢体积、卵泡数目均呈负相关(r=-0.391、-0.402,P<0.05),血清Vaspin水平与卵巢体积、卵泡数目均呈正相关(r=0.429、0.452,P<0.05)。ROC曲线结果显示,血清Omentin诊断PCOS的曲线下面积(AUC)为0.841,临界值为71.74ng/L;血清CTRP9诊断PCOS的AUC为0.782,临界值为229.04ng/mL;血清Vaspin诊断PCOS的AUC为0.808,临界值为0.62mg/L;三者联合诊断PCOS的AUC为0.908。结论PCOS患者血清Omentin、CTRP9水平降低,Vaspin水平升高;血清Omentin、CTRP9、Vaspin水平与患者病情密切相关;血清Omentin、CTRP9、Vaspin三者联合检测对PCOS诊断具有重要价值。

Objective To investigate the levels of Omentin, C1q/tumor necrosis factor-related protein 9(CTRP9) and visceral adipose tissue-derived serine protease inhibitor(Vaspin) in patients with polycystic ovary syndrome(PCOS), and to analyze the correlation between their levels and patients′ conditions and their diagnostic value for PCOS. Methods A total of 106 PCOS patients admitted to Handan Central Hospital from October 2015 to March 2021 were selected as the observation group. According to the classification, they were divided into 4 subgroups: type 1 group(n=36), type 2 group(n=28), type 3 group(n=24), and type 4 group(n=18). 64 healthy subjects during the same period were selected as the control group. Serum levels of Omentin, CTRP9 and Vaspin were detected in the two groups. The observation group received transvaginal ultrasound. Ovarian volume and follicles with ovarian diameter <9 mm were counted. Pearson correlation was used to analyze the correlation between serum Omentin, CTRP9, Vaspin levels and PCOS, and receiver operating characteristic(ROC) curve was used to evaluate the diagnostic value of serum Omentin, CTRP9, Vaspin levels in patients with PCOS. Results The levels of serum Omentin and CTRP9 in the observation group were lower than those in the control group, and the levels of Vaspin were higher than those in the control group(P<0.05). Compared with type 1 group, the levels of Omentin and CTRP9 in serum of type 4,type 3 and type 2 groups were all decreased, and type 4 group <type 3 group <type 2 group(P<0.05).Compared with type 1 group, serum Vaspin level of type 4 group, type 3 group and type 2 group were increased, and type 4 group > type 3 group> type 2 group(P<0.05). Pearson correlation analysis showed that serum Omentin levels were negatively correlated with the ovarian volume and the number of follicles(r=-0.458,-0.469, P<0.05). Serum CTRP9 levels were negatively correlated with the ovarian volume and the number of follicles(r=-0.391,-0.402, P<0.05).The serum Vaspin level was positively correlated with the ovarian volume and the number of follicles(r=0.429, 0.452, P<0.05). ROC curve results showed that the area under curve(AUC) of PCOS patients diagnosed by serum Omentin was 0.841, and the critical value was 71.74 ng/L. The AUC of serum CTRP9 in the diagnosis of PCOS patients was 0.782, and the critical value was 229.04 ng/mL. The AUC of serum Vaspin in the diagnosis of PCOS patients was 0.808, and the critical value was 0.62 mg/L. The AUC of the combined diagnosis of PCOS patients was 0.908. Conclusions Serum Omentin and CTRP9 levels were decreased and Vaspin levels were increased in PCOS patients. The levels of serum Omentin, CTRP9 and Vaspin were closely related to patients′ conditions. The combined detection of serum Omentin, CTRP9 and Vaspin is of great value in the diagnosis of PCOS patients, which is worthy of promotion.