FABP4、GLP-1、和肽素在肥胖型多囊卵巢综合征中的表达及与胰岛素抵抗的相关性研究

Expression of FABP4,GLP-1,and copeptin in obese polycystic ovary syndrome and their correlation with insulin resistance

目的 探讨脂肪细胞型脂肪酸结合蛋白4(FABP4)、胰高血糖素样肽-1(GLP-1)、和肽素在肥胖型多囊卵巢综合征(PCOS)中的表达及与胰岛素抵抗的相关性。方法 选择2018年6月至2021年3月门头沟区医院收治的123例PCOS患者,根据体质量指数(BMI)将PCOS患者分为超重和肥胖组(BMI≥24.0 kg/m^(2))71例和正常体质量组(BMI在18.5~<24.0 kg/m^(2))52例,另选择同期于该院妇科门诊体检的健康女性63例为对照组。于月经周期第3~5天采集静脉血,检测血清FABP4、GLP-1、和肽素水平及糖脂代谢、性激素、胰岛素抵抗指标。采用Pearson相关分析FABP4、GLP-1、和肽素水平与糖脂代谢、性激素、胰岛素抵抗的相关性;采用多因素线性回归分析影响肥胖型PCOS患者胰岛素抵抗的因素。结果 超重和肥胖组血清FABP4、和肽素、睾酮(T)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、餐后2 h血糖(2 hBG)、空腹胰岛素(FINS)水平及胰岛素抵抗指数(HOMA-IR)高于正常体质量组和对照组(P<0.05),GLP-1水平低于正常体质量组和对照组(P<0.05)。FABP4水平与BMI、TC、PFG、FINS、HOMA-IR呈正相关(P<0.05),和肽素水平与FPG、FINS、HOMA-IR呈正相关(P<0.05),GLP-1水平与BMI、TC、PFG、FINS、HOMA-IR呈负相关(P<0.05)。BMI、TC、FPG、FABP4、GLP-1、肽素水平是肥胖型PCOS患者胰岛素抵抗的影响因素(P<0.05)。结论 FABP4、和肽素和GLP-1水平与胰岛素抵抗有关,有望成为肥胖型PCOS患者胰岛素抵抗评估的潜在生物学指标及治疗靶点。

Objective To investigate the expression of fatty acid binding protein 4 of adipocyte type(FABP4),glucagon-like peptide-1(GLP-1),and copeptin in obese polycystic ovary syndrome(PCOS)and their correlation with insulin resistance.Methods A total of 123 PCOS patients admitted to the Mentougou District Hospital from June 2018 to March 2021 were divided into overweight and obese group(71 cases,BMI≥24.0 kg/m^(2))and normal body weight group(52 cases,BMI 18.5-<24.0 kg/m^(2))according to body mass index(BMI).A total of 63 women were selected as the control group.Serum FABP4,GLP-1,and copeptin levels,glucose and lipid metabolism,sex hormones,and insulin resistance indexes were detected in venous blood samples collected from the third to the fifth day of the menstrual cycle.Pearson correlation was used to analyze the correlation between FABP4,GLP-1,and copeptin and glucose and lipid metabolism indicators,sex hormones,and insulin resistance.Multivariate linear regression was used to analyze the factors affecting insulin resistance in obese PCOS patients.Results The levels of serum FABP4,copeptin,testosterone(T),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),fasting plasma glucose(FPG),2-hour post-meal blood glucose(2 hBG),fasting insulin(FINS),insulin resistance index(HOMA-IR)in overweight and obese group were higher than those in normal body weight group and control group(P<0.05),GLP-1 level was lower than that of normal body weight group and control group(P<0.05).FABP4 was positively correlated with BMI,TC,PFG,FINS and HOMA-IR(P<0.05),and copeptin was positively correlated with FPG,FINS and HOMA-IR(P<0.05),while GLP-1 was negatively correlated with BMI,TC,PFG,FINS and HOMA-IR(P<0.05).BMI,TC,FPG,FABP4,GLP-1 and copeptin were influencing factors for insulin resistance in obese PCOS patients(P<0.05).Conclusion The levels of FABP4,copeptin and GLP-1 are related to insulin resistance,and are expected to be potential biological indicators and therapeutic targets for the assessment of insulin resistance in obese PCOS patients.