多囊卵巢综合征患者血清Betatrophin水平及其与代谢参数的相关性分析

Serum Betatrophin level in patients with polycystic ovary syndrome and its relationship with metabolic parameters

目的探究多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者血清Betatrophin水平及其与代谢参数的相关性。方法选取2017年12月至2019年9月郑州人民医院收治的PCOS患者98例(PCOS组),根据体质量指数(body mass index,BMI)将其分为非肥胖组(n=45)与肥胖组(n=53);根据胰岛素抵抗指数(HOMA-IR)值将其分为非IR组(n=21)与IR组(n=77);根据总睾酮(TT)水平将其分为非高雄激素组(n=24)与高雄激素组(n=74)。另取健康女性90例作为对照组。对两组患者基线资料、脂代谢指标、激素指标、糖代谢指标及Betatrophin水平进行记录。应用Pearson检验及Logisitc回归模型,分析PCOS患者血清Betatrophin水平升高的影响因素。结果与对照组比较,PCOS组BMI、体脂肪、腰臀比(WHR)、极低密度脂蛋白(VLDL)、低密度脂蛋白胆固醇(LDL)、高密度脂蛋白胆固醇(HDL)、三酰甘油(TG)、总胆固醇(TC)、游离睾丸素(FAI)、TT、黄体生成素(LH)、硫酸脱氢异雄酮(DHEA-S)、17-羟孕酮(17-OHP)、卵泡刺激素(FSH)、空腹血糖(FBG)、空腹胰岛素(FINS)、HOMA指数(HOMA-IR)水平明显偏高,而HDL水平明显偏低,组间差异有统计学意义(P<0.01)。肥胖组血清Betatrophin水平明显高于非肥胖组(163.99±126.97 vs 110.99±102.97),差异有统计学意义(t=3.21,P<0.001);而IR组血清Betatrophin水平高于非IR组(160.26±136.80 vs 133.17±112.06),高雄激素组血清Betatrophin水平高于非高雄激素组(173.51±147.85 vs 144.26±124.56),但差异无统计学意义(P>0.05)。PCOS组血清Betatrophin水平与BMI、WHR、TG、FAI、FBG、FINS均呈正相关(P<0.05),与HDL呈负相关(P<0.05)。Logistic分析结果显示,BMI、WHR、TG是血清Betatrophin水平升高的独立影响因素。结论PCOS患者血清Betatrophin水平显著升高,且与BMI、WHR、TG、HDL、FAI、FBG、FINS,可能在PCOS的发生发展及肥胖、胰岛素抵抗(insulin resitance,IR)、血脂及雄激素代谢紊乱中起重要作用。

Objective To investigate the relationship between serum Betatrophin levels and metabolic parameters in patients with polycystic ovary syndrome(PCOS).Methods 98 patients with PCOS(PCOS group)treated in Zhengzhou People’s Hospital from Dec.2017 to Sep.2019 were selected.They were divided into non-obese group(n=45)and obese group(n=53)according to BMI value;They were divided into non-IR group(n=21)and IR group(n=77)according to HOMA-IR value;They were divided into non-hyperandrogen group(n=24)and hyperandrogen group(n=74)according to TT level;Another 90 healthy women were taken as the control group.The baseline data,lipid metabolism indexes,hormone indexes,glucose metabolism indexes and Betatrophin levels of the two groups were recorded.Pearson test and logisitc regression model were used to analyze the influencing factors related to the increase of serum Betatrophin level in patients with PCOS.Results Compared with the control group,PCOS group had higher level of BMI,body fat,WHR,VLDL,LDL,TG,TC,FAI,TT,LH,DHEA-S,17-OHP,FSH,FBG,FINS,and HOMA-IR,while the HDL level was significantly lower.The difference was significant(P<0.01).Serum Betatrophin level in obese group was significantly higher than that in the control group(163.99±126.97 vs 110.99±102.97),and the difference was statistically significant(t=3.21,P<0.001);serum Betatrophin level in IR group was higher than that in the control group(160.26±136.80 vs 133.17±112.06),and the serum Betatrophin level in IR group was higher than that in the control group(173.51±147.85 vs 144.26±124.56),but the difference was not statistically significant(P>0.05).Serum Betatrophin levels in PCOS group were positively correlated with BMI,WHR,TG,FAI,FBG,FINS(P<0.05),and negatively correlated with HDL(P<0.05).Logistic analysis showed that BMI,WHR and TG were independent factors affecting the increase of serum Betatrophin level.Conclusion Serum Betatrophin levels of PCOS patients are significantly increased,and BMI,WHR,TG,HDL,FAI,FBG,FINS may play an important role in the occurrence and development of PCOS and obesity,insulin resistance,blood lipids and androgen metabolism disorders.