PCOS患者血清ADMA、Ghrelin水平对肥胖及胰岛素抵抗的预测价值

Predictive value of serum ADMA and Ghrelin levels on obesity and insulin resistance in PCOS patients

目的探究多囊卵巢综合征(PCOS)患者血清ADMA、Ghrelin水平与肥胖、胰岛素抵抗(IR)的相关性。方法选取2017年1月至2019年3月就诊的146例患有PCOS女性作为PCOS组,根据BMI和WHR将患者分为PCOS肥胖组和PCOS非肥胖组,根据HOMA-IR将患者分为IR-PCOS组和NIR-PCOS组,另选取同期因输卵管因素或男方因素就诊的102例患者作为对照组;比较各组患者血清ADMA、Ghrelin水平及其他临床资料;比较三组的临床资料,采用Pearson检验进行相关性分析;采用ROC曲线分析ADMA、Ghrelin及二者联合对PCOS患者肥胖和IR的预测价值。结果PCOS组血清ADMA水平显著高于对照组,Ghrelin水平显著低于对照组;PCOS肥胖组ADMA水平显著高于PCOS非肥胖组,Ghrelin水平显著低于PCOS非肥胖组;IR-PCOS组ADMA水平显著高于NIR-PCOS组,Ghrelin水平显著低于NIR-PCOS组;血清ADMA、Ghrelin水平分别与BMI、WHR、FINS、HOMA-IR、FSH、LH、T具有明显相关性;ADMA、Ghrelin及二者联合预测PCOS患者肥胖的AUC分别为0.792、0.752和0.856,预测患者IR的AUC分别为0.814、0.783和0.875。结论PCOS患者血清ADMA水平上升、Ghrelin水平下降,对PCOS患者的肥胖和IR具有较高的预测价值。

Objective To explore the correlation of serum ADMA,Ghrelin levels with obesity and insulin resistance(IR)in patients with polycystic ovary syndrome(PCOS).Methods 146 female patients with PCOS from January 2017 to March 2019 were selected as PCOS group.According to BMI and WHR,patients were divided into PCOS obese group and PCOS non-obese group,patients were divided into IR-PCOS group and NIR-PCOS group according to HOMA-IR,and 102patients with fallopian tube factors or male factors in the same period were selected as control group.Compare the clinical data of the three groups;compare the clinical data of the three groups,use Pearson test for correlation analysis;use ROC curve to analyze the predictive value of ADMA,Ghrelin and their combination on obesity and IR in patients with PCOS.Results Serum ADMA level in PCOS group was significantly higher than that in control group,while Ghrelin level was significantly lower than that in control group;ADMA level in PCOS obese group was significantly higher than that in PCOS non-obese group,while Ghrelin level was significantly lower than that in PCOS non-obese group;ADMA level in IR-PCOS group was significantly higher than that in NIR-PCOS group,while Ghrelin level was significantly lower than that in NIR-PCOS group;serum ADMA and Ghrelin levels were significantly correlated with BMI,WHR,FINS,HOMA-IR,FSH,LH,T,respectively.The AUC of ADMA,Ghrelin and their combination for predicting obesity in patients with PCOS were 0.792,0.752 and 0.856respectively,and the AUC for predicting IR were 0.814,0.783 and 0.875,respectively.Conclusion The increase of serum ADMA level and the decrease of Ghrelin level in patients with PCOS have a high predictive value for obesity and IR in patients with PCOS.