补硒对多囊卵巢综合征患者不对称二甲基精氨酸及心血管指标的影响

Influence of selenium supplementation for treating patients with polycystic ovary syndrome on their asymmetric dimethyl arginine level and their cardiac metabolic risk factors

目的:探讨补硒对多囊卵巢综合征(PCOS)患者不对称二甲基精氨酸(ADMA)水平、心脏代谢危险因素和性激素水平的影响。方法:2021年1月-2022年1月在本院妇科门诊就诊的76例PCOS患者,随机分为补硒组(34例)和对照组(32例)。补硒组每日口服富硒酵母片60μg,对照组服用安慰剂,连续服用12周。分别于干预前和结束后,检测空腹血糖(FBG)、血清胰岛素、总胆固醇(TC)、甘油三酯(TG)和高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白-AI(Apo-A1)和载脂蛋白-B100(Apo-B100)水平。酶联免疫吸附法测定血清总T、性激素结合球蛋白(SHBG)和ADMA的水平。胰岛素抵抗的静态模型评估(HOMA-IR)计算胰岛素抵抗性。结果:干预后补硒组循环ADMA(52.4±18.64 ng/L)和T(0.49±0.31 ng/ml)水平低于对照组(63.96±15.77 ng/L、0.67±0.32 ng/ml),Apo-B100/Apo-A1比值(0.61±0.16)低于对照组(0.67±0.19);两组FBG、胰岛素和HOMA-IR及其他血脂水平无差异(均P<0.05)。结论:补硒12周对PCOS患者的循环ADMA、总T水平和Apo B 100/Apo AI比值均有提升作用,其他心脏代谢危险因素未见明显改善。

Objective: To investigate the effects of selenium supplementation for patients with polycystic ovary syndrome(PCOS) on their asymmetric dimethyl arginine(ADMA) level, their cardiac metabolic risk factors, and sex hormones levels. Methods: 76 patients with PCOS were randomly divided into study group(34 cases) and control group(32 cases). The patients in the study group were given oralselenium-enriched yeast tablet 60 μg every day for 12 weeks, and the patients in the control group were given placebo. The levels of fasting blood glucose(FBG), serum insulin, total cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), apolipoprotein AI(Apo-A1), and Apo-B 100 of the patients in the two groups were measured before and after intervention. The levels of serum total testosterone(T), sex hormone binding globulin(SHBG), and ADMA of the patients in the two groups were detected by ELISA. The insulin resistance(IR) of the patients in the two groups was calculated by homeostasis model assessment of IR(HOMA-IR). Results: After intervention, the levels of ADMA(52.4±18.64 ng/L) and T(0.49±0.31 ng/ml) of the patients in the study group were significantly lower than those(63.96±15.77 ng/L and 0.67±0.32 ng/ml) of the patients in the control group. The Apo-B100/Apo-A1 ratio(0.61±0.16) of the patients in the study group was significantly lower than that(0.67±0.19) of the patients in the control group(all P<0.05). There were no significant differences in the levels of FBG, insulin, and other lipid, and the HOMA-IR value of the patients between the two groups(P>0.05). Conclusion: The selenium supplementation for the patients with PCOS for 12 weeks has a positive effect on their ADMA and total T levels, and Apo B 100/Apo AI ratio,but which has no significant improvement on their other cardiac metabolic risk factors.