可溶性CD36与多囊卵巢综合征及代谢风险因素的相关性

Correlation of soluble CD36 with polycystic ovary syndrome and metabolic risk factors

目的研究血清中可溶性CD36(soluble CD36,sCD36)与多囊卵巢综合征(polycystic ovary syndrome,PCOS)及其代谢风险因素的相关性。方法本研究采用病例对照研究,回顾性选择2015年4月至2015年7月期间在北京大学第三医院妇产科生殖医学中心接受体外受精-胚胎移植的PCOS患者(PCOS组,n=110)和同期、年龄匹配的单纯因男性因素或输卵管因素不孕人群(对照组,n=108),收集受试者的一般资料、临床数据,采用酶联免疫吸附法测定血清中sCD36水平,并对sCD36及临床指标间的相关性进行分析,运用logistic回归和受试者工作特征(receiver operating characteristic,ROC)曲线判定sCD36对PCOS的诊断价值,进一步在PCOS组内根据体质量指数、血压、稳态模型胰岛素抵抗(insulin resistance,IR)指数和血脂分代谢亚组比较sCD36水平,分析sCD36在PCOS不同代谢类型中的作用。结果PCOS组血清sCD36水平为1.27μg/L,显著高于对照组(0.84μg/L,P<0.001);PCOS组内,sCD36水平与黄体生成素(β=9.537,P=0.012)、黄体生成素/卵泡刺激素(β=85.374,P=0.011)、雄烯二酮(β=10.449,P=0.028)、0.5 h胰岛素(β=1.260,P=0.015)、1 h胰岛素(β=1.213,P=0.014)之间存在线性正相关。sCD36诊断PCOS的ROC曲线下面积为0.827,并且其诊断灵敏度(84.54%)、约登指数(0.56)均高于雄烯二酮(65.10%、0.45)和睾酮(58.72%、0.40)。PCOS合并IR亚组中,sCD36水平显著高于PCOS不合并IR亚组且sCD36与PCOS患者中IR风险相关(OR=1.010,95%CI:1.004~1.017,P=0.002)。结论PCOS患者血清中sCD36水平具有良好的PCOS诊断效能,可作为PCOS发生风险预测标志物,并且与PCOS中IR相关。

Objective To analyze the correlation of soluble CD36(sCD36)in serum with polycystic ovary syndrome(PCOS)and metabolic risk factors.Methods PCOS group(n=110)and the age matched patients with infertility due to male or tubal factors alone(n=108)who underwent in vitro fertilization-embryo transfer at the Center for Reproductive Medicine,Department of Obstetrics and Gynecology of Peking University Third Hospital from April 2015 to July 2015 were selected in this retrospective case-control study.General information and clinical data were collected,and serum sCD36 level was detected by enzyme-linked immunosorbent assay.Correlation analysis was used to determine the relationship between sCD36 and clinical indices.Logistic analysis and receiver operating characteristic(ROC)curve were used to determine the diagnostic value of sCD36 for PCOS.PCOS group was divided into subgroups based on body mass index,blood pressure,homeostasis model assessment for insulin resistance(IR)and serum lipids.And sCD36 level was compared between metabolic subgroups in patients with PCOS to analyze the role of sCD36 in different metabolic types of PCOS.Results In patients with PCOS,sCD36 level was 1.27μg/L,which was significantly increased compared with 0.84μg/L of control group(P<0.001).And in PCOS group,luteinizing hormone(β=9.537,P=0.012),luteinizing hormone/follicle-stimulating hormone(β=85.374,P=0.011),androstenedione(β=10.449,P=0.028),0.5 h insulin(β=1.260,P=0.015)and 1 h insulin(β=1.213,P=0.014)showed positive linear correlation with sCD36(all P<0.05).As for the diagnostic value of sCD36 for PCOS,the area under the curve of ROC was 0.827,meanwhile,the specificity(84.54%)and Youden index(0.56)of sCD36 were higher than those of androstenedione(65.10%,0.45)and testosterone(58.72%,0.40).In the subgroup of PCOS with IR,the level of sCD36 was significantly higher than that of the non-IR subgroup,and sCD36 was correlated with IR in patients with PCOS(OR=1.010,95%CI:1.004-1.017,P=0.002).Conclusion The level of serum sCD36 has predictive value for PCOS.sCD36 can be used as a marker to predict the risk of PCOS and is related to IR in patients with PCOS.