METRNL在PCOS患者血清中的表达及意义

Expression and significance of METRNL in serum of PCOS patients

目的探讨多囊卵巢综合征(PCOS)患者血清中METRNL的表达情况,寻找PCOS治疗的新靶点。方法选取2022年7-10月就诊于河北大学附属医院生殖中心门诊被确诊为PCOS的131例患者为实验组(PCOS组),另收集同期确诊为男方因素不孕的且其他各项实验室检查结果均正常的50例女性作为正常对照组。应用酶联免疫吸附(ELISA)法检测血清中METRNL水平,化学发光法检测血清中睾酮(T)、卵泡刺激素(FSH)、黄体生成素(LH)水平;对所有研究对象进行胰岛素释放实验(IRT)及葡萄糖耐量实验(OGTT)。同时根据体质量指数(BMI)将PCOS组分为肥胖组及非肥胖组;根据胰岛素抵抗指数(HOMA-IR)将PCOS组分为胰岛抵抗组(PCOS-IR组)与非胰岛抵抗组(PCOS-非IR组),比较PCOS及PCOS亚组与对照组之间的METRNL、激素水平等差异,并用Pearson分析各指标间的相关性。结果PCOS组与对照组比较,BMI、T、LH/FSH、HOMA-IR及METRNL水平均有统计学差异(P<0.05)。PCOS肥胖组患者的HOMA-IR水平显著高于非肥胖者(P<0.05),METRNL的表达水平显著低于非肥胖PCOS患者(P<0.05);与对照组比较,PCOS非肥胖组的T、LH/FSH及HOMA-IR值均显著升高(P<0.05),而METRNL的表达水平显著降低(P<0.05)。PCOS-IR组的BMI水平显著高于PCOS-非IR组(P<0.05),METRNL的表达水平显著低于PCOS-非IR组(P<0.05);与对照组比较,PCOS-非IR组的T、LH/FSH均显著升高(P<0.05),METRNL的表达水平显著降低(P<0.05)。Pearson相关分析结果显示,所有研究对象中METRNL与HOMA-IR、BMI、T及LH/FSH均呈负相关(P<0.05),而在PCOS组中,METRNL与HOMA-IR、BMI均呈负相关(P<0.05),与T及LH/FSH无相关性。结论血清中METRNL水平的变化及其与HOMA-IR、BMI、T及LH/FSH的关系,可能与PCOS的发生有关,有望成为PCOS治疗的新靶点。

Objective:To investigate the serum expression of METRNL in the patients with polycystic ovarian syndrome(PCOS),and to find a new therapeutic target for PCOS.Methods:A total of 131 patients who were diagnosed as PCOS at the Clinic of Reproductive Center of Affiliated Hospital of Hebei University from July to October 2022 were selected as the experimental group(PCOS group),and another 50 women who were diagnosed with male infertility during the same period and had normal laboratory test results were collected as the normal control group.The enzyme-linked immunosorbent assay(ELISA)was used to detect serum METRNL levels.The serum levels of FSH,LH and testosterone(T)were detected by chemiluminescence method.Oral glucose tolerance test(OGTT)and insulin release test(IRT)were performed for all enrolled subjects.The patients in PCOS group were divided into an obese group and a non-obese group according to body mass index(BMI),and the patients were divided into the insulin resistance(IR)group and the non-IR group according to HOMA-IR index.The differences in METRNL and hormone levels between PCOS,PCOS subgroups and the control group were compared,and Pearson was to analyze the correlation between each indicator.Results:There were significant differences in BMI,T,LH/FSH,HOMA-IR,and METRNL levels between the PCOS group and the control group(P<0.05).The HOMA-IR levels in PCOS obese patients were significantly higher than those in non-obese patients(P<0.05).Compared with the control group,the levels of T&LH/FSH,and HOMA-IR values of the non-obese PCOS group were significantly increased(P<0.05),while the METRNL expression level was significantly reduced(P<0.05).The BMI level of the PCOS-IR group was significantly higher than that of the PCOS-non-IR group(P<0.05),while the METRNL expression level was significantly lower than that of the PCOS-non-IR group(P<0.05).Compared with the control group,the levels of T,LH/FSH in the PCOS non-IR group were significantly increased(P<0.05),while the METRNL expression level was significantly reduced(P<0.05).Pearson correlation analysis showed that METRNL was negatively correlated with HOMA-IR,BMI,T and LH/FSH in all patients(P<0.05),while METRNL was negatively correlated with HOMA-IR and BMI(P<0.05),but was not correlated with T and LH/FSH in PCOS group.Conclusions:The changes of serum METRNL level and its relationship with HOMA-IR,BMI,T and LH/FSH may be related to the occurrence of PCOS and it is expected to be a new target for the treatment of PCOS。