血清前蛋白转化酶枯草溶菌素9、分泌型卷曲相关蛋白-4表达与肥胖性多囊卵巢综合征患者性激素、糖脂代谢的相关性

Correlation between the expression of serum preprotein convertase subtilisin/kexin type 9,secreted frizzled related protein-4 and sex hormone,glucose and lipid metabolism in patients with obese polycystic ovary syndrome

目的探讨肥胖性多囊卵巢综合征患者血清前蛋白转化酶枯草溶菌素9(PCSK9)、分泌型卷曲相关蛋白-4(SFRP-4)表达与性激素、糖脂代谢的相关性。方法回顾性选取2021年4月至2022年10月徐州市妇幼保健院诊治的130例多囊卵巢综合征患者作为研究对象,根据体质量指数将患者分为肥胖组60例,非肥胖组70例。采用酶联免疫吸附法检测血清PCSK9、SFRP-4水平。对肥胖性多囊卵巢综合征患者血清PCSK9、SFRP-4水平与性激素(促黄体生成素、睾酮、卵泡刺激素)、糖代谢指标[空腹血糖(FPG)、糖化血红蛋白(HbAlc)、空腹胰岛素(FINS)、稳态模型评估法胰岛素抵抗指数(HOMA-IR)]、脂代谢指标[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]的相关性进行Pearson法分析。结果肥胖组较非肥胖组多囊卵巢综合征患者血清PCSK9、SFRP-4水平均显著升高[(679.36±162.21)μg/L比(421.68±103.74)μg/L、(302.87±70.58)μg/L比(184.21±52.45)μg/L],差异有统计学意义(P<0.05);与非肥胖组相比,肥胖组患者促黄体生成素、睾酮水平明显升高[(18.36±5.34)U/L比(9.47±2.21)U/L、(3.61±0.97)nmol/L比(3.02±0.84)nmol/L](P<0.05),卵泡刺激素水平明显降低[(7.28±1.62)U/L比(8.03±2.10)U/L],差异有统计学意义(P<0.05);肥胖组多囊卵巢综合征患者FPG、HbAlc、FINS水平及HOMA-IR均显著高于非肥胖组[(5.46±0.67)mmol/L比(5.04±0.49)mmol/L、(7.96±0.98)%比(6.68±0.77)%、(34.08±3.64)U/L比(23.67±2.52)U/L、8.27±1.84比5.30±1.52],差异有统计学意义(P<0.05);与非肥胖组相比,肥胖组多囊卵巢综合征患者TC、TG、LDL-C水平均显著升高[(4.86±0.67)mmol/L比(4.12±0.54)mmol/L、(1.64±0.36)mmol/L比(1.06±0.21)mmol/L、(2.81±0.56)mmol/L比(2.14±0.42)mmol/L](P<0.05),HDL-C水平明显降低[(1.11±0.25)mmol/L比(1.52±0.40)mmol/L],差异有统计学意义(P<0.05);肥胖性多囊卵巢综合征患者血清PCSK9、SFRP-4水平与促黄体生成素、睾酮、FPG、HbAlc、FINS、HOMA-IR、TC、TG、LDL-C呈正相关(P<0.05),与卵泡刺激素、HDL-C呈负相关(P<0.05)。结论肥胖性多囊卵巢综合征患者血清PCSK9、SFRP-4水平升高,与患者性激素、糖脂代谢有关。

Objective To investigate the correlation between the expression of serum preprotein convertase subtilisin/kexin type 9(PCSK9),secreted frizzled related protein-4(SFRP-4)and sex hormone,glucose and lipid metabolism in obese polycystic ovary syndrome(PCOS)patients.Methods A total of 130 patients with polycystic ovary syndrome diagnosed and treated in Xuzhou Maternal and Child Health Hospital from April 2021 to October 2022 were selected as the study subjects,the patients were divided into obese group(60 cases)and non obese group(70 cases)according to body mass index.Enzyme linked immunosorbent assay was applied to detect the serum levels of PCSK9 and SFRP-4.The correlation between serum PCSK9,SFRP-4 levels and sex hormones(luteinizing hormone,testosterone,follicle stimulating hormone),glucose metabolism indicators[fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS),homeostatic model assessment insulin resistance index(HOMA-IR)],lipid metabolism indexes[total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)]in patients with obese polycystic ovary syndrome was analyzed by Pearson method.Results The serum levels of PCSK9 and SFRP-4 in obese group were significantly higher than those in non obese group:(679.36±162.21)μg/L vs.(421.68±103.74)μg/L,(302.87±70.58)μg/L vs.(184.21±52.45)μg/L,the difference was statistically significant(P<0.05).Compared with the non obese group,the obese group had significantly higher levels of luteinizing hormone and testosterone:(18.36±5.34)U/L vs.(9.47±2.21)U/L,(3.61±0.97)nmol/L vs.(3.02±0.84)nmol/L(P<0.05),and significantly lower levels of follicle stimulating hormone:(7.28±1.62)U/L vs.(8.03±2.10)U/L,with statistically significant differences(P<0.05);the levels of FPG,HbA1c,FINS and HOMA-IR in obese group were significantly higher than those in non obese group:(5.46±0.67)mmol/L vs.(5.04±0.49)mmol/L,(7.96±0.98)%vs.(6.68±0.77)%,(34.08±3.64)U/L vs.(23.67±2.52)U/L,8.27±1.84 vs.5.30±1.52,and the differences were statistically significant(P<0.05);compared with the non obese group,the obese group had significantly increased levels of TC,TG and LDL-C:(4.86±0.67)mmol/L vs.(4.12±0.54)mmol/L,(1.64±0.36)mmol/L vs.(1.06±0.21)mmol/L and(2.81±0.56)mmol/L vs.(2.14±0.42)mmol/L(P<0.05),and HDL-C level was significantly reduced:(1.11±0.25)mmol/L vs.(1.52±0.40)mmol/L,with statistically significant differences(P<0.05);the levels of serum PCSK9 and SFRP-4 in obese polycystic ovary syndrome patients were positively correlated with luteinizing hormone,testosterone,FPG,HbA1c,FINS,HOMA-IR,TC,TG and LDL-C(P<0.05),and negatively correlated with follicle stimulating hormone and HDL-C(P<0.05).Conclusions The serum PCSK9 and SFRP-4 levels in obese polycystic ovary syndrome patients are elevated,which is related to sex hormones,glucose and lipid metabolism.