多囊卵巢综合征人群血清CTRP7水平的变化及影响因素分析

Variation of serum CTRP7 levels in patients suffering from polycystic ovary syndrome and analysis of its influencing factors

目的探讨多囊卵巢综合征(PCOS)女性血清C1q肿瘤坏死因子相关蛋白7(CTRP7)水平的变化,并分析CTRP7与胰岛素抵抗(IR)的关系。方法选择2022年9月—2023年9月于本院内分泌科就诊的255例PCOS患者(PCOS组)和同期在本院体检中心体检的126名年轻健康女性(对照组)作为研究对象。PCOS组按BMI=25 kg/m^(2)为切点将PCOS患者又分为肥胖亚组(146例)和非肥胖亚组(109例);对照组按BMI=25 kg/m^(2)为切点又分肥胖亚组(12例)和非肥胖亚组(114例)。38例初诊的PCOS患者接受6个月单药司美格鲁肽改善胰岛素抵抗的治疗。采用酶联免疫吸附法(ELISA)检测血清CTRP7水平,分析血清CTRP7与相关代谢指标的关系。结果PCOS组血清CTRP7水平高于对照组[(165.07±65.04)vs(109.64±39.97)μg/L,P<0.05];PCOS肥胖亚组血清CTRP7水平高于PCOS非肥胖亚组[(189.09±65.19)vs(134.67±50.76)pg/ml,P<0.05]。38例肥胖PCOS患者连续使用司美格鲁肽单药治疗6个月后,治疗后的CTRP7水平较治疗前有显著下降[(174.31±61.724)vs(205.29±69.63),P<0.05]。相关性分析显示,CTRP7与BMI、WHR、FPG、2h-PG、FIns、2 h-Ins、HOMA-IR、TC、LDL-C、FAT、TEST成正相关(P<0.05),多元线性逐步回归分析表明,BMI、HOMA-IR是血清CTRP7水平的影响因素(R^(2)=0.311、0.353,F=169.68、103.17,P<0.05)。结论血清CTRP7水平在新诊断PCOS及肥胖人群中升高,可能与IR有关,PCOS患者使用司美格鲁肽改善胰岛素抵抗治疗后血清CTRP7水平较治疗前明显降低。

Objective To investigate the variation of serum C1q tumor necrosis factor related protein7(CTRP7)level in women with polycystic ovary syndrome(PCOS),and analyze the relationship between CTRP7 and insulin resistance(IR).Methods 255 women suffering from PCOS(PCOS group)who visited department of endocrinology of the hospital from September 2022 to September 2023,and 126 healthy women(the control group)who received health examination in the same hospital during the same period were enrolled as study objects.Patients in PCOS group were divided in to the obese subgroup(n=146)and non-obese subgroup(n=109)set BMI=25kg/m^(2) as the cut-off value.And the control group was also divided in to the obese subgroup(n=12)and the non-obese subgroup(n=114).Thirty-eight newly diagnosed PCOS patients were treated with semaglutide mono-therapy for 6 months to improve insulin resistance.The level of serum CTRP7 was monitored by enzyme-linked immunosorbent assay(ELISA),and the relationship between CTRP7 and related metabolic indexes was analyzed.Results Circulating CTRP7 levels were significantly increased in PCOS women compared with controls[(165.07±65.04)vs(109.64±39.97)ug/l,P<0.05].The serum CTRP7 level of PCOS obese subgroup was higher than that of PCOS non-obese subgroup[(189.09±65.19)vs(134.67±50.76)pg/mL,P<0.05].After being treated with semaglutide mono-therapy for six months,serum CTRP7 concentrations of the 38 PCOS patients markedly decreased than that before treatment[(174.31±61.724)vs(205.29±69.63),P<0.05].Correlation analysis showed that CTRP7 was positively correlated with BMI,WHR,FPG,2h-PG,FIns,2 h-Ins,HOMA-IR,TC,LDL-C,FAT and TEST(P<0.05).Multiple linear stepwise regression analysis showed that BMI and HOMA-IR were the influencing factors of serum CTRP7 level(R^(2)=0.311,0.353,F=169.68,103.17,P<0.05).Conclusions Circulating CTRP7 levels were increased significantly in newly diagnosed PCOS patients and obese subjects,it may be related to IR.After being treated with semaglutide mono-therapy for 6 months to improve insulin resistance,serum CTRP7 concentrations in PCOS women markedly decreases than before.