二甲双胍联合炔雌醇环丙孕酮片对多囊卵巢综合征患者血清miR-124及Th1/Th2细胞因子平衡偏移的影响

Effect of metformin combined with ethinylestradiol and cyproterone acetate tablets on the shift of serum miR-124 and Th1/Th2 cytokine balance in patients with polycystic ovary syndrom

目的探讨二甲双胍联合炔雌醇环丙孕酮片对多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者血清miR-124水平及Th1/Th2细胞因子平衡偏移的影响。方法纳入2022年1月至2023年2月在攀枝花市妇幼保健院接受治疗的200例PCOS患者,分为观察组(n=100)和对照组(n=100);观察组给予二甲双胍联合炔雌醇环丙孕酮片治疗,对照组给予炔雌醇环丙孕酮片治疗,连续治疗3个月;收集两组患者临床资料,治疗前后血脂[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)]水平、空腹血糖(fasting plasma glucose,FPG)、空腹血清胰岛素(fins insulin,FINS)水平及胰岛素抵抗指数(HOMA-IR);检测血清miR-124、白细胞介素(IL)-2、IL-6、γ干扰素(interferon-γ,INF-γ)。结果治疗后观察组TG、TC、LDL-C水平显著降低(P<0.05);治疗后观察组TG、TC、LDL-C水平低于对照组(P<0.05);治疗前两组患者FPG、FINS、HOMA-IR比较差异无统计学意义(P>0.05),治疗后观察组FPG、FINS、HOMA-IR水平显著降低(P<0.05);且治疗后观察组FPG、FINS、HOMA-IR水平低于对照组(P<0.05);治疗前两组患者IL-2、IL-6、INF-γ及miR-124水平比较差异无统计学意义(P>0.05);治疗后观察组IL-6、INF-γ水平低于治疗前,IL-2、miR-124水平高于治疗前(P<0.05);治疗后观察组IL-6、INF-γ水平低于对照组,IL-2、miR-124水平高于对照组,差异有统计学意义(P<0.05)。结论二甲双胍联合炔雌醇环丙孕酮片能够明显改善PCOS患者胰岛素抵抗,调节糖脂代谢,改善Th1/Th2细胞因子平衡偏移状态。

Objective To investigate the effects of metformin combined with ethinylestradiol and cyproterone acetate tablets on serum miR-124 levels and Th1/Th2 cytokine balance shift in patients with polycystic ovary syndrome(PCOS).Methods A total of 200 PCOS patients treated at Panzhihua Maternal and Child Health Hospital from January 2022 to February 2023 were included and divided into an observation group(n=100)and a control group(n=100).The observation group received metformin combined with ethinylestradiol and cyproterone acetate tablets,while the control group received ethinylestradiol and cyproterone acetate tablets alone.The treatment duration was 3 months.Clinical data,lipid levels[total cholesterol(TC),triglyceride(TG),low density lipoprotein-C(LDL-C)],fasting plasma glucose(FPG),fasting serum insulin(FINS),and homeostasis model assessment-IR(HOMA-IR)were collected before and after treatment.Serum miR-124,interlenkin(IL)-2,IL-6,and interferon-γ(INF-γ)were also measured.Results After treatment,TG,TC,and LDL-C levels in the observation group significantly decreased(P<0.05).Post-treatment TG,TC,and LDL-C levels in the observation group were lower than those in the control group(P<0.05).There were no statistically significant differences in FPG,FINS,and HOMA-IR between the two groups before treatment(P>0.05).After treatment,FPG,FINS,and HOMA-IR levels in the observation group significantly decreased(P<0.05),and these levels were lower than those in the control group(P<0.05).There were no significant differences in IL-2,IL-6,INF-γ,and miR-124 levels between the two groups before treatment(P>0.05).After treatment,IL-6 and INF-γlevels decreased,and IL-2 and miR-124 levels increased in the observation group(P<0.05).Post-treatment IL-6 and INF-γlevels were lower,while IL-2 and miR-124 levels were higher in the observation group compared to the control group(P<0.05).Conclusion Metformin combined with ethinylestradiol and cyproterone acetate tablets can significantly improve insulin resistance,regulate glucolipid metabolism and improve the state of Th1/Th2 cytokine balance s hift in PCOS patients.