多囊卵巢综合征患者血清IL-36α,CTRP6水平表达与临床诊断价值研究

Study on the Expression of Serum IL-36αand CTRP6 in Patients with Polycystic Ovary Syndrome and Their Clinical Diagnostic Value

目的研究多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者血清白细胞介素-36α(interleukin-36α,IL-36α)、C1q/肿瘤坏死因子相关蛋白6(C1q/tumor necrosis factor-related protein 6,CTRP6)水平表达及临床诊断价值研究。方法选取2019年4月~2022年4月新疆医科大学第五附属医院就诊的98例PCOS患者(PCOS组),以70例同期体检的健康女性为对照(对照组)。酶联免疫吸附实验(ELISA)检测两组血清IL-36α,CTRP6表达。Pearson相关分析血清IL-36α,CTRP6水平与临床指标的相关性。多因素Logistic回归分析影响PCOS发生的因素。受试者工作特征(ROC)曲线评价血清IL-36α,CTRP6及联合检测对PCOS的诊断效能。结果PCOS组血清CTRP6(18.25±3.67μg/L)、空腹血糖(5.71±0.49nmol/L)、空腹胰岛素(18.96±2.68mIU/L)、稳态模型胰岛素抵抗指数(HOMA-IR)(4.72±0.46)、黄体生成素(6.17±1.44Iu/L)、睾酮(1.32±0.42nmol/L)、卵巢数目(17.86±5.20个)和卵巢体积(9.29±2.14cm^(3))高于对照组(5.14±1.28μg/L,4.76±0.54mmol/L,8.63±1.65mIU/L,1.83±0.33,4.92±1.39IU/L,0.86±0.28nmol/L,6.76±1.94个,5.26±1.31cm^(3)),而血清IL-36α(0.67±0.13ng/L)、卵泡刺激素(4.27±1.33IU/L)低于对照组(2.11±0.38ng/L,5.42±1.67IU/L),差异具有统计学意义(t/χ^(2)=4.962~44.934,均P<0.05)。1型、2型、3型和4型PCOS患者血清IL-36α(0.87±0.15ng/L,0.70±0.12ng/L,0.51±0.11ng/L,0.42±0.10ng/L)水平依次降低,而CTRP6(14.07±3.35μg/L,17.66±3.97μg/L,21.16±3.67μg/L,24.08±3.53μg/L)水平依次升高,差异具有统计学意义(F=61.281,33.854,均P<0.05)。血清IL-36α与卵巢数目、卵巢体积、空腹胰岛素、HOMA-IR呈负相关(r=-0.661,-0.621,-0.554,-0.671,均P<0.05)。血清CTRP6与卵巢数目、卵巢体积、空腹胰岛素、HOMA-IR呈正相关(r=0.625,0.631,0.537,0.738,均P<0.05)。CTRP6(OR=1.327,95%CI:1.104~1.596)是影响PCOS发生的独立危险因素,IL-36α(OR=0.707,95%CI:0.547~0.914)是保护因素。血清IL-36α,CTRP6联合检测诊断PCOS的曲线下面积(95%CI)为0.933(0.872~0.969),大于单一指标检测的0.870(0.821~0.926)和0.898(0.854~0.940),差异具有统计学意义(Z=4.258,4.119,均P<0.05)。结论PCOS患者血清IL-36α降低,CTRP6水平升高,与PCOS病情程度有关,两者联合检测对PCOS具有较高的诊断价值。

Objective To study the serum expression of interleukin-36α(IL-36α),C1q/tumor necrosis factor-related protein 6(CTRP6)levels in patients with polycystic ovary syndrome(PCOS)and their diagnostic value.Methods A total of 98 PCOS patients diagnosed and treated in the Fifth Affiliated Hospital of Xinjiang Medical University from April 2019 to April 2022 were taken as the PCOS group,and 70 healthy women were taken as the control group.Enzyme-linked immunosorbent assay was applied to detect serum IL-36αand CTRP6 level expression.The correlation between the expression of serum IL-36α,CTRP6 levels and clinical indicators was analyzed by Pearson correlation analysis.Multivariate logistic regression analysis was used to analyze factors affecting the occurrence of PCOS.Receiver operating characteristic curve was used to evaluate the diagnostic efficacy of serum IL-36α,CTRP6 and combination in PCOS.Results Serum CTRP6(18.25±3.67μg/L),FPG(5.71±0.49nmol/L),FINS(18.96±2.68mIU/L),HOMA-IR(4.72±0.46),LH(6.17±1.44IU/L),T(1.32±0.42nmol/L),ovarian number(17.86±5.20)and ovarian volume(9.29±2.14cm^(3))in the PCOS group were higher,while serum IL-36α(0.67±0.13ng/L)and FSH(4.27±1.33IU/L)were lower compared with those in the control group(5.14±1.28μg/L,4.76±0.54mmol/L,8.63±1.65mIU/L,1.83±0.33,4.92±1.39IU/L,0.86±0.28nmol/L,6.76±1.94个,5.26±1.31cm^(3),2.11±0.38ng/L,5.42±1.67IU/L),with significant differences(t/χ^(2)=4.962~44.934,all P<0.05).Serum IL-36α(0.87±0.15ng/L,0.70±0.12ng/L,0.51±0.11ng/L,0.42±0.10ng/L)levels in patients with type 1,type 2,type 3,and type 4 PCOS were decreased sequentially,while CTRP6(14.07±3.35μg/L,17.66±3.97μg/L,21.16±3.67μg/L,24.08±3.53μg/L)were increased sequentially,with significant differences(F=61.281,33.854,all P<0.05).There was a negative correlation between serum IL-36αand ovarian number,ovarian volume,FINS and HOMA-IR(r=-0.661,-0.621,-0.554,-0.671,all P<0.05).Serum CTRP6 was positively correlated with ovarian number,ovarian volume,FINS and HOMA-IR(r=0.625,0.631,0.537,0.738,all P<0.05).CTRP6(OR=1.327,95%CI:1.104~1.596)was an independent risk factor affecting the occurrence of PCOS,while IL-36α(OR=0.707,95%CI:0.547~0.914)was a protective factor.The area under the curve(95%CI)of combination of IL-36αand CTRP6 for the diagnosis of PCOS was 0.933(0.872~0.969),which was greater than that of IL-36α,CTRP6 alone[0.870(0.821~0.926),0.898(0.854~0.940)],with significant differences(Z=4.258,4.119,all P<0.05).Conclusion The decrease of serum IL-36αand the increase of CTRP6 in PCOS patients are related to the severity of PCOS,and the combined detection of the two may have high diagnostic value for PCOS.