初诊多囊卵巢综合征患者空腹血清Orexin A、Nesfatin-1水平变化

发布时间：2018-05-27 12:42

本文选题：多囊卵巢综合征 + OrexinANesfatin-1　；参考：《安徽医科大学》2014年硕士论文

【摘要】：目的观察初诊多囊卵巢综合征（PCOS）患者空腹血清OrexinA（OXA）、Nesfatin-1水平的变化，探讨其在PCOS发生和发展中的意义。方法 1.选取就诊于我院初诊的PCOS患者57例(PCOS组)，月经正常的健康女性56例(对照组)；按照体质指数（BMI）≥25kg/m2或＜25kg/m2的标准，将PCOS组分为超重/肥胖亚组(PCOS-OW/OB，n=32)和正常体重亚组(PCOS-NW，n=25)，对照组按同样标准分为超重/肥胖亚组(Control-OW/OB，n=26)和正常体重亚组(Control-NW，n=30)。 2.采集所有研究对象的姓名、年龄、职业、月经周期、婚育史等基本信息；测量所有研究对象的身高、体重、腰围（WC）及臀围，计算身体质量指数（BMI）和腰臀比（WHR），并对其进行体格检查。 3.所有研究对象于月经周期第2~5天清晨空腹采集肘静脉血（月经稀发及闭经者时间不限）。用于对黄体生成素（LH）、卵泡刺激素（FSH）、睾酮（T）、甘油三酯（TG）、胆固醇（TC）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）的检测。 4.所有受试者于同一天清晨空腹（禁食12～14小时）行口服75g葡萄糖耐量试验（OGTT），分别抽取0、30、60及120min静脉血5ml，，离心后收集血清，-80°冰箱冻存备用。检测指标包括：空腹血糖（FBG）、餐后2h血糖（P2hBG）、空腹胰岛素（FINS）及餐后2h胰岛素（P2hINS），并计算稳态模型胰岛素抵抗指数。备用标本用于同一检测OXA及Nesfatin-1的水平。结果 1.一般资料及临床生化指标的比较：PCOS组与对照组相比，年龄、BMI、WC、TG、TC、HDL、LDL、P2hBG差异无统计学意义；PCOS组WHR和FBG高于对照组(P0.05)， LH、LH/FSH、T、FINS、HOMA-IR明显高于对照组(P0.01)；而FSH水平低于对照组(P0.05)。PCOS-OW/OB亚组BMI、WC、WHR、FINS、P2hINS、HOMA-IR高于PCOS-NW亚组，Control-OW/OB亚组BMI、WC、WHR、TG、LDL、FBG、P2hBG、FINS、P2hINS、HOMA-IR高于Control-NW亚组，HDL低于Control-NW亚组。PCOS-OW/OB亚组LH、LH/FSH、T、HOMA-IR高于Control-OW/OB亚组。PCOS-NW亚组WC、LH、LH/FSH、T、FINS、P2hINS、HOMA-IR高于Control-NW亚组。 2.OXA、Nesfatin-1水平比较：PCOS组OXA水平及Nesfatin-1水平均明显低于对照组(P0.01)；Control-NW亚组和Control-OW/OB亚组OXA水平及Nesfatin-1水平均明显高于PCOS对应亚组(P0.01)；PCOS和对照组中，OW/OB亚组OXA及Nesfatin-1水平均低于NW亚组(P0.01或P0.05)。 3.相关性分析：校正年龄和BMI后，PCOS组血清OXA水平与LH、LH/FSH、FBG、P2hBG、HOMA-IR呈负相关（r=-0.313、r=-0.302、r=-0.353、r=-0.294、r=-0.283，P0.05或P＜0.01）；而血清Nesfatin-1水平与FBG、FINS、HOMA-IR呈负相关（r=-0.379、r=-0.428、r=-0.476，P＜0.01）。结论 1.初诊的多囊卵巢综合征患者存在显著的胰岛素抵抗和高雄激素血症； 2.初诊的多囊卵巢综合征患者血清OXA、Nesfatin-1水平明显下降，这可能参与了多囊卵巢综合征的发生和发展。
[Abstract]:objective
Objective To observe the changes of fasting serum OrexinA (OXA) and Nesfatin-1 levels in patients with newly diagnosed polycystic ovary syndrome (PCOS), and to explore their significance in the occurrence and development of PCOS.
Method
1. selected 57 PCOS patients (group PCOS) and 56 healthy women with normal menstruation (control group). According to the body mass index (BMI) > 25kg/m2 or < 25kg/m2, the PCOS group was divided into overweight / obese subgroup (PCOS-OW/OB, n=32) and normal weight subgroup (PCOS-NW, n=25), and the control group was divided into overweight / obesity subgroup (Co) according to the same standard. Ntrol-OW/OB, n=26) and normal weight subgroup (Control-NW, n=30).
2. the basic information, such as name, age, occupation, menstrual cycle, history of marriage and childbirth, were collected for all the subjects; the height, weight, waist circumference (WC) and hip circumference of all the subjects were measured, and the body mass index (BMI) and the waist to hip ratio (WHR) were calculated and the physical examination was carried out.
3. all the subjects collected the elbow vein blood on the early morning of the menstrual cycle (2~5) on the early morning of the menstrual cycle (LH, FSH), testosterone (T), triglyceride (TG), cholesterol (TC), high-density lipoprotein (HDL), and low density lipoprotein (LDL).
4. all subjects were given an oral 75g glucose tolerance test (OGTT) on the same morning on the same day (fasting 12~14 hours). 0,30,60 and 120min venous blood 5ml were extracted respectively. After centrifugation, serum was collected and -80 degree refrigerator was frozen in reserve. The test indexes included fasting blood glucose (FBG), postprandial 2H blood sugar (P2hBG), fasting insulin (FINS) and postprandial 2H insulin (P2hINS). The steady-state model insulin resistance index was calculated. The spare samples were used for the same detection of OXA and Nesfatin-1 levels.
Result
Comparison of general data and clinical biochemical indexes: there was no significant difference in age, BMI, WC, TG, TC, HDL, LDL, P2hBG in the PCOS group compared with the control group, and the WHR and FBG in the PCOS group were higher than the control group. The HOMA-IR is higher than the PCOS-NW subgroup, and the Control-OW/OB subgroup BMI, WC, WHR, TG, LDL, FBG, P2hBG are higher than those of the PCOS-NW group.
2.OXA, Nesfatin-1 level: OXA level and Nesfatin-1 level in group PCOS were significantly lower than that of control group (P0.01), and OXA level and Nesfatin-1 level in Control-NW subgroup and Control-OW/OB subgroup were significantly higher than that in PCOS subgroup (P0.01).
3. correlation analysis: after correction of age and BMI, the level of serum OXA in group PCOS was negatively correlated with LH, LH/FSH, FBG, P2hBG, HOMA-IR (r=-0.313, r=-0.302, r=-0.353, r=-0.294, r=-0.294, or < 0.01).
conclusion
1. the newly diagnosed polycystic ovary syndrome patients had significant insulin resistance and Kaohsiung steroid hormones.
2. the levels of serum OXA and Nesfatin-1 in newly diagnosed polycystic ovary syndrome decreased significantly, which may be involved in the occurrence and development of polycystic ovary syndrome.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.75

【参考文献】