多囊卵巢综合征人群中基于补体C3的胰岛素敏感性评分模型的建立

发布时间：2017-12-28 23:01

本文关键词：多囊卵巢综合征人群中基于补体C3的胰岛素敏感性评分模型的建立　出处：《重庆医科大学学报》2016年11期 　论文类型：期刊论文

【摘要】：目的:以多囊卵巢综合征(polycystic ovary syndrome,PCOS)人群为研究对象,通过构建包含补体C3的胰岛素敏感性(insulin sensitivity,IS)评分模型,探索一种简便易行的方法对PCOS患者的IR进行评估。方法:纳入99名PCOS患者及116名年龄匹配的正常女性,测量人体参数及空腹血生化指标(胰岛素、hs-CRP、补体C3等),计算稳态模型胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA2-IR)。对所有PCOS患者及其中20名正常对照行高胰岛素-正葡萄糖钳夹术,结果以M值表示。在PCOS组中,采用多元线性回归,以M值为应变量,以BMI、LDL-C、补体C3、超敏C反应蛋白、空腹血清胰岛素为自变量,建立IS评分(即M值的预测值)模型方程,用ROC曲线评估该模型诊断IR的价值。结果:IS评分=19.36-0.35×BMI-2.28×C3(R~2=0.54,P=0.000)。IS评分和HOMA2-IR诊断PCOS患者IR的ROC曲线下面积分别为0.89(95%CI=0.82~0.96)和0.75(95%CI=0.64~0.86),当IS评分=8.93时,其诊断PCOS患者IR的灵敏度和特异度分别为0.70和0.95,Youden指数0.63。当HOMA2-IR=0.47时,其诊断的灵敏度和特异度分别为0.60和0.88,Youden指数0.47。结论:包含补体C3的IS评分模型评估PCOS人群的IR具有较好的诊断价值。
[Abstract]:Objective: to build a polycystic ovary syndrome (PCOS) population as a research object, and construct a insulin sensitivity (IS) scoring model containing complement C3 to explore a simple and feasible method to evaluate IR in PCOS patients. Methods: 99 PCOS patients and 116 age matched normal women were enrolled. The body parameters and fasting blood biochemical indexes (insulin, hs-CRP, complement C3, etc.) were measured. The steady-state homeostasis insulin resistance index (homeostasis model assessment of insulin resistance) was calculated. All PCOS patients and 20 normal controls were treated with high insulin - glucose clamp, and the results were indicated by the M value. In group PCOS, multiple linear regression was used. Taking M as dependent variable, BMI, LDL-C, complement C3, hypersensitive C reactive protein and fasting serum insulin as independent variables, IS equation (M value predicted value) model equation was established, and ROC curve was used to evaluate the value of the model in diagnosing IR. Results: the IS score was =19.36-0.35 x BMI-2.28 x C3 (R~2=0.54, P=0.000). The area under the ROC curve of IS score and HOMA2-IR diagnosis in PCOS patients was 0.89 (95%CI=0.82~0.96) and 0.75 (95%CI=0.64~0.86) respectively. When IS score was =8.93, the sensitivity and specificity of PCOS in diagnosis of PCOS patients were 0.70 and 0.95, respectively, and the index of PCOS was 0.63. When HOMA2-IR=0.47, the sensitivity and specificity of the diagnosis were 0.60 and 0.88, respectively, and the Youden index was 0.47. Conclusion: the IS scoring model containing complement C3 is of good diagnostic value for evaluating the IR of PCOS population.
【作者单位】：重庆医科大学附属第一医院内分泌科;汕头大学医学院第一附属医院内分泌科;重庆市第一人民医院内分泌科;
【基金】：国家自然科学基金资助项目(编号:81300310、81370954) 国家临床重点专科建设资助项目(编号:财社[2011]170号) 重庆市卫生计生委医学科研资助项目(编号:2016MSXM004)
【分类号】：R711.75
【正文快照】： 多囊卵巢综合征(polycystic ovary syndrome,PCOS)以闭经或月经稀发、排卵障碍和高雄激素为主要特征,在育龄期妇女中的患病率为4%~8%[1]。50%~80%的PCOS患者存在胰岛素抵抗(insulin re-sistance,IR)[2],而IR是肥胖、2型糖尿病及心脑血管疾病重要的共同病理生理基础。因此,对PC

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