PCOS患者血清irisin水平及其与胰岛素抵抗的关系研究

发布时间：2018-05-13 15:10

  本文选题：多囊卵巢综合征 + 鸢尾素　； 参考：《重庆医科大学》2015年硕士论文

【摘要】：目的多囊卵巢综合征(polycystic ovarian syndrome, PCOS)患者多数伴有不同程度的胰岛素抵抗(insulin resistance, IR)。已有研究表明细胞因子Irisin与2型糖尿病IR有一定的相关性,但还没有关于PCOS血清Irisin水平与IR关系的相关报道。本研究旨在了解PCOS患者和正常人的血清Irisin水平,及血清Irisin与PCOS患者IR及糖脂代谢相关指标的关系。方法164名新确诊为PCOS的患者和126名与实验组年龄匹配的健康志愿者纳入实验。所有受试者均测量空腹时的身高、体重、血压、腰围、臀围,计算腰臀比、BMI等,测血脂,性激素,行OGTT试验。用高胰岛素正葡萄糖钳夹试验(Euglycemic hyperinsulinemic clamp, EHC)评估受试者胰岛素敏感性(即胰岛素抵抗)情况,用M值表示。酶联免疫法测量血清Irisin浓度。结果：(1) PCOS患者的BMI、WHR、FAT%、SBP/DBP、TG、TC、 HDL-C、LDL-C、FBG、2hPBG、FINS、2hlns、HbA1c、TEST、LH/FSH、 PRL、FAI较正常人升高,而SHBG则降低(P0.05或P0.01)。(2) PCOS患者血清Irisin水平较正常组显著升高；无论是PCOS患者还是正常人,肥胖亚组(BMI23kg/m2)的血清Irisin水平均较非肥胖亚组(BMI23kg/m2)明显升高(P0.05)。(3)在高胰岛素正葡萄糖钳夹试验中,PCOS患者的M值降低(P0.05),短暂快速升高的胰岛素水平会引起血清Irisin浓度的显著减少(P0.05)。(4)血清Irisin水平与BMI、FAP%、TG、TC、FFA、2hPBG、 FIns、2hIns、FAI、HOMA-IR、HOMA2-IR呈正相关(P0.05或P0.01),与M值呈显著负相关(P0.01)；多元逐步回归分析显示,FAT%是影响血清Ⅰrisin水平的独立危险因素。Irisin的浓度越高,PCOS的风险越高。结论PCOS患者的血清Irisin水平升高,与肥胖和胰岛素抵抗有相关性,推测可能参与肥胖和PCOS的病理生理过程,可能是肥胖、胰岛素抵抗及PCOS的生物学标志物。
[Abstract]:Objective most of the polycystic ovarian syndrome, PCOS) patients with polycystic ovary syndrome (PCOS) were associated with insulin resistance (IRV). Some studies have shown that cytokine Irisin is associated with IR in type 2 diabetes, but there is no report on the relationship between serum Irisin level of PCOS and IR. The purpose of this study was to investigate the level of serum Irisin in patients with PCOS and normal subjects, and the relationship between serum Irisin and IR, glucose and lipid metabolism in patients with PCOS. Methods 164 newly diagnosed PCOS patients and 126 age-matched healthy volunteers were enrolled in the study. Height, weight, blood pressure, waist circumference, hip circumference, waist to hip ratio, blood lipid, sex hormone and OGTT test were measured in all subjects. The insulin sensitivity (insulin resistance) was evaluated by Euglycemic hyperinsulinemic clamp, EHC) in hyperinsulinemic glucose clamp test. Serum Irisin concentration was measured by enzyme linked immunosorbent assay (Elisa). Results (1) the serum Irisin levels in PCOS patients were significantly higher than those in normal controls (P 0.05 or P 0.01). The serum Irisin levels in patients with PCOS were significantly higher than those in normal controls (P 0.05, P 0.05 or P 0.01N. 2) the serum Irisin levels in patients with PCOS were significantly higher than those in normal controls, whether in PCOS patients or in normal controls, but the levels of Irisin in patients with PCOS were significantly higher than those in normal controls. The levels of serum Irisin in patients with PCOS were significantly higher than those in normal controls, both in patients with PCOS and in normal subjects, and the levels of serum Irisin in patients with PCOS were significantly higher than those in normal controls. The serum Irisin level of obese subgroup was significantly higher than that of non-obese subgroup (BMI23 kg / m2). (P 0.05 + glucose clamp test decreased M value of P0. 05% in hyperinsulinemic positive glucose clamp test. Transient and rapid increase of insulin level resulted in a significant increase in serum Irisin concentration in the obese subgroup (P < 0. 05). The level of BMI23 kg / m2) in the obese subgroup was significantly higher than that in the non obese subgroup (P 0. 05 kg / m 2). The serum Irisin level was positively correlated with BMI-FAPP 2h PBG, FInsn 2hInsAFAIHOMA-IRHOMA2-IR, and negatively correlated with M value (P0.01. multiple stepwise regression analysis showed that FAT% was an independent risk factor affecting serum 鈪，

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