多囊卵巢综合征患者血清SOX9 mRNA、PPARγ mRNA表达与疾病严重程度及预后的关系

目的探讨多囊卵巢综合征(PCOS)患者血清性别决定区Y框蛋白9(SOX9)信使核糖核酸(mRNA)、过氧化物酶体增殖物激活受体γ(PPARγ)mRNA表达水平与疾病严重程度、预后的相关性。方法选取2018年3月至2020年1月于该院住院治疗的102例PCOS患者为PCOS组,同期选取99例体检健康女性为对照组。根据出院后1年内患者是否不孕,将其分为预后良好组66例(出院后1年内怀孕)和预后不良组36例(出院后1年内不孕);根据PCOS患者病情类型,将其分为:A型组无排卵或稀发排卵(O)+雄激素水平升高的生化和临床表现(HA)+卵巢多囊样改变(P)]23例、B型组(O+HA)27例、C型组(HA+P)26例、D型组(O+P)26例。采用实时荧光定量聚合酶链式反应(qRT-PCR)法检测血清SOX9 mRNA、PPARγmRNA水平;采用全自动生化分析仪检测空腹胰岛素(FINS)、空腹血糖(FPG)、卵泡刺激素(FSH)、睾酮(T)、雌二醇(E2)水平;Pearson法分析PCOS患者血清SOX9 mRNA、PPARγmRNA与T、体质量指数(BMI)、FINS水平的相关性;多因素Logistic回归分析影响PCOS预后的因素。结果PCOS组BMI、FINS、T水平均显著高于对照组,差异有统计学意义(P<0.05)。对照组、A型组、B型组、C型组、D型组血清SOX9 mRNA水平依次降低,PPARγmRNA水平依次升高,两两比较差异均有统计学意义(P<0.05)。PCOS患者血清SOX9 mRNA与PPARγmRNA水平呈负相关(r=-0.649,P<0.05);SOX9 mRNA水平与T、BMI、FINS呈负相关(r=-0.498、-0.512、-0.523,P<0.05);PPARγmRNA水平与T、BMI、FINS呈正相关(r=0.502、0.476、0.517,P<0.05)。预后不良组SOX9 mRNA水平显著低于预后良好组,PPARγmRNA、T、BMI、FINS水平均显著高于预后良好组,差异有统计学意义(P<0.05)。PPARγmRNA是影响PCOS患者不孕的独立危险因素(P<0.05),SOX9 mRNA是影响PCOS患者不孕的保护因素(P<0.05)。结论PCOS患者血清SOX9 mRNA水平降低,PPARγmRNA水平升高,且二者与患者病情及预后均有一定的相关性。

Expression of SOX9 mRNA and PPARγ mRNA in serum of patients with polycystic ovary syndrome and their relationship with disease severity and prognosis

Objective To investigate the relationship between expression levels of sex-determining region Y-box 9(SOX9)messenger RNA(mRNA)and peroxisome proliferator-activated receptorγ(PPARγ)mRNA in serum of patients with polycystic ovary syndrome(PCOS)with disease severity and prognosis.Methods A total of 102 patients with PCOS who were hospitalized in Jianli People′s Hospital from March 2018 to January 2020 were selected as the PCOS group,at the same time,99 healthy women were selected as the control group.According to whether the patients were infertile within one year after discharge,they were divided into good prognosis group(66 cases were pregnant within one year after discharge)and poor prognosis group(36 cases were infertile within one year after discharge);according to the types of PCOS patients,they were divided into:type A groupanovulation or rare ovulation(O)+biochemical and clinical manifestations of elevated androgen level(HA)+polycystic ovarian change(P)]23 cases,type B group(O+HA)27 cases,type C group(HA+P)26 cases,and type D group(O+P)26 cases.The levels of serum SOX9 mRNA and PPARγmRNA were detected by real-time fluorescence quantitative PCR(qRT-PCR)].The levels of fasting insulin(FINS),fasting blood glucose(FPG),follicle stimulating hormone(FSH),testosterone(T)and estradiol(E2)were detected by automatic biochemical analyzer.Pearson method was used to analyze the correlation between serum SOX9 mRNA,PPARγmRNA and T,BMI,FINS levels.Multivariate Logistic regression analysis was used to analyze the prognostic factors of PCOS.Results BMI,FINS and T levels in PCOS group were significantly higher than those in control group,the differences were statistically significant(P<0.05).The levels of serum SOX9 mRNA in control group,type A group,type B group,type C group and type D group were decreased in turn,while the levels of PPARγmRNA were increased in turn,the differences were statistically significant(P<0.05).There was a negative correlation between serum SOX9 mRNA and PPARγmRNA level in PCOS patients(r=-0.649,P<0.05);SOX9 mRNA level was negatively correlated with T,BMI and FINS(r=-0.498,-0.512,-0.523,P<0.05);PPARγmRNA level was positively correlated with T,BMI and FINS,the difference was statistically significant(r=0.502,0.476,0.517,P<0.05).The level of SOX9 mRNA in poor prognosis group was significantly lower than that in good prognosis group,while levels of PPARγmRNA,T,BMI and FINS were significantly higher than those in good prognosis group,the differences were statistically significant(P<0.05).PPARγmRNA was an independent risk factor of infertility in PCOS patients(P<0.05),while SOX9 mRNA was a protective factor of infertility in PCOS patients(P<0.05).Conclusion The level of serum SOX9 is decreased and the level of PPARγis increased in PCOS patients,and both of them are certainly related to the condition and prognosis of PCOS patients.