多囊卵巢综合征子宫内膜胰岛素受体和胰岛素样生长因子-Ⅰ的表达与临床特征研究

目的:检测多囊卵巢综合征(PCOS)患者子宫内膜胰岛素受体(IR)、胰岛素样生长因子-Ⅰ(IGF-Ⅰ)的表达,研究其与PCOS患者性激素、血脂、胰岛素抵抗指数(HOMA)、体重指数(BM I)等临床特征的关系。方法:选取P-COS患者31例作为实验组,输卵管性不孕患者20例作为对照组。采用免疫组化方法检测子宫内膜IR、IGF-Ⅰ表达。用免疫法测定血清性激素、血脂、糖耐量葡萄糖试验(OGTT)、胰岛素释放试验(INS)。结果:实验组子宫内膜IR表达低于对照组,IGF-Ⅰ表达高于对照组。PCOS肥胖组IR低于非肥胖组,肥胖组IGF-Ⅰ表达高于非肥胖组;胰岛素抵抗组IGF-Ⅰ表达高于非胰岛素抵抗组。相关性分析发现IGF-Ⅰ表达与BM I、HOMA呈正相关。结论:PCOS患者子宫内膜IR表达低于正常妇女,但IGF-Ⅰ表达却增高。肥胖及胰岛素抵抗增加了IGF-Ⅰ在子宫内膜的表达。

Study on the expression and clinical characteristics of insulin receptor and insulin like growth factor-I of endometrium in patients with polycystic ovarian syndrome

Objective:To detect the expression of insulin receptor and insulin-like growth factor-Ⅰ of endometrium in patients with polycystic ovarian syndrome(PCOS),explore the correlation between the expression of insulin receptor and insulin-like growth factor-Ⅰin endometrium and sex hormone,serum lipids,insulin resistance index and body mass index.Methods:The expression levels of insulin receptor and insulin-like growth factor-Ⅰ in endometrium from 31 cases with PCOS(experimental group) and 20 cases with tubal infertility(control group) were detected by immunohistochemical staining,the levels of sex hormone and serum lipids were monitored, oral glucose tolerance test and insulin release test were carried out in the study.Results:The level of insulin receptor in endometrium of experimental group was lower than that of control group,the level of insulin-like growth factor-Ⅰ reversed.The level of IR in obese PCOS group was lower than that in PCOS with normal BMI group,the level of insulin-like growth factor-Ⅰin PCOS with insulin resistance group was higher than that in PCOS without insulin resistance group.There was positive correlation between insulin-like growth factorⅠ and BMI,insulin resistance index.Conclusion:The level of insulin receptor is lower than healthy women,but insulin-like growth factor-Ⅰ reverses.Obesity and insulin resistance increase the expression level of insulin-like growth factor-Ⅰ.