多囊卵巢综合征患者血清脂联素水平及与胰岛素抵抗相关性的研究

目的:检测多囊卵巢综合征(PCOS)患者血清脂联素(APN)水平,探讨APN与胰岛素抵抗(IR)的相关性。方法:研究对象于月经周期第3~5天行75g糖耐量实验(OGTT实验),分别测定0h、1h、2h的血糖(FPG、PG1h、PG2h)、胰岛素(FINS、INS1h、INS2h)和脂联素(FAPN、APN1h、APN2h)。PCOS患者给予达英-353个周期联合二甲双胍治疗3个月后复查上述指标,比较治疗前后的变化。结果:(1)PCOS组与对照组均表现为肥胖组APN水平低于非肥胖组,且PCOS组中肥胖组与非肥胖组的APN水平均低于对照组(P<0.05);(2)PCOS组中肥胖组与非肥胖组的FINS、INS1h、INS2h、AUCins及HOMA-IR均高于对照组,且肥胖PCOS组高于非肥胖PCOS组(P<0.05);(3)PCOS组经二甲双胍联合达英-35治疗后FINS、INS1h、INS2h、AUCins、HOMA-IR均降低(P<0.05),而APN水平明显升高;(4)相关性分析表明,PCOS患者APN水平与FINS、INS1h、INS2h、FPG、AUCins、HOMA-IR和BMI均呈负相关。多元逐步回归分析显示,APN与FINS、HOMA-IR的相关性最显著。结论:PCOS患者APN水平显著降低与IR密切相关。

Investigation of adiponectin levels in women with polycystic ovary syndrome and the relationship between adiponectin and insulin resistance

Objective：To determine serum adiponectin concentrations in women with and without polycystic ovary syndrome（PCOS） and to explore possible relationship between adiponectin and insulin resistance. Methods： Serum levels of adiponectin, glucose and insulin were measured at 0hour, 1 hour,2hour during 75g oral glucose-tolerance test （OGTT）. To further investigate the relationship of adiponectin and insulin resistance, the women with PCOS were treated with Diane-35 and mefformin 500 mg rid for 3 months. All indicatrix were measured after treatment. Results：（ 1 ）Adiponectin concentrations were found to be significantly decreased in women with PCOS and in obese women without PCOS as compared with lean women without PCOS ; （2） Insulin levels at 0,1 hour, 2hour during OGTT （ FINS, INS1h, INS2h） and insulin area under the curve （AUCins） , HOMA-IR were higher in women with PCOS ; （ 3 ） There was a significant increase in adiponectin levels when treated with metformin and Diane-35. While significantly decrease in FINS, INS1 h, INS2h, AUCins, HOMA-IR; （4） Pearson analysis showed that adiponectin concentrations correlated inversely with FINS, INS1h, INS2h, AUCins, HOMA-IR, FPG and body mass index （BMI）. A stepwise multiple linear regression analysis showed that FINS, HOMA-IR enter the regression equation. Conclusion： Adiponectin concentrations is found to be significantly decreased in women with PCOS. A strong correlation between serum adiponection and insulin resistance is observed.