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目的探讨初诊多囊卵巢综合征(PCOS)患者胰岛素抵抗、肥胖指标和性激素的关联性。方法选取2014年3月-2016年3月就诊于佛山市三水区人民医院初诊的PCOS患者60例设为阳性组,并招募月经正常的健康女性30例设为阴性组。计算体质量指数(BMI)和腰臀比(WHR),并收集血清检测促黄体生成素(LH)、卵泡刺激素(FSH)、甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)。通过进行葡萄糖耐量试验,检测血糖、胰岛素水平,评估胰岛素抵抗的指标。采用双抗体夹心酶联免疫吸附法(ELISA)测定血清Orexin A及Nesfatin-1,并进行相关性分析。结果两组BMI和WHR相比差异有统计学意义(P<0.05),LH、FSH、T、LDL-C、TG水平相比差异有统计学意义(P<0.05),且阳性组LH/FSH>3。两组各胰岛素抵抗指标相比差异有统计学意义(P<0.05)。与阴性组相比,阳性组血清OXA及Nesfatin-1水平均明显降低(P<0.01)。阳性组和阴性组的肥胖亚组OXA及Nesfatin-1水平均明显低于对应的非肥胖亚组(P<0.05)。相关性分析显示,PCOS组空腹血清OXA水平与HOMA-IR、LH、LH/FSH、FBG和P2h BG关联性最为密切。此外,Nesfatin-1水平与HOMA-IR、FINS和FBG相关性最为显著。结论 PCOS患者体内的胰岛素抵抗、性激素和肥胖指标发生了显著性变化,对判断和纠正PCOS患者代谢综合征的发生有临床意义。
Objective To investigate the association between insulin resistance, obesity and sex hormones in newly diagnosed polycystic ovary syndrome (PCOS) patients. Methods From March 2014 to March 2016, 60 patients with newly diagnosed PCOS in Sanshui District People’s Hospital of Foshan City were enrolled as positive group and 30 healthy women with normal menstruation were recruited as negative group. Body mass index (BMI) and waist-to-hip ratio (WHR) were calculated and the serum levels of LH, FSH, TG, TC, Cholesterol (HDL-C), Low Density Lipoprotein Cholesterol (LDL-C). Through the glucose tolerance test, blood glucose, insulin levels, indicators of assessment of insulin resistance. Serum Orexin A and Nesfatin-1 were detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA), and the correlation was analyzed. Results There was significant difference between the two groups in BMI and WHR (P <0.05), LH, FSH, T, LDL-C and TG levels were statistically significant (P <0.05) > 3. There was significant difference between the two groups in each index of insulin resistance (P <0.05). Compared with the negative group, the levels of serum OXA and Nesfatin-1 in the positive group were significantly decreased (P <0.01). The levels of OXA and Nesfatin-1 in the obese subgroups of the positive and negative groups were significantly lower than those in the corresponding non-obese subgroup (P <0.05). Correlation analysis showed that the fasting serum OXA level in PCOS group was most closely related to HOMA-IR, LH, LH / FSH, FBG and P2h BG. In addition, the correlation between Nesfatin-1 levels and HOMA-IR, FINS and FBG was the most significant. Conclusion The changes of insulin resistance, sex hormones and obesity in PCOS patients have significant changes, which are of clinical significance in judging and correcting the metabolic syndrome in PCOS patients.