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多囊卵巢综合征女性的血浆脂联素与胰岛素抵抗

Plasma adiponectin and insulin resistance in women with polycystic ovary syndrome.

作者信息

Ardawi Mohammed Salleh M, Rouzi Abdulrahim A

机构信息

Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

出版信息

Fertil Steril. 2005 Jun;83(6):1708-16. doi: 10.1016/j.fertnstert.2004.11.077.

Abstract

OBJECTIVE

To determine plasma adiponectin concentration in women with and without polycystic ovary syndrome (PCOS) and to assess possible correlations of adiponectin to the hormonal and metabolic parameters, including measures of insulin resistance (IR).

DESIGN

Case-control study.

SETTING

Tertiary-referral university hospital.

PATIENT(S): One hundred eighty selected women were classified as follows: 45 obese (body mass index [BMI] >30 kg/m2) with PCOS; 45 lean (BMI <25 kg/m2) with PCOS; 45 obese (BMI >30 kg/m2) without PCOS, and 45 lean (BMI <25 kg/m2) without PCOS.

INTERVENTION(S): Blood samples were collected from all women with or without PCOS between 8 and 11 am, after an overnight fast.

MAIN OUTCOME MEASURE(S): Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), thyroid-stimulating hormone (TSH), free T4, testosterone (T), 17-alpha-hydroxyprogesterone, Delta4-androstenedione (Delta4-A), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), sex hormone-binding globulin (SHBG), insulin, and plasma levels of adiponectin and glucose. Measures of IR included fasting serum insulin, glucose-to-insulin ratio, and homeostasis model assessment (HOMA).

RESULT(S): 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. Adiponectin concentrations correlated inversely with body weight, BMI, fasting plasma glucose, serum insulin, Delta4-A, DHEA, DHEAS, and HOMA but correlated positively with serum T, SHBG, FAI, and glucose-to-insulin ratio. Multiple regression analysis showed that BMI, HOMA, Delta4-A, and insulin were independent determinants of adiponectin concentrations.

CONCLUSION(S): Hypoadiponectinemia is evident in obese and lean women with PCOS with variable degree of IR; and it is suggested that IR per se or other metabolic abnormalities of PCOS are involved in the regulation of adiponectin concentration in women with PCOS.

摘要

目的

测定患有和未患有多囊卵巢综合征(PCOS)的女性的血浆脂联素浓度,并评估脂联素与激素及代谢参数(包括胰岛素抵抗[IR]指标)之间的可能相关性。

设计

病例对照研究。

设置

三级转诊大学医院。

患者

180名入选女性分类如下:45名肥胖(体重指数[BMI]>30kg/m²)的PCOS患者;45名瘦(BMI<25kg/m²)的PCOS患者;45名肥胖(BMI>30kg/m²)的非PCOS患者,以及45名瘦(BMI<25kg/m²)的非PCOS患者。

干预措施

所有患有或未患有PCOS的女性在禁食过夜后,于上午8点至11点采集血样。

主要观察指标

血清促黄体生成素(LH)、促卵泡生成素(FSH)、促甲状腺激素(TSH)、游离T4、睾酮(T)、17-α羟孕酮、Δ4-雄烯二酮(Δ4-A)、脱氢表雄酮(DHEA)、硫酸脱氢表雄酮(DHEAS)、性激素结合球蛋白(SHBG)、胰岛素,以及脂联素和葡萄糖的血浆水平。IR指标包括空腹血清胰岛素、葡萄糖与胰岛素比值以及稳态模型评估(HOMA)。

结果

与非PCOS的瘦女性相比,发现PCOS女性和非PCOS肥胖女性的脂联素浓度显著降低。脂联素浓度与体重、BMI、空腹血糖、血清胰岛素、Δ4-A、DHEA、DHEAS和HOMA呈负相关,但与血清T、SHBG、游离雄激素指数(FAI)和葡萄糖与胰岛素比值呈正相关。多元回归分析表明,BMI、HOMA、Δ4-A和胰岛素是脂联素浓度的独立决定因素。

结论

在患有不同程度IR的肥胖和瘦PCOS女性中,低脂联素血症明显;提示IR本身或PCOS的其他代谢异常参与了PCOS女性脂联素浓度的调节。

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