多囊卵巢综合征中的低度慢性炎症指标及二甲双胍的有益作用。

Indices of low-grade chronic inflammation in polycystic ovary syndrome and the beneficial effect of metformin.

作者信息

Diamanti-Kandarakis Evanthia, Paterakis Thomas, Alexandraki Krystallenia, Piperi Christina, Aessopos Athanasios, Katsikis Ilias, Katsilambros Nikolaos, Kreatsas George, Panidis Dimitrios

机构信息

Endocrine Section, First Department of Internal Medicine, Laiko General Hospital, Medical School, University of Athens, Athens, Greece.

出版信息

Hum Reprod. 2006 Jun;21(6):1426-31. doi: 10.1093/humrep/del003. Epub 2006 Feb 23.

DOI:10.1093/humrep/del003

PMID:16497699

Abstract

BACKGROUND

Women with polycystic ovary syndrome (PCOS) have an increased prevalence of insulin resistance (IR) and related disorders. Elevated serum levels of cellular adhesion molecules (CAMs) reflect low-grade chronic inflammation and have been associated with several insulin-resistant states. The objective of this study is to investigate whether soluble inflammatory markers [soluble intercellular adhesion molecule-1 (sICAM-1), soluble endothelial leukocyte adhesion molecule-1 (sE-selectin), soluble vascular cell adhesion molecule-1 (sVCAM-1) and C-reactive protein (CRP)] are altered in PCOS and to further elucidate the effect of metformin treatment on their levels.

METHODS

Two young populations were studied [62 women with PCOS and 45 normal women of similar age, BMI and waist-to-hip ratio (WHR)]. Plasma levels of sICAM-1, sVCAM-1, sE-selectin and high-sensitivity CRP (hsCRP) were measured in both groups. Additionally, the effect of metformin on these molecules was investigated in 22 women with PCOS who accepted to metformin protocol (1700 mg daily for a 6-month period).

RESULTS

In the total population studied, plasma levels of hsCRP (mg/l), sICAM-1 (ng/ml) and sE-selectin (ng/ml) were higher in the PCOS group compared with those in controls (hsCRP 1.31 +/- 0.22 versus 0.92 +/- 0.27, P = 0.014, sICAM-1 301.21 +/- 24.80 versus 209.86 +/- 17.05, P = 0.025, sE-selectin 57.37 +/- 4.08 versus 45.67 +/- 4.62, P = 0.045, respectively). sVCAM-1 (ng/ml) did not differ statistically among the two groups (P = 0.896). A significant reduction in hsCRP and sVCAM-1 was achieved after 6 months of metformin administration: PCOS pretreatment hsCRP 1.92 +/- 0.60 versus PCOS post-treatment hsCRP 0.52 +/- 0.26, P = 0.005; PCOS pretreatment sVCAM-1 668.09 +/- 98.38 versus PCOS post-treatment sVCAM-1 365.82 +/- 99.77, P = 0.039.

CONCLUSION

These findings imply the presence of chronic inflammation in women with PCOS. Metformin decreases the levels of plasma inflammatory indices. Further investigation is required to determine whether these findings may prove to be of clinical significance for PCOS patients.

摘要

背景

多囊卵巢综合征（PCOS）女性胰岛素抵抗（IR）及相关疾病的患病率增加。血清细胞黏附分子（CAMs）水平升高反映低度慢性炎症，且与多种胰岛素抵抗状态相关。本研究的目的是调查可溶性炎症标志物[可溶性细胞间黏附分子-1（sICAM-1）、可溶性内皮白细胞黏附分子-1（sE-选择素）、可溶性血管细胞黏附分子-1（sVCAM-1）和C反应蛋白（CRP）]在PCOS患者中是否发生改变，并进一步阐明二甲双胍治疗对其水平的影响。

方法

研究了两个年轻人群[62例PCOS女性和45例年龄、BMI及腰臀比（WHR）相似的正常女性]。两组均检测了sICAM-1、sVCAM-1、sE-选择素和高敏CRP（hsCRP）的血浆水平。此外，对22例接受二甲双胍治疗方案（每日1700 mg，为期6个月）的PCOS女性，研究了二甲双胍对这些分子的影响。

结果

在整个研究人群中，PCOS组的hsCRP（mg/l）、sICAM-1（ng/ml）和sE-选择素（ng/ml）血浆水平高于对照组（hsCRP：1.31±0.22对0.92±0.27，P = 0.014；sICAM-1：301.21±24.80对209.86±17.05，P = 0.025；sE-选择素：57.37±4.08对45.67±4.62，P = 0.045）。两组间sVCAM-1（ng/ml）无统计学差异（P = 0.896）。二甲双胍治疗6个月后，hsCRP和sVCAM-1显著降低：PCOS治疗前hsCRP为1.92±0.60，PCOS治疗后hsCRP为0.52±0.26，P = 0.005；PCOS治疗前sVCAM-1为668.09±98.38，PCOS治疗后sVCAM-1为365.82±99.77，P = 0.039。