Xita Nectaria, Papassotiriou Ioannis, Georgiou Ioannis, Vounatsou Maria, Margeli Alexandra, Tsatsoulis Agathocles
Department of Endocrinology, University of Ioannina, 45110 Ioannina, Greece.
Metabolism. 2007 Jun;56(6):766-71. doi: 10.1016/j.metabol.2007.01.008.
Central adiposity plays an important role in the insulin resistance of the polycystic ovary syndrome (PCOS) through the dysregulated production of various adipokines. Polycystic ovary syndrome has also been described as a low-grade inflammation state characterized by elevated levels of C-reactive protein (CRP). Furthermore, CRP is a strong independent predictor of the metabolic syndrome and cardiovascular disease. Recently, the adiponectin-to-leptin (A/L) ratio has been proposed as a potential atherogenic index in obese type 2 diabetic patients. The aim of this study was to evaluate the potential role of the A/L ratio in the metabolic and proinflammatory phenotype of PCOS. We studied 74 Greek women with PCOS (38 normal-weight and 36 overweight-obese women). The A/L ratio was negatively correlated with BMI (r = -0.79 P < .001), homeostasis model assessment (r = -0.642, P < .001), triglycerides (r = -0.67, P < .001), and total cholesterol (r = -0.38, P < .01), and positively correlated with high-density lipoprotein cholesterol (r = 0.38, P < .01) and sex hormone-binding globulin (r = 0.39, P = .001). After controlling for BMI, the A/L ratio was independently associated with insulin resistance indexes and triglycerides. Furthermore, the A/L ratio was negatively correlated with CRP (r = -0.746, P < .0001). Multiple regression analysis revealed that BMI and the A/L ratio were the only independent significant determinants of CRP (beta = .436, P = .003 and beta = -.398, P = .007, respectively). Studying normal-weight and overweight-obese women separately, we found an independent association between the A/L ratio and CRP in both groups (beta = -.460, P = .009 in normal-weight women and beta = -.570, P = .001 in overweight-obese women). In conclusion, the A/L ratio may serve as a biomarker of both insulin resistance and low-grade inflammation, providing the link between these cardiovascular risk factors in women with PCOS.
中心性肥胖通过多种脂肪因子产生失调，在多囊卵巢综合征（PCOS）的胰岛素抵抗中起重要作用。多囊卵巢综合征也被描述为一种以C反应蛋白（CRP）水平升高为特征的低度炎症状态。此外，CRP是代谢综合征和心血管疾病的强有力独立预测指标。最近，脂联素与瘦素比值（A/L）被提议作为肥胖2型糖尿病患者潜在的动脉粥样硬化指数。本研究的目的是评估A/L比值在PCOS代谢和促炎表型中的潜在作用。我们研究了74名希腊PCOS女性（38名体重正常和36名超重肥胖女性）。A/L比值与体重指数（r = -0.79，P <.001）、稳态模型评估（r = -0.642，P <.001）、甘油三酯（r = -0.67，P <.001）和总胆固醇（r = -0.38，P <.01）呈负相关，与高密度脂蛋白胆固醇（r = 0.38，P <.01）和性激素结合球蛋白（r = 0.39，P =.001）呈正相关。在控制体重指数后，A/L比值与胰岛素抵抗指标和甘油三酯独立相关。此外，A/L比值与CRP呈负相关（r = -0.746，P <.0001）。多元回归分析显示，体重指数和A/L比值是CRP仅有的独立显著决定因素（β =.436，P =.003和β = -.398，P =.007）。分别研究体重正常和超重肥胖女性时，我们发现两组中A/L比值与CRP均存在独立关联（体重正常女性中β = -.460，P =.009；超重肥胖女性中β = -.570，P =.001）。总之，A/L比值可能作为胰岛素抵抗和低度炎症的生物标志物，在PCOS女性中提供这些心血管危险因素之间的联系。
