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钙调节激素、胰岛素抵抗与多囊卵巢综合征。

Calciotropic hormones, insulin resistance, and the polycystic ovary syndrome.

机构信息

Department of Genetics, Reproductive Medicine Research Center, Royan Institute, 5 Hafez Street, BaniHashem Square, 19395-4644 Tehran, Iran.

出版信息

Fertil Steril. 2010 Mar 1;93(4):1208-14. doi: 10.1016/j.fertnstert.2008.11.031. Epub 2009 Feb 20.

Abstract

OBJECTIVE

To investigate whether abnormalities in serum concentrations of 1,25-dihydroxyvitamin D [1,25(OH)(2)D], 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), calcium, and phosphorus were associated with risk of polycystic ovary syndrome (PCOS) and obesity. The possible correlations of the calciotropic hormones with insulin resistance were also examined.

DESIGN

Case-control study.

SETTING

Department of Genetics, Royan Institute.

PATIENT(S): Eighty-five women with PCOS and 115 control women were recruited.

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Serum levels of glucose, insulin, total calcium, phosphorus, PTH, 25(OH)D, and 1,25(OH)(2)D were measured in all 200 subjects.

RESULT(S): The presence of PCOS had age- and body mass index (BMI)-independent positive effects on serum phosphorus, PTH, 25(OH)D, and insulin concentrations as well as on insulin resistance. Furthermore, overweight/obese (BMI > or =25 kg/m(2)) women with PCOS had significantly decreased levels of 1,25(OH)(2)D and glucose compared with normal-weight (BMI <25 kg/m(2)) women with PCOS. In women with PCOS, phosphorus was correlated negatively with insulin and insulin resistance and positively with 1,25(OH)(2) D. In addition, in normal-weight patients, PTH correlated positively with insulin and insulin resistance.

CONCLUSION(S): It is possible that elevated levels of phosphorus and PTH in women with PCOS, at least in part, through their effects on insulin levels and insulin resistance, are involved in pathogenesis of the syndrome.

摘要

目的

研究血清中 1,25-二羟维生素 D [1,25(OH)(2)D]、25-羟维生素 D [25(OH)D]、甲状旁腺激素 (PTH)、钙和磷浓度的异常是否与多囊卵巢综合征 (PCOS)和肥胖有关。还检查了钙调节激素与胰岛素抵抗的可能相关性。

设计

病例对照研究。

地点

罗扬研究所遗传学系。

患者

85 名患有 PCOS 的女性和 115 名对照组女性被招募。

干预措施

无。

主要观察指标

所有 200 名受试者的血清葡萄糖、胰岛素、总钙、磷、PTH、25(OH)D 和 1,25(OH)(2)D 水平。

结果

PCOS 的存在对血清磷、PTH、25(OH)D 和胰岛素浓度以及胰岛素抵抗具有年龄和体重指数 (BMI) 独立的正向影响。此外,超重/肥胖 (BMI≥25 kg/m(2)) 患有 PCOS 的女性与正常体重 (BMI<25 kg/m(2)) 患有 PCOS 的女性相比,1,25(OH)(2)D 和葡萄糖水平显著降低。在患有 PCOS 的女性中,磷与胰岛素和胰岛素抵抗呈负相关,与 1,25(OH)(2)D 呈正相关。此外,在正常体重患者中,PTH 与胰岛素和胰岛素抵抗呈正相关。

结论

至少在部分情况下,PCOS 患者中磷和 PTH 水平升高可能通过对胰岛素水平和胰岛素抵抗的影响参与了该综合征的发病机制。

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