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[青少年多囊卵巢综合征中的血浆胃动素。]

[Plasma metastin in adolescent polycystic ovary syndrome.].

作者信息

Chen Xiao-Li, Mo Ya-Qin, Li Lin, Chen Ya-Xiao, Li Yu, Zhang Qing-Xue, Yang Dong-Zi

机构信息

Department of Obstetrics and Gynecology, Second Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510120, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2009 Oct;44(10):745-9.

Abstract

OBJECTIVE

This study was designed to investigate the correlationship between plasma metastin and pathogenesis of adolescent women with polycystic ovary syndrome (PCOS).

METHODS

From Jan. 2006 to Jun. 2006, 42 PCOS patients including 19 adolescent women and 23 adults with syndrome were treated in Second Affiliated Hospital of Sun Yat-Sen University. According to the range of age, those patients were divided into 19 cases in adolescent group (</= 19 years) and 23 cases in adult group (> 19 years). Meanwhile, 20 adolescent women were matched as controls. Blood samples were collected between day 1 and day 5 of a spontaneous bleeding episode in the PCOS groups and a menstrual cycle of the controls. The levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), free T (FT), dehydroepiandrosterone sulfate (DHEAS), sex hormone-binding globulin (SHBG), insulin, glucose, and metastin were detected from day 1 to day 5 of spontaneous bleeding or withdrawal bleeding by progesterone. On the next day, oral glucose tolerance test (75 g) and insulin release test were performed on those above patients and controls. The area under curve (AUC), the ratio of fasting blood glucose to insulin (GIR) and homeostasis model assessment insulin resistance index (HOMA-IR) were calculated.

RESULTS

(1) The level of hormone: the level of LH was in (12 +/- 7) U/L in adult group and (12 +/- 8) U/L in adolescent PCOS group, which were significantly higher than (6 +/- 4) U/L in controls (P < 0.05). The level of FT was (2.3 +/- 1.2) pmol/L in adult group, which was significantly higher than (1.3 +/- 0.8) pmol/L in adolescent group and (1.1 +/- 0.5) pmol/L in control group (P < 0.05). It was observed that the level of (3.1 +/- 2.7)micromol/L in adolescent group was significantly lower than (6.3 +/- 2.7) micromol/L in control group (P < 0.05). Meanwhile, the level of FAI of 5.6 +/- 4.1 in adult group was significantly higher than 3.0 +/- 1.3 in control group (P < 0.05). No significant difference in FSH, T and SHBG levels among three groups were observed (P > 0.05). (2) Metastin and metabolism: Both the levels of fasting blood insulin, 2-hour insulin and AUC of insulin were (13 +/- 7) mU/L, (88 +/- 59) mU/L and (133 +/- 80) mUxL(-1)xmin(-1) in adolescent group, which were significantly higher than (7 +/- 3) mU/L, (57 +/- 29) mU/L and (82 +/- 34) mUxL(-1)xmin(-1) in control group. The fasting blood insulin of (13 +/- 7) mU/L in adolescent group was significantly higher than (9 +/- 5) mU/L in adult group. The level of fasting blood glucose and 2-hour glucose were (5.01 +/- 0.44) mmol/L and (6.48 +/- 1.16) mmol/L in adult group, which were significantly higher than (4.68 +/- 0.29) mmol/L and (5.44 +/- 0.83) mmol/L in control group and (4.67 +/- 0.30) mmol/L and (5.93 +/- 1.44) mmol/L in adolescent group. The glucose AUC of (9.99 +/- 1.85) mmolxL(-1)xmin(-1) in adult group was significantly higher than (8.42 +/- 1.53) mmolxL(-1)xmin(-1) in control group (P < 0.05). HOMA-IR of 2.6 +/- 2.0 in adolescent group was significantly higher than 1.4 +/- 0.7 in control group. GIR of 10 +/- 8 in adolescent group was significantly lower than 16 +/- 10 in control group (P < 0.05). The metastin level of (0.25 +/- 0.19) pmol/L in adolescent group and (0.29 +/- 0.29) pmol/L in adult group were all significantly higher than (0.18 +/- 0.23) pmol/L in control group (PPh glucose were observed (r = 0.256, 0.286 and 0.267. P = 0.044, 0.025 and 0.043).

CONCLUSIONS

The expression of metastin in adolescent PCOS women was significantly higher that of normal adolescent women. The increased level of metastin might be associated with pathogenesis of adolescent women with PCOS.

摘要

目的

本研究旨在探讨血浆胃动素与青春期多囊卵巢综合征(PCOS)发病机制之间的相关性。

方法

2006年1月至2006年6月,中山大学附属第二医院收治了42例PCOS患者,其中包括19例青春期女性和23例成年女性。根据年龄范围,将这些患者分为青春期组(≤19岁)19例和成年组(>19岁)23例。同时,选取20例青春期女性作为对照。在PCOS组自然出血期的第1天至第5天以及对照组的一个月经周期内采集血样。在自然出血或黄体酮撤退性出血的第1天至第5天,检测黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)、游离睾酮(FT)、硫酸脱氢表雄酮(DHEAS)、性激素结合球蛋白(SHBG)、胰岛素、葡萄糖和胃动素的水平。次日,对上述患者及对照组进行口服葡萄糖耐量试验(75g)和胰岛素释放试验。计算曲线下面积(AUC)、空腹血糖与胰岛素比值(GIR)和稳态模型评估胰岛素抵抗指数(HOMA-IR)。

结果

(1)激素水平:成年组LH水平为(12±7)U/L,青春期PCOS组为(12±8)U/L,均显著高于对照组的(6±4)U/L(P<0.05)。成年组FT水平为(2.3±1.2)pmol/L,显著高于青春期组的(1.3±0.8)pmol/L和对照组的(1.1±0.5)pmol/L(P<0.05)。观察到青春期组(3.1±2.7)μmol/L的水平显著低于对照组的(6.3±2.7)μmol/L(P<0.05)。同时,成年组5.6±4.1的游离雄激素指数显著高于对照组的3.0±1.3(P<0.05)。三组间FSH、T和SHBG水平无显著差异(P>0.05)。(2)胃动素与代谢:青春期组空腹血胰岛素、2小时胰岛素及胰岛素AUC水平分别为(13±7)mU/L、(88±59)mU/L和(133±80)mU·L⁻¹·min⁻¹,均显著高于对照组的(7±3)mU/L、(57±29)mU/L和(82±34)mU·L⁻¹·min⁻¹。青春期组空腹血胰岛素(13±7)mU/L显著高于成年组的(9±5)mU/L。成年组空腹血糖和2小时血糖水平分别为(5.01±0.44)mmol/L和(6.48±1.16)mmol/L,显著高于对照组的(4.68±0.29)mmol/L和(5.44±0.83)mmol/L以及青春期组的(4.67±0.30)mmol/L和(5.93±1.44)mmol/L。成年组葡萄糖AUC(9.99±1.85)mmol·L⁻¹·min⁻¹显著高于对照组的(8.42±1.53)mmol·L⁻¹·min⁻¹(P<0.05)。青春期组HOMA-IR为2.6±2.0,显著高于对照组的1.4±0.7。青春期组GIR为10±8,显著低于对照组的16±10(P<0.05)。青春期组胃动素水平为(0.25±0.19)pmol/L,成年组为(0.29±0.29)pmol/L,均显著高于对照组的(0.18±0.23)pmol/L(P<0.05)。青春期PCOS组胃动素水平与空腹血糖、2小时血糖及胰岛素AUC呈正相关(r=0.256、0.286和0.267,P=0.044、0.025和0.043)。

结论

青春期PCOS女性胃动素表达显著高于正常青春期女性。胃动素水平升高可能与青春期PCOS女性的发病机制有关。

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