Altuğ Şen Tolga, Köken Reşit, Narcı Adnan, Yılmazer Mehmet
Afyon Kocatepe University, Faculty of Medicine, Department of Pediatrics 03200 Afyonkarahisar, Turkey.
J Pediatr Adolesc Gynecol. 2011 Aug;24(4):211-7. doi: 10.1016/j.jpag.2011.02.007. Epub 2011 Apr 1.
Elevated levels of plasma homocysteine and depressed ghrelin levels have been found to be associated with insulin resistance in a number of clinical situations, such as polycystic ovary syndrome. This study was designed to determine the relationship of plasma homocysteine and ghrelin levels with obesity in polycystic ovary syndrome.
Forty-four adolescents and young women (24 lean, 20 obese) 16-21 years old with polycystic ovary syndrome and age matched 20 healthy adolescents and young women were participated the study. Fasting samples were collected for serum vitamin B12, folate, plasma total homocysteine and ghrelin levels. Serum levels of follicle-stimulating hormone, luteinizing hormone, dehydroepiandrosterone sulfate, insulin, 17-hydroxyprogesterone, free testosterone, sex-hormone binding globulin were measured. Also, serum concentrations of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides were determined. Oral glucose tolerance test was done, and HOMA-IR index was used to define insulin resistance.
Plasma total homocysteine levels were significantly higher in women with polycystic ovary syndrome and their plasma ghrelin levels were depressed compared to control group (P < 0.05). Obese adolescents with polycystic ovary syndrome had more depressed plasma ghrelin levels compared to lean ones (P < 0.05). Homocysteine levels didn't correlate with body mass index, but positively correlated with insulin resistance (P < 0.05).
Elevated plasma homocysteine levels in polycystic ovary syndrome was independent from obesity. Adversely ghrelin levels were depressed with polycystic ovary syndrome in relation to obesity.
在多囊卵巢综合征等多种临床情况下，已发现血浆同型半胱氨酸水平升高和胃饥饿素水平降低与胰岛素抵抗有关。本研究旨在确定多囊卵巢综合征患者血浆同型半胱氨酸和胃饥饿素水平与肥胖之间的关系。
44名16 - 21岁患有多囊卵巢综合征的青少年和年轻女性（24名瘦者，20名肥胖者）以及20名年龄匹配的健康青少年和年轻女性参与了该研究。采集空腹样本以检测血清维生素B12、叶酸、血浆总同型半胱氨酸和胃饥饿素水平。检测血清促卵泡生成素、促黄体生成素、硫酸脱氢表雄酮、胰岛素、17 - 羟孕酮、游离睾酮、性激素结合球蛋白水平。此外，还测定了血清总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯浓度。进行口服葡萄糖耐量试验，并使用HOMA - IR指数来定义胰岛素抵抗。
与对照组相比，多囊卵巢综合征女性的血浆总同型半胱氨酸水平显著更高，且其血浆胃饥饿素水平降低（P < 0.05）。与瘦的多囊卵巢综合征青少年相比，肥胖的多囊卵巢综合征青少年血浆胃饥饿素水平更低（P < 0.05）。同型半胱氨酸水平与体重指数无关，但与胰岛素抵抗呈正相关（P < 0.05）。
多囊卵巢综合征患者血浆同型半胱氨酸水平升高与肥胖无关。相反，与肥胖相关的多囊卵巢综合征患者胃饥饿素水平降低。
