Singh Shilpi, Akhtar Nishat, Ahmad Jamal
Department of Obstetrics & Gynaecology, Faculty of Medicine, J.N. Medical College, Aligarh Muslim University, Aligarh 202002, India.
Diabetes Metab Syndr. 2012 Oct-Dec;6(4):207-11. doi: 10.1016/j.dsx.2012.05.013. Epub 2012 Jul 6.
An interaction between adiponectin, steroid synthesis or action and measures of insulin resistance (IR) have been reported in the pathogenesis of polycystic ovary syndrome (PCOS). The present study was done to determine plasma adiponectin concentration (PAC) in women with and without PCOS and to assess its correlation to the hormonal and metabolic parameters including measures of IR. The effect of Metformin for 6 months in PCOS was also evaluated.
In total, 72 selected women were classified as follows: 17 obese (body mass index (BMI))>25 kg/m(2) with PCOS; 19 normal weight (BMI) 18-22.9 kg/m(2) with PCOS; 17 obese (BMI)>25 kg/m(2) without PCOS and 19 normal weight (BMI) 18-22.9 kg/m(2) without PCOS.
Blood samples were collected from all women with PCOS between 0800 and 1100 h, after an overnight fast.
Serum level of LH, FSH, TSH, total T4, testerosterone, 17-α-hydroxyprogesterone (17OHP), DHEAS, insulin, adiponectin and glucose. Measures of IR included fasting serum insulin (FSI), glucose-to-insulin ratio, and homeostasis model assessment (HOMA).
Waist-hip ratio (WHR), insulin, and HOMA index were significantly higher in the lower adiponectin group than in the higher adiponectin group. By using stepwise multiple regression analysis, in model 1 (including BMI, FSI, fasting plasma glucose (FPG) with other variables such serum as testerosterone and DHEAS), the weight and contributions from other variables, namely FSI and FPG were significant independent determinants of fasting PAC (adjusted r(2)=0.66); and in model 2 (including BMI, HOMA, FPG only as an index of IR with other variables such as serum testerosterone and DHEAS), BMI, and HOMA were significant independent determinants of fasting PAC (adjusted r(2)=0.59). FPG, HOMA index and FSI were significantly lower after Metformin treatment in both obese and non-obese PCOS while adiponectin levels increased significantly.
多囊卵巢综合征（PCOS）发病机制中已报道脂联素、类固醇合成或作用与胰岛素抵抗（IR）指标之间存在相互作用。本研究旨在测定患和未患PCOS女性的血浆脂联素浓度（PAC），并评估其与包括IR指标在内的激素和代谢参数的相关性。还评估了二甲双胍对PCOS患者6个月的疗效。
总共72名入选女性分为以下几组：17名肥胖（体重指数（BMI）>25kg/m²）的PCOS患者；19名正常体重（BMI 18 - 22.9kg/m²）的PCOS患者；17名肥胖（BMI>25kg/m²）的非PCOS患者和19名正常体重（BMI 18 - 22.9kg/m²）的非PCOS患者。
所有PCOS女性在过夜禁食后，于08:00至11:00采集血样。
血清促黄体生成素（LH）、促卵泡生成素（FSH）、促甲状腺激素（TSH）、总甲状腺素（T4）、睾酮、17-α-羟孕酮（17OHP）、硫酸脱氢表雄酮（DHEAS）、胰岛素、脂联素和葡萄糖水平。IR指标包括空腹血清胰岛素（FSI）、血糖与胰岛素比值以及稳态模型评估（HOMA）。
低脂联素组的腰臀比（WHR）、胰岛素和HOMA指数显著高于高脂联素组。通过逐步多元回归分析，在模型1（包括BMI、FSI、空腹血糖（FPG）以及其他变量如血清睾酮和DHEAS）中，体重以及其他变量即FSI和FPG的贡献是空腹PAC的显著独立决定因素（调整后r² = 0.66）；在模型2（包括BMI、HOMA、仅作为IR指标的FPG以及其他变量如血清睾酮和DHEAS）中，BMI和HOMA是空腹PAC的显著独立决定因素（调整后r² = 0.59）。在肥胖和非肥胖PCOS患者中，二甲双胍治疗后FPG、HOMA指数和FSI显著降低而脂联素水平显著升高。
