Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
Korean J Intern Med. 2013 Jul;28(4):456-63. doi: 10.3904/kjim.2013.28.4.456. Epub 2013 Jul 1.
BACKGROUND/AIMS: Many women with polycystic ovary syndrome (PCOS) exhibit insulin resistance. Adipose tissue plays an important role in insulin resistance, and adipokines including tumor necrosis factor (TNF)-α and adiponectin are altered in PCOS. Insulin-like growth factor binding protein-3 (IGFBP-3), alone or in conjunction with other adipokines, is also associated with insulin resistance. We evaluated the effects of TNF-α, adiponectin, and IGFBP-3 on insulin sensitivity and the relationships among these proteins in women with PCOS.
We recruited 40 women with PCOS and 40 age- and body mass index (BMI)-matched regular cycling women (controls). The women were divided into obese (BMI ≥ 25 kg/m(2)) and nonobese (BMI < 25 kg/m(2)) groups. Anthropometric measurements were performed, and serum levels of TNF-α, adiponectin, and IGFBP-3 were determined. Insulin sensitivity was estimated using the metabolic clearance rate (MCR) of glucose calculated from the oral glucose tolerance test.
Serum levels of TNF-α and IGFBP-3 did not differ between the PCOS and control groups, but adiponectin levels in the PCOS group were lower than those in control women in the nonobese group (p < 0.05). TNF-α, adiponectin, and IGFBP-3 levels were not correlated with each other in women with PCOS, but a significant positive correlation was observed between adiponectin levels and MCR (p < 0.05). Multiple regression analysis revealed that adiponectin levels were significantly associated with insulin sensitivity (p < 0.05) in women with PCOS.
IGFBP-3 and TNF-α levels were not associated with insulin sensitivity, but adiponectin levels were related to insulin sensitivity in women with PCOS.
背景/目的:许多多囊卵巢综合征(PCOS)患者存在胰岛素抵抗。脂肪组织在胰岛素抵抗中起着重要作用,肿瘤坏死因子(TNF)-α和脂联素等脂肪因子在 PCOS 中发生改变。胰岛素样生长因子结合蛋白-3(IGFBP-3)单独或与其他脂肪因子一起,也与胰岛素抵抗有关。我们评估了 TNF-α、脂联素和 IGFBP-3 对 PCOS 患者胰岛素敏感性的影响,以及这些蛋白之间的关系。
我们招募了 40 名 PCOS 患者和 40 名年龄和体重指数(BMI)匹配的正常排卵女性(对照组)。这些女性分为肥胖(BMI≥25kg/m²)和非肥胖(BMI<25kg/m²)两组。进行了人体测量学测量,并测定了血清 TNF-α、脂联素和 IGFBP-3 水平。使用口服葡萄糖耐量试验计算的葡萄糖代谢清除率(MCR)来估计胰岛素敏感性。
PCOS 组和对照组的血清 TNF-α和 IGFBP-3 水平无差异,但非肥胖组 PCOS 组的脂联素水平低于对照组女性(p<0.05)。在 PCOS 患者中,TNF-α、脂联素和 IGFBP-3 水平之间没有相关性,但脂联素水平与 MCR 呈显著正相关(p<0.05)。多元回归分析显示,脂联素水平与 PCOS 患者的胰岛素敏感性显著相关(p<0.05)。
IGFBP-3 和 TNF-α 水平与胰岛素敏感性无关,但脂联素水平与 PCOS 患者的胰岛素敏感性相关。