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多囊卵巢综合征中瘦素与胰岛素抵抗的关联:一项病例对照研究。

Association of leptin and insulin resistance in PCOS: A case-controlled study.

作者信息

Namavar Jahromi Bahia, Dabaghmanesh Mohammad Hassan, Parsanezhad Mohammad Ebrahim, Fatehpoor Faranak

机构信息

Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Int J Reprod Biomed. 2017 Jul;15(7):423-428.

Abstract

BACKGROUND

Endocrine abnormalities related to polycystic ovary Syndrome (PCOS) are important problems.

OBJECTIVE

To compare serum leptin levels between infertile women with and without PCOS. To rank sensitivity of six indirect methods for detection of insulin resistance (IR) and to evaluate the association between leptin and IR in PCOS group.

MATERIALS AND METHODS

This Case-controlled study performed on 189 infertile women referred to Shiraz Mother and Child Hospital during 2012-2015. Ninety-nine PCOS cases according to Rotterdam criteria were compared to 90 cases without PCOS. Serum leptin, body mass index (BMI), several hormones, and their correlation coefficients with leptin were compared. IR in PCOS women was measured by indirect methods, including fasting blood sugar (FBS), fasting insulin (FI), glucose/insulin, homeostatic model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and MacAuley index. Association between IR and leptin was evaluated. Independent sample t-test and Pearson's test were used.

RESULTS

Infertile women with PCOS had higher BMI (26.47±3.62 vs. 24.82±5.18 kg/m) and serum leptin levels (41.79±187.89 vs. 19.38±12.57 ng/mL). Leptin showed significant association with weight and BMI in both groups (p<0.001) and to age in non-PCOS group. HOMA-IR showed the highest rate of IR followed by FI and QUICKI methods. The mean leptin levels had positive association with IR assessed by HOMA-IR (p<0.001), QUICKI (p<0.001), FI (p=.002), and FBS (p=0.02).

CONCLUSION

BMI and IR have positive association with serum leptin in PCOS infertile women. HOMA-IR followed by FI and QUICKI is the most sensitive test for detection of IR.

摘要

背景

与多囊卵巢综合征(PCOS)相关的内分泌异常是重要问题。

目的

比较患有和未患有PCOS的不孕女性的血清瘦素水平。对六种检测胰岛素抵抗(IR)的间接方法的敏感性进行排序,并评估PCOS组中瘦素与IR之间的关联。

材料与方法

本病例对照研究于2012年至2015年期间对转诊至设拉子妇幼医院的189名不孕女性进行。根据鹿特丹标准将99例PCOS病例与90例无PCOS的病例进行比较。比较血清瘦素、体重指数(BMI)、几种激素及其与瘦素的相关系数。通过间接方法测量PCOS女性的IR,包括空腹血糖(FBS)、空腹胰岛素(FI)、血糖/胰岛素、胰岛素抵抗稳态模型评估(HOMA-IR)、定量胰岛素敏感性检查指数(QUICKI)和麦考利指数。评估IR与瘦素之间的关联。使用独立样本t检验和Pearson检验。

结果

患有PCOS的不孕女性的BMI(26.47±3.62 vs. 24.82±5.18 kg/m)和血清瘦素水平(41.79±187.89 vs. 19.38±12.57 ng/mL)更高。两组中瘦素均与体重和BMI显著相关(p<0.001),在非PCOS组中与年龄相关。HOMA-IR显示出最高的IR率,其次是FI和QUICKI方法。通过HOMA-IR(p<0.001)、QUICKI(p<0.001)、FI(p = 0.002)和FBS(p = 0.02)评估,平均瘦素水平与IR呈正相关。

结论

在患有PCOS的不孕女性中,BMI和IR与血清瘦素呈正相关。HOMA-IR其次是FI和QUICKI是检测IR最敏感的测试。

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