非肥胖多囊卵巢综合征女性循环骨桥蛋白及其与肝脂肪含量的关系：一项病例对照研究。
Circulating osteopontin and its association with liver fat content in non-obese women with polycystic ovary syndrome: a case control study.
机构信息
Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujian Road, Shanghai, 200127, China.
Department of Emergency, South Campus, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
出版信息
Reprod Biol Endocrinol. 2018 Mar 27;16(1):31. doi: 10.1186/s12958-018-0331-4.
BACKGROUND
Osteopontin (OPN) plays an important role in inflammatory processes and insulin resistance. Polycystic ovary syndrome (PCOS) is a reproductive metabolic disease associated with insulin resistance and metabolic abnormalities, including high levels of liver fat content (LFC). The objective of this study was to explore whether circulating OPN independently contributes to elevated LFC in non-obese PCOS patients.
METHODS
This study included 61 non-obese PCOS patients and 56 age-matched healthy women from Shanghai, China. After an overnight fast, all participants underwent anthropometric measurements, oral glucose tolerance tests, lipid profile and sex hormone measurements. Quantitative measurement of LFC by ultrasonography was performed. OPN concentrations were measured using ELISA. An independent samples t-test and the Mann-Whitney U test were performed to compare variables between the two groups; one-way ANOVA and Kruskal-Wallis test were performed to compare four subgroups of patients. Correlations were determined by Spearman's correlation tests. Stepwise multiple linear regression analyses were performed to assess for independent contributors. A receiver operating characteristic curve with the maximum Youden index was calculated for the optimal cut-off value.
RESULTS
In non-obese PCOS women, circulating OPN levels were increased in the subgroups with a higher body mass index (BMI) and free androgen index (FAI), and the LFC levels were increased in the elevated OPN subgroups. Moreover, increased OPN was associated with increased FAI and LFC in PCOS women, and the association between OPN and LFC was independent of triglyceride, HOMA-IR and FAI after adjusting for PCOS status in all participants. OPN combined with FAI and hsCRP may better predict NAFLD than WHR in this study cohort. However, there was no significant difference in circulating OPN levels between non-obese PCOS and normal control women.
CONCLUSIONS
Increased OPN levels may be related to FAI and elevated LFC in non-obese women with PCOS.
背景
骨桥蛋白（OPN）在炎症过程和胰岛素抵抗中发挥重要作用。多囊卵巢综合征（PCOS）是一种与胰岛素抵抗和代谢异常相关的生殖代谢疾病，包括肝内脂肪含量（LFC）升高。本研究旨在探讨循环 OPN 是否独立导致非肥胖 PCOS 患者 LFC 升高。
方法
本研究纳入了 61 例非肥胖 PCOS 患者和 56 例年龄匹配的健康女性，均来自中国上海。所有参与者均在禁食过夜后进行体格检查、口服葡萄糖耐量试验、血脂谱和性激素测量。采用超声检测定量测量 LFC。采用 ELISA 法检测 OPN 浓度。采用独立样本 t 检验和 Mann-Whitney U 检验比较两组间变量；采用单因素方差分析和 Kruskal-Wallis 检验比较患者的四个亚组。采用 Spearman 相关检验确定相关性。采用逐步多元线性回归分析评估独立贡献因素。采用最大 Youden 指数计算受试者工作特征曲线的最佳截断值。
结果
在非肥胖 PCOS 女性中，BMI 和游离雄激素指数（FAI）较高的亚组中循环 OPN 水平升高，LFC 水平升高的亚组中 OPN 水平升高。此外，在 PCOS 女性中，升高的 OPN 与升高的 FAI 和 LFC 相关，并且在调整所有参与者的 PCOS 状态后，OPN 与 LFC 之间的相关性独立于甘油三酯、HOMA-IR 和 FAI。在本研究队列中，OPN 联合 FAI 和 hsCRP 预测非酒精性脂肪性肝病（NAFLD）可能优于 WHR。然而，非肥胖 PCOS 女性与正常对照组女性之间的循环 OPN 水平无显著差异。
结论
在非肥胖 PCOS 女性中，升高的 OPN 水平可能与 FAI 和升高的 LFC 相关。
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