研究肥胖和消瘦的沙特多囊卵巢综合征（PCOS）女性的ghrelin 和 leptin 水平及其与代谢特征的关系。
A study of ghrelin and leptin levels and their relationship to metabolic profiles in obese and lean Saudi women with polycystic ovary syndrome (PCOS).
机构信息
Department of Zoology, King Saud University, Riyadh, Saudi Arabia.
Department of Obstetrics and Gynecology, Umm Al-Qura University, Makkah, Saudi Arabia.
出版信息
Lipids Health Dis. 2018 Aug 21;17(1):195. doi: 10.1186/s12944-018-0839-9.
BACKGROUND
Polycystic ovary syndrome (PCOS) is considered as one of the most frequently encountered hormonal pathologies in women during their reproductive years. Leptin and ghrelin, peptide hormones with adipostatic and orexigenic effect, respectively, seem to be involved in the metabolic changes that occur in PCOS. The aim of this study was to determine serum ghrelin and leptin levels in obese and lean Saudi women with PCOS and to investigate their relationship to the metabolic profiles in these women.
METHODS
This study was conducted as a prospective, observational, cross-sectional, case-control study, at the Department of Obstetrics and Gynecology, Al-Noor Hospital, Makkah, Kingdom of Saudi Arabia. The study population included 252 women [130 women with PCOS (diagnosed according to the Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus, 2003) and 122 normo-ovulatory women as matched controls] attending the outpatient Gynecology Clinic. Demographic details were recorded, blood was extracted following overnight fast and serum was used for the determination of serum ghrelin and leptin levels and other hormonal and biochemical parameters including total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, glucose, and insulin. Insulin resistance and sensitivity were calculated as HOMA-IR and HOMA-S.
RESULTS
No significant differences in ghrelin (P = 0.1830) and leptin (P = 0.8329) levels were detected between the PCOS and control groups. However, ghrelin levels were significantly lower; and leptin levels were significantly higher in obese PCOS patients in comparison with lean patients (P = 0.0001 for both). In the PCOS group, there were significant correlations between ghrelin and leptin levels with Body Mass Index (BMI), waist-hip ratio, total cholesterol, triglycerides, HDL, LDL and insulin levels. Multiple regression analysis demonstrated that insulin was the main determinant for ghrelin (R = 0.316) and leptin (R = 0.352) levels (P = 0.0001 for both).
CONCLUSIONS
Although serum ghrelin and leptin levels were found to be normal in women with PCOS; yet, there is a relationship, possibly linked to obesity, hyperinsulinemia and insulin resistance between these levels and metabolic profile of Saudi PCOS.
背景
多囊卵巢综合征（PCOS）被认为是女性在生育年龄最常遇到的激素病理学之一。瘦素和胃饥饿素是具有脂肪生成和食欲刺激作用的肽类激素，它们似乎参与了 PCOS 发生的代谢变化。本研究旨在确定肥胖和瘦的沙特 PCOS 妇女的血清胃饥饿素和瘦素水平，并研究它们与这些妇女代谢特征的关系。
方法
本研究是在沙特阿拉伯麦加的 Al-Noor 医院妇产科进行的一项前瞻性、观察性、横断面、病例对照研究。研究人群包括 252 名妇女[130 名 PCOS 妇女（根据 2003 年鹿特丹 ESHRE/ASRM 赞助的 PCOS 共识诊断）和 122 名正常排卵妇女作为匹配对照）]，她们在妇科门诊就诊。记录人口统计学资料，禁食过夜后抽取血液，用于测定血清胃饥饿素和瘦素水平以及其他激素和生化参数，包括总胆固醇、甘油三酯、高密度脂蛋白（HDL）胆固醇、低密度脂蛋白（LDL）胆固醇、葡萄糖和胰岛素。胰岛素抵抗和敏感性分别计算为 HOMA-IR 和 HOMA-S。
结果
PCOS 组和对照组之间的胃饥饿素（P=0.1830）和瘦素（P=0.8329）水平无显著差异。然而，与瘦的 PCOS 患者相比，肥胖的 PCOS 患者的胃饥饿素水平显著降低，而瘦素水平显著升高（均 P=0.0001）。在 PCOS 组，胃饥饿素和瘦素水平与体重指数（BMI）、腰臀比、总胆固醇、甘油三酯、HDL、LDL 和胰岛素水平之间存在显著相关性。多元回归分析表明，胰岛素是胃饥饿素（R=0.316）和瘦素（R=0.352）水平的主要决定因素（均 P=0.0001）。
结论
尽管 PCOS 妇女的血清胃饥饿素和瘦素水平被认为是正常的，但它们之间存在一种关系，这种关系可能与肥胖、高胰岛素血症和胰岛素抵抗有关，与沙特 PCOS 的代谢特征有关。
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