多囊卵巢综合征女性脂联素与瘦素比值及其与胰岛素抵抗的关系
Adiponectin to Leptin Ratio and its Association with Insulin Resistance in Women with Polycystic Ovarian Syndrome.
作者信息
Mishra Pragya, Mittal Pratima, Rani Anita, Bharti Rekha, Agarwal Varsha, Suri Jyotsna
机构信息
Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India.
Department of Biochemistry, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India.
出版信息
Indian J Endocrinol Metab. 2022 May-Jun;26(3):239-244. doi: 10.4103/ijem.ijem_137_22. Epub 2022 Aug 4.
BACKGROUND
Adiponectin and leptin play a major role in metabolic homeostasis. Adiponectin to Leptin ratio can be used as an indicator of insulin resistance and a marker of polycystic ovarian syndrome (PCOS). The study was planned to compare serum adiponectin, leptin, and adiponectin to leptin ratio in age and BMI matched women with and without PCOS and to find out the association of adiponectin to leptin ratio with Insulin resistance in these women.
METHODS
It was a cross-sectional study done in the Gynecology outpatient clinic in a tertiary care center. A total of 120 women, 60 with PCOS and 60 age and BMI matched women without PCOS, who presented in the clinic after the index cases were enrolled and tested for serum adiponectin, leptin, and insulin sensitivity. The main outcome measures were serum levels of adiponectin, leptin, adiponectin to leptin ratio, oral glucose tolerance test, serum insulin and HOMA-IR.
RESULTS
PCOS women had lower serum Adiponectin, higher serum Leptin level and lower Adiponectin to Leptin ratio compared to non PCOS women, 2.15 ± 3.07 ng/ml vs 10.7 ± 27.91 ng/ml, < 0.0001; 24.25 ± 16.5 ng/ml vs 13.89 ± 11.19 ng/ml, = 0.0003 and 0.15 ± 0.24 vs 3.03 ± 15.04, < 0.0001, respectively. Plasma glucose 2 hours after 75 gm glucose and serum Insulin was significantly increased in PCOS women (108.78 ± 10.22 mg/dl vs 100.18 ± 4.89 mg/dl, = 0.001 and 5.7 ± 9.53 mU/ml vs 3.02 ± 5.34 mU/ml, = 0.02, respectively). The mean values of fasting plasma glucose and HOMA-IR were comparable in both groups, = 0.145, = 0.719, respectively. There was no significant association of A/L Ratio with BMI, plasma glucose 2 hours after 75 gm glucose, serum Insulin and HOMA-IR, in these women, r = -0.074, = 0.5754; r = -0.203, = 0.12; r = -0.018, = 0.8915; and r = -0.041, = 0.757, respectively.
CONCLUSION
Adiponectin to leptin ratio is significantly reduced in women with PCOS but has no association with insulin resistance.
背景
脂联素和瘦素在代谢稳态中起主要作用。脂联素与瘦素的比值可作为胰岛素抵抗的指标以及多囊卵巢综合征（PCOS）的标志物。本研究旨在比较年龄和体重指数（BMI）匹配的患有和未患有PCOS的女性的血清脂联素、瘦素以及脂联素与瘦素的比值，并找出这些女性中脂联素与瘦素的比值与胰岛素抵抗之间的关联。
方法
这是一项在三级医疗中心的妇科门诊进行的横断面研究。共有120名女性，60名患有PCOS，60名年龄和BMI匹配且未患有PCOS的女性，在纳入指标病例并对其进行血清脂联素、瘦素和胰岛素敏感性检测后在门诊就诊。主要观察指标为血清脂联素水平、瘦素水平、脂联素与瘦素的比值、口服葡萄糖耐量试验、血清胰岛素和稳态模型评估胰岛素抵抗（HOMA-IR）。
结果
与非PCOS女性相比，PCOS女性的血清脂联素水平较低，血清瘦素水平较高，脂联素与瘦素的比值较低，分别为2.15±3.07 ng/ml对10.7±27.91 ng/ml，P<0.0001；24.25±16.5 ng/ml对13.89±11.19 ng/ml，P = 0.0003；0.15±0.24对3.03±15.04，P<0.0001。PCOS女性口服75克葡萄糖后2小时的血浆葡萄糖和血清胰岛素显著升高（分别为108.78±10.22 mg/dl对100.18±4.89 mg/dl，P = 0.001；5.7±9.53 mU/ml对3.02±5.34 mU/ml，P = 0.02）。两组的空腹血糖平均值和HOMA-IR相当，分别为P = 0.145，P = 0.719。在这些女性中，A/L比值与BMI、口服75克葡萄糖后2小时的血浆葡萄糖、血清胰岛素和HOMA-IR均无显著关联，r分别为-0.074，P = 0.5754；r = -0.203，P = 0.12；r = -0.018，P = 0.8915；r = -0.041，P = 0.757。
结论
PCOS女性的脂联素与瘦素比值显著降低，但与胰岛素抵抗无关。
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