Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin 300052, China; Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin Medical University General Hospital, Tianjin 300052, China.
Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin 300052, China; Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin Medical University General Hospital, Tianjin 300052, China.
Eur J Obstet Gynecol Reprod Biol. 2024 Jun;297:24-29. doi: 10.1016/j.ejogrb.2024.03.034. Epub 2024 Mar 27.
To investigate the relationship between body composition and serum visfatin and apelin levels in patients with polycystic ovary syndrome (PCOS).
In this prospective observational study, the differences in body composition, levels of gonadal hormone concentrations, glucose metabolism, apelin, and visfatin were compared between PCOS patients and the control group. PCOS patients were further divided into different subgroups according to different obesity criteria and the differences between serum visfatin and apelin levels in different subgroups were compared. Finally, the correlation of serum visfatin levels and apelin levels with body composition, and metabolism-related indicators in PCOS patients was explored.
A total collected 178 cases of PCOS patients and 172 cases of healthy women (control group) between 2020 July and 2021 November. In PCOS patients, their weight, Body Mass Index (BMI), Waist Hip Rate (WHR), Fat-Free Mass Index (FFMI), Percent Body Fat (PBF), Fat mass index (FMI), PBF of Arm, PBF of Leg, PBF of the Trunk, Visceral Fat Level (VFL), fasting insulin (FINS), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and Luteinizing hormone (LH) were significantly higher than in the control group (all P < 0.001), Percent Skeletal Muscle (PSM), PSM of Leg, and PSM of the Trunk were significantly decreased than in the control group (all P < 0.001). The PCOS patients had significantly higher serum visfatin levels and apelin levels compared with the control group (all P < 0.001). In PBF > 35 % PCOS patients, the apelin and visfatin levels were significantly higher than the PBF ≤ 35 % PCOS patients. In WHR ≥ 0.85 and BMI ≥ 24 kg/m PCOS patients, the visfatin levels were significantly higher than the WHR < 0.85 and BMI < 24 kg/m PCOS patients. Serum apelin and visfatin positively correlated with BMI level, WHR, FFMI, PBF, FMI, PBF of arms, PBF of legs, PBF of the trunk, VFL, FBG, HOMA-IR index and negatively correlated with PSM, PSM of legs, and PSM of the trunk (all P < 0.001).
Compared with healthy women, Patients with PCOS have an increased fat content in various parts of the body, reduced skeletal muscle content, and are often complicated by metabolic abnormalities. Serum visfatin and apelin correlated not only with obesity, fat mass, and fat distribution but also with muscle mass and distribution. It may be possible to reduce the long-term risk of metabolic disease in PCOS through the monitoring and management of the body composition in PCOS patients or to reflect the therapeutic effect of PCOS.
探讨多囊卵巢综合征(PCOS)患者体成分与血清内脏脂肪素和脂联素水平的关系。
采用前瞻性观察性研究,比较 PCOS 患者与对照组之间的体成分、性腺激素浓度、葡萄糖代谢、脂联素和内脏脂肪素水平的差异。根据不同的肥胖标准,将 PCOS 患者进一步分为不同亚组,并比较不同亚组血清内脏脂肪素和脂联素水平的差异。最后,探讨 PCOS 患者血清内脏脂肪素和脂联素水平与体成分和代谢相关指标的相关性。
2020 年 7 月至 2021 年 11 月期间共收集了 178 例 PCOS 患者和 172 例健康女性(对照组)。PCOS 患者的体重、体重指数(BMI)、腰臀比(WHR)、去脂体重指数(FFMI)、体脂肪百分比(PBF)、脂肪质量指数(FMI)、臂部 PBF、腿部 PBF、躯干 PBF、内脏脂肪水平(VFL)、空腹胰岛素(FINS)、胰岛素抵抗评估的稳态模型(HOMA-IR)和黄体生成素(LH)均明显高于对照组(均 P<0.001),而去脂体重百分比(PSM)、腿部 PSM 和躯干 PSM 明显低于对照组(均 P<0.001)。与对照组相比,PCOS 患者的血清内脏脂肪素和脂联素水平明显升高(均 P<0.001)。在 PBF>35%的 PCOS 患者中,脂联素和内脏脂肪素水平明显高于 PBF≤35%的 PCOS 患者。在 WHR≥0.85 和 BMI≥24kg/m的 PCOS 患者中,内脏脂肪素水平明显高于 WHR<0.85 和 BMI<24kg/m的 PCOS 患者。血清脂联素和内脏脂肪素与 BMI 水平、WHR、FFMI、PBF、FMI、臂部 PBF、腿部 PBF、躯干 PBF、VFL、空腹血糖(FBG)、HOMA-IR 指数呈正相关,与 PSM、腿部 PSM 和躯干 PSM 呈负相关(均 P<0.001)。
与健康女性相比,PCOS 患者全身各部位脂肪含量增加,骨骼肌含量减少,常伴有代谢异常。血清内脏脂肪素和脂联素不仅与肥胖、脂肪量和脂肪分布有关,而且与肌肉量和分布有关。通过监测和管理 PCOS 患者的体成分,可能降低 PCOS 患者发生长期代谢性疾病的风险,或反映 PCOS 的治疗效果。