多囊卵巢综合征患者血清肌肉生长抑素与肥胖、胰岛素抵抗的相关性研究
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摘要
目的:研究肌肉生长抑素(MSTN)与PCOS患者肥胖、胰岛素抵抗、性激素水平的相关性。方法:通过横断面病例对照研究,将165例多囊卵巢综合征患者根据体重指数分为肥胖组和非肥胖组,同时选取142例健康妇女作为对照组。对非肥胖的PCOS患者与对照组,肥胖与非肥胖的PCOS患者之间的MSTN水平、空腹血糖、空腹胰岛素、胰岛素抵抗指数,BMI、腰围、腰臀比及性激素水平进行比较,用回归分析判断MSTN与上述指标间的相关性。结果:与对照组相比,PCOS患者MSTN水平明显升高,但排除肥胖因素后,对照组与非肥胖PCOS患者MSTN比较,差异无统计学意义(P>0.05);回归分析显示:MSTN水平与腰围、腰臀比、BMI、血清睾酮水平有明显相关性。用多变量回归分析矫正BMI和血清睾酮水平后,MSTN水平与PCOS有明显相关性(β=0.356,P=0.0005)。本研究并不支持MSTN水平与代表胰岛素抵抗的HOMA-IR有相关性,尽管后者与PCOS的发生、发展密切相关。结论:MSTN与肥胖及血清睾酮水平有明显相关性,与PCOS也有明显相关性。本研究并不支持MSTN水平与PCOS患者胰岛素抵抗有相关性。
Objective:To analyze the correlation between myostatin level and the obesity,insulin resistance,as well as sex hormone levels in patients with polycystic ovary syndrome(PCOS).Methods:Using cross-sectional case-control method,165 PCOS patients were divided into obese group and no-obese group.At the same time,one hundred and forty-two healthy women were chosen as control group.The level of fasting glucose,fasting insulin,HOMA-IR(the index of insulin resistence),BMI,waist circumference,waist-hip ratio and the level of sex hormone were determined and compared between the control group and non-obese PCOS group,between the obese and non-obese PCOS group.The correlation between MSTN and the indicators mentioned above was analyzed by regression analysis.Results:(1)Compared with control group,the MSTN level was higher significantly in the patients with PCOS but there was no significant difference between non-obese PCOS group and control group,excluding the obesity factor.Regression analysis showed that the MSTN level was significantly related to the waist circumference,waist-hip ratio,BMI and the testosterone level.After adjusting the BMI and testosterone,the mutivariate regression analysis showed that the MSTN level is significantly related to the PCOS.No correlation between the MSTN level and the insulin resistance in PCOS patients was observed,though the latter is closely related to the occurrence and progression of PCOS.Conclusion:MSTN level was correlated with obesity,serum testosterone level and PCOS.But no correlation between MSTN level and insulin resistance in PCOS patients.
Objective:To analyze the correlation between myostatin level and the obesity,insulin resistance,as well as sex hormone levels in patients with polycystic ovary syndrome(PCOS).Methods:Using cross-sectional case-control method,165 PCOS patients were divided into obese group and no-obese group.At the same time,one hundred and forty-two healthy women were chosen as control group.The level of fasting glucose,fasting insulin,HOMA-IR(the index of insulin resistence),BMI,waist circumference,waist-hip ratio and the level of sex hormone were determined and compared between the control group and non-obese PCOS group,between the obese and non-obese PCOS group.The correlation between MSTN and the indicators mentioned above was analyzed by regression analysis.Results:(1)Compared with control group,the MSTN level was higher significantly in the patients with PCOS but there was no significant difference between non-obese PCOS group and control group,excluding the obesity factor.Regression analysis showed that the MSTN level was significantly related to the waist circumference,waist-hip ratio,BMI and the testosterone level.After adjusting the BMI and testosterone,the mutivariate regression analysis showed that the MSTN level is significantly related to the PCOS.No correlation between the MSTN level and the insulin resistance in PCOS patients was observed,though the latter is closely related to the occurrence and progression of PCOS.Conclusion:MSTN level was correlated with obesity,serum testosterone level and PCOS.But no correlation between MSTN level and insulin resistance in PCOS patients.
引文
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4 张晓芳,王玮,武科.多囊卵巢综合征患者血清C反应蛋白、内脂素和Chemerin的表达水平及临床意义[J].实用临床医药杂志,2015,19(9):94-97.
5 海杰,周丽端,逯晓辉,张世阳.多囊卵巢综合征患者尿酸与胰岛素抵抗的关系研究[J].中国全科医学,2014,17(5):586-587.
6 Niu D,Wang L,Bai Z,et al.Identification and expression characterization of the myostatin(MSTN)gene and association analysis with growth traits in the razor clam Sinonovacula constricta[J].Gene,2015,555(2):297-304.
7 Han DS,Chu-Su Y,Chiang CK,et al.Serum myostatin is reduced in individuals with metabolic syndrome[J].PLoS One,2014,9(9):e108230.
8 Shan T,Liang X,Bi P,et al.Myostatin knockout drives browning of white adipose tissue through activating the AMPKPGC1α-Fndc5pathway in muscle[J].FASEB J,2013,27(5):1981-1989.
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10 Akpan I,Goncalves MD,Dhir R,et al.The effects of a soluble activin type IIB receptor on obesity and insulin sensitivity[J].Int J Obes(Lond),2009,33(11):1265-1273.
11 Allen DL,Hittel DS,McPherron AC.Expression and function of myostatin in obesity,diabetes,and exercise adaptation[J].Med Sci Sports Exerc.2011,43(10):1828-1835.
12 Hittel DS,Berggren JR,Shearer J,et al.Increased secretion and expression of myostatin in skeletal muscle from extremely obese women[J].Diabetes,2009,58(1):30-38.
13 Burghen GA,Givens JR,Kitabchi AE.Correlation of hyperandrogenism with hyperinsulinism in polycystic ovary disease[J].J Clin Endocrinol Metab,1980,50(1):113-116.
14 Nandi A,Chen Z,Patel R,et al.Polycystic ovary syndrome[J].Endocrinol Metab Clin North Am,2014,43(1):123-147.
15 Sam S.Adiposity and metabolic dysfunction in polycystic ovary syndrome[J].Horm Mol Biol Clin Investig,2015,21(2):107-116.14
16 Motta AB.The role of obesity in the development of polycystic ovary syndrome[J].Curr Pharm Des,2012,18(17):2482-2491.
17 Bernardo BL,Wachtmann TS,Cosgrove PG,et al.Postnatal PPARdelta activation and myostatin inhibition exert distinct yet complimentary effects on the metabolic profile of obese insulinresistant mice[J].PLoS One,2010,5(6):e11307.
2 李春红.多囊卵巢综合征致不孕65例分析[J].实用心脑肺血管病杂志,2010,18(1):59.
3 罗晓燕,许良智.多囊卵巢综合征患者体成分与代谢综合征的相关性分析[J].南方医科大学学报,2012,32(9):1325-1327.
4 张晓芳,王玮,武科.多囊卵巢综合征患者血清C反应蛋白、内脂素和Chemerin的表达水平及临床意义[J].实用临床医药杂志,2015,19(9):94-97.
5 海杰,周丽端,逯晓辉,张世阳.多囊卵巢综合征患者尿酸与胰岛素抵抗的关系研究[J].中国全科医学,2014,17(5):586-587.
6 Niu D,Wang L,Bai Z,et al.Identification and expression characterization of the myostatin(MSTN)gene and association analysis with growth traits in the razor clam Sinonovacula constricta[J].Gene,2015,555(2):297-304.
7 Han DS,Chu-Su Y,Chiang CK,et al.Serum myostatin is reduced in individuals with metabolic syndrome[J].PLoS One,2014,9(9):e108230.
8 Shan T,Liang X,Bi P,et al.Myostatin knockout drives browning of white adipose tissue through activating the AMPKPGC1α-Fndc5pathway in muscle[J].FASEB J,2013,27(5):1981-1989.
9 Cleasby ME,Jarmin S,Eilers W,et al.Local overexpression of the myostatin propeptide increases glucose transporter expression and enhances skeletal muscle glucose disposal[J].Am J Physiol Endocrinol Metab,2014,306(7):E814-E823.
10 Akpan I,Goncalves MD,Dhir R,et al.The effects of a soluble activin type IIB receptor on obesity and insulin sensitivity[J].Int J Obes(Lond),2009,33(11):1265-1273.
11 Allen DL,Hittel DS,McPherron AC.Expression and function of myostatin in obesity,diabetes,and exercise adaptation[J].Med Sci Sports Exerc.2011,43(10):1828-1835.
12 Hittel DS,Berggren JR,Shearer J,et al.Increased secretion and expression of myostatin in skeletal muscle from extremely obese women[J].Diabetes,2009,58(1):30-38.
13 Burghen GA,Givens JR,Kitabchi AE.Correlation of hyperandrogenism with hyperinsulinism in polycystic ovary disease[J].J Clin Endocrinol Metab,1980,50(1):113-116.
14 Nandi A,Chen Z,Patel R,et al.Polycystic ovary syndrome[J].Endocrinol Metab Clin North Am,2014,43(1):123-147.
15 Sam S.Adiposity and metabolic dysfunction in polycystic ovary syndrome[J].Horm Mol Biol Clin Investig,2015,21(2):107-116.14
16 Motta AB.The role of obesity in the development of polycystic ovary syndrome[J].Curr Pharm Des,2012,18(17):2482-2491.
17 Bernardo BL,Wachtmann TS,Cosgrove PG,et al.Postnatal PPARdelta activation and myostatin inhibition exert distinct yet complimentary effects on the metabolic profile of obese insulinresistant mice[J].PLoS One,2010,5(6):e11307.