多囊卵巢综合征痰湿证内分泌特征及颗粒细胞胰岛素受体底物1/2mRNA的表达
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摘要
目的：探讨多囊卵巢综合征痰湿证临床及内分泌特征性指标,从而为多囊卵巢综合征的中医规范化诊治提供依据；探讨PCOS痰湿证患者代谢及生殖功能紊乱的发病机理。
方法：临床研究一以45例正常育龄妇女为对照组,135例PCOS患者分为2组：非痰湿组、痰湿组,化学发光法测定血清性激素水平及DHEA-S、FPG、FINS、SHBG水平。分别比较三组初潮年龄、月经周期、BMI、腰围、SBP、DBP等临床指标的差异性,三组血清性激素水平及DHEA-S、SHBG、FPG、FINS、HOMA-IR及FAI水平的差异性。临床研究二以进入体外受精-胚胎移植(IVF-ET)的PCOS患者为研究对象,RT-PCR方法检测PCOS痰湿组、PCOS非痰湿组及对照组卵巢黄素化颗粒细胞胰岛素受体底物1/2mRNA的表达。
结果：1.各组间临床特征比较：月经周期PCOS两组与对照组比较均有显著性差异(P<0.05); BMI、腰围PCOS痰湿组与对照组及非痰湿组比较均有显著性差异(P<0.05)。2.各组间性激素及DHEA-S的比较：LH、T值PCOS两组与对照组比较均有显著性差异(P<0.05); DHEA-S值PCOS非痰湿组与对照组比较有显著性差异(P<0.05), PCOS痰湿组与对照组比较有极显著性差异(P<0.01), PCOS痰湿组与PCOS非痰湿组比较也有显著性差异(P<0.05)。3.各组间胰岛素抵抗相关参数及SHBG、FAI的比较：FINS、HOMA-IR、SHBG、FAI值PCOS痰湿组与对照组比较有极显著性差异(P<0.01),PCOS痰湿组与PCOS非痰湿组比较也有显著性差异(P<0.05)4. PCOS痰湿组患者胰岛素受体底物-1mRNA的表达水平明显高于对照组及非痰湿组(P＜0.05); PCOS非痰湿组胰岛素受体底物-1mRNA的表达水平也明显高于对照组；PCOS痰湿组胰岛素受体底物-2mRNA的表达水平明显低于对照组及非痰湿组(P<0.05); PCOS非痰湿组胰岛素受体底物-2mRNA的表达与对照组相比差异无显著性意义(P>0.05)。
结论：PCOS痰湿证从生殖内分泌、代谢、卵巢局部分子水平等多个层面具有明显的胰岛素抵抗特征,可为PCOS痰湿证的辨证论治提供客观依据；PCOS痰湿证患者
卵巢颗粒细胞胰岛素受体底物1/2mRNA的表达失衡可能是其产生胰岛素抵抗的发病机制之一。
Objective:1.To explore the characteristic index of PCOS patients with phlegm-dampness in order to give further basis on standardized diagnosis and treatment of PCOS.2. To explore the moleculau mechanism of IR in PCOS patients with phlegm-dampness.
Methods:In clinical study 1,45 normal reproductive-aged women as controls, and 135 PCOS patients were divided into two groups:phlegm-dampness group and non phlegm-dampness group. Serum sex hormone,as well as DHEA-S,FPG,FINS,SHBG levels were measured by chemiluminescence. Indeics above and other parameters (menstrual cycle,BMI, waist size,Homa-IR, FAI etc were compared among groups. In clinical study 1,luteinizing granulosa cells from 20 PCOS patients and 10 patients with normal menstruation as controls were collected, IRS-1 and IRS-2 mRNA expression were examined by semi-quantitative RT-PCR.
Results:1.clinical characteristics:menstrual cycle:PCOS groups>control; BMI, waist size:phlegm-dampness PCOS group>control,phlegm-dampness PCOS group>non phlegm-dampness group (P＜0.05).2.sex hormone and DHEA-S:LH、T levels:PCOS groups>control, DHEA-S level:phlegm-dampness PCOS group>control (P<0.01), phlegm-dampness PCOS group>non phlegm-dampness group (P<0.05).3.IR related parameters:FINS、HOMA-IR、FAI:phlegm-dampness PCOS group>control (P<0.01), phlegm-dampness PCOS group>non phlegm-dampness group (P<0.05);SHBG level:phlegm-dampness PCOS group significantly (P＜0.05), meanwhile, compared with the non phlegm-dampness PCOS group, IRS-1 mRNA expression of phlegm-dampness group PCOS granulosa cells also increased and IRS-2 mRNA expression lowered significantly(P<0.05).
Conclusion:1.There were characteristic expression on BMI、waist size、DHEA-S、SHBG、FPG、FINS、HOMA-IR andFAI levels in phlegm-dampness PCOS patients,they might be one of objective diagnosis basis of phlegm-dampness PCOS patients.2.There was local insulin resistance in ovary of PCOS patients.IRS-1/2 ratio imbalance mignt be the main mechanism of IR in phlegm-dampness PCOS patients.
方法：临床研究一以45例正常育龄妇女为对照组,135例PCOS患者分为2组：非痰湿组、痰湿组,化学发光法测定血清性激素水平及DHEA-S、FPG、FINS、SHBG水平。分别比较三组初潮年龄、月经周期、BMI、腰围、SBP、DBP等临床指标的差异性,三组血清性激素水平及DHEA-S、SHBG、FPG、FINS、HOMA-IR及FAI水平的差异性。临床研究二以进入体外受精-胚胎移植(IVF-ET)的PCOS患者为研究对象,RT-PCR方法检测PCOS痰湿组、PCOS非痰湿组及对照组卵巢黄素化颗粒细胞胰岛素受体底物1/2mRNA的表达。
结果：1.各组间临床特征比较：月经周期PCOS两组与对照组比较均有显著性差异(P<0.05); BMI、腰围PCOS痰湿组与对照组及非痰湿组比较均有显著性差异(P<0.05)。2.各组间性激素及DHEA-S的比较：LH、T值PCOS两组与对照组比较均有显著性差异(P<0.05); DHEA-S值PCOS非痰湿组与对照组比较有显著性差异(P<0.05), PCOS痰湿组与对照组比较有极显著性差异(P<0.01), PCOS痰湿组与PCOS非痰湿组比较也有显著性差异(P<0.05)。3.各组间胰岛素抵抗相关参数及SHBG、FAI的比较：FINS、HOMA-IR、SHBG、FAI值PCOS痰湿组与对照组比较有极显著性差异(P<0.01),PCOS痰湿组与PCOS非痰湿组比较也有显著性差异(P<0.05)4. PCOS痰湿组患者胰岛素受体底物-1mRNA的表达水平明显高于对照组及非痰湿组(P＜0.05); PCOS非痰湿组胰岛素受体底物-1mRNA的表达水平也明显高于对照组；PCOS痰湿组胰岛素受体底物-2mRNA的表达水平明显低于对照组及非痰湿组(P<0.05); PCOS非痰湿组胰岛素受体底物-2mRNA的表达与对照组相比差异无显著性意义(P>0.05)。
结论：PCOS痰湿证从生殖内分泌、代谢、卵巢局部分子水平等多个层面具有明显的胰岛素抵抗特征,可为PCOS痰湿证的辨证论治提供客观依据；PCOS痰湿证患者
卵巢颗粒细胞胰岛素受体底物1/2mRNA的表达失衡可能是其产生胰岛素抵抗的发病机制之一。
Objective:1.To explore the characteristic index of PCOS patients with phlegm-dampness in order to give further basis on standardized diagnosis and treatment of PCOS.2. To explore the moleculau mechanism of IR in PCOS patients with phlegm-dampness.
Methods:In clinical study 1,45 normal reproductive-aged women as controls, and 135 PCOS patients were divided into two groups:phlegm-dampness group and non phlegm-dampness group. Serum sex hormone,as well as DHEA-S,FPG,FINS,SHBG levels were measured by chemiluminescence. Indeics above and other parameters (menstrual cycle,BMI, waist size,Homa-IR, FAI etc were compared among groups. In clinical study 1,luteinizing granulosa cells from 20 PCOS patients and 10 patients with normal menstruation as controls were collected, IRS-1 and IRS-2 mRNA expression were examined by semi-quantitative RT-PCR.
Results:1.clinical characteristics:menstrual cycle:PCOS groups>control; BMI, waist size:phlegm-dampness PCOS group>control,phlegm-dampness PCOS group>non phlegm-dampness group (P＜0.05).2.sex hormone and DHEA-S:LH、T levels:PCOS groups>control, DHEA-S level:phlegm-dampness PCOS group>control (P<0.01), phlegm-dampness PCOS group>non phlegm-dampness group (P<0.05).3.IR related parameters:FINS、HOMA-IR、FAI:phlegm-dampness PCOS group>control (P<0.01), phlegm-dampness PCOS group>non phlegm-dampness group (P<0.05);SHBG level:phlegm-dampness PCOS group
Conclusion:1.There were characteristic expression on BMI、waist size、DHEA-S、SHBG、FPG、FINS、HOMA-IR andFAI levels in phlegm-dampness PCOS patients,they might be one of objective diagnosis basis of phlegm-dampness PCOS patients.2.There was local insulin resistance in ovary of PCOS patients.IRS-1/2 ratio imbalance mignt be the main mechanism of IR in phlegm-dampness PCOS patients.
引文
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