血清Irisin及Zonulin水平用于诊断PCOS患者胰岛素抵抗的临床价值研究
摘要
目的探讨多囊卵巢综合征(PCOS)患者血清鸢尾素(Irisin)及连蛋白(Zonulin)水平改变及其临床诊断价值。方法纳入2013年5月-2016年5月就诊的PCOS患者85例为PCOS组,64名健康体检的女性为对照组。使用酶联免疫吸附方法检测两组女性血清Irisin及Zonulin水平,分析与临床指标的相关性及诊断PCOS患者胰岛素抵抗的效能。结果 PCOS组患者血清Irisin(0. 41±0. 14)μg/ml、Zonulin水平(7. 21±2. 96) pg/ml显著高于对照组女性的(0. 26±0. 09)μg/ml、(4. 30±1. 62) pg/ml,差异有统计学意义(P<0. 01)。PCOS组患者Irisin及Zonulin水平分别与BMI、WHA、FPG、FINS、HOMA-IR、TG、T呈显著正相关,与HDL-C呈负相关。Irisn单独诊断PCOS患者是否存在IR的AUC为0. 793 (95%CI:0. 697～0. 889,P<0. 01),Zonulin的AUC为0. 773 (95%CI:0. 668～0. 878,P<0. 01),血清Irisin联合Zonulin诊断的AUC为0. 881 (95%CI为0. 808～0. 953,P <0. 001)。结论 PCOS患者血清Irisin及Zonulin水平存在显著升高,且Irisin联合Zonulin诊断PCOS是否存在胰岛素抵抗的效能较高。
引文
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[13]Moreno-Navarrete JM,Sabater M,Ortega F,et al.Circulating zonulin,a marker of intestinal permeability,is increased in association with obesity-associated insulin resistance[J].PLoS One,2012,7(5):e37160.
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[15]Mokkala K,Tertti K,Ronnemaa T,et al.Evaluation of serum zonulin for use as an early predictor for gestational diabetes[J].Nutr Diabetes,2017,7(3):e253.
[2]Macut D,Bjekic-Macut J,Rahelic D,et al.Insulin and the polycystic ovary syndrome[J].Diabetes Res Clin Pract,2017,130:163-170.
[3]Chen JQ,Huang YY,Gusdon AM,et al.Irisin:a new molecular marker and target in metabolic disorder[J].Lipids Health Dis,2015,14:2.
[4]Fasano A.Intestinal permeability and its regulation by zonulin:diagnostic and therapeutic implications[J].Clin Gastroenterol Hepatol,2012,10(10):1096-1100.
[5]Polak K,Czyzyk A,Simoncini T,et al.New markers of insulin resistance in polycystic ovary syndrome[J].J Endocrinol Invest,2017,40(1):1-8.
[6]Goodman NF,Cobin RH,Futterweit W,et al.American association of clinical endocrinologists,american college of endocrinology,and androgen excess and pcos society disease state clinical review:guide to the best practices in the evaluation and treatment of polycystic ovary syndrome-part 1[J].Endocr Pract,2015,21(11):1291-1300.
[7]刘红梅.多囊卵巢综合征与胰岛功能、性激素水平相关性研究[D].吉林长春:吉林大学,2014.
[8]Glintborg D.Endocrine and metabolic characteristics in polycystic ovary syndrome[J].Dan Med J,2016,63(4):B5232.
[9]Mokkala K,Pellonpera O,Roytio H,et al.Increased intestinal permeability,measured by serum zonulin,is associated with metabolic risk markers in overweight pregnant women[J].Metabolism,2017,69:43-50.
[10]Winn NC,Grunewald ZI,Liu Y,et al.Plasma Irisin Modestly Increases during Moderate and High-Intensity Afternoon Exercise in Obese Females[J].PLoS One,2017,12(1):e0170690.
[11]Li M,Yang M,Zhou X,et al.Elevated circulating levels of irisin and the effect of metformin treatment in women with polycystic ovary syndrome[J].J Clin Endocrinol Metab,2015,100(4):1485-1493.
[12]Chang CL,Huang SY,Soong YK,et al.Circulating irisin and glucose-dependent insulinotropic peptide are associated with the development of polycystic ovary syndrome[J].J Clin Endocrinol Metab,2014,99(12):E2539-2548.
[13]Moreno-Navarrete JM,Sabater M,Ortega F,et al.Circulating zonulin,a marker of intestinal permeability,is increased in association with obesity-associated insulin resistance[J].PLoS One,2012,7(5):e37160.
[14]Zhang D,Zhang L,Yue F,et al.Serum zonulin is elevated in women with polycystic ovary syndrome and correlates with insulin resistance and severity of anovulation[J].Eur J Endocrinol,2015,172(1):29-36.
[15]Mokkala K,Tertti K,Ronnemaa T,et al.Evaluation of serum zonulin for use as an early predictor for gestational diabetes[J].Nutr Diabetes,2017,7(3):e253.