多囊卵巢综合征患者血清Vaspin、CTRP9水平及相关影响因素分析
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摘要
目的分析多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者血清丝氨酸蛋白酶抑制剂Vaspin、肿瘤坏死因子相关蛋白9(C1q/tumor necrosis factor-related protein-9,CTRP9)的水平及相关影响因素。方法将于本院2016年3月至2017年8月确诊的59例PCOS患者纳入观察组,按照体质指数(body mass index,BMI,≥28 kg/m~2定义为肥胖)将其分为观察A组(非肥胖,28例)和观察B组(肥胖,31例);另选取同期于本院行健康体检的60例健康女性纳入对照组,根据BMI分为对照A组(非肥胖,31例)和对照B组(肥胖,29例)。检测并对比四组受检者血清Vaspin、CTRP9水平,分析其一般情况及生化指标。结果观察组患者血清Vaspin水平明显高于对照组(P<0.05),CTRP9水平明显低于对照组(P<0.05)。Pearson相关性分析显示:PCOS患者Vaspin水平与其高密度脂蛋白胆固醇(HDL-C)及120~180分钟葡萄糖代谢率(M120-180)水平呈负相关(r分别为-0.20、-0.18;P_均<0.05),与BMI、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素(FINS)、甘油三酯(TG)、总睾酮水平及腰围、稳态模型胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)水平呈正相关(r分别为0.21、0.19、0.20、0.20、0.19、0.21、0.19、0.21;P_均<0.05)。PCOS患者CTRP9水平与HDL-C、M120-180呈正相关(r分别为0.20、0.18;P_均<0.05),与BMI、TC、LDL-C、FINS、TG、总睾酮水平及腰围、HOMA-IR水平呈负相关(r分别为-0.21、-0.19、-0.20、-0.20、-0.19、-0.21、-0.19、-0.21;P_均<0.05)。结论与健康人群相比,PCOS患者血清Vaspin水平较高,CTRP9水平较低;BMI、TC、HDL-C、腰围、FINS、TG、总睾酮、HOMA-IR、LDL-C、M120-180与血清Vaspin、CTRP9水平均密切相关。
Objective To analyze the serum Vaspin and C1 q/tumor necrosis factor-related protein-9(CTRP9) levels in patients with polycystic ovary syndrome(PCOS) and related factors. Method 59 patients with PCOS diagnosed in our hospital from March 2016 to August 2017 were included in observation group, and were divided into observation group A(non-obesity, 28 cases) and observation group B(obesity, 31 cases) according to BMI. A total of 60 healthy women were enrolled in control group, and were divided into control group A(non-obesity, 31 cases) and control group B(obesity, 29 cases) according to BMI. The levels of Vaspin and CTRP9 in serum of four groups were detected and compared, and the general situation and biochemical indexes were analyzed. Result The serum levels of Vaspin in observation group were higher than that in control group(P < 0.05), and serum CTRP9 levels were lower than that in control group(P < 0.05). Pearson correlation analysis showed that: Vaspin level was negatively correlated with HDL-C and M120-180(r =-0.20、-0.18; P_(all)< 0.05), and positively correlated with BMI, TC, LDL-C, FINS, TG, total testosterone levels and waist circumference, homeostasis model assessment of insulin resistance(HOMA-IR)(r = 0.21, 0.19, 0.20, 0.20, 0.19, 0.21, 0.19, 0.21; P_(all)< 0.05). CTRP9 levels was positively correlated with HDL-C and M120-180(r = 0.20、0.18; P_(all)<0.05), negatively correlated with BMI, TC, LDL-C, waist circumference, FINS, TG, total testosterone and HOMA-IR(r=-0.21,-0.19,-0.20,-0.20,-0.19,-0.21,-0.19,-0.21; P_(all)< 0.05). Conclusion Compared with healthy women, serum Vaspin levels were higher and CTRP9 levels were lower; serum Vaspin, CTRP9 levels of PCOS patients were closely related with BMI, TC, HDL-C, waist circumference, FINS, TG, total testosterone, HOMA-IR, LDL-C, M120-180.
Objective To analyze the serum Vaspin and C1 q/tumor necrosis factor-related protein-9(CTRP9) levels in patients with polycystic ovary syndrome(PCOS) and related factors. Method 59 patients with PCOS diagnosed in our hospital from March 2016 to August 2017 were included in observation group, and were divided into observation group A(non-obesity, 28 cases) and observation group B(obesity, 31 cases) according to BMI. A total of 60 healthy women were enrolled in control group, and were divided into control group A(non-obesity, 31 cases) and control group B(obesity, 29 cases) according to BMI. The levels of Vaspin and CTRP9 in serum of four groups were detected and compared, and the general situation and biochemical indexes were analyzed. Result The serum levels of Vaspin in observation group were higher than that in control group(P < 0.05), and serum CTRP9 levels were lower than that in control group(P < 0.05). Pearson correlation analysis showed that: Vaspin level was negatively correlated with HDL-C and M120-180(r =-0.20、-0.18; P_(all)< 0.05), and positively correlated with BMI, TC, LDL-C, FINS, TG, total testosterone levels and waist circumference, homeostasis model assessment of insulin resistance(HOMA-IR)(r = 0.21, 0.19, 0.20, 0.20, 0.19, 0.21, 0.19, 0.21; P_(all)< 0.05). CTRP9 levels was positively correlated with HDL-C and M120-180(r = 0.20、0.18; P_(all)<0.05), negatively correlated with BMI, TC, LDL-C, waist circumference, FINS, TG, total testosterone and HOMA-IR(r=-0.21,-0.19,-0.20,-0.20,-0.19,-0.21,-0.19,-0.21; P_(all)< 0.05). Conclusion Compared with healthy women, serum Vaspin levels were higher and CTRP9 levels were lower; serum Vaspin, CTRP9 levels of PCOS patients were closely related with BMI, TC, HDL-C, waist circumference, FINS, TG, total testosterone, HOMA-IR, LDL-C, M120-180.
引文
[1]田勍,王海宁,王海燕,等.多囊卵巢综合征患者不同表型之间代谢异常的特点分析[J].中国糖尿病杂志,2017,25(1):14-18.
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[9]王雪,张翠莲,张少娣,等.体质量指数对多囊卵巢综合征患者移植优质胚胎后早期妊娠丢失的影响[J].实用妇产科杂志,2016,32(3):220-224.
[10]贺飞,陈文信,李红,等.肥胖与多囊卵巢综合征的关系探讨及肥胖型多囊卵巢综合征治疗的研究进展[J].河北中医,2016,38(9):1422-1426,1431.
[11]Mazaki-Tovi S,Vaisbuch E,Tarca AL,et al.Characterization of Visceral and Subcutaneous Adipose Tissue Transcriptome and Biological Pathways in Pregnant and Non-Pregnant Women:Evidence for Pregnancy-Related Regional-Specific Differences in Adipose Tissue[J].PLo S One,2015,10(12):e0143779.
[12]王丽,林翔东,倪桂莲,等.急性脑梗死患者血清Vaspin Omentin-1水平及其临床意义[J].浙江临床医学,2016,18(3):415-417.
[13]Marcher AB,Loft A,Nielsen R,et al.RNA-Seq and MassSpectrometry-Based Lipidomics Reveal Extensive Changes of Glycerolipid Pathways in Brown Adipose Tissue in Response to Cold[J].Cell Rep,2015,13(9):2000-2013.
[14]王明明,刘师伟,杜芳,等.Vaspin对糖尿病肾病大鼠肾脏保护作用的研究[J].中国中西医结合肾病杂志,2016,17(8):675-677.
[15]杨铧琦,康东.多囊卵巢综合征的临床表现及内分泌变化的研究分析[J].中国医学前沿杂志(电子版),2016,8(7):80-82.
[16]李向红,哈灵侠,刘春莲,等.多囊卵巢综合征患者胰岛素抵抗与性激素的关系研究[J].中国医学前沿杂志(电子版),2017,9(11):54-57.
[17]Azziz R.Does the risk of diabetes and heart disease in women with polycystic ovary syndrome lessen with age?[J].Fertil Steril,2017,108(6):959-960.
[18]Dewailly D Age-stratified thresholds of anti-Müllerian hormone improve prediction of polycystic ovary syndrome over a population-based threshold[J].Clin Endocrinol(Oxf),2017,87(6):649-650.
[19]Palomba S,La Sala GB.Pregnancy complications in women with polycystic ovary syndrome:importance of diagnostic criteria or of phenotypic features?[J].Hum Reprod,2016,31(1):223-224.
[20]王婉雪,张加苗,谢易冉,等.转录因子阴阳1在多囊卵巢综合征患者性激素合成中的调节作用研究[J].实用妇科内分泌电子杂志,2018,5(7):38-39.
[2]张琳,李敬,王泽,等.多囊卵巢综合征患者促甲状腺激素对血糖、血脂的影响[J].山东大学学报(医学版),2017,55(1):80-84.
[3]丁春丽,侯丽辉,郝松莉,等.多囊卵巢综合征患者中医体质与性激素、脂代谢的相关性分析[J].中医杂志,2016,57(15):1303-1307.
[4]Gower BA,Goss AM.A lower-carbohydrate,higher-fat diet reduces abdominal and intermuscular fat and increases insulin sensitivity in adults at risk of type 2 diabetes[J].J Nutr,2015,145(1):177S-183S.
[5]梁琳.多囊卵巢综合征发生的危险因素及运动减脂干预措施对其影响的研究进展[J].中华妇幼临床医学杂志(电子版),2016,12(3):354-359.
[6]Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group.Revised 2003 consensus diagnostic criteria and long-term health risks related to polycystic ovary syndrome[J].Fertil Steril,2004,81(1):19-25.
[7]胡婷.多囊卵巢综合征的病因研究进展[J].中华妇幼临床医学杂志(电子版),2016,12(3):360-363.
[8]彭真,张全,王丽娥,等.控制体重对肥胖型多囊卵巢综合征患者的疗效观察[J].生殖医学杂志,2016,25(11):992-997.
[9]王雪,张翠莲,张少娣,等.体质量指数对多囊卵巢综合征患者移植优质胚胎后早期妊娠丢失的影响[J].实用妇产科杂志,2016,32(3):220-224.
[10]贺飞,陈文信,李红,等.肥胖与多囊卵巢综合征的关系探讨及肥胖型多囊卵巢综合征治疗的研究进展[J].河北中医,2016,38(9):1422-1426,1431.
[11]Mazaki-Tovi S,Vaisbuch E,Tarca AL,et al.Characterization of Visceral and Subcutaneous Adipose Tissue Transcriptome and Biological Pathways in Pregnant and Non-Pregnant Women:Evidence for Pregnancy-Related Regional-Specific Differences in Adipose Tissue[J].PLo S One,2015,10(12):e0143779.
[12]王丽,林翔东,倪桂莲,等.急性脑梗死患者血清Vaspin Omentin-1水平及其临床意义[J].浙江临床医学,2016,18(3):415-417.
[13]Marcher AB,Loft A,Nielsen R,et al.RNA-Seq and MassSpectrometry-Based Lipidomics Reveal Extensive Changes of Glycerolipid Pathways in Brown Adipose Tissue in Response to Cold[J].Cell Rep,2015,13(9):2000-2013.
[14]王明明,刘师伟,杜芳,等.Vaspin对糖尿病肾病大鼠肾脏保护作用的研究[J].中国中西医结合肾病杂志,2016,17(8):675-677.
[15]杨铧琦,康东.多囊卵巢综合征的临床表现及内分泌变化的研究分析[J].中国医学前沿杂志(电子版),2016,8(7):80-82.
[16]李向红,哈灵侠,刘春莲,等.多囊卵巢综合征患者胰岛素抵抗与性激素的关系研究[J].中国医学前沿杂志(电子版),2017,9(11):54-57.
[17]Azziz R.Does the risk of diabetes and heart disease in women with polycystic ovary syndrome lessen with age?[J].Fertil Steril,2017,108(6):959-960.
[18]Dewailly D Age-stratified thresholds of anti-Müllerian hormone improve prediction of polycystic ovary syndrome over a population-based threshold[J].Clin Endocrinol(Oxf),2017,87(6):649-650.
[19]Palomba S,La Sala GB.Pregnancy complications in women with polycystic ovary syndrome:importance of diagnostic criteria or of phenotypic features?[J].Hum Reprod,2016,31(1):223-224.
[20]王婉雪,张加苗,谢易冉,等.转录因子阴阳1在多囊卵巢综合征患者性激素合成中的调节作用研究[J].实用妇科内分泌电子杂志,2018,5(7):38-39.