| PCOS 患者胰岛素释放试验峰值后移与胰岛素分泌总量及敏感性的特征分析 |
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| 引用本文： | 朱 琳,林延润,杨发达,陈跃瑜,谢煜楠.PCOS 患者胰岛素释放试验峰值后移与胰岛素分泌总量及敏感性的特征分析[J].现代检验医学杂志,2022,0(5):154-158. |
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| 作者姓名： | 朱 琳 林延润 杨发达 陈跃瑜 谢煜楠 |
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| 作者单位： | 佛山市南海区妇幼保健院检验科, 广东佛山 528200 |
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| 摘 要： | 目的 分析胰岛素释放试验（insulin release test，IRT） 峰值后移的多囊卵巢综合征（polycystic ovarysyndrome，PCOS）患者的胰岛素分泌特征，探讨胰岛素峰值后移对胰岛素敏感度的影响。方法 回顾性分析2019 年11 月～ 2021 年12 月在佛山市南海区妇幼保健院妇科就诊的PCOS 患者120 例。首次就诊时行空腹血糖（fasting plasmaglucose，FPG）和IRT 检测，根据IRT 的峰值时间进行分组，峰值时间在30min 为I30 组（n=30），在60min 为I60 组（n=30），在120min 为I120 组（n=30）和在180min 为I180 组（n=30）。比较四组FPG 和IRT 各时间点血浆胰岛素水平的差异，通过公式计算出胰岛素敏感指数(insulin sensitivity index，ISI)、胰岛素抵抗指数(insulin resistance index ，IRI) 和胰岛素曲线下面积（area under the curve ，AUC），比较这三个指标以及峰值的血浆胰岛素水平在四组的差异，通过Pearson 相关性分析探讨峰值后移与胰岛素分泌总量和胰岛素敏感度指标的相关性。结果 ①单因素方差分析显示四组的FPG 和30min 的胰岛素水平差异无统计学意义（F=1.795, 1.780，均P ＞ 0.05），但达峰时间影响空腹和60，120，180min 的胰岛素分泌量，差异均有统计学意义（F = 9.355 ～ 24.170，均P ＜ 0.05）。②四组ISI 和AUC 差异无统计学意义（F=1.906,0.492，均P ＞ 0.05），而IRI 和峰值的胰岛素值从I30 组到I180 组均呈递增趋势，差异有统计学意义（F=10.360，5.140，均P ＜ 0.05）。③ Pearson 相关性分析表明ISI,AUC 与峰值后移无相关性(r =-0.077，-0.014，均P ＞ 0.05)，IRI 和峰值的胰岛素水平与峰值后移呈显著正相关(r =0.359，0.335，均P =0.000)。结论 PCOS 患者胰岛素峰值后移对空腹和60，120，180min 的胰岛素分泌量有影响；随着胰岛素峰值后移，峰值的胰岛素水平和胰岛素抵抗程度增加，但胰岛素敏感性和胰岛素分泌总量变化不明显。
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| 关 键 词： | 多囊卵巢综合征 胰岛素 胰岛素释放试验 峰值后移 |
Analysis of the Relationship between the Peak Shift of Insulin Release Test and Total Insulin Secretion and Sensitivity in Patients with PCOS |
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| ZHU Lin,LIN Yan-run,YANG Fa-da,CHEN Yue-yu,XIE Yu-nan.Analysis of the Relationship between the Peak Shift of Insulin Release Test and Total Insulin Secretion and Sensitivity in Patients with PCOS[J].Journal of Modern Laboratory Medicine,2022,0(5):154-158. |
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| Authors: | ZHU Lin LIN Yan-run YANG Fa-da CHEN Yue-yu XIE Yu-nan |
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| Affiliation: | Department of Clinical Laboratory, Nanhai District Maternal and Child Health Hospital of Foshan City, Guangdong Foshan 528200，China |
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| Abstract: | Objective To analyze the characteristics of total insulin secretion in patients with polycystic ovary syndrome（PCOS） with peak value shifted backward in insulin release test（IRT） and to explore the effect of Insulin peak shift on insulin sensitivity. Methods A retrospective analysis was made of 120 women with PCOS were enrolled from November 2019 to December 2021 at Nanhai District Maternal and Child Health Hospital in Foshan. Fasting plasma glucose (FPG) and IRT were performed at the first visit. According to the peak time of insulin release test, the peak value appeared at 30min in I30 group (n = 30), at 60min in I60 group (n = 30), at 120min in I120 group (n = 30) , and the peak value at 180min was I180 group (n= 30). The differences of FPG and plasma insulin level at each time point of IRT in four groups were analyzed and Insulin Sensitivity Index (ISI), Insulin Resistance Index (IRI), area under curve (AUC) of insulin and the peak insulin values were calculated, and the differences of these four indexes among the four groups were compared. Pearson correlation analysis was used to investigate the correlation between peak shift and total insulin secretion and sensitivity. Results ① Univariate analysis of variance showed that there was no significant difference in FPG and plasma insulin level at 30min（F=1.795, 1.780， all P ＞ 0.05）, but the peak time of insulin secretion affected insulin levels at fasting and 60,120,180min, and there were significantly different among the four groups（F=10.740 ～ 24.170，all P ＜ 0.05）. ② ISI and AUC were not significantly different（F=1.906，0.492，all P ＞ 0.05）. However, IRI and peak insulin values increased from I30 group to I180 group, the difference was statistically significant （F=10.360，5.140，all P ＜ 0.05）. ③ Pearson correlation analysis showed that there was no correlation between ISI, AUC and Insulin Peak Shift(r=-0.077, -0.014，all P ＞ 0.05), IRI and insulin peak shift were positively correlated(r=0.359，0.335， all P ＜ 0.000). Conclusion The backward shift of insulin peak in patients with PCOS has an effect on fasting insulin and 60,120,180min insulin secretion after taking sugar water. As the peak value moved back, the insulin level of the peak value increased, and the degree of insulin resistance increased, but the change of insulin sensitivity and total insulin secretion was not obvious. |
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