多囊卵巢综合征患者胰岛素抵抗与纤溶系统的相关性

目的:探讨多囊卵巢综合征患者胰岛素抵抗与纤溶系统的相关性。方法:对41例多囊卵巢综合征患者(其中21例胰岛素抵抗,20例非胰岛素抵抗)、30例健康同龄人,分别测定空腹血糖、空腹胰岛素、血浆组织型纤溶酶原激活物(t-PA)及血浆组织纤溶酶原激活物抑制因子-1(PAI-1),并计算体重指数及稳态模型胰岛素抵抗指数(HOMA-IR)。结果:胰岛素抵抗的多囊卵巢综合征患者的血浆组织纤溶酶原激活物抑制因子-1的水平较无胰岛素抵抗的多囊卵巢综合征患者及正常对照组明显升高(P<0.05),并与胰岛素抵抗指数呈明显相关性,无胰岛素抵抗的多囊卵巢综合征患者PAI-1水平较正常对照组高(P<0.05);血浆组织型纤溶酶原激活物在3组之间无明显的改变(P>0.05)。结论:胰岛素抵抗的多囊卵巢综合征患者的PAI-1水平增高和无明显变化的t-PA表达,显示存在低纤溶活性状态。这种纤溶活性的改变可能是胰导素抵抗的多囊卵巢综合征患者早期发生动脉粥样硬化和流产的发病机理。

Study of relationship between insulin resistance and fibrinolytic system in PCOS patients

Objective:To explore the relationship between insulin resistance(IR) and fibrinolytic system in Polycystic ovary syndrome(PCOS) patients.Methods:Fasting glucose,fasting insulinemia,PAI-1 and t-PA were measured in 41 patients with polycystic ovary syndrome(including 21 insulin resistance people and 20 insulin sensitive people) and in 30 controls.Body mass index(BMI) and homeostasis model assessment for insulin resistance(HOMA-IR) were also calculated.Results:The level of PAI-1 was higher in insulin resistance PCOS patients than insulin sensitive PCOS patients and controls(P<0.05) and PAI-1 correlated with HOMA-IR significantly.Also the level of PAI-1 was higher in PCOS patients without insulin resistance than controls(P<0.05).There was no significant alteration of the expression of t-PA in three groups(P>0.05).Conclusion:The increased PAI-1 and no change of t-PA in insulin resistance PCOS patients indicated hypofibrinolytic state.The fibrinolytic derangement may be the pathogenesis of early artherosclerosis and miscarriage in insulin resistance patients.