白细胞介素8及皮质醇含量变化与特发性早产的关系

目的探讨白细胞介素8(IL-8)及皮质醇含量的变化及其与特发性早产的关系.方法采用酶联免疫吸附(ELISA)法,检测35例特发性早产孕妇(早产组)及17例同期正常孕妇(对照组)血清和尿液中IL-8含量,并用放射免疫法检测血清中皮质醇含量.结果早产组孕妇血清、尿液中IL-8含量分别为(0.26±0.13)μg/L、(0.16±0.15)×10-2g/mol肌酐,明显高于对照组的(0.16±0.08)μg/L、(0.04±0.02)×10-2g/mol肌酐(P＜0.05,P＜0.01);早产组孕妇血清皮质醇含量为(765.83±408.55)μ/L,明显高于对照组的(512.41±142.65)μg/L(P＜0.01);早产组血清中IL-8与皮质醇含量呈正相关关系(r=0.448,P＜0.05).结论IL-8和皮质醇含量的变化在早产的发病中起着重要作用.     

妊娠肝内胆汁淤积症胎儿总胆汁酸浓度与肾上腺皮质功能变化的关系

目的　探讨妊娠肝内胆汁淤积症(ICP)胎儿总胆汁酸浓度与胎儿肾上腺皮质功能变化的关系。　方法　采用放射免疫法测定正常孕妇22例(对照组)及ICP孕妇20例(ICP组)胎儿脐血皮质醇及硫酸脱氢表雄酮(DHEA S)浓度;循环酶法测定两组母血及脐血总胆汁酸浓度。　结果　ICP组胎儿脐血总胆汁酸浓度(8.93±3.16) mmol/L高于对照组(4.33±1.51) mmol/L,两组比较有显著性差异(P<0. 05),且与母血胆汁酸浓度呈正相关。ICP 组脐血皮质醇浓度(99. 83±41. 34)ng/ml与对照组(74.93±29.58)ng/ml相比无明显差别(P>0.05)。ICP组脐血DHEA S浓度(24.62±8.89)μg/dl明显低于对照组(69.18±39.37)μg/dl,两组比较有显著性差异(P<0.05)。ICP组脐血DHEA S与皮质醇比值(0.29±0.09)亦明显低于对照组(0.87±0.31),两组比较有显著性差异(P<0.05)。ICP组脐血皮质醇、DHEA S浓度及DHEA S与皮质醇比值均与脐血胆汁酸浓度相关(相关系数分别为:r1= 0.87,r2=-0.88,r3=-0.84;P<0.05)。　结论　ICP孕妇的胎儿总胆汁酸浓度增高,与母血总胆汁酸浓度呈正相关;ICP孕妇的胎儿肾上腺皮质功能受损,其受损程度与脐血总胆汁酸浓度呈正相关。     

妇女血清可溶性Fas/FasL与反复自然流产的关系初探

目的:探讨妇女血清可溶性Fas/FasL(sFas/sFasL)在反复自然流产(RSA)发病中的作用。方法:采用ELISA法检测62例RSA妇女(RSA组)、34例正常妊娠妇女(正常妊娠组)和34例正常非孕妇女(对照组)血清sFas/sFasL水平。结果:RSA组sFas含量(1051.44±420.87pg/ml)高于对照组(529.49±241.01pg/ml),差异有显著性(P<0.05);正常妊娠组sFas含量(520.19±253.82pg/ml)与对照组相比差异无显著性(P>0.05)。RSA组、正常妊娠组、对照组sFasL含量分别为1.29±0.82ng/ml、1.20±0.85ng/ml、1.32±1.01ng/ml,3组间比较,差异无显著性(P>0.05)。结论:反复自然流产的发生可能与血清sFas水平升高有关,而与血清sFasL无明显相关。     

子宫内膜异位症血清及腹腔液瘦素水平的比较分析

目的:探讨子宫内膜异位症(内异症)患者血清和腹腔液瘦素水平的变化及其在内异症发病中的作用。方法:采用RIA的方法测定35例内异症患者和15例非内异症患者(对照组)血清和腹腔液中瘦素的含量,并与R-AFS评分进行相关性分析。结果:两组间体重指数差异均无显著性(P>0.05),内异症患者血清瘦素水平与对照组间比较差异无显著性(分别为2.992±2.169μg/L,1.977±1.549μg/L)(P>0.05),其腹腔液中瘦素水平明显高于对照组(分别为4.502±2.935μg/L,1.633±0.979μg/L)(P<0.01)。轻度及重度内异症患者腹腔液瘦素水平均明显高于对照组,轻度组又较重度组明显升高(分别为5.546±3.106μg/L,3.806±2.666μg/L,1.633±0.979μg/L)(P<0.05),内异症患者腹腔液瘦素水平与R-AFS评分间呈直线负相关关系。结论:内异症患者腹腔液中瘦素水平明显升高,并随疾病的严重程度而降低,可能在内异症的发生发展中发挥重要作用,而血清瘦素水平不能影响该疾病的发生及发展。     

子痫前期患者滋养细胞中KiSS-1基因及基质金属蛋白酶9表达的临床意义

目的探讨胎盘滋养细胞中KiSS-1基因及基质金属蛋白酶(MMP)9在子痫前期发病中的作用及其与新生儿预后的相关性。方法采用RT-PCR和western blot(蛋白印迹法)检测40例子痫前期患者(其中轻度15例、重度25例,子痫前期组)和20例正常足月正常妊娠妇女(正常妊娠组)胎盘滋养细胞中KiSS-1mRNA和MMP-9mRNA及其蛋白的表达,并与其临床症状及其新生儿围产结局进行相关性分析。结果(1)子痫前期组滋养细胞中KiSS-1mRNA及其蛋白表达水平分别为1.73±0.24和(78.4±8.0)μg/100μg总蛋白,其中轻度患者为1.50±0.15和(72.4±6.9)μg/100μg总蛋白,重度患者为1.87±0.20和(83.5±3.6)μg/100μg总蛋白;均显著高于正常妊娠组的1.24±0.25和(63.4±2.7)μg/100μg总蛋白(P<0.01)。(2)子痫前期组MMP-9mRNA及其蛋白表达水平分别为0.09±0.06和(9.6±4.3)μg/100μg总蛋白,其中轻度患者为0.11±0.08和(10.0±3.2)μg/100μg总蛋白,重度患者为0.07±0.05和(7.8±2.0)μg/100μg总蛋白;均显著低于正常妊娠组的0.17±0.10和(17.9±7.3)μg/100μg总蛋白(P<0.01)。(3)子痫前期组KiSS-1mRNA及其蛋白表达水平与中心动脉压(MAP)和24h尿蛋白定量呈正相关,r分别为0.610(P=0.023)、0.713(P=0.011)和0.397(P=0.003)、0.638(P=0.002);与有、无眼底动脉痉挛呈显著正相关,r分别为0.499(P=0.000)和0.511(P=0.000)。子痫前期组MMP-9mRNA及其蛋白表达水平则与MAP、24h尿蛋白定量及有、无眼底动脉痉挛呈显著负相关,r分别为0.561(P=0.042)、0.571(P=0.022)、0.275(P=0.039)、0.375(P=0.048)、0.346(P=0.001)、0.543(P=0.000)。(4)子痫前期组MMP-9mRNA及其蛋白表达水平与新生儿体重呈显著正相关,r分别为0.651(P=0.000)和0.544(P=0.004);KiSS-1mRNA及其蛋白表达水平与其呈显著负相关,r分别为0.759(P=0.000)和0.865(P=0.000)。(5)随着新生儿窒息程度加重,MMP-9mRNA及其蛋白表达水平呈降低趋势,KiSS-1mRNA及其蛋白表达水平呈升高趋势(P均<0.05)。结论MMP-9和KiSS-1表达失衡在子痫前期发病中起重要作用,且与新生儿预后密切相关。     

胰岛素样生长因子1及胰岛素样生长因子结合蛋白1表达与妊娠期高血压疾病发病的关系

目的探讨胰岛素样生长因子1(IGF-1)与胰岛素样生长因子结合蛋白1(IGFBP-1)在妊娠期高血压疾病发病中的作用。方法采用酶联免疫吸附法(ELISA)及免疫组化方法检测60例妊娠期高血压疾病患者(妊娠期高血压疾病组,其中妊娠期高血压20例、轻度子痫前期19例、重度子痫前期21例)及18例正常妊娠妇女(对照组)的血清及胎盘组织中IGF-1及IGFBP-1的水平,并分析妊娠期高血压疾病组患者血清中IGF-1水平与胎盘组织中IGFBP-1的相关性。结果(1)血清IGF-1水平:妊娠期高血压疾病组为(229±100)μg/L,明显低于对照组的(336±120)μg/L,两组比较,差异有统计学意义(P<0.01)。妊娠期高血压患者血清中IGF-1水平为(303±80)μg/L,轻度子痫前期患者为(233±77)μg/L,重度子痫前期患者为(155±73)μg/L。3者间比较,差异有统计学意义(P<0.05)。(2)胎盘组织中IGF-1阳性率:妊娠期高血压疾病组为48%(29/60),明显低于对照组的83%(15/18),两组比较,差异有统计学意义(P<0.01);轻、重度子痫前期患者明显低于对照组(P<0.05,P<0.01)。(3)血清中IGFBP-1水平:妊娠期高血压疾病组为(161±90)μg/L,明显高于对照组的(98±75)μg/L,两组比较,差异有统计学意义(P<0.01)。妊娠期高血压患者为(97±73)μg/L,轻度子痫前期患者为(157±69)μg/L,重度子痫前期患者为(225±81)μg/L。3者间比较,差异有统计学意义(P<0.05)。(4)胎盘组织中IGFBP-1阳性率:妊娠期高血压疾病组为77%(46/60),明显高于对照组的39%(5/18),两组比较,差异有统计学意义(P<0.01);轻、重度子痫前期患者明显高于对照组(P<0.05,P<0.01)。(5)相关性:妊娠期高血压疾病组患者血清及胎盘组织中IGF-1水平分别与相应部位的IGFBP-1水平均呈负相关(r=-0.269,P<0.05;r=-0.396,P<0.01)。血清中IGFBP-1水平与胎盘组织中IGFBP-1表达水平呈正相关(r=0.388,P<0.01)。结论孕妇血清及胎盘组织中IGF-1、IGFBP-1水平变化与妊娠期高血压疾病发病及病情发展有关。     

妊娠高血压综合征患者血清可溶性白细胞介素6受体和可溶性糖蛋白的检测

目的　观察妊娠高血压综合征（妊高征）患者血清可溶性白细胞介素6受体（sIL-6R）和可溶性糖蛋白(sgp130)的变化。方法　应用酶联免疫吸附法（ELISA）检测40例妊高征患者（妊高征组）和20例正常非孕妇女（对照组I）、20例正常妊娠妇女（对照组II）血清sIL-6R和sgp130水平。结果妊高征组血清sIL-6R为(196.7±12.9)μg/L,sgp130为(379.4±79.3)μg/L;对照组I血清sIL-6R为(174.8±46.2)μg/L,sgp130为(273.6±28.3)μg/L;对照组II血清sIL-6R为(174.4±48.3)μg/L,sgp130为(254.4±34.7)μg/L。妊高征组血清sIL-6R和sgp130水平均高于对照组I和对照组II,差异有极显著性（P<0.01）。妊高征组中,随病情加重,血清sIL-6R、sgp130水平逐渐升高。差异有极显著性（P<0.01）。对照组II血清sIL-6R和sgp130水平与对照组I比较,差异无显著性（P>0.05）。结论　血清sIL-6R和sgp130水平变化与妊高征的病情发展有关。     

缺铁性贫血孕妇外周血及脐血TNF-α、IL-6和EPO水平的变化及其对新生儿免疫功能的评估

目的:探讨缺铁性贫血(IDA)孕妇及其新生儿脐血肿瘤坏死因子(TNF-α)、白介素-6(IL-6)、促红细胞生成素(EPO)的水平变化及对新生儿免疫功能的影响。方法:采用酶联免疫吸附方法检测58例IDA孕妇和30例正常健康孕妇外周血及其新生儿脐血中TNF-α、IL-6和EPO的水平。结果:58例IDA孕妇血TNF-α、IL-6和EPO的水平分别为(143.65±15.36)μg/L,(586.32±133.65)ng/L,(28.76±7.89)mIU/ml,均显著高于正常孕妇组的(90.24±10.04)μg/L,(432.75±132.83)ng/L,(17.81±3.65)mIU/ml(P<0.05);IDA新生儿脐血中的TNF-α、IL-6、EPO的水平分别为(155.64±8.56)μg/L,(856.34±163.67)ng/L,(23.86±7.78)mIU/ml,均显著高于正常新生儿脐血中的(93.14±11.24)μg/L,(636.75±152.85)ng/L,(16.87±4.75)mIU/ml(P<0.05)。IDA孕妇外周血血清TNF-α、EPO水平与脐血血清中二者水平呈正相关,而IL-6二者间不相关。结论:缺铁性贫血孕妇及所分娩的新生儿免疫功能均呈现不同程度的下降,机体缺铁与免疫因子的生成能相互影响,孕期补铁至关重要。     

孕妇血清瘦素水平测定对妊娠期糖耐量异常的预测价值

目的　探讨孕妇血清瘦素水平测定对妊娠期糖耐量异常有无预测价值。方法　采用葡萄糖负荷试验法对 583例孕妇行妊娠期糖尿病筛查,根据筛查结果分为糖耐量正常组及糖耐量异常组(包括妊娠期糖耐量低减和妊娠期糖尿病)孕妇。同时检测两组孕妇不同孕周的血清瘦素水平。结果　(1)糖耐量正常组 507例孕妇血清瘦素水平由孕 24周的 (7.0±1.8)μg/L逐渐缓慢上升,至孕 34~35周时上升最为明显,形成峰值为(9.4±2.1)μg/L,之后略有下降。(2)糖耐量异常组 76例(妊娠期糖耐量低减 61例、妊娠期糖尿病 15例 )孕妇血清瘦素水平波动在 ( 11.3±3.1 )μg/L至(14.5±4.3)μg/L之间,不同孕周间的血清瘦素水平比较,差异无统计学意义 (P>0.05)。(3)糖耐量异常组孕妇平均血清瘦素水平为(12.5±3.5)μg/L,显著高于糖耐量正常组的 (8.5±2.6 )μg/L,且在任何孕周,糖耐量异常组孕妇血清瘦素水平均比糖耐量正常组显著升高,两组比较,差异有统计学意义(P<0.05)。(4) 15例妊娠期糖尿病孕妇中,有 10例血清瘦素水平超过 14.0μg/L。当瘦素水平≥17.0μg/L时, 64.7%的孕妇有不同程度的糖耐量异常。瘦素水平与妊娠期糖耐量低减和妊娠期糖尿病的患病率呈正相关。结论　血清瘦素水平与妊娠期糖耐量异常有相关性, 血清瘦素水平升高对妊娠期     

原因不明习惯性流产患者主动免疫治疗前后T辅助细胞1、2型细胞因子的变化

目的探讨原因不明习惯性流产（UHA）患者主动免疫治疗前后血清T辅助细胞（TH）1/TH2型细胞因子的变化。方法采用酶联免疫吸附法检测30例正常非妊娠妇女(正常非孕组)、30例正常妊娠妇女(正常妊娠组)和33例UHA患者(流产组)淋巴细胞主动免疫治疗前后血清TH1型细胞因子［白细胞介素(IL)2、IL-12、γ干扰素］和TH2型细胞因子（IL-4、IL-10、转化生长因子β1）水平。结果(1)流产组治疗前血清IL-2、IL-12的水平分别为(13.3±13.8)ng/L、(50.5±25.8)ng/L,明显高于正常非孕组的(4.6±6.4)ng/L、(20.3±28.2)ng/L（P<0.01）;IL-4、IL-10的水平分别为(13.8±1.0)ng/L、(13.5±0.7)ng/L,明显低于正常非孕组的(14.5±1.2)ng/L、(14.9±2.4)ng/L（P<0.01）;γ干扰素、转化生长因子β1的水平分别为(45.4±104.8)ng/L、(31.8±26.6)μg/L,与正常非孕组的(15.2±3.6)ng/L、(30.3±27.9)μg/L比较,差异无显著性(P>0.05)。(2)流产组治疗后血清IL-2［(5.6±9.0)ng/L］、IL-12［(28.5±40.3)ng/L］水平,较治疗前明显降低(P<0.01);IL-4［(14.7±1.2)ng/L］、IL-10(15.0±1.8)ng/L］水平,较治疗前明显升高(P<0.01);γ干扰素［(45.4±99.2)ng/L］、转化生长因子β1［(43.0±56.8)μg/L］水平与治疗前比较,差异无显著性(P>0.05)。(3)流产组治疗后上述细胞因子的水平与正常非孕组比较,差异均无显著性(P>0.05)。(4)正常妊娠组IL-2水平［(1.6±4.3)ng/L］较正常非孕组明显降低(P<0.05),IL-4［(16.3±0.8)ng/L］、转化生长因子β1［(49.2±33.7)μg/L］水平较正常非孕组明显升高(P<0.01,P<0.05),正常妊娠组γ干扰素［(15.3±3.7)ng/L］、IL-10［(17.4±10.0)ng/L］水平与正常非孕组比较,差异无显著性(P>0.05)。结论UHA患者血清TH1型细胞因子占优势,主动免疫治疗可下调TH1型细胞因子,上调TH2型细胞因子。     

Study on the effect of compound quinesterol on plasma cortisol concentration in fertile women]

This research reports on the concentration of plasma cortisol and the results of an oral glucose tolerance test in 60 fertile women taking quinestrol for between 4 and 13 years. In these women, the mean plasma cortisol concentration was 27.72 +or- 1.05 mcg/100 ml, which was significantly higher than 19.76 +or- 0.86 mcg/100 mg in 20 cases with a history of taking shortacting oral contraceptives and 15.53 +or- 0.50 mcg/100 ml in the normal volunteers. There was no significant difference in mean blood glucose levels between the group taking quinestrol and the control group. The above results indicated that the effect of quinestrol on adrenal cortisol function may be through the negative feedback of t pituitary-adrenal cortex axis. As a result, the levels of plasma cortisol were increased. Small doses of quinestrol had no apparent effect on carbohydrate metabolism.     

Effect of antepartum betamethasone treatment on cortisol levels in cord plasma,amniotic fluid,and the neonate

Antepartum betamethasone treatment in pregnancies which terminated at less than 37 weeks of gestation resulted in a rapid and significant decrease in cord plasma cortisol levels. Mean values ± S.E. were 5.17 ± 0.39 μg per 100 ml. in 90 untreated cases, 2.17 ± 0.32 μg per 100 ml. in 29 cases treated at least 24 hours prior to delivery, and 2.27 ± 0.38 μg per 100 ml. in 18 cases in which treatment was begun within 24 hours of delivery. The mean cortisol concentration in five amniotic fluid samples obtained after betamethasone administration (0.93 ± 0.19 μg per 100 ml.) was significantly less than in seven control samples (1.85 ± 0.21 μg per 100 ml.). These results suggest that betamethasone suppressed endogenous cortisol production by maternal and/or fetal adrenals. However, blood cortisol levels during the first days of life of treated neonates were considerably increased in comparison to those in cord plasma, suggesting that there was rapid recovery of their adrenal function.     

复方炔雌醚对育龄妇女肾上腺皮质功能的影响

对口服长效避孕药复方炔雌醚的育龄妇女进行了尿中皮质类固醇及血浆皮质醇浓度的测定,并与正常对照组(103例)作了比较。结果发现54例妇女服药半年后尿中17-OH水平降低,其中28例服药延长到一年时,尿中三类皮质激素(17-OH、17-KS 及17-KGS)浓度均减少。66例曾服复方炔雌醚片2年以上的妇女,尿中三类皮质激素水平亦降低。20例曾短期应用短效避孕药的妇女,血浆皮质醇浓度在正常范围,其中3例服用复方炔雌醚片7～8周期后,皮质醇水平明显升高。本研究提示上述变化可能与复方炔雌醚片对垂体—肾上腺皮质功能及皮质激素代谢酶系的影响有关。     

Unbound cortisol in umbilical cord plasma and maternal plasma: a reinvestigation

Unbound cortisol was assayed in maternal and cord plasma. A method was used in which experimental conditions are carefully selected to approach as closely as possible the in vivo situation.¹ In maternal plasma at term, the proportion of unbound cortisol (9.7 ± 1.5%) (mean ± SE) was identical to that of normal nonpregnant women (9.7 ± 0.4%). However, the concentration of unbound cortisol was 3-fold higher at term (46.0 ± 5.9 ng/ml) than that in nonpregnant women (14.2 ± 1.0 ng/ml). During labor an increase was observed, and at birth the proportion (and concentration) of unbound cortisol was extremely high varying between 17.0 ± 0.8% (92.3 ± 7.4 ng/ml) and 20.9 ± 1.4% (130.4 ± 17.9 ng/ml) (spontaneous and induced vaginal deliveries, respectively). In cord plasma at term and before labor (fetuses delivered by elective cesarean section), the proportion of unbound cortisol was high (29.1 ± 1.3 %) but its concentration (9.6 ± 1.1 ng/ml) was only slightly lower than that observed in normal adults. Labor had an important stimulatory effect as observed in cases of vaginal delivery after spontaneous labor (proportion of unbound cortisol 35.1 ± 1.2%, concentration of unbound cortisol 15.4 ± 1.35 ng/ml, respectively). No difference was observed between spontaneous and provoked labor since similarly high values of unbound cortisol were found in cord plasma after oxytocin-induced labor followed by vaginal delivery (36.2 ± 1.4% and 23.0 ± 5.2 ng/ml).     

我国正常生育力男子精浆的微量元素研究

本文报告测试了68例正常生育力成年男子精浆中的锌、铜,铁等微量元素和镁,测试结果如下:锌130±5.64μg/ml,铜1.84±0.158μg/ml,铁0.801±0.104μg/ml,镁103.86±10.01μg/ml。所测得的数值均在正常范围内。在正常范围内的精液,精浆中的锌、镁含量与精液质量(精子密度和活动力)之间无显著差异。但铜的含量与精子活动度关系密切,含量高则活动度差,反之则活动度好。铁的含量与精子密度关系也十分密切,含量高时精子密度也高。     

The effect on the fetal pituitary-adrenal axis of dexamethasone administration early in the second trimester of pregnancy

Objective.?To evaluate the effect of a single dose of dexamethasone to pregnant women at early second trimester on the fetal pituitary-adrenal axis.

Methods.?Thirty-eight women between 13 and 15 weeks' gestation were included in the study. Blood was taken from the mothers and their fetuses for the evaluation of plasma ACTH, cortisol, and free cortisol levels before and after treatment with a single dose of 1?mg of dexamethasone orally at 11 p.m. the night before the termination of pregnancy.

Results.?The mean plasma ACTH was significantly lower following dexamethasone administration (8.5?±?5.1 vs. 18.4?±?10.9 pg/ml). Similarly, plasma cortisol was significantly lower after dexamethasone treatment (208.3?±?168.7 vs. 772.7?±?206.1?nmol/l), as well as plasma free cortisol levels (2.6?±?0.0 vs. 6.1?±?6.1?nmol/l). Mean plasma ACTH levels were not significantly different in the fetuses after dexamethasone treatment (33.6?±?22.7 vs. 42.5?±?21.9 pg/ml). Moreover, mean fetal plasma cortisol was not different before and after treatment (108.2?±?27.2 vs. 94.3?±?47.2?nmol/l), as well as the mean free cortisol levels (7.7?±?5.2 vs. 7.0?±?4.3?nmol/l).

Conclusions.?A single dose of 1?mg of dexamethasone to the mother early in the second trimester of pregnancy does not result in a significant suppression of the fetal pituitary axis.     

The effect of a single course of antenatal corticosteroids on maternal adrenal function at term

Objective: To determine if one course of antenatal corticosteroids at 32 weeks produces maternal adrenal suppression at term.

Methods: The adrenocorticotropic hormone (ACTH) stimulation test was administered at 38 weeks to 11 pregnant women who had received a single course of antenatal betamethasone prior to 33 weeks and to six control subjects.

Results: There was no difference in basal cortisol levels (mean?±?standard deviation) between the two groups: 41.6?±?6.9?μg/dl for controls versus 36.0?±?7.8?μg/dl for the steroid group, p?=?0.16. Peak cortisol levels at 45?min following ACTH stimulation were not different: 61.6?±?3.5?μg/dl for controls versus 55.0?±?2.6?μg/dl for the steroid group, p?=?0.16. The power of the study to detect a statistical difference in the observed peak cortisol levels was greater than 95%. None of the study subjects had laboratory criteria or clinical signs of adrenal suppression.

Conclusions: A single course of betamethasone for women at risk for preterm delivery does not produce adrenal insufficiency at term and stress dose steroids are not recommended.     

胰岛素对子宫内膜间质细胞分泌IGF-1和IGFBP-1的影响

目的 :了解胰岛素对子宫内膜间质细胞分泌胰岛素样生长因子 1(IGF 1)和胰岛素样生长因子结合蛋白 1(IGFBP 1)的影响。方法 :用含不同浓度雌二醇和胰岛素的培养液培养增生晚期人子宫内膜间质细胞 2 4h后 ,留取培养液测定IGF 1。用含不同浓度孕酮和胰岛素的培养液培养分泌晚期人子宫内膜间质细胞 2 4h后 ,留取培养液测定IGFBP 1。结果 :1.增生晚期间质细胞培养液中IGF 1的浓度 :2 0 μU ml胰岛素组为 1.39±0 .33μg L ,低于 10 0 μU ml胰岛素组 (2 .0 3± 0 .5 3μg L) (P <0 .0 1) ;10 0ng L雌二醇 + 2 0 μU ml胰岛素组为 2 .18± 0 .36 μg L ,低于 10 0g L雌二醇 + 10 0 μU ml胰岛素组 (3.4 2± 0 .75 μg L) (P<0 .0 1)。 2 .分泌晚期间质细胞液中IGFBP 1浓度 :2 0 μU ml胰岛素组为 0 .16± 0 .5 8μg L ,低于对照组 (P <0 .0 1) ,高于 10 0 μU ml胰岛素组 (0 .10± 0 .4 8μg L) (P <0 .0 1) ;10 μg L孕酮 + 2 0 μU ml胰岛素组为 2 .10± 1.17μg L ,低于 10 μg L孕酮组 (P <0 .0 1) ,高于 10 μg L孕酮 + 10 0 μU ml胰岛素组 (0 .5 0± 0 .2 8μg L) (P <0 .0 1)。 结论 :1.胰岛素促进增生期子宫内膜间质细胞分泌IGF 1;2 .胰岛素抑制分泌晚期子宫内膜间质细胞分泌IGFBP 1。     

Adiponectin, leptin and lipid profiles evaluation in oral contraceptive pill consumers

Background

The aim of this study was to evaluate serum lipid profiles, leptin and adiponectin levels in women with a normal menstrual cycle receiving low-dose (LD) combined oral contraceptive pill (COC) (levonorgestrel 0.15?mg, ethinyl-estradiol 0.03?mg).

Study design

Serum adiponectin and leptin concentrations were measured by enzyme-linked immunosorbent assay (ELISA), and spectrophotometric assay was used for serum lipid and lipoprotein profiles assay in 50 healthy women with normal menstrual cycles who served as the control group and 50 women taking COCs. Unpaired t test and Chi-square test were used for comparison of variables between oral contraceptive users and non-oral contraceptive users.

Results

Serum adiponectin and leptin levels were changed in COC consumers. The data obtained for adiponectin in COC consumers (6.6?±?4.06?μg/ml) were significantly lower (?27.4%, P?=?0.004) than control group (9.1?±?5.09?μg/ml). The difference between the serum leptin concentration of the control group (11.5?±?6.9?ng/ml) and women receiving COCs (14.1?±?6.7?ng/ml) was not significant (+18.4%, P?=?0.083). There was nonsignificant difference between HDL levels of subjects taking COC (44.02?±?10.7?mg/dl) and control group (49.4?±?14.3?mg/dl). The LDL levels of COC consumer (131.40?±?66.40?mg/dl) was significantly higher (P?=?0.002) than controls (102.30?±?44.0?mg/dl). The serum cholesterol concentration of women receiving COC (193.2?±?70.4?mg/dl) was significantly higher (P?=?0.05) than controls (172.8?±?49.6?mg/dl). The age of COC consumption and the duration of intake of COCs beyond 36?months had no significant effect on the adiponectin and leptin concentrations.

Conclusion

LD COC uptake results in a significant decrease in serum adiponectin concentration, nonsignificant increase in leptin levels and a more atherogenic lipid profile by significantly increasing LDL and nonsignificantly decreasing HDL concentrations. These findings suggested that COC may reduce or stimulate the adiponectin and leptin concentrations, respectively. This might be due to an effect of these pills on adipocyte maturation via inhibition or stimulation of the synthesis of new adiponectin and leptin molecules or may be a result of the increased frequency of a particular allele of the adiponectin and leptin. It is suggested that these alterations in adiponectin and leptin concentrations and lipid profiles may be related to their probable effects in response to various pathological and physiological properties of COC or its metabolites. It seems that probably free radicals produced during metabolism of COCs change the amounts of adipokines and atherogenic lipids.     

Morning plasma cortisol is low among obese women with polycystic ovary syndrome

Abstract

Polycystic ovary syndrome (PCOS) is the most common cause for androgen excess in women. It is associated with wide variety of metabolic disorders. The present study assessed morning plasma cortisol in women with PCOS. One hundred and ninety seven cases and 55 controls were enrolled for this study. The mean age of patients and controls were 23?±?5.6 years and 25?±?4.3 years. One hundred twelve (56%) women with PCOS had BMI >25. Serum cortisol levels were significantly higher in lean PCOS women compared to controls (13.4?±?5.1 versus 11.3?±?4.5, p?<?0.01) and over-weight PCOS women group (13.4?±?5.1 versus 9.3?±?3.2, p?<?0.01). There was a trend for less acne and hirsutism with increase in BMI. Morning plasma cortisol was lower among obese women with PCOS. Morning plasma cortisol correlated negatively with BMI in PCOS women with normal glucose tolerance.