血清蛋白质酪氨酸磷酸酶 1B、雌二醇水平与青少年脾虚肝郁型闭经病人肥胖的关系

目的 检测青少年脾虚肝郁型闭经病人血清蛋白质酪氨酸磷酸酶1B(PTP1B)、雌二醇(E2)水平,并探讨其与肥胖的关系.方法 选取2019年1―8月于张家口市中医院妇科门诊确诊的青少年脾虚肝郁型闭经病人110例作为研究对象,按照青少年肥胖诊断标准分为青少年脾虚肝郁型闭经发生肥胖60例(闭经肥胖组)和青少年脾虚肝郁型闭经未发生肥胖50例(闭经未肥胖组).另选取同期健康体检者60例作为对照组.收集研究对象的体质量、肥胖度、体质量指数(BMI)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)等资料.酶联免疫吸附法(ELISA)检测受试者外周血血清中PTP1B、E2水平.logistic回归分析青少年脾虚肝郁型闭经病人发生肥胖的影响因素.受试者工作特征曲线(ROC)分析二者对青少年脾虚肝郁型闭经病人发生肥胖的诊断效能.结果 与对照组、闭经未肥胖组相比,闭经肥胖组体质量(77.25±12.43)kg比(49.65±7.13)kg、(51.89±8.27)kg]、肥胖度(41.64±13.26)％比(16.75±2.85)％、(17.75±3.26)％]、BMI(29.75±5.36)kg/m2比(20.86±4.13)kg/m2、(21.26±4.35)kg/m2]、TC(4.62±0.93)mmol/L比(3.25±0.65)mmol/L、(3.34±0.81)mmol/L]、TG(1.94±0.26)mmol/L比(0.86±0.12)mmol/L、(0.88±0.18)mmol/L]、LDL(2.75±0.53)mmol/L比(1.87±0.35)mmol/L、(1.95±0.42)mmol/L]水平明显升高(P<0.05);对照组、闭经未肥胖组、闭经肥胖组PTP1B(53.63±12.56)ng/mL、(72.16±16.42)ng/mL、(85.24±21.35)ng/mL]、E2水平(283.76±73.15)ng/mL、(357.46±83.81)ng/mL、(426.63±95.52)ng/mL]均依次升高(P<0.05).TC、LDL、PTP1B、E2水平均是青少年脾虚肝郁型闭经病人发生肥胖的独立危险因素(P<0.05),PTP1B、E2联合检测对青少年脾虚肝郁型闭经病人发生肥胖的ROC曲线下面积为0.750.结论 PTP1B、E2水平在青少年脾虚肝郁型闭经发生肥胖病人体内均升高,二者均是致病的独立危险因素,有一定的诊断效能,可能为临床诊断青少年脾虚肝郁型闭经病人发生肥胖提供一定参考.

Relationships with obesity on serum PTP1B and E2 levels in adolescent patients with spleen deficiency and liver depression type amenorrhea

Objective To detect the levels of serum protein tyrosine phosphatase 1B (PTP1B) and estradiol (E2) in adolescent patients with spleen deficiency and liver depression type amenorrhea, and to explore the relationships between them and obesity.Meth? ods A total of 110 cases of adolescent patients with spleen deficiency and liver depression type amenorrhea diagnosed in the Gynecological Clinic of Zhangjiakou City Hospital of Traditional Chinese Medicine from January to August 2019 were selected as the study objects. According to the diagnostic criteria for obesity in adolescents, they were assigned into 60 cases of obesity in adolescent patientswith spleen deficiency and liver depression type amenorrhea (amenorrhea with obesity group) and 50 cases of non obesity in adolescentpatients with spleen deficiency and liver depression type amenorrhea (amenorrhea without obesity group). In addition, 60 healthy people in the same period were selected as the control group. The body mass, obesity, body mass index (BMI), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL) were collected. Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of PTP1B and E2. Logistic regression was used to analyze the influencing factors of obesity in adolescent patients with spleen deficiency and liver depression type amenorrhea. The receiver operating characteristic curve (ROC) was used to analyze the diagnostic efficacy of them for obesity in adolescent patients with spleen deficiency and liver depression type amenorrhea.Results The body mass (77.25±12.43) kg vs. (49.65±7.13) kg, (51.89±8.27) kg], obesity degree (41.64±13.26) % vs. (16.75± 2.85) %, (17.75±3.26) %], BMI (29.75±5.36) kg/m2 vs. (20.86±4.13) kg/m2, (21.26±4.35) kg/m2], TC (4.62±0.93) mmol/L vs. (3.25± 0.65) mmol/L, (3.34±0.81) mmol/L], TG (1.94±0.26) mmol/L vs. (0.86±0.12) mmol/L, (0.88±0.18) mmol/L], LDL levels (2.75±0.53) mmol/L vs. (1.87±0.35) mmol/L, (1.95±0.42) mmol/L] of the amenorrhea obesity group were significantly higher than those in the control group and the amenorrhea without obesity group (P<0.05); the levels of PTP1B (53.63±12.56) ng/mL, (72.16±16.42) ng/mL,(85.24±21.35) ng/mL] and E2 (283.76±73.15) ng/mL, (357.46±83.81) ng/mL, (426.63±95.52) ng/mL] in the control group, amenorrheawithout obesity group and amenorrhea obesity group increased in turn (P<0.05). The levels of TC, LDL, PTP1B and E2 were the independent risk factors of obesity in adolescent patients with spleen deficiency and liver depression type amenorrhea (P<0.05); the area under ROC curve of obesity in adolescent patients with spleen deficiency and liver depression type amenorrhea detected by PTP1B combined with E2 was 0.750.Conclusion The levels of PTP1B and E2 are increased in the adolescent patients with spleen deficiency andliver depression type amenorrhea and obesity, both of them are independent risk factors for the disease, and have certain diagnostic efficacy, which may provide some reference for the clinical diagnosis of obesity in adolescent patients with spleen deficiency and liver depression type amenorrhea.