蛋白聚糖和ADAMTS-1在多囊卵巢综合征患者血清中的表达及其临床意义

目的：探讨蛋白聚糖（Versican）和Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶（ADAMTS-1）在多囊卵巢综合征（PCOS）患者血清中的表达，阐明二者在PCOS发病中的作用。方法：选取80例PCOS患者（PCOS组）和100名正常体检妇女（对照组）为研究对象，测量2组受试对象身高和体质量，计算体质量指数（BMI）；采用酶联免疫吸附试验（ELISA）法检测2组受试对象血清中Versican和ADAMTS-1水平，测定2组受试对象血清中卵泡刺激素（FSH）、黄体生成激素（LH）、睾酮（T）、空腹血糖（FBG）和空腹胰岛素等水平；采用胰岛素抵抗指数稳态模式评估法（HOMA-IR）评估胰岛素抵抗。采用Pearson直线相关分析法分析Versican和ADAMTS-1与代谢指标的相关性。结果：PCOS组患者血清中Versican水平低于对照组（P=0.004），PCOS组患者血清中ADAMTS-1水平低于对照组（P<0.01）。Versican和ADAMTS-1预测PCOS的灵敏度、特异度、受试者工作特征（ROC）曲线下面积（AUC）分别为76.74% vs 63.64%（P=0.018）、52.94% vs 40.73%（P=0.009）和0.675（0.550~0.795）vs 0.714（0.601~0.827）（P=0.032）。PCOS组患者Versican水平与FBG水平呈负相关关系（r=-0.738，P=0.022），ADAMTS-1水平与FBG水平亦呈负相关关系（r=-0.524，P=0.043）。结论：Versican和ADAMTS-1在PCOS患者外周血中低表达，并与胰岛素抵抗呈负相关关系，在PCOS发生中可能起抑制作用。

Expressions of Versican and ADAMTS-1 in polycysticovary syndrome patients and their clincal significances

Objective: To determine the expressions of Versican and a distintegrin and metalloprotease with thrombospondin type 1 motifs(ADAMTS-1) in serum in the polycystic ovary syndrome (PCOS) patients, and to clarify their roles in the pathogenesis of PCOS.Methods: A total of 80 patients with PCOS (PCOS group) and 100 healthy women (control group) were selected.The heights and body weights of the subjects in two groups were measured; and the body mass index(BMI) was calculated.The levels of serum Versican and ADAMTS-1 of the subjects in two groups were measured by enzyme-linked immunosorbent assay(ELISA) method.The levels of serum follicle stimulating hormone(FSH),luteinizing hormone(LH),testosterone(T),fasting blood glucose(FBG),fasting insulin of the subjects in two groups were detected; insulin resistance was evaluated according to Homeostasis Model Assessment of Insulin Resistance (HOMA-IR).The correlations between Versican,ADAMTS-1 and the metabolic indexes were analyzed by Pearson linear correlation analysis.Results: The serum Versican level of the paticnts in PCOS group was significantly decreased compared with control group (P=0.004);the serum ADAMTS-1 level was also decreased (P<0.01). The sensitivities,the specificities and the area under receiver operating characteristic (ROC) curve (AUC) of Versican and ADAMTS-1 in prediction of PCOS were 76.74% vs 63.64% (P=0.018),52.94% vs 40.73% (P=0.009) and 0.675 (0.550-0.795) vs 0.714(0.601-0.827) (P=0.032), respectively. The correlation analysis showed that in PCOS group the serum level of Versican of the patients was negatively correlated with FBG(r=-0.738,P=0.022), and ADAMTS-1 was negatively correlated with FBG(r= -0.524,P=0.043).Conclusion: Versican and ADAMTS-1 lowly express in the patients with PCOS. They are negatively correlated with the insulin resistance.They may play inhibitory effects in the occurrence of PCOS.