多囊卵巢综合征患者血清对氧磷酯酶1活性、氧化应激与胰岛素抵抗的关系

目的探讨对氧磷酯酶1（PON-1）活性、氧化应激在多囊卵巢综合征（PCOS）患者发生胰岛素抵抗（IR）中的作用。方法41例PCOS患者分为肥胖组17例和非肥胖组24例，另有20名健康女性纳入正常对照组。所有研究对象均行口服糖耐量试验（OGTT）和胰岛素释放试验，使用稳态模型评价IR及胰岛B细胞分泌功能，空腹静脉取血检测丙二醛（MDA）、超氧化物歧化酶（SOD）活性及PON-1活性。结果（1）PCOS非肥胖组和PCOS肥胖组的空腹胰岛素、餐后2小时血糖及胰岛素、HOMA—IR及HOMA-β均高于正常组（P〈0．05），且PCOS肥胖组的空腹胰岛素、餐后2小时血糖及胰岛素、HOMA—IR均高于PCOS非肥胖组（P％0．05）。（2）PCOS非肥胖组和PCOS肥胖组的MDA、SOD及PON-1与正常组比较差异有统计学意义（P〈0．05）；PCOS肥胖组的SOD显著低于PCOS非肥胖组（P％0．01），而MDA及PON-1两组之间差异无统计学意义（P〉0．05）。（3）相关分析显示：在PCOS非肥胖组，SOD与PON—1正相关（r=0．417，P〈0．05），SOD与IR负相关（r=0．492，P〈0．05）。结论PCOS患者无论肥胖与否，均存在餐后血糖升高、PON-1活性降低、氧化应激、IR，且肥胖患者更为严重；PCOS患者的氧化应激与IR相关。

The correlation of serum paraoxonase-1 and oxidative stress with insulin resistance in patients with polycystic ovary syndrome

Objective To observe the role of paraoxonase-1 and oxidative stress in pathogenesis of insulin resistance in patients with polycystic ovary syndrome （PCOS）. Methods 41 PCOS patients divided into obese group and non-obese group with 20 healthy volunteers as a control. The 75g oral glucose tolerance test （OGTT） and insulin releasing test （IRT） were performed. The insulin resistance and β-eell function were estimated with homeostasis model assessment （HOMA）. The fasting serum concentration of malondialdehyde （MDA）, and the activities of superoxide dismutase （SOD） and paraoxonase-1 （PON-1） were assayed. Results （1） The levels of fasting plasma insulin, 2 hour plasma glucose and insulin, the index of insulin resistance （HOMA-IR） and β-cell function （HOMA-β） were significantly higher in PCOS patients of both non-obese group and obese group than in healthy controls（all P〈0.05）. HOMA-β was not different between non-obese group and obese group in PCOS patients（P〉0.05）, while the the levels of BMI, 2hPG, Fins, 2hIns, and HOMA-IR were significantly higher in obese group than in non-obese group（all P〈0. 05）. （2）The PCOS patients in both non-obese group and obese group showed higher MDA and lower SOD and PON-1 than in healthy controls（P〈0.05）. The serum concentration of MDA and the activity PON-1 showed no differences between non-obese group and obese group in PCOS patients （both, P~0.05）, but The activity of SOD was significantly lower in obese group than in non-obese group （P〈0. 01）. （3） SOD had a positive correlation with PON-I（r=0. 417, P=0.043）, and a negative correlation with HOMA IR（r=0. 492, P=0. 015）in non-obese PCOS group. Conclusion The PCOS patients has an increased postprandial plasma glucose, impared PON-1 activity, oxidative stress, insulin resistance, and high level of plasma insulin in non-obese and especially in obese subgroup. Insulin resistance is related to oxidative stress in patients with PCOS.