多囊卵巢综合征患者血清瘦素水平及相关因素分析

目的:探讨PCOS患者血清瘦素水平变化及与内分泌、代谢指标之间的关系。方法:PCOS患者62例,根据体重指数(BMI)分为肥胖PCOS组30例(BMI≥24kg/m2)和非肥胖PCOS组32例(BMI<24kg/m2)。同时选择年龄和体重相匹配的62例月经规律的正常妇女做为对照组,根据BMI分为肥胖对照组30例和非肥胖对照组32例。分别检测空腹血糖、胰岛素、瘦素、性激素及促性腺激素浓度,利用HOMA(homeostasis model assessment,HOMA)模型计算胰岛素抵抗指数(HOMA-IR);同时测定患者BMI和腰臀比例(WHR)。结果:肥胖PCOS组血瘦素水平明显高于非肥胖PCOS组和对照组(P<0.01、P<0.01);非肥胖PCOS组血瘦素水平明显高于非肥胖对照组(P<0.01),而与肥胖对照组无显著差异(P>0.05)。Logistic回归分析显示PCOS患者血瘦素水平与BMI和HOMA-IR均呈高度正相关(P<0.01、P<0.01),与血LH/FSH比值和雄激素水平无相关性(P>0.05)。结论:PCOS患者血清瘦素水平与BMI和血胰岛素水平密切相关;PCOS患者可能同时存在瘦素抵抗和胰岛素抵抗。

The study on correlation between leptin concentration and the related factors of polycystic ovary syndrome

Objective:To study the relationship between serum leptin concentration and other endocrine index and to research leptin significance in PCOS.Methods:The study included the samples from patients with PCOS with overweight(n=32),PCOS with normal weight(n=30)and control group with the overweight(n=32),with normal weight(n=30).Serum luteinizing hormone(LH),follicle stimulating hormone(FSH)and testosterone(T)were measured by chemiluminescence assay,serum leptin levels by ELISA,fasting insulin(FIN)by radioimmunoassay,and fasting plasma glucose(FPG)by oxidase assay.Insulin resistance index was calculated using homeostasis model assessment(HOMA)to analyze the relationship between these markers and insulin resistance.Results:The levels of serum leptin in obese PCOS group were significantly higher than in non-obese PCOS group and control group(P<0.01,P<0.01).The levels of serum leptin in non-obese PCOS group were significantly higher than in non-obese control groups(P<0.01),but had no significant different from those in obese control group(P>0.05)The levels of serum leptin in PCOS were positively correlated with BMI and HOMA-IR(r=0.761,P<0.01;r=0.707,P<0.01),but not with LH/FSH and T(P>0.05).Conclusion:Leptin levels in PCOS patients were correlated closely with insulin and BMI,suggesting leptin resistance and insulin resistance may coexist in PCOS patients.