多囊卵巢综合征患者血PAI-1和uPA含量的变化

目的观察多囊卵巢综合征(PCOS)患者外周血纤溶酶原激活抑制物1(PAI-1)和尿激酶型纤溶酶原激活物(uPA)的水平。方法实验分PCOS组和对照组,PCOS组又分为肥胖组和正常体重组,用酶联免疫吸附法(ELISA)测定PCOS组与对照组患者血浆PAI-1及血清uPA水平,并测定体重指数(BMI)、腰臀比(WHR)、空腹血糖(FPG)、空腹胰岛素及胰岛素释放试验(IRT),以稳态模型公式评估胰岛素抵抗(IR),并计算胰岛素曲线下面积(AUC)。结果PCOS组与对照组相比,黄体生成素/卵泡刺激素(LH/FSH)、睾酮(T)、空腹血糖、稳态(HOMA)指数、AUC及PAI-1含量均显著升高(P<0.05)。其中,PCOS肥胖组与正常体重组相比,HOMA指数、AUC及PAI-1含量也显著升高(P<0.05)。在相关性分析中,PAI-1与HOMA指数、PAI-1与AUC、PAI-1与BMI、HOMA-IR与BMI均有显著相关性(P<0.0001)。结论胰岛素抵抗和肥胖是影响PCOS患者PAI-1水平升高的一个很重要因素,抗PAI-1的研究可能为多囊卵巢综合征的治疗提供一个新的方法。

Change of plasma PAI-1 and uPA content in polycystic ovarian sysdrome

Objective To detect the plasma plasminogen activator inhibitor-1(PAI-1)and urokinase-type plasminogen activator(uPA)levels in PCOS and control of different BMI.Methods This experiment is divided into PCOS group and control group,PCOS group also divided into obesity and without obesity.To assay plasma PAI-1 and serum uPA of PCOS with or without obesity by enzyme-linked immunosurbent assay(ELISA),and to meassure body mass index(BMI),waist hip ratio(WHR),blood glucose,fasting insulin and IRT.To evaluate insulin resistance with Homa Model and to measure insulin area under curve(AUC).Results LH/FSH,T,blood glucose,HOMA-IR,AUC and the plasma level of PAI-1 were significantly increased in PCOS as compared with normal control,and HOMA-IR,AUC and the plasma level of PAI-1 were also increased in obesity as compared with non-obesity of PCOS(P<0.05).In the Spearman bivariate correlation analysis,significant correlation were found between PAI-1 and HOMA-IR,PAI-1 and AUC,PAI-1 and BMI,HOMA-IR and BMI(P<0.0001).Conclusion The increase of PAI-1 is the result of metabolism disorder with hyperinsulinism and obesity.PAI-1 is one of evalution marker of insulin resistance.Anti-PAI-1 study may function as a new approach to prevent obesity and insulin resistance.