氧化应激在肥胖型多囊卵巢综合征发病中的作用

目的探讨氧化应激在多囊卵巢综合征(PCOS)特别是肥胖型PCOS发病中的作用,以提高PCOS的疗效。方法将85例PCOS患者按体质量指数(BMI)分为超重及肥胖(PCOS1)组43例,正常体质量(PCOS2)组42例,同时选取85例内分泌正常且体质量正常的不孕患者作为对照组,测定所有患者血清中氧化应激指标如超氧化物歧化酶(SOD)活力、8异前列腺素F2α(8-iso-PGF2α)及内脂素(visfatin)水平,采用直线回归分析各指标间的关系。结果PCOS1、PCOS2两组血清SOD活力均低于对照组(P<0.05);PCOS1组SOD活力较PCOS2组更低(P<0.05);PCOS1组血清8-iso-PGF2α及visfatin水平高于PCOS2组及对照组(P<0.05),PCOS2组与对照组差异无统计学意义。经直线回归分析发现:PCOS患者SOD活力随着8-iso-PGF2α水平的升高而降低,回归系数为-0.407(P=0.000);血清visfatin水平随着BMI增大、8-iso-PGF2α水平升高而升高,回归系数分别为0.402(P=0.008)、0.612(P=0.000),但随着SOD活力升高而下降,回归系数为-0.513(P=0.000)。对照组上述指标间尚未发现存在线性关系。结论 PCOS患者存在氧化应激损伤,正常体质量的PCOS患者氧化应激损伤不明显,超重及肥胖型PCOS患者氧化应激损伤严重,提示氧化应激可能是肥胖型PCOS发病的关键环节。

The role of oxidative stress in the pathogenesis of polycystic ovary syndrome

Objective To investigate the role of oxidative stress in pathogenesis of polycystic ovary syndrome(PCOS),especially in the obese PCOS.Methods 43 PCOS patients with BMI≥23 kg/m2 were grouped into PCOS1.42 PCOS patients with BMI<23 kg/m2 were grouped into PCOS2.Meanwhile,85 infertility patients with normal endocrine function and body weight were grouped into control group.All patients were subjected to the measurement of serum levels of superoxide dismutase(SOD),8-iso-prostaglandin F2α(8-iso-PGF2α) and visfatin.The difference among PCOS1,PCOS2 and control group were compared and the relationships between the indexes were analyzed with simple liner regression analysis.Results The serum level of SOD in PCOS1 and PCOS2 were lower than that in the control group(P<0.05),and the serum level of SOD in PCOS1 was lower than that in PCOS2(P<0.05).The serum levels of 8-iso-PGF2α and visfatin in PCOS1 were higher than those in PCOS2 and control group(P<0.05).The serum levels of 8-iso-PGF2α and visfatin between PCOS2 and control group were not statistical different.In PCOS1 and PCOS2 groups,SOD activity decreased with increasing levels of 8-iso-PGF2α,the regression coefficient was-0.407.For serum vifation,there were positive correlations with both BMI and 8-iso-PGF2α,but negative correlation with SOD; the coefficients were 0.402(P=0.008),0.612(P=0.000),and-0.153(P=0.000),respectively.The indexes mentioned above did not have the liner relationship in the control group.Conclusion There was oxidative stress in PCOS patients,which was not obvious in the normal weight PCOS patients but quite severe in the obese PCOS patients.