多囊卵巢综合征患者血清单核细胞趋化蛋白-1水平与血脂代谢的相关性

目的:探讨多囊卵巢综合征(PCOS)患者血清中单核细胞趋化蛋白-1(MCP-1)的变化与血脂代谢的关系.方法:应用ELISA方法检测65例PCOS患者及20例体重指数(BMI)＜25 kg/m2的正常对照组血清中MCP-1水平,用化学发光法检测血清中泌乳素(PRL)、促黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)和睾酮(T)水平,用放射免疫法检测血清中雄烯二酮(A)水平;同时检测血脂:甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)、脂蛋白(a)[LP(a)].根据BMI将PCOS患者分为:肥胖组27例(BMI≥25 kg/m2),非肥胖组38例(BMI＜25 kg/m²).结果:PCOS组MCP-1(P=0.001)及ApoB(P=0.018)水平明显高于正常对照组,而ApoA/ApoB的比值明显低于正常对照组(P=0.015).肥胖PCOS患者血清MCP-1水平明显高于非肥胖PCOS患者(P =0.012),非肥胖PCOS患者MCP-1水平明显高于正常对照组(P=0.03).单因素相关分析显示,MCP-1与BMI(r=0.366,P=0.001),LH(r=0.262, P=0.016),TG(r=0.480,P=0.000)及ApoB(r=0.289,P=0.008)呈正相关,与ApoA/ ApoB的比值呈负相关(r＝-0.282,P=0.009);控制BMI的偏相关分析显示,MCP-1与LH(r=0.2577,P=0.020)及TG(r=0.4611, P=0.000)呈正相关.多元回归分析显示TG和BMI是影响MCP-1的主要因素,而且TG的影响更大.结论:肥胖与非肥胖PCOS患者血清MCP-1水平均明显升高;MCP-1的升高与BMI,LH,TG,ApoB及ApoA/ApoB的比值有关;TG和BMI是影响PCOS患者血清MCP-1改变的主要因素,而且TG的影响更大;MCP-1可能参与了PCOS的病理生理过程以及PCOS患者远期并发症的发生.

Monocyte chemoattractant protein-1 and its correlation with lipoprotein inpolycystic ovary syndrome

OBJECTIVE: To measure serum monocyte chemoattractant protein-1 (MCP-1) levels and study its associations with lipoproteins in patients with polycystic ovary syndrome (PCOS). METHODS: Sixty-five PCOS women and 20 ovulating normal women with body mass index (BMI) < 25 kg/m2 as controls were recruited. PCOS women were divided to two groups: 27 BMI >or = 25 kg/m2 patients as obese group; 38 BMI < 25 kg/m2 as non-obese group. Serum MCP-1 was assayed by enzyme-linked immunosorbent assays (ELISA). Serum prolactin (PRL), follicle stimulating hormone (FSH), luteinizing (LH), estradiol (E2) and testosterone (T) were assayed by chemoluminescence method. Serum androstenedione (A) was assayed by radioimmunity method in patients. And triglycerides (TG), total cholesterol (TC), apoprotein A (ApoA), apoprotein B (ApoB) , lipoprotein (a) [LP(a)], high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol (HDL-C and LDL-C) were measured. RESULTS: MCP-1 (P = 0.001) and ApoB (P = 0.018) levels were found to be significantly increased in PCOS groups compared with that of controls, but the ratio of ApoA/ ApoB was significantly decreased in groups PCOS (P = 0.015). PCOS obese group had markedly higher MCP-1 serum levels than non-obese group (P = 0.012), and MCP-1 serum levels in PCOS non-obese group higher than controls (P = 0.03). Univariate analysis revealed that serum MCP-1 levels were significantly and positively correlated with BMI (r = 0.350, P = 0.001), LH(r = 0.262, P = 0.016), TG (r = 0.480, P = 0.000) and ApoB (r = 0.289, P =0.008); but significantly and negatively correlated with the ratio of ApoA/ ApoB (r = -0.282, P = 0.009). Partial correlation showed that serum MCP-1 levels were correlation with LH (r = 0.2577, P = 0.020) and TG (r = 0.4611,P = 0.000). Multiple regression analysis showed that MCP-1 levels was influenced by BMI and TG. Furthermore, TG showed more effect on MCP-1 levels. CONCLUSION: PCOS obese and non-obese patients had higher serum MCP-1 levels than controls. MCP-1 was correlated with BMI, LH ,TG, ApoB and the ratio of ApoA/ ApoB. BMI and TG were two major determining factors of MCP-1 in patients with PCOS. Furthermore,TG had more effect on MCP-1 levels. Based on the above findings, we presume that MCP-1 is likely to participate in the pathophysiology and long-term complication of PCOS.