单核细胞趋化蛋白-1与多囊卵巢综合征临床特征的相关性研究

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（MCP）-1浓度的变化及其与PCOS患者临床特征的关系。方法将PCOS患者和对照者根据体重指数分为PCOS肥胖组（27例）、PCOS非肥胖组（38例）及肥胖对照组和非肥胖对照组（后两组各20例）。应用ELISA方法检测PCOS组及对照组血清中MCP-1水平,应用化学发光法检测血清泌乳素、黄体生成素（LH）、卵泡刺激素（FSH）、雌二醇和睾酮,应用放射免疫方法检测血清雄烯二酮水平;同时检测空腹血糖和空腹胰岛素。结果（1）非肥胖PCOS组血清中MCP-1水平明显高于非肥胖对照组（984-67）ng／ml vs（584-41）ng/ml,P＜0．05]。（2）Pearson相关分析显示,MCP-1与体重指数（r=0．339,P=0．000）、LH（r=0．224,P=0．024）及稳态模型的胰岛素抵抗指数（HOMA-IR,r=0．239,P=0．016）呈正相关,与胰岛素敏感指数（ISI）呈负相关（r=-0．250,P=0．011）;排除体重指数影响后的偏相关分析显示,MCP-1与LH（r=0．2873,P=0．0006）呈正相关,与其他临床指标之间无明显相关（P＞0．05）。（3）多元回归分析结果显示,体重指数（t=3．607,P=0．000）和LH（t=2．298,P=0．024）是影响血清中MCP-1的主要因素,其中体重指数的影响因素更明显。结论PCOS患者血清中MCP-1水平的升高与LH有关;PCOS可能是一种慢性炎症性疾病;MCP-1可能参与了PCOS患者的肥胖、高胰岛素血症和胰岛素抵抗的发生。

Association of monocyte chemoattractant protein-1 and the clinical characteristics of polycystic ovary syndrome: analysis of 65 cases

OBJECTIVE: To investigate the association of monocyte chemoattractant protein-1 (MCP-1) and the clinical characteristics of polycystic ovary syndrome: (PCOS). METHODS: Fasting peripheral venous blood samples were collected on the 2nd or 3rd day of the menstrual cycle or when there was no dominant follicle shown by ultrasonography after amenorrhea from 65 POCS patients, aged 30 +/- 3, 27 being attributed to the obese group according the body mass index (BMI) and 38 to the non-obese group, and 40 patients with infertility, aged 31 +/- 3, as controls, subdivided into obese and non-obese subgroups (both n = 20), and then the samples of serum. Were obtained. The level of MCP-1 was examined by ELISA. The levels of prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, and testosterone (T) were assayed with chemoluminescence methods, and the level of androstenedione was detected by raioimmunoassay. The level of serum insulin was detected by chemoluminescence method and the serum glucose (SG) was detected by oxidase enzymic method. Insulin sensitivity index (ISI) and homeostasis model assessment insulin resistance (HOMA-IR) were calculated. RESULTS: (1) The levels of serum LH, T, and LH/FSH of the obese and non-obese POCS subgroups were all significantly higher than the corresponding obese and non-obese control subgroups (all P < 0.05). (2) The level of MCP-1 of the non-obese PCOS subgroup was (98 +/- 67) ng/ml, significantly higher than that of the non-obese controls (58 +/- 41 mg/L, P < 0.05)]. (3) Pearson correlation showed that serum PCP-1 was significantly positively correlated with BMI (r = 0.339, P = 0.000). LH (r = 0.224, P = 0.024)), and HOMA-IR (r = 0.239, P = 0.016), and significantly negatively correlated with ISI (r = -0.250, P = 0.0006). (3) Multiple regression analysis showed that BMI and LH were the principal factors influencing the level of MCP-1 in the POCS patients. CONCLUSION: The serum level of MCP-1 is associated with the LH level in POCS patients. POCS may a chronic inflammatory disease. MCP-1 is likely to participate in obesity, hyperinsulinemia, and insulin resistance in POCS.