LEP、APN与多囊卵巢综合征的相关性研究(1)
摘要：目的 探讨血清瘦素(LEP)和脂联素(APN)与多囊卵巢综合征(PCOS)之间的关系。方法 选择2012年8月～2013年8月确诊PCOS的女性39例作为PCOS组。因单纯输卵管因素或/及男方因素不孕就诊的女性42例为非PCOS组。两组再分肥胖组和非肥胖组。检测早卵泡期FSH、LH、T、FPG、FINS、计算HOMA-IR。另测定血清LEP、APN，计算L/A。结果 ①PCOS组LEP水平及L/A比值显著高于非PCOS组，两组肥胖者均较非肥胖者升高。②PCOS组APN水平显著低于非PCOS组，PCOS组肥胖者较非肥胖者下降。③相关性分析：所有研究对象LEP及L/A比值与HOMA-IR成正相关，APN则与之成负相关。④多元回归分析：单独的LEP或APN指标与PCOS的相关性均不强烈，而L/A比值则与患病有明显相关。结论 LEP、APN可能参与PCOS的发生、发展过程，L/A比值是优于单独的APN或LEP的一个新指标，是PCOS患病的独立危险因素。
关键词：多囊卵巢综合征；瘦素；脂联素；胰岛素抵抗；肥胖
, http://www.100md.com
Abstract：Objective To investigate the development of PCOS and the influent factors among the LEP，APN.Methods 39 PCOS patients were sampled in experimental group，and 42 patients with pure tubal factor and/or male factor infertility were randomly assigned as control group.Then the two groups were divided into obese and non-obese group.The following outcomes were measured in four groups：①early follicular phase serum FSH、LH、T、FPG、FINS；and count HOMA-IR；(2)the serum LEP，APN，and count L/A ratio.Results ①the levels of LEP and the L/A ratios in PCOS patients were higher than that of the non-PCOS patients，the levels of LEP in obese patients were higher than that of non-obese patients.②the levels of APN in PCOS patients were lower than that of the non-PCOS patients.The levels of APN in obese patients were lower than that of non-obese patients in PCOS patients.③Correlation analysis：The level of LEP and L/A ratio was positively correlated with HOMA-IR.④Multivariate regression analysis：there was no significant correlation between single LEP or APN and PCOS，but the L/A ratio was significantly related with PCOS.Conclusion LEP，APN may be involved in the occurrence and development of PCOS.The L/A ratio is superior to separate APN or LEP，and it is independent risk factor for the development of PCOS disease.
, 百拇医药
Key words：Polycystic ovary syndrome；Leptin；Adiponectin；Insulin resistance；Obesity
PCOS是育龄期女性最常见的生殖内分泌疾病，其发病率约为5%～10%[1]，病因尚不明确。目前发现瘦素(LEP)和脂联素(APN)与PCOS的胰岛素抵抗(IR)关系密切。本研究采用病例对照的方法以PCOS患者为病例组，以非PCOS组女性为对照组，以是否BMI≥25将两组再各分为肥胖组和非肥胖组。比较不同组血清瘦素、脂联素、L/A比值的差异，研究其与IR的关系。并进行多因素回归分析探讨LEP、APN在PCOS发病中的作用，及与IR、肥胖的相关性。
1资料与方法
1.1一般资料 选择2012年8月～2013年8月因月经异常、不孕、痤疮、多毛等就诊于门诊确诊的PCOS女性39例作为PCOS组。随机抽取同期年龄、体重、体重指数(BMI)、腰围(WC)、臀位(HC)、腰臀比(WHR)无显著差异的，因单纯输卵管因素或/及男方因素不孕就诊的女性42例为非PCOS组。按照是否BMI≥25kg/m2再将两组分为肥胖组和非肥胖组。
1.2方法 根据人体测量学方法，测量体重、身高、WC、HC，计算BMI、WHR。于月经来潮第3～5d(闭经者不限)空腹采集肘静脉血5ml两管。一管血样标本经4000r/min离心5min后取血清，采用化学发光法测定睾酮(T)、空腹胰岛素(FINS)、促卵泡生成素(FSH)、促黄体生成素(LH)、雌二醇(E2)、泌乳素(PRL)。氧化酶法测定空腹血糖(FPG)。计算HOMA-IR=(FIN×FPG)/22.5。另一管血样标本经2000r/min离心20min后取上层血清2ml，置于-20℃冰箱内，待标本收集齐全后，采用ELISA法测定血清APN、LEP，计算L/A比值。, http://www.100md.com(陈育娟)
关键词：多囊卵巢综合征；瘦素；脂联素；胰岛素抵抗；肥胖
, http://www.100md.com
Abstract：Objective To investigate the development of PCOS and the influent factors among the LEP，APN.Methods 39 PCOS patients were sampled in experimental group，and 42 patients with pure tubal factor and/or male factor infertility were randomly assigned as control group.Then the two groups were divided into obese and non-obese group.The following outcomes were measured in four groups：①early follicular phase serum FSH、LH、T、FPG、FINS；and count HOMA-IR；(2)the serum LEP，APN，and count L/A ratio.Results ①the levels of LEP and the L/A ratios in PCOS patients were higher than that of the non-PCOS patients，the levels of LEP in obese patients were higher than that of non-obese patients.②the levels of APN in PCOS patients were lower than that of the non-PCOS patients.The levels of APN in obese patients were lower than that of non-obese patients in PCOS patients.③Correlation analysis：The level of LEP and L/A ratio was positively correlated with HOMA-IR.④Multivariate regression analysis：there was no significant correlation between single LEP or APN and PCOS，but the L/A ratio was significantly related with PCOS.Conclusion LEP，APN may be involved in the occurrence and development of PCOS.The L/A ratio is superior to separate APN or LEP，and it is independent risk factor for the development of PCOS disease.
, 百拇医药
Key words：Polycystic ovary syndrome；Leptin；Adiponectin；Insulin resistance；Obesity
PCOS是育龄期女性最常见的生殖内分泌疾病，其发病率约为5%～10%[1]，病因尚不明确。目前发现瘦素(LEP)和脂联素(APN)与PCOS的胰岛素抵抗(IR)关系密切。本研究采用病例对照的方法以PCOS患者为病例组，以非PCOS组女性为对照组，以是否BMI≥25将两组再各分为肥胖组和非肥胖组。比较不同组血清瘦素、脂联素、L/A比值的差异，研究其与IR的关系。并进行多因素回归分析探讨LEP、APN在PCOS发病中的作用，及与IR、肥胖的相关性。
1资料与方法
1.1一般资料 选择2012年8月～2013年8月因月经异常、不孕、痤疮、多毛等就诊于门诊确诊的PCOS女性39例作为PCOS组。随机抽取同期年龄、体重、体重指数(BMI)、腰围(WC)、臀位(HC)、腰臀比(WHR)无显著差异的，因单纯输卵管因素或/及男方因素不孕就诊的女性42例为非PCOS组。按照是否BMI≥25kg/m2再将两组分为肥胖组和非肥胖组。
1.2方法 根据人体测量学方法，测量体重、身高、WC、HC，计算BMI、WHR。于月经来潮第3～5d(闭经者不限)空腹采集肘静脉血5ml两管。一管血样标本经4000r/min离心5min后取血清，采用化学发光法测定睾酮(T)、空腹胰岛素(FINS)、促卵泡生成素(FSH)、促黄体生成素(LH)、雌二醇(E2)、泌乳素(PRL)。氧化酶法测定空腹血糖(FPG)。计算HOMA-IR=(FIN×FPG)/22.5。另一管血样标本经2000r/min离心20min后取上层血清2ml，置于-20℃冰箱内，待标本收集齐全后，采用ELISA法测定血清APN、LEP，计算L/A比值。, http://www.100md.com(陈育娟)
参见：首页 > 医疗版 > 疾病专题 > 妇产科 > 妇科综合征及其它 > 多囊卵巢综合征