LEPAPN与多囊卵巢综合征相关性研究.docVIP

LEPAPN与多囊卵巢综合征相关性研究 　　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 　　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. 　　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