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目的探讨多囊卵巢综合征(PCOS)患者血清脂联素水平与高胰岛素血症(HI)的关系。方法将2003年12月至2004年6月郑州大学第三附属医院确诊的40例PCOS患者,根据空腹血胰岛素水平将其分为PCOS-HI组(INS>15mU/L)22例,PCOS非HI组(INS≤15mU/L)18例,并选择25例健康者为对照组。采用酶联免疫吸附法测定3组空腹血脂联素水平,化学发光法测定胰岛素、性激素,葡萄糖氧化酶法测定血糖。计算3组胰岛素敏感指数(ISI),评价胰岛素抵抗程度。结果PCOS-HI组血清脂联素水平(1.80±0.48)mg/L,PCOS非HI组(2.79±0.50)mg/L,明显低于对照组的(3.94±0.66)mg/L,且PCOS-HI组低于非HI组,差异有统计学意义(P<0.05)。PCOS-HI组ISI(-4.41±0.32),PCOS非HI组(-3.97±0.40),明显低于对照组的(-3.21±0.43),差异有统计学意义(P<0.05)。PCOS-HI组空腹胰岛水平(19.88±5.62)mU/L,PCOS非HI组(10.63±4.50)mU/L,明显高于对照组的(8.03±3.98)mU/L,且PCOS-HI组高于非HI组,差异有统计学意义(P<0.05)。PCOS-HI组空腹血糖(5.24±0.58)mmol/L,PCOS非HI组(5.10±0.62)mmol/L,对照组(5.07±0.59)mmol/L,3组比较差异无显著性意义。PCOS患者血清脂联素水平与INS呈显著负相关,与ISI呈正相关。结论PCOS患者血清脂联素水平降低与INS呈显著负相关,提示脂联素影响PCOS-HI的发生和发展。
Objective To investigate the relationship between serum adiponectin and hyperinsulinemia (HI) in patients with polycystic ovary syndrome (PCOS). Methods Forty PCOS patients diagnosed at the Third Affiliated Hospital of Zhengzhou University from December 2003 to June 2004 were divided into PCOS-HI group (INS> 15mU / L) according to the fasting blood insulin level, 22 cases of PCOS were non-HI Group (INS≤15mU / L) 18 cases, and 25 cases of healthy control group. The fasting blood adiponectin level was measured by enzyme-linked immunosorbent assay, and the levels of insulin, sex hormone and glucose oxidase were measured by chemiluminescence. Three groups of insulin sensitivity index (ISI) were calculated to evaluate the degree of insulin resistance. Results The level of serum adiponectin in PCOS-HI group was significantly lower than that in control group (1.80 ± 0.48) mg / L and PCOS non-HI group (2.79 ± 0.50) mg / L, HI group was lower than non-HI group, the difference was statistically significant (P <0.05). The ISI of PCOS-HI group (-4.41 ± 0.32) and PCOS non-HI group (-3.97 ± 0.40) was significantly lower than that of the control group (-3.21 ± 0.43), the difference was statistically significant (P <0.05). The levels of fasting islet (19.88 ± 5.62) mU / L and PCOS-HI group (10.63 ± 4.50) mU / L in PCOS-HI group were significantly higher than those in control group (8.03 ± 3.98) mU / L In non-HI group, the difference was statistically significant (P <0.05). The fasting blood glucose (5.24 ± 0.58) mmol / L, PCOS-HI group (5.10 ± 0.62) mmol / L in PCOS-HI group and (5.07 ± 0.59) mmol / L in PCOS-HI group had no significant difference. Serum levels of adiponectin in PCOS patients were significantly negatively correlated with INS and positively correlated with ISI. Conclusion The decrease of serum adiponectin level in PCOS patients has a significant negative correlation with INS, suggesting that adiponectin affects the occurrence and development of PCOS-HI.