本文選題：多囊卵巢綜合征 + OrexinANesfatin-1　； 參考：《安徽醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的 觀察初診多囊卵巢綜合征（PCOS）患者空腹血清OrexinA（OXA）、Nesfatin-1水平的變化，探討其在PCOS發(fā)生和發(fā)展中的意義。 方法 1.選取就診于我院初診的PCOS患者57例(PCOS組)，月經(jīng)正常的健康女性56例(對(duì)照組)；按照體質(zhì)指數(shù)（BMI）≥25kg/m2或＜25kg/m2的標(biāo)準(zhǔn)，將PCOS組分為超重/肥胖亞組(PCOS-OW/OB，n=32)和正常體重亞組(PCOS-NW，n=25)，對(duì)照組按同樣標(biāo)準(zhǔn)分為超重/肥胖亞組(Control-OW/OB，n=26)和正常體重亞組(Control-NW，n=30)。 2.采集所有研究對(duì)象的姓名、年齡、職業(yè)、月經(jīng)周期、婚育史等基本信息；測量所有研究對(duì)象的身高、體重、腰圍（WC）及臀圍，計(jì)算身體質(zhì)量指數(shù)（BMI）和腰臀比（WHR），并對(duì)其進(jìn)行體格檢查。 3.所有研究對(duì)象于月經(jīng)周期第2~5天清晨空腹采集肘靜脈血（月經(jīng)稀發(fā)及閉經(jīng)者時(shí)間不限）。用于對(duì)黃體生成素（LH）、卵泡刺激素（FSH）、睪酮（T）、甘油三酯（TG）、膽固醇（TC）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）的檢測。 4.所有受試者于同一天清晨空腹（禁食12～14小時(shí)）行口服75g葡萄糖耐量試驗(yàn)（OGTT），分別抽取0、30、60及120min靜脈血5ml，，離心后收集血清，-80°冰箱凍存?zhèn)溆�。檢測指標(biāo)包括：空腹血糖（FBG）、餐后2h血糖（P2hBG）、空腹胰島素（FINS）及餐后2h胰島素（P2hINS），并計(jì)算穩(wěn)態(tài)模型胰島素抵抗指數(shù)。備用標(biāo)本用于同一檢測OXA及Nesfatin-1的水平。 結(jié)果 1.一般資料及臨床生化指標(biāo)的比較：PCOS組與對(duì)照組相比，年齡、BMI、WC、TG、TC、HDL、LDL、P2hBG差異無統(tǒng)計(jì)學(xué)意義；PCOS組WHR和FBG高于對(duì)照組(P0.05)， LH、LH/FSH、T、FINS、HOMA-IR明顯高于對(duì)照組(P0.01)；而FSH水平低于對(duì)照組(P0.05)。PCOS-OW/OB亞組BMI、WC、WHR、FINS、P2hINS、HOMA-IR高于PCOS-NW亞組，Control-OW/OB亞組BMI、WC、WHR、TG、LDL、FBG、P2hBG、FINS、P2hINS、HOMA-IR高于Control-NW亞組，HDL低于Control-NW亞組。PCOS-OW/OB亞組LH、LH/FSH、T、HOMA-IR高于Control-OW/OB亞組。PCOS-NW亞組WC、LH、LH/FSH、T、FINS、P2hINS、HOMA-IR高于Control-NW亞組。 2.OXA、Nesfatin-1水平比較：PCOS組OXA水平及Nesfatin-1水平均明顯低于對(duì)照組(P0.01)；Control-NW亞組和Control-OW/OB亞組OXA水平及Nesfatin-1水平均明顯高于PCOS對(duì)應(yīng)亞組(P0.01)；PCOS和對(duì)照組中，OW/OB亞組OXA及Nesfatin-1水平均低于NW亞組(P0.01或P0.05)。 3.相關(guān)性分析：校正年齡和BMI后，PCOS組血清OXA水平與LH、LH/FSH、FBG、P2hBG、HOMA-IR呈負(fù)相關(guān)（r=-0.313、r=-0.302、r=-0.353、r=-0.294、r=-0.283，P0.05或P＜0.01）；而血清Nesfatin-1水平與FBG、FINS、HOMA-IR呈負(fù)相關(guān)（r=-0.379、r=-0.428、r=-0.476，P＜0.01）。 結(jié)論 1.初診的多囊卵巢綜合征患者存在顯著的胰島素抵抗和高雄激素血癥； 2.初診的多囊卵巢綜合征患者血清OXA、Nesfatin-1水平明顯下降，這可能參與了多囊卵巢綜合征的發(fā)生和發(fā)展。
[Abstract]:objective
Objective To observe the changes of fasting serum OrexinA (OXA) and Nesfatin-1 levels in patients with newly diagnosed polycystic ovary syndrome (PCOS), and to explore their significance in the occurrence and development of PCOS.
Method
1. selected 57 PCOS patients (group PCOS) and 56 healthy women with normal menstruation (control group). According to the body mass index (BMI) > 25kg/m2 or < 25kg/m2, the PCOS group was divided into overweight / obese subgroup (PCOS-OW/OB, n=32) and normal weight subgroup (PCOS-NW, n=25), and the control group was divided into overweight / obesity subgroup (Co) according to the same standard. Ntrol-OW/OB, n=26) and normal weight subgroup (Control-NW, n=30).
2. the basic information, such as name, age, occupation, menstrual cycle, history of marriage and childbirth, were collected for all the subjects; the height, weight, waist circumference (WC) and hip circumference of all the subjects were measured, and the body mass index (BMI) and the waist to hip ratio (WHR) were calculated and the physical examination was carried out.
3. all the subjects collected the elbow vein blood on the early morning of the menstrual cycle (2~5) on the early morning of the menstrual cycle (LH, FSH), testosterone (T), triglyceride (TG), cholesterol (TC), high-density lipoprotein (HDL), and low density lipoprotein (LDL).
4. all subjects were given an oral 75g glucose tolerance test (OGTT) on the same morning on the same day (fasting 12~14 hours). 0,30,60 and 120min venous blood 5ml were extracted respectively. After centrifugation, serum was collected and -80 degree refrigerator was frozen in reserve. The test indexes included fasting blood glucose (FBG), postprandial 2H blood sugar (P2hBG), fasting insulin (FINS) and postprandial 2H insulin (P2hINS). The steady-state model insulin resistance index was calculated. The spare samples were used for the same detection of OXA and Nesfatin-1 levels.
Result
Comparison of general data and clinical biochemical indexes: there was no significant difference in age, BMI, WC, TG, TC, HDL, LDL, P2hBG in the PCOS group compared with the control group, and the WHR and FBG in the PCOS group were higher than the control group. The HOMA-IR is higher than the PCOS-NW subgroup, and the Control-OW/OB subgroup BMI, WC, WHR, TG, LDL, FBG, P2hBG are higher than those of the PCOS-NW group.
2.OXA, Nesfatin-1 level: OXA level and Nesfatin-1 level in group PCOS were significantly lower than that of control group (P0.01), and OXA level and Nesfatin-1 level in Control-NW subgroup and Control-OW/OB subgroup were significantly higher than that in PCOS subgroup (P0.01).
3. correlation analysis: after correction of age and BMI, the level of serum OXA in group PCOS was negatively correlated with LH, LH/FSH, FBG, P2hBG, HOMA-IR (r=-0.313, r=-0.302, r=-0.353, r=-0.294, r=-0.294, or < 0.01).
conclusion
1. the newly diagnosed polycystic ovary syndrome patients had significant insulin resistance and Kaohsiung steroid hormones.
2. the levels of serum OXA and Nesfatin-1 in newly diagnosed polycystic ovary syndrome decreased significantly, which may be involved in the occurrence and development of polycystic ovary syndrome.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R711.75

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