本文選題：多囊卵巢綜合征 + 鳶尾素��； 參考：《重慶醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的多囊卵巢綜合征(polycystic ovarian syndrome, PCOS)患者多數(shù)伴有不同程度的胰島素抵抗(insulin resistance, IR)。已有研究表明細(xì)胞因子Irisin與2型糖尿病IR有一定的相關(guān)性,但還沒(méi)有關(guān)于PCOS血清Irisin水平與IR關(guān)系的相關(guān)報(bào)道。本研究旨在了解PCOS患者和正常人的血清Irisin水平,及血清Irisin與PCOS患者IR及糖脂代謝相關(guān)指標(biāo)的關(guān)系。方法164名新確診為PCOS的患者和126名與實(shí)驗(yàn)組年齡匹配的健康志愿者納入實(shí)驗(yàn)。所有受試者均測(cè)量空腹時(shí)的身高、體重、血壓、腰圍、臀圍,計(jì)算腰臀比、BMI等,測(cè)血脂,性激素,行OGTT試驗(yàn)。用高胰島素正葡萄糖鉗夾試驗(yàn)(Euglycemic hyperinsulinemic clamp, EHC)評(píng)估受試者胰島素敏感性(即胰島素抵抗)情況,用M值表示。酶聯(lián)免疫法測(cè)量血清Irisin濃度。結(jié)果：(1) PCOS患者的BMI、WHR、FAT%、SBP/DBP、TG、TC、 HDL-C、LDL-C、FBG、2hPBG、FINS、2hlns、HbA1c、TEST、LH/FSH、 PRL、FAI較正常人升高,而SHBG則降低(P0.05或P0.01)。(2) PCOS患者血清Irisin水平較正常組顯著升高；無(wú)論是PCOS患者還是正常人,肥胖亞組(BMI23kg/m2)的血清Irisin水平均較非肥胖亞組(BMI23kg/m2)明顯升高(P0.05)。(3)在高胰島素正葡萄糖鉗夾試驗(yàn)中,PCOS患者的M值降低(P0.05),短暫快速升高的胰島素水平會(huì)引起血清Irisin濃度的顯著減少(P0.05)。(4)血清Irisin水平與BMI、FAP%、TG、TC、FFA、2hPBG、 FIns、2hIns、FAI、HOMA-IR、HOMA2-IR呈正相關(guān)(P0.05或P0.01),與M值呈顯著負(fù)相關(guān)(P0.01)；多元逐步回歸分析顯示,FAT%是影響血清Ⅰrisin水平的獨(dú)立危險(xiǎn)因素。Irisin的濃度越高,PCOS的風(fēng)險(xiǎn)越高。結(jié)論P(yáng)COS患者的血清Irisin水平升高,與肥胖和胰島素抵抗有相關(guān)性,推測(cè)可能參與肥胖和PCOS的病理生理過(guò)程,可能是肥胖、胰島素抵抗及PCOS的生物學(xué)標(biāo)志物。
[Abstract]:Objective most of the polycystic ovarian syndrome, PCOS) patients with polycystic ovary syndrome (PCOS) were associated with insulin resistance (IRV). Some studies have shown that cytokine Irisin is associated with IR in type 2 diabetes, but there is no report on the relationship between serum Irisin level of PCOS and IR. The purpose of this study was to investigate the level of serum Irisin in patients with PCOS and normal subjects, and the relationship between serum Irisin and IR, glucose and lipid metabolism in patients with PCOS. Methods 164 newly diagnosed PCOS patients and 126 age-matched healthy volunteers were enrolled in the study. Height, weight, blood pressure, waist circumference, hip circumference, waist to hip ratio, blood lipid, sex hormone and OGTT test were measured in all subjects. The insulin sensitivity (insulin resistance) was evaluated by Euglycemic hyperinsulinemic clamp, EHC) in hyperinsulinemic glucose clamp test. Serum Irisin concentration was measured by enzyme linked immunosorbent assay (Elisa). Results (1) the serum Irisin levels in PCOS patients were significantly higher than those in normal controls (P 0.05 or P 0.01). The serum Irisin levels in patients with PCOS were significantly higher than those in normal controls (P 0.05, P 0.05 or P 0.01N. 2) the serum Irisin levels in patients with PCOS were significantly higher than those in normal controls, whether in PCOS patients or in normal controls, but the levels of Irisin in patients with PCOS were significantly higher than those in normal controls. The levels of serum Irisin in patients with PCOS were significantly higher than those in normal controls, both in patients with PCOS and in normal subjects, and the levels of serum Irisin in patients with PCOS were significantly higher than those in normal controls. The serum Irisin level of obese subgroup was significantly higher than that of non-obese subgroup (BMI23 kg / m2). (P 0.05 + glucose clamp test decreased M value of P0. 05% in hyperinsulinemic positive glucose clamp test. Transient and rapid increase of insulin level resulted in a significant increase in serum Irisin concentration in the obese subgroup (P < 0. 05). The level of BMI23 kg / m2) in the obese subgroup was significantly higher than that in the non obese subgroup (P 0. 05 kg / m 2). The serum Irisin level was positively correlated with BMI-FAPP 2h PBG, FInsn 2hInsAFAIHOMA-IRHOMA2-IR, and negatively correlated with M value (P0.01. multiple stepwise regression analysis showed that FAT% was an independent risk factor affecting serum 鈪，

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