多囊卵巢综合症患者血清betatrophin水平与胰岛素抵抗的相关性研究

Correlation between levels of circulating betatrophin and insulin resistance in females with polycystic ovary syndrome

摘要:

目的：探讨多囊卵巢综合征（polycystic ovary syndrome，PCOS）患者中betatrophin水平与胰岛素抵抗的相关性。方法：在横断面研究中，纳入了44名PCOS患者和35名健康妇女。计算稳态模型胰岛素抵抗指数（homeostatic model assessment insulin resistance，HOMA-IR）及稳态模型胰岛β细胞功能指数（homeostatic model assessment β cell function，HOMA-β），并采用酶联免疫吸附法（enzyme-linked immunosorbent assay，ELISA）测定血清betatrophin水平，分析betatrophin与胰岛素抵抗（insulin resis－tance，IR）的关系。同时观察37名PCOS患者经二甲双胍及罗格列酮钠治疗3个月后上述指标的变化情况。结果：PCOS患者血清betatrophin水平明显低于正常对照组[（0.43±0.15） ng/mL和（1.17±0.57） ng/mL，P=0.000]。相关性分析表明，在PCOS患者中，血清betatrophin水平与空腹血糖（fasting plasma glucose，FPG）、餐后2h血糖（2h postprandial plasma glucose，2hPG）、空腹胰岛素（fasting insulin，FINS）、HOMA-IR、超敏C反应蛋白（high-sensitivity C-reactive protein，hs-CRP）水平呈负相关（r=-0.331，r=-0.372，r=-0.311，r=-0.337，r=-0.338，均P＜0.05）。多元逐步回归分析显示，在PCOS患者中，HOMA-IR是betatrophin的独立影响因素（P＜0.05）。罗格列酮+二甲双胍治疗3个月后，PCOS患者betatrophin浓度较其基线值升高[（0.87±0.51） ng/mL和（0.42±0.17） ng/mL，P=0.000]。结论：PCOS患者存在betatrophin水平明显降低，且与IR负相关。

Abstract:

Objective：To investigate circulating betatrophin levels in females with polycystic ovary syndrome（PCOS） and its correla－tion with insulin resistance（IR）. Methods：Forty-four women with PCOS and thirty-five healthy women were recruited in a cross-sec－tional study. Serum concentrations of betatrophin was measured by enzyme-linked immunosorbent assay（ELISA）. The correlation of betatrophin with IR and metabolic parameters was also analyzed. Then twenty-seven PCOS patients were studied longitudinally after three mouths of metformin and rosiglitazone sodium treatment. Results：Serum betatrophin levels were lower in PCOS patients than in healthy control subjects（0.43±0.15） ng/mL vs. （1.17±0.57） ng/mL，P=0.000. Serum betatrophin negatively correlated with fasting plasma glucose（FPG），2h postprandial plasma glucose（2hPG），fasting insulin（FINS），homeostatic model assessment insulin resistance（HOMA-IR），high-sensitivity C-reactive protein （hs-CRP），even after controlling for age and body mass index（BMI） in PCOS par－ticipants（r=-0.331，r=-0.372，r=-0.311，r=-0.337，r=-0.338，all P<0.05）. Moreover，stepwise multiple regression analysis showed that HOMA-IR was independently related to betatrophin in PCOS subjects（P<0.05）. After rosiglitazone sodium and metformin treatment，PCOS patients showed higher betatrophin concentrations than its baseline levels（0.87±0.51） ng/mL vs. （0.42±0.17） ng/mL，P=0.000. Conclusion：Circulating betatrophin levels are de－creased in patients with PCOS，and associated with IR.