摘要
目的 :探讨多囊卵巢综合征 (PCOS)患者血循环中瘦素水平与其它内分泌、代谢指标之间的关系 ,进一步研究瘦素的作用规律。方法 :PCOS患者 82例 ,行葡萄糖耐量试验 (OGTT)、胰岛素释放试验 ,测定 5个时点的血糖、胰岛素以及C 肽 (C P)浓度 ;测定空腹血瘦素、性激素及促性腺激素浓度 ;同时测定患者的体重指数 (BMI)、腰臀比例(WHR) ,观察胰岛素增敏剂治疗对瘦素的影响。瘦素和胰岛素用放免法测定 ,C 肽和性激素用发光免疫法测定。结果 :肥胖组瘦素水平显著高于消瘦组 (P =0 .0 0 0 1 ) ,瘦素水平与体重指数呈高度正相关 (P =0 .0 0 0 1 ) ;与腰臀比例、空腹、60min、1 2 0min胰岛素浓度呈显著正相关 (P分别为 0 .0 1 96、0 .0 3 0 8、0 .0 0 0 6、0 .0 0 1 4) ;与OGTT各时点的血糖、C 肽浓度以及血糖、胰岛素、C 肽曲线下面积之间无显著相关性 (P >0 .0 5 )。二甲双胍、文迪雅对瘦素水平无显著影响。结论 :PCOS患者的瘦素浓度与体内脂肪含量及分布密切相关。PCOS患者可能同时存在瘦素抵抗和胰岛素抵抗。用改善胰岛素敏感性药物治疗对瘦素水平无显著影响。
Objective:To study the relationship between serum leptin concentration and other endocrine index and to research leptin's significance in PCOS.Methods:Oral glucose tolerance test (OGTT) and insulin releasing test were performed and C Peptide(C P)were measured at 5 time point.Serum fasting leptin and sexy hormones concentrations were measured in 82 PCOS patients.BMI and WHR were also calculated.The influence on leptin of insulin sensitizing therapy was observed.Leptin and insulin were measured by radioimmuoassay (RIA), C P and sexy hormones were measured by chemiluminescent immunoassay system.Results:Leptin concentration in obese PCOS women was significantly higher than that in lean group (P=0.0001). Leptin concentration was highly positively correlated with BMI(P=0.0001),WHR as well as fasting,1h and 2h insulin levels in PCOS subjects(P=0.0196,0.0308,0.0006 and 0.0014 respectively).Leptin concentration in PCOS had no correlations with glucose levels of any time as well as areas under the curve (AUC) of glucose,insulin and C P. Metformin and rosigliotazone did not significantly change the leptin concentration.Conclusions:There is a close correlation between circulating leptin concentration and the fat amount and distribution in PCOS patients.Leptin resistance and insulin resistance may exist at the same time in PCOS patients.Insulin sensitizing therapy do not significantly change the leptin concentration.
出处
《现代妇产科进展》
CSCD
2003年第5期345-347,共3页
Progress in Obstetrics and Gynecology
