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了解多囊卵巢综合征(PCOS)患者血总脂联素与PCOS发病及其胰岛素敏感性的关系,探讨脂联素(APN)在PCOS发病机制中的作用。将58名PCOS患者按血清胰岛素高低分为2组。选正常体重的非PCOS女性29名作为对照。应用多元回归方程分析影响血总脂联素、PCOS发病、胰岛素敏感性的因素。3组研究对象的血脂联素与腰臀比(r=-0.39、r=-0.36)及lnHOMA-IR(r=-0.53、r=-0.45)均成负相关,血脂联素不是PCOS发病的独立保护因素(P>0.1),LH/FSH(OR=1.51;95%CI:1.16～1.96;P=0.01)和lnHOMA-IR(OR=1.26;95%CI:1.10～1.44;P=0.01)是其独立危险因素。但血脂联素是PCOS高胰岛素血症的独立保护因素(OR=0.81;95%CI:0.67～0.97;P=0.02);而腰臀比是其独立危险因素(OR=8.57;95%CI:2.14～34.30;P=0.01)。血脂联素是空腹胰岛素和lnHOMA-IR的独立影响因素(B=-0.22,P=0.001;B=-0.02,P=0.002)。说明血清脂联素与P-COS的发病无直接关系,但与PCOS高胰岛素血症有关。脂联素可能是通过影响胰岛素敏感性而参与PCOS的病理生理改变。
To investigate the relationship between total adiponectin and PCOS incidence and insulin sensitivity in patients with polycystic ovary syndrome (PCOS) and to explore the role of adiponectin (APN) in the pathogenesis of PCOS. 58 PCOS patients were divided into two groups according to the level of serum insulin. 29 healthy non-PCOS women with normal body weight were selected as controls. Multiple regression equation was used to analyze the factors affecting the blood total adiponectin, PCOS incidence and insulin sensitivity. Blood adiponectin in the three groups was negatively correlated with WHR (r = -0.39, r = -0.36) and lnHOMA-IR (r = -0.53, r = -0.45) (P = 0.1), LH / FSH (OR = 1.51; 95% CI: 1.16-1.96; P = 0.01) and lnHOMA-IR (OR = 1.26; 95% CI: 1.10-1.44; Is its independent risk factor. However, adiponectin was an independent protective factor of PCOS in hyperinsulinemia (OR = 0.81; 95% CI: 0.67-0.97; P = 0.02); while waist-hip ratio was an independent risk factor (OR = 8.57; 95% CI: 2.14 ~ 34.30; P = 0.01). Adiponectin was an independent determinant of fasting insulin and lnHOMA-IR (B = -0.22, P = 0.001; B = -0.02, P = 0.002). Serum adiponectin and P-COS incidence is not directly related, but with hyperinsulinemia PCOS. Adiponectin may be involved in the pathophysiology of PCOS by affecting insulin sensitivity.