论文部分内容阅读
目的:以多囊卵巢综合征(polycystic ovary syndrome,PCOS)人群为研究对象,通过构建包含补体C3的胰岛素敏感性(insulin sensitivity,IS)评分模型,探索一种简便易行的方法对PCOS患者的IR进行评估。方法:纳入99名PCOS患者及116名年龄匹配的正常女性,测量人体参数及空腹血生化指标(胰岛素、hs-CRP、补体C3等),计算稳态模型胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA2-IR)。对所有PCOS患者及其中20名正常对照行高胰岛素-正葡萄糖钳夹术,结果以M值表示。在PCOS组中,采用多元线性回归,以M值为应变量,以BMI、LDL-C、补体C3、超敏C反应蛋白、空腹血清胰岛素为自变量,建立IS评分(即M值的预测值)模型方程,用ROC曲线评估该模型诊断IR的价值。结果:IS评分=19.36-0.35×BMI-2.28×C3(R~2=0.54,P=0.000)。IS评分和HOMA2-IR诊断PCOS患者IR的ROC曲线下面积分别为0.89(95%CI=0.82~0.96)和0.75(95%CI=0.64~0.86),当IS评分=8.93时,其诊断PCOS患者IR的灵敏度和特异度分别为0.70和0.95,Youden指数0.63。当HOMA2-IR=0.47时,其诊断的灵敏度和特异度分别为0.60和0.88,Youden指数0.47。结论:包含补体C3的IS评分模型评估PCOS人群的IR具有较好的诊断价值。
OBJECTIVE: To establish a model of insulin sensitivity (IS) score for patients with polycystic ovary syndrome (PCOS) and to explore a simple and convenient method for evaluating the prognosis of patients with PCOS IR for evaluation. Methods: Ninety-nine PCOS patients and 116 age-matched normal women were included in the study. Body parameters and fasting blood biochemical parameters (insulin, hs-CRP, complement C3, etc.) were measured and the homeostasis model assessment of insulin resistance , HOMA2-IR). All patients with PCOS and 20 normal controls were treated with insulin-plus-glucose clamp. The results were expressed as M values. In the PCOS group, multivariate linear regression was used to establish the IS score (ie, the predictive value of M value) with M value as the dependent variable and BMI, LDL-C, complement C3, high sensitivity C-reactive protein and fasting serum insulin as independent variables ) Model equation, the ROC curve was used to assess the diagnostic value of this model. Results: IS score = 19.36-0.35 × BMI-2.28 × C3 (R ~ 2 = 0.54, P = 0.000). The area under the receiver operating characteristic (ROC) curve of IR for PCOS with IS and HOMA2-IR were 0.89 (95% CI = 0.82-0.96) and 0.75 (95% CI 0.64-0.86) respectively. When the IS score was 8.93, The sensitivity and specificity of IR were 0.70 and 0.95, respectively, and the Youden index was 0.63. When HOMA2-IR = 0.47, the diagnostic sensitivity and specificity were 0.60 and 0.88 respectively, and the Youden index was 0.47. CONCLUSIONS: The IS score model that includes complement C3 has a good diagnostic value for assessing IR in PCOS populations.