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目的研究多囊卵巢综合征(PCOS)患者临床干预前后血清内脂素水平变化及其在PCOS病理生理机制中可能发挥的作用。方法选取2012年8月-2013年9月该院生殖医学科71例PCOS患者为PCOS组,45例健康志愿者或在生殖医学中心行辅助治疗的为对照组。比较血清内脂素水平及相关因素;根据PCOS患者不同BMI及胰岛素抵抗指数(HOMA-IR)分组,检测不同组间血清内脂素水平差异;比较38例PCOS患者治疗前后血清内脂素、BMI、睾酮(T)、LH/FSH值及HOMA-IR变化。结果 71例PCOS患者总体血清内脂素水平低于对照组,但差异无统计学意义(P>0.05),内脂素水平与HOMA-IR呈低度正相关(r=0.385,P<0.01);对照组内脂素水平未发现与其他因素有明显相关性。PCOS各组内脂素水平和对照组无差别,仅PCOS肥胖患者血清内脂素水平显著低于对照组,差异有统计学意义(P<0.05)。PCOS治疗后T、BMI、HOMA-IR及LH/FSH均显著降低,治疗前后差异均有统计学意义(P<0.01),而内脂素水平较治疗前显著升高,差异有统计学意义(P<0.05)。PCOS治疗前后血清内脂素水平变化与T、BMI、HOMA-IR及LH/FSH的变化均无明显相关性。结论肥胖PCOS患者内脂素水平低于对照组,PCOS患者经治疗干预后内分泌及代谢指标均得到改善,但内脂素水平升高,提示内脂素可能在改善PCOS患者临床指标上发挥作用。
Objective To study the changes of serum visfatin levels before and after clinical intervention in patients with polycystic ovary syndrome (PCOS) and its possible role in the pathophysiology of PCOS. Methods From August 2012 to September 2013, 71 PCOS patients in the reproductive medicine department of the hospital were PCOS group, 45 healthy volunteers or adjuvant treatment in the reproductive medicine center. The levels of serum visfatin and the related factors were compared. According to the different BMI and insulin resistance index (HOMA-IR) group, the differences of serum visfatin levels in different groups were compared. The changes of plasma visfatin, BMI , Testosterone (T), LH / FSH value and HOMA-IR changes. Results The total serum visfatin level in 71 PCOS patients was lower than that in the control group, but the difference was not statistically significant (P> 0.05). There was a low positive correlation between plasma visfatin and HOMA-IR (r = 0.385, P <0.01) There was no significant correlation between the level of visfatin and other factors in the control group. There was no difference in the level of visfatin between the PCOS groups and the control group. The level of serum lipids in the PCOS group was significantly lower than that in the control group (P <0.05). The levels of T, BMI, HOMA-IR and LH / FSH were significantly decreased after PCOS treatment, with significant difference before and after treatment (P <0.01), while the level of visfatin was significantly higher than that before treatment (P <0.01) P <0.05). Changes of serum visfatin levels before and after PCOS had no significant correlation with changes of T, BMI, HOMA-IR and LH / FSH. Conclusions The level of visfatin in obese patients with PCOS is lower than that in the control group. The endocrine and metabolic indexes of patients with PCOS after treatment are improved, but the level of visfatin is increased, suggesting that visfatin may play a role in improving the clinical features of patients with PCOS.