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目的探讨内脂素对多囊卵巢综合征(PCOS)患者卵巢颗粒细胞胰岛素受体底-1(IRS-1)和IRS-2表达的影响及其机制。方法将15例单纯输卵管性不孕并不伴胰岛素抵抗(IR)的患者(NO组),14例PCOS患者不孕且不伴IR的(PCOS-NIR组)和12例PCOS不孕伴IR的患者(PCOS-IR组)的颗粒细胞行体外培养,用ELISA检测血清和卵泡内脂素水平;给予超生理浓度的内脂素100 ng/mL干预后,用RT-PCR和western blotting方法检测IRS-1和IRS-2 mRNA和蛋白的表达。结果 PCOS-NIR组和PCOS-IR组血清和卵泡液内脂素水平较对照组明显升高(P<0.05);基础状态下,与NO组比较,PCOS患者无论是否伴有IR,颗粒细胞IRS-1的表达均升高(P<0.05),IRS-2表达均降低(P<0.05);超生理浓度的内脂素干预后,IRS-1和IRS-2的这种变化趋势均较干预前更加明显(P<0.05)。结论 PCOS患者无论是否伴有胰岛素抵抗,其体内升高内脂素的水平,可能引起卵巢局部IRS-1/IRS-2的平衡紊乱。
Objective To investigate the effect of visfatin on the expression of insulin receptor-1 (IRS-1) and IRS-2 in ovarian granulosa cells in patients with polycystic ovary syndrome (PCOS) and its mechanism. Methods Fifteen patients with simple tubal infertility who did not have insulin resistance (IR), 14 patients with PCOS who were infertile without PCOS (PCOS-NIR group) and 12 patients with PCOS who had infertility with IR The granulosa cells of PCOS-IR group were cultured in vitro and the levels of serum lipids and follicular visfatin were measured by ELISA. After intervention with 100 ng / mL visfatin of super-physiological concentration, the expression of IRS was detected by RT-PCR and western blotting -1 and IRS-2 mRNA and protein expression. Results Compared with the control group, the levels of serum lipids and lipofuscin in PCOS-NIR group and PCOS-IR group were significantly increased (P <0.05). Compared with NO group, (P <0.05), while the expression of IRS-2 was decreased (P <0.05). The changes of IRS-1 and IRS-2 in intervention group Before more obvious (P <0.05). Conclusions PCOS patients with or without insulin resistance may increase the levels of visfatin in the ovaries, which may cause the imbalance of IRS-1 / IRS-2 in the ovary.