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目的:探讨多囊卵巢综合征(polycystic ovarian syndrome,PCOS)患者血清鸢尾素(irisin)水平及其与胰岛素抵抗(insulin resistance,IR)的关系。方法:纳入PCOS患者60例及健康女性志愿者80例,测量血清激素、血清鸢尾素浓度等,用HOMA稳态模型抵抗指数评估IR,胰岛β细胞功能指数(HOMA-β)、口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)30 min胰岛素血糖与空腹胰岛素血糖差值的比(△Ins30/△Glu30)、胰岛素与血糖比值曲线下面积(AUCIns/Glu)评估β细胞功能,以及采用Pearson’s相关和多元逐步线性回归分析血清鸢尾素与IR的关系。结果:PCOS患者血清鸢尾素较对照组升高(P<0.05);血清鸢尾素水平与体质指数(r=0.381,P=0.003)、空腹血糖(r=0.565,P=0.000)、空腹胰岛素(r=0.551,P=0.000)、餐后2 h胰岛素(r=0.299,P=0.020)、LH/FSH(r=0.802,P=0.000)、孕酮(r=0.349,P=0.006)、TG(r=0.306,P=0.018)、HOMA-IR(r=0.632,P=0.000)、AUCIns/Glu(r=0.317,P=0.014)呈正相关;多元逐步回归分析显示PCOS患者血清鸢尾素与HOMA-IR相关,与β细胞功能(HOMA-β,△Ins30/△Glu30,AUCIns/Glu)无相关(F=169.05,R2=0.945,P=0.00)。结论:PCOS患者血清鸢尾素水平升高,可能在IR的发病机制中起作用。
Objective: To investigate the serum irisin level and its relationship with insulin resistance (IR) in patients with polycystic ovarian syndrome (PCOS). Methods: 60 PCOS patients and 80 healthy female volunteers were enrolled in this study. Serum hormones and serum irisin concentrations were measured. HOMA homeostasis model index (IR), insulin resistance β cell function index (HOMA-β), oral glucose tolerance test (△ Ins30 / △ Glu30), the area under the curve of insulin to blood glucose ratio (AUCIns / Glu) of 30 min oral glucose tolerance test (OGTT), and Pearson’s correlation Multivariate stepwise linear regression analysis of serum irisin and IR. Results: Serum irisin in PCOS patients was significantly higher than that in control group (P <0.05). Serum irisin levels were positively correlated with body mass index (r = 0.381, P = 0.003), fasting blood glucose (r = 0.502, P = 0.000), 2 h postprandial insulin (r = 0.299, P = 0.020), LH / FSH (r = 0.306, P = 0.018), HOMA-IR (r = 0.632, P = 0.000) and AUCIns / Glu (r = 0.317, P = 0.014). The multivariate stepwise regression analysis showed that serum irisin and HOMA -IR and no correlation with β-cell function (HOMA-β, △ Ins30 / △ Glu30, AUCIns / Glu) (F = 169.05, R2 = 0.945, P = 0.00). Conclusion: Serum irisin levels in PCOS patients may play a role in the pathogenesis of IR.