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目的:探讨不同表现型多囊卵巢综合征(PCOS)患者血清和卵泡液中脂联素水平及黄素化颗粒细胞脂联素、脂联素受体mRNA表达的差异,及其对卵子成熟和IVF结局的影响。方法:随机选择行体外受精-胚胎移植(IVF-ET)的71例患者并分4组,第1组为肥胖PCOS组(BMI>24kg/m2)14例,第2组为正常体重PCOS组(BMI≤24kg/m2)22例,第3组为肥胖非PCOS组(BMI>24kg/m2)17例,第4组为正常体重非PCOS组(BMI≤24kg/m2)18例。采用酶联免疫吸附法(ELISA)测定采卵日血清和卵泡液中脂联素蛋白表达水平,逆转录聚合酶链反应(RT-PCR)半定量测定卵巢黄素化颗粒细胞脂联素、脂联素受体mRNA的表达水平。结果:两组PCOS患者血清与卵泡液中脂联素及颗粒细胞脂联素受体水平与相应对照组无差异;肥胖患者(PCOS或非PCOS)中血清脂联素与颗粒细胞脂联素受体的表达低于正常体重者(P<0.05);4组卵泡液脂联素含量明显低于血清含量(P<0.05)且两者显著相关(r=0.38,P<0.01);颗粒细胞内无脂联素mRNA的表达;PCOS患者血清脂联素与BMI负相关(r=-0.394,P<0.05),与注射HCG日>14mm卵泡数正相关(r=0.381,P<0.05);妊娠患者血清脂联素水平明显高于未妊娠者(P<0.05)。结论:人卵巢黄素化颗粒细胞有脂联素受体mRNA的表达,但不表达脂联素mRNA;脂联素及其受体表达与肥胖密切相关,与PCOS无明显相关性;采卵日血清中高水平脂联素可预示良好的IVF结局。
OBJECTIVE: To investigate the difference of adiponectin and adiponectin receptor mRNA expression in serum and follicular fluid of patients with different phenotype polycystic ovary syndrome (PCOS) and their relationship with maturation and IVF outcome Impact. Methods: A total of 71 patients with IVF-ET were randomly divided into 4 groups. Group 1 was obese PCOS group (BMI> 24kg / m2), and group 2 was normal weight PCOS group BMI≤24kg / m2). The third group was 17 cases of obese non-PCOS group (BMI> 24kg / m2), and the fourth group of 18 cases of non-PCOS group (BMI≤24kg / m2) The expression of adiponectin in sera and follicular fluid of ovums was detected by enzyme-linked immunosorbent assay (ELISA), and the levels of adiponectin, adiponectin and adiponectin in ovarian luteinized granulosa cells were determined by reverse transcription-polymerase chain reaction (RT-PCR) Receptor mRNA expression levels. Results: Adiponectin and granulocyte adiponectin levels in serum and follicular fluid of two groups of PCOS patients were similar to those of the corresponding control group. Serum adiponectin and granulocyte adiponectin in obese patients (PCOS or non-PCOS) (P <0.05). The content of adiponectin in follicular fluid of 4 groups was significantly lower than that of serum (P <0.05), and both of them were significantly correlated (r = 0.38, P <0.01) No adiponectin mRNA expression was detected in the serum of patients with PCOS. Serum adiponectin was negatively correlated with BMI (r = -0.394, P <0.05), and positively correlated with the number of follicles> 14mm on the day of HCG injection (r = 0.381, Serum adiponectin levels were significantly higher in non-pregnant patients (P <0.05). Conclusion: Human ovarian luteinized granulosa cells have adiponectin receptor mRNA expression but not adiponectin mRNA expression. The expression of adiponectin and its receptor is closely related to obesity, but not PCOS. Horizontal adiponectin predicts good IVF outcome.