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目的探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者视黄醇结合蛋白-4(retinol binding protein4,RBP-4)及其与各项代谢指标和性激素指标的相关性研究。方法将中山市博爱医院收治的PCOS患者36例设为观察组,正常妇女30例为对照组进行对比观察。于月经期第三天抽取空腹静脉血去血清,血浆送检验科测定血脂,其中包括总胆固醇(total cholesterol,TC),甘油三酯(triglyceride,TG),低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)和高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C);测定空腹胰岛素(insulin)及空腹血糖(fasting blood glucose,FBG)水平;测定空腹及服糖后2小时的胰岛素及血糖水平;稳态模型评估法测定的胰岛素抵抗指数(homeostasismodel of assessment for insulin resistence index,HOMA-IRI)=(空腹血糖×空腹胰岛素)/22.5。血总睾酮(total testosterone,TT)、硫酸脱氢表雄酮(dehydroepiandrosterone sulfate,DHEAS)、促黄体生成素(luteinizinghormone,LH)、卵泡生成素(follicle stimulating hormone,FSH)和雌二醇(eatradiol,E2)采用电化学发光免疫法测定。空腹血浆RBP-4浓度采用夹心酶联免疫分析法(enzyme-linked immunosorbent assay,ELISA)的方法测定。结果 PCOS组患者血清RBP-4的水平明显高于对照组(P<0.05);PCOS组患者胰岛素、FBG和HOMA-IRI的水平明显高于对照组(P<0.05),而血HDL-C的水平明显低于对照组(P<0.05);TT、DHEAS、LH/FSH和E2水平明显高于对照组(P<0.05)。PCOS组患者RBP-4水平与血清体质量指数(bodymass index,BMI)、Insulin、FBG和HOMA-IRI呈正相关,r值依次为0.32、0.27、0.25和0.31(P<0.05);PCOS组患者血清RBP-4水平与血清TT、DHEAS、LH/FSH水平有明显的正相关,r值依次为0.43、0.35和0.38(P<0.05);与E2呈负相关,r值为-0.26(P<0.05)。结论 PCOS患者血浆RBP-4水平显著升高,且血清RBP-4与BMI、FBG、insulin、HOMA-IRI,与TT、DHEAS、LH/FSH水平均有显著正相关,提示RBP-4在PCOS中具有重要意义。
Objective To investigate the relationship between retinol binding protein 4 (RBP-4) and various metabolic and sex hormonal parameters in patients with polycystic ovary syndrome (PCOS). Methods 36 patients with PCOS admitted to Pok Oi Hospital of Zhongshan City were selected as observation group and 30 normal women as control group. On the third day of the menstrual period, fasting venous blood was drawn to serum, and the plasma samples were sent to the laboratory for determination of blood lipids, including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured. Fasting blood glucose (FBG) and fasting insulin (HOMA-IRI) = (fasting blood glucose × fasting insulin) /22.5, as determined by the steady-state model assessment. Total testosterone (TT), dehydroepiandrosterone sulfate (DHEAS), luteinizing hormone (LH), follicle stimulating hormone (FSH) and estradiol E2) Electrochemiluminescence immunoassay. Fasting plasma RBP-4 concentration was measured by enzyme-linked immunosorbent assay (ELISA). Results Serum levels of RBP-4 in patients with PCOS were significantly higher than those in controls (P <0.05). The levels of insulin, FBG and HOMA-IRI in patients with PCOS were significantly higher than those in controls (P <0.05) (P <0.05). The levels of TT, DHEAS, LH / FSH and E2 were significantly higher than those of the control group (P <0.05). RBP-4 levels in patients with PCOS were positively correlated with serum BMI, Insulin, FBG and HOMA-IRI, r values were 0.32,0.27,0.25 and 0.31 (P <0.05), PCOS group serum RBP-4 levels were positively correlated with serum TT, DHEAS and LH / FSH levels, r values were 0.43,0.35 and 0.38 (P <0.05), negatively correlated with E2, r value was -0.26 ). Conclusions Serum RBP-4 levels in patients with PCOS are significantly increased. Serum RBP-4 levels are positively correlated with BMI, FBG, insulin, HOMA-IRI and TT, DHEAS and LH / FSH levels It is of great significance.