多囊卵巢综合征患者血清25(OH)D3与糖脂代谢的相关性研究
Research on the relationship between serum 25 hydroxyvitamin D3 and glucolipid metabolism in patients with polycystic ovary syndrome
  
DOI:10.3969/j.issn.1006.7108.2017.10.008
中文关键词:  多囊卵巢综合征  肥胖  超重  25羟维生素D3  胰岛素抵抗
英文关键词:Polycystic ovary syndrome  Obesity  Overweight  25-hydroxyvitamin D3  Insulin resistance
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作者单位
廖鑫1 张琳1 张晗1 阳琰1 高琳1* 张开羽2 李思成1 李豪鹏1 廖玉兰1 1.贵州省遵义市遵义医学院附属医院内分泌科,贵州 遵义563099 2.贵州省湄潭县人民医院,贵州 遵义564100 
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中文摘要:
      目的 观察多囊卵巢综合征(Polycystic ovary syndrome,PCOS)患者血清25羟维生素D3[25 hydroxyvitamin D,25( OH) D3 ]水平,探讨PCOS患者维生素D对糖脂代谢的影响。方法 选取2015年12月至2016年9月我院住院及门诊新诊断的70 例PCOS患者及70例年龄及体重指数均匹配的健康对照者。根据BMI分为四组:超重/肥胖PCOS组(OW/OB + PCOS组)36 例,非肥胖PCOS组(PCOS组)34例,超重/肥胖对照组(OW/OB组)37例,非肥胖对照组(NC组)33例。测定血清25(OH) D3、空腹血糖(FPG)、总胆固醇(TC )、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和髙密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(HbAlc)、空腹胰岛素(Fins)、性激素水平,采用稳态模型TOMA-IR指数评估胰岛素抵抗(Insulin resistance,IR)程度。 结果 ①OW/OB +PCOS组25(OH)D3、HDL-C均较OW/OB组显著降低,而TG、Fins、HOMA-IR均较OW/OB组显著增髙(P < 0. 05);②OW/OB +PCOS 组 25(OH)D3、HDL-C 均较 PCOS 组显著减低、而 TG、Fins、HOMA-IR 均显著增髙(P <0. 05) ;③PCOS 组25(OH)D3、HDL-C较NC组均显著减低,而TG、Fins、HOMA-IR、LH、TES则均显著增髙(P < 0. 05);④相关分析示25(OH) D3 水平与 BMI、FINS、HOMA-IR、TG 呈负相关(r = -0. 208,P =0.034; r = -0.918,P =0.000; r = -0. 799,P =0.000; r =-0.683,P = 0.002),与HDL-C呈正相关(r =0.585,P =0.001)。结论 PCOS患者血清25(OH)D3水平减低与肥胖和脂代谢紊乱密切相关。
英文摘要:
      Objective To observe the levels of serum 25 hydroxyvitamin D3 [ 25 (OH) D3] in patients with polycystic ovary syndrome (PCOS) and to investigate the association of vitamin D with glucose and lipid metabolism in PCOS patients. Method A total of 70 patients with newly-diagnosed PCOS from January 2015 to September 2016 were enrolled,and 70 age and body mass index (BMI) - matched healthy controls were also enrolled in the study. According to BMI,the subjects were divided into four groups : Overweight/obese PCOS group (OW/OB + PCOS group,n =36),non-obese PCOS group (PCOS group,n =34), overweight/obese control group (OW/OB group,n = 37),non-obese control group (NC group n =33). Serum 25 (OH) D3 and glycosylated hemoglobin ( HbAlc),fasting blood glucose (FPG),fasting insulin (FINS),total cholesterol ( TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) and sex hormone levels were determined. The IR index was calculated by the homeostasis model assessment method (HOMA-IR). Results ①Compared with those in OW/OB group,patients in OW/OB + PCOS group had decreased 25( OH) D3 and HDL-C (P <0. 05),but elevated TG,Fins,HOMA-IR,LH and TES levels(P <0. 05).② Compared with those in PCOS group,patients in OW/OB + PCOS group had reduced 25 ( OH) and HDL-C ( P <0. 05),but elevated TG, FINS, HOMA-IR, LH and TES levels ( P <0. 05).③ Compared with those in NC group,patients in POCS group had significantly decreased 25 (OH) D3 and HDL-C (P < 0. 05),but significantly increased TG,FINS,HOMA-IR,LH and TES levels (P < 0. 05).④ Correlation analysis showed that 25 ( OH) D3 levels were negatively correlated with BMI,FINS,HOMA-IR and TG (r = -0. 208,P =0. 034 ; r = -0. 918,P =0. 000 ; r =- 0. 799,P =0. 000 ; r = -0. 683,P =0. 002),and was positively correlated with HDL-C (r =0. 585,P =0. 001). Conclusion The decrease of serum 25(OH) D3 level in patients with PCOS is closely related to obesity and lipid metabolism disorder.
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