LEP、APN與多囊卵巢綜合征的相關性研究

摘要：目的 探討血清瘦素（LEP）和脂聯素（APN）與多囊卵巢綜合征（PCOS）之間的關系。方法 選擇2012年8月～2013年8月確診PCOS的女性39例作為PCOS組。因單純輸卵管因素或/及男方因素不孕就診的女性42例為非PCOS組。兩組再分肥胖組和非肥胖組。檢測早卵泡期FSH、LH、T、FPG、FINS、計算HOMA-IR。另測定血清LEP、APN，計算L/A。結果 ①PCOS組LEP水平及L/A比值顯著高于非PCOS組，兩組肥胖者均較非肥胖者升高。②PCOS組APN水平顯著低于非PCOS組，PCOS組肥胖者較非肥胖者下降。③相關性分析：所有研究對象LEP及L/A比值與HOMA-IR成正相關，APN則與之成負相關。④多元回歸分析：單獨的LEP或APN指標與PCOS的相關性均不強烈，而L/A比值則與患病有明顯相關。結論 LEP、APN可能參與PCOS的發生、發展過程，L/A比值是優于單獨的APN或LEP的一個新指標，是PCOS患病的獨立危險因素。

關鍵詞：多囊卵巢綜合征；瘦素；脂聯素；胰島素抵抗；肥胖

Abstract：Objective To investigate the development of PCOS and the influent factors among the LEP，APN.Methods 39 PCOS patients were sampled in experimental group，and 42 patients with pure tubal factor and/or male factor infertility were randomly assigned as control group.Then the two groups were divided into obese and non-obese group.The following outcomes were measured in four groups：①early follicular phase serum FSH、LH、T、FPG、FINS；and count HOMA-IR；（2）the serum LEP，APN，and count L/A ratio.Results ①the levels of LEP and the L/A ratios in PCOS patients were higher than that of the non-PCOS patients，the levels of LEP in obese patients were higher than that of non-obese patients.②the levels of APN in PCOS patients were lower than that of the non-PCOS patients.The levels of APN in obese patients were lower than that of non-obese patients in PCOS patients.③Correlation analysis：The level of LEP and L/A ratio was positively correlated with HOMA-IR.④Multivariate regression analysis：there was no significant correlation between single LEP or APN and PCOS，but the L/A ratio was significantly related with PCOS.Conclusion LEP，APN may be involved in the occurrence and development of PCOS.The L/A ratio is superior to separate APN or LEP，and it is independent risk factor for the development of PCOS disease.

Key words：Polycystic ovary syndrome；Leptin；Adiponectin；Insulin resistance；Obesity

PCOS是育齡期女性最常見的生殖內分泌疾病，其發病率約為5%～10%[1]，病因尚不明確。目前發現瘦素（LEP）和脂聯素（APN）與PCOS的胰島素抵抗（IR）關系密切。本研究采用病例對照的方法以PCOS患者為病例組，以非PCOS組女性為對照組，以是否BMI≥25將兩組再各分為肥胖組和非肥胖組。比較不同組血清瘦素、脂聯素、L/A比值的差異，研究其與IR的關系。并進行多因素回歸分析探討LEP、APN在PCOS發病中的作用，及與IR、肥胖的相關性。

1資料與方法

1.1一般資料 選擇2012年8月～2013年8月因月經異常、不孕、痤瘡、多毛等就診于門診確診的PCOS女性39例作為PCOS組。隨機抽取同期年齡、體重、體重指數（BMI）、腰圍（WC）、臀位（HC）、腰臀比（WHR）無顯著差異的，因單純輸卵管因素或/及男方因素不孕就診的女性42例為非PCOS組。……