摘要
目的探讨血清白脂素(Asprosin)、微小RNA-206(miR-206)、缺血修饰白蛋白(IMA)在多囊卵巢综合征(PCOS)患者中的表达及临床意义。方法选取2019年6月—2022年6月青岛市市立医院收治的PCOS患者120例为病例组,根据体质量指数(BMI)分为超重/肥胖亚组和体质量正常亚组,再根据胰岛素抵抗指数(HOMA-IR)分为胰岛素抵抗(IR)亚组和非IR亚组,另选同期健康体检育龄妇女60例为健康对照组。检测并比较各组血清Asprosin、miR-206、IMA表达水平及与各指标的相关性,多因素Logistic回归分析PCOS患者发生IR的危险因素,受试者工作特征曲线(ROC)分析各指标对PCOS发生IR的预测价值。结果病例组BMI、HOMA-IR、总胆固醇、三酰甘油、黄体生成素、卵泡刺激素、睾酮、hs-CRP、Asprosin、IMA高于健康对照组,miR-206低于健康对照组(t=2.029、9.850、5.568、12.664、7.221、8.900、6.973、9.876、9.876、16.038、35.177,P均<0.05)。超重/肥胖亚组PCOS患者Asprosin、IMA高于体质量正常亚组(t=4.399、3.054,P均<0.01),miR-206低于体质量正常亚组(t=2.916,P<0.05)。IR亚组PCOS患者Asprosin、IMA高于非IR亚组,miR-206低于非IR亚组(t=5.467、3.514、10.158,P<0.01)。Asprosin与BMI、HOMA-IR、总胆固醇、三酰甘油呈正相关(r=0.425、0.524、0.405、0.423,P<0.01),miR-206与HOMA-IR、Asprosin、IMA呈负相关(r=-0.332、-0.415、-0.433,P<0.001),IMA与HOMA-IR、Asprosin呈正相关(r=0.624、0.394,P<0.05)。Asprosin高、miR-206低、IMA高是影响PCOS发生IR的危险因素[OR(95%CI)=2.385(1.191~4.722)、3.367(1.580~7.175)、2.153(1.053~4.404)],各指标分别及联合预测PCOS发生IR的曲线下面积(AUC)为0.761、0.894、0.667、0.918,联合预测的AUC高于Asprosin、IMA(Z=3.831、4.663,P<0.01)。结论Asprosin、IMA在PCOS患者血清中异常高表达,miR-206异常低表达,三者表达与IR程度有关,可能参与PCOS患者IR的发生发展,对预测PCOS患者发生IR具有一定价值。
Objective To explore the expression and clinical significance of serum albumin(Asposin),microRNA-206(miR-206),and ischemic modified albumin(IMA)in patients with polycystic ovary syndrome(PCOS).Methods One hundred and twenty PCOS patients admitted to Qingdao Municipal Hospital from June 2019 to June 2022 were selected as the case group.They were divided into overweight/obese subgroups and normal subgroups based on body mass index(BMI),and insulin resistance(IR)subgroups and non IR subgroups based on insulin resistance index(HOMA-IR).Additionally,60 healthy women of childbearing age during the same period were selected as the healthy control group.Detect and compare the expression levels of Asposin,miR-206,and IMA in serum of each group,and their correlation with various indicators.Multivariate logistic regression analysis was used to analyze the risk factors for IR in PCOS patients.The receiver operating characteristic curve(ROC)was used to analyze the predictive value of each indicator on the occurrence of IR in PCOS.Results The BMI,HOMA-IR,total cholesterol,triacylglycerol,Luteinizing hormone,follicle stimulating hormone,testosterone,hs CRP,Asprosin,IMA in the case group were higher than those in the healthy control group,and miR-206 was lower than that in the healthy control group(t=2.029,9.850,5.568,12.664,7.221,8.900,6.973,9.876,9.876,16.038,35.177,all P<0.05).The Asprosin and IMA levels in PCOS patients in the overweight/obesity subgroup were higher than those in the normal body mass subgroup(t=4.399,3.054,P<0.01).The Asposin and IMA levels in the IR subgroup of PCOS patients were higher than those in the non-IR subgroup,while miR-206 levels were lower than those in the non-IR subgroup(t=5.467,3.514,10.158,P<0.01).Asposin was positively correlated with BMI,HOMA-IR,total cholesterol,and triglycerides(r=0.425,0.524,0.405,0.423,P<0.01),miR-206 was negatively correlated with HOMA-IR,Asposin,and IMA(r=-0.332,-0.415,-0.433,P<0.001),and IMA was positively correlated with HOMA-IR,Asposin(r=0.624,0.394,P<0.05).High Asposin,low miR-206,and high IMA are risk factors for the occurrence of IR in PCOS[OR(95%CI)=2.385(1.191-4.722),3.367(1.580-7.175),2.153(1.053-4.404)].The area under the curve(AUC)for predicting IR in PCOS were 0.761,0.894,0.667,and 0.918,respectively,and jointly predicted AUC was higher than Asposin and IMA(Z=3.831,4.663,P<0.01).Conclusion Asposin and IMA are abnormally high expressed in the serum of PCOS patients,while miR-206 is abnormally low expressed.Their expression is related to the degree of IR and may be involved in the occurrence and development of IR in PCOS patients,which has certain value in predicting the occurrence of IR in PCOS patients.
作者
欧慧慧
胡新
李婧
张畅
Ou Huihui;Hu Xin;Li Jing;Zhang Chang(Department of Reproductive Medicine,Qingdao Hospital,University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital),Shandong Province,Qingdao 266000,China)
出处
《疑难病杂志》
CAS
2023年第10期1078-1083,1089,共7页
Chinese Journal of Difficult and Complicated Cases
