多囊卵巢综合征患者血清维生素 D 水平与肥胖、胰岛素抵抗的相关性分析

摘要

Objective To investigate the correlation of serum vitamin D with obesity and insulin resistance in patients with polycystic o-vary syndrome.Methods 1 1 8 cases with polycystic ovary syndrome admitted to our hospital during December 201 3 to March 201 5 were included in this study (i.e.,PCOS group).Meanwhile,80 cases of normal menstruation women in the same period were chosen as control group.The levels of 25 -(OH)D in serum,obesity -related indexes (i.e.,BMI,waist/hip ratio,leptin)and insulin resistance related indexes (i.e.,insulin,HOMA -IR,HOMA -β,QUICKI)were compared between these two groups.Also,the correlation of 25-(OH)D with indexes of obesity and insulin resistance were analysed.Results Serum 25 -(OH)D level and QUICKI in the PCOS group were significantly lower than the control group,while BMI,waist/hip ratio,leptin,insulin,HOMA -IR and HOMA -βin the P-COS group were higher than the control group,showing statistically significant difference (P <0.05).25 -(OH)D levels and QUICKI in different body mass indexes in the PCOS group were lower than the control group.And insulin levels,HOMA -IR and HOMA -βwere higher (P <0.05).25 -(OH)D levels of patients with insulin resistance in the PCOS group were lower than patients without in-sulin resistance (P <0.05).And BMI,waist/hip ratio and leptin in the PCOS group were higher than patients without insulin resistance (P <0.05).Correlation analysis showed that serum vitamin D levels were positively correlated with QUICKI but significantly negatively correlated with BMI,waist/hip ratio,leptin,insulin,HOMA -IR and HOMA -β.Conclusions Serum vitamin D levels showed signifi-cantly negative correlation with obesity and insulin resistance in patients with polycystic ovary syndrome.All of the three factors were closely related to the occurrence of polycystic ovary syndrome.%目的：探讨多囊卵巢综合征患者（PCOS）血清维生素 D 水平与肥胖、胰岛素抵抗的相关性分析。方法选择2013年12月—2015年3月该院妇产科就诊的118例 PCOS 为研究对象（PCOS 组），选择同期进行健康体检、月经正常的80例育龄期妇女为对照组，比较两组患者的血清25－（OH）D 水平、肥胖相关指标（BMI、腰围／臀围比值、瘦素）、胰岛素抵抗相关指标（胰岛素、HOMA －IR、HOMA －β、QUICKI），分析血清25－（OH）D 水平与肥胖相关指标和胰岛素抵抗相关指标的相关性。结果PCOS 组血清25－（OH）D 的水平和 QUICKI 指数均明显低于对照组，而 PCOS 组中 BMI 指数、腰围／臀围比值、瘦素水平、胰岛素水平、HOMA －IR 和 HOMA －β均高于对照组，差异均具有统计学意义（P ＜0．05）。不同体质量指数的 PCOS 组25－（OH） D 水平和 QUICKI 指数均低于对照组，胰岛素水平、HOMA －IR 和 HOMA －β均高于对照组，差异均具有统计学意义（P ＜0．05）。PCOS 组中胰岛素抵抗患者25－（OH）D 水平低于非胰岛素抵抗患者，BMI 指数、腰围／臀围比值、瘦素水平均高于非胰岛素抵抗患者（P ＜0．05）。相关性的分析结果显示，血清维生素 D 水平与 QUICKI 指数呈明显正相关，而与 BMI 指数、腰围／臀围比值、瘦素水平、胰岛素水平、HOMA －IR 和 HOMA －β均呈明显的负相关。结论PCOS 血清维生素 D 水平与肥胖和胰岛素抵抗均呈明显的负相关，三者与 PCOS 的发生密切相关。