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

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(0H)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/0B组)37例,非肥胖对照组(NC组)33例.测定血清25(0H)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)和高密度脂蛋白胆固醇(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HOMA-IR指数评估胰岛素抵抗(Insulin resistance,IR)程度.结果 OW/OB+ PCOS组25(OH)D3、HDL-C均较OW/0B组显著降低,而TG、Fins、HOMA-IR均较OW/OB组显著增高(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均显著增高(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则均显著增高(P＜0.05);④相关分析示25(0H)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.%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 (HD)L-C) and sex hormone levels were determined.The IR index was calculated by the homeostasis model assessment method (HOMA-IR).Results Compared 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 these in PCOS group,patients in OW/OB + PCOS group had reduced 25 (OH) D3 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.