PCOS患者胰岛素抵抗与INSR基因甲基化状态的关系

摘要

目的 探讨多囊卵巢综合征(PCOS)患者胰岛素抵抗与INSR基因甲基化状态之间的关系.方法 PCOS患者35例,根据HOMA指数诊断胰岛素抵抗(IR)分为胰岛素抵抗组(IR组)17例和非IR组18例.对比两组之间的年龄、体质量指数(BMI)和腰臀比(WHR)、基础性激素睾酮(T)、黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)及催乳素(PRL),空腹胰岛素(FINS)和空腹血糖(FBG)和HOMA指数,利用甲基化特异性PCR技术检测两组患者子宫内膜INSR基因的DNA甲基化状态,并进行统计分析.结果 两组患者之间BMI、WHR、FINS、FBG、HOMA指数的比较差异有统计学意义(P<0.05),IR组的空腹胰岛素、BMI和WHR显著高于非IR组;两组患者之间年龄、FSH、LH、E2、T的比较差异无统计学意义(P>0.05).两组患者子宫内膜细胞提取的INSR基因经甲基化特异性PCR后,所有病例均未检出完全甲基化状态的特征条带,24例显示部分甲基化状态的特征条带,其中PCOS-IR组13例,PCOS-非IR组11例;11例显示非甲基化状态,其中PCOS-IR组4例,PCOS-非IR组7例.比较了IR组与非IR组基因部分甲基化状态发生率,未见统计学差异(P>0.05).结论 PCOS患者存在子宫内膜INSR基因的部分甲基化改变,目前还不能证实IR引起子宫内膜局部INSR基因的甲基化模式改变.%Objective To study the relationship between insulin resistance and methylation of insulin receptor (INSR) gene in the endometrium of women with polycystic ovary syndrome (PCOS). Methods Based on the HOMA index, 35 patients with PCOS were divided into insulin resistant group (IR group, n=18) and non-resistant group (NIR group, n= 18). The patients' age, serum estridol, testosterone, FSH and LH, fasting insulin and fasting blood glucose were compared between the two groups. The endometrial samples were obtained from the patients to examine DNA methylation status of INSR gene in the endometrial cells using methylation-specific PCR. Results The BMI, WHR, fasting glucose, fasting insulin, and HOMA index differed significantly between the two groups (P<0.05). PCR analysis showed partial methylation in the promoter region of INSR gene in 13 samples in IR group and 11 samples in NIR group, without detection of full methylation of the INSR gene in either group. The methylation status showed no significant difference between the two groups (P=0.328). Conclusion Partial methylation of the INSR gene occurs in the endometria of PCOS patients, but this study does not provide a strong evidence supporting the relationship between insulin resistance and INSR gene methylation in women with PCOS.