摘要
目的:探讨多囊卵巢综合征(PCOS)患者瘦素(Leptin)水平的变化及其相关影响因素,观察了解复方醋酸环丙孕酮(Diane-35)以及复方醋酸环丙孕酮(Diane-35)联合二甲双胍对并发高胰岛素血症(HI)的PCOS患者Leptin及其他代谢指标的影响。方法:检测50例PCOS患者与20例正常对照者血清中Leptin浓度以及黄体生成素(LH)/卵泡刺激素(FSH)比值、睾酮(T)、空腹血糖(FPG)、空腹胰岛素(FINS)浓度,并进行比较。然后将其中26例合并HI的PCOS患者随机分为A、B组,A组用复方醋酸环丙孕酮(Diane-35)治疗,B组用复方醋酸环丙孕酮+二甲双胍(Met)治疗,各3个月,比较治疗前后上述指标的变化。结果:PCOS患者Leptin、LH/FSH、T、FINS浓度高于对照组,差异有统计学意义(P<0.05);Leptin水平与BMI、FINS呈正相关(P<0.05),与T及LH/FSH无相关性;治疗前,A、B组年龄、BMI、Leptin、LH/FSH、T、FINS差异均无统计学意义(P>0.05);治疗后,A组T、LH/FSH下降显著(P<0.05),BMI、Leptin、FINS差异无统计学意义(P>0.05);B组Leptin、FINS、T、LH/FSH均降低(P<0.05),BMI虽有降低但差异无统计学意义(P>0.05);B组Leptin、FINS、T、LH/FSH较A组低(P<0.05),BMI虽有降低,但差异无统计学意义(P>0.05)。结论:PCOS患者存在Leptin水平异常,Leptin与PCOS胰岛素抵抗、高胰岛素血症密切相关。Diane-35联合二甲双胍可有效降低合并HI的PCOS患者血清中Leptin、FINS及T水平,治疗效果优于单用Diane-35。
Objective： To evaluate levels of leptin in PCOS and note any relationships with insulin resistance and sex hormone. Investigate the effects of Diane- 35 and metformin to the leptin and insulin level of women with PCOS and hyperinsulinemia. Methods： Fifty patients with PCOS and twenty age and body mass index-matched controls were included in the study. In all patients, serum concentration of leptin, fasting plasma glucose, fasting insulin, T, FSH and LH were measured to compare and investigate the relationship of leptin to insulin and sex hormone. Then divide the 26 women with PCOS and hyperinsulinmia into A and B groups. Group A were treated with Diane- 35. Group B were treated with both Diane- 35 and metformin. All were treated 3 months. Compare the changes of those indexes before and after the treatement. Results： Serum leptin, fasting insulin levels, LH/FSH, and T in PCOS were significantly higher than those in control group （P 〈0.05）, Serum leptin was positively correlated with BMI and fasting insulin （P〈0.05）. Before treatment, age, BMI, Leptin, FINS, T, LH/FSH was not significant different between group A and B （P 〉0.05）. After treatment, （1） In group A, T, LH/FSH was significant lower （P 〈0.05）, the change of BMI, Leptin, FINS were not significant different （P 〉0. 05） ; （2） In group B, Leptin, FINS, T, LH/FSH were all significant lower （P 〈0.05）, though BMI decreased, but this change was not significant （P 〉0.05） ; （3） FINS, T, LH/FSH in group B were significant lower than group A （P 〈0.05）. Conclusion： The leptin concentration is abnormal in PCOS women. Leptin is close related to insulin resistance and hyperinsulinmia in PCOS. Diane-35 combined with metformin can effectively decrease the levels of Leptin, FINS, T in women with PCOS and hyperinsulinmia, Its therapy result is better than only using Diane-35.
出处
《新疆医科大学学报》
CAS
2008年第7期821-823,共3页
Journal of Xinjiang Medical University
