摘要
目的探讨血清内脂素水平与多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者子宫内膜病理状态的关系,为PCOS患者子宫内膜病变的诊断提供指导。方法选取2018年1月至2019年5月在唐山市妇幼保健院收治的PCOS患者68例,根据子宫内膜病理检查结果分为非正常子宫内膜组(n=27)和正常子宫内膜组(n=41),另选同期健康体检女性30例为对照组。比较3组一般资料及性激素、血脂、胰岛功能及内脂素水平,多因素Logistic回归分析PCOS患者子宫内膜增生及癌变的独立影响因素,利用受试者工作特征(ROC)曲线分析内脂素对PCOS患者子宫内膜病变的诊断价值。结果与对照组相比,非正常子宫内膜组、正常子宫内膜组体质量指数、腰臀比、总胆固醇、甘油三酯、空腹胰岛素(fasting insulin,FINS)、胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)、胰岛β细胞分泌指数(isletsβcell secretory index,HOMA-β)、促黄体生成素、睾酮及内脂素水平均明显增高(P<0.05);与正常子宫内膜组相比,非正常子宫内膜组体质量指数、腰臀比、FINS、HOMA-IR、HOMA-β及血清内脂素水平均明显增高(P<0.05)。多因素Logistic回归分析结果显示,FINS(OR=2.125,95%CI:1.056-4.279)、HOMA-IR(OR=4.811,95%CI:1.976-11.715)、HOMA-β(OR=2.396,95%CI:1.300-4.417)及内脂素(OR=1.510,95%CI:1.186-1.921)水平均为PCOS患者发生子宫内膜增生及癌变独立危险因素(P<0.05)。ROC曲线分析,血清内脂素水平诊断PCOS患者子宫内膜增生及癌变的曲线下面积为0.839(95%CI:0.768-0.921)。结论血清内脂素水平是PCOS患者子宫内膜增生及癌变的独立影响因素,对PCOS患者子宫内膜病变的诊断有重要价值。
Objective To investigate the relationship between serum visfatin levels and endometrial pathology in patients with polycystic ovary syndrome(PCOS),to provide guidance for diagnosis of endometrial lesions in PCOS patients.Methods 68 patients with PCOS admitted to Tangshan Maternal and Child Health Hospital from January 2018 to May 2019 were enrolled.According to the results of endometrial pathology,they were divided into abnormal endometrial group(n = 27) and normal endometrium group(n = 41),30 women in the same period of healthy physical examination were selected as the control group.Compared the general information and sex hormones,blood lipids,islet function and visfatin levels of 3 groups.Multivariate logistic regression analysis was used to analyze the independent influencing factors of endometrial hyperplasia and carcinogenesis in patients with PCOS.The receiver operating characteristic(ROC) curve was used to analyze the diagnostic value of visfatin for endometrial lesions in patients with PCOS.Results Compared with control group,body mass index,waist-hip ratio,total cholesterol,triglycerides,fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR),islets β cell secretory index(HOMA-β),luteinizing hormone,testosterone and visfatin levels were significantly increased in abnormal endometrial group and normal endometrial group(P<0.05).Compared with normal endometrium group,body mass index,waist-hip ratio,FINS,HOMA-IR,HOMA-β and serum visfatin level were significantly increased in abnormal endometrial group(P<0.05).Multivariate Logistic regression analysis showed that FINS(OR = 2.125,95 % CI: 1.056-4.279),HOMA-IR(OR = 4.811,95 % CI: 1.976-11.715),HOMA-β(OR = 2.396,95 % CI:1.300-4.417) and visfatin(OR = 1.510,95 % CI: 1.186-1.921) were independent risk factors for endometrial hyperplasia and carcinogenesis in PCOS patients(P<0.05).ROC curve analysis showed that area under the curve of serum visfatin level for diagnosis of endometrial hyperplasia and carcinogenesis in PCOS patients was 0.839(95 % CI: 0.768-0.921).Conclusion Serum visfatin level is an independent influencing factor of endometrial hyperplasia and carcinogenesis in patients with PCOS,and is of great value in the diagnosis of endometrial lesions in patients with PCOS.
作者
王琳
耿女
曾彬
李翠
韩宝生
樊桂玲
WANG Lin;GENG Nv;ZENG Bin;LI Cui;HAN Baosheng;FAN Guiling(Department of Family Planning,Tangshan Maternal and Child Health Hospital,Tangshan Hebei 063000,P.R.China;Department of Reproductive Genetics,Tangshan Maternal and Child Health Hospital,Tangshan Hebei 063000,P.R.China)
出处
《中国计划生育和妇产科》
2020年第7期64-67,共4页
Chinese Journal of Family Planning & Gynecotokology
基金
河北省医学科学研究重点课题(项目编号:20181316)。
关键词
内脂素
多囊卵巢综合征
子宫内膜增生
癌变
visfatin
polycystic ovary syndrome
endometrial hyperplasia
carcinogenesis
