【摘要】 目的探讨纤溶酶原激活物抑制因子1(PAI-1)基因启动子区4G及5G的多态基因型分布,及其与多囊卵巢综合征(PCOS)发病的关系。方法应用聚合酶链反应-限制性片段长度多态性技术,检测101例PCOS患者(PCOS组)与42例因男性或单纯输卵管因素不孕患者(对照组)PAI-1基因启动子区4G基因型及5G多态基因型分布,测定并计算两组患者的体重指数、胰岛素抵抗指数、胰岛素敏感指数及自然流产数等临床指标。根据体重指数将PCOS患者分为肥胖者(48例)与非肥胖者(53例)。结果PCOS组PAI-1基因启动子区4G基因型频率为57%(58/101),对照组为38%(16/42);PCOS组5G基因型频率为43%(43/101),对照组为62%(26/42)。两组4G及5G基因型频率分别比较,差异均有统计学意义(P<0.05)。肥胖者胰岛素抵抗指数、胰岛素敏感指数与非肥胖者比较,差异均有统计学意义(P<0.05,P<0.01)。肥胖者4G基因型频率为48%(23/48),非肥胖者为68%(36/53);肥胖者5G基因型频率为52%(25/48),非肥胖者为32%(17/53)。两者4G及5G基因型频率分别比较,差异均有统计学意义(P<0.05)。27例有妊娠史的PCOS患者中,自然流产14例,4G基因型频率为79%(11/14),5G基因型频率为21%(3/14);无自然流产13例,4G基因型频率为38%(5/13),5G基因型频率为62%(8/13),两者4G与5G基因型频率分别比较,差异均有统计学意义(P<0.05)。结论PAI-1基因启动子区4G基因型频率高,可能与PCOS的发病,尤其是与非肥胖者发生PCOS有关,并与PCOS患者的自然流产率高有关。更多还原

【Abstract】 Objective To investigate the correlation of 4G and 5G genetypes distribution of plasminogen activator inhibitor-1(PAI-1) gene polymorphism in its promoter region with polycystic ovary syndrome (PCOS). Methods In 101 Chinese PCOS patients and 42 women as control, 4G and 5G polymorphisms of PAI-1 gene were detected with PCR-restriction fragment length polymorphism (RFLP). Pregnant history, body mass index(BMI), waist-hip ratio(WHR) were collected and Homastasis Model Assessment score for insulin resistant(Homa-IR)and insulin sensitive index(ISI) in PCOS groups were calculated . Results The distributions of PAI-1 gene polymorphisms 4G type (4G/4G genetype) and 5G type (5G/5G,4G/5G genetype) were different between the PCOS group and the control. The PCOS group had higher 4G type 57%(58/101) distribution than that of the control group 38%(16/42);5G type is vise verse ( P <0.05). PCOS patients were divided into obese and non-obese sub-groups according to BMI. There were significant lower Homa -IR and higher ISI in non-obese subgroup than that in obese group( P <0.05 ; P <0.01). 68% (36/53)4G type distribution in the non-obese is higher than that [48%(23/48)] in obese sub-group( P <0.05). There were higher 4G type distribution 79% (11/14)and lower 5G type distribution 21%(3/14) in spontaneous miscarriage group than that of in non-spontaneous miscarriage group 38%(5/13) and 62%(8/13) among patients who impregnated at least once ( n =27, P < 0.05). Conclusion PAI-1 gene polymorphism 4G genetype may be correlated with PCOS in Chinese women, especially in PCOS patients with non-obese PCOS and spontaneous miscarriage.更多还原