【摘要】 目的:通过研究肥胖型多囊卵巢综合征(PCOS)纤溶酶原激活物抑制因子1(PAI-1)基因启动子区4G/5G多态性的分布及其与胰岛素敏感性、PAI-1水平的相互关系,以期找到治疗肥胖型PCOS的新方法。方法:选取135例PCOS患者和124例正常对照者,计算体重指数(BMI)和腰臀比(WHR);PCOS组又根据体质指数(BMI值)分出肥胖型与非肥胖型两组。用PCR方法测定PAI-1基因启动子区4G/5G基因多态性分布;ELISA法检测血浆PAI-1水平、空腹胰岛素(INS)、空腹血糖(G),并计算胰岛素抵抗指数(Homa-IR)、胰岛素敏感指数(ISI)。结果:4G/5G基因多态性分布在PCOS组和正常对照组间有显著差异,PCOS组中4G/4G基因型频率47.41%高于正常对照组的16.13%,比较差异有统计学意义(P<0.05)。PCOS组PAI-1水平高于对照组,肥胖型PCOS组PAI-1水平、WHR、空腹INS、Homa-IR均高于非肥胖组,比较差异均有统计学意义(P<0.05),但两组间4G/5G基因型分布无显著性差异。结论:PCOS尤其是肥胖型PCOS有较高的PAI-1水平。PAI-1基因启动子区4G等位基因可增加血浆PAI-1水平。PAI-1基因启动子区4G基因型频率高可能和PCOS发病有关,但与PCOS肥胖发病无关。抗PAI-1的研究可能提供一个新的治疗肥胖型PCOS的方法。更多还原

【Abstract】 Objective:To investigate the prevalence of 4G/5G polymorphism of plasminogen activator inhibitor-1(PAI-1)gene in obese polycystic ovary syndrome(PCOS)and their relationships between insulin sensitivity and plasma fibrinolysis function,to find a new way to prevent obesity and insulin resistance of obese PCOS.Method:135 patients and 124 controls were selected.Body mass index(BMI)and waist-to-hip(WHR) ratio were determined.Based on the BMI,the PCOS patients were divided into two groups:74 patients without obesity and 61 patients with obesity.Blood samples were obtained for DNA analysis.PAI-1 plasma levels,fasting insulin and fasting glucose were measured by the ELISA in all subjects.The 4G/5G polymorphic site of the PAI-1 gene promoter region was amplified by the polymerase chain reaction(PCR).We evaluate insulin resistance with Homa- IR and measure insulin sensitivityindex(ISI).Result:Comparison of the clinical data:BMI,WHR,fasting insulin,Homa-IR in patients with obesity were significant greater than those in patients without obesity,the difference was statistically significant between the groups( P <0.05);The PCOS group had significantly higher 4G/4G than the control group,whereas there were significantly less 5G/5G.PCOS women have higher levels of PAI-1 compared with the control group( P <0.05).There was no statistical difference of genotype distribution between patients with obesity and patients without obesity, whereas there was a statistically significant difference in the PAI-1 levels among the groups( P <0.05).Conclusion:The presence of the 4G allele in PAI-1 promoter region of the gene further increases the PAI-1 levels.PAI-1 gene polymorphism 4G genetype may be correlated with PCOS in Chinese women.PAI-1 gene polymorphism 4G genetype may be not correlated with obesity of PCOS in Chinese women.Anti-PAI-1 study may be a new way to prevent obesity and insulin resistance of obese PCOS.更多还原