【摘要】 目的 研究血清脂联素（APN）、内脂素（visfatin）、结合珠蛋白（Hp）水平与多囊卵巢综合征（PCOS）患者胰岛素抵抗（IR）指数的临床意义。方法 选择2018年2月至2021年3月南阳市中心医院诊治的102例PCOS患者，分为肥胖组（BMI≥23 kg/m2,47例）和非肥胖组非肥胖组（BMI<23 kg/m2,55例）、IR组（HOMA-IR≥2.69,52例）和非IR组（HOMA-IR<2.69,50例），另选择同期健康志愿者96例作为对照组。检测不同人群血清APN、visfatin、Hp水平，分析三者与IR指数关系及对IR的预测价值。结果 FPG、黄体生成素（LH）、visfatin、Hp、HOMA-IR、空腹胰岛素（FINS）、LH/卵泡雌激素（FSH）和体质量指数（BMI）水平：肥胖组>非肥胖组>对照组，APN水平：肥胖组<非肥胖组<对照组，差异均有统计学意义（P<0.05）。血清APN水平与HOMA-IR呈负相关（P<0.05）,visfatin、Hp水平与HOMA-IR呈正相关（P<0.05）。IR组患者BMI、FPG、LH、visfatin、Hp、HOMA-IR和FINS水平均显著高于非IR组，APN水平显著低于非IR组，差异均有统计学意义（P<0.05）。BMI、APN、visfatin、Hp均为诱发PCOS患者IR发生的危险因素（P<0.05）。血清APN、visfatin、Hp三者联合的曲线下面积（AUC）值以及特异度均高于单一指标预测（P<0.05）。结论 PCOS患者均存在血清APN、visfatin、Haptoglobin水平的异常变化，三者有可能参与PCOS患者IR的发生发展，有望通过上述血清指标预测IR的发生。更多还原

【Abstract】 Objective To study the clinical significance of serum adiponectin(APN),visfatin(visfatin),haptoglobin(Hp)and insulin resistance(IR)index in patients with polycystic ovary syndrome(PCOS). Methods 102 patients with PCOS diagnosed and treated in Nanyang Central Hospital between February 2018 and March 2021 were selected. They were divided into the obesity group and the non-obesity group,the IR group and the non-IR group. Meanwhile,96 healthy volunteers were selected as the control group. The levels of serum APN,visfatin and Hp in different groups were detected. The correlation between the three indicators and IR index,and their predictive value for IR were analyzed. Results The levels of fasting plasma glucose(FPG),luteinizing hormone(LH),visfatin,Hp,HOMA-IR,fasting insulin(FINS),LH/follicle-stimulating hormone(FSH)and body mass index(BMI)decreased in sequence,while APN level increased in sequence from the obesity group,the non-obesity group to the control group,with statistically significant differences among the groups(P<0.05). Serum APN level was negatively correlated with HOMA-IR(P<0.05),while the levels of visfatin and Hp were positively correlated with it(P<0.05). The levels of BMI,FPG,LH,visfatin,Hp,HOMA-IR and FINS in the IR group were significantly higher than those in the non-IR group,while APN level was significantly lower than that in the non-IR group,with statistically significant differences(P<0.05). BMI,APN,visfatin and Hp were risk factors of IR in patients with PCOS(P<0.05). The area under the curve(AUC)value and specificity of serum APN combined with visfatin and Hp were higher than that of single indicator(P<0.05). Conclusion There are abnormal changes in serum APN,visfatin,and Haptoglobin levels in PCOS patients. These three may be involved in the occurrence and development of IR in PCOS patients. It is expected that the above serum indicators can predict the occurrence of IR.更多还原