摘要目的 探讨Betatrophin与多囊卵巢综合征(PCOS)患者的25羟基维生素D3[25(OH)D3]等代谢指标的关系.方法 收集24例PCOS患者及年龄性别匹配的健康对照组20例,测量其身高、体重、腰围、臀围等体测指标,计算体质指数(BMI)和腰臀比.检测25(OH)D3、Ca2+、空腹血糖、空腹胰岛素等相关代谢血生化指标,计算稳态模型胰岛素抵抗指数(HOMA-IR)值.采用酶联免疫吸附试验(ELISA)检测血清Betatrophin水平,独立样本t检验比较两组之间的差异,直线相关分析研究Betatrophin与体测及生化指标的相关性,多元线性回归分析Betatrophin的影响因素.结果 PCOS组Betatrophin水平较健康对照组低[(0.341 ±0.034) ng/ml比(0.810±0.162)ngml,t=4.271,P＜0.001],BMI[(27.691 ±4.392) kg/m2比(23.310±4.781)kg/m2,t=-2.073,P＜0.05]、空腹血糖[(5.950±0.411) mmol/L比(4.883 ±0.314) mmol/L,t=-2.142.P＜0.05]、HOMA-IR[(4.946± 0.741)比(3.387±0.397),t=-2.493,P＜0.05]、三酰甘油[(1.510±0.848) mmol/L比(1.037±0.402)mmol/L,t=-2.223,P＜0.05]、低密度脂蛋白胆固醇[(3.43 1±0.479)mmol/L比(2.396±0.435) mmol/L,t=-2.433,P＜0.05]较健康对照组高,而高密度脂蛋白胆固醇水平较低[(1.014±0.321)mmol/L比(1.419±0.287)mmol/L,t=2.218,P＜0.05].PCOS患者Betatrophin水平与HOMA-IR(r=0.425,P＜0.05)、25(OH)D3 (r=0.577,P＜0.05)和Ca2+(r=0.448,P＜0.05)呈正相关,与BMI(r=-0.451,P＜0.05)、三酰甘油(r=-0.454,P＜0.05)、LDL-C (r=-0.551,P＜0.05)呈负相关.25(OH)D3含量高的组(＞35 nmol/L)Betatrophin水平明显高于25(OH)D3含量低的组(＜35 nmol/L)[(0.539±0.092)ng/ml比(0.199 ±0.031) ng/ml,t=-3.072,P＜0.01].多元线性回归分析发现PCOS患者Betatrophin水平的主要影响因素为BMI(OR=-0.260)、HOMA-IR(OR=0.218)、25(OH)D3 (OR=0.238)、三酰甘油(OR=-0.162).结论 Betatrophin与PCOS患者胰岛素抵抗、血脂紊乱及25(OH)D3缺乏相关.

abstractsObjective Through the detection of the levels of serum betatrophin,anthropometric and biochemical indices,to determine the alteration of betatrophin levels in patients with polycystic ovary syndrome (PCOS) and the relationship between betatrophin levels and metabolic indexes such as 25-hydroxy vitamin D3 [25 (OH) D3].Methods The study group was composed of 24 women with PCOS and 20 age-natched healthy women as controls.Following general physical examination of the subjects,anthropometrie measurements were performed (height,weight,waist circumference,hip circumference).Body mass index (BMI) and waist-hip ratio were calculated;25 (OH) D3,Ca2+,fasting blood glucose,fasting insulin,triglycerides,high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C) were also measured and homeostasis model assessment of insulin resistance (HOMA-IR) were evaluated in all subjects.Serum betatrophin levels were examined with an enzyme-linked immunosorbent assay (ELISA).Using independent sample T test to compare the differences between groups,the linear correlation analysis was performed to study the correlation of betatrophin with anthropometric and biochemical indices,the influencing factors of betatrophin were analyzed by multiple linear regression.Results Circulating betatrophin levels [(0.341±0.034) ng/ml vs.(0.810±0.162) ng/ml,t=4.271,P＜0.001] and HDL-C [(1.014±0.321) mmol/L vs.(1.419±0.287) mmol/L,t=2.218,P＜0.05] significantly decreased in women with PCOS compared with controls,and BMI [(27.691±4.392) kg/m2 vs.(23.310±4.781) kg/m2,t=-2.073,P＜0.05],fasting blood glucose [(5.950±0.411) mmol/L vs.(4.883±0.314) mmol/L,t=-2.142,P＜ 0.05],HOMA-IR [(4.946 ± 0.741) vs.(3.387± 0.397),t=-2.493,P＜0.05],triglycerides [(1.510± 0.848) mmol/L vs.(1.037±0.402) mmol/L,t=-2.223,P＜0.05],LDL-C [(3.431±0.479) mmol/L vs.(2.396±0.435) mmol/L,t=-2.433,P＜0.05] were obviously increased.Moreover,there was a postive correlation between betatrophin and HOMA-IR (r=0.425,P＜0.05) as well as 25(OH)D3 (r=0.577,P＜0.05) and Ca2+ (r=0.448,P＜0.05),while the betatrophin was negatively related to BMI (r=-0.451,P＜0.05),triglycerides (r=-0.454,P＜0.05),LDL-C (r=-0.551,P＜0.05).Circulating betatrophin levels were higher when 25 (OH) D3 levels were beyond 35 nmol/L in PCOS patients [(0.539±0.092) ng/ml vs.(0.199±0.031) ng/ml,t=3.072,P＜0.001],and the multiple linear regression analysis showed that the main factors affecting the levels of betatrophin were BMI (OR=-0.260),HOMA-IR (OR=0.218),25(OH)D3 (OR=0.238),and glycerol (OR=-0.162).Conclusion It is speculated that betatrophin may be a valuable predictive factor of PCOS because betatrophin is closely associated with insulin resistance,lipid metabolism disorders and the lack of 25-hydroxy vitamin D3 in PCOS patients.