摘要目的 分析多囊卵巢综合征(PCOS)患者血清瘦素水平及其与胰岛素抵抗的相关性,探讨二甲双胍对PCOS不孕患者的临床疗效.方法 选取86例PCOS患者和100例非PCOS健康体检者为研究对象,均分为肥胖患者和非肥胖者,调查BMI、血清瘦素、FPG、胰岛素和胰岛素抵抗指数(IR),并分析其相关性.PCOS患者随机分为A组和B组(二甲双胍治疗组),观察二甲双胍对PCOS不孕患者的临床疗效.结果 PCOS患者血清瘦素、胰岛素水平和IR均明显高于对照组,差异有统计学意义(P＜0.001).PCOS患者中胰岛素抵抗者的瘦素水平显著高于非胰岛素抵抗者,差异有统计学意义(P＜0.001);瘦素水平与BMI、胰岛素和IR均呈正相关(P＜0.05),与FPG无明显相关性(P＞0.05).B组患者排卵率(58.1％)、妊娠率(25.6％)明显高于A组(分别为27.9％、9.3％),差异均有统计学意义(P＜0.05).结论 PCOS患者瘦素和胰岛素水平均明显升高,瘦素水平升高是肥胖的内在表现,胰岛素抵抗与瘦素抵抗可同时存在,血清瘦素与BMI、胰岛素和IR呈明显正相关.二甲双胍可显著提高PCOS不孕患者的排卵率和妊娠率.

abstractsObjective To analyze the level of serum leptin and its relations with insulin resistance in patients with polycystic ovary syndrome (PCOS) so as to investigate the clinical effect of aciesis in PCOS under treatment of metformin.Methods 86 cases with PCOS (observation group) and 100 non-PCOS women (as controls) were chosen as the objects for the study.Body mass index (BMI),serum leptin,fasting blood glucose,insulin and IR index were measured and the relativity analyzed.PCOS patients were randomly divided into group A and group B,with clinical effect of metformin observed.Results Both serum leptin and insulin levels and the IR index in observation group were significantly higher than those in the control group (P＜0.001).In the PCOS group,leptin levels in patients with insulin resistance was significantly higher than that in patients who were without (P＜0.001).The leptin levels were positive correlated to BMI,insulin and IR index (P＜ 0.05),but not to fasting plasma glucose (P＞0.05).The rate of ovulation was 58.1％ in group B,much higher than that in group A 27.9％ (P＜0.05).The rate of pregnancy as 25.6％ in group B was also much higher than that in group A 9.3％ (P＜0.05).Conclusion In patients with PCOS,the levels of leptin and insulin were significantly elevated if the elevation of leptin levels was inherent in obesity.Both resistances on insulin and leptin might exist at the same time.The serum leptin was positively correlated with BMI,insulin and IR index.It seemed worthwhile to treat the patients with metformin in aciesis of PCOS to improve both the rates on ovulation and pregnancy.