摘要目的 运用正葡萄糖高胰岛素钳夹技术评价多囊卵巢综合征(PCOS)患者白细胞介素18(IL-18)血清浓度和胰岛素抵抗的关系.方法 共收集42例PCOS患者和38例年龄和体重指数(BMI)相匹配的对照组女性的相关临床资料,并检测其血清IL-18浓度.对其中41例受试者进行正葡萄糖高胰岛素钳夹试验.计算胰岛素抵抗各相关指标[稳态期平均葡萄糖输注率(M),单位血清胰岛素浓度下葡萄糖输注率(M/I)及葡萄糖代谢清除率(MCRg)值].结果 PCOS患者血清IL-18水平显著高于对照组(P=0.033).而肥胖组与正常体重组相比,IL-18血清浓度并无显著差异(P=0.902).血清IL-18浓度与钳夹试验所得各参数呈显著负相关(与M、M/I和MCRg分别为r=-0.419、-0.396和-0.405,分别P=0.006、0.010和0.009),而与稳态模型评估β细胞功能指数(HOMA-β)指数间呈显著的正相关(r=0.334,P=0.035).结论 血清IL-18浓度在PCOS患者中显著升高,同时其值与钳夹试验所得反映胰岛素抵抗的各参数间显著负相关,提示IL-18血清浓度可能是介导体内炎症过程与胰岛素抵抗发生间的重要细胞因子.

abstractsObjective To evaluate the relationship between interleukin-18(IL-18) and insulin resistance, measured by euglycemic hyperinsulinemic clamp, in women with polycystic ovary syndrome (PCOS). Methods Forty-two young women with PCOS and 38 age-and body mass index (BMI)- matched control women were recruited in this study. A complete hormonal assay was performed and serum IL-18 level was determined in each subject. And euglycemic hyperinsulinemic clamp test was completed in 41 of the above subjects. Results Serum IL-18 levels were increased in the PCOS women, as compared with the control (P=0.033). When all subjects were divided into lean and obese groups, the IL-18 levels were slightly increased in the obese subjects (P=0.902). IL-18 levels were negatively correlated with all the clamp parameters [mean glucose infusion rate (M), M-to-insulin ratio (M/I) and glucose metabolic clearance rate (MCRg), r =-0.419,-0.396,and-0.405,P=0.006,0.010 and 0.009 respectively], but were positively associated with HOMA-β index(r=0.334, P=O.035). Conclusion Serum IL-18 level was significantly increased in PCOS women and was strongly associated with the parameters obtained from the euglycemic hyperinsulinemic clamp, indicating that IL-18 may be an important mediator between inflammation and insulin resistance.