多囊卵巢综合征患者肾素血管紧张素与雄激素及胰岛素抵抗的相关性

目的探讨多囊卵巢综合征(PCOS)患者肾素血管紧张素与雄激素及胰岛素抵抗的相关性。方法选择PCOS患者和正常对照组妇女各40例,检测血浆肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、胰岛素、血糖和性激素水平。结果①F-G评分、LH/FSH比值、T、PRA和AngⅡ浓度,空腹胰岛素(FINS)、胰岛素抵抗指数(Homa IR)、胰岛素分泌指数(Homaβ)显示,PCOS组>对照组(P<0.05);②PCOS组PRA与月经周期、AngⅡ、LH/FSH、T、FINS、Homa IR、Homaβ、β细胞功能评定指数(MBCI)呈正相关性(分别为r=0.40,0.44,0.37,0.35,0.50,0.42,0.48,0.38,P<0.05);AngⅡ与月经周期、LH/FSH比值、T呈正相关(分别r=0.34,0.32,0.42,P<0.05);AngⅡ与FSH呈负相关(r=-0.36,P<0.05)。结论①多囊卵巢综合征存在肾素-血管紧张素-雄激素级联亢进;②RAS亢进可能参与PCOS胰岛素抵抗和生育障碍的发生。

Correlation between renin angiotensin system and insulin resistance & testosterone in women with polycystic ovary syndrome

Objective To investigate the correlation between renin-angiotensin system(RAS) and testosterone,and insulin resistance in women with polycystic ovary syndrome(PCOS).Methods Plasma renin activity(PRA) and the concentrations of AngⅡ,serum FSH,LH,T,E_2,insulin and glucose were measured in 40 women with PCOS and in 40 controls.Results ① Ferriman-Gallwey score,LH/FSH,Serum T level, plasma PRA and concentration of AngⅡ were significantly higher in women with PCOS than those in healthy women ((P<0.05)).② Positive correlation was found significantly between PRA and menstrual cycles,AngⅡ,and LH/FSH,T,fasting insulin(FINS),insulin resistance index(HomaIR),Homa β,modified beta-cell function index(MBCI) in women with PCOS(r=0.40,0.44,0.37,0.35,0.50,0.42,0.48,0.38,P<0.05).Plasma angiotensin Ⅱ correlated significantly with menstrual cycles,LH/FSH, and T(r=0.34,0.32,0.42,P<0.05).There was significant negative correlation between AngⅡ and FSH(r=-0.36,P<0.05).Conclusion There is elevation of cascade from rennin angiotensin system to androgen,which may take part in insulin resistance and anovulation in women with polycystic ovary syndrome.