目的:探讨多囊卵巢综合征(PCOS)患者体成分与血清内脂素和apelin水平的关系。
方法:在这项前瞻性观察研究中,身体成分的差异,性腺激素浓度的水平,葡萄糖代谢,apelin,比较PCOS患者和对照组的内脂素水平。根据不同肥胖标准将PCOS患者进一步分为不同亚组,比较不同亚组血清内脂素和apelin水平的差异。最后,血清内脂素和Apelin水平与身体成分的相关性,并探讨PCOS患者代谢相关指标。
结果:共收集了2020年7月至2021年11月的178例PCOS患者和172例健康女性(对照组)。在PCOS患者中,他们的体重,身体质量指数(BMI),腰臀围率(WHR),无脂质量指数(FFMI)身体脂肪百分比(PBF),脂肪质量指数(FMI)PBF的手臂,腿的PBF,后备箱的PBF,内脏脂肪水平(VFL),空腹胰岛素(FINS),稳态模型对胰岛素抵抗(HOMA-IR)和促黄体生成素(LH)的评估值明显高于对照组(均P<0.001),骨骼肌百分比(PSM),腿的PSM,与对照组相比,躯干的PSM和PSM均显着降低(均P<0.001)。PCOS患者血清内脂素和apelin水平明显高于对照组(均P<0.001)。在PBF>35%的PCOS患者中,apelin和visfatin水平显著高于PBF≤35%的PCOS患者.在WHR≥0.85和BMI≥24kg/m2的PCOS患者中,内脂素水平显著高于WHR<0.85和BMI<24kg/m2的PCOS患者.血清apelin和visfatin水平与BMI呈正相关,WHR,FFMI,PBF,FMI,武器的PBF,腿的PBF,后备箱的PBF,VFL,FBG,HOMA-IR指数与PSM呈负相关,腿的PSM,和躯干的PSM(所有P<0.001)。
结论:与健康女性相比,PCOS患者身体各个部位的脂肪含量增加,减少骨骼肌含量,并经常因代谢异常而变得复杂。血清内脂素和apelin不仅与肥胖相关,脂肪量,和脂肪分布,但也与肌肉质量和分布。通过监测和管理PCOS患者的身体成分或反映PCOS的治疗效果,可能降低PCOS患者发生代谢性疾病的长期风险。
OBJECTIVE: To investigate the relationship between body composition and serum visfatin and
apelin levels in patients with polycystic ovary syndrome (PCOS).
METHODS: In this prospective observational study, the differences in body composition, levels of gonadal hormone concentrations, glucose metabolism,
apelin, and visfatin were compared between PCOS patients and the control group. PCOS patients were further divided into different subgroups according to different obesity criteria and the differences between serum visfatin and apelin levels in different subgroups were compared. Finally, the correlation of serum visfatin levels and apelin levels with body composition, and metabolism-related indicators in PCOS patients was explored.
RESULTS: A total collected 178 cases of PCOS patients and 172 cases of healthy women (control group) between 2020 July and 2021 November. In PCOS patients, their weight, Body Mass Index (BMI), Waist Hip Rate (WHR), Fat-Free Mass Index (FFMI), Percent Body Fat (PBF), Fat mass index (FMI), PBF of Arm, PBF of Leg, PBF of the Trunk, Visceral Fat Level (VFL), fasting insulin (FINS), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and Luteinizing hormone (LH) were significantly higher than in the control group (all P < 0.001), Percent Skeletal Muscle (PSM), PSM of Leg, and PSM of the Trunk were significantly decreased than in the control group (all P < 0.001). The PCOS patients had significantly higher serum visfatin levels and
apelin levels compared with the control group (all P < 0.001). In PBF > 35 % PCOS patients, the
apelin and visfatin levels were significantly higher than the PBF ≤ 35 % PCOS patients. In WHR ≥ 0.85 and BMI ≥ 24 kg/m2 PCOS patients, the visfatin levels were significantly higher than the WHR < 0.85 and BMI < 24 kg/m2 PCOS patients. Serum
apelin and visfatin positively correlated with BMI level, WHR, FFMI, PBF, FMI, PBF of arms, PBF of legs, PBF of the trunk, VFL, FBG, HOMA-IR index and negatively correlated with PSM, PSM of legs, and PSM of the trunk (all P < 0.001).
CONCLUSIONS: Compared with healthy women, Patients with PCOS have an increased fat content in various parts of the body, reduced skeletal muscle content, and are often complicated by metabolic abnormalities. Serum visfatin and apelin correlated not only with obesity, fat mass, and fat distribution but also with muscle mass and distribution. It may be possible to reduce the long-term risk of metabolic disease in PCOS through the monitoring and management of the body composition in PCOS patients or to reflect the therapeutic effect of PCOS.