【摘要】：背景:多囊卵巢綜合征(polycystic ovary syndrome,PCOS)是一種常見的內(nèi)分泌、代謝紊亂疾病,多伴有肥胖表型。其發(fā)病機(jī)制尚不明確,當(dāng)前認(rèn)為是由遺傳、環(huán)境等多因素多環(huán)節(jié)共同引起。Micro RNA(miRNA)作為一種非編碼小分子單鏈RNA,主要在轉(zhuǎn)錄后水平調(diào)控基因的表達(dá)。miRNA的異常表達(dá)與多種代謝紊亂有關(guān),包括肥胖、糖尿病,以及PCOS。近來許多學(xué)者發(fā)現(xiàn)miR-21、miR-27a、miR-27b與炎癥、激素代謝、脂肪合成、肥胖、胰島素信號傳導(dǎo)有關(guān),然而目前關(guān)于miR-21、miR-27a、miR-27b的表達(dá)與PCOS患者肥胖及相關(guān)代謝紊亂的關(guān)系研究甚少。目的:研究肥胖和非肥胖型PCOS患者外周血淋巴細(xì)胞miR-21、miR-27a、miR-27b的表達(dá)水平及控制體重對其表達(dá)的影響,探討miR-21、miR-27a、miR-27b與PCOS肥胖及相關(guān)代謝紊亂(高雄激素血癥、高胰島素血癥)的關(guān)系。方法:1.納入PCOS患者60例,根據(jù)WHO對成年人體重指數(shù)(BMI)的劃分標(biāo)準(zhǔn)分為非肥胖組(BMI25kg/m2,22例)和肥胖組(BMI≥25kg/m2,38例)。2.采用電化學(xué)發(fā)光檢測PCOS患者血清促卵泡素(b FSH)、促黃體生成素(b LH)、雌二醇(b E2)、孕激素(b P)、睪酮(bT)、空腹胰島素(FINS)水平。3.采用葡萄糖氧化酶法測定PCOS患者空腹血糖(Glu)。4.應(yīng)用實時熒光定量PCR(q PCR)法檢測外周血淋巴細(xì)胞miR-21、miR-27a、miR-27b的表達(dá)水平。5.肥胖組控制體重后復(fù)測上述指標(biāo)。結(jié)果:1.肥胖組PCOS患者bT、Glu、FINS、HOMA-IR水平均顯著高于非肥胖組,且2.差異有統(tǒng)計學(xué)意義(P0.05)。3.肥胖組PCOS患者外周血淋巴細(xì)胞miR-21、miR-27a、miR-27b的表達(dá)水平明顯高于非肥胖組(2.83±0.60 vs 1.18±0.24;2.63±0.42 vs 1.13±0.19;2.74±0.49 vs1.16±0.17;P均0.05)。4.配對樣本t檢驗結(jié)果顯示肥胖組PCOS患者控制體重后b FSH、b E2、b P的水平與控制體重前相比,差異無明顯統(tǒng)計學(xué)意義(P0.05);BMI、b LH、bT、Glu、FINS、HOMA-IR水平較控制體重前顯著降低,且差異有統(tǒng)計學(xué)意義(P0.05)。5.肥胖組PCOS患者控制體重后外周血淋巴細(xì)胞miR-21、miR-27a、miR-27b的表達(dá)水平較控制前明顯降低(1.88±0.27 vs 2.81±0.61;2.16±0.39 vs 2.69±0.37;2.27±0.40 vs 2.72±0.47;P均0.05)。6.miR-21的表達(dá)量與bT呈正相關(guān)性(r=0.342,P=0.008),miR-27a、miR-27b的表達(dá)量與FINS呈正相關(guān)性(r=0.413,P=0.001;r=0.397,P=0.002)。結(jié)論:miR-21、miR-27a、miR-27b與PCOS肥胖及相關(guān)代謝紊亂(高雄激素血癥、高胰島素血癥)息息相關(guān)。miR-21可能主要與bT代謝異常有關(guān),而miR-27a、miR-27b可能主要與胰島素代謝異常有關(guān)。miR-21、miR-27a、miR-27b分別通過不同途徑參與了PCOS肥胖和高雄激素血癥、高胰島素血癥的惡性循環(huán)。
[Abstract]:Background: polycystic ovary syndrome (polycystic ovary syndrome,PCOS) is a common endocrine and metabolic disorder with obesity phenotype. Its pathogenesis is not clear, and it is currently considered to be caused by many factors, such as heredity, environment and so on. Micro RNA (miRNA), as a kind of non-coding small molecule single chain RNA, is considered to be caused by many factors, such as heredity, environment and so on. The abnormal expression of miRNA is related to a variety of metabolic disorders, including obesity, diabetes, and PCOS.. Recently, many scholars have found that miR-21,miR-27a,miR-27b is related to inflammation, hormone metabolism, fat synthesis, obesity and insulin signal transduction. However, at present, it is about miR-21,miR-27a,. There is little research on the relationship between the expression of miR-27b and obesity and related metabolic disorders in PCOS patients. Objective: to study the expression of miR-21,miR-27a,miR-27b in peripheral blood lymphocytes of obese and non-obese PCOS patients and the effect of weight control on its expression, and to explore the effect of miR-21,miR-27a,. Relationship between miR-27b and obesity and related metabolic disorders (hyperandrogenemia, hyperinsulinemia) in PCOS. Method: 1. 60 patients with PCOS were divided into non-obese group (BMI25kg/m2,22) and obese group (BMI 鈮，

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