肥胖型多囊卵巢综合征的氧化应激与脂代谢关系的研究

doi:10.3969/j.issn.1006-7795.2021.04.006

摘要/Abstract

摘要： 目的探讨肥胖型多囊卵巢综合征(polycystic ovary syndrome, PCOS)患者氧化应激程度及其与脂代谢的关系。方法选取2018年8月至2018年11月就诊于首都医科大学附属北京妇产医院内分泌科的PCOS患者130例作为研究组,按体质量指数(body mass index, BMI)将PCOS患者分为3组,正常体质量PCOS组45例、超重PCOS组42例、肥胖PCOS组43例。同时选取40例因女方输卵管因素或男方因素而不孕或正常体检的体质量正常的健康育龄女性作为对照组。测量所有参与者的人体测量学指标、内分泌代谢指标及各氧化应激指标,比较各组PCOS患者与对照组各氧化应激指标的特点。结果肥胖PCOS组的丙二醛(malondialdehyde, MDA)明显高于其他3组(P<0.05)。肥胖PCOS组与超重PCOS组的超氧化物歧化酶(superoxide dismutase, SOD)、视黄醇(retinol, RET)均明显低于正常体质量PCOS组。肥胖PCOS组与超重PCOS组的总抗氧化活性(total antioxidant activity,TAA)与维生素E(vitamin E, VE)均明显低于正常体质量对照组(P<0.05)。氧化指标MDA与BMI、总胆固醇(total cholesterol, TC)、三酰甘油(triglyceride,TG)呈正相关(P<0.05),而抗氧化指标SOD及RET与BMI、腰围、TC、TG均呈负相关(P<0.05)。线性回归分析显示,MDA、RET及VE均受分组变量影响,MDA随着本研究BMI分组的递增而升高,回归系数为0.214(P=0.005),RET及VE均随着本研究BMI分组的递增而降低,回归系数分别为-0.243(P=0.001)、-0.174 (P=0.023)。而SOD及TAA均随着TG增加而降低,回归系数分别为-0.411(P＜0.001)、-0.269(P＜0.001)。结论氧化应激在肥胖型PCOS患者发病中的作用更明显,肥胖型PCOS患者抗氧化能力的降低与三酰甘油升高相关,提示肥胖可能通过脂代谢紊乱加重PCOS患者的氧化应激过程。

关键词: 多囊卵巢综合征, 氧化应激, 肥胖, 脂代谢

Abstract: Objective To explore the degree of oxidative stress in obese patients with polycystic ovary syndrome(PCOS) and its relationship with lipid metabolism. Methods From August 2018 to November 2018, 130 cases of PCOS patients in the Gynecological Endocrinology Department of Beijing Gynecology Hospital, Capital Medical University were selected as study group and 40 healthy women with normal weight who were infertile because of fallopian tube factor or male factor or normal physical examination were selected as control group at the same time. According to the body mass index (BMI), PCOS was divided into three groups, with 45 cases in the PCOS group with normal weight, 42 cases in the PCOS group with overweight, and 43 cases in the PCOS group with obesity. The anthropometric indexes, endocrine indexes, metabolic and oxidative stress indexes of all participants were measured. The characteristics of oxidative stress indicators were compared between the PCOS patients and the control group. Results The malondialdehyde (MDA) of the PCOS group with obesity was significantly higher than the other three groups (P<0.05). The superoxide dismutase (SOD) and retinol (RET) of the PCOS group with obesity and the PCOS group with overweight were significantly lower than those of the PCOS group with normal weight. The total antioxidant activity (TAA) and vitamin E (VE) of the PCOS group with obesity and the PCOS group with overweight were significantly lower than those of the control group with normal weight (P<0.05). The oxidation index MDA was positively correlated with BMI, total cholesterol (TC), and triglyceride (TG) (P<0.05), while the antioxidant index SOD and RET were negatively correlated with BMI, waist circumference (WC), TC, and TG (P<0.05). Linear regression analysis indicated that MDA, RET and VE were all affected by group variable. The MDA increased with the increase of the groups according to BMI, with a regression coefficient of 0.214 (P=0.005), The RET and VE decreased with the increase of the groups according to BMI, with a regression coefficient of -0.243 (P=0.001) and -0.174 (P=0.023). The SOD and TAA decreased with the increase of TG, and the regression coefficients were -0.411 (P＜0.001) and -0.269 (P＜0.001), respectively. Conclusion The oxidative stress was an obvious factor in the pathogenesis of PCOS patients with obesity. The decrease of the antioxidant capacity in PCOS patients with obesity was related to the increase of TG, suggesting that obesity may aggravate the oxidative stress process of PCOS patients through lipid metabolism disorders.

Key words: polycystic ovary syndrome, oxidative stress, obesity, pathogenesis

中图分类号:

R711.75

王虎生, 阮祥燕, 程姣姣, Alfred O. Mueck. 肥胖型多囊卵巢综合征的氧化应激与脂代谢关系的研究[J]. 首都医科大学学报, 2021, 42(4): 540-546.

Wang Husheng, Ruan Xiangyan, Cheng Jiaojiao, Alfred O. Mueck. Study on the relationship between oxidative stress and lipid metabolism in obese women with polycystic ovary syndrome[J]. Journal of Capital Medical University, 2021, 42(4): 540-546.

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