血清OC、TSP-1、ANGPTL2与多囊卵巢综合征患者胰岛素抵抗、性激素和卵巢间质血流的关系研究

摘要 目的：分析血清骨钙素（OC）、血小板反应蛋白-1（TSP-1）、血管生成素样蛋白2（ANGPTL2）与多囊卵巢综合征（PCOS）患者胰岛素抵抗（IR）、性激素和卵巢间质血流的关系。方法：选取2020年1月～2022年4月内蒙古自治区人民医院收治的125例PCOS患者（PCOS组），根据稳态模型评估（HOMA）-IR分为IR组68例和非IR组57例，另选取同期67例体检健康成年女性（对照组）。收集研究对象HOMA-IR和性激素、卵巢间质血流指标，采用酶联免疫吸附法检测血清OC、TSP-1、ANGPTL2水平。比较PCOS组与对照组、IR组与非IR组之间性激素、卵巢间质血流指标、血清OC、TSP-1、ANGPTL2水平的差异。采用Pearson/Spearman相关性分析法分析PCOS患者血清OC、TSP-1、ANGPTL2水平与HOMA-IR、性激素和卵巢间质血流指标的相关性。结果：PCOS组HOMA-IR、黄体生成素（LH）、LH/促卵泡生成素（FSH）、睾酮（T）、收缩期峰值速度（PSV）、ANGPTL2水平高于对照组，搏动指数（PI）和阻力指数（RI）、OC、TSP-1水平低于对照组（P＜0.05）。IR组LH、LH/FSH、T、PSV、ANGPTL2水平高于非IR组，PI、RI、OC、TSP-1水平低于非IR组（P＜0.05）。Pearson/Spearman相关性分析显示，PCOS患者血清OC、TSP-1水平与HOMA-IR、LH、LH/FSH、T、PSV呈负相关，与PI、RI呈正相关（P＜0.05）；血清ANGPTL2水平与PCOS患者HOMA-IR、LH、LH/FSH、T、PSV呈正相关，与PI、RI呈负相关（P＜0.05）。结论：血清OC、TSP-1在PCOS患者血清中低表达，ANGPTL2在PCOS患者血清中高表达，三者与PCOS患者IR、性激素和卵巢间质血流密切相关。

Relationship Study between Serum OC, TSP-1, ANGPTL2 and Insulin Resistance, Sex Hormone and Ovarian Interstitial Blood Flow in Patients with Polycystic Ovary Syndrome

ABSTRACT Objective: To analyze the relationship between serum osteocalcin (OC), thrombospondin-1 (TSP-1) and angiopoietin-like protein 2 (ANGPTL2) and insulin resistance (IR), sex hormones and ovarian interstitial blood flow in patients with polycystic ovary syndrome (PCOS). Methods: 125 patients with PCOS who were admitted to People''s Hospital of Inner Mongolia Autonomous Region from January 2020 to April 2022 (PCOS group) selected, and they were divided into IR group with 68 cases and non-IR group with 57 cases according to homeostasis model assessment (HOMA)-IR, another 67 healthy adult women (control group) were selected during the same period. HOMA-IR, sex hormone and ovarian interstitial blood flow indexes of research subjects were collected, and serum OC, TSP-1 and ANGPTL2 levels were detected by enzyme linked immunosorbent assay. The differences of sex hormone, ovarian interstitial blood flow indexes, serum OC, TSP-1 and ANGPTL2 levels between PCOS group and control group, IR group and non-IR group were compared. Pearson/Spearman correlation analysis was used to analyze the correlation between serum OC, TSP-1, ANGPTL2 levels and HOMA-IR, sex hormone and ovarian interstitial blood flow indexes in patients with PCOS. Results: The HOMA-IR, luteinizing hormone (LH), LH/ follicle-stimulating hormone (FSH), testosterone (T), peak systolic velocity (PSV) and ANGPTL2 levels in PCOS group were higher than those in control group, while the pulsatile index (PI), resistance index (RI), OC and TSP-1 levels were lower than those in control group (P<0.05). The LH, LH/FSH, T, PSV and ANGPTL2 in IR group were higher than those in non-IR group, while the PI, RI, OC and TSP-1 levels were lower than those in non-IR group (P<0.05). Pearson/Spearman correlation analysis showed that serum OC and TSP-1 levels were negatively correlated with HOMA-IR, LH, LH/FSH, T and PSV in patients with PCOS, but positively correlated with PI and RI (P<0.05). Serum ANGPTL2 level was positively correlated with HOMA-IR, LH, LH/FSH, T and PSV in patients with PCOS, and negatively correlated with PI and RI (P<0.05). Conclusion: Serum OC and TSP-1 are low expression in patients with PCOS, while ANGPTL2 is high expression in patients with PCOS, which are closely related to IR, sex hormone and ovarian interstitial blood flow.