国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2013, Vol. 32 ›› Issue (1): 16-19.

• 论著 • 上一篇    下一篇

代谢综合征对女性生育功能的影响及相关机制研究

孙 挺, 李 蓉, 郝桂琴, 耿 岚, 郭梁洁   

  1. 518036 广东深圳，北京大学深圳医院（孙 挺，李 蓉，郝桂琴，耿 岚，郭梁洁）；汕头大学医学院（孙 挺）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2013-01-15 发布日期:2013-01-15
  • 通讯作者: 李 蓉

Effect of Metabolic Syndrome on Female Reproductive Function

SUN Ting，LI Rong，HAO Gui-qin，GENG Lan，GUO Liang-jie   

  1. Peking University Shenzhen Hospital，Shenzhen 518036，Guangdong Province，China（SUN Ting，LI Rong，HAO Gui-qin，GENG Lan，GUO Liang-jie）；Shantou University Medical College，Shantou 515041，Guangdong Province，China（SUN Ting）
  • Received:1900-01-01 Revised:1900-01-01 Published:2013-01-15 Online:2013-01-15
  • Contact: LI Rong

PDF (PC)

7396

摘要： 目的：探讨卵巢颗粒细胞中胰岛素受体底物2（IRS-2）、过氧化物酶体增殖物激活受体γ（PPAR-γ）基因表达与不孕症及代谢综合征（MS）发病之间的关系。方法：MS未用药组27例，经饮食指导、加强锻炼及运用降脂、降糖药物等治疗后达标者为MS用药组13例，非MS正常体质量指数妇女30例作为对照组，采用半定量竞争性反转录聚合酶链反应（RT-qPCR）检测3组妇女卵巢颗粒细胞中IRS-2、PPAR-γ mRNA的表达水平。结果：对照组促性腺激素（Gn）用量低于MS未用药组和MS用药组，MS未用药组人绒毛膜促性腺激素（hCG）日雌二醇（E2）水平低于MS用药组和对照组，MS未用药组hCG日子宫内膜厚度大于对照组。MS未用药组的获卵数、MⅡ期卵细胞数均少于其余2组。3组患者D3优质胚胎率、胚胎移植率、临床妊娠率、流产率和活产率差异均无统计学意义（P＞0.05）。3组IRS-2、PPAR-γ mRNA的相对表达水平相比，差异均有统计学意义（P＜0.05）。结论：MS患者IRS-2、PPAR-γ mRNA的功能缺陷，导致局部存在胰岛素抵抗，进而导致女性生殖功能降低。

关键词: 代谢综合征X, 受体, 胰岛素, 过氧化物酶体增殖物激活受体, 卵巢

Abstract: Objective：To compare the expressions of IRS-2，PPAR-γ mRNAs in the granular cells from patients with metabolic syndrome （MS） and normal women，and explore the relation between MS and infertility. Methods：Twenty-seven patients with MS were regarded as group A，13 patients with MS who reached the standards of blood fat and sugar by combination therapy with food，sport and drugs as group B，and 30 women without MS as the control group. Quantitative RT-qPCR was used to detect the expression of IRS-2，PPAR-γ mRNAs in the granular cells. Results：The dose of Gn of the control group was significantly lower than those of group A and Group B. （Endometrial thickness on the day of hCG injection of group A was significantly higher than those of group B and control group.） E2 level on the day of hCG injection of group A was also significantly lower. Total numbers of retrieved oocyte and mature oocyte of group A were significantly lower than those of group B and control group. However，there were not significant differences in the high-quality embryo rates，implantation rates，clinic pregnancy rates，live birth rates and miscarriage rates among three groups（P＞0.05）. There were significant differences in those parameters among three groups （P＜0.01）. Conclusions：The elevated expressions of IRS-2 and PPAR-γ mRNAs could be related with the local insulin resistance，which could play a role in the pathological mechanism of female reproductive disorders.

Key words: Metabolic syndrome X, Receptor, insulin, Peroxisome proliferator-activated receptors, Ovary