摘要目的: 探究多囊卵巢综合征(PCOS)患者血清Nesfatin-1、Omentin-1的表达及其与胰岛素抵抗(IR)的关系。方法: 选取2023年1月至2024年6月于本院进行治疗的PCOS患者93例作为研究组,根据稳态模型胰岛素抵抗指数(HOMA-IR)分为合并IR组42例和非IR组51例,选择同期健康体检人员58例作为对照组,并收集一般资料。使用全自动生化分析仪分析血清生化指标,使用ELISA法对血清Nesfatin-1和Omentin-1进行检测,使用Pearson相关性分析研究组血清Nesfatin-1、Omentin-1水平以及与IR相关指标的相关性,采用Logistic回归分析PCOS患者IR的影响因素,利用ROC曲线分析血清空腹胰岛素(FINS)、Nesfatin-1和Omentin-1水平对PCOS患者IR的诊断价值。结果: 研究组的BMI(27.55±2.46 VS 23.28±2.07)、腰臀比(0.86±0.13 VS 0.78±0.11)、FBG(4.79±1.23 VS 3.64±0.72)、FINS(13.49±2.56 VS 9.62±2.05)、HOMA-IR(2.93±0.74 VS 1.56±0.31)、TC(4.36±0.93 VS 3.95±0.85)、TG(2.26±0.55 VS 1.46±0.26)和LDL-C(2.95±0.45 VS 2.48±0.39)明显高于对照组,HDL-C(1.14±0.25 VS 1.28±0.29)、Nesfatin-1(18.27±4.39 VS 29.83±6.88)和Omentin-1(64.59±8.39 VS 82.16±14.88)的表达水平均明显低于对照组(t=2.722~13.373,P<0.05)。非IR组的BMI(26.23±2.04 VS 28.64±2.37)、腰臀比(0.82±0.09 VS 0.89±0.11)、FBG(3.88±0.86 VS 5.54±1.14)、FINS(11.76±1.55 VS 14.91±2.24)、HOMA-IR(2.03±0.64 VS 3.67±0.92)、TC(4.15±0.69 VS 4.53±0.77)、TG(2.06±0.38 VS 2.42±0.50)和LDL-C(2.83±0.31 VS 3.05±0.37)明显低于合并IR组,HDL-C(1.27±0.22 VS 1.03±0.18)、Nesfatin-1(20.65±3.16 VS 16.31±2.87)和Omentin-1(71.94±7.72 VS 58.54±6.97)明显高于合并IR组(t=2.481~9.765,P<0.05)。Pearson分析显示,血清Nesfatin-1、Omentin-1水平与BMI、腰臀比、FBG、FINS、TG和LDL-C呈现负相关(r=-0.429、-0.495、-0.447、-0.378、-0.439,P<0.05)(r=-0.408、-0.508、-0.435、-0.632、-0.412、-0.419,P<0.05),和HDL-C呈现正相关(r=0.445,P<0.05)(r=0.429,P<0.05),Nesfatin-1和Omentin-1水平呈现正相关(r=0.485,P<0.05);Logistic分析显示,FINS[OR/95%CI=2.631(1.051-6.584)]、Nesfatin-1[OR/95%CI=0.589(0.430-0.808)]和Omentin-1[OR/95%CI=0.697(0.541-0.898)]是PCOS患者IR的影响因素(P<0.05);ROC分析表明,FINS、Nesfatin-1和Omentin-1水平分别诊断PCOS患者IR的AUC为0.866,0.871,0.869,三者联合诊断的AUC为0.953,明显高于单独诊断的AUC(Z三者联合-FINS=2.069,P=0.039;Z三者联合-Nesfatin-1=2.037,P=0.042;Z三者联合-Omentin-1=1.998,P=0.046)。结论: PCOS患者Nesfatin-1和Omentin-1水平下调,其水平变化与IR密切相关,两因子联合FINS检测对PCOS合并IR有较高的诊断价值。
Abstract：Objective: To investigate the expression of serum Nesfatin-1 and Omentin-1 in patients with polycystic ovary syndrome (PCOS) and their relationship with insulin resistance (IR). Methods: From January 2023 to June 2024, 93 PCOS patients who received treatment in our hospital were included as the study group. According to the steady-state model of insulin resistance index (HOMA-IR), they were separated into a combined IR group of 42 cases and a non IR group of 51 cases. 58 healthy individuals who underwent physical examinations were included as the control group, and general data were collected. Fully automatic biochemical analyzer was applied to analyze serum biochemical indicators. ELISA method was applied to detect serum Nesfatin-1 and Omentin-1. Pearson correlation was applied to analyze the serum levels of Nesfatin-1 and Omentin-1 in the study group, and their correlation with IR related indicators. Logistic regression was applied to analyze the influencing factors of insulin resistance in PCOS patients. ROC curve was applied to analyze the diagnostic value of serum fasting insulin (FINS), Nesfatin-1, and Omentin-1 levels for insulin resistance in PCOS patients. Results: Compared to the control group, the research group exhibited significantly higher BMI (27.55±2.46 VS 23.28±2.07), waist-to-hip ratio (0.86±0.13 VS 0.78±0.11), FBG (4.79±1.23 VS 3.64±0.72), FINS (13.49±2.56 VS 9.62±2.05), HOMA-IR (2.93±0.74 VS 1.56±0.31), TC (4.36±0.93 VS 3.95±0.85), TG (2.26±0.55 VS 1.46±0.26), and LDL-C (2.95±0.45 VS 2.48±0.39). Meanwhile, the expression levels of HDL-C (1.14±0.25 VS 1.28±0.29), Nesfatin-1 (18.27±4.39 VS 29.83±6.88), and Omentin-1 (64.59±8.39 VS 82.16±14.88) were notably lower in the research group than in the control group (t=2.722~13.373, P＜0.05). The BMI (26.23±2.04 VS 28.64±2.37), waist-to-hip ratio (0.82±0.09 VS 0.89±0.11), FBG (3.88±0.86 VS 5.54±1.14), FINS (11.76±1.55 VS 14.91±2.24), HOMA-IR (2.03±0.64 VS 3.67±0.92), TC (4.15±0.69 VS 4.53±0.77), TG (2.06±0.38 VS 2.42±0.50), and LDL-C (2.83±0.31 VS 3.05±0.37) in the non-IR group were significantly lower than those in the combined IR group. Meanwhile, HDL-C (1.27±0.22 VS 1.03±0.18), Nesfatin-1 (20.65±3.16 VS 16.31±2.87), and Omentin-1 (71.94±7.72 VS 58.54±6.97) were significantly higher in the non-IR group than in the combined IR group (t=2.481~9.765, P＜0.05). Pearson analysis revealed that serum levels of Nesfatin-1 and Omentin-1 were negatively correlated with BMI, waist-to-hip ratio, FBG, FINS, TG, and LDL-C (r=-0.429, -0.495, -0.447, -0.378, -0.439, P<0.05) (r=-0.408, -0.508, -0.435, -0.632, -0.412, -0.419, P<0.05), positively correlated with HDL-C (r=0.445, P<0.05) (r=0.429, P<0.05), and positively correlated between Nesfatin-1 and Omentin-1 levels (r=0.485, P<0.05). Logistic analysis indicated that FINS [OR/95% CI=2.631 (1.051~6.584)], Nesfatin-1 [OR/95% CI=0.589 (0.430~0.808)], and Omentin-1 [OR/95% CI=0.697 (0.541~0.898)] were influencing factors of insulin resistance (IR) in patients with polycystic ovary syndrome (PCOS)(P<0.05). ROC analysis showed that the AUC of FINS, Nesfatin-1, and Omentin-1 levels for diagnosing IR in PCOS patients was 0.866, 0.871, and 0.869, respectively. The AUC of the combined diagnosis of the three was 0.953, which was obviously higher than that of the individual diagnosis (Z triple combination - FINS=2.069, P=0.039; Z triple combination - Nesfatin-1=2.037, P=0.042; Z triple combination - Omentin-1=1.998, P=0.046). Conclusion: Patients with Polycystic Ovary Syndrome (PCOS) exhibit downregulation of Nesfatin-1 and Omentin-1 levels, and their changes are closely correlated with insulin resistance (IR). The combined detection of these two factors and fasting insulin (FINS) levels holds high diagnostic value for PCOS combined with IR.
魏馨怡, 杨晓红, 罗宁. 多囊卵巢综合征患者血清Nesfatin-1 Omentin-1的表达及其与胰岛素抵抗的关系[J]. 河北医学, 2025, 31(9): 1573-1579.
WEI Xinyi, et al. The Expression of Serum Nesfatin-1 and Omentin-1 in Patients with Polycystic Ovary Syndrome and Their Relationship with Insulin Resistance. HeBei Med, 2025, 31(9): 1573-1579.
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2025, Vol. 31 
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