脂质蓄积指数与血清ApoB/ApoA1比值对多囊卵巢综合征合并代谢综合征的预测价值

    Predictive value of the ratio of LAP to serum ApoB/ApoA1 in polycysticovarian syndrome combined with metabolic syndrome

    • 摘要:
      目的探讨并比较脂质蓄积指数(LAP)与血清载脂蛋白B(ApoB)与载脂蛋白A1(ApoA1)比值(ApoB/ApoA1)对多囊卵巢综合征(PCOS)合并代谢综合征(MS)预测价值。
      方法选取PCOS病人136例作为研究对象,按是否合并MS分为合并组和非合并组。收集2组病人体格指标、糖脂代谢指标及内分泌相关指标,计算LAP与血清ApoB/ApoA1值。对比2组各指标的差异,分析LAP、血清ApoB/ApoA1值与其他指标的相关性,采用受试者工作特征曲线(ROC)分析其对PCOS合并MS的预测诊断价值。
      结果合并组和非合并组在年龄、黄体生成素(LH)、催乳素(PRL)、雌激素(E2)、总胆固醇(TC)上比较差异均无统计学意义(P>0.05),合并组的腰围(WC)、舒张压(SBP)、收缩压(DBP)、体质量指数(BMI)、促卵泡激素(FSH)、睾酮(T)、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、ApoB/ApoA1、LAP高于非合并组,高密度脂蛋白胆固醇(HDL-C)低于非合并组,差异有统计学意义(P < 0.01)。ApoB/ApoA1、LAP与年龄、WC、SBP、DBP、BMI、FSH、PRL、E2、T、FPG、FINS、HOMA-IR、TC、TG、LDL-C均呈正相关关系(P < 0.01)。ApoB/ApoA1与LAP诊断PCOS合并MS的ROC曲线下面积(AUC)分别为0.780和0.845,ApoB/ApoA1的特异度和灵敏度分别为50.0%和100.0%,LAP的特异度和灵敏度分别为67.5%和99.0%。二者联合诊断PCOS合并MS的AUC为0.818,特异度和灵敏度分别为55.0%和100.0%,其预测效能低于LAP,高于ApoB/ApoA1。
      结论LAP与血清ApoB/ApoA1比值可作为预测诊断PCOS合并MS的重要指标,其中LAP诊断PCOS合并MS的可信度高于ApoB/ApoA1。

       

      Abstract:
      ObjectiveTo explore and compare the predictive value of the ratio of lipid accumulation product(LAP) to serum ApoB/ApoA1 in polycysticovarian syndrome(PCOS) combined with metabolic syndrome(MS).
      MethodsA total of 136 PCOS patients were selected as the research objects.According to the diagnosis of MS, patients were divided into the combined group and non-combined group.Physical indexes, glycolipid metabolism indexes and endocrine related indexes were collected to calculate the ratio of LAP to serum ApoB/ApoA1.The differences between the two groups and the correlation between LAP, serum ApoB/ApoA1 ratio and other indexes were compared.The ROC curve was used to analyze the predictive diagnostic value of LAP and serum ApoB/ApoA1 ratio for PCOS combined with MS.
      ResultsThere was no significant difference in age, LH, PRL, E2 and TC between the two groups(P>0.05).The WC, SBP, DBP, BMI, FSH, T, FPG, FINS, HOMA-IR, TG, LDL-C, ApoB/ApoA1 and LAP in the combined group were higher than those in the non-combined group, and the HDL-C was lower than that in the non-combined group(P < 0.01).The results of correlation analysis showed that ApoB/ApoA1 and LAP were positively correlated with age, WC, SBP, DBP, BMI, FSH, PRL, E2, T, FPG, FINS, HOMA-IR, TC, TG and LDL-C(P < 0.01).The AUC of ApoB/ApoA1 and LAP were 0.780 and 0.845 respectively.The specificity and sensitivity of ApoB/ApoA1 were 50.0% and 100.0%, respectively, and the specificity and sensitivity of LAP were 67.5% and 99.0%, respectively.The AUC of PCOS combined with MS was 0.818, the specificity and sensitivity were 55.0% and 100.0%, respectively.The prediction efficiency was lower than LAP and higher than ApoB/ApoA1.
      ConclusionsThe ratio of LAP and serum ApoB/ApoA1 can be used as an important index to predict the diagnosis of PCOS combined with MS, and the reliability of LAP in the diagnosis of PCOS combined with MS is higher than ApoB/ApoA1.

       

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