生殖医学杂志

目的探讨长链非编码RNA(lncRNA)人类母系表达基因3(MEG3)的表达与多囊卵巢综合征(PCOS)患者胰岛素抵抗(IR)的关系。方法选取2018年7月至2020年8月本院收治的123例PCOS患者为研究对象进行前瞻性分析,根据胰岛素抵抗指数(HOMA-IR)水平分为IR组(n=54)和非IR组(n=69),另选取同期在本院体检的健康女性85例为对照组。检测各组患者的血脂、血糖水平以及相关激素水平;采用实时荧光定量PCR(qRT-PCR)法检测血清中lncRNA MEG3表达水平;通过Logistic回归分析PCOS患者IR发生的影响因素。利用受试者工作特征曲线(ROC)评价血清lncRNA MEG3水平对PCOS患者IR的诊断价值。结果 3组中血清lncRNA MEG3表达水平比较,IR组显著低于非IR组和对照组,非IR组显著低于对照组(P<0.05)。Pearson相关分析表明lncRNA MEG3水平与腰臀比(WHR)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素(FINS)、睾酮(T)、HOMA-IR水平呈负相关(P<0.05),与高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBG)、雌二醇(E₂)水平呈正相关(P<0.05)。多因素回归分析显示,lncRNA MEG3为PCOS患者发生IR的影响因素(P<0.05)。血清lncRNA MEG3水平预测PCOS患者IR发生的曲线下面积(AUC)为0.946[95%CI(0.889,0.978)],对应的敏感度为98.15%,特异度为85.51%。结论 PCOS患者血清中lncRNA MEG3呈低水平表达,且其表达水平与HOMA-IR呈负相关;lncRNA MEG3可能影响PCOS患者IR的发生。

Objective:To investigate the relationship between the expression of long non-coding RNA(lncRNA) human maternal expression gene 3(MEG3) and insulin resistance(IR) in the patients with polycystic ovary syndrome(PCOS). Methods:A total of 123 PCOS patients admitted to our hospital from July 2018 to August 2020 were recruited and divided into IR group(n=54) and non-IR group(n=69) according to the level of insulin resistance index(HOMA-IR). And 85 healthy women who received physical examinations in our hospital during the same period served as controls(control group). Blood lipid level, blood glucose level and related hormone levels were determined, and real-time fluorescent quantitative PCR(qRT-PCR) was employed to detect the expression of lncRNA MEG3 in serum. Logistic regression was used to analyze the factors affecting occurrence of IR in PCOS patients. Receiver operating characteristic curve(ROC) was used to evaluate the diagnostic value of serum lncRNA MEG3 level for IR in PCOS patients. Results:The serum lncRNA MEG3 level in IR group was significantly lower than those in non-IR group and control group(P<0.05),and that in non-IR group was significantly lower than that in control group(P<0.05). Pearson correlation analysis showed that serum lncRNA MEG3 level was negatively correlated with waist to hip ratio(WHR),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),fasting insulin(FINS),testosterone(T) and HOMA-IR levels(P<0.05),while positively correlated with high-density lipoprotein cholesterol(HDL-C),fasting blood glucose(FBG),and E₂ levels(P<0.05). Multivariate regression analysis showed that lncRNA MEG3 was an influencing factor for IR in PCOS patients(P<0.05). The area under the ROC curve(AUC) of serum lncRNA MEG3 level for predicting IR in PCOS patients was 0.946[(95%CI(0.889,0.978)],and the corresponding sensitivity was 98.15% and specificity was 85.51%.Conclusions:The expression of lncRNA MEG3 in the serum of PCOS patients was low, and its expression level was negatively correlated with HOMA-IR. LncRNA may affect the occurrence of IR in PCOS patients.