Diabetes and Metabolism Journal

  • 제30권2호
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  • Pages.104-111
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  • 2006
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  • 2233-6079(pISSN)
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  • 2233-6087(eISSN)
대한당뇨병학회 (Korean Diabetes Association)
권호 표지

다낭성 난소증후군 환자의 아디포넥틴, TNF-$\alpha$, IL-6 농도와 인슐린저항성의 관계

Serum Adiponectin, TNF-$\alpha$, IL-6 and Insulin Resistance in Women with Polycystic Ovary Syndrome

김영아;노정현;김동준;엄태현;조종래;장나영;권수경;이순희;박정현;고경수;이병두;임경호
Kim, Young-A;Noh, Jung-Hyun;Kim, Dong-Jun;Um, Tae-Hyun;Cho, Chong-Rae;Jang, Na-young;Kwon, Soo-Kyung;Lee, Soon-Hee;Park, Jeong-Hyun;Ko, Kyung-Soo;Rhee, Byoung-Doo;Lim, Kyung-Ho

  • 발행 : 2006.03.31
⟨ 이전 논문 다음 논문 ⟩

초록

연구배경: 다낭성 난소증후군 (PCOS)은 특징적으로 인슐린저항성이 잘 동반되는 것으로 알려져 있으나 그 기전은 정확히 밝혀져 있지 않으며, 아디포카인이 PCOS에서 비만과 무관하게 인슐린저항성과 관련이 있는지에 대해서는 논란이 있다. 따라서 저자들은 한국인 PCOS 환자에서 혈중 아디포카인 농도가 인슐린저항성과 연관이 있는지를 알아보고자 하였다. 방법: 13명의 비만한 PCOS환자, 15명의 비만하지 않은 PCOS환자, 8명의 비만한 대조군, 8명의 비만하지 않은 대조군에서 혈청 아디포넥틴, TNF-$\alpha$, IL-6와 인슐린 감수성 지표를 측정하여 이들의 상호관계를 관찰하였다. 결과: HOMA-IR은 비만한 PCOS군과 비만한 대조군 사이에서는 차이가 없었으나 비만하지 않은 PCOS군에서는 비만하지 않은 대조군에 비하여 높았다. 아디포넥틴 농도는 PCOS군과 대조군 모두 비만한 경우 낮게 나타났으나 아디포넥틴, TNF-$\alpha$ 및 IL-6 농도는 비만한 PCOS군과 비만한 대조군 사이에 차이가 없었으며, 비만하지 않은 PCOS군과 비만하지 않은 대조군 사이에서도 차이가 없었다. PCOS군에서 아디포넥틴 농도는 BMI, 허리둘레, 지방량, 공복 인슐린 농도 및 HOMA-IR과 음의 상관관계가 있었다. 그러나 대조군에서는 아디포넥틴 농도가 다른 변수와 상관관계를 보이지 않았다. 아디포넥틴을 종속변수로 한 다중회귀분석에서는 이변량 상관관찰에서 상관관계를 보이던 공복 인슐린 농도와 HOMA-IR은 의미가 없었다. TNF-$\alpha$와 IL-6 농도는 PCOS군과 대조군에서 모두 다른 변수들과 상관관계를 보이지 않았다. 비만하지 않은 PCOS군에서 이변량 상관관찰에서 HOMA-IR과 상관관계가 있는 변수는 허리둘레, 지방량 등이었으며, QUICKI는 BMI, 허리둘레, SHBG 등과 의미 있는 상관관계를 보였다. 결론: PCOS에서 비만도와 독립적으로 인슐린저항성을 보이지만, 혈중 아니포넥틴, TNF-$\alpha$ 및 IL-6 농도는 비만도에 의존적이며, PCOS 유무가 혈중 아디포카인 농도에 직접적인 영향을 미치지 않는 것으로 생각된다.

Background: To determine plasma adipokines such as adiponectin, IL-6 and TNF-$\alpha$ concentrations in women with and without polycystic ovary syndrome (PCOS) and to assess possible correlations of adipocytokines to the hormonal and metabolic parameters, including measures of insulin resistance (IR). Methods: Forty-four selected women were classified as follows: 13 obese (body mass index [BMI] $\geq$25 kg/m$^2$) with PCOS; 15 non-obese (BMI < 25 kg/m$^2$) with PCOS; 8 obese without PCOS, and 8 non-obese without PCOS. Blood samples were collected from all women with or without PCOS after an overnight fast. Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone, 17-$\alpha$-hydroxyprogesterone, dehydroepiandrosterone sulfate (DHEA-S), sex hormone-binding globulin (SHBG), insulin, glucose, adiponectin, TNF-$\alpha$ and IL-6 were measured. Measures of IR included HOMA-IR and QUICKI. Results: In non-obese group, fasting insulin levels and HOMA-IR in PCOS were significantly higher compared to control. However, Adiponectin, TNF-$\alpha$ and IL-6 concentrations were found not to be different in obese women with PCOS as compared with obese women without PCOS and in non-obese women with PCOS as compared with non-obese women without PCOS. Adiponectin concentrations correlated inversely with BMI, waist circumference (WC), total fat mass, serum insulin, and HOMA-IR in PCOS group. However, multiple regression analysis showed that BMI was the only independent determinant of adiponectin concentration. Conclusion: Our results suggest that insulin sensitivity per se probably does not play any role in the control of adipokines levels such as adiponectin, TNF-$\alpha$ and IL-6 in PCOS women

키워드

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