关键词: α-klotho蛋白, 糖脂代谢, 胰岛素抵抗, 肥胖, 三酰甘油, 总胆固醇, 多囊卵巢综合征

Abstract:

Objective To investigate the changes in serum alpha-klotho（α-klotho） protein levels in patients with polycystic ovary syndrome（PCOS） and its relation to glucose and lipid metabolism and insulin resistance（IR）. Methods A total of 258 PCOS patients（PCOS group） and 60 healthy subjects（healthy control group） were enrolled from the Affiliated Hospital of Hebei University from May 2023 to September 2023. The levels of serum α-klotho protein，fasting plasma glucose（FPG），fasting insulin（FINS），triglyceride（TG），total cholesterol（TC），high-density lipoprotein cholesterol（HDL-C），low-density lipoprotein cholesterol（LDL-C），testosterone（T），estradiol（E₂），follicle-stimulating hormone（FSH），luteinizing hormone（LH），progesterone（P） and prolactin（PRL） were determined. The PCOS patients were classified based on body mass index（BMI） and homeostasis model assessment-insulin resistance（HOMA-IR），including PCOS non-obese non-IR group（62 cases），PCOS non-obese-IR group（59 cases），PCOS obese non-IR group（56 cases） and PCOS obese IR group（81 cases）. Multivariate linear regression analysis was used to evaluate the correlations within the PCOS group. Results The serum α-klotho protein level in PCOS group was lower than that in healthy control group（P<0.001）. There was statistical significance in BMI，waist-to-hip ratio（WHR），LH，LH/FSH ratio，T，HOMA-IR，TC，TG，HDL-C，LDL-C and α-klotho protein among all the PCOS groups and healthy control group（P<0.001）. The α-klotho protein level in PCOS non-obese non-IR group was higher than those in PCOS non-obese IR group，PCOS obese non-IR group and PCOS obese IR group（P<0.05）. The α-klotho protein levels in PCOS obese non-IR group and PCOS non-obese IR group were higher than that in PCOS obese IR group（P<0.05），and there was no statistical significance in α-klotho protein levels between PCOS obese non-IR group and PCOS non-obese IR group（P>0.05）. In all the study subjects，α-klotho protein was negatively correlated with BMI，HOMA-IR，T and LH/FSH ratio（P<0.01）. In the PCOS patients，α-klotho protein was negatively correlated with BMI，HOMA-IR，TG and TC（P<0.05），and it was positively correlated with HDL-C（P<0.01）. Conclusions The low level of α-klotho protein in PCOS patients is related to abnormal glucose and lipid metabolism and may aggravate the progression of PCOS. α-klotho protein may be a target for the diagnosis and treatment of PCOS.

Key words: Alpha-klotho protein, Glucose and lipid metabolism, Insulin resistance, Obesity, Triglyceride, Total cholesterol, Polycystic ovary syndrome