目的 探讨多囊卵巢综合征（PCOS）患者血清趋化素（chemerin）/内脂素（visfatin）比值水平及其对胰岛素抵抗（IR）的诊断价值。 方法 选取2022年1月至2024年12月医院收治的264例PCOS患者为对象，根据稳态模型评估胰岛素抵抗指数（HOMA-IR）将患者分为非IR组（HOMA-IR < 2.69）和IR组（HOMA-IR ≥ 2.69）。对比两组患者临床资料、糖脂代谢、性激素及chemerin/visfatin，采用多因素logistic回归分析PCOS患者发生IR的影响因素。受试者工作曲线（ROC曲线）评估相关指标对PCOS患者发生IR的价值。 结果 共有152例患者发生IR，IR样本内检出率为57.58%。根据HOMA-IR将患者分为非IR组（n = 112）和IR组（n = 152）；IR组体质量指数（BMI）、谷丙转氨酶（ALT）、血肌酐（Scr）、C反应蛋白（CRP）、空腹血糖（FBG）、总胆固醇（TC）、甘油三酯（TG）、黄体生成素（LH）、chemerin/visfatin水平高于非IR组，促卵泡生成素（FSH）低于非IR组（P < 0.05）；排除混杂因素后，logistic多因素回归分析发现，FBG、LH、chemerin/visfatin是PCOS患者发生IR的危险因素，FSH是保护因素（P < 0.05）；ROC曲线分析显示，FBG、FSH、LH、chemerin/visfatin联合检测评估PCOS患者发生IR的AUC值高于单项检测（Z = 3.923、4.768、4.193、3.427，P < 0.05）。 结论 chemerin/visfatin与PCOS患者发生IR密切相关，联合FBG、FSH、LH评估PCOS患者发生IR的价值较高。

Objective To explore the level of the serum chemerin/visfatin ratio in patients with polycystic ovary syndrome （PCOS） and its diagnostic value for insulin resistance （IR）. Methods 264 PCOS patients admitted to the hospital from January 2022 to December 2024 were selected as the subjects. According to the steady-state model evaluation of insulin resistance index （HOMA-IR）， the patients were divided into non IR group （HOMA-IR < 2.69） and IR group （HOMA-IR ≥ 2.69）. Clinical data， glucose-lipid metabolism parameters， sex hormone levels， and serum Chemerin and Visfatin levels were compared between the two patient groups. Multivariate logistic regression identified the risk factors for insulin resistance in PCOS patients. Receiver Operating Curve （ROC） is used to evaluate the value of relevant indicators for the occurrence of IR in PCOS patients. Results A total of 152 patients developed IR in the hospital， with a detection rate of 57.58% in IR samples. According to HOMA-IR， patients were divided into non IR group （n = 112） and IR group （n = 152）； The body mass index （BMI）， alanine aminotransferase （ALT）， serum creatinine （Scr）， C-reactive protein （CRP）， fasting blood glucose （FBG）， total cholesterol （TC）， triglycerides （TG）， luteinizing hormone （LH）， and chemerin/visfatin levels in the IR group were higher than those in the non IR group， while follicle stimulating hormone （FSH） levels were lower than those in the non IR group （P < 0.05）； logistic multiple regression analysis found that FBG， LH， chemerin/visfatin are risk factors for IR in PCOS patients， while FSH is a protective factor （P < 0.05）； ROC curve analysis showed that the AUC value of combined detection of FBG， FSH， LH， chemerin/visfatin in evaluating the occurrence of IR in PCOS patients was higher than that of single detection （Z = 3.923， 4.768， 4.193， 3.427， P < 0.05）. Conclusion chemerin/visfatin is closely related to the occurrence of insulin resistance in PCOS patients， and the combined use of FBG， FSH， and LH has high value in evaluating the occurrence of insulin resistance in PCOS patients.