多囊卵巢综合征患者血清趋化素/内脂素比值水平及其对胰岛素抵抗的诊断价值

doi:10.3969/j.issn.1006-5725.2026.04.004

Abstract

Abstract:

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.

Key words: chemokines, lipids, polycystic ovary syndrome, insulin resistance

CLC Number:

R711.75

Yunhong JIAO,Weiliang ZHANG,Wei SONG. The diagnostic value of serum chemerin/visfatin ratio for insulin resistance in PCOS patients[J]. The Journal of Practical Medicine, 2026, 42(4): 564-570.

Figures/Tables 7

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References 27

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项目	IR组（n = 152）	非IR组（n = 112）	χ2/t值	P值
年龄/岁	33.47 ± 3.73	33.68 ± 3.56	0.461	0.645
BMI/（kg/m²）	23.07 ± 2.62	22.43 ± 2.44	2.019	0.044
文化程度/［例（%）］			0.202	0.653
高中及以下	84（55.26）	65（58.04）
大专及以上	68（44.74）	47（41.96）
居住地/［例（%）］			0.654	0.419
城镇	114（75.00）	79（70.54）
农村	38（25.00）	33（29.46）
吸烟/［例（%）］	33（21.71）	28（25.00）	0.393	0.531
饮酒/［例（%）］	39（25.66）	30（26.79）	0.491	0.483
收缩压/mmHg	138.33 ± 10.47	137.79 ± 10.14	1.174	0.242
舒张压/mmHg	88.29 ± 8.63	87.55 ± 8.44	0.695	0.487
心率/（次/min）	96.74 ± 10.22	95.49 ± 10.15	0.985	0.326
血红蛋白/（g/L）	122.58 ± 10.49	122.42 ± 10.35	0.123	0.902
血钾/（mmol/L）	3.24 ± 0.60	3.29 ± 0.63	0.655	0.513
血钠/（mmol/L）	135.44 ± 5.57	135.28 ± 5.42	0.233	0.816
血钙/（mmol/L）	2.52 ± 0.18	2.53 ± 0.17	0.457	0.648
血磷/（mmol/L）	1.36 ± 0.15	1.35 ± 0.14	0.551	0.582
ALT/（U/L）	28.57 ± 8.42	25.13 ± 7.26	3.215	0.001
Scr/（μmol/L）	89.45 ± 12.33	85.21 ± 10.87	2.847	0.005
CRP/（mg/L）	5.87 ± 2.13	3.21 ± 1.56	10.892	< 0.001
FBG/（mmol/L）	5.12 ± 0.75	4.73 ± 0.66	4.391	0.001
TC/（mmol/L）	4.68 ± 0.55	4.52 ± 0.52	2.574	0.011
TG/（mmol/L）	1.33 ± 0.29	1.25 ± 0.22	2.446	0.015
TT/（nmol/L）	3.12 ± 0.33	3.05 ± 0.26	1.859	0.064
FAI	6.85 ± 1.25	6.59 ± 1.27	1.659	0.098
卵巢体积/cm3	11.25 ± 2.45	10.81 ± 2.38	1.460	0.146
窦卵泡数/个	14.12 ± 3.21	13.53 ± 3.66	1.390	0.166
FSH/（U/L）	7.23 ± 1.66	8.15 ± 1.92	4.163	< 0.001
LH/（IU/L）	20.25 ± 3.37	18.33 ± 2.93	4.832	< 0.001
FINS/（mIU/L）	12.58 ± 3.12	8.42 ± 2.02	11.267	< 0.001
chemerin/visfatin	8.25 ± 2.27	7.13 ± 1.73	4.369	< 0.001

自变量	赋值
BMI	原值
ALT	原值
Scr	原值
CRP	原值
FBG	原值
TC	原值
TG	原值
FSH	原值
LH	原值
FINS	原值
chemerin/visfatin	原值

因素	B	SE	Wald	P值	OR	95%CI
BMI	0.096	0.060	2.548	0.110	1.101	0.978 ~ 1.239
ALT	0.071	0.038	3.427	0.064	1.074	0.996 ~ 1.158
Scr	0.405	0.299	1.840	0.175	1.500	0.835 ~ 2.695
CRP	0.041	0.029	2.003	0.157	1.042	0.984 ~ 1.103
FBG	0.830	0.220	14.263	< 0.001	2.293	1.491 ~ 3.528
TC	0.041	0.247	0.028	0.868	1.042	0.643 ~ 1.689
TG	0.562	0.549	1.047	0.306	1.754	0.598 ~ 5.144
FSH	-0.195	0.085	5.238	0.022	0.823	0.696 ~ 0.972
LH	0.165	0.050	11.138	0.001	1.180	1.071 ~ 1.300
FINS	0.052	0.037	2.809	0.094	1.053	0.992 ~ 1.118
chemerin/visfatin	0.375	0.078	23.075	< 0.001	1.455	1.249 ~ 1.696

指标	AUC	标准误差	95%CI	P值	cut-off值	约登指数	敏感度/%	特异度/%
FBG	0.658^*	0.034	0.597 ~ 0.715	< 0.001	> 5.114 mmol/L	0.283	53.29	75.00
FSH	0.601^*	0.036	0.539 ~ 0.661	< 0.001	≤ 7.880 U/L	0.222	67.76	54.46
LH	0.639^*	0.034	0.578 ~ 0.697	< 0.001	> 20.704 IU/L	0.240	42.80	81.20
chemerin/visfatin	0.684^*	0.032	0.624 ~ 0.740	< 0.001	> 8.712	0.345	53.29	81.25
联合检测	0.781	0.028	0.726 ~ 0.829	< 0.001		0.483	72.37	75.89
Z_{FBG-联合检测}	3.923
Z_{FSH-联合检测}	4.768
Z_{LH-联合检测}	4.193
Z_{chemerin/visfatin-联合检测}	3.427

The diagnostic value of serum chemerin/visfatin ratio for insulin resistance in PCOS patients

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