| Objective: the molecular mechanism of endometrial insulin resistance in patients withPCOStheir polymorphism of IRS1Gly972Arg and the expression of endometrial IRS1and ofendometrial IRS1protein and of endometrial IRS1tyrosine phosphorylationwere divided intoinsulin resistance (IR)and without IR by oral glucose tolerance test (OGTT) and insulinrelease test (IRT).Methods: Collected73PCOS when they were seeking medical advice. They weredivided into two groups,46PCOS with IR and27PCOS without IR Measuredserum-sexual-hormon,body mass index (BMl), oral glucose torlerance test (OGTT) andinsulin release test (IRT),Gly972 Arg polymorphism,the expression of IRS-1wereanalyzed by immunohistochemistry,used Western blot method to detect IRS-1protein and itstyrosine phosphorylation in endometrial.Results:(1)46cases with IR in73patients,the incidence rate of IR is63%.(2) The clinical features of body weight, BMI, waist circumference and WHR, acanthosisnigricans syndrome in PCOS, the difference between the IR and without IR was statisticallysignificant, while hirsutism score between the two groups had no significant difference.(3) The sex hormone index showed no significant difference between two groups. In which21cases with hyperandrogenemia in the IR group, the difference was statistically significant.(4) IRS-1Gly972Arg DNA sequencing results: in73cases of PCOS, genotype GG71cases, genotype GA2cases, IR group and IR group with1cases in each group, two groupswere not statistically significant, and genotype AA was not founded.(5) The expression of endometrial tissue IRS-1, IRS-1protein and IRS-1tyrosinephosphorylation:①The expression of endometrial tissue IRS-1, the gray of PCOS with IR and withoutIR scale values respectively (131.94+18.39),(78.16+6.87), the difference was statisticallysignificant (P<0.01). ②The expression of endometrial protein of IRS-1by Western blot, IRS-1proteinscanning density value is: PCOS without IR (4.4±0.29)×107, PCOS with IR (2.5±0.81)×107,the difference was statistical significance.③The expression of endometrial IRS-1tyrosine phosphorylation by Western Blot, IRS-1tyrosine phosphorylation scanning density value is: PCOS without IR (1.7±0.35)×107, PCOSwith IR (0.6±0.2)×107, the difference was statistical significance.Conelusions:(1) IR in women with PCOS was higher incidence. Their weight, BMI, waist circumferenceand WHR, acanthosis nigricans syndrome in PCOS with IR were significantly higher thanthose without IR, the differences between the two groups was statistically significant. Sexhormone level is not relevant to IR..(2) IRS-1Gly972Arg mutation rate is low, the difference of its polymorphism in PCOS IRand withuot IR was not statistically significant (P>0.05), and was not related to the clinicalfeatures of PCOS and IR.(3) The expression of endometrial IRS-1, the IRS-1protein and the IRS-1tyrosinephosphorylation in PCOS with IR reduced significantly. The endometrial local IR afterINSR is existent. The polymorphisms of IRS-1Gly972Arg is irrelevant to the expression ofendometrial IRS-1, the IRS-1protein and the IRS-1tyrosine phosphorylation of PCOS with IR.(4) In this study the clinical hyperandrogenism was significantly lower than the foreignreports, indicating the crowd of racial differences, F-G score accord with European andAmerican crowd. Should be more clinical observation of the large sample center, according tothe results by evidence-based medicine, work out the conforms to our country women'shirsutism criteria.The main innovative points of this research are:(1) It is the first time to do the research of the function of insulin substrate1(IRS-1) geneGly972Argpolymorphism1in the molecular mechanism of endometrial IR in patients withPCOS. (2) The research result first indicates that Gly972Arg polymorphism has no effect in themolecular mechanism of endometrial IR in patients with PCOS..(3) The research result first indicates that Gly972Arg polymorphism has no influence toexpression of endometrial IRS1, IRS1protein and IRS1protein tyrosine phosphorylation inpatients with PCOS. |
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