The Clinical Features And Serum Metabolomics Studies On Patients Of Polycystic Ovary Syndrome With Type2 Diebetes Mellitus

Objective:To study the differences in clinical characteristics,gluco-lipid metabolism and serum metabolites during the polycystic ovary syndrome with insulin resistance,polycystic ovary syndrome with Type 2 diabetes mellitus,type 2 diabetes mellitus and the body mass index matched normal female reveals a comprehensive clinical and metabolic characteristics in patients with polycystic ovary syndrome,polycystic ovary syndrome with type 2 diabetes mellitus and type 2 diabetes mellitus.The aim of the study was to find the different pathogenesis of insulin resistance between polycystic ovary syndrome and type 2 diabetes mellitus and to explore the special biomarkers of polycystic ovary syndrome with type 2 diabetes mellitus inorder to provide the basises for clinical diagnosis and treatment.Methods:Combining the clinical study and metabonomics technology as the method,based on the Rotterdam diagnostic criteria and Type 2 diabetes diagnostic criteria from 2013 Chinese type 2 diabetes prevention and treatment guideline into the subjects.The research has four groups,patients of PCOS with T2DM,16 cases(group A);patients of PCOS with insulin resistance,40 cases(group B);patients of T2DM,20 cases(group C);healthy women(control),25 cases(group D).Collecting the clinical data and serum samples for blood sugar,blood lipids and gonadal hormone,and using high performance liquid chromatography mass spectrometry technology screening four groups of subjects serum metabolomics differences content.Results:(1)clinical research results:Systolic blood pressure in patients of group A was significantly higher than the patients of group B and D;diastolic blood pressure significantly higher than the other three groups;there is statistical significance,P<0.05.Hairy score of group B was obviously higher than that patients of group A and C,patients of group A higher than group C,there is statistical significance,P<0.05.LH and FSH ratio of group B was higher than group D;The levels of T,SHBG and FAI in group A and B were significantly higher than those in control group D;the levels of FBG,GLU120,Aucg in group A were higher than those in group B and D,INS120 level was higher than group C and D,Auci level was higher than group C,HOMA-IR,TC and LDL levels were higher than group D,there is statistical significance,P<0.05.The levels of INS120,Auci,TC and LDL in group B is higher than those in group D。The level of IGI in group A was lower than group D,there is statistical significance,P<0.05.(2)the metabonomic research results:According to the difference of the selected variables,identified a total of 62 different metabolites,mainly involved in lipid metabolism,fatty acid amide metabolism,amino acid metabolism.The levels of FFA and phenylalanine in group A were significantly higher than group D,the levels of L-Glutamine and inosine were lower than group D.The levels of carnitine,LPC,PC,LPE,PE,SM,Na-Acetyl-lysine,phe-phe,γ-Glu-leu and creatinine were lower than those in group D,the levels of leucine and hypoxanthine were higher than group D.The levels of FFA,carnitine,LPC,PC,LPE,SM,creatinine,leucine,phe-phe and γ-Glu-leu were obviously higher than group D;the levels of L-Glutamine,GCDCA,GDCA,uric acid,inosine and hypoxanthine wre lower than group D.The levels of FFA,carnitine,LPC,LPE,SM,creatinine,leucine,phe-phe and γ-Glu-leu were higher than group D;the levels of L-Glutamine,uric acid,inosine and hypoxanthine wre lower than group D,there is statistical significance,P<0.05.Conclusion:(1)Phlegm-dampness constitution may be cause the potential risk factors of IGT and T2DM in PCOS patients.(2)Insulin resistance is the core pathogenesis of PCOS and T2DM,but there are differ ences between the two.PCOS shows the function of insulin regulation of gl ucose decreased,causing compensatory increase in insulin;T2DM showedβ-cell dysfunction and lack of insulin secretion.(3)Metabolomics analysis showed:metabolic markers of PCOS with IR mainly involved in free fatty acid;metabolic markers of PCOS with T2DM included free fatty acid and amino acid;metabolic markers of T2DM contained Leucine,uricacid,GDCA,Phenylalanine,L-Glutamine.We explore the special biomarkes of these disease which provide the basises for clinical diagnosis and treatment.