Correlation Between Hormone Levels And Sleep, Mental State And Ultrasound Characteristics In Patients With Polycystic Ovary Syndrom

CORRELATION BETWEEN ANXIETY/DEPRESSION AND SLEEP DISORDERS IN PATIENTS WITH POLYCYSTIC OVARY SYNDROMEObjective:To explore whether there is any association between anxiety/depression and metabolic parameters,disease characteristics or sleep status in Chinese female patients with polycystic ovary syndrome.Methods:Patients with PCOS who visited the Gynecology outpatient department of Chongqing Hospital of Traditional Chinese Medicine from July 2018 to January 2020 were selected as the research subjects.With the consent of the patients,PCOS related questionnaires were conducted for all patients,and demographic characteristics such as age,education level,occupation,smoking and alcohol consumption,menstruation,marital status and other general information were investigated in detail;sleep status,sleep status-related variables were measured by Pittsburgh Sleep Quality Index(PSQI).Hospital anxiety(HADS-A)and depression Scale(HADS-D)were used to investigate mental health status.Subjects were numbered and anthropometric measurements were taken to calculate body mass index(BMI).Blood examination data(such as blood glucose,blood lipids,sex hormones and other related parameters)and ultrasound examination data(such as ovarian volume,sinus follicle count,number of 2-5mm follicles,uterine,ovarian and ovarian medullary artery blood flow parameters,etc.)were recorded for each study object.After completing the survey,collect valid questionnaires,sort out and input data,and conduct statistical analysis.Statistical analysis was performed using IBM SPSS22.0.General characteristics of the subjects were expressed as rates(percentages)or median(quartiles).If the data were continuous but did not conform to normal distribution or the variance between the two groups was uneven,the Mann-Whitney U test was performed.The chi-square test and Fisher’s exact probability test were used to determine the categorical variables between the two groups(race,place of residence,smoking status,drinking habits and marital status,etc.).Secondhand smoke,income and education were analyzed by chi-square trend test.Logistic regression analysis was used to test associations between mental health(anxiety and depression)and sleep disorders,biochemical indicators(hormones,blood sugar and lipids),ultrasonic features and disease features(hirsutism,obesity,acne,infertility).The results are then reported as odds ratios(OR)with 95%confidence intervals(CI).For the relationship between sleep and anxiety,OR was further investigated after taking into account factors such as place of residence,second-hand smoke and alcohol consumption.The relationship between sleep and depression was further investigated by second-hand smoke and education.P values of < 0.05 were considered statistically significant.Results:1.Basic informationIn our study,433 women with PCOS were enrolled.Among 433 PCOS patients,26.6%(n=115)had anxiety disorder and 23.6%(n=102)had depression,according to HADS score.PCOS women with anxiety lived in rural areas more(P=0.043),were exposed to secondhand smoke(P=0.031)and drank alcohol more frequently(P=0.010)than women without anxiety.PCOS women with depression were less educated(P=0.021)and more frequently exposed to secondhand smoke(P=0.024)than PCOS women without depression.2.The relationship between patients’ anxiety/depression and their disease characteristicsThere were no statistical difference of infertility(P=0.574,0.517),BMI(P=0.233,0.798),waist-hip ratio(P=0.334,0.850),systolic blood pressure(P=0.287,0.702),diastolic blood pressure(P=0.088,0.576),Ferriman-Gallwey score(P=0.992,0.550),acne score(P=0.761,0.477)between anxiety/depression and non-anxiety/depression groups.3.The relationship between biochemical markers and anxiety/depressionThere were no significant difference of testosterone(T)(P=0.210,0.443),prolactin(PRL)(P=0.666,0.628),estrogen(E2)(P=0.502,0.178),luteinizing hormone(LH)(P=0.351,0.209),follicle-stimulating hormone(FSH)(P=0.142,0.444),progesterone(P=0.363,0.264)and other sex hormone indexes between patients of anxiety/depression and non-anxiety/depression.There were no significant difference of fasting blood glucose(FG)(P=0.799,0.941),fasting insulin(FI)(P=0.509,0.230),1h blood glucose(1h PG)(P=0.316,0.681),1h insulin(1h PI)(P=0.603,0.931),2h blood glucose(2h PG)(P=0.997,0.510),2h insulin(2h PI)(P=0.840,0.306),3h blood glucose(3h PG)(P=0.755,0.706),3h PI(P=0.361,0.896),HOMA-IR(P=0.510,0.237)and other glucose related parameters between patients with anxiety/depression and non-anxiety/depression.There were no significant difference of triglyceride(P=0.928,0.303),total cholesterol(P=0.734,0.491),high-density lipoprotein(P=0.327,0.674),low-density lipoprotein(P=0.413,0.121),and other blood lipid levels between patients with anxiety/depression and non-anxiety/depression.4.Relationship between ultrasound characteristics and anxiety/depressionUterine arterial pulse index(PI)was lower in the anxiety/depression group(OR 0.397,95% CI,0.159-0.990,P = 0.048).There were no significant difference of ovarian volume(P=0.376,0.471),sinus follicle count(P=0.811,0.252),2-5mm follicle number(P=0.643,0.221),uterine artery RI(P=0.061,0.227),ovarian artery RI(P=0.613,0.697),ovarian medullary artery RI(P=0.589,0.767),uterine artery PI(P=0.604),ovarian artery PI(P=0.686,0.268),ovarian medullary artery PI(P=0.306,0.730)between patients with anxiety/depression and non-anxiety/depression.5.Relationship between sleep and anxiety/depressionThe scores of sleep quality(P=0.006),sleep disturbance(P=0.000)and daytime dysfunction(P=0.005)in anxiety group were higher than those in non-anxiety group.The scores of sleep quality(P=0.028),sleep disturbance(P=0.037)and daytime dysfunction(P=0.012)in the depressive group were higher than those in the non-depressive group.Conclusion:1.Anxiety/depression in PCOS is associated with a number of sleep-related disorders,including sleep quality,sleep disturbances,and daytime dysfunction.2.Severity of disease characteristics(infertility,hirsutism,acne,etc.)was not associated with the development of anxiety/depression.No significant difference was found between serum lipid level,blood glucose level and PCOS anxiety/depression.STUDY ON THE CORRELATION BETWEEN ULTRASONOGRAPHIC CHARACTERISTICS AND HORMONE AND METABOLIC LEVEL OF POLYCYSTIC OVARY SYNDROMEObjective:The study aimed to evaluate how ultrasound features relate with clinical,sex hormone levels and some metabolic indices in patients with polycystic ovary syndrome(PCOS)among the Han Chinese Population.Methods:149 PCOS patients were recruited on July 2018 and January 2020 at the Chongqing Hospital of Traditional Chinese Medicine.PCOS was diagnosed in accordance with the Rotterdam criteria.Spearman analysis and multiple linear regression models were used to determine how the ultrasound features(number of follicles per follicular size category,ovarian volume,uterine blood flow status and the ovarian blood flow status)correlate with clinical,sex hormone levels and some metabolic indices in the PCOS patients.Results:Antral follicle count(AFC)and the number of follicles with sizes ≤6mm were positively associated with the metabolic indices: BMI,blood glucose and insulin levels.The number of follicles with sizes > 6mm was positively associated with some sex hormone levels and fasting glucose.Ovarian volume(OV)was positively correlated with fasting blood glucose levels.Uterine and ovarian blood flow statuses neither correlated with sex hormone levels nor the metabolic indices.Multiple regression models showed that BMI was highly associated with AFC and the number of follicles which have sizes ranging from 2mm to 4mm.Also,LH/FSH was more associated with the number of follicles with sizes ranging from 5mm to 9mm while fasting blood glucose was more associated with OV.Conclusions:During the early follicular phase(cycle days 2 – 5),the ultrasound features correlated weakly with the sex hormone levels and the metabolic indices among the Han Chinese PCOS patients.This indicates that doppler imaging of polycystic ovary morphology might help predict the extent of sex hormone and metabolic impairments of PCOS patients.