A Study On The Correlation Between SHBG,Lipids Of Metabolism And Insulin Resistance In Women With PCOS

Objectives Polycystic ovarian syndrome (PCOS) is a common endocrine-metabolic and the main androgen disorder in women , and a high percentage of whom exhibit peripheral insulin resistance (IR ) , but its etiology is not clear by now . PCOS has been suggested to be associated with a high risk of developing cardiovascular disease and type 2 diabets . IR is associated with many factors . In many PCOS patients , overweight or central obesity is generally associated with increases in fasting insulin levels , insulin resistance , and glucose intolerance , and has been identified as a target for new therapeutic strategy , in eluding early change in life style . Early biochemical marker(s) for identifying at-risk patients will be useful for prevention studies . The sex hormone binding globulin (SHBG) is a sort of material which is produced by liver and closely related to the androgenic metabolism of the body . There is also a relation between SHBG and IR , which is worth to research . The main goal of the present study was to search for such tools . This study was designed to observe 60 patients' insulin levels during fasting and oral glucose tolerance test, as well as the serum concentrations of SHBG and lipids of metabolism, and basal blood samples for follicle stimulating hormone (FSH) , luteinizing hormone (LH) , estradiol (E2) , testosterone (T) were obtained and tested .Then to assess the biological variability of total testosterone and SHBG in PCOS and to explore the relationship between IR , serum SHBG levels andlipids of metabolism in women with PCOS , as well as to determine the use of SHBG as a surrogate marker of insulin resistance in PCOS .Methods Sixty PCOS patients were recruited to participated in the study group . Thirty normal reproductive age-matched individuals with regular menstrual cycles were regarded as control group . Sixty women with PCOS ( 32 obese with BMI ≥25 kg/m2 and 28 non-obese with BMI <25 kg/m2) and thirty women ( 16 obese with BMI^25 kg/m2 and 14 non-obes with BMI <25 kg/m2 ) were studied . PCOS women and healthy women in control group entered the study after overnight bed rest and fasting 12 hours during the early follicular phase of the menstrual cycles . Body mass index (BMI) , waist-to -hip ratio (WHR ) and basal blood samples for follicle stimulating hormone (FSH) , luteinizing hormone (LH) , estradiol (E2) , testosterone (T) were obtained and tested . We investigated them by measuring insulin levels during fasting and oral glucose tolerance test, as well as the serum concentrations of SHBG and lipids of TC, TG, HDL, apoA and apoB . Then we compared each group's BMI , WHR , serum concentrations of SHBG and lipids , as well as insulin levels during fasting and oral glucose tolerance test . The insulin resistance was calculated by the homeostasis model assessment method (HOMA-IR) and insulin sensitivity index (ISI) . PCOS Group IR was composed of 31 women with PCOS whose serum insulin level after glucose loading at 120 minutes were more than 160mIU/L.Results The age between the PCOS group (29.30±3.42 age) and the control (31.32±4.16 age) had no differences . The BMI (with BMI 27.42±4.28 and 23.82±6.36 respectively ) and WHR ( with WHR 0.89±0.26 and 0.75±0.24 respectively) in patients with PCOS were significantly higher than that in the control (P<0.05) . There was no differences of age ,BMI and WHR between the Pob group and the Pnob group ,as well as the Cob group and the Cnob group . The concentrations of Fins , LH , HOMA-IR ,and testosterone ( T ) in patients with PCOS were significantly higher than that in the control group (P<0.05) ; The levels of Fins in patients with Pob were significantly higher as compared to the Pnob (P<0.05) . After glucose loading , 23 patients had IR in Pob group and 8 patients had IR in Pnob group . Compared with healthy women , PCOS patients showed significantly lower ISI . The IRgroup had lower SHBG levels. The means of TC , TG , apoB were significantly greater in study group than that in control group . But the means of HDL and SHBG of study g...