Analysis Of Clinical Presentations In A Large-Scale Chinese Women With Polycystic Ovary Syndrome (PCOS).

Objective :To analyze the clinical presentations of a large-scale Chinese women with polycystic ovary syndrome(PCOS).Methods: One thousand and forty PCOS patients attending the clinic of Shandong Provincial Hospital Human Reproductive Center between January 2002 and December 2006 were included in this retrospective study.All the patients had been performed a 75gOGTT.Clinial presentations , serum hormonal levels , glucose levels , insuline levels and lipid rofiles were reviewed.Results:.The presence of oligomenorrhea was 60%(651/1040) while amenorrhea was 19.71% (205/1040) .Menstrual disorder of all the adult patients could trace back to their adolescent menarches.There were 450 obesity cases of which 259 patients were central obesity.The incidence of acanthosis nigricans was 15.19%(158/1040), 65.19%(103 /158)with obesity and 34.81%(55/158)non-obesity. 2.The prevalence of hypertriglyceridemia was 5.58% (58/1040) while hypercholesteremia was 7.02% (73/1040), abnormality of HDL was 0.10% (1/1040) and abnormality of LDL was 12.69% (132/1040), The rate of lipid profiles abnormality in obesity PCOS was more obviously elevated than non-obesity.3.173 patients were diagnosed as DM according to National Diabetes Data Group (NDDG)criteria while 179 were IGT, 27 were IFG and 9 were IFG+IGT. Those women with plasma glucose values abnormality of 0, 30min, 60min, 120min, 180min were 19 cases0.98% (19/173), 74cases42.77% (74/173), 110 cases 63.58% (110/173), 42cases24.28% (42/173) and 12cases 6.94% (12/173). Ten (10/173) patients would have been undetected if fasting plasma glucose level was not evaluated ,while omission of 30min,60min,120min,or 180min plasma glucose level would have resulted in 16cases9.25%(16/173),50cases28.90%(50/173),28cases 6.18%(28/173)and lcases 0.58% (1/173) missed diagnoses respectively.If we take three times blood samples to evaluate plasma glucose level,there would be 39cases22.54% (39/173) (0min+30min+60min), 102cases58.96% (0min+30min+120min), 21casesl2.14% (0min+30min+180), 34casesl9.65% (0min+60min+120min), 45cases26.01% (0min+60min+180min ), 123cases71.10% (0min+120min+180min) to be missed.Compared AUC, of plasma glucose and insulin in 5 times with 3 times(0min+30min+60min) , the difference has the statistics significance.BMI were positively correlated with HOMA-IR(r=0. 29987 , P<0.01) as well as WHR(r=0.12441,P<0. 0001).Conclusions: 1.The prevalence of obesity as higher in PCOS than common person.The state of obesity has a positive relation with IR.2.The prevalence rate of lipid profiles abnormality in obesity group was higher than in non-obesity. 3.Simplified OGTT reducing the test to 4 times from 5 times (missing values of 180min evaluation point) is essential for all the PCOS.4.Losing weight is the primary therapy for PCOS .