Application Of Irisin In The Treatment Of Polycystic Ovary Syndrome

Objective: To analysis the correlation between the serum irisin and the metabolic parameters for patients with polycystic ovarian syndrome(PCOS);and analysis the changes of irisin and the improvement of clinical and biochemical indexes after treatment of traditional Chinese medicine and western medicine in polycystic ovary syndrome.PART ONEMethods:79 patients were recruited(October 2014 to December 2015 in Chongqing Medical University General Hospital) from the Reproductive Health and Infertility who were diagnosed as PCOS as case group, 57 patients with tubal and/or male factor infertility and regular menstruation were selected as the control group. Serum sex hormone six,lipids,oral glucose tolerance and insulin release test were performed in all patients.Enzyme-linked immunoassay determination serum leptin and irisin levels.Results:(1) The irisin level of PCOS groups was higher than that in control [(205.56±40.28)(157.77±25.26)μg/L, p<0.001] and the level in obesity PCOS patients was higher than that in non-obesity PCOS patients[(224.39±38.95)(192.75±36.26)μg/L, P=0.001].The irisin level of PCOSgroups was higher than that in control [(27.85 ±4.51)(12.64±4.45)ng/ml,p<0.001](2)There were no significant differences in age, FSH and TC between the two groups(p > 0.05).The BMI,LH,LH/FSH,T,HOMA-IR, fasting glucose,2 hour glucose,fasting insulin,2 hour insulin,LDL-C, TG,leptin level of PCOS were higher than those in the control group(p<0.05).(3) Pearson Correlation analysis revealed that the irisin level had positive correlation with BMI, WHR, HOMA-IR, 2h FBG,TC and TG(r=0.317,r=0.372,r=0.24,r=0.259,r= 0.139,r=0.242,p<0.05),but negative correlation with the LDL-C(r=-0.355,P=0.001).Other clinical parameters,including age, FSH, LH, T, FBG, FIns, 2h FIns, LDL-C, leptin were not correlated with irisin levels(r=0.103、r=0.132、r=-0.157、r=0.006、r=-0.056、r=0.103、r=0.192、r=0.075、0.063,均 p>0.05).(4) Multiple linear regression analysis showed that WHR was the significantly negatively associated with serum irisin levels,and WHR was the negative independent determinant of serum irisin.Conclusions:Serum leptin was significantly higher in patients with PCOS, suggesting that leptin resistance.The irisin level of PCOS groups were significantly increased may reflect irisin “tolerance”or “resistance”;there is a positive correlation relationship between irisin and HOMA-IR,may be associated with the development of insulin resistance.PART TWOMethods:60 PCOS patients with insulin resistance and kidney yang deficiency syndrome,30 patients received metformin(250mg tid)(western medicine group),30 patients received kidney-and-spleen-strengthening herbs treatment(traditional Chinese medicine group).The changes of the serum irisin level and the relevant indexes were observed before and after treatment.Results:(1)In western medicine group after therapy treatment, there were significant decrease in serum irisin,BMI, WHR, HOMA-IR, LH, T,FBG, FIns( p < 0.05),after treatment ovulation recovery rate was a significant increase(three months after treatment is 53.3%;six months after treatment was 93.3%).(2)serum irisin,BMI, WHR, HOMA-IR, LH, T, FBG, FIns were lower than before therapy in traditional Chinese medicine group(p<0.05),after treatment ovulation recovery rate was a significant increase(three months after treatment is 50%;six months after treatment was 90%)(3) After treatment, no significant differences in BMI 、 WHR 、HOMA-IR、LH、T、FBG、FIns between the two groups(p>0.05); no significant differences in ovulation recovery rate between traditional Chinese medicine group and western medicine group(P>0.05).Conclusions:There was a significant decrease in circulating irisin in PCOS after treatment, irisin better reflect the improvement of insulinresistant. Chinese medicine and Western medicine can effectively reduce insulin resistance in PCOS patients with kidney yang deficiency, improve ovulation situation.