The Research On The Clinical Therapeutic Effect On The Obese PCOS-IR And The Experimental Mechanism Of Glycolipid Metabolism In Ovarian GC By APN Signal Pathway Of Tonifying Kidney And Resolving Phlegm

Objective: The effects of Tonifying Kidney and Resolving Phlegm(TKRP)on serum sex hormone levels,insulin resistance(IR)and body mass index(BMI)in the Patients with Obese Polycystic Ovary Syndrome and IR(PCOS-IR),and to study the effect of TKRP on the expression of related genes of APN/AMPK signal pathway and glycolipid metabolism in ovarian granulosa cells(GC)of the SD mice,and to explore the mechanism of Chinese medicine TKRP to regulate obese PCOS-IR.Methods:1.Clinical research: Eighty-six patients with obese PCOS-IR diagnostic criteria were selected.Forty-six cases were treated by oral administration of Chinese medicine TKRP.Forty patients were orally treated with rosiglitazone in the control group.Both groups were treated for three menstrual cycles.The Traditional Chinese medicine(TCM)symptom scores,LH/FSH,T,FINS and BMI were observed between before and after treatment.2.Experimental research: The 3-4 weeks old SD female rats were selected and the ovarian GC was isolated and cultured according to the experimental requirements.To observe the influence on the expression of Adipo R1/2 protein,the genes of AMPK,Cyp19 a,and PPAR-α/β/γ in APN/AMPK signal pathway in ovarian GC of the SD female mice.Results: 1.There were significant differences in the scores of TCM syndromes between two groups and in each group before and after treatment(P<0.05),and the treatment group was superior to the control group;2.There were significant differences in LH/FSH,T,FINS and BMI between each group before and after treatment(P<0.05),the difference was not statistically significant between two groups comparison after treatment(P>0.05);3.Compared with the blank serum group,the expression of Adipo R1 and Adipo R2 on the GC cell membrane of the rosiglitazone group and the middle/low dose group of the TKRP increased(P<0.05 or P<0.01);4.The expression of AMPK,Cyp19 a,PPAR-α/β/γ in GC was determined by Realtime-PCR.Compared with blank serum group,the m RNA expression of AMPK,Cyp19 a,PPAR-α/β/γ in GC of the rosiglitazone group and the middle/low dose group of the TKRP has up to a higher level(P<0.05 or P<0.01).Conclusion: 1.The TKRP can down-regulate the scores of TCM syndromes,the serum hormone levels of LH/FSH and T,FINS,BMI,and etc.2.The TKRP can activate the expression of APN/AMPK pathway in ovarian GC,and up-regulate the expression of Adipo R1/2 protein and the genes of AMPK,CCND2,PPAR-α/β/γ in ovarian GC.3.Combined the clinical trials with the experiment of GC culture in vitro,suggesting that TKRP method can improve obese PCOS-IR patients with clinical Chinese medicine symptoms,reproductive hormone disorders and glycolipid metabolism disorders by activating the APN / AMPK signal pathway and downstream related signal molecules of GC.