Analysis Of Factors Associated With Abnormal Lipid Metabolism And Intestinal Flora In PCOS

【Objective】Blood lipid concentrations,sex hormone levels,intestinal flora plate colony counts and calculated the colony count and B/E value of each bacteria in PCOS patients were measured.To investigate the factors associated with abnormal lipid metabolism in PCOS patients and also to analyze the correlation with its existence.【Methods】Seventy-two patients with PCOS(39 of them with combined dyslipidemia)and 42 healthy women who attended the outpatient clinic of the First Affiliated Hospital of Dali University from September 2019 to September 2020 and met the diagnostic criteria of the 2018 Chinese Guidelines for the Treatment of Polycystic Ovary Syndrome without drug treatment were collected.1.The contents were as follows:Personal data,menstrual and reproductive history,and family medical history were collected on the day of the visit;height,weight,WC,HC,and blood pressure were measured and recorded,and BMI and WHR were calculated.fasting blood lipid concentrations,sex hormone levels,and gynecological ultrasound were measured;and stool specimens were collected from the study subjects during non-menstrual periods.2.Grouping.According to the 2016 Guidelines for the Prevention and Treatment of Dyslipidemia in Chinese Adults,patients with PCOS were classified into the PCOS dyslipidemia group(PAL)and the PCOS normal lipid metabolism group(PL)if they met one of TC > 6.2 mmol/L;TG > 2.3 mmool/L;LDL-C > 4.1 mmol/L;HDL-C < 1.0mmol/L,and healthy women In addition,according to the "Health Industry Standard of the People’s Republic of China-Adult Weight Determination"(2013 version),18.5 ≤BMI < 24.0 KG/m2 was considered normal,24.0≤BMI < 28.0 KG/m2 was considered overweight,and BMI ≥28.0 KG/m2 was considered obese,and the differences in the proportions between the three groups were compared by stratification of BMI.3.Statistical methodsStatistical analysis was performed using the statistical software SPSS24.0.and the counting data were expressed as percentages,and chi-square test was selected;the measurement data were expressed as mean ± standard deviation,and one-way ANOVA was used to compare between multiple groups,and when there were differences between groups,two comparisons were made by lsd,and the P value(<0.05)was determined after calculating the statistics,and the differences were statistically significant.【Results】1.abnormalities of lipid metabolism in patients with PCOSThere were 72 cases of PCOS patients in this study,and 39 cases of PCOS patients with abnormal lipid metabolism,accounting for 54.17% of the total.Among them,15cases(20.83% of the total)had elevated TC,25 cases(34.72% of the total)had elevated TG,13 cases(18.06% of the total)had elevated LDL-C,and 9 cases(12.5% of the total)had decreased HDL-C.2.Comparison of sex hormones among PAL,PL and CG groupsIn terms of serum sex hormone testing,the differences between the PAL,PL,and CG groups were statistically significant in LH,FSH,LH/FSH,P,and T(F=25.771,p<0.05;F=142.490,p<0.05;F=150.932,p<0.05;F=0.443,p<0.05;F=6.7420.000,p<0.05),while the differences in PRL and E were not statistically significant(F=63.078,p>0.05;F=4095.623,p>0.05),and the results of multiple comparisons suggest that the PAL group had significantly higher values in LH,LH/FSH,and T than the PL and CG groups,and the PL group had higher values in LH,LH/FSH,and T than the CG group.3.Comparison of the general conditions of PAL,PL and CG groupsThe differences in the values of BMI,WHR,systolic blood pressure,and systolic blood pressure between the PAL,PL,and CG groups were statistically significant(F=65.543,p<0.05;F=38.732,p<0.05;(F=93.574,p<0.05;F=48.967,p<0.05),and the results of multiple comparisons suggested that in the PAL group significantly higher values in BMI,WHR,systolic blood pressure,and diastolic blood pressure than those in in the PL and CG groups,and in the PL group also had slightly higher values in BMI,WHR,systolic and diastolic blood pressure than the CG group.4.Analysis of PAL group,PL group and CG group according to BMI stratificationBMI stratification by group: of the total number of 114 people,69 people(60.5%)had 18.5 ≤ BMI <24.0 KG/m2(normal weight),including 6 people(8.7%)in the PAL group,21 people(30.4%)in the PL group,and 42 people(60.9%)in the CG group;24.0≤ BMI <28.0 KG/m2(overweight)were 39(34.2%),all in the PCOS group,27(69.2%)in the PAL group,12(30.8%)in the PL group;and 6 people(5.3%)with BMI ≥28.0KG/m2(obese),all in the PAL group with 6 people(100%).5.Comparison of intestinal colony-related indexes among PAL,PL and CG groupsThe difference in Enterobacteriaceae between the PAL,PL and CG groups was statistically significant(F=1108.722,p<0.05),and the results of multiple comparisons suggested that the PAL group had significantly higher values in Enterobacteriaceae than the PL and CG groups,and the PL group had higher values in Enterobacteriaceae than the CG group;The difference between the three groups in Clostridium was statistically significant(F=632.961,p<0.05),and the results of multiple comparisons suggested that the PAL group had significantly higher values in Clostridium than the PL and CG groups,and the PL group also had higher values in Clostridium than the CG group;The difference between the three groups in bifidobacteria was statistically significant(F=896.515,p<0.05),and the results of multiple comparisons suggested that the PAL group had significantly lower values in bifidobacteria than the PL and CG groups;the PL group also had lower values in bifidobacteria than the CG group;The difference between the three groups in Lactobacillus was statistically significant(F=626.097,p<0.05),and the results of multiple comparisons suggested that the PAL group had significantly lower values in Lactobacillus than the PL and CG groups,the PL group also had lower values in Lactobacillus than the CG group;The difference between the three groups in bacteroid was statistically significant(F=448.274,p<0.05),and the results of multiple comparisons suggested that the PAL group had significantly lower value in bacteroid than the PL and CG groups;the PL group also had a lower value in bacteroid than the CG group;The difference between the three groups in Enterococcus was not statistically significant(F=2.918,p>0.05).6.Comparison of PAL,PL and CG groups regarding intestinal B/E valuesThe differences in B/E values between the PAL,PL and CG groups were statistically significant(F=1557.346,p<0.05),and the results of multiple comparisons suggested that the B/E values of PCOS patients were all smaller than normal(1),with the B/E values of the PAL group(0.79±0.03)being significantly lower than those of the PL group(0.98±0.03)and CG group(1.26±0.05);the B/E values of the PL group were also lower than those of the CG group.【Conclusion】1.Abnormal lipid metabolism is a common metabolic abnormality in the metabolic abnormality syndrome of PCOS patients.2.Patients with PCOS have sex hormone disorders,manifested by elevated levels of LH,LH/FSH,and T.Sex hormone disorders are most serious in patients with combined dysl-ipidemia,suggesting that dyslipidemia is not only related to sex hormone disorders in PCOS,but also aggravates the degree of disorders.3.Patients with PCOS combined with abnormal lipid metabolism will increase with the increase of BMI and WHR,therefore,clinical attention should be paid to monitoring lipids in PCOS patients with increased weight and increased In addition,systolic and diastolic blood pressure were elevated in patients with PCOS,and the increase was more pronounced in the PAL group,suggesting that abnormal lipid metabolism in PCOS may also cause elevated blood pressure.4.PCOS patients are mostly obese and overweight,and obesity is significant among patients with combined lipid metabolism abnormalities,suggesting that obese patients with PCOS are more likely to have lipid metabolism disorders than overweight patients,indicating that obesity causes lipid metabolism disorders and plays an important role in the development of lipid metabolism abnormalities in PCOS,and obesity and PCOS lipid metabolism are intertwined,forming a vicious circle.5.Patients with PCOS showed intestinal flora disorders,as shown by the increase in the number of Enterobacteriaceae and Clostridium difficile and the decrease in the number of Bifidobacterium,Lactobacillus and Bacteroides in fecal specimens;in patients with combined lipid metabolism abnormalities,the intestinal flora disorders were significant,indicating that intestinal flora is related to the development of lipid metabolism abnormalities in PCOS.6.The decrease of B/E value in PCOS patients was lower than the normal value(1),suggesting the existence of intestinal flora disorders in PCOS patients,showing a decrease in the number of bifidobacteria and an increase in the number of Enterobacteri-aceae(decrease in B/E value),which led to the imbalance of intestinal microecology,with the lowest BE value in patients with combined lipid metabolism abnormalities,indicating the most serious intestinal flora disorders,further indicating that the occurrence and development of lipid metabolism abnormalities in PCOS and This further indicates that there is a correlation between the occurrence and development of lipid metabolism abnormalities in PCOS and intestinal flora disorders.