| Objective: The purpose of this experiment is to explore the relationship serum insulin-like growth factor 1(IGF-1),IGF-binding protein 3(IGFBP-3)and polycystic ovary syndrome and its related mechanisms,and to provide an important theoretical basis for the diagnosis and endocrine therapy of PCOS.Methods: 1.119 PCOS patients admitted The Second Affiliated Hospital of Dalian medical University were selected as the study group from October 2018 to December2020.At the same time,54 patients who have normal physical examination were selected as control group.Serum hormone levels(Testosterone T,Follicle-Stimulating Hormone FSH,Luteinizing Hormone LH),IGF-1 and IGFBP-3 levels were measured.The Fasting Blood Glucose(FBG)and Fasting Insulin(FINS)were measured and their insulin resistance index was calculated.At the same time,the height and weight were measured and their body mass index(BMI)was calculated.2.SPSS 20.0 was used for statistical analysis,and the data that obeyed the normal distribution were compared with the independent sample t test,otherwise the Mann-Whitney U non-parametric test was used.The purpose is to compare the differences in serum IGF-1,IGFBP-3,sex hormones,BMI and HOMA-IR between the study group and the control group,and explore their effects on polycystic ovary syndrome.Spearman correlation analysis method was used to analyze the correlation between the indicators of PCOS,and the R software ggcorrplot package was used to visualize the analysis results.3.According to BMI,the study group was further divided into obesity group and non-obese group,and the differences in indicators between the two groups were compared to explore the influence of obesity on PCOS.4.According to HOMA-IR,PCOS patients were divided into insulin resistance group and non-insulin resistance group.The differences between the two groups were compared to explore the effect of insulin resistance on PCOS.5.For indicators that are different between the study group and the control group,binary logist regression analysis was used to evaluate their impact on the prevalence of PCOS in the study subjects,and the ROC curve was further drawn to evaluate its diagnostic efficacy.Results:1.Serum IGF-1,LH,LH/FSH and T levels in the study group were significantly higher than those in the control group(P<0.05),BMI and HOMA-IR of the study group were higher than those in the control group,but the difference was not significant,there was no difference in serum IGFBP-3 levels between the two groups.2.The results of correlation analysis among study group2.1 There was a significant positive correlation between IGF-1 and IGFBP-3 levels(r=0.39,P<0.01).There was a significant positive correlation between serum IGF-1 and LH/FSH value(r=0.2,P<0.05).There was no significant correlation between IGF-1level and LH,FSH,T,FINS,BMI,HOMA-IR.2.2 There was a significant positive correlation between serum IGFBP-3 and FINS(r=0.34,P<0.01).There was a significant positive correlation between serum IGFBP-3and BMI(r=0.30,P<0.01).There was a significant positive correlation between serum IGFBP-3 and HMOA-IR(r=0.32,P<0.01).There was no significant correlation between serum IGFBP-3 level and serum LH,FSH,LH/FSH,T levels.2.3 There was a significant positive correlation between the BMI and the IGFBP-3levels of the study(r=0.30,P<0.01),There was a significant positive correlation between BMI and HMOA-IR(r=0.37,P<0.001),There was a significant positive correlation between BMI and FINS(r=0.40,P<0.001),There was a significant positive correlation between BMI and FBG(r=0.19,P<0.05),There was no significant correlation with serum LH,FSH and T level in PCOS.2.4 There was a significant positive correlation between HOMA-IR and IGFBP-3(r=0.32,P<0.01),There was a significant positive correlation between HOMA-IR and FINS(r=0.98,P<0.001),There was a significant positive correlation between HOMA-IR and BMI(r=0.37,P<0.001),There was a significant positive correlation between HOMA-IR and FBG(r=0.57,P<0.001).There was no significant correlation between HOMA-IR and serum LH,FSH,LH/FSH,T level.3.Further divided the study group into obese and non-obese groups according to the BMI of PCOS patients,Serum IGFBP-3,HOMA-IR and FINS levels in obese group were significantly higher than those in non-obese group,Differences were statistically significant(P<0.05).4.According to the insulin resistance index(HOMA-IR)of PCOS patients,the study group was divided into two groups: insulin resistance and non-insulin resistance,The serum IGFBP-3,FINS and FBG levels in the insulin resistance group were significantly higher than those in the control group,Differences were statistically significant(P<0.05).5.There were significant differences between the study group and the control group(LH,LH/FSH,T and IGF-1)using binary logist regression analysis of their impact on the prevalence of PCOS in the study subjects,The ROC curve was further drawn to evaluate its diagnostic efficacy.The results showed that serum LH,LH/FSH,T,IGF-1 levels increased,and the risk of PCOS in the study subjects increased,and the difference was significant(P<0.05);The area under the ROC curve of T is 0.81(95%CI0.75,0.87 P<0.001),the area under the ROC curve of LH is 0.79(95%CI 0.73,0.86P<0.001),and the area under the ROC curve of LH/FSH is 0.73(95 %CI 0.65,0.81P<0.001),the ROC curves of the above indicators are all above the reference level,and the area under the curve is greater than 0.5,all of which have certain diagnostic significance.The area under the ROC curve of IGF-1 is 0.61(95% CI 0.53,0.70P<0.05),but the ROC curve of IGF-1 coincides with the reference line,which is of no diagnostic value.Conclusions: 1.The level of serum IGF-1 in patients with PCOS is elevated,and is positively correlated with the level of LH/FSH in the body,but it has no diagnostic value for PCOS.2.There is no significant difference between IGFBP-3 in the study group and the control group,but IGFBP-3 is closely related to the levels of BMI,HOMA-IR and IGF-1 in PCOS patients,and there is a positive correlation.3.Obesity is closely related to insulin resistance.The FSH level of obese PCOS patients is significantly lower than that of non-obese PCOS patients. |
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