| PART ⅠClinical features of polycystic ovary syndrome and analysis of glucose and lipid metabolism in Ningxia Hui and Han womenObjective:Polycystic ovary syndrome (PCOS) is one of the most common endocrine-metabolic disorders,Its core is insulin resistance, and often along with obesity, dyslipidemia or hypertension, which are high risk factors for diabetes and coronary heart disease, suggesting that, PCOS may be an early manifestation of the metabolic syndrome.Due to the heterogeneity of the clinical manifestations of PCOS patients with different people at different incidence, clinical features also exist significant differences. Ningxia Hui people have its own unique characteristics and customs. Previous studies about the PCOS of Ningxia Hui people have not been reported. This research analysis the clinical and glucose lipid metabolism characteristics through different subgroups of PCOS patients in different Ethnic of Ningxia region.To provide a scientific and reasonable basis for the diagnosis, early treatment and prevention of long-term complications of Ningxia Hui PCOS patients.Methods:468 PCOS patients (217 Hui and 251 Han) were collected from reproductive medicine center of the General Hospital of Ningxia Medical University during September 2010 to May 2014, while 180 cases of non-PCOS patients were selected as control group from Hui people. PCOS patients were diagnosed according to the Rotterdam PCOS consensus criteria. Serum hormone, glucose and lipid levels were detected. Serum hormone including Follicle stimulating hormone(FSH), Luteinizing hormone(LH), Prolactin(PRL), total testosterone(T), estradiol (E2). All the PCOS patients were divided into two groups respectively according to HOMA IR, BMI, serum total testosterone, LH/FSH. Endocrine and metabolic characteristics were compared among the subgroups of PCOS patients in different Ethnic.Results(1) The hirsutism rate was higher in Han than in Hui patients, the difference was statistically significant (P≤0.05), there were no statistically significant in oligomenorrhea, PCO, the incidence of acne, hyperandrogenism, insulin resistance, BMI≥25kg/m2 and LH/FSH≥2.The rates of type 2 diabetes+IGR and the abnormal incidence of TG, TC, LDL, HDL were higher in PCOS patients than control group of Hui people, the difference were statistically significant (P≤0.05, P≤0.01). (2) The age, systolic blood pressure, diastolic blood pressure,testosterone levels were lower in Hui women compared with Han women with PCOS,the difference was statistically significant (P≤0.05, P≤0.01);The age was younger while the BMI, systolic blood pressure, diastolic blood pressure, LH, LH/FSH, testosterone levels were higher in Hui PCOS group than Hui control group,the difference was statistically significant (P≤0.01).(3) The LDL was lower in Hui women compared with Han women with PCOS,the difference was statistically significant (P≤0.05);The FPG,2hPG, FINS,2hINS, HOMA-IR, CHO, TG, LDL, ApoB were higher in Hui women with PCOS compared with control group,the difference was statistically significant(P≤0.05,P≤0.01).(4) In Han PCOS women.compared with non-insulin-resistance group, BMI, systolic blood pressure, FPG, FINS,2hINS, HOMA-IR were increased, LH and LH/FSH were decreased in insulin resistance group,and the difference was statistically significant (P≤0.05, P≤0.01);In Hui PCOS women,compared with non-insulin-resistance group,BMI, systolic blood pressure, diastolic blood pressure, FPG, FINS,2hINS, HOMA-IR, TG, ApoB levels were increased,and HDL levels was decreased in insulin resistance group.and the difference was statistically significant (P≤0.05, P≤0.01).(5) In Han PCOS women,compared with non-obese group,the age, BMI, WC, WHR, systolic blood pressure, diastolic blood pressure, FPG.2hPG, FINS,2hINS. HOMA-IR, TG were increased, LH and HDL were decreased in obese group,and the difference was statistically significant (P≤0.05, P≤0.01);In Hui PCOS women,compared with non-obese group, BMI, WC, WHR, systolic and diastolic blood pressure, FINS, 2hINS, HOMA-IR, TG, LDL, ApoB were increased, HDL was decreased in obese group, the difference was statistically significant (P≤0.05, P≤0.01).(6) In Han PCOS women,compared with the normal androgen group,the BMI, systolic blood pressure, testosterone, CHO, LDL, ApoB levels were increased in hyperandrogenism group,the difference was statistically significant (P≤0.05, P≤0.01); In Hui PCOS women,compared with the normal androgen group, WC, LH and testosterone levels were increased in hyperandrogenism group,the difference was statistically significant (P≤0.05, P≤0.01).(7) In Han PCOS women,compared with the LH/FSH<2 group,systolic blood pressure, LH, LH/FSH levels were increased,FSH, FINS,2hINS, lower HOMA-IR levels were decreased in LH/FSH≥2 group,the difference was statistically significant (P≤0.05, P≤0.01); In Hui PCOS women,compared with the LH/FSH<2 group,LH, LH/FSH, T levels were increased,FSH,2hINS were decreased in LH/FSH≥2 group,the difference was statistically significant (P≤0.05).Conclusion:(1) The incidence rates of hirsutism, systolic blood pressure, diastolic blood pressure and LDL were lower in Hui than in Han patients,, suggesting that clinical features and glucose and lipid metabolism were different between Hui and Han people,Han PCOS patients may be more likely have the occurrence of cardiovascular disease than Hui PCOS patients.(2) In different subgroups characterized by insulin resistance, obesity, hyperandrogenism and LH/FSH≥2,Hui and Han PCOS patients had varying degrees of glucose and lipid metabolism disorders,but the clinical manifestations were different between two Ethnics,suggesting that for different Ethnics and different clinical subgroups,the intervention treatments should be individualized.PART Ⅱ Association study between polycystic ovarian syndrome and the polymorphisms of DENND1A、LHCGR、THADA in Hui women of Ningxia regionObjective:Previous studies have reported the clinical manifestations of PCOS patients were different between different races,and this was related with different regions and different genetic background. Three susceptibility loci for PCOS, at 2pl6.3,2p21, and 9q33.3 were identified by using the genome-wide association study (GWAS) on PCOS in Han Chinese women in 2011, but the conclusions were different in different populations of other regions, which showed that it might be related with the differences of the genetic background. Hui ethnic is one of a large population in the China minority, because of its beliefs, diet and lifestyle features, making it a relatively closed communities, the basic situation of the ethnic’s physical characteristics, genetic factors and lifestyle did not fundamentally changed.So.there was an important significance for the study of PCOS which affected by both genetic and environment.Domestic studies about PCOS were Han population-based studies,therefore,different ethnic groups, different geographical studies were needed to fully understand this complex disease.In our present study,we analyzed the association between three SNPs and PCOS,to provide a preliminary study to explore the candidate genes for PCOS.Methods:Genomic DNA was extracted from the peripheral blood samples. The single nueleotide polymorphisms(SNPs) were detected through polymerase chain reaction. Serum hormone, glucose and lipid levels were detected. Serum hormone including Follicle stimulating hormone(FSH), Luteinizing hormone(LH), Prolactin(PRL), testosterone(T), estradiol (E2).Results:There was a significant difference between the PCOS group and the control group in CC, CT and TT genotype frequencies of rsl3405728(P<0.05); There was a significant difference between the PCOS group and the control group in T allele frequencies of rs13405728(P<0.05); In SNP rs13405728 sites of PCOS group,compared TT genotype with CC and CT genotypes,the T, TG, LDL levels were increased,the difference was statistically significant (P<0.05). No significant differences were observed in the genotypes and allele distributions of rs13429458 and rs2479106 polymorphisms between the PCOS and control groups.There was no significant differene in the clinical and metabolic characteristics in women with PCOS with different genotypes in the SNP rsl3429458 and rs2479106.Conclusion:The rs13405728 of LHCGR gene might be associated with the pathogenesis of PCOS in Ningxia Hui women,and the TT genotype was associated with abnormal lipid metabolism in PCOS. |
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