The Change Of Adiponectin And High Sensitive C-Reactive Protein In Polycystic Ovary Syndrome

Objective:To prove into the change of adiponectin (APN) and hing sensitive C-reactive protein (hs-CRP) in polycystic ovary syndrome (PCOS) patients and its significance for pathology of PCOS, and then prove into its connection with traditional Chinese medicine(TCM).Methods:The significance of APN and hs-CRP for pathology of PCOS will be studied from tradional Chinese medicine and western medicine approaches. Tradional Chinese medicine study: Decided TCM syndrome types of the 46 PCOS patients according to tradional Chinese medicine theory to prove into the syndrome law of PCOS ,and divided the patients into five groups: 17cases of kidney-yang-deficiency group,4 cases of kidney-yin- deficiency group, 10 cases of the group of stagnation of liver-Qi, 7 cases of the blood stasis group and 8 cases of phlegm-dampness group.The 42 cases of control group were compared with the five groups.The comparation of APN, hs-CRP and the vascular endothelium function of the control group and the five groups of patients was inspected.Then analyze the colleration of APN, hs-CRP and TCM syndrome types and the suggestion would be made for the patients.Western medicine study: Forfty-six patients with PCOS and forty-two patients with sterility for oviduct reasons as control group were divided for four groups:22 cases of obese PCOS patients,24 cases of nonobese PCOS patients,21 cases of obese control group and 21 cases of nonobese control group.Serum adiponectin levels of the four groups were detected by enzyme linked immunosorbent assay (ELISA) ,and the serum high sensitive C-reactive protein levels were detected by dispersion nephelometer,fasting plasma glucose by glucose oxidation enzyme method,fasting insulin by electrochemiluminescence immunoassay method,and calculated the insulin resistance homa model (HOMA-IR). At the same time, vascular endothelium dependent dilatation function is measured with coloudr ultrasonoscope and the colleration of APN, hs-CRP, HOMA-IR and vascular endothelium function was inspected . Result: In the 46 PCOS patients,there were 17 cases of kidney-yang-deficiency group(at the proportion of 37.0%),4 cases of kidney-yin- deficiency group (at the proportion of 8.7%), 10 cases of the group of stagnation of liver-Qi (at the proportion of 21.7%), 7 cases of the blood stasis group (at the proportion of 15.2%) and 8 cases of phlegm-dampness group (at the proportion of 17.4%). The syndrome type of kidney-yang-deficiency had the highest proporting in polycystic ovarian syndrome (P<0.05). The level of APN was lower in the phlegm-dampness group than in control group and the level of hs-CRP was higher in the blood stasis group and the phlegm-dampness group, also he insuline resistance ratio was significantly higher in kidney-yang-deficiency group and kidney-yin-dificiency group and phlegm-dampness group than in the control group (P<0.05). The vascular endothelium function is notable in the blood stasis group and the phlegm-dampness group.The serum APN level of PCOS group was lower than the control group(P<0.05),and that the level was lower in obses patients than in nonobese patients.The hs-CRP level of PCOS group was higher than the control group(P<0.05) ,and that the level was higher in obese patients than in nonobese patients.APN level was correlated negatively with BMI ,HOMA-IR and hs-CRP level(P<0.05).Conclusion : 1 .The syndrome type of kidney-yang-deficiency was the most common TCM syndrome type in the PCOS and after it was the the syndrome type of stagnation of liver-Qi and the stasis blood and phlegm-dampness played important roles in the pathology of PCOS.2. The change of APN level and hs-CRP level was closely correlated with insulin resistance and the injured vascular endothelium function,APN and hs-CRP play roles in the pathology of PCOS and have influence for the future life of the patiens,and obesity is another important factor to influence the pathology of PCOS.3. The change of APN level, hs-CRP level and injured vascular endothelium function had a correlation with TCM syndrome type , the suggestion could be made for the patients to avoid type 2 DM by decide the TCM syndrome types.