The Effect Of Insulin And Insulin Receptor On The Changes Of Endometrial Pathology In Patients With Polycystic Ovary Syndrome

Objective:To study the endometrial pathologic characteristic in patients with PCOS and the effect of endocrine and metabolic changes on endometrium and the expression and significance of insulin receptor protein in endometrium of patients with polycystic ovary syndrome.Methods:Histopathologic HE stain techniques used to characterize endometrial changes with PCOS women.Serum prolactin(PRL),luteinizing(LH),follicle stimulating hormone(FSH),estradiol(E₂),testosterone(T),androstenedione(A) were measured by radioimmunol techniques.Glycemia and insulin(INS)response to OGTT were also assessed in PCOS patients.The expression of insulin receptor protein in endometrium from 44 PCOS and 28 normal controls was studied by means of immunohistochemical method.Results:(1)There were showed anovulatory endometrium in PCOS patients,including proliferation phase,simple hyperplasia,atypical hyperplasia.The other showed ovulatory secretary phase endometrium.(2)The INS levels at Omin,60min,120min and area under curve of INS (AUC)were higher in the anovulation endometrium group than those of ovulation endometrium group(p＜0.05).(3)AUC were higher in the hyperplasia endometrium group than that of proliferation endometrium group(p＜0.05).the INS level at 60min and 120min after OGTT and AUC were elevated obviously in the simple hyperplasia endometrium compared with the proliferation group(p＜0.05).(4)There was no difference between the control and PCOS in proliferation; Insulin receptor protein showed weak staining in the cell of PCOS secretary phase endometium;Compared with the control, there were strongly positive staining in the glandular cells of abnormal hyperplasia endometrium.Conclusion:Hyperinsulinnemia play an role in the endometrium of PCOS with anovulation and hyperinsulin binding increased insulin receptor may be an potential role of the neoplastic transformation of endometrium..Insulin receptor could take part in endometrial transportation during secretary phase.