Study Of The Relationship Between The Polycystic Ovary Syndrome Combined With Insulin Resistance And The IGF-I System

Objective To investigate serum and follicular fluid alterations of factor-â… (IGF-â… ),IGF-â… binding proteins-â… (IGFBP-â… ), and the alteration of IGF-â… receptor(IGF-IR) of ovary in patients with PCOS. Methods Assayed the serum T,FI,FG,2 hourâ… ,2 hour G, BMI and the ovarian parameter (OV,NF and TA) of the patientsand patients in our clinic, chose out 15 patients as the PCOS combined insulinresistance group, 15 patients as control patients. The age was not significantlydifferent in these two groups. IGF-â… and IGFBP-â… were assayed in the follicular fluidfrom 15 patients with the polycystic ovary syndrome (PCOS) combined with insulinresistance and 15 women with normal menstrual cycle. Peripheral serum wascollected and assayed at the same time. Comparison of IGF-â… in follicular fluid andperipheral serum, PCOS group and control group were conducted. The expression ofIGF-IR was detected with immmunohistochemical methods in both groups. And therelationship between the level of serum and follicular fluid IGF-â… ,IGFBP-â… and theparameters of insulin resistance (such as ISI,QUICIâ… and BMI) and the ovarianultrasound parameters (such as OV,NF) in both groups. Results Serum IGF-â… concentration in PCOS combined with insulin resistance group was not different fromthat in the control women, but it was higher in follicular fluid in the PCOS combinedinsistence resistance group; serum IGFBP-â… concentration in PCOS combined withinsulin resistance group was lower than that in the control group; and it also lower infollicular fluid in the PCOS combined insulin resistance group; follicular fluid IGF-â… concentration was higher than that in serum in PCOS group; follicular fluid IGF-â… concentration was not different from that in the serum level in control group. Insubjects with the PCOS combined insulin resistance group, higher follicular fluidIGF-â… lever correlated with the higher T,LH,LH/FSH and NF; the serum IGF-â… levelcorrelated with ISI,BMI; the lower follicular fluid IGFBP-â… level correlated with T,LH,LH/FSH, NF. Beside these, the level of ISI,QUICIâ… correlated with T,LH,LH/FSH, OV,NF. IGF-IR located in ovaries' theca cell, spatially in the surface oftheca cells in the PCOS combined with insulin resistance group. Conclusions IGF-â… system in the micro-environment may play a role in the pathophysiology of PCOScombined with insulin resistance. In PCOS patients, the higher insulin level and thehigher concentration of the serum free IGF-â… together make out the resistance to insulin in the insulin affected organizations. But in the ovary, the IGF-IR was stillsensitive to the insulin, and the high insulin level resulted in the higher expression ofIGF-IR and the higher expression of IGF-â… in ovary. There for, as the effect of theIGF-â… , the theca cell secreted more and more T, result in the difficult of ovulating.