Study On The Endometrial Histopathology, Insulin Metabolism And The Expression Of IRS-1 Serine 307 Phosphorylation In Polycystic Ovary Syndrome

ObjectiveThe purpose of this study was to explore affected factors for endometrialhistopathology and action of insulin resistance(IR) in endometrial histopathology ofpolycystic ovary syndrome(PCOS) by analyzing characteristic of endometrialhistopathology, endocrinopathy of PCOS and expression of insulin receptorsubstrate-1 (IRS-1) and serine307 phosphorylation in endometrial.MethodsCollected 30 patients of PCOS as study group, 30 patients with infertility or benignovary turner as control group when they were seeking medical advice. MeasuredSerum-sexual-hormone, Body mass index(BMI), Oral glucose torlerance test andInsulin release test, Used Western blot method to detect IRS-1 and serinephosphorylation in endometrial. The study group was divided into two groups by twomethod. Method1: According the results of endometrial histopathology, The studygroup was divided into two group, 13 cases of endometrial hyperplasia as groupA(abnoemal), 17 cases of normal endometrial as group N(normal).Method 2:According insulin resistance, The study group was divided into insulin resistancegroup (â… ) and non insulin resistance group (â…¡).Results1. Endometrial histopathology and relatongship with IR,BMI,Testosterone:Theprevalence of endometrial hyperplasia and carcinoma was 43.3% (13/30) in 30 casespatients of PCOS, including 7 cases of simple hyperplasia, 1 case of complexhyperplasia, 4 cases of atypical hyperplasia, and 1 case of carcinoma;Normalendometrial occupied 56.7% in PCOS, including 16 cases of proliferative phase and 1cases of secretory phase. In 30 cases patients of control group, there were 22 cases ofproliferative phase endometrial and 8 cases of secretory phase endometrial. The levelof Testosterone(T) had no relation with endometrial hyperplasia. IR and BMI had close relation with endometrial hyperplasia.2. Serumal sextual index,BMI,HOMA-IR:(1) Estradiol level between PCOS andcontrol group was no difference, also no difference between A group and N group inPCOS.(2) Luteinizing hormone:There was satisfactical difference between PCOS andcontrol group(P＜0.01) and no difference between A group and N group in PCOS.(3)Follicle stimulating hormone: We found no difference between PCOS and controlgroup and also no difference between A and N group in PCOS. (4)Ratio of LH to FSH:Satisfactical difference was deteted between PCOS and control group (P＜0.01)butno difference between A group and N group in PCOS.(5)Prolactin: There was nodifference between PCOS and control group and also no difference between A groupand N group in PCOS. (6) T: There was satisfactical difference between PCOS andcontrol group (P＜0.01)but no difference between A and N group in PCOS.(7)Progesterone:No difference was found between PCOS and control group also betweenA and N group.(8)BMI:The BMI of PCOS was higher than contral groupsignificantly, (P＜0.05), no difference between A and N.(9)HOMA-IR: The HOAM-IRof PCOS was higher than contral group significantly, (P＜0.01), no difference betweenA and N.3. Analyzing correlation of IR, sextual hormone and BMI:In PCOS there waspositive correlation between IR with T,BMI (rs=0.338,P=0.009＜0.01;rs=0.760,P=0.000＜0.01);but no correlation between IR with LH, FSH,LH/FSH,E₂. There was no correlation between BMI with LH, FSH, LH/FSH,PRL,P,E₂.LH correlated with T (rs=0.476,P=0.000 (0.01).4. IRS-land Serine307 phosphorylation in endometrial:The expression of IRS-1 inendometrial of PCOS and control group was (0.3501±0.1191),(0.3072±0.1696)respectively,there was no difference (P＞0.05),and the expression of its Serine307phosphorylation in endometrial of PCOS and control group was(0.7052±0.3585),(0.4492±0.2433) respectively, difference was found between them(P=0.002＜0.01). PCOS was divided into two groups by two methods Method 1: The expression of IRS-1 and its Serine307 phosphorylation in group A(0.3824±0.1277;0.8588±0.2943) were higher than group N (0.3254±0.1095; 0.5878±0.3662); therewas no difference in IRS-1 (P＞0.05) but significant difference in its Serine307phosphorylation between two group (P=0.038＜0.05). Method 2: According insulinresistance, the expression of IRS-1 and its Serine307 phosphorylation in groupâ… (0.3583±0.1185;0.8478±0.3486) were higher than groupâ…¡(0.3407±0.1237;0.5422±0.3045); there was no difference in IRS-1 between two groups(P＞0.05) butsignificant difference in its Serine307 phosphorylation between them(P=0.016＜0.05).Conclusions1. Insulin resistance-hyperinsulinemia is central key in pathyphysiology of PCOS andis the important factor to disturb sextual hormone in PCOS.2. Serine307 phosphorylation is higher in endometrial of PCOS,so it indicates that theway of insulin metabolism is inhibited in endometrial of PCOS, and it may be moreaggravating in hyperplasia endometrial than normal endometrial of PCOS.