Study Of Prevalent Factors Of PCOS And Effect Of Dietary Intake On Glycometabolism

Part 1 Analysis of prevalent factors of Polycystic ovary syndromeObjective To analyze the related prevalent factors of PCOS.Methods A total of 89 subjects,47 women with PCOS and 42 controls,participated in the study.Each subject underwent a physical examination and laboratory evaluation for a diagnosis of PCOS.Data of prevalent factors,such as birth weight,family history and moreover dietary intake in the whole 24 hours,were collected through questionnaire-based interviews and were then underwent a cross-sectional study.Results(1)The family prevalence of diabetes mellitus(DM) and menstrual disorder (amenorrhea or oligomenorrhea) was higher in PCOS than the control women(P＜0.000),and that of alopecia was not statistical significant(P＞0.05).(2)BW was lower in PCOS than the control women(P＜0.000).(3)The total energy intake was higher in PCOS than the control women(P＜0.05).(4)Age of menarche and amount of exercise were neither statistical significant(P＞0.05).Conclusions Each of obesity,low birth weight and family history of menstrual disorder was an independent risk factor for PCOS and family history of DM might be effective to PCOS,which implied that familial inheritance,BW and postnatal dietary intake might be considered as an important risk factor for PCOS.Part 2 The study of dietary intake of polycystic ovary syndromeObjective To investigate and analyze the nutritional status,energy and dietary constituents of patients with PCOS,and finally to find out the effect of dietary intake on the pathogenesis of PCOS.Methods Dietary intake during the past 24 hours was collected by questionaire and calculated into the total energy and the quantity and proportion of carbohydrate, protein and lipid in the diet from forty-seven PCOS women and forty-two age-matched healthy control women.The data of the anthropometric measurements, clinical manifestations of hyperandrogenism and serum levels of follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),testosterone(T) and prolactin(PRL) were also collected and compared through the case control study.Results(1) Energy,the quantity of carbohydrate,lipid,and sum of carbohydrate, protein and lipid intake were all higher in PCOS group than in the control one(all P＜0.05),however,the proportion of protein is lower in PCOS group(P＜0.01).(2) Body mass index(BMI) was all positively related with the total energy intake,the quantity and corporation of lipid(r=0.286,0.367,0.404,all P＜0.01),but was negatively related with the corporation of protein in the diet(r=-0.361,P＜0.05).Conclusions PCOS women have taken more energy,lipid and carbohydrate,but lower proportion of protein,and such dietary constitution may directly lead to higher morbidity rate of obesity in PCOS women.So energy restriction and dietary modulation should be an important clinical intervention for PCOS.Part 3 Relationship between dietary intake and glycometabolism in the women with polycystic ovary syndromeObjective To analyze the relationship between dietary intake and glycometabolism in PCOS women and to summarize the characteristics of nutritional status, glycometabolism and dietary constituents of the obese and non-obese women with PCOS,and finally to find out the effect of dietary intake on the pathogenesis of insulin resistance(IR) of PCOS.Methods Dietary intake during the past 24 hours was collected by questionaire and calculated into the total energy and the quantity and proportion of carbohydrate, protein and lipid in the diet from 21 obese and 25 nonobese women with PCOS,that were separated by body mass index(BMI).The data of the anthropometric measurements,clinical manifestations of hyperandrogenism and serum levels of follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2), testosterone(T) and prolactin(PRL) were also collected and compared between the two groups through the case control study.Results(1)Fasting plasma glucose(FPG) and area under the curve of glucose (GAUC) were both positively related with the proportion of lipid in the diet(r= 0.331,r=0.404,P＜0.05,P＜0.01).Fasting insulin(FINS) was positively related with the quantity of carbonhydrate(r=0.368,P＜0.05) and negatively related with the proportion of protein(r=-0.522,P＜0.01).Area under the curve of insulin (IAUC) was negatively related with the proportion of protein(r=-0.380,P＜0.05). Homeostasis model assessment of insulin resistance(HOMA-IR) was positively related with the proportion of lipid(r=0.340,P＜0.05) and negatively related with the proportion of protein(r=-0.388,P＜0.05).Homeostasis model assessment of insulin sensitivity(HOMA-IS) was positively related with the quantity of carbohydrate(r=0.412,P＜0.01).△I30/△G30 was positively related with the quantity of carbohydrate(r=0.509,P＜0.01) and negatively related with the proportion of protein(r=-0.363,P＜0.05)(2)FINS,GAUC,IAUC and HOMA-IR were all higher in obese than non-obese PCOS(P＜0.01,＜0.05,＜0.05,＜0.01).(3) Energy,the quantity of carbohydrate,lipid,and sum of carbohydrate,protein and lipid intake were all higher in obese than non-obese PCOS(P＜0.01,＜0.05,＜0.01,＜0.05,＜0.01),however,the proportion of protein is lower in obese than non-obese PCOS(P＜0.01).Conclusions Obese women with PCOS have more severe glucose metabolic disturbance and they have taken more energy,carbohydrate,but lower proportion of protein.Such dietary constitution may directly lead to sever metabolic disturbance.So energy restriction and dietary modulation should be an important clinical intervention for the women with PCOS.Novelty of this studyIt is the first time of our study to analyze risk factors of PCOS like birth weight (BW),family history,dietary intake and so on.Quantitative analysis to the dietary intake of PCOS and its comparison between obese and non-obese PCOS has not been reported yet.We also had an initial study to the relationship between dietary intake of PCOS women and their glycometabolism.All these studies provided the theoretical reasons for us to interfere in the clinically treatment with PCOS by suitable diet.