The Investigation Of Clinical Features And Analysis Of Related Factors Of Polycystic Ovary Syndrome Of Reproductive Age Women In Tianjin

OBJECTIVE:Through cross-sectional investigation,we screened the patients of polycystic ovary syndrome(PCOS) of reproductive women in Tianjin.With case-control study,analyze the clinical datas of PCOS patients.To explore the prevalence,clinical traits and incidence of related factors of PCOS female of reproductive age in Tianjin.METHODS:In accordance with the cluster stratified sampling method,we randomly selected 1500 women of reproductive age in Tianjin area to carry out a questionnaire interview about PCOS.Including:completing questionnaire,physical examination,gynecologic examination,transvaginal ultrasonography examination,drawing blood,determination of endocrine and metabolitic indicators.Based on ESHRE/ASRM criteria screening out 94 cases of polycystic ovary syndrome of reproductive age women,according to the proportion of 1 to 2 to elect the same period under investigation 188 cases of women with the same age,normal menstruation,without endocrine disorders as a normal control group for case-control study.Using EpiData3.0.2 to input datas into database.Univariate and multivariate Logistic regession analysis of factors of clinical history,clinical traits,ovarian morphology,serum sex hormone and index between case group and control group to explore its prevalence,clinical traits and possible pathogenesis of relevant factors.RESULTS:1.We completed 1333 Valid questionnaires.Consider ESHRE/ASRM criteria as the diagnosis standard,there are 94 females diagnosed as PCOS,the incidence rate of PCOS women of reproductive age in Tianjin area is 7.05%.The infertility rate of PCOS women of reproductive age is 24.5%.2.The clinical traits of 94 PCOS reproductive females are:The menstruation of 54.3%PCOS females is abnormal,82.4%is menstruation oligotrichia and 17.6%is secondary amenorrhea.64.9%PCOS females with high androgen-emia,the clinical showing of high androgen of PCOS female crinosity and acne is 11.7%and 13.8%. Transvaginal or transrectum ultrasonography examination,81.9%PCOS female show polycystic ovary,in which 40.3%show polycystic in two ovaries,59.7%show half polycystic ovary,and 23.4%female follicles distribution show necklace sign.Ovarian volume of 8.5%PCOS female is≥10ml.67.7%PCOS female having LH/FSH≥2.0,80.6%PCOS female having LH/FSH≥1.5.38.3%PCOS female having insulin resistance,the incidence of insulin resistance of obesity PCOS female is 59.6%,and non-obesity female is 17.0%.13.8%PCOS female is BP≥130/85mmHg,6.4%PCOS female TG≥2.79mmol/1.The PCOS of type I(PCO/HA/IM),typeⅡ(PCO/HA),typeⅢ(PCO/IM),typeⅣ(HA/IM) occupied 24.5%,53.2%,8.5%,13.8%.38.3%PCOS female is BMI≥25Kg/m~2,34%PCOS female is WHR≥0.85.68.1%PCOS female not having habits of exercise.The relative of PCOS female having diabetes mellitus,high tension,gynecology tumor,menstruation oligotrichia,infertility,and alpecia is 31.9%, 54.3%,8.5%,8.5%,5.3%,and 9.6%.3.The outcomes of univariate Logistic regession analysis show:pathogenesis of relevant factors of PCOS reproductive female of Tianjin are:obesity,SHBG,FTI,INS, IR,TG,LH,the ratio of LH/FSH,less exercise,infertility,relative of diabetes mellitus and high tension,mother and sisters of gynecology tumor,menstruation oligotrichia and infertility,father and brother of alpecia.4.The outcomes of multivariate Logistic regession analysis show:less exercise, obesity,mother and sisters of menstruation oligotrichia and father and brothers of alpecia are the high risk factors of pathogenesis of reproductive female in Tianjin.CONCLUSION:1.The incidence rate of PCOS women of reproductive age in Tianjin area is about 7.05%.The infertility rate of PCOS women of reproductive age is about 24.5%.2.The PCOS of reproductive age women in Tianjin area likely occurs between 20 to 35 years old.The PCOS shows:the early onset in puberty,to the peak incidence of 30 to 35 years old,significant drop of incidence after 30 year old,to the 40 years old vest,as the decline of ovarian reserve,metabolic disorders of the reproductive system in PCOS patients tend to ease. 3.Abnormal menstruation(including menstruation oligotrichia and secondary amenorrhea),high androgen-emia,and polycystic ovary(there are more than 12 small follicles with the diameter of 2 to 9mm in unilateral or bilateral ovary)are the important clinic features of reproductive female.2003ESHRE/ASRM criteria suits for considering as the diagnosis standard of PCOS in Tianjin area.4.LH/FSH≥2 is the important pathological change of PCOS.Whether it be considered as a diagnostic indicator,still need increase sample size to further explore.5.The different proportion of clinical types of PCOS of reproductive age women in Tianjin is different,mainly in typeⅡ(PCO/HA).6.The related factors of pathogenesis of reproductive female in Tianjin are: obesity,SHBG,FTI,INS,IR,TG,LH,the ratio of LH/FSH,less exercise,infertility,relative of diabetes mellitus and high tension,mother and sisters of gynecology tumor, menstruation oligotrichia and infertility,father and brother of alpecia.Less exercise, obesity,mother and sisters of menstruation oligotrichia and father and brother of alpecia are the high risk factors of pathogenesis.7.The incidence of PCOS of reproductive age women in Tianjin is genetic-related, diet,region,environment,profession has nothing to do.PCOS is multi-gene genetic disease.