| Objectives:Polycystic ovary syndrome(PCOS) is one of the most common gynecologic and endocrine problems.Insulin resistance and hyperandrogenism are the characteristics of PCOS.The present study was aimed to compare the prevalence of hormones and glucose metabolic disturbance in women with PCOS,and to observe the therapeutic efficacy of different agents improving insulin resistance and antihyperandrogen.Methods:A total of 78 women aged from 18 to 32 years old who were diagnosed as PCOS were enrolled to our research.1.Oral glucose tolerance testS(OGTT) of 75g glucose and insulin release tests (IRT) were performed in all the paitents.Blood glucose level and insulin level was measured at fasting,1 hour,2 hours and 3 hours after taking glucose.Moreover,A fasting blood sample was obtained to measure follicle stimulating hormone(FSH), luteinizing hormone(LH),estradiol(E2) and testosterone(T).Body mass index (BMI),waist-to-hip ratio(WHR),luteinizing hormone / follicle stimulating hormone (LH/FSH) and homeostasis model assessment of insulin resistance(HOMA-IR) were calculated.The prevalence and influential factors of glucose metabolic disturbance were further analysed.2.All the patients were divided in to two groups by BMI,There were 29 cases of obesity(BMI≥28kg/m~2) and 49 cases of non-obesity(BMI＜28kg/m~2).A further analysis among obesity,glucose tolerance,insulin resistance and sex hormone was performed.3.78 cases of PCOS were randomly divided into three groups.Group A(n=25) was assigned to receive Diane-35 for 3 months.Group B(n=27) was given metformin for 6 months,and combination with Diane-35 for the last 3 months.Group C(n=26) was given rosiglitazone for 6 months,and combination with Diane-35 for the last 3 months,too.The above-mentioned parameters were re-evaluated after the treatment period.Results:1.79.49%patients were normal glucose tolerance.There were more than 20%patients had an glycometabolic dysfunction.(15.38 IGT,1.28%IFG,3.85% DM).2.Patients with glycometabolic dysfunction had an higher level of BMI,WHR, T and HOMA-IR than those with normal glucose tolerance(P＜0.01 or P＜0.05). However,there were no significant difference in LH,FSH,LH/FSH and(P＞0.05).3. The incidence rate of glycometabolic dysfunction in obesity patients was 37.93%, while 10.20%in non-obesity patients.The difference had a statistical significance(x~2=8.59,P=0.003).4.Patients with obesity had a higher level of insulin,1PG,WHR,HOMA-IR and T than those non-obesity ones.(P＜0.05 or P＜0.01).5.BMI was positively correlated with WHR,FINS,T and HOMA-IR (r=0.436,P＜0.01;r=0.480,P＜0.01;r=0.252,P=0.003;r=0.378,P＜0.01).FINS was positively correlated with BMI,WHR,T and HOMA-IR(r=0.480,P＜0.01;r=0.281, P=0.005;r=0.271,P=0.022;r=0.786,P＜0.01 )o 6.Patients in Group A had an obvious decrease in LH,LH/FSH and T after treatment(P＜0.01).BMI,WHR,LH,LH/FSH and T were decreased significantly in cases of group B(P＜0.01 or P＜0.05).There was a marked reduction in LH,LH/FSH and T(P＜0.01),while BMI increased significantly(P＜0.05) in group C.Group B had a lower level of BMI than group A and group C.(P＜0.01 or P＜0.05),as well as a lower level of WHR than group C (P＜0.05).Group A had a higher level of LH,LH/FSH and T than group B and group C.(P＜0.01 or P＜0.05).7.After treatment,women in group A showed a significant increase in FINS and HOMA-IR,(P＜0.05).While fasting and post-OGTT insulin concentrations and HOMA-IR decreased in group B and group C(P＜0.01).F1BS had a higher level in group A in contrast to that in group B and group C.(P＜0.05).Group B and group C showed higher reduction in fasting and post-OGTT insulin concentrations and HOMA-IR than those in group A(P＜0.01 or P＜0.05).Moreover, group C had an obvious lower level in fasting and post-OGTT insulin concentrations and HOMA-IR than those in group B(P＜0.01).Conclusions:1.The prevalence rate of glycometabolism disorder is 20.51%. OGTT is the essential examination for all the PCOS patients.2.PCOS patients with obesity prone to have a higher chance of glycometabolism disorder,insulin resistance and hyperandrogenism.3.Obesity,insulin resistance and hyperandrogenism are interactive.4.Diane-35 have a positive role in the improvement of sex hormone, however,they do not improve the insulin sensitivity.Both metformin plus Diane-35 and rosiglitazone plus Diane-35 can improve the insulin resistance and imbalance of other endocrine hormones of PCOS cases.The first choice of PCOS patients with obese is metformin in plus Diane-35,While for the PCOS cases with normal weight or with severe insulin resistance,rosiglitazone in plus Diane-35 is a better choice.
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