The Metabolic Characteristics Of Polycystic Ovary Syndrome And The Correlation Analysis With Insulin Resistance

BackgroundPolycystic ovary syndrome (PCOS) is the most common reproductive disordersin the women of childbearing age. It is also the main cause of oulatory infertility.PCOS has a high degree of heterogeneity in clinical manifestations. Patients withPCOS have liability to type2diabetes and many of them are obese. Some studieshave indicated that fat distribution pattern was an independent risk factor forcardiovascular or metabolic diseases. Also the abnormal distribution of fat tissue hasrelationship with endocrine metabolism，thereby induce the reproductive dysfunctionof women in child-bearing age.ObjectiveTo explore the characteristics of blood glucose metabolism, lipid metabolism,bone metabolism, gonadal hormone levels, and fat distribution in PCOS patientswhich may provide the new strategy for the treatment of PCOS.MethodsFifty-six PCOS patients and39healthy control women were enrolled. Weight,height, waist circumference, hip circumference, body mass index (BMI) and waist-hipratio were measured. And the PCOS group was further divided into2subgroupsaccording to BMI: normal weight subgroup (n=18) and overweight or obesity group(n=38). Fasting plasma glucose, triglyceride, total cholesterol, high densitylipoprotein, low density lipoprotein, fasting insulin, luteinizing hormone, folliclestimulating hormone, progesterone, testosterone, prolactin, estradiol were measuredwith blood samples. The insulin resistance index was calculated with HOMA-IR=（FPG×FINS）/22.5. Bone mineral density (BMD), bone mineral content (BMC),body Fat mass and lean fat mass were measured by dual-energy X-ray absorptiometry(DXA). Statistical analysis were performed with SPSS19.0software. Results1. The level of Weight, BMI, WC, WHR, FPG, FINS, HOMA-IR, TG, TC,LDL-C LH, LH/FSH, T in PCOS group were significantly higher than those inhealthy controls（P<0.05）; The levels of HDL-C was higher in the healthy controlsthan in PCOS group (P<0.05).2. The values of BMC of left upper limb, BMC and BMD of right upper limb,the body’s BMC and BMD and Z value in PCOS group were higher than those inhealthy controls (P <0.05).3. Fat mass of the body, right upper limb, trunk, and abdomen, fat-free weight(Lean mass+BMC) and fat percentage (Fat%) in PCOS patients were significantlyhigher than those in healthy controls (P <0.05). Fat-free weight and Android/Gynoidfat ratio of Bilateral lower limbs and hip in PCOS group were higher than those inhealthy controls (P <0.05).4. BMD of overweight and obesity PCOS subgroup was positively correlatedwith BMI and HOMA-IR respectively (r=0.530，p<0.01; r=0.456，p<0.01). BMC ofnormal weight subgroup was negatively correlated with T score(r=-0.688，p<0.01).Whole body BMC was positively correlated with BMI and HOMA-IR（r=0.352，p<0.05；r=0.560，p<0.05）in overweight and obesity PCOS subgroup.5. Body fat mass was positively correlated with BMI, HOMA-IR and WCrespectively in healthy controls（r=0.827,0.322and0.726respectively，p<0.05）whilebody fat mass was positively correlated with BMI, HOMA-IR, and WC in overweightand obesity PCOS subgroup（r=0.579,0.377, and0.513respectively, p<0.05）.6. Abdomen fat mass was positively correlated with BMI, HOMA-IR and WC inhealthy controls(r=0.775,0.400and0.674respectively, p<0.05). Abdomen fat masswas positively correlated with BMI, HOMA-IR and WC in normal weight PCOSsubgroup(r=0.511,0.500and0.483respectively, p<0.05). Abdomen fat mass waspositively correlated with BMI, HOMA-IR and WC in overweight and obesity PCOSsubgroup (r=0.530,0.358and0.329respectively, p<0.05).7. Whole body BMD was positively correlated with fat-free weight inoverweight and obesity PCOS subgroup.(r=0.344, p<0.05).` Conclusion1. PCOS patients have liability to metabolic syndrome such as glucose and lipidmetabolism disorders and insulin resistance.2. PCOS patients also show the abnormal of bone metabolism and bodycomposition.3. Both abdomen and whole body fat mass were higher in PCOS group. PCOSpatient showed a central obesity which related with their insulin resistance.4. Losing weight, especially reducing abdomen fat mass may be helpful toprevent the development of complications of PCOS and which may provided us a newtreatment strategy.