| Objective: By measuring the differences of serum leptin levels in obese and non-obese patients with the polycystic ovary syndrome(PCOS), and by observing the changes of serum leptin level in patients with PCOS after treatment, and by evaluating the relationship between leptin and body mass index, sex hormone and insulin resistance index, we can analyze the correlation between the expression level of leptin and PCOS patients, as well as to discuss whether leptin can be used as a potential target for the diagnosis and treatment of patients with PCOS.Methords: We have taken 73 patients who were diagnosed with PCOS for the first time at the center of reproductive medicine of Yan cheng Maternal and Child Health-Care Center from January 2014 to January 2015 as the object of observation. Based on body mass index(BMI), they were assigned to two groups: the obese group(BMI≥25, n = 38) and the non-obese group(BMI < 25, n = 35). Meanwhile, comparision group was recruited by 63 normal fertile women(infertility for male factor or tubal factor) with normal menstrual cycle and normal ovulation, at the same time, 63 normal fertile women in comparision group were also divided as the obese control group(BMI≥25, n = 31) and the non-obese control group(BMI < 25, n = 32) according to BMI. During the period of second days to fifth days in the menstrual cycle between 8:00 AM and 10:00AM(amenorrhea is required to determine the bilateral ovaries in no dominant follicle, between endometrial thickness is less than or equal to 5mm), fasting venous blood were detected in the above groups with the following aspects serum leptin by enzyme linked immunosorbent assay, sex hormone including follicle stimulating hormone(FSH), luteinizing hormone(LH) and testosterone(T) by immunochemiluminometric assays, fasting plasma glucose(FPG) by hexokinase end point method, fasting insulin( FINS) by timed-resolved fluoroimmuno assay, and then calculated homeostasis model assessment for insulin resistance(HOMA-IR). On the fifth day of the menstrual cycle,PCOS groups began oral Diane-35(1 tablets/time, 1 times/day, taking 21 consecutive days, and began to take the second course sequentially on the fifth day in next menstruation, a total of 3 courses of treatment). And in the second combined metformin(0.85-1.70)g/days, 1 month for 1 courses of treatment, a total of 3 courses). After the 3 courses of treatments fasting, venous bloods were taken to review the above indexes between 8:00 AM and 10:00AM on the first 2-5 days in the next menstrual cycle. The changes of the above indexes were observed in the PCOS patients after treatment.Results: 1. The expression level of serum Leptin in the PCOS groups was significantly higher than that in the comparision groups, and the difference was significant(P<0.01). The expression level of serum Leptin in the obese group with PCOS was significantly higher than in the non-obese group with PCOS, and there were significant differences in statistics between the groups(P<0.01).2. The expression levels of LH, T, FPG and FINS in the PCOS groups were significantly higher than in the comparision groups, and the difference had statistical significance(P<0.01), but there was no significant difference in the expression level of FSH between PCOS groups and comparision groups(P > 0.05). The expression levels of LH, T and FINS in the obese group with PCOS and the obese comparision group were different, and the differences were statistically significant(P < 0.01). In the obese group with PCOS, FPG was slightly higher than that in the obese comparision group, but not statistically significant(P > 0.05); the expression levels of LH, T, FINS and FPG in the non-obese group with PCOS and that in the non-obese comparision group were different, and the differences had statistical significance(P < 0.01).3. After treatment, the expression level of serum Leptin was significantly decreased in the obese and non-obese groups with PCOS compared with that before treatment, and the difference was statistically significant(P<0.01).4. After treatment, there was no significant difference in the expression level of serum Leptin between the PCOS groups and the comparision groups(P>0.05). After treatment, the expression level of serum Leptin had no significant difference between the obese group with PCOS and the obese comparision group(P > 0.05), but after the treatment, the expression level of serum Leptin in the non-obese group with PCOS was higher than that in the obese comparision group, and the difference was statistically significant(P < 0.01).5. In the PCOS groups, the expression levels of LH, T, FPG and FINS after treatment were significantly lower than that before treatment, and the difference was statistically significant(P<0.01). BMI was also lower compared with that before treatment; the difference was statistically significant(P < 0.05). In the obese group with PCOS, FPG after treatment was decreased compared with that before treatment, and the difference was statistically significant(P <0.05). Meanwhile, BMI, LH, T and FINS were significantly decreased compared with that before treatment, and the difference was statistically significant(P <0.01). In non-obese group with PCOS, BMI and T after the treatment was the decreased compared with that before treatment, and the difference was statistically significant(P < 0.05); and also, LH and FINS were significantly decreased, the difference was statistically significant(P < 0.01), but there was no significant change in FPG after treatment(P>0.05). Also FSH had no significant difference before and after treatment(P>0.05).6. After the treatment of PCOS groups, the expression level of BMI, FPG and FINS decreased, there was no significant difference vs comparision groups(P > 0.05); However, the expression level of LH and T in PCOS groups was higher than that in comparision groups after treatment, and the difference was statistically significant(P < 0.01). There were not significant differences in the expression levels of BMI, LH, FPG, FINS after treatment between the obese group with PCOS and the obese comparision group(P > 0.05), but the expression levels of T was significantly different(P < 0.01); the expression levels of LH, BMI between the non-obese group with PCOS and the obese comparision group was different, and it was statistical significance(P < 0.05), the expression level of T was significantly different between the two groups, and it was statistically significant(P < 0.01), but the expression level of FPG and FINS was not statistical significance(P > 0.05).7. Serum leptin was significantly positive related to BMI, T, and HOMA-IR in PCOS patients before and after treatment.Conclusions: Serum leptin was increased significantly in PCOS patients and it was higher in the obese group than in the non-obese group. After treatment, BMI, FPG, FINS in PCOS patients showed no difference with normal people, which indicates that the treatment of Diane-35 combined with metformin hydrochloride was effective. After the combined treatment, the expression levels of the serum Leptin was also decreased significantly and it was close to the level in normal people, and the decline of serum leptin in the obese group with PCOS was particularly significant. Before and after treatment, the expression levels of serum Leptin and BMI, T, HOMA-IR in PCOS patients were significantly positive correlation. We can consider that leptin may play a important role in the pathogenesis and development of PCOS, and it was closely related to sex hormone disorder and insulin resistance. Therefore, leptin can be considered as a potential target for the diagnosis of PCOS, and as one of prediction indexes of PCOS diagnosis. |
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