Study On The Correlation Between Different TCM Syndrome Types And Insulin Resistance Of Polycystic Ovarian Syndrome

ObjectiveTo investigate the correlation between different TCM syndrome types and insulin resistance in patients with polycystic ovarian syndrome, and to explore the value of OGTT and IRT in diagnostic criteria of insulin resistance.MethodsThe sixty PCOS patients were divided into three groups according to the syndrome differentiation of TCM:phlegm-damp syndrome (PDS) group, liver stagnation syndrome (LSS) group and kidney deficiency syndrome (KDS) group. All the patients were undertaken oral glucose tolerance test (OGTT) and insulin releasing test (IRT). The indexes such as blood glucose, insulin, AUC, HOMA-IR were collected. The intergroup difference of each indexes was compared. The incidence of IR basing on two different methods was analyzed:simple diagnostic criteria and insulin releasing curve rating method. The SPSS 20.0 software package was used to analyze the data, the main analysis methods were ANOVA, rank sum test and chi-square test etc.Results1. Among the 60 patients with PCOS, there were 32 cases(55.33%) in PDS group,18 cases (30.00%) in LSS group and 10 cases (16.67%) in KDS group. There was a statistical difference in the distribution (P<0.01)2. The BMI and WHR of PDS group were higher than the other groups(P< 0.01). There was no significant difference between the LSS and KDS groups. The PDS group had an average BMI of over 25, and an average WHR of over 0.85. Obviously, the patients in PDS group had a severe obesity. The patients in LSS and KDS groups almostly maintained a healthy weight, but the WHR was greater than or equal to 0.80.3. There were no significant differences in the level of glu-0.5, glu-2 and glu-3 after 75g OGTT among the three groups (P>0.05). The average level of serum glucose in the three groups at five different timing points were in the normal range. But there was a general tendency that the PDS group had a higher serum glucose level than the other groups. The FPG was higher than that in the KDS group (P<0.05), the glu-1 and GAUC were higher than those in the LSS group (P<0.05,P<0.01).4. The level of FINS, INS-2, IAUC and HOMA-IR in the PDS group was significantly higher than that in the LSS and KDS group. The average FINS was over 15 μ IU/mL in the PDS group.5. There were 18 patients (30%) suffering from abnormal glucose metabolism(IFG/IGT/DM). One of them reached the standard of diabetes. There was no significant difference in the incidence rate of abnormal glucose metabolism between three groups (P>0.05).6. Basing on the simple diagnostic criteria, the incidence of IR in PDS group was higher than that in the two other groups. However, there was no significant difference between three groups by using the insulin releasing curve rating method. For the LLS and KDS groups, there was significant difference to inflect the situation of IR by using the two different methods, it was higher by using the insulin releasing curve rating method.ConclusionAmong the patients with PCOS, the insulin resistance in PDS group is severer. OGTT and IRT are more sensitive in reflectting the situation of IR, especially in patients with non-phlegm-damp syndrome.