Study About The Variation Of Endocannabinoid System In Polycystic Ovary Syndrome Patients Treated With Diane-35 And Metformin

Objective : To assess the level of endocannabinoids in serum and expressions of the cannabinoid receptors type1 and hydrolytic enzymes FAAH in endometrium in polycystic ovary syndrome patients treated with Diane-35 and metformin before and after as well as normal women.To comfirm that the variation of endocannabinoid system plays an important role in the polycystic ovary syndrome pathogenic process and to provide a theoretical foundation to investigate the pathologic physiology mechanism of polycystic ovary syndrome.Methods:60 patients who were treated in the Assisted Reproduction Center of Second Hospital of Hebei Medical University from January 2015 to January 2016 were randomly selected in this research,including 30 cases of polycystic ovary syndrome patients and 30 cases of normal women.All the patients had their venous blood sample taken in the second or third day of their menstrual cycle when limosis in order to measure the level of anandamide and 2-arachidonoyl glycerol.After menorrhea two or three days they had their endometrium sample taken in order to measure the expression of the CB1 and the hydrolytic enzymes FAAH.Take the venous blood and endometrium sample again after treating the polycystic ovary syndrome patients with Diane-35 and metformin three months later.All the data was recorded and analysed with SPSS23.0 software package.Result:1 The average AEA serum level of PCOS group before treating with Diane-35 and metformin was 15.66ng/ml while the normal women group was 9.89ng/ml.The independent sample t-test was used to compare means.It shows significant difference between the two groups(P=0.02,Table 2).At the same time,the wilcoxon test method was applied to compared the 2-AG serum level and it shows no significant difference in PCOS group before and after treating with Diane-35 and metformin(P=0.71,Table 2).The average AEA serum level of PCOS group after treating with Diane-35 and metformin was 13.69ng/ml.The paired t-test was applied to compare means between the PCOS patients before and after treating with Diane-35 and metformin and AEA serum level shows a significant difference(P=0.03,Table 2)while the 2-AG serum level shows no difference at the same time(P=0.67,Table 2).2 The median expression of CB1 receptor in endometrium of PCOS before treating with Diane-35 and metformin was 4.0 as well as the normal women group.There is no significant difference between these two groups(P=0.24,Table 3).The median expression of CB1 receptor in endometrium of PCOS after treating with Diane-35 and metformin was also 4.0.It has no significant difference with the median expression of CB1 receptor after treating with Diane-35 and metformin(P=0.75,Fig.3).3 The average expression of FAAH in endometrium of PCOS before treating with Diane-35 and metformin was 309.29±130.11.The average expression of FAAH in endometrium of normal women was 406.85±116.78.The PCOS group before treating with Diane-35 and metformin is significantly lower than the normal women group(P=0.003,Table3).The average expression of FAAH in endometrium of PCOS after treating with Diane-35 and metformin was 359.07±132.33.The FAAH expression shows a significant increase after PCOS patients treating with Diane-35 and metformin(P<0.001,Table 3).Conclusion:1 There is an obvious change in PCOS endocannabinoid system compared with normal women.2 The paranormal endocannabinoids serum level and the decreased FAAH expression in endometrium may become an important performance on the process of PCOS progress.3 Monitoring the serum level of AEA may become a new index for measuring the PCOS progression.