Analysis Of Insulin Resistance And Glycolipid Metabolism Characteristics In Patients With Polycystic Ovary Syndrome During Adolescent And Reproductive Age

?Objective?In recent years,Polycystic ovary syndrome(PCOS)has been called for renaming by metabolic disorder syndrome(MRS),to pay attention to complications such as glycolipid metabolic disease,cardiovascular disease,and infertility.It is speculated that the onset of PCOS can be attributed to puberty,which gets worse during reproductive age and has a major impact on a whole women's life.The degree of insulin resistance and glycolipid metabolism associated with PCOS is different from adolescence and reproductive age.At present,the diagnostic standard of PCOS in adolescence is various,and adolescent often be excessive or missed diagnosticed.In 2016,our country formulated diagnostic criteria of PCOS in adolescence.It is necessary to evaluate the PCOS patients in puberty,and try to make early detection,diagnosis and treatment.To analysis of the clinical characteristics,insulin resistance(IR)and glycolipid metabolism of PCOS patients in adolescent and reproductive age,we aim to find out the differences of IR and glycolipid metabolism in different age groups of PCOS patients,which help to recognize the early factors of PCOS and the aggravating factors in the process of the disease.?Methods?Retrospective analysis of the finally diagnosed with polycystic ovary syndrome patients during January 2014 to December 2017,due to menstrual abnormalities,infertility or impaired glucose tolerance in the Third Affiliated Hospital of Guangzhou Medical University outpatient department in obstetrics and Gynecology,according to 2016 Chinese consensus on diagnosis and treatment of adolescent PCOS and the Rotterdam standard of PCOS in 2003,a total of 219.All patients were divided into adolescent group and reproductive age group,including 68 Adolescence and 151 patients of reproductive-age.According to body mass index(BMI),the two groups were further divided into obese and non-obese groups.In the study,there were 21 cases of adolescent obesity,64 cases of obesity at reproductive-age.Then compared and analyzed the parameters between the groups,such as abnormal period,the prevalence of insulin resistance(IR),glycolipid metabolism and metabolic syndrome(MetS)in adolescent and reproductive-age.?Results?1.The onset of PCOS average age in adolescence and reproductive-age patients were 14.29±1.96 years,21.09±6.51 years.2.About 92.6% adolescent girls and 41.39% reproductive-age patients with PCOS evaluated oligomenorrhea.About 18.54% reproductive-age patients characterized by menopause,which was higher than that of the adolescent group(7.4%).The age of menarche in adolescent PCOS patients(12.5±1.17 years)is less than that in the reproductive-age group(13.15±1.37 years).In addition,the average menarche age(12.4±1.23 years)in non-obese adolescences was earlier than that in non-obese reproductive-age patients(13.09±1.40 years).The system of menorrhagia is higher in reproductive-age patients than adolescences(P<0.05).3.The blood T levels in obesity group of reproductive-age [2.02(0.90)] and non-obese group of adolescent [2.14(0.51)] were higher than non-obese group of reproductive-age [1.80(1.01)],(P<0.05).No matter adolescent or reproductive-age patients,the blood LH levels in obese group were lower in non-obese group(P < 0.05).LH/FSH in non-obese group of adolescent were far higher than non-obesity group of reproductive-age.4.The prevalence of insulin resistance(IR)accounted for 43.38% in all PCOS patients,while 55.88% of patients in adolescences was significantly higher than that in the reproductive-age patients(37.75%).IR accounted for 70.59% in obesity patients.Fasting insulin(FINS),1h-insulin(INS1h),2h-insulin(INS2h),HOMA-IR in obesity group were significantly higher than non-obese group among adolescent and reproductive age(P < 0.05).IR,FINS and HOMA-IR in non-obese adolescent group were higher in non-obese reproductive-age group.The incidence of hyperinsulinemia(50%)was higher in the reproductive-age group.5.The prevalence of abnormal glucose tolerance in adolescent and reproductive-age patients was 19.12% and 29.80% respectively;Both the rate of abnormal glucose tolerance,1hBG in obesity group were higher than in non-obese group(P < 0.05),which was increased with the age.6.TC was significantly higher in both obesity group and non-obese group of reproductive-age patients than in adolescent PCOS patients with the same BMI(P<0.05).The blood level of TG was higher in obesity group than non-obesity group in reproductive-age group(P<0.05),the same as LDL-C in non-obesity group of reproductive-age patients than in adolescent non-obesity group(P<0.05).7.Through single factor analysis,there was a positive correlation among HOMA-IR,BMI and TG in adolescent patients,while a positive correlation in HOMA-IR and BMI,waist-hip ratio,LDL-C,TG,and TC of patients of reproductive-age patients.?Conclusion?1.The rate of insulin resistance(IR)in the non-obese PCOS patients during,reproductive age is lower than that of adolescent patients;IR in obese(especially abdominal obesity)PCOS patients have a higher incidence than PCOS adolescent patients.2.Impaired glucose tolerance(IGT)was higher in both obese and non-obese PCOS patients than in the adolescent patients;in the non-obese patients,the PCOS patients in reproductive age was higher than that at puberty.3.Total cholesterol(TC),triglyceride cholesterol(TG),low density lipoprotein(LDL-C)and low density lipoprotein(LDL-C)were higher in PCOS patients of reproductive age than those of PCOS adolescence.There was no significant effect of obesity on TC,the increase of TG in obese people was more obvious,and LDL-C increased in non-obese patients.4.Early menarche may be associated with early onset of PCOS in puberty.