| Polycystic ovary syndrome(PCOS)is one of the most common endocrine diseases among reproductive-age women.Its major clinical manifestations include menstrual irregularities,signs of androgen excess,obesity,insulin resistance and elevated serum LH levels.Most women with PCOS have glucose and lipid metabolism issues,such as insulin resistance,atherosclerosis and metabolic syndrome.It is difficult to diagnose PCOS,because the pathology and etiology of polycystic ovary syndrome remain uncertain.At present,the most used diagnosis of polycystic ovary syndrome is 2003 Rotterdam Criteria based on the presence of at least two of the following conditions: 1)oligoamenorrhea and/or anovulation;2)hyperandrogenism(clinical and/or biochemical);and 3)polycystic ovary on ultrasound examination and exclusion of other etiologies(congenital adrenal hyperplasia,androgen-secreting tumors,Cushing’s syndrome).It is worth noting that dyslipidemia and glucose metabolism disorder are the most common metabolic abnormalities in PCOS patients,which are closely related to obesity,insulin resistance and cardiovascular disease.Therefore,it is very important to study the relationship between lipid metabolism and glucose metabolism in patients with PCOS for improving the quality of life in PCOS patients and explaining physio pathologic mechanism.Our study aims to investigate the association between glucose metabolism and lipid metabolism in polycystic ovary syndrome patients.There were four parts in our study: 1)Correlation between dyslipidemia and insulin resistance in polycystic ovarian syndrome;2)Feasibility analysis of triglyceride as a surrogate marker for insulin resistance in Chinese women with Polycystic Ovary Syndrome;3)Insulin-like growth factor-1 and insulin-like growth factor binding protein-3 levels in women with polycystic ovary syndrome;4)Correlation between serum lipoprotein A and other biochemical indexes in patients with polycystic ovary syndrome.PART I Correlation between Dyslipidemia and Insulin Resistance in Polycystic Ovarian SyndromeObjective To study the association of dyslipidemia,insulin resistance and obese in polycystic ovarian syndrome.Methods Height,weight,age,lipid parameters,free testosterone(FT),OGTT,insulin release test were measured from 200 women with PCOS according to Rotterdam consensus.Body mass index,HOMA-IR et.al were calculated.PCOS patients were divided into two groups by lipid levels.Results Age,BMI,FT,HOMA-IR,FPG,GLU60,GLU120,GLU180,FIN,INS30,INS60,INS120,INS180 levels of the dyslipidemia group were significantly higher than that of normal lipid group.The ROC curve analysis demonstrated that the best marker for insulin resistance was triglyceride(TG),with the areas under the ROC curve of 0.798,and the optimal cut-off point was 1.025.Conclusions TG can be used as a useful surrogate marker for insulin resistance in China women with PCOS.PART II Feasibility Analysis of Triglyceride as a Surrogate Marker for Insulin Resistance in Chinese Women with Polycystic Ovary SyndromeObjective To analyze the feasibility of Triglyceride as a Surrogate Marker for Insulin Resistance in Chinese Women with Polycystic Ovary SyndromeMethods Height,weight,age,lipid parameters,OGTT,insulin release test were measured from 171 women with PCOS according to Rotterdam consensus.Body mass index and HOMA-IR were calculated.PCOS patients were divided into two groups by body mass indexResults TG,HDL,LDL,FPG,G30,G60,G120,G180,FINS,I30,I60,I120,I180 levels of the obese group were significantly higher than that of the non-obese group.The ROC curve analysis demonstrated that triglyceride could be used as a surrogate marker for insulin resistance in non-obese women with Polycystic Ovary Syndrome,with the areas under the ROC curve of 0.791,and the optimal cut-off point was 1.585.Conclusion TG can be used as a surrogate marker for insulin resistance in non-obese Chinese women with polycystic ovary syndromePART III Insulin-like Growth Factor-1 and Insulin-like Growth Factor Binding Protein-3 Levels in Women with Polycystic Ovary SyndromeObjective Women with polycystic ovary syndrome may exhibit metabolism problems such as obesity,insulin resistance,impaired glucose tolerance and abnormal lipid metabolism.IGF1 plays an important role,and IGFBp3 is the most abundant carrier protein for IGF1 in the blood.So,it’s important to make clear about the levels of IGF1 and IGFBp3,and the association between IGF1,IGFBp3 and other clinical index of women with PCOS.Methods We select 124 women with PCOS,who were first visited to our hospital from 2014 to 2016 and without drug treatment.Height,weight,IGF1,IGFBp3,OGTT and insulin release test were measured.Body mass index(BMI)and HOMA-IR were calculated.The women were divided into groups by BMI(body mass index),FBG(fasting blood-glucose),G120(OGTT 2-hour blood-glucose)and HOMA-IR(homeostasis model assessment of insulin resistance)to analyze the association between these indexes.Results 1.IGFBp3 levels in obese group and insulin IR group were significantly higher than those in non-obese group and NIR group;2.The IGFBp3 level in the NGT group was significantly lower than that in the abnormal glucose group(IFG+IGT+T2DM),p<0.05;3.There is a linear correlation between IGFBp3 and IGF1,r=0.404,r2=0.164,p<0.001,linear regression equation is IGF1=9.83+50.84IGFBp3 4.IGFBp3 and IGF1 were significantly correlated with 17-OH,r=0.253,0.248,P<0.05;5.IGFBp3 was significantly related to G0,G60,G120,G180,FINS,HOMA-IR;6.IGF1 and TG were significantly correlated,r=0.248,p<0.001Conclusions IGFBp3 is associated with glucose metabolism.Elevated IGFBp3 can increase the risk of glucose metabolism issues and insulin resistance in PCOS patients.PART IV Correlation Between Serum Lipoprotein A and Other Biochemical Indexes in Patients with Polycystic Ovary SyndromeObjective To analyze Correlation Between Serum Lipoprotein A and Other Biochemical Indexes in Patients with Polycystic Ovary SyndromeMethods We select 143 women with PCOS,who were first visited to our hospital from 2014 to 2016 and without drug treatment.Height,weight,TG,TC,LDL,HLD,Lp A,IGF1,IGFBp3,OGTT and insulin release test were measured.Body mass index(BMI)and HOMA-IR were calculated.The women were divided into groups by Lipoprotein A and HOMA-IR(homeostasis model assessment of insulin resistance)to analyze the association between these indexes.Results Age,BMI,FT,SHBG,TG,TC,LDL,HDL of IR group is significantly different from NIR group.TG,TC,HLD,LDL and Lp A is associated with some other indexes.17OHP、TC、LDL of group I is significantly different from group II.Conclusion we suggest that the laboratory of the hospital should test lipoprotein A,if conditions permit. |
