The Study On The Functional Change Of HPA Axis In PCOS Patients With Obesity And Depression And The Study Of The Correlation With TCM Syndromes

Objectives: To study the changes of HPA axis function in PCOS patients with obesity and depression,and so as to explore the correlation of TCM syndromes and the state of obesity and depression.Methods:145 patients with PCOS who met the inclusion and exclusion criteria were selected.Collect social demography,anthropometric data,information of four traditional Chinese medicine diagnosis,SDS score,etc.According to BMI and Self-Rating Depression Scale(SDS)score,patients with PCOS was divided into obesity depression group(FD)and the depression group(FN),non-obese depression group(TD),not fat not depression group(TN).Compare the four groups of demographic data,body measurement index,biochemical index etc,and explorethe changes of HPA axis function in PCOS patients with obesity,and the correlation of TCM syndromes and the state of obesity and depression.Results: 1.This study included 145 patients meeting the criteria,including 26 in FD group,48 in FN group,22 in TD group and 49 in TN group.2.There were no statistically significant differences among the four groups in education background,marital status,height and age(P>0.05).3.Body weight,BMI,waist circumference,hip circumference and WHR of FD group and FN group were higher than those of TD group and TN group(P < 0.05),and there was no statistically significant difference among other groups(P>0.05).4.There was no significant difference in ACTH level among the four groups.Compared with FN group and TN group,FD group had higher cortisol level(P<0.05).Compared with FN group and TN group,TD group had higher cortisol levels(P<0.05).There was no significant difference among the other groups(P>0.05).5.Compared with FD group and FN group,TN group had lower FPG level,and the difference was statistically significant(P<0.05).Compared with TD and TN groups,FD and FN groups had higher basal insulin levels and homa-IR values,homa-levels,with statistically significant differences(P<0.05),and no statistically significant differences among other groups(P>0.05).6.There was no statistically significant difference in PRL,LH,FSH,FH/FSH,E2,P,T,and DHEAS among the four groups(P>0.05).7.The correlation between ATCH,COR and various indicators was analyzed in 145 PCOS patients,and T,DHEAS and SDS scores were positively correlated with ACTH.DHEAS and SDS scores were positively correlated with COR.8.The depression rate of kidney deficiency and liver depression syndrome was higher than that of kidney deficiency and blood stasis syndrome and phlegm and blood stasis syndrome(all P < 0.05),and there was no statistically significant difference among other groups(P > 0.05).There was no significant difference in the proportion of obesity among the groups.9.There was no statistically significant difference in ACTH and COR levels among thegroups of four syndromes(P > 0.05).Conclusions: 1.Compared with non-obese PCOS,obese PCOS patients have more severe insulin resistance,stronger function of pancreatic islet cells,more obvious glucose metabolism disorder,and a higher risk of type 2 diabetes.2.Through literature analysis,the depression detection rate of PCOS patients was significantly higher than that of normal women.Andthe COR level of PCOS patients was higher in the depressed state.It suggested that depression,as an adverse emotion,would change the function of the HPA axis.3.Testosterone and DHEAS in PCOS patients were positively correlated with the levels of ACTH and COR,which further indicated that the HPA axis was correlated with the hyperandrogenemia of PCOS patients.4.There is an obvious correlation between depression syndrome and depression mood in Traditional Chinese Medicine,which provides strong evidence for clinical practitioners to treat depression syndrome from the perspective of soothing liver and relieving depression.