Correlation Analysis Of Cystatin C And Homocysteine Levels With Obesity And Insulin Resistance In Patients With Polycystic Ovary Syndrome

Objective:To analysis the correlation between the levels of serum cystatin C and homocysteine levels and obesity and insulin resistance in patients with polycystic ovary syndrome(PCOS).Methods:A retrospective cross-sectional study was conducted to collect 92 patients with PCOS who were admitted to the Department of Endocrine and Metabolic Diseases and the Infertility Clinic of Reproductive Center,Affiliated Hospital of North Sichuan Medical College,from October 1,2020 to December 30,2021.According to BMI level,30 cases were divided into Normal body recombination(18.5kg/m2≤BMI ≤23.9 kg/m2),33 cases were super-recombination(24 kg/m2≤BMI≤27.9 kg/m2);obesity group(BMI≥28kg/m2)include 29 cases.According to the HOMA-IR level,they were divided into IR group(HOMA-IR≥ 2.69))52 cases and NIR group(HOMA-IR<2.69)40 cases.According to the classification criteria of Rotterdam diagnostic criteria,① Ovarian anovulation and/or rare ovulation(OA);②clinical and/or biochemical manifestations(HA)of hyperandrogenism;③ Gynecological ultrasound showed polycystic ovary(PCOM)92 PCOS patients were divided into four groups:(1)Group A(29 cases),which was the classic PCOS phenotype group(PHO)(29 cases),including PCOM+HA+OA.(2)Group B,17 cases of high androgen anovulatory phenotype(HO),including HA+OA,ultrasound examination of normal ovarian morphology.(3)Group C was 33 cases with high androgen ovulation phenotype(PH),including PCOM+HA,normal menstruation.(4)There were 13 cases in group D,including non-hyperandrogen phenotype group(PO)including PCOM+OA.The levels of Cys-C,Hcy and metabolic indexes in PCOS patients with different BMI,HOMA-IR and different PCOS subtypes were compared and statistically analyzed.Logistic multiple regression analysis was used to explore the risk factors of obesity and insulin resistance in PCOS patients.Results:(1)In this study,35.8%of PCOS patients were overweight and 31.5%of them were obese.67.3%of all subjects suffered overweight and obesity,56.5%of all subjects had insulin resistance,41.3%of all subjects had hyperandrogenism,and 58.7%of all subjects had LH/FSH≥ 1.(2)The levels of Cys-C,HOMA-IR,FINS and T in obese group and overweight group were both significantly higher than those in non-obese group(P<0.05).(3)The levels of BMI,Cys-C,Hey,FINS,T,TG and P in the IR group were both significantly higher than those in the NIR group(P<0.05).(4)The levels of HOMA-IR,FINS and TC in group A were higher than those in group C(P<0.05).The levels of Cys-C,T and TG in group A were significantly higher than those in group C and group D(P<0.01).The levels of BMI in group A were higher than those in group D(P<0.01).The levels of Cys-C,T in group B were higher than those in group C and group D(P<0.05).The level of Hey in group B was higher than that in group C(P<0.05).The level of UA in group B was higher than that in group D(P<0.05).The more severe the PCOS phenotype is,the more likely it is to merge Cys-C,Hey,glucose and lipid metabolism and uric acid metabolism disorders.(5)The level of Cys-C was positively correlated with the levels of BMI,Hcy,FINS,HOMA-IR,TG,TC and T,and negatively correlated with the level of FSH(T(r=0.529)>HMOA-IR(r=0.426)>FINS(r=0.415)>TG(r=0.412)>Hcy(r=0.411)>FSH(r=-0.244)>TC(r=0.209).(6)The level of Hcy was positively correlated with the levels of BMI,Cys-C,FINS,HOMA-IR and T(HMOA-IR(r= 0.511)>BMI(r=0.502)>Cys-C(r=0.411)>T(r=0.382).(7)By the Logistic multiple regression analysis,the results of this research showed that high levels of FINS(OR=2.029;95%CI:1.26-3.268;P=0.004),Hcy(OR=1.024;95%CI;1.089-1.436;P=0.002),CysC(OR=1.282;95%CI:1.045-1.572;P=0.017),TC(OR=0.911;95%CI:0.844-0.985;P=0.018),T(OR=1.024;95%CI:1.001-1.049;P=0.045),E2(OR=1.026;95%CI:1.000-1.053;P=0.046)were risk factors for suffering from obesity and IR in PCOS patients.Conclusion:The levels of Cys-C and Hcy are closely related to metabolic abnormalities in PCOS patients.The levels of Cys-C and Hcy were positively correlated with the levels of BMI and HOMA-IR in PCOS patients.Combing the levels of Cys-C and Hcy with the levels of BMI and HOMA-IR,we probably can judge the degree of metabolic disorders in PCOS patients in a way.