Original article

Clinical study on characteristics of endocrine metabolism in the patients of polycystic ovary syndrome with different body mass index

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  • Department of Endocrinology, Sir Run Run Hospital, Nanjing Medical University, Nanjing 211116, China

Received date: 2021-04-16

  Online published: 2022-07-25

Abstract

Objective To investigate clinical characteristics of endocrine hormones and metabolic indicators in the patients of polycystic ovarian syndrome (PCOS) with different body mass index (BMI). Methods A total of 76 patients with PCOS were enrolled. Their age, height, and weight were recorded, and their BMI were calculated. The sex hormone levels, thyroid function, fasting plasma glucose (FPG), fasting serum insulin (FINS), total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured, and the homeostasis model assessment of insulin resistance (HOMA-IR) and free androgen index (FAI) were calculated. According to different BMI, the patients were divided into obese, overweight, and normal weight groups, and the differences of endocrine and metabolism indexes among three groups were compared. As HOMA-IR≥2.69 was diagnostic cut-off point of insulin resistance, the proportion of patients with insulin resistance in different BMI groups was calculated respectively. As FAI≥6.1 was the diagnostic cut-off point of hyperandrogenism, the proportion of patients with hyperandrogenism in different BMI groups were also calculated. The chi-square test was used to analyze the difference of the incidence of insulin resistance or hyperandrogenemia in PCOS patients among three groups. Results The levels of sex hormone binding globulin (SHBG) all increased gradually while the levels of FINS and HOMA-IR decreased gradually in the PCOS patients in the obesity, overweight and normal weight groups. The differences had statistical significance among the three groups (P<0.05). Luteinizing hormone (LH), LH/follicle-stimulating hormone (FSH) were significantly lower while thyroid stimulating hormone (TSH) was significantly higher in the obese group than those in both overweight and normal weight groups (P<0.05). FAI, TC, TG, LDL-C in both obese and overweight groups were significantly higher than those in normal weight group (P<0.05). Free thyroxine (FT4), anti-Müllerian hormone (AMH) and HDL-C in obesity group were significantly lower than those in normal weight group(P<0.05). Spearman correlation analysis showed that BMI was positively correlated with FAI, thyroid-stimulating hormone (TSH), FPG, INS, HOMA-IR, TG, LDL-C (r=0.401, 0.315, 0.362, 0.644, 0.656, 0.582, 0.315 respectively, P<0.05), and negatively correlated with LH, LH/FSH, SHBG, FT4, AMH, HDL-C (r=-0.364, -0.236, -0.624, -0.304, -0.369, -0.542, P<0.05). The results of the chi-square test indicated that the incidence of insulin resistance and hyperandrogenemia increased gradually in the patients in normal, overweight, and obese groups, and the insulin resistance in the obese and overweight groups was significantly higher than normal weight group (P<0.05), while there was no significant difference between the overweight group and the obese group. In addition, there were statistical difference in hyperandrogenism among three groups (P<0.05). Conclusions The PCOS patients with obesity or overweight have more significant insulin resistance, hyperandrogenemia and abnormal blood lipid metabolism, while the level of pituitary gonadotropin increased more in the PCOS patients with normal weight.

Cite this article

CAO Wei, CHEN Rourou, XIE Yuan, ZOU Jing, HE Rongbo, QIAN Li, LIU Yu . Clinical study on characteristics of endocrine metabolism in the patients of polycystic ovary syndrome with different body mass index[J]. Journal of Internal Medicine Concepts & Practice, 2021 , 16(06) : 381 -386 . DOI: 10.16138/j.1673-6087.2021.06.003

References

[1] Escobar-Morreale HF. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment[J]. Nat Rev Endocrinol, 2018, 14(5): 270-284.
[2] Talmor A, Dunphy B. Female obesity and infertility[J]. Best Pract Res Clin Obstet Gynaecol, 2015, 29(4): 498-506.
[3] Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome[J]. Fertil Steril, 2004, 81(1): 19-25.
[4] Wang Q, Guo T, Tao Y, et al. Association between serum adipocyte factor level and insulin resistance in polycystic ovarian syndrome[J]. Gynecol Endocrinol, 2011, 27(11): 931-934.
[5] 周泽虹, 倪任敏, 赵晓苗, 等. 高雄激素血症的FAI诊断界值分析[C]. 广东省医学会第二次生殖医学学术会议, 2012: 409.
[6] McGee WK, Bishop CV, Bahar A, et al. Elevated androgens during puberty in female rhesus monkeys lead to increased neuronal drive to the reproductive axis: a possible component of polycystic ovary syndrome[J]. Hum Reprod, 2011, 27(2): 531-540.
[7] Cadagan D, Khan R, Amer S. Thecal cell sensitivity to luteinizing hormone and insulin in polycystic ovarian syndrome[J]. Reprod Biol, 2016, 16(1): 53-60.
[8] Malini NA, Roy George K. Evaluation of different ranges of LH: FSH ratios in polycystic ovarian syndrome (PCOS)—clinical based case control study[J]. Gen Comp Endocrinol, 2018, 260: 51-57.
[9] Milutinoviéc DV, Nikoliéc M, Veliôckoviéc N, et al. Enhanced inflammation without impairment of insulin signaling in the visceral adipose tissue of 5α-dihydrotestosterone-induced animal model of polycystic ovary syndrome[J]. Exp Clin Endocrinol Diabetes, 2017, 125(8): 522-529.
[10] Corbould A. Chronic testosterone treatment induces selective insulin resistance in subcutaneous adipocytes of women[J]. J Endocrinol, 2007, 192(3): 585-594.
[11] Janssen OE, Mehlmauer N, Hahn S, et al. High prevalence of autoimmune thyroiditis in patients with polycystic ovary syndrome[J]. Eur J Endocrinol, 2004, 150(3): 363-369.
[12] Morgante G, Musacchio MC, Orvieto R, et al. Alterations in thyroid function among the different polycystic ovary syndrome phenotypes[J]. Gynecol Endocrinol, 2013, 29(11): 967-969.
[13] Muscogiuri G, Sorice GP, Mezza T, et al. High-normal TSH values in obesity: is it insulin resistance or adipose tissue’s guilt?[J]. Obesity (Silver Spring), 2013, 21(1): 101-106.
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