The Clinical Features And Serum Metabolomics Studies On Patients With Different Syndromes Of Polycystic Ovary Syndrome

Objective:To study the differences in clinical characteristics,glucolipid metabolism,gonadal hormone levels and serum metabolites during the different syndromes in patients with polycystic ovary syndrome and the body mass index matched normal female.Revealing a comprehensive clinical and metabolic characteristics in patients with different syndromes,Finding the specific biomarkers for different types of diseases,and verified the preliminary research results,to provide the basis for clinical diagnosis,treatment and prevention of long-term complications of the disease.Methods:Combining the clinical study and metabonomics technology as the method,based on the Rotterdam diagnostic criteria and TCM Syndrome diagnostic criteria into the subjects,The research has four groups,patients with phlegm-dampness syndrome of PCOS,37 cases(group A);non-phlegm-dampness of PCOS,40 cases(group B);normal female that body mass index-matched patients with phlegm-dampness syndrome of PCOS,22 cases(group C).and that body mass index-matched patients with non-phlegm-dampness syndrome of PCOS,32 cases(group D).collecting the clinical data and serum samples for blood sugar,blood lipids and gonadal hormone,and using high performance liquid chromatography mass spectrometry technology screening four groups of subjects serum metabolomics differences content.Results:(1)clinical research results:the age of menarche of patients in group A and group B was later than the normal control groups,F-G score and the incidence of skin excessive fat,the incidence of acne,the incidence of acan-thosis nigricans in group A and group B was signif-icantly increased than group C and group D,LH,LH/FSH,E2,T,FAI,FGS,TG levels were significantly higher than those in the control group;the level of HDL was lower than that of the control group,there is statistical significance,P<0.05.BMI,WHR,systolic blood pressure,the incidence of acanthosis nigricans and skin excessive fat,FAI,FGS,FINS,HOMA-IR levels in the group A were signifycantly increased;and LH,LH/FSH,HDL levels in group B were signifycantly increased;between the group C and group D,The presence of BMI,WHR,systolic blood pressure,FBG,TG,LDL,HOMA-IR increased,the blood lipids,blood pressure is associated with body mass index,but fat distribution abnormalities and sugar,lipid meta-bolism disorder in PCOS disease states is more obvious,the results are basically consistent with the previous results.(2)the metabonomic research results:according to the difference of the selected variables,identified a total of 44 different metabolites,mainly involved in lipid metabolism,fatty acid amide metabolism,amino acid metabolism,androgen metabolic pathway.The level of free fatty acid in the group A and group B were significantly higher than the corresponding control groups,and the level of group A was higher than that of group B;The level of carnitine C4:0 in the group A and group B was significantly lower than the corresponding control groups,and The level of carnitine C14:0、carnitine C1 8:2 and carnitine C3:0 in the group A was higher than the group B;dehydroepiandrosterone sulfate in the group B was significantly higher than that of group A;The level of LPC and LPE in the group A and group B were lower than those in the control groups,and the level of group A were signifycantly lower than that of group B;glycocholic acid in the group B was significantly lower than the control group;Palmitic amide,PEA,AEA in the group A and group B were higher than those in the control groups,glycollsylation of phenylalanine,glycosylation of tryptophan and phenylalaninephenylalanine levels in group A was significantly higher than that of the group C and the group B;The level of Hypoxanthine in group A was signifycantly higher than that in the control group.Conclusion:(1)from the clinical and metabolomic features:" phlegmdamp-Ness " PCOS is given priority to with abnormal glucose and lipid metabolism and insulin resistance,and " non-phlegm dampness " PCOS with disorders of gonadal axis and hyperandrogenism,PCOS patients were divided into " phlegm-dampness " and " non-phlegm dampness " can reflect the basic characteristics and the severity of disease.guiding for prevention and treatment of long-term complications.the pathogenesis of PCOS is related to insulin resistance,endocrine hormone metabolism and inflammatory reaction.(2)the metabonomics method can be used for the identification of polycystic ovary syndrome with different syndrome,and provide a basis for syndrome diagnosis.(3)metabolomics analysis showed:metabolic markers in "phlegm-dampness " PCOS mainly involved in free fatty acid metabolism,including FFA18:1,FFA20:4,FFA20:1,FFA20:3,FFA22:5,FFA16:1,FFA20:5,FFA22:6,L-Aspartic,FFA20:6;”non-phlegm dampness "PCOS is mainly involved in fatty acid metabolism,androgen metabolism and fatty acid metabolism,including AEA,FFA22:5,ANDS,Palmitic amid,FFA22:6,FFA18:3,FFA20:1,FFA20:2,FFA20:6,PEA.