| OBJECTIVES:To investigate the changes of plasma polyunsat-urated fatty acids (PUFAs) and tumor necrosis factor-a (TNF-a) levels, and further explore their relationship with obesity, insulin resistance, hyperandrogenism and LH/FSH in women with PCOS.METHODS:Two hundred and five Women(aged 18 to 40 years) with PCOS were screened out according to the diagnostic criteria of Rotterdam conference (2003). A group of 117 healthy infertile women of corresponding period was taken as the normal control group. These women were chosen randomly from reproductive center due to the problems of uterine tubes or males. Height (Ht), weight(Wt), waist circumference (WC), hip circumference (HC), triglycerides (TG), total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C) were tested. The fasting plasma glucose (FPG) was detected by glucose oxidase.The plasma fasting insulin (FINS), luteinizint hormone(LH), follicle stimulating hormone (FSH), total testosterone(T), prolactin(PRL) and thyroid-stimulating hormone(TSH)were examined by Chemoluminescence method. TNF-αwas examined by enzyme-linked immunosorbentassay (ELISA). The BMI, waist-to-hip ratio (WHR),homeostasis model assessment for insulin resistance (HOMA-IR) and LH/FSH were calculated. The plasma n-3PUFAs and n-6PUFAs were detected by gas chromatography-mass spectrometry (GC-MS), and their ratio(n-6/n-3 PUFAs) was calcutated. RESULTS:①Compared with the control group, BMI,WHR, TG, LDL, FBS, FINS, HOMA-IR, LH, FSH, LH/FSH, FT and T were significantly higher and HDL were obviously lower in women with PCOS(P<0.05). Compared with the obese and nonobese control group, dramatic increases in n-6PUFAs,n-6/n-3PUFAs were observed in obese PCOS group(P<0.05), and dramatic increases in n-3PUFAs, n-6PUFAs, n-6/n-3PUFAs were observed in nonobese PCOS group.②There was a higher n-3PUFAs, n-6PUFAs, n-6/n-3PUFAs and TNF-αin women with PCOS compared with the control group.③Linear correlation showed that T was positive correlation with TNF-α, and BMI was positive correlation with n-3 PUFAs,n-6 PUFAs, TNF-α. HOMA-IR was positive correlation with n-3 PUFAs, n-6 PUFAs,TNF-α. FSH/LH was negative correlation with n-3 PUFAs.④Multiple stepwise regression analysis showed that TNF-αwas an independent risk factor of obesity with n-6PUFAs, n-3PUFAs, n-6/n-3PUFAs and TNF-αas independent variables, T as the dependent variable.⑤Multiple logistic regression analysis revealed that TNF-a, n-6PUFAs were risk factors of obesity with n-6PUFAs, n-3PUFAs, n-6/n-3PUFAs and TNF-αas independent variables, BMI as the dependent variable. Multiple Stepwise Regression Analysis of reciprocal effect showed that n-6PUFAs and TNF-a reciprocally affected BMI in women with PCOS.⑥Using n-6PUFAs, n-3PUFAs, n-6/n-3PUFAs and TNF-a as independent variables, HOMA-IR as the dependent variable, Multiple Stepwise Regression Analysis showed that n-6PUFAs were risk factors of obesity. Multiple Stepwise Regression Analysis of reciprocal effect showed that n-6PUFAs and TNF-a reciprocally affectd HOMA-IR in women with PCOS.⑦Taking n-6PUFAs, n-3PUFAs, n-6/n-3PUFAs and TNF-αas independent variables, T as the dependent variable, Multiple Stepwise Regression Analysis showed that n-3PUFAs was an independent risk factor of obesity. Multiple Stepwise Regression Analysis of reciprocal effect showed the same rusult.CONCLUSION:①Compared with the control group, n-6PUFAs, n-3PUFAs, (n-6/n-3)PUFAs,TNF-αwere obviously higher in women with PCOS.②The increase of TNF-αprobably participated in the formation of obesity and hyperandrogenism in PCOS, and the increase of n-6PUFAs probably affect the formation of obesity and hyperandrogeni-sm in PCOS. The increase of n-3PUFAs was an independent effect factor of decrease of LH/FSH in PCOS.③N-6PUFAs and TNF-αreciprocally affected BMI and insulin resistence in women with PCOS,while TNF-αmay have no reciprocally effect with n-3PUFAs, n-6PUFAs and n-6/n-3PUFAs on BMI and insulin resistence in women with PCOS. |
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