| Background and Objective: Polycystic ovary syndrome (PCOS) is a highly heterogeneous endocrine disorder of women that always results in infertility. It is charaeterized by oligomenorrhea or amenorrhea,hyperandrogenism, insulin resistance,infertility,acne,obesity and multiple small subcapsular cystic follicles in the ovary on ultrasonography. Many studies Pointed out that PCOS may be explained by the interaction of a few key gene and tiny effect genes with genetic susceptibility and environmental factors and The key gene is likely different between different ethics and families. There were many different investigations of genes of PCOS abroad,but the results were not uniform between different studies. There were few studies on the causative gene of PCOS in our country. It is proved by the overseas researchers that digit ratio shows differences in gender, race and region, which relates to the individual aggression behavior, physical education, musical talent, susceptivity of AIDS virus, myocardial infarction, breast carcinoma, quantity of sperm, schizophrenia and homosexuality, But few corresponding research was held in domestic.We chose the candidate gene associated with the androgen receptor gene and sex hormone binding globulin gene to study,considering the endocrinal characteristics such as hyperandrogenism. The Purpose of this study is to explore the association between the CAG and TAAAA microsatellite fragment Polymorphism of androgen receptor gene and sex hormone binding globulin gene clinical characteristies with PCOS,and to seareh the causative genes of PCOS so as to provide theoretical base to prevent and treat PCOS. Method:191 Patients were recruited (2008 October to 2010 April) from the Center for Reproductive Medicine,The Affiliated Hospital of Ningxia Medical University out patient clinic who diagnosed as PCOS as case group, 70 healthy people were recruited as control group. All the subjects were excluded from other endocrinopathy and did not have any hormonal therapy for the past 3 months before the study. For the PCOS patients,circulating hormonal parameters and fasting blood glucose and insulin were measured;Serum total circulating hormonalparameters Were carried in control groups.The PCOS patients were divided into hyperandrogenic and normal-androgenic subgroups according to Serum totalandrogen level, insulin resistance and non-insulin resistance subgroups according to HOMA-IR.DNA was extracted from solidified b1ood of PCOS patients and control subjects,then genomic DNA was used for PCR amplification of the androgen receptor gene CAG microsatellite fragment and sex hormone binding globulin gene TAAAA microsatellite fragment. Agarose gel and capillary electrophoresis respectively detected the products, at last, sequencing of the DNA to determine the CAG and TAAAA repeat numbers. authropometry methods were adopted to measure the length of 2ndto 5thdigit of left and right hand (palmar aspect) and to calculate the ratio of length of ifferent digits and compared with the difference of gender and region.Results:1. PCOS analysis of clinical data1.1 PCOS group compared to normal control group,two groups of age, menarche age,systolic blood pressure, diastolic blood pressure, FSH, PRL, E2, CHOL, LDL, HDL have no difference, There are differences between Menstrual cycle, waist circumference, hip circumference, WHR, BMI, recover from illness sore incidence, LH, T and TG , PCOS group were higher than the normal control group.1.2 PCOS patients and the male hormone androgen group compared the control group,the age of two groups, fasting glucose, postprandial 2-hour blood glucose, LH, FSH, PRL, E2 did not differ significantly, 2-hour postprandial insulin, T, BMI is different, PCOS group were higher than the normal control group1.3 Group of PCOS and insulin resistance in patients with non-insulin-resistant group,the age of two groups,and the level of E2,FSH,LH,PRL have no difference, The group of PCOS patients with insulin resistance in the T, BMI, WHR, and two points in time blood glucose and insulin levels were higher than those of non-insulin resistant group of PCOS patients, and the difference was significant, exist in the androgen group the number of cases of insulin resistance in patients with androgen present in the normal group of patients with insulin resistance in the number of cases there are differences, Group of patients with androgen number of cases higher than normal number ofandrogen.1.4 Obese PCOS patients compared with non-obese group, Both groups were age, fasting glucose, postprandial 2 h blood glucose, E2, FSH, LH, PRL levels have no difference, The fasting insulin, 2-hour postprandial insulin, IR, T, BMI, WHR difference between, Obese group were higher than non-obese group.2. Assoication research between AR gene (CAG) n Repetition and Polycystic ovary syndrome (PCOS)2.1 AR gene (CAG) n repeats in the overall distribution: AR-CAG repeats in the PCOS group 11-33,mainly distribution in 22,23,21;in the compare group was 13-30, mainly distribution in 22,21,23,majority are 22 in both groups, 22 is bounded by the two groups,by AR gene contained CAG repeats, Divided into a short set of CAG(n≤22),long group CAG(n>22),the repetition of two group gene are similar, No statistically significant.2.2 Long-short group and the AR gene CAG repeat group of patients in the PCOS group and the male hormone androgen levels in the normal group, the distribution of the number of cases higher than that of the short length of the patients group,the difference have statistically significant, Long-short group and the AR gene CAG group of patients with insulin resistance in PCOS group and the distribution of non-insulin-resistant group no difference.3. SHBG gene (TAAAA) n repeats associated with the study of polycystic ovary syndrome.3.1 SHBG gene (TAAAA) n repeats in the overall distribution;there are 6,7,8,9 repeated allele, Not detected 10 times and 11 times repeat. Detected in 6 / 6,6 / 7,6 / 8,6 / 9,6 / 11,7 / 7,7 / 8,7 / 9,7 / 10,8 / 8,8 / 9,8 / 10,9 / 9,9 / 10 a total of 14 genotypes, Not detected 6 / 10,10/10,7 / 11,8 / 11,9 / 11,10/11,11/11 genotype.in the entire group, Allele frequency 9> 6> 7> 8, No significant difference in the allele distribution.3.2 SHBG PCOS patients and controls gene allele frequency, genotype distribution of the total composition, no significant difference. Group of PCOS patients with insulin resistance and insulin resistance in genotype distribution of non-comparison between the constituent ratio of the total clothmeaningless, 9 / 9 genotype group than in the insulin resistance of non-insulin resistant group, there are differences between the two groups.Conclusion: (1)Ningxia Han PCOS patients with hyperandrogenism, obesity, endocrine and metabolicfeatures of insulin resistance and hyperandrogenism and hyperinsulinemia can interact.(2)Patients with polycystic ovary syndrome, lipid metabolism, blood lipid abnormalitiesmainly for its TG levels.(3)Han women in PCOS patients in Ningxia AR-CAG repeats and testosterone levels were positively correlated, that is, the shorter CAG repeats, The higher AR activity, the lower testosterone levels; while shorter CAG repeats and higher testosterone levels may affect the PCOS The performance of the patients in Kaohsiung, the two have superimposed.(4)AR-CAG polymorphism and hyperinsulinemia was no direct correlation between thecould be indirectly affected by hyperandrogenism the occurrence of hyperinsulinemia. There was no direct correlation between the AR-CAG polymorphism and Hyperinsulinemia, Hyperandrogenism may be indirectly affected by the occurrence of hyperinsulinemia;(5)Ningxia Han women SHBG gene promoter (TAAAA) n repeat polymorphism alleles,genotypes and different number of foreign reports. 9 / 9 genotype (TAAAA) n repeat polymorphism may be associated with PCOS and insulin resistance.(6)SHBG gene promoter (TAAAA) n polymorphism is not a important and sensitive genetic factors and indicators cause of abnormal glucose metabolism in Ningxia Han PCOS patients. |
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