Factors Associated With Obese Patients With Polycystic Ovarian Syndrome And Correlation With Serum Ghrelin And Obestatin

Objective:According to comparing epidemiological data of obese and non-obese patients with polycystic ovarian syndrome(PCOS),we analysis the relevant factors of disease in patients with PCOS.By determining the concentration of serum Ghrelin、Obestatin in obese and non-obese patients with PCOS and the change after metformin treatment for4months, to investigate if there is a difference in obese and non-obese PCOS patients, to a more comprehensive and in-depth understanding of disease.so that to provide theoretical basis for disease diagnosis and treatment.Method:Total of90women were enrolled in the research who attended gynecology division of outpatient to the second hospital of Tianjin medical university from June2011to December2011.Body mass index(BMI) as a standard,60PCOS patients were divided into two groups:30cases in obese group(BMI>25kg/m2)and30cases in non-obese group(BMI＜25kg/m2),30infertile cases in the same period of regular menstruation with tubal or man factor as control group. The questionnaire content mainly includes age、menstrual history、pregnancies、with or without family history of diabetes and psychological problems and so on. The data was analyzed by logistic statistics. Ovarian sexual hormone and Sugar metabolism experiment were measured by completely automatic chemiluminescence method. Enzyme-linked immunosorbent assay (ELISA) was applied to detect the levels of serum Ghrelin and Obestatin. The indexes were compared by one-way ANOVA.The correlation between Ghrelin、 Obestatin and biological metabolic index was analyzed by simple correlation analysis. In this study,26cases in obese group and10cases in non-obese group with insulin resistance (IR), after metformin500mg Tid treatment for4months,follow-up of patients with general condition and metabolism index changes, and detect serum levels of Ghrelin and Obestatin using ELISA.Paired sample T test compare serum Ghrelin and Obestatin levels before and after treatment.Results:(1) The questionnaire data single factor logistic regression analysis showed that family history of diabetes, psychological problems had a certain statistical relationship with the occurrence of obese PCOS patients, but had no statistical relationship with non-obese PCOS patients; Other personal habits such as smoking, drinking, preference for sweets, sports and its fertility had no statistical significance with obese and non-obese PCOS. Epidemiological studies have found that obese PCOS patients have extended menstrual cycle or higher amenorrhea rates, non-obese PCOS patients’menstrual dripping wet incidence is higher.(2)Obese and non-obese group, control group were detected serum Ghrelin and Obestatin; Obese group serum Ghrelin and Obestatin levels were significantly lower compared with non-obese group and control group(P<0.05); other than there was no statistically significant difference between non-obese group and control group(P>0.05).(3)The level of Ghrelin/Obestatin in obese group was obviously higher than that in non-obese group (P＜0.05), the non-obese group and control group have no significant difference(P>0.05).(4)In obese group,serum Ghrelin level negatively correlated with FIN, HOMA-IR,in on-obese group,serum Ghrelin level showed a negative correlation with LH, LH/FSH and T.(5) The correlation of serum Obestatin is similar with Ghrelin.(6)After treatment,obese PCOS patients’serum Ghrelin、Obestatin levels increased significantly,the difference was statistically significant (P＜0.05), rather than the non-obese group has no significant difference(P>0.05).Obese PCOS patients’ Ghrelin/Obestatin levels decreased significantly compared with before(P<0.05), non-obese group has no significant change(P>0.05).(7)After treatment,obese patients’BMI、FIN、HOMA-IR significantly decreased than before(P<0.05), while FBG is not obvious, non obese patients’BMI、FBG、FIN、HOMA-IR had no obvious difference compared with before (P>0.05).Conclusions:The pathogenesis of obese PCOS patients is given priority to metabolic disorders,however the pathogenesis of non-obese PCOS patients were mainly because of hypothalamus-pituitary-ovarian axis dysfunction. Metformin therapy can improve obese PCOS patients’state of metabolic disorder, making serum Ghrelin and Obestatin levels increase. The secretion disorder of serum Ghrelin and Obestatin is closely related to the disease of obese PCOS. Ghrelin and Obestatin secretion disorder lead to IR,which may be one of the pathogenesis of obese PCOS.