The Clinical Significance Of Inflammatory And Immune Factors In Polycystic Ovary Syndrome

Object:To analyze the relationship between endocrine characteristics and immunologic and inflammatory state in women with polycystic ovarian syndrome(PCOS).To explore the pathogenesis of PCOS, and guide clinical treatment.Methods:Based on ESHRE/ASRM criteria, we collected100patients with PCOS and60healthy married women as control from Endocrinology Department of General Hospital of Tianjin Medical University in2013.4-2014.3. The level of serum sexual hormone, oral glucose tolerance test(OGTT), immuno-inflammation parameters were measured, including height, weight, luteinizing hormone(LH), follicle stimulating hormone(FSH), testosterone(T), C-reactive protein(CRP), anti-nuclear antibodies(ANA), thyroid peroxidase antibody(TPOAb), thyroglobulin antibody(TGAb). Then the parameters were compared between the groups. Pearson correlation analysis was used to analyze the association between CRP and other related factors. The PCOS patients were divided into antibody positive and antibody negative groups respectively according to results of ANA, TPOAb or TGAb test respectively. Then the parameters were compared between the antibody positive and antibody negative groups. The PCOS patients were randomly divided into group A, group B and group C, each group has33-34patients. Group A was treated with pioglitazone plus metformin, group B was treated with Diane-35plus metformin, group C was treated with metformin, the medication time of each group lasts for3months. Then the parameters were compared before and after treatment. All data were analyzed using SPSS17.0software. When comparing two factors, analysis of two sample t test was used; when analysis of correlation between two factors was performed, Pearson correlation was used; when comparing therapeutic effect, paired samples T Test was used, and a one-way analysis of variance was used to compare the data among three treatment groups.Results: 1. All parameters were significantly higher in observation group than in control group, with statistical difference(P<0.05). The serum CRP concentration was positively correlated with BMI, HOMA-IR, LH/FSH in PCOS(r=0.367, P=0.000; r=0.269, P=0.007; r=0.453, P=0.000).2. LH/FSH was higher in antibody positive group than in antibody negative group, with statistical difference(P<0.05).3. BMI, HOMA-IR, LH/FSH, T and CRP in A group were significantly lower than pretheraphy; BMI, LH/FSH, T and CRP in B group were significantly lower than pretheraphy; BMI and CRP in C group were significantly lower than pretheraphy, with statistical difference (P<0.05). LH/FSH and T were significantly lower in A group and in B group than in C group after treatment; HOMA-IR was significantly lower in A group> in B group> in C group after treatment; CRP was significantly lower in A group> in B group and in C group after treatment, with statistical difference (P<0.05).Conclusions:1. Insulin resistance, hyperinsulinemia, hyperandroganism, elevated level of LH and ratio of LH/FSH were all endocrinic and metabolic characteristics of PCOS.2. The serum CRP concentration is gradually increased with the worsening of BMI and HOMA-IR. And there was positive correlation between CRP and LH/FSH; meanwhile, the ratio of LH/FSH was higher in antibody positive group than in antibody negative group, which means sexual hormone disturbance can lead to chronic inflammation and autoimmune diseases in some way.3. The abortion rate was higher in thyroid antibody positive group than in thyroid antibody negative group, which remind us to be aware of the thyroid antibody screening to avoid abortion.4. The therapy of pioglitazone plus metformin was the better choose for the patients with severe insulin resistance, inflammation and immune reaction.