| Polycystic ovary syndrome(PCOS) is one kind of reproductive endocrine disorders and metabolic disease for women of childbearing age with the incidence of5%-10%. Its main feature is the ovulation barrier, hyperandrogen hormones and insulin resistance(Insulin Resistance IR). Insulin resistance(insulin resistance IR)plays an important role in the pathogenesis of PCOS, and the androgen can also be caused by inhibition of IR signaling pathways after insulin receptor. Studies in recent years, the presence of chronic inflammatory responses in patients with PCOS, cross dialogue through inflammatory signal transduction pathway and insulin signal transduction pathway(crosstalk), which induce IR, is the initiating factor and center link to IR in patients with PCOS.C reactive protein(CRP) is an independent predictor of cardiovascular disease,which is a stable marker of chronic inflammation. Recent studies show that CRP levels increase significantly in patients with PCOS, and has a high correlation degree with IR. A lot of research indicate pathophysiology of abnormal CRP plays an important role in the pathogenesis of PCOS on IR and glucose with lipid metabolism.Vascular endothelial growth factor(VEGF) can promote vascular endothelial cell proliferation, angiogenesis and increasing vascular permeability. In the female reproductive aspect through from the follicle development, fertilization, implantation,placentation, fetal growth, development and delivery process of 6-1. The studyconfirmed that serum VEGF concentration in patients with PCOS is higher than that of non PCOS patients, and VEGF+405G/C gene polymorphism is closely related to the PCOS. SRAGE in many cells and tissues can inhibit P21 RAS, MAPK(ERK1/2)pathway to reduce NF- kappa generate B, Ap-1, and the latter is the key factor to promote VEGF formation. The content of two for correlation factor in serum and follicular fluid of patients with PCOS, and the correlation between s RAGE in patients with PCOS and VEGF, there is no domestic and foreign reports. In this study,through the determination of serum PCOS in patients with CRP, s RAGE, VEGF and follicular fluid s RAGE and VEGF levels, the relationship between the three and PCOS discussed, to provide the theoretical basis for PCOS in patients with chronic inflammation. For the purpose of further research on the regulation mechanism of s RAGE effect of POCS mechanism and s RAGE, strategies and provide the theoretic basis of clinical treatment for PCOS hyperinsulinemia, IR and chronic inflammation,provide the theoretical basis for exploring new approaches to the treatment of PCOS.ObjectiveSoluble receptor for advanced glycation end products(s RAGE) is the advanced glycation end products of the endogenous secretion, to ligand binding and RAGE competition, and blocking the activation of cell surface receptors, known as the "decoy receptor", as a protective factor to prevent, delaying the occurrence of certain diseases, such as diabetes, atherosclerosis. Application of purified rat s RAGE block RAGE interaction, expression could inhibit the inflammatory factor, thus inhibiting the inflammatory reaction caused by injury. In the reproduction, s RAGE is closely related with good fertility potential, can predict the ovarian reserve function,involved in the regulation of oocyte and embryo development. The relationship between s RAGE and inflammatory factor, IR and ovarian reserve, suggesting that it may participate in the development process of PCOS and PCOS, but the exact relationship and action mechanism still needs further study.Materials and methodsThis experiment selected 61 cases in 2014 November to 2015 February in reproductive center of the First Affiliated Hospital of Zhengzhou University during in vitro fertilization and embryo transfer help pregnant patients. According to the PCOS diagnosis standard to choose 31 patients as group PCOS, 30 cases of male factor infertility due to the regular menstrual cycles, fasting blood glucose, serum sex hormone and insulin tests were normal patients as control group. According to the homeostasis model insulin resistance index(Homeostasis model assessment of insulin resistance, HOMA-IR) of 31 PCOS patients were divided into insulin resistance group(IR group) and 16 cases of non insulin resistance group(non IR) in15 cases. Using the ELISA with IR group, the PCOS adsorption method PCOS in non IR group, serum CRP, control group s RAGE, VEGF level and s RAGE, VEGF levels in follicular fluid.Result1. Three groups of patients with age, FSH, E2, Gn based use days and Gn had no significant difference between the total use(P > 0.05); IR-PCOS group and non IR-PCOS group of patients with LH, LH / FSH and T levels were higher than those in the control group(P<0.05); group IR-PCOS level in T patients was significantly higher than that of non IR-PCOS patients(P<0.05).2. PCOS serum CRP, s RAGE, VEGF levels were higher than those in the control group(P<0.05); group IR-PCOS, serum CRP, VEGF concentrations were significantly higher than those in non IR-PCOS group, while the s RAGE level lower than non IR-PCOS group, the difference was statistically significant(P<0.05).3. In group PCOS, s RAGE, VEGF levels in follicular fluid were higher than that in control group(P<0.05); the level of s RAGE in IR-PCOS group than in non IR-PCOS group(P<0.05), low levels of VEGF than the latter(P<0.05).Conclusions1. PCOS patients, especially in patients with insulin resistance, the presence of CRP, s RAGE and VEGF in patients with metabolic abnormalities, suggesting that PCOS not only the existence of endocrine and metabolic abnormalities, but also in the presence of a chronic inflammatory state;2. Insulin resistance in patients with POCS might play an important role in the mechanism of chronic inflammation, between the two mutually promote the development of a vicious circle;3. PCOS overexpression in patients with follicular fluid s RAGE and VEGF may have some relevance, the common influence of egg quality. |
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