Study On Endocrine And Metabolic Characteristics And Syndrome Distribution Of Traditional Chinese Medicine In Patients Of Polycystic Ovarian Syndrome With Different BMI

Objective:To collect the clinical data of PCOS patients,analyze the endocrine and metabolic parameters of PCOS patients with different BMI and their TCM syndrome characteristics,and explore the correlation between BMI and laboratory parameters,so as to reveal the endocrine and metabolic characteristics of PCOS patients with different BMI and their TCM syndrome distribution characteristics,further to provide an effective objective basis for TCM syndrome differentiation and treatment of PCOS.Methods:To formulate a unified clinical observation form,and collect the clinical data of 246 PCOS patients who were treated in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from November 2018 to January 2020,and make a syndrome differentiation.According to BMI classification criteria,PCOS patients in different BMI groups were divided into normal BMI group(83 cases),overweight group(78 cases)and obese group(85 cases).The endocrine and metabolic characteristics of PCOS patients with different BMI groups and the distribution characteristics of TCM were analyzed.Results:1.General data: There was no significant difference in age,course of disease,age at menarche and days of menstruation between PCOS patients with different BMI(P>0.05).There was significant difference in menstrual cycle between PCOS patients with different BMI(P<0.01).2.Anthropometric parameters: There were significant differences in systolic blood pressure,diastolic blood pressure,waist circumference,hip circumference and WHR levels among PCOS patients with different BMI(P<0.01).The incidence of abdominal obesity was20.48%,73.08% and 97.65% in the normal BMI group,the overweight group and the obesity group respectively,the difference was statistically significant(P<0.01).3.Extrinsic signs: There was no significant difference in hirsutism score and incidence of hirsutism among different BMI(P>0.05).There was no significant difference in acne scores(P>0.05);there was a significant difference in the incidence of acne(P<0.01).There were significant differences in acanthosis nigricans score and incidence of acanthosis nigricans(P<0.01).4.Ultrasonographic parameters: The mean ovarian diameter levels of overweight group(2.96±0.39)and obese group(3.08±0.36)were higher than those of normal BMI group(2.79±0.35),and the differences were statistically significant(P<0.01).There was no significant difference in the distribution of polycystic ovarian changes with different BMI(P>0.05).5.Laboratory parameters: LH and LH/FSH levels were lower in the obese group than in the normal BMI group.HDL-C levels were lower in the overweight group than in the obese group than in the normal BMI group.The TSH level was higher in the obese group than in the normal BMI group.The FPG,FINS,HOMA-IR,TG,LDL-C,and TC levels were higher in the overweight and obese groups than in the normal BMI group.The FPG,FINS,HOMA-IR,and TG levels were higher in the obese group than in the overweight group,and the differences were statistically significant(P<0.05).Among them,LH,LH/FSH,and HDL-C were negatively correlated with BMI,and TSH,TC,LDL-C,TG,FPG,FINS,and HOMA-IR were positively correlated with BMI.6.Endocrine characteristics: The incidence of elevated LH/FSH ratio in different BMI groups was higher in the normal BMI group(45.78%)than in the obese group(14.12%),and the difference was statistically significant(P<0.01).There was no significant difference in the incidence of hyperandrogenism(P>0.05).7.Metabolic characteristics: There were significant differences in the incidence of abnormal fasting blood glucose,hyperinsulinemia,insulin resistance,increased systolic blood pressure,increased diastolic blood pressure,hyperlipidemia,and metabolic syndrome among different BMI groups(P<0.05).Among them,insulin resistance was predominant in all three groups of abnormal glucose metabolism,low high-density lipoproteinemia(37.74%)and hypertriglyceridemia(33.96%)were predominant in the normal BMI group,low high-density lipoproteinemia(36.76%)was predominant in the overweight group,and mixed hyperlipidemia(36.71%)and hypertriglyceridemia(35.44%)were predominant in the obese group.8.Characteristics of TCM distribution: The TCM syndrome distribution of PCOS patientswas mainly spleen deficiency and phlegm-dampness syndrome(32.93%),followed by Yang deficiency syndrome of kidney(21.54%).The syndrome distribution of TCM in PCOS patients with different BMI was different,and the difference was statistically significant(P<0.01).Among them,Yang deficiency syndrome of kidney(26.50%)and syndrome of qi stagnation and blood stasis syndrome(22.89%)were predominant in the normal BMI group,and spleen deficiency and phlegm-dampness syndrome were predominant in both the overweight(30.77%)and obese(57.65%)groups.Conclusion:There are significant differences in the distribution of TCM in PCOS patients with different BMI.Overweight/obese PCOS patients are mainly characterized by deficiency of spleen and phlegm-dampness syndrome,while PCOS patients with normal BMI are mainly characterized by Yang deficiency syndrome of kidney and syndrome of qi stagnation and blood stasis syndrome.BMI has a high correlation with endocrine and metabolic disorders in PCOS.Therefore,reasonable regulation of BMI levels in PCOS patients and optimization of TCM syndrome differentiation treatment options may be important in delaying the occurrence and development of PCOS,reducing the incidence of complications or complications and improving clinical efficacy.