Effects Of Different Treatments On Chronic Low-grade Inflammation In Patients With Polycystic Ovary Syndrome

Background:polycystic ovary syndrome(PCOS)is one of the most common endocrine diseases in gynecology.Polycystic ovary syndrome(PCOS)is the most common cause of irregular menstruation,amenorrhea and irregular menstruation in young women,which seriously affects the quality of life and mental state of young women.Polycystic ovary syndrome is characterized by chronic anovulation and hyperandrogenemia.It is characterized by irregular menstruation,amenorrhea,infertility,hirsutism,acne and active obesity.The incidence rate of women of childbearing age is 5% to 8%,which often leads to infertility.Polycystic ovary syndrome is characterized by persistent anovulation or rare ovulation,clinical or biochemical hyperandrogenemia and polycystic ovary morphology.In addition,PCOS is prone to central obesity and is considered to be in a proinflammatory state.Although the pathogenesis of PCOS is still unclear,evidence supporting chronic low-grade inflammatory response in patients with PCOS is gradually being discovered.This inflammatory response may also be associated with other important features of PCOS,including insulin resistance and cardiovascular disease(CVD)risk factors.The degree of inflammation was mild,mainly manifested as the increase of inflammatory factors such as C-reactive protein(CRP),interleukin and the total amount of interleukin.This inflammatory state is closely related to the long-term pathogenesis of cardiovascular disease,but its mechanism is still controversial:endocrine abnormalities,central obesity,insulin resistance and so on are possible causes.The effect of commonly used drugs such as metformin and oral contraceptives on this inflammatory state is not clear,and a large number of studies are needed to confirm.Objectives:whether there is low-grade inflammation in patients with polycystic ovary syndrome(PCOS),especially when the body mass index(BMI)of patients with PCOS is normal,and this chronic low-grade inflammatory state will be affected by the body indexes,sex hormones,blood lipids,fasting insulin,insulin sensitivity index and blood glucose in patients with polycystic ovary syndrome.Whether compound cyproterone acetate tablets and metformin will effectively improve the status of chronic inflammatory factors in patients.Methods:85 patients with polycystic ovary syndrome in our hospital from April 2019 to April 2020 were selected as the research group,and 85 healthy women who had physical examination in our hospital at the same time were selected as the control group The levels of glucose and lipid metabolism and fasting blood glucose were detected and analyzed.The patients in the study group were randomly divided into group A and group B.42 patients in group A and 43 patients in group B were treated with metformin in group A,and patients in group B were treated with compound cyproterone acetate.All patients were treated for 90 days,and then their body indexes and white blood cell count were reviewed to observe the effect of different drug treatment on the patients’ body indicators and other factors Intervention measures for chronic low-grade inflammation in patients with polycystic ovary syndrome.Results:There was no significant difference in age,weight,follicle stimulating hormone,total cholesterol,low density lipoprotein,apolipoprotein B and fasting blood glucose between the two groups(P > 0.05).However,the ratio of waist circumference to hip circumference in the study group was significantly higher than that in the control group(P < 0.05),luteinizing hormone and testosterone in the study group were significantly higher than those in the control group(P < 0.05)Triglyceride,fasting insulin and two hours postprandial blood glucose were higher in the study group than those in the control group,and the difference was statistically significant(P < 0.05).The high-density lipoprotein,apolipoprotein A1 and insulin sensitivity of the study group were significantly lower than those of the control group(P < 0.05).The C-reactive protein and white blood cell count in the study group were significantly higher than those in the control group(P < 0.05).In patients with normal body fat and similar age,the level of C-reactive protein and white blood cell count in the study group were also significantly higher than those in the control group(P < 0.05).When the patients were overweight or obese,the difference between C-reactive protein was more obvious(P < 0.05).The factors that promote the increase of C-reactive protein in patients with polycystic ovary syndrome include: body fat,triglyceride and insulin sensitivity index,body fat and triglyceride increase,and the level of C-reactive protein in patients with polycystic ovary syndrome is also increased.However,when the insulin sensitivity index decreased,the level of C-reactive protein increased,and there was a negative correlation between the two.The order of action of body fat,triglyceride and insulin sensitivity index on C-reactive protein is insulin sensitivity index,body fat volume and triglyceride.There was no relationship between C-reactive protein level and waist circumference,waist hip ratio and waist / height ratio(P > 0.05).Fasting insulin,blood glucose,total cholesterol,high-density lipoprotein,low-density lipoprotein,apolipoprotein A1 and apolipoprotein B had no correlation with C-reactive protein height.Compared with before treatment,there was no significant difference in body fat,waist circumference,waist hip circumference ratio,fasting insulin,fasting blood glucose,two hours postprandial blood glucose,insulin sensitivity index and white blood cell count in group A after treatment(P > 0.05).After treatment,the level of C-reactive protein in group a was significantly lower than that before treatment(P <0.05).Compared with before treatment,there was no significant difference in body fat,waist circumference,waist hip circumference ratio,fasting insulin,fasting blood glucose,postprandial two-hour blood glucose and insulin sensitivity index in group A after treatment(P > 0.05).After treatment,the level of C-reactive protein in group A was significantly higher than that before treatment(P < 0.05),and the white blood cell count of patients after treatment increased compared with that before treatment The difference was not statistically significant(P < 0.05).After treatment,there was no significant difference in body fat,waist circumference,waist hip circumference ratio,fasting insulin,fasting blood glucose,postprandial two-hour blood glucose and insulin sensitivity index in group B(P >0.05).After treatment,the level of C-reactive protein in group B was significantly higher than that before treatment(P < 0.05),and the white blood cell count after treatment was higher than that in group A,but the difference was not statistically significant Statistical significance(P < 0.05).Conclusions:(1)PCOS patients with normal weight also have chronic low-grade inflammation.(2)Chronic low-grade inflammation in patients with polycystic ovary syndrome is closely related to insulin resistance,body weight and triglycerides,but not with endocrine abnormalities and obesity.(3)Treatment with metformin in patients with polycystic ovary syndrome can greatly improve the state of chronic low-grade inflammation,but the treatment of compound cyproterone acetate in patients with polycystic ovary syndrome is likely to aggravate the chronic low-grade inflammation of patients.(4)In the treatment of chronic low-grade inflammation of polycystic ovary syndrome patients with compound cyproterone acetate can be combined with metformin treatment,in order to reduce the intensification of the situation.Therefore,compound cyproterone acetate combined with metformin can effectively improve the chronic low-grade inflammation in patients with PCOS.