Correlation Analysis Of Body Mass Index With Insulin Resistance And Glucose And Lipid Metabolism In Patients With Polycystic Ovary Syndrome

ObjectiveBy analyzing the changes and correlations of different body mass index（BMI）and insulin resistance（IR）,glucose and lipid metabolism indexes,endocrine hormone indexes and liver and kidney function indexes in patients with polycystic ovarysyndrome（PCOS）,we shall assess the patient’s risk of related metabolic abnormalities,so as to provide a reference basis for clinically guiding patients to lose weight earlyand clinical intervention.Materials and methodsSelected PCOS patients who attended the Gynecological Endocrinology Clinic of Northwest Women’s and Children’s Hospital from January 1,2017 to December 1,2019,as the research objects.According to the inclusion and exclusion criteria,234PCOS patients were finally included in the study.The PCOS diagnostic criteria adopted the 2003 Rotterdam International Diagnostic Criteria.According to the BMI level in the 2004 Chinese Adult Overweight and Obesity Prevention Guidelines,the study subjects were divided into normal group（BMI<24kg/m²）113 cases and overweight group（28kg/m²>BMI≥24kg/m²）80 cases,obesity group（BMI≥28kg/m²）41 cases.The general data of the subjects were recorded:such as age,height,weight,clinical symptoms and signs,gynecological B-ultrasound,etc.The main observation indicators included the following aspects:（1）Serum insulin and glucose metabolism related indicators:insulin homeostasis model index（HOMA-IR）,oral glucose tolerance test（OGTT）,insulin release test（IRT）;（2）Lipid metabolism indicators:total cholesterol（TC）,triglycerides（TG）,low-density lipoprotein cholesterol（LDL-C）,high-density lipoprotein cholesterol（HDL-C）;（3）Endocrine hormone indicators:anti-Müllerian hormone（AMH）,follicle stimulating hormone（FSH）,luteinizing hormone（LH）,prolactin（PRL）,estradiol（E2）,progesterone（P）,Testosterone（T）;（4）Liver and kidney function indicators:alanine aminotransferase（ALT）,aspartate5aminotransferase（AST）,blood urea nitrogen（BUN）,blood creatinine（SCR）,uric acid（UA）.The changes and correlation analysis of different BMI with glucose and lipid metabolism index,endocrine hormone index and liver and kidney function index were compared.Results1.Comparison of HOMA-IR,insulin and glucose metabolism indexes of the three groups of patients:The incidence of IR in the obese group,overweight group and normal group were 87.80%,57.50%,and 46.02%,respectively.That is,the incidence of IR in the obese group is much higher than that in the overweight and normal groups;The HOMA-IR of the obese group was significantly higher than that of the overweight and normal groups（4.63±3.23,2.89±1.41,2.00±1.08）,and the difference was statistically significant（P<0.05）.In addition,the values of OGTT and IRT five-point method in the obese group were significantly higher than those in the super-recombinant and normal groups except 3h PG and 3h INS,and the differences were statistically significant（P<0.05）;Among them,in any two comparisons of different BMI groups,there was no significant difference in FPG between the overweight and obese groups（P>0.05）,and the other two groups had significant differences（P<0.05）.At the same time,Pearson linear analysis showed that HOMA-IR,FPG,and FINS were positively correlated with BMI（r=0.24,P<0.001;r=0.11,P<0.001;r=0.26,P<0.001）.2.Comparison of lipid metabolism indexes of the three groups of patients:The TG,TC and LDL-C of the obese group were significantly higher than those of the overweight and normal groups,and the HDL-C of the normal group was significantly higher than that of the overweight and obese groups,and the differences were statistically significant（P<0.05）;And it was statistically significant in the comparison of any two groups of different groups（P<0.05）.Pearson linear correlation analysis showed that TG,TC and LDL-C were positively correlated with BMI（r=0.17,P<0.001;r=0.24,P<0.001;r=0.31,P<0.001）,And HDL-C was negatively correlated with BMI（r=-0.20,P<0.001）.3.Comparison of endocrine hormone indicators among the three groups of patients:The AMH,LH/FSH and LH of the obesity group were significantly lower than those of the overweight and normal groups.The T of the obese group was significantly higher than that of the overweight and normal groups,and the difference was statistically significant（P<0.001）.There was no significant difference in FSH,PRL,E₂and P（P>0.05）;Among them,in any two comparisons,AMH,LH/FSH,LH and T are also significantly different（P<0.05）.Correlation analysis showed that AMH,LH/FSH and LH were negatively correlated with BMI（r=-0.5,P<0.001;r=-0.39,P<0.001;r=-0.21,P<0.001）,There was a positive correlation between T and BMI（r=0.51,P<0.001）.4.Comparison of liver and kidney function indexes of the three groups of patients:The ALT and UA of the obese group were significantly higher than those of the overweight and normal groups,and the difference was statistically significant（P<0.001）.But AST,BUN and SCR have no significant difference（P>0.05）;Among them,in the comparison of any two groups,except for the normal group and the super-recombinant ALT,there was no significant difference（P>0.05）,and the other two groups had significant differences（P<0.001）.Correlation analysis showed that ALT and UA were positively linearly correlated with BMI（r=0.16,P<0.001;r=0.24,P<0.001）.Conclusion1.The BMI of PCOS patients is positively correlated with HOMA-IR.The risk of IR in obese patients is much higher than that in non-obese patients.Early guidance of patients to lose weight and clinical intervention is particularly important.2.BMI is closely related to disorders of glucose and lipid metabolism,and obese PCOS patients are more likely to develop disorders of glucose and lipid metabolism.3.BMI is negatively correlated with AMH,LH,LH/FSH,and positively correlated with T.The incidence of abnormal endocrine metabolism in PCOS patients increases with weight gain.4.BMI is positively correlated with ALT and UA,obesity can increase the risk of liver and kidney disease in PCOS patients.In short,for PCOS patients,obese people are more prone to disorders of glucose and lipid metabolism,reproductive endocrine,and abnormal liver and kidney function metabolism.