| Objective:To investigate the correlation of serum triglyceride-glucose index(Ty G)and non-traditional lipid parameters with metabolic syndrome(MS)and its components in patients with polycystic ovary syndrome(PCOS),and to evaluate the ability of Ty G index and non-traditional lipid parameters to predict MS in PCOS patients.Methods:In this retrospective study,157 patients diagnosed with PCOS in the Department of Endocrinology and Metabolism and Reproductive Medicine of Lanzhou University Second Hospital from January 2020 to September 2022 were selected.The enrolled subjects were divided into two groups(combined MS group and non-MS group)according to whether they met the diagnostic criteria for MS.The general clinical data of all the included subjects were collected,including age,height,weight,blood pressure(BP)and medical history(including past medical history,menstrual history and reproductive history).Laboratory parameters such as fasting blood glucose(FBG),2-hour post-load oral glucose tolerance test(OGTT)or 2-hour postprandial blood glucose(2h BG),fasting insulin(FINS),and 2-hour post-OGTT or 2-hour postprandial insulin(2h INS),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),blood uric acid(UA),thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4),and serum total testosterone(TT).Ty G index was calculated based on FBG and fasting TG levels,Ty G=Ln[TG(mg/d L)×FBG(mg/d L)/2].Non-traditional lipid parameters were calculated by serum TG,TC,HDL-C and LDL-C levels,which mainly included TG/HDL-C,TC/HDL-C,LDL-C/HDL-C and non-HDL-C.Spearman correlation analysis was used to analyze the correlation between Ty G-related indexes and non-traditional lipid parameters and insulin resistance.Univariate Logistic regression analysis was used to compare and determine the relationship between Ty G index and non-traditional lipid parameters and MS.The receiver operating characteristic curve(ROC)was used to evaluate the efficacy of each parameter in identifying MS in PCOS patients,and P<0.05 was considered statistically significant.Results:1.Among the 157 PCOS patients,55 patients were PCOS with MS and102 patients were PCOS without MS.There were 74 patients(47.1%)with BMI≥25kg/m~2,39 patients(24.8%)with hypertension,36 patients(22.9%)with hyperglycemia,55 patients(35.0%)with high TG and 49 patients(31.2%)with low HDL-C in PCOS patients.The prevalence of MS in PCOS patients was 35.0%.2.Among the 157 PCOS patients,57(36.3%)had no MS components,32(20.4%)had one MS component abnormality,13(8.3%)had two MS components abnormality,29(18.5%)had three MS components abnormality,20 patients(12.7%)with four abnormal MS components and 6 patients(3.8%)with five abnormal MS components.In general,63.7%of PCOS patients had different degrees of metabolic abnormalities.3.Compared with patients in the non-MS group,The levels of BMI,BP,FBG,FINS,2h BG,2h INS,HOMA-IR,TG,TC,LDL-C,UA,Ty G index,Ty G-BMI,TC/HDL-C,TG/HDL-C,LDL-C/HDL-C,non-HDL-C,TT and FT3 increased significantly in patients with MS group,the differences were statistically significant(P<0.05).The HDL-C level of PCOS patients with MS was significantly lower than that in PCOS patients without MS,and the difference was statistically significant(P<0.05).There were no significant differences in age,TSH and FT4 levels between the two groups(P>0.05).4.In patients with PCOS,the levels of Ty G,Ty G-BMI,TG/HDL-C,TC/HDL-C,LDL-C/HDL-C,and non-HDL-C increased with the increase in the number of MS abnormal components.5.Spearman correlation analysis showed that Ty G index(r=0.610),Ty G-BMI(r=0.705),TG/HDL-C(r=0.599),TC/HDL-C(r=0.544),LDL-C/HDL-C(r=0.542)and non-HDL-C(r=0.397)were positively correlated with HOMA-IR in PCOS patients(P<0.001).6.Binary univariate logistic regression analysis showed that,the BMI,BP,FBG,FINS,2h BG,2h INS,HOMA-IR,TG,TC,low HDL-C,UA,Ty G,Ty G-BMI,TG/HDL-C,TC/HDL-C,LDL-C/HDL-C and non-HDL-C were risk factors for MS in women with PCOS(P<0.05).After adjusting for age and BMI,the Ty G,Ty G-BMI,TG/HDL-C,TC/HDL-C,LDL-C/HDL-C,and non-HDL-C were still associated with an increased risk of MS(P<0.05).7.The results of ROC curve analysis showed that Ty G,Ty G-BMI,TG/HDL-C,TC/HDL-C,LDL-C/HDL-C and non-HDL-C had high predictive value for PCOS complicated with MS.Ty G-BMI(AUC 0.909,95%CI 0.864-0.954)was better than TG/HDL-C(AUC 0.876,95%CI 0.823-0.930),TC/HDL-C(AUC 0.862,95%CI 0.803-0.921),Ty G(AUC 0.849,95%CI 0.783-0.914),LDL-C/HDL-C(AUC 0.844,95%CI0.783-0.905),and non-HDL-C(AUC 0.759,95%CI 0.681-0.836)in predicting the occurrence of MS.The optimal cut-off point was 225.993,and the sensitivity and specificity were 90.90%and 83.30%,respectively.Conclusion:1.Most PCOS patients(63.7%)had different degrees of metabolic abnormalities,and the prevalence of MS was high in PCOS patients(35.0%).2.Ty G,Ty G-BMI index and non-traditional lipid parameters are novel,clinically convenient and practical markers for the assessment of IR,which have high diagnostic and predictive value for MS in PCOS patients,and can be used to identify the risk of MS in PCOS patients early. |
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