| Objective: Polycystic ovarian syndrome(PCOS)is a reproductive endocrine disorder,most of whom also have metabolic syndrome(MetS).However,insulin resistance(IR)is considered as a key element in the pathogenesis of both PCOS and MetS.The Homeostasis model assessment-IR(HOMA-IR)is a simple band index of IR.Triglyceride-glucose indices(TyG indices)are a new indicator obtained from the product of fasting blood glucose(FBG)and fasting triglycerides(TG).It has been shown that the new indicator is easy to get,inexpensive and widely applicable and can be an alternative to IR.Therefore,the aim of this study is to investigate the clinical significance TyG index changes have in treating PCOS combined with MetS,find out the correlations between TyG indices and the risk of MetS in patients with PCOS,and assess the predictive value of these indices to PCOS combined with MetS.Methods:Patients with PCOS treated in the Department of Reproductive Medicine of Xingtai People’s Hospital from September 2021 to September2022 were selected as study subjects and a retrospective analysis was conducted.Finally,436 patients were included in this study.Among them,333(76.4%)had no MetS while 103(23.6%)had MetS.Biochemical indices(such as FBG,TG)and related hormone levels were measured,and TyG indices were calculated from the natural logarithm of the product of FBG and TG.Logistic regression analyses were performed to investigate the correlations between TyG index and the possible risk factors of PCOS complicated by MetS.Multiple regression analyses were used to evaluate the correlations between TyG indices and PCOS combined with MetS.There are three models were established.The model I was an unadjusted Model.The model II was adjusted for Age and BMI.And The model Ⅲwas adjusted for SBP,DBP,AMH,ALT,AST,TC,HDL and LDL in addition to the confounding factors in model I.In addition,TyG indices were divided into a categorical variables(TyG triple quantiles)for sensitivity analysis to test the reliability of the results.Results:1.The results of analysis shows MetS has positive correlations with weight,BMI,SBP,DBP,AMH,ALT,AST,TC,TG,LDL-C,FBG,INS,IR and TyG indices,and has negative correlations with HDL-C.2.After adjusting potential confounders,it is shown that TyG indices are positively correlated with the risk of developing PCOS in combination with MetS(OR 1.29,95% CI 1.11-1.50).Compared to those with the lowest tertile in the TyG indices,the risk of patients with the highest tertile developing MetS is 4.1 times higher(OR 5.1,95% CI 1.83-14.24).3.The TyG indices are nonlinearly related to the risk of MetS development and there is a saturation threshold effect.In patients with PCOS,the inflection point of the calculated curve of the two-stage linear regression model is 8.6,and the risk of MetS onset is significantly higher when the TyG indices are bigger than 8.6.4.ROC curves shows that the cut-off value of the TyG indices are 8.76 in women with PCOS complicated by MetS.When the TyG indices are higher than 8.76,the risk of developing MetS increases 2.99 times for every 1 higher in the indices.Conclusion:There are positive and independent correlations between TyG indices and the prevalence of MetS in women with PCOS.The optimal threshold value of TyG indices for detecting MetS is 8.76,and the risk of MetS increases 2.99 times for every 1 higher in the indices.Therefore,TyG indices can be used as a simple,cost-effective and efficient method to screen for MetS in women with PCOS. |
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