The Study On Screening The Biological Markers For Phlegm-dampness Syndrome Of PCOS Based On Metabonomics

Objective: To study the difference of serum metabolites for polycystic ovarysyndrome (PCOS) in patients with phlegm-dampness syndrome, non-phlegm-dampnesssyndrome and healthy people, with the application of metabonomics based on nuclearmagnetic resonance (NMR),and analyse the mechanism of different metabolites, exploringthe biomarkers associated with phlegm-dampness syndrome of PCOS,to explore thepathogenesis of phlegm-dampness syndrome of PCOS from the level ofmetabonomics.Method: After the preparation of clinical serum samples for groups withphlegm-dampness syndrome of PCOS, non-phlegm-dampness syndrome of PCOS,andthe healthy people,with20cases in each group,preprocessing the hydrogen spectrum fornuclear magnetic resonance,then using SIMCA-P+software for pattern recognition ofmultivariate analysis.After data analysis with the methods of the principal componentanalysis (PCA) and partial least squares discriminant analysis (PLS-DA), then the datawas amended by the orthogonal partial least squares discriminant analysis (OPLS-DA),according to the analysis of different metabolic components, the biomarkers ofphlegm-dampness syndrome of PCOS were finally screened and identified.Results:1.Comparing with the level of serum metabolites in the healthy people, the level of1-methyl histidine, citrate, ethanol, glycerol phosphate choline, low density lipoprotein L1,lipid L6were lower in patients with phlegm-dampness syndrome of PCOS, withstatistically significant difference (P<0.05).And its level of acetoacetate,very low densitylipoprotein L5,lipid L7,lactate, lysine,n-acetyl glycoprotein, threonine were higher, withstatistically significant difference (P<0.05).2.Comparing with the level of serum metabolites in the healthy people, the level ofcitrate, low density lipoprotein L1and L3, very low density lipoprotein L2, lipid L6, L7, L8and L9were lower in patients with non-phlegm-dampness syndrome of PCOS,withstatistically significant difference (P<0.05).And its level of creatine, formate, glutamate,glutamine, glycine, leucine, lysine, valine,α-glucose and β-glucose were higher, withstatistically significant difference (P<0.05)3.In terms of the level of serum metabolites,there were also significant differencesbetween patients with phlegm-dampness syndrome and non-phlegm-dampness syndrome.Comparing with the serum metabolites in the non-phlegm-dampness syndrome of PCOS,the level of ethanol, glycerin phosphate choline, phosphate choline, low density lipoproteinL1, α-glucose and β-glucose were lower in patients with phlegm-dampness syndrome ofPCOS, with statistically significant difference (P<0.05). and the level of acetoacetate,citrate,lactate, very low density lipoprotein L5, lipid L7, isoleucine, lysine were higher.with statistically significant difference (P<0.05).Conclusion:1.The comprehensive analysis of the metabolites in different groups found:the levelof ethanol, glycerol phosphate choline, low density lipoprotein L1in serum ofphlegm-dampness syndrome of PCOS were significantly lower, while the level of citrate,acetoacetate, very low density lipoprotein L5, lipid L7, lactate, lysine were significantlyhigher.This9metabolites could be the potential biomarkers for patients withphlegm-dampness syndrome of PCOS.2.The change mechanism of serum metabolites in PCOS patients was closely relatedwith the tricarboxylic acid cycle, glucose metabolism, lipid metabolism and proteinmetabolism. It was mainly manifested by the disorders of tricarboxylic acid cycle, slowedglucose metabolism, and increased lipid and protein metabolism.3.The PCOS patients with phlegm-dampness syndrome had been accompanied bysignificant obstruction of tricarboxylic acid cycle and disorders of glucose and lipidmetabolism. compared with PCOS patients of non-phlegm-dampness syndrome, glycolysisenhancement and gluconeogenesis inhibition were more apparent, lipid mobilization wasstrengthened. Indicating that there were more significant disorders of glucose and lipidmetabolism in PCOS Patients with phlegm-dampness syndrome, insulin resistance may bepotentially connected with this.