| Objective:1.The aim of the study was to analyze the distribution of Chinese medicine syndrome types of PCOS,and the differences of clinical features between different syndrome patients with PCOS;2.To access the characteristics of sex hormone concentration and the metabolic parameters in the umbilical cord blood of newborns,whose mothers were with PCOS;3.We made a proteomics study on placenta of patients with PCOS by iTRAQ combined with LC-MS/MS to find proteins expressed differently,for the sake of constructing a placenta protein map of PCOS to explore the probable "fetal origins" of pathogenesis.Methods:This study was divided into clinical research and proteomics research.The clinical data of 496 patients with PCOS were collected to make a retrospective analysis.On the basis of the results,12 pregnant women who were diagnosed with PCOS in the pattern of phlegm and blood stasis syndrome were chosen as PCOS group,and 11 healthy pregnant women matched with patients in PCOS group were recruited as control group in the same period to make a prospective study.The fasting blood samples of all full-term subjects were collected,and the umbilical cord blood samples of newborns were collected.All of the blood samples were tested for the sex hormone concentration and the metabolic parameters.After the birth of newborns,the birth weight,body length and head circumference were measured immediately.After the delivery of placenta,the length,width,thickness and weight were measured at once.Then the samples of placenta were collected and saved in-80oC refrigerator for proteomics study in the future.Results:1.The results of retrospective analysis:of 469 patients with PCOS,163 cases were phlegm and blood stasis syndrome(34.75%),157 cases were phlegm dampness syndrome(33.48%),90 cases were kidney liver depression syndrome(19.19%),and 5 9 cases were kidney deficiency and blood stasis syndrome(12.5 8%).Compared with the patients with PCOS of kidney liver depression syndrome and kidney deficiency and blood stasis syndrome,the score of acanthosis nigricans,the level of BMI,WC,HC,SHBG,FAI,FPG,FINS,HOMA·IR,TG,CHOL,LDL,ApoB,and ApoB/ApoA-1 ratio increased(P<0.05),but the level of HDL and ApoA-1 decreased in the patients of phlegm and blood stasis syndrome and phlegm dampness syndrome(P<0.05).WHR was higher in the patients of phlegm and blood stasis syndrome than in the patients of kidney liver depression syndrome and kidney deficiency and blood stasis syndrome(P<0.05).Compared with the patients of phlegm and blood stasis syndrome,the level of ApoB and the ApoB/ApoA-1 ratio were lower in the patients of phlegm dampness syndrome(P<0.05),the level of FSH and LH were higher in the patients of kidney deficiency and blood stasis syndrome(P<0.05).When compared with the patients of phlegm dampness syndrome,the level of LH was higher in the patients of kidney deficiency and blood stasis syndrome(P<0.05),but the level of T was lower in the patients of kidney liver depression syndrome(P<0.05);2.The results of prospective study:there were no statistical difference between PCOS group and control group in age,pre-pregnancy BMI,gestational age,and pregnant times(P>0.05),but the weight gain during pregnancy was higher in women with PCOS than in controls(P<0.05).Compared with the newborns of the controls,PI was higher while head circumference was lower in PCOS group(P<0.05).There were no differences in weight,length,width,and thickness of placenta between two groups(P>0.05).The level of T,A,DHEAS,FAI,CHOL,AopB,and the ApoB/ApoA-1 ratio were higher in subjects with PCOS than in controls(P<0.05).The mean DHEAS,HDL,and CHOL were higher in cord blood of newborns of PCOS women than in controls(P<0.05),and the level of DHEAS was significantly increased(P<0.01);3.The results of proteomics study:there were 24956 unique peptides and 4593 proteins in the placenta samples of two groups.Compared with the control group,258 proteins expressed differently in PCOS group,of which 5 8 proteins expressed up and 200 proteins expressed down.These differently expressed proteins involved in 22 biological processes,and the top five were cellular process(83.3%),single organism process(83.3%),biological regulation(67.4%),metabolic regulation(66.7%),response to stimulus(51.6%).86.8%of proteins related to binding,and 3 6.0%of proteins related to catalytic activity.These 25 8 proteins mainly located in organelle(83.7%),membrane(4 5.7%),extracellular region(39.9%)and so on.They involved in the signaling pathways of cell adhesion,connection,and motion,immunity,apoptosis,cancer and hemostasis.Fnl was most close to the other proteins,and the followed proteins was keratin I syndrome cytoskeleton 15.Conclusion:1.Compered with the patients with PCOS of phlegm dampness syndrome,kidney liver depression syndrome,and kidney deficiency and blood stasis syndrome,the endocrine metabolic disorders are most serious in phlegm and blood stasis syndrome patients with PCOS,;2.The endocrine metabolic disorders of patients with PCOS can affect the level of androgen and lipid metabolism in their neonatal umbilical cord blood,which lead the offspring of patients with PCOS to be exposed in androgen excess intrauterine environment,and increase the risk of long-term chronic disease;3.iTRAQ can screen differently expressed proteins in placenta of patients with PCOS efficiently and rapidly,and build a clear protein map.These proteins are expected to become the diagnostic biomarkers for PCOS,and will provide biological clue for early diagnosis,prevention,and revealing the probable "fetal origins" of pathogenesis of PCOS in the future;4.The differential expression of Fnl and keratin I syndrome cytoskeleton 15 in placenta of patients with PCOS may change the structure and function of placenta,which then will affect the intrauterine environment of fetal of patients with PCOS.This finding should be further verified in the future. |
PDF Full Text Request