Analysis Of Metabolism Characteristics About PCOS Patients And Effects Of Diane35 And Metformin The Association Between The Gene LRP-5(rs3736228) Polymorphism And PCOS

Chapter oneThe polycystic ovarian syndrome(PCOS)is a common endocrine metabolism disorder disease,it affects 5-10%reproductive-aged women and 75%infertility women of ovulation failure.Obesity,hyperandrogenism,insulin resistance,lipid metabolism dysfunction pathology characteristics are the risk factors of long-term complications such as diabetes mellitus and cardiovascular disease Research had discovered clinical sings and symptoms of PCOS patients had apparente heterogeneity and distinguished ethnic differences also.The state of high LH,hyperandrogenism lead to infaust follicular development environment,accordingly effect follicle normal development.In the patients under the therapy of ART will display follicular development slow-moving or stagnate and early abortion.Diane35 can degrade the composition and biologic activity of androgen,metformin can improve the state of insulin resistance,they are the first choice of treatment.Objective To Analysis of metabolism characteristics about 325 PCOS patients and study the effect of Diane35 in combination with Metformin for two months.Methods(1)Analysis the incidence rate of obesity,hyperandrogenism,insulin resistance,lipid metabolism dysfunction about 325 PCOS patients.(2)Analysis the changes of those parameters (BMI,WHR,T,LH,17-OH,SHBG,HOMA-IR,TG,TC,HDL,LDL,ApoB),after two months treatment by Diane35 with Metformin on 54 patients. Result(1)The incidence rate of obesity is 28.62%(93/325),among of them android type obesity is 53.27%(173/325).The rate of hairiness is 1.89%(6/325),rate of acne is 2.81%(9/325),rate of IR is 59.56% (194/325).The rate of IGT is 12.85%(42/325).12 patients are diabetes, rate is 3.76%(12/325).The rate of increased total cholesterol is 7.56% (25/325),increased triglyeride is 27.8%(90/325),high-density lipoprotein decreased is 8.59%(28/325),low density lipoprotein increased is 22.41%(73/325),apolipoprotein B increased is 20.85%(68/325).The total rate of lipid metabolism dysfunction is 60.82%(198/325).(2)BMI,WHR,T,17-OH,HOMA-IR,TG,LDL,ApoB were significant decreased(P＜0.05),and SHBG was significant increased(P＜0.05), Others such as HDL,TC have no significant changes(P＞0.05).Conclusion Han PCOS patients with obesity in android type has more obvious incidence rate,it is necessary to take further study about the evaluation of the value of WHR as a PCOS patients' clinical diagnosis and treatment.Han PCOS patients also exists with high incidence of insulin resistance,high androgen level,suggesting that there has high-risk of long-term complications,and need for early intervention.After Diane-35 with metformin treatment by two months,can improve PCOS patients' signs,endocrine disorders,glucose and lipid metabolism disorders. Chapter twoThe family gather phenomenon of PCOS prompts heredity factor is the vital role in its pathogenesis.At present,the studies on the incidence of PCOS include the androgen metabolism-related genes,glucose metabolism-related genes,and gonadotropin-related genes.Obesity is not only the impact factor on human health of the common diseases,but also risk factor a number of complex disease.About 40-50%of pcos are suffered with obesity.Obesity,abdominal obesity in particular,may increase insulin resistance(insulin resisted,IR)level.Research shows that obesity type is highly decided by heredity,and obesity-related candidate genes are:LEP,LEPR,UCPs,PPAR-r,etc.Low-density lipoprotein receptor-related protein-5 has vital and remarkable role to glycometabolism and lipid metabolism.The gene LRP-5 polymorphism is associated with obesity phenotypes,especially with rs4988300(G/T)locus.However,there are few studies in relationship between other LRP-5 SNP polymorphism and PCOS.Objective To investigate the association between the polymorphism of LRP-5 at rs3736228(C/T)locus with PCOS,obesity and glycolipid metabolism.Methods Denaturing High Performance Liquid Chromatography (DHPLC)was used to amplify the SNP of the gene LRP-5 at rs3736228(C/T)locus for all 201 PCOS patients and the control group(109 healthy subjects).Comparisons were conducted in gene polymorphism between PCOS patients and congtrol group.Results There are 59 unsymmetric figures in 201 PCOS samples, 40 unsymmetric figures in 109 congtrol samples at rs3736228(C/T)locus. There have significant differences on BMI and TG in PCOS patients group.There has no difference between PCOS and control by the rate of unsymmetric figures. Conclusion LRP-5 gene SNP rs3736228(C/T)polymorphism may be related with obesity and lipid metabolism disorders in PCOS.