The Correlation Research Of Insulin Resistance With Serum Adiponectin And PTEN Of Endometrial In Polycystic Ovary Syndrome

OBJECTIVEThe purpose of this study was to analyze the women endocrine characteristics and the feature of endometrial pathology,determine the expression in the endometrium and the levels of serum adiponectin in PCOS.Investigate the effect of insulin resistance(IR)in endocrine disorder and endometrial hyperplasia in polycystic ovarian syndrome(PCOS).METHODSTo collect PCOS patients from general hospital of tianjing medical college department of gynecology in 2007.1-2007.11.The experimental group includes 58 PCOS patients,whose age were 15-37(28.33±4.52),36 made pathologic study of endometrium;To collect 37 persons for control group,whose age were 24-43(30.00±5.40),include eumenorrhea,fallopian tubes infertility(none of ovulation failure) or ovary benign neoplasm patients who want to surgery,28 carry out pathologic study of endometrium,.The PCOS patients divided intoâ… group(insulin resistance group,30 cases)andâ…¡group(without insulin resistance group,28 cases);According to the pathological finding the PCOS patients were divided into A group(11 cases) whose endometrium had paraplasm or canceration and B group(25 cases)who had normal endometrium(include proliferative or secretory phase endometrium); According to BMI the PCOS patients were divided into overweight and obesity group(BMI≥23,45 cases)and normal body weight group(BMI＜23,13 cases).Serum sexual hormone were measured in each group,oral glucose tolerance test(OGTT) and insulin releasing test were measured in experimental group,only fasting blood glucose were measured in control group,pathology examination were taken in all endometriums;Expression of PTEN in endometrium were detect by immunohistochemisty SP methods,serum adiponectin levels were measured by radio-immunity. RESULT:一.The comparison of serum sexual hormone,insulin,BMI and APN in each group.1.The characteristics of PCOSThe incidence of insulin resistance in PCOS was 51.7%,5.7%in control group and 66.7%in obesity;In PCOS the ratio of LH/FSH more than 2 was 55.2%,the testesterone higher were 42.8%,overweight were 10.4%,obesity patients were 67.2%.2.the comparison of serum sexual hormone,HOMA-IR,INS-AUC,BMI and APN in each group.(1)LH:LH were dramatically higher inâ… andâ…¡groups than control group,P＜0.05, there were no difference betweenâ… andâ…¡group.(2)LH/FSH:LH/FSH were dramatically higher inâ… andâ…¡groups than control group,there were no difference betweenâ… andâ…¡group.(3)E₂:There were no difference among the groups.(4)T:The levels of testesterone were significantly higher inâ… andâ…¡groups than in the control group,there were no difference betweenâ… andâ…¡group.(5)BMI:The BMI ofâ… group significantly higher than theâ…¡group and control group,there were no difference betweenâ…¡group and control group.(6)INS-AUC:INS-AUC were significantly higher inâ… group thanâ…¡group.(7)APN:The levels of APN were significantly lower inâ… group than inâ…¡group and control group,there were no difference betweenâ…¡group and control group.3.the comparison of serum sexual hormone,HOMA-IR,INS-AUC,BMI and APN in overweight and obesity and control group.(1)LH:LH were significantly lower in PCOS overweight and obesity than PCOS normal weight,and higher in PCOS normal weight than control normal weight. (2)LH/FSH:LH/FSH were significantly lower in PCOS overweight and obesity than PCOS normal weight,higher in PCOS overweight and obesity than control overweight and obesity and higher in PCOS normal weight than control normal weight.(3)E₂:There were no difference among the groups.(4)T:The levels of testesterone were significantly higher in PCOS overweight and obesity than in control overweight and obesity.(5)HOMA-IR:The HOMA-IR were significantly higher in PCOS overweight and obesity than in PCOS normal weight and control overweight and obesity.(6)INS-AUC:INS-AUC were significantly higher in PCOS overweight and obesity than PCOS normal weight.(7)APN:The levels of adiponectin in PCOS overweight and obesity were significantly lower than in PCOS normal weight and control overweight and obesity,and lower in control overweight and obesity than control normal weight.4.The relations of serum sexual hormone,HOMA-IR,INS-AUC,BMI and APN in PCOS.There were positive correlation between HOMA-IR and BMI in PCOS;There were no correlation between HOMA-IR and LH,LH/FSH,T,E₂.There were positive correlation between INS-AUC and BMI,T.There were positive correlation between LH and T.There were negative correlation between adiponectin and BMI,INS-AUC,HOMA-IR.二.The relations of insulin resistance and endometrial disorder.The PCOS women who examined the pathologic study of endometrium,include 20 cases of insulin resistance,there were 6 cases in A group,and 14 cases in B group;and 16 cases without insulin resistance,there were 5 cases in A group,and 11 cases in B group.There were no difference between them.三.The relations between the levels of serum adiponectin and endometrial disorder.The levels of serum adiponectin significantly lower in PCOS-A than PCOS-B and control group.The levels of adiponectin lower in PCOS-B than in control group,but there were no difference between them.å››.The expression of PTEN in the endometriumThe expression of PTEN in the endometrium were significantly lower in PCOS than control group,so in PCOS-A than PCOS-B and control group;The expression of PTEN were lower in PCOS-â… than PCOS-â…¡,but there were no difference between them.The expression of PTEN were significantly lower in PCOS overweight and obesity than in the patients of normal body weight and control overweight and obesity.There were absence of PTEN in each group,the absence percentage in control group,PCOS-B and PCOS-A were 3.6%,8%,18%respectively,which increase gradually,but there were no statistical difference between them. There were negative correlation between PTEN and INS-AUC,HOMA-IR,and there were no correlation with E₂,T,LH/FSH,APN,BMI.CONCLUSION1.Insulin resistance and hyperinsulinism were important pathophysiology change of PCOS,hyperinsulinism were correlated with hyperandrogenemia.2.There were hypoadiponectinemia in PCOS obesity patients,there were negative correlation between adiponectin and obesity,insulin resistance,the low-level of adiponectin concerned with endometrial disorder.3.The expression of PTEN in the endometrium of PCOS decreased,the level of PTEN were negative correlation with insulin resistance,the expression decrease or absence concerned with endometrial disorder.