Study Of Endocrine And Serum Visfatin In Different Traditional Chinese Medicine Patterns Of Women With Polycystic Ovary Syndrome

Objective： To explore the characteristics of different patterns intraditional Chinese medicine (TCM) and endocrinal metabolism ofpolycystic ovary syndrome (PCOS) and improve the level of the diagnosisand treatment with integrated Chinese and western medicine.PART ONEMethods：Five hundred and ten PCOS patients were placed into thefollowing TCM pattern subgroups: Kidney-Yang deficiency (KYD) group,Spleen-Yang deficiency (SYD) group, stagnant Liver-Qi transforming intoheat (SLQTH) group, and Kidney-yin deficiency (KYIND) group. Theendocrinal metabolic indexes such as OGTT, insulin release test and BMIwere analyzed retrospectively for the patients enrolled. HOMA-IR and I/Gwere calculated.Results: Of all patients with PCOS, there were192in the KYD group(37.7%),167in the SYD group (32.8%),84in the SLQTH group (16.4%), and67in the KYIND group (13.1%). Most of patients were differentiated asKYD and SYD (P<0.01).44%of PCOS patients presented abnormal glucosetolerance. The difference in glucose tolerance abnormality rate was notsignificant statistically in comparison among four patterns.62.7%of PCOSpatients presented insulin resistance. The level of insulin resistance in SYDgroup was higher than the other three pattern groups (P<0.01). Thesensitivity in HOMA-IR and I/G diagnosis was89.4%and87.5%respectively, without significant difference (P>0.05). The specificity inHOMA-IR and I/G diagnosis was94%and75%respectively. The specificityof HOMA-IR was stronger (P<0.01).Conclusion: KYD and SYD patterns are most common in PCOSpatients. The metabolic abnormality in PCOS patients is characterized asinsulin resistance. HOMA-IR presents the better specificity in the diagnosisof insulin resistance.PART TWOMethods： Serum levels of visfatin, total cholesterol (TC)，triglyceride (TG) in recent Two hundred and twelve PCOS patients weredetermined respectively. The correlations between serum visfatin levels andHOMA-IR, FPG, FINS, BMI, T, TC, and TG were analyzed.Results: Visfatin levels in all PCOS subgroups were higher than thosein the control group (P<0.01or P<0.05). Among these subgroups, the visfatin levels in the SYD group were significantly higher than those in theother three TCM pattern groups (P<0.05). There were no statisticaldifferences among the remaining three pattern groups. The levels of BMI,FINS, HOMA-IR, T, and TG were significantly higher in all subgroups thanthose in the control group (P<0.05). There were no significant differences inFPG and TC between all PCOS subgroups and the control group (P>0.05).The SYD group had higher levels of FINS and HOMA-IR compared withthe KYD, SLQTH, and KYIND groups (P<0.05). In all subgroups, aftercontrolling for BMI, TG, TC, and age, visfatin was positively correlated withFINS and HOMA-IR, and was not correlated with T.Conclusion: Increased visfatin is a common pathophysiologicmanifestation in PCOS patients. The SYD group had the highest levels ofvisfatin, and visfatin was positively correlated with FINS and HOMA-IR.