Studys On Irisin Levels In Serum And Endometrium With Polycystic Ovary Syndrome

Objective: To investigate the association between PCOS(polycystic ovary syndrome)patients with metabolic disturbance and serumirisin level;and to explore the expression of irisin in endometrial tissue of patients with PCOS and its correlation with insulin resistance of the endometrial tissue.Method: The article was a prospective study about the infertile patients which included 40 patients with PCOS(experimental group)and 30 patients without PCOS(control group)from March 2015 to December2015 in the Second Hospital of Hebei Medical University of reproductive medicine center for in vitro fertilization and embryo transfer(IVF-ET).Inclusion criteria: Age below 35,with double ovaries,basal FSH<10mIu/mL,without endometriosis,past half a year without history of hormone therapy,no smoking,drinking,history of drug dependence.The reason for their spouses with oligo-astheno-terazoospermia and obstructiveazoospermia were excluded.Experimental group was according with the Rotterdam Diagnostic Criteria for PCOS;control group patients werewomenwith regular menstruation,and the ones due to the fallopian tube line IVF-ET assisted reproduction.Experimental group: group A(experimental group)in accordance with the standard of 40 cases of PCOS patients.A1 group: according to body mass index(BMI),40 patients with PCOS were divided into: obesity group(A1F)and non-obese group(A1N);A2 group: according to whether the patients with dyslipidemia 40 patients with PCOS were divided into dyslipidemia group(A2BF group)ortholiposis group(group A2N);Group B(control group): in accordance with the above standard,20 patients without metabolic abnormalities of non-PCOS patients.According to BMI,they were divided into: obesity group(BF)and non-obese grou-p(BN).In control group,only four patients with dyslipidemia,for the differences in the number of cases,this test was not set up according to the grouping of dyslipidemia factor.Recording all patients' age,duration of infertility,the height,weight,waist circumference,hip circumference,and calculating the BMI,waist hip ratio(WHR),body mass index(body adiposity index,BAI = height/waist),fat free mass,body fat rate.A group of patients in the period 2-5 days or irregular menstrual ultrasound shows no advantage follicle and except pregnancy any day after menstruation sex hormones,FPG(Fasting Plasma Glucose),blood lipids,liver function,insulin and Irisin;Diagnostic curettage for endometrial tissue.Group B patients in the period 2-5 days measurement sex hormones,FPG,blood lipids,liver function,insulin and Irisin;Diagnostic curettage for endometrial tissue.Record fornumber of oocytes retrieved,rate of fertilization,rate of high-quality embryonic,high quality embryo rate,frozen wholeembryo rate,cycle refrigeration rate,clinical pregnancy rate,rate of implantation and abortion rate,etc.By the method of enzyme-linked immunosorbent assay(ELISA)determing irisin in two groups of serum level;analysisingirisin serum levels in A1 F group and A1 N,A2BF group and A2 N,BF and BN group to determine wether there were different;using immunohistochemical method to determine whether there wasirisin in endometrium.Analysis A1 F group and A1 N,A2BF group and A2 N,BF and BN group irisin in serum level difference;Compared group A a-nd group B in endometrial irisin and to determine wether its content haddifferences.Results:1General situation and biochemical indexesThe patients with PCOS had higher BMI,the duration of infertility,waist circumference,hip circumference,body fat rate,fat free mass,LH,FINS,HOMA-IR,ALTthan control group,having statistically significant(P<0.05).The levels of PCOS patients' LH,T,FINS,HOMA-IR,ALT,duration of Gn,dosage of Gn were significantly higher than control group,having statistically significant(P<0.05).PCOS patients' FSH lower than control group(P<0.05).The age,E2,FPG,TC,TG,HDL-C,LDL-C and AST ofPCOS and control group had no statistically significant(P>0.05).2 The comparisonindex and result related IVFControl group patients retrieved less oocytes than PCOS patients(P<0.05).The patients of two groups had no obvious difference in fertilization rate,cleavage rate,portable embryo rate,cycle of freezing rate,embryo freezing rate,biochemical pregnancy rate,clinical pregnancy rate,implantation rate and abortion rate(P>0.05).3 The comparison of the related contentThe irisin level of PCOS(0.76±0.36)ug/mllower than control group(1.32±0.29)ug/ml(P<0.05).PCOS patients with obesity had lower serum irisin level than the normal weight,having statistical significance(P<0.05).PCOS patients with dyslipidemia had higher serum irisin level than theortholiposis,and the difference had statistically significant(P<0.05).Serum irisin level of obesity in control group was lower than those with normal weight.The study showed that,the serum irisin level of PCOS patients was negatively correlated with body weight,BMI and WHR(R1=-0.747,P1=0.013;R2=-0.762,P2=0.000;R3=-0.846,P3=0.000)in PCOS patients;It had positive correlation with body fat rate,BAI,FPGand HOMA-IR(R4=0.426,P4=0.029;R5=0.531,P5=0.037;R6=0.588,P6=0.037;R7=0.685,P7=0.013).Serum irisin,in control group,was negatively correlated with body weight,BMI and WHR(Rw=-0.801,Pw=0.031;RBMI=-0.494,PBMI=0.004;RWHR=-0.792,PWHR= 0.028).Serum irisin in control group was positivelycorrelatedwithHOMAIR(RHOMA-IR=0.619,PHOMA-IR= 0.028).Multivariate linear regression analysis revealed that in PCOS patients,weight and HOMA-IR were meaningful serum irisin predictor(?1=-0.158,t1=-1.544,P1=0.000**;?2=-0.787,t2=-7.866,P2=0.000**).In the patients with PCOS,BMI could be used to predict serum irisin(?=-0.956,t=-16.393,P=0.000**).The expression of irisin was found in endometrial.The irisin level of PCOS group in endometrial was lower than the control group,and the difference was statistically significant(t=-5.867,P=0.00*).The endometrial irisin of PCOS with obesity was lower than PCOS normal weight group;the endometrial irisin level of PCOS with dyslipidemia was higher than the PCOS with nomal blood lipids group,but the two groups had no significant difference and statistically significant(t=1.191,P=0.241;t=1.171,P=0.294).The endometrial irisin level of control group with nomal weight group was higher than PCOS obesity group,but there was no obvious statistically significant(t=1.368,P=0.193).Conclusions:The levels of serum irisin of patients with PCOS were associated withbody weight,and positively correlated with glucose and lipid metabolism abnormalities and insulin resistance.The expression of irisin in endometrial tissue with,PCOS were negatively correlated with weight and lipid metabolism abnormalities.