Clinical Analysis Of Insulin Resistance And Glycolipid Metabolism In Patients With PCOS At Different Ages

Objective:To investigate analyze the occurence of insulin resistance(IR) and the characteristics of glycolipid metabolism in non-obese and obese women with PCOS.Method:From March 2012 to December 2014,72 adolescent patients with PCOS and74reproductive-age with PCOS were collected.According to the limt of Body Mass Index [BMI(25kg/m2)],the patients were divided into obseity group and non-obesity group. Collecting participants’ clinical data age,,height,weight, the level of sexual hormone,oral glucose tolerance test(OGTT) and Serum lipid were retrospectively reviewed,and B-mode ultrasono-graphy for ovaries and uterus was examined. Then compared the parameters between the groups.Such as the prevalence of type 2diabetes mellitus, results of oral glucose tolerance test,impaired glucose tolerance(IGT), 7insulin resistance and dyslipidemia.Results:1、Puberty PCOS patients(90%) and reproductive-age with PCOS(88%) had menstrual disorders. In which reproductive period of 24 patients with PCOS from puberty onset.2 、 The fasting blood glucose(FBG) and 2-hour postprandial blood glucose((2h PBG) in adolescent obese PCOS are higher than the non-obese, but no statistical difference between two groups(P > 0.05), Fasting insulin(FINS) and insulin(2h)(INS2h) in obesity group were significantly higher than non-obese group(P < 0.05), HOMA- IR was statistically difference between the two groups(P < 0.05).GLU2 h and FINS in obesity group were significantly higher than the non-obese group in reproductive-age PCOS(P < 0.01), HOMA-IR has significant difference between the two groups(P < 0.01). IR accounted for 55.55%(40/72)in 72 adolescent PCOS, the FBG was normal, elevated 2h PBG accounted for 16.66%(12/72); IR in 74reproductive-age PCOS accounted for 60.81%(45/74), abnormal FBG took up 6.75%(5/74), rising 2h PBG took up 18.91%(14/74), 2 cases were diagnosed diabetes.The FBG of reproductive-age(5.04 ± 0.53) higher than the adolescent PCOS group(4.36 ± 1.92)(P < 0.05).3、The prevalence of impaired glucose tolerance(IGT)was 26.02%(38/146)in146 PCOS patients, which was mainly found in reproductive-age group, it account for 81.5%(31/38).The other was 19.5%(7/38), the rate of IGT in reproductive-age group was higher than in adolescent group(P < 0.01),which was increased with the age, the difference was statistically significant(P < 0.05). 68.43%(26/38)IGT in obese group were significantly higher than the 31.57%(12/38)in non-obese group with PCOS(P < 0.01), which was statistically different between the two groups(χ2=18.44,P < 0.01). the rates of diabetes between non-obese(0%)and obese(5.55%)have statistical significance(χ2=16.005,P < 0.01),the incidence of IGT increased with BMI.4、HDL-C in adolescent obese group was significantly lower than the non-obese group(P < 0.01), the rest of the lipid metabolism had no remarkable difference(P >0.05). TG in reproductive-age obese group was higer than the non-obese(P < 0.01),the same as LDL-C and the rest of lipid had no significant difference(P > 0.05).Dyslipidemia was more likely related with the age and weight.5 、 The incidence of low insulin sensitivity low in the obese group was obviously higher than the non-obese(P < 0.05), and the incidence of low PCOS insulin sensitivity in the reproductive-age PCOS was higher(56.7%) than the adolescent with PCOS(38.9%)(P < 0.05), MBI showed a negative correlation with IR.Conclusion1、Most of PCOS have menstrual disorders, reproductive-age PCOS may be a continuation of adolescent PCOS2、 Both obese and non-obese PCOS patients should take OGTT and lipid exzamine3、The obese patients with PCOS have more severely metabolic imbalances than the non-obese ones.The obese patients with PCOS show high levels of insulin and insulin resistance4、 In order to reduce abnormal glucolipid metabolism,we should pay attention to the patients about insulin sensitivity..5 、 The elevated triglycerides(TG) and low density lipoprotein cholestrtol(LDL-C), high-density lipoprotein cholestrtol(HDL-C) are harmful to the health of patients with PCOS,we should pay attention to PCOS-associated complications.