The Relationshiop Between Post-dexamethasone-suppression-text Cortisol And Metabolic Indexes In Polycystic Ovarian Syndrome

Objective: To investigate the relationship among glucose and lipid metabolism, uric acid, insulin resistance and function of pancreas (3-cell in polycystic ovary syndrome patients under different post-dexamethasone-suppression-test cortisol (pDexa) levels.Methods: Totally 48 patients with PCOS and 14 healthy controls were finally recruited from October, 2014 to February, 2016 of the First Affiliated Hospital of Guangxi Medical University. Height, Weight, Luteinizing hormone(LH), Follicular stimulating hormone (FSH) , Testosterone (T), Estrogen (E2),Prolactin (PROL), Progestin (PROG), Homeostasis model assessment of insulin resistance (HOMA-IR) , Insulin sensitivity index (ISI), Homeostasis model assessment of insulin secretion (HOMA-?) were observed in both PCOS and controls. Besides, AUCins0-3h /AUCglu0-3h and Modified beta cell function index(MBCI) were calculated according to data of OGTT and insulin releasing test(followed by the overnight lmg dexamethasone suppression test ) in PCOS.Meanwhile, fasting blood glucose and insulin were detected in healthy controls.All the blood parameters mentioned above were compared between PCOS and controls, normal weight and the over-weight (?24 kg/m2, or <24kg/m2),levels of pDexa (?26.05nmol/L and < 26.05nmol/L, respectively ) and all the people of pDexa < 26.05nmol/L with subgroups in BMI (?24 kg/m2,or<24kg/m2), respectively.Results: 1) Levels of BMI,UA, LDL-C, I0, HOMA-p, HOMA-IR and Testosterone in PCOS were higher than the healthy controls, but the ISI is relatively lower. 2) Levels of cortisol and pDexa with normal weight were higher than the over-weight in PCOS. Levels of TG, UA, HOMA-IR, G0, I0,AUCins0-3h, AUCglu0-3h, AUCins0-3h/AUCglu0-3h in over-weight group were higher than the normal weight, but levels of HDL-C and ISI were lower. Level of Testosterone in PCOS was significantly higher than healthy controls (P <0.05), but there was no differences between normal weight and the over-weight in PCOS. 3) Levels of BMI, TSH, UA, I0, I2, G1 HOMA-IR, AUCglu0-3h in pDexa < 26.05 nmol/L subgroup were higher than the ones with pDexa ?26.05 nmol/L, but levels of ISI and Cortisol were lower than the latter. In subgroup of pDexa < 26.05 nmol/L,all the blood parameters mentioned above were significantly higher than healthy controls (P < 0.05) except for the TSH.Testosterone was without differences between subgroups in PCOS of different pDexa levels (?26.05nmol/L, or < 26.05nmol/L), but levels of Testosterone in PCOS was higher than healthy controls. 4) In subgroup of pDexa <26.05 nmol/L,levels of TG, UA,HOMA-IR, G1, G2, Ii, I2, I3, AUCglu0-3h,AUCins0-3h in the over-weight were higher than ones with normal weight, but levels of ISI,HDL-C and Cortisol were relatively lower.Conclusion: 1) PCOS were in metabolic abnormalities of blood glucose,lipid and urea acid and those ones were with insulin resistance and hyperandrogenism, especially in the over-weight. 2) PCOS showed dysfunction of HPA axis, levels of cortisol in nomal weight in PCOS was higher than in the over-weight in PCOS and healthy controls. But there was nothing wrong with feedback function about HPA axis in the patients. 3) The lower level of pDexa was, the higher levels of BMI?TSH?UA?G1?AUCgluO-3h?HOMA-IR?I1?I2 were.