| Objective In order to analysis the differences in endocrine and metabolic characteristics of patients with polycystic ovary syndrome complicated with metabolic syndrome and patients without metabolic syndrome,and to explore the value of lipid accumulation product in the diagnosis of metabolic syndrome in patients with polycystic ovary syndrome.Subjects and Methods Retrospective analysis of the finally diagnosed with polycystic ovary syndrome patients during January 2015 to January 2017,due to menstrual abnormalities,infertility or impaired glucose tolerance in the Third Affiliated Hospital of Guangzhou Medical University endocrinology hospitalized,according to the China Ministry of Health in 2011 diagnostic criteria for polycystic ovary syndrome and a complete case data,a total of 138.According to the diagnostic criteria for the diagnosis of metabolic syndrome recommended by the guidelines for the prevention and treatment of type 2 diabetes in 2013,138 patients with PCOS were divided into 39 patients with metabolic syndrome and 99 patients without metabolic syndrome.In order to analysis the differences in endocrine and metabolic characteristics among two groups,and use ROC curve to explore the value of lipid accumulation product in the diagnosis of metabolic syndrome in patients with polycystic ovary syndrome.Results 1.According to age stratification,the incidence of PCOS and the highest incidence of PCOS combined with MS were 26-30 years old,the difference between the incidence of PCOS and the incidence of PCOS combined with MS was not statistically significant.(P> 0.05).According to BMI results,PCOS patients were divided into three groups,the incidence of MS increased from 6.38%(3/47)of BMI <24 kg /m2 to 52.5% of BMI≥28 kg / m2(21/40),the difference between the groups was statistically significant(P <0.05).2.The abnormality of MS components in patients with PCOS combined with MS was 92.3%(36/39)in abdominal obesity,74.4%(29/39)in hypertriglyceridemia,and decreased in high density lipoprotein 56.4%(22/39);impaired glucose tolerance by 38.5%(15/39);type 2 diabetes 35.9%(14/39);hypertension 15.3%(6/39).There were no 17.4%(24/138)MS components in PCOS patients,25.4%(35/138)of one MS component,29.0%(40/138)with two abnormality components,and three components abnormally 18.8%(26/138),with four components abnormally 8.0%(11/138),with five components abnormally 1.4%(2/138).3.PCOS combined with MS group BMI,waist circumference,hip circumference,waist to hip ratio,systolic blood pressure and diastolic blood pressure were significantly higher than those without MS group,the difference was statistically significant(P<0.05),PCOS combined with MS group FPG,2h PG,FINS,TG,HDL-C,HOMA-IR LH、LF/FSH、LAP were significantly higher than those without MS group,the difference was statistically significant(P<0.05).There was no statistically significant difference between FSH,T,E2,PRL and P in the two groups.4.The LAP index of PCOS patients with high waist circumference and high TG and low HDL-C was significantly higher than that of patients without MS,the difference was statistically significant(P<0.05).The LAP of PCOS patients with insulin resistance was significantly higher than that of patients without insulin resistance,P <0.05,the difference was statistically significant.5.The best predictors of metabolic syndrome in patients with PCOS were TG≥1.70 mmol / L and the Youden index was 0.55;the best negative predictive index is the waist circumference,95.16% of WC <85cm PCOS patients do not merge metabolic syndrome;the best positive predictive index is high density lipoprotein,70.97% of HDL-C≤1.04 mmol / L PCOS patients with metabolic syndrome.6.Logistic regression analysis showed that WC,2h PG and LAP were the risk factors of MS in PCOS patients,and HDL-C was the protective factor of MS in PCOS patients.7.Through the correlation analysis,there was a positive correlation between LAP and BMI,WC,HOMA-IR,TG,SBP,FPG and 2h PG in PCOS patients,and it was negatively correlated with HDL-C.The ROC curve analysis showed that the area of BMI,WC,TG,LAP and HOMA-IR were 0.801,0.834,0.806,0.888 and 0.808,the difference was statistically significant(P<0.05).LAP diagnosis PCOS combined with MS under the largest area of the curve.LAP was 56.82,the sensitivity was 84.6%,and the specificity was 83.8%.Therefore,LAP is the best indicator for the diagnosis of MS in PCOS patients.Conclusion 1.PCOS patients with high incidence of MS,obesity increased PCOS patients with MS.2.Compared with PCOS patients without MS,PCOS patients with MS were more likely to develop dyslipidemia,hypertension and insulin resistance.3.ROC curve analysis showed that LAP could serve as a simple and effective indicator for screening PCOS patients with MS. |
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