| Objective Polycystic ovary syndrome?PCOS?is a common re-productive endocrine and metabolic disorders in women of childbearing age,is a clinical syndrome with endocrine disorders,accompanied by a variety of metabolic disorders.The clinical features of Polycystic Ovary were characterized by continuous non-ovulation,excessive androgen,and Polycystic Ovary,and the clinical features of PCOS patients showed het-erogeneity.International reported prevalence in reproductive age women of PCOS patients is about 5?10%[1].There is no exact and uniform prev-alence report of PCOS in China.For the diagnosis of PCOS,China has been using the diagnostic criteria proposed by ESHRE/ASRM at the Rot-terdam meeting,referred to as“the Rotterdam Standard”,and domestic experts in obstetrics and gynecology have basically reached consensus on the standards of Rotterdam.The purpose of this study is to investigate the prevalence and clinical biochemical characteristics of single-center fe-male PCOS patients in Tibetan Plateau?mainly of Tibetan women of childbearing age?.Through the comparison and analysis of the character-istics of demography,geographical features?altitude?and disease-related features of PCOS patients,to find the pathogenic factors and influence factors of patients with PCOS,reasonably and correctly using objective data.It provides a data reference for the prevention and treatment of fe-male PCOS patients in the Tibetan plateau area.It also provides data ref-erence for the nationwide,large-scale and multi-center epidemiological investigation in our country.Methods PCOS patients were diagnosed with the diagnostic criteria developed by the European Society for Reproductive and Embryo Re-productive Medicine and the American Society of Reproductive Medicine?ESHRE/ASRM?in Rotterdam in 2003,and Collected from January2016 to August 2016 in Tibet university people's hospital of gynecology and obstetrics gynecology and reproductive endocrine clinics diagnosed with PCOS patients.At the same time,a total of 266 cases of non-PCOS women of childbearing age were enrolled in the women of childbearing age as control group?157 cases of Tibetan,62 cases of Han and 47 cases of other nationalities?.Obstetricians and gynecologists will ask and col-lect all patient information,including name,age,ethnicity,origin,occu-pation,educational level,marriage and childbirth,as well as the main complaints during treatment?menstrual disorders,oligomenorrhea,amenorrhea,vagina Hemorrhage,etc.?.The patients were carefully ex-amined,including height,weight,abdominal circumference,blood pres-sure,body mass index?BMI?,physical examination findings such as acne,hirsutism and acanthosis nigricans,Luteinizing hormone?LH?,follicle stimulating hormone?FSH?,estradiol?E2?,progesterone?P?,testosterone?T?and pituitary prolactin?PRL?and other female endocrine hormones.Finally,the data and information were collected to calculate outpatient composition ratio of PCOS patients in gynecological reproductive and endocrine clinic of single center in Tibet Plateau to estimate the overall prevalence.Then a case-control study was conducted in PCOS patients and non-PCOS patients.Describe the clinical features of single center PCOS patients in the Tibetan Plateau.According to ethnicity,age,BMI,abdominal circumference,signs and laboratory indexes,we compared the clinical features of different PCOS patients in different subgroups to ex-plore the related factors of PCOS in Tibet plateau.The statistical methods were processed with SPSS20.0.Count data adoption rate or composition ratio indicates,and X2 test was used for comparison between the two groups.Measured data were expressed as mean±standard??x±s?devia-tion.Statistical analysis was performed using t-test or non-parametric test.The P values were both bilateral,and P<0.05 for the difference was sta-tistically significant.Results?1?From January 2016 to August 2017,2597 patients were enrolled in Gynecological Endocrinology Clinic at People's Hospital of Tibet University.The number of patients diagnosed with PCOS was 266cases,175 were Tibetan?65.79%?,Han 86 cases?32.33%?,other nation-alities in 5 cases?1.88%?,outpatient PCOS accounted for 10.24%?266/2597?.?2?PCOS case group and control group for interethnic com-parison,the difference was statistically significant?P<0.05?.?3?Cases of PCOS group and the control group according to the age stratification,di-vided into<20 and 21?31,31?40,and>40 groups of four,comparing differences between two groups of age was statistically significant?P<0.05?.?4?The PCOS patients accounted for the highest proportion of service staff,accounting for 37.20%.The patients with PCOS had the highest level of education in high school or secondary school,accounting for 35.70%of the total.The differences between the two groups were sta-tistically significant?P<0.05?.?5?Epidemiological characteristics of clinical data of PCOS cases:34.21%?91/266?of infertility,33.08%?88/266?of oligomenorrhea,21.80%?58/266?of amenorrhea,3.76%?10/266?of vaginal irregular bleeding,hirsutism 37.6%?100/266?,acne45.49%?121/266?,lactation 7.89%?21/266?,acanthosis-nigricans 17.67%?47/266?.?6?Biochemical indicators and B-mode ultrasound epidemio-logical characteristics:PCOS case group of 99 cases of biochemical Kaohsiung,accounting for 37.22%?99/266?between the groups,and there were 137 cases of LH/FSH?2?3 in the PCOS group,accounting for51.50%?137/266?of the patients in the PCOS group.There was a statis-tically significant difference between the two groups in LH,FSH,LH/FSH,and T?P=0.00<0.05?.There was no statistically significant dif-ference in PRL?P=0.58>0.05?.There were 162 cases of PCO in PCOS patients,accounting for 60.9%?162/266?.?7?There were 84 cases of overweight?BMI?24 and BMI<28?in PCOS case group,accounting for31.58%?84/266?,and 13 cases were overall obesity,accounting for 4.89%?13/266?,and there was no statistically significant difference in BMI be-tween the case group and the control group?P>0.05?.There were 169cases?63.53%?in the PCOS case group with WC>80cm?169/266?.There was significant difference in WC between the case group and the control group?P<0.05?.?8?The constituent ratio of outpatient clinics in Nyingchi who were with PCOS at an average elevation of about 3000meters in the Tibetan Plateau was 9.77%?26/266?,and the average constituent ratio in Lhasa,Xigatse and Nagqu over 3500 meters above sea level was 31.20%?83/266??14.66%?39/266?and 15.41%?41/266?,respectively.There was no significant difference in altitude between the case group and the control group?P>0.05?.Conclusion?1?The prevalence of PCOS in Tibet Plateau?based on single center?was slightly higher than the average reported prevalence of PCOS in the Tibetan Plateau.?2?The prevalence of PCOS may be related to ethnicity.?3?PCOS patients in the Tibetan Plateau occur in the early 21to 30 years,indicating that PCOS is associated with age,and the high prevalence of women of childbearing age.?4?oligomenorrhea,acne,hir-sutism,high T and PCO are important clinical,biochemical and imaging features of patients with PCOS.The diagnostic criteria of ESHRE/ASRM in 2003 are applicable to the Tibetan Plateau.?5?The chief com-plaint of Tibetan PCOS patients were infertility,followed by oligo-menorrhea and amenorrhea.?6?WC is more likely to report overweight than BMI.?7?As the altitude increases,the prevalence of PCOS may be higher. |
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