Fasting Insulin In Clinical Diagnosis Of PCOS Application And Relevance

Polycystic ovary syndrome(PCOS)is the most common reproductive endocrine disease in women of childbearing age and is the main cause of chronic anovulation and hyperandrogenism,Common clinical symptoms include thinning,infertility,hirsutism and obesity.Pathophysiological changes in PCOS involve neuroendocrine,protein metabolism,glucose metabolism,lipid metabolism and ovarian local regulatory factors.Fasting insulin(FINS)is often used to determine the existence of insulin resistance,and insulin resistance is one of the important features of PCOS.The purpose of this paper is to explore the relationship between fasting insulin and hyperandrogenism,fasting insulin and anti-Müllerian hormone(AMH),free testosterone(FT),androstenedione(AD)comparison to explore the relationship between fasting insulin and fasting insulin for diagnostic value in PCOS.Methods:The patients who had been diagnosed with PCOS from January 2017 to October 2017 in First Hospital Affiliated to Nanhua University gynecologic outpatient clinic and Wu Fan outpatient clinic were selected as experimental group,Non-PCOS patients as control group.Polycystic ovary syndrome using the Rotterdam standards of the American Society of Reproductive Medicine(2003).Venous blood was taken on the 3-5 day of the menstrual cycle(no limit of the menopause)in all patients,detection of fasting insulin,serum free testosterone,androstendione,and AMH levels,compare the difference of each test index between the experimental group and the control group.All subjects were treated with insulin resistance group(group IR)and non insulin resistance group(non IR group),body mass index is divided into obese and non-obese group,fasting insulin,serum free testosterone,androstenedione,serum AMH and PCOS statistical correlation analysis.Results:(1)In addition to age,FINS,FT,AD,AMH and HOMA-IR were all higher than those in the non PCOS group(P<0.001).(2)FINS and HOMA-IR,IR group were higher than non-IR group(P <0.001);FINS and HOMA-IR,obese group were higher than non-obese group(P <0.001).(3)FINS and FT,AD and AMH were positively correlated between three variables(r=0.132,0.168,1.161),and the correlation with AD and AMH was statistically significant(P<0.05),and the correlation between FT was not statistically significant(P>0.05).There is a positive correlation between FT and AD and AMH(r=0.275,P<0.05).(4)The ROCAUC of FINS is 0.711,the ROCAUC of FT is 0.783,the ROCAUC of AD is 0.653,the ROCAUC of AMH is 0.744,and four indexes have statistical significance for the diagnosis of PCOS(P<0.05).(5)The confidence interval for FINS diagnosis of PCOS(5.07-30.26)?U/ml;for biochemical HA with FT?4.2 pg/ml(from the golden field test),when the FINS threshold was 19.37 ?U/ml,respectively The rate was 78.7%;when AD?3.3 ng/ml was used as biochemical HA(from the golden field test),the FINS threshold was 20.82 ?U/ml,the coincidence rate was 61.7%.Conclusion:(1)FINS,FT,AD and AMH have good consistency with PCOS,and FINS can be used as an auxiliary diagnostic index for PCOS.(2)There is a positive correlation between FINS and FT and AD,and insulin resistance and hyperandrogenism are closely related.(3)Biochemical HA with FT?4.2 pg/ml,when the FINS threshold was 19.37 ?U/ml,the coincidence rate was 78.7%;when AD?3.3 ng/ml was the biochemical HA,the FINS threshold was 20.82?U/ml,respectively.The compliance rate is 61.7%.