Study On The Changes Of CYP17A1 And CYP11A1 Concentrations Of Patients With Polycystic Ovary Syndrome And Their Correlation With Insulin Resistance

Objective:To investigate the different concentrations of CYP17A1 and CYP11A1,the key enzymes for androgen synthesis,in serum and follicular fluid of normal subjects,patients with insulin resistance(IR),and patients with polycystic ovary syndrome(PCOS)with or without IR.Methods:89 patients diagnosed with PCOS in the Department of Endocrinology and Reproduction Center of the Affiliated Hospital of Zunyi Medical University were enrolled,and another 74 age-matched healthy women were enrolled in the same period.The steady-state model insulin resistance index(HOMA-IR)was calculated in all study subjects,and they were divided into the following four groups according to whether they were accompanied by IR:①normal control group(NC group,n=38);②insulin resistance group(IR group,n=36);③PCOS without insulin resistance group(PCOS group,n=46);④PCOS with insulin resistance group(PCOS+IR group,n=43).The related endocrine metabolic indexes such as fasting insulin(FINS),sex hormones such as follicle stimulating hormone(FSH)and luteinizing hormone(LH),CYP17A1 and CYP11A1 were measured and calculated.The differences in CYP17A1 and CYP11A1 levels between the groups were compared,and the influencing factors and their relationship with IR were analyzed.Results:(1)Comparison of indexes among the four groups:①In serum,CYP17A1 and CYP11A1 levels were not statistically different among the four groups,and in follicular fluid,CYP11A1 levels were not statistically different among the groups;Compared with the NC group,CYP17A1 was significantly increased in the PCOS group and the PCOS+IR group(P<0.05);Compared with the IR group,CYP17A1 was significantly increased in the PCOS group and PCOS+IR group(P<0.05);Compared with the PCOS group,CYP17A1 was significantly increased in the PCOS+IR group(P<0.05).②Compared with NC group,BMI,FINS,triglyceride(TG),low density lipoprotein cholesterol(LDL-C),uric acid(UA),Anti-Müllerian hormone(AMH)and HOMA-IR in PCOS group were significantly higher(P<0.05),and progesterone(P)and sex hormone binding globulin(SHBG)were significantly lower(P<0.05).In PCOS+IR group,BMI,FINS,blood pressure,TG,LDL-C,AMH,HOMA-IR and free testosterone index(FTI)increased significantly,while high density lipoprotein cholesterol(HDL-C),P and SHBG decreased significantly(P<0.05).Compared with PCOS group,BMI,blood pressure,TC,HOMA-IR and FTI in PCOS+IR group were significantly higher,and HDL-C was significantly lower(P<0.05).(2)Correlation analysis:follicular fluid CYP17A1 levels were positively correlated with FINS,HOMA-IR,TEST,DHEAS,and FTI,and there was no significant correlation between them and other indexes(P>0.05).(3)Multiple stepwise regression analysis:TEST was the key factor influencing CYP17A1.HOMA-IR was not an independent influencing factor of CYP17A1.(4)Binary logistic regression analysis:HDL-C and SHBG were protective factors for PCOS,and BMI,TG,LDL-C,TEST,AMH,HOMA-IR and CYP17A1 were risk factors for PCOS.CONCLUSION:CYP17A1 may play an important role in the development of PCOS,and there be a strong association between high CYP17A1 expression and IR,which enhances the effect on PCOS when both are present.