Analysis Of High Triglyceride Waist Circumference Phenotype And TCM Syndrome Type And Clinical Characteristics Of Different Glucose Metabolism In Patients With Polycystic Ovary Syndrome

Objective:By analyzing the general clinical data,biochemical index level,difference of glucose metabolism status and distribution of TCM syndrome type of PCOS patients with different triglyceride waist phenotype groups;In order to find out the differences in clinical indicators of PCOS patients with different triglyceride waist circumference phenotype and focus on analyzing whether different phenotypes are the influencing factors of abnormal glucose metabolism in PCOS patients,providing a basis for the early screening of glucose metabolism level in clinical PCOS patients with high triglyceride waist circumference phenotype.Methods:A total of 948 PCOS patients who visited the department of Gynecology Outpatient Department of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from January 2014 to December 2021 and were included in the clinical scientific research information integration system were selected.According to the level of triglyceride and waist circumference,there were 211 cases of normal triglyceride and waist circumference(NWNT)group,451 cases of high waist circumference(EW)group,17 cases of high triglyceride(HTG)group,and 269 cases of high triglyceride waist circumference(HTGW).SPSS26.0 software was used to analyze the proportion of different phenotypes and the incidence of abnormal glucose metabolism in PCOS patients.The general clinical characteristics,sex hormone levels,glucose and insulin metabolism levels,blood lipid levels,thyroid hormone levels,incidence of insulin resistance,glucose metabolism status and distribution of TCM syndrome type were analyzed among the four phenotype groups.Finally,different phenotype groups of PCOS patients and their correlation with abnormal glucose metabolism were analyzed by Logistic regression.Results:1.Among 948 PCOS patients,the proportions of NWNT group,HTG group,EW group and HTGW group were 22.26%,1.79%,47.57% and28.38%,respectively.2.In the 948 PCOS patients in this study,HTGW phenotype was most common in sputum and blood stasis type,accounting for 44.24%.3.HTGW phenotype compared to NWNT phenotype,Age,SBP,DBP,body weight,BMI,WC,HC,WHR,black spiny skin score,FPG,120-minute blood glucose,FINS,120-minnte insulin,TG,TC,LDL,APOB,FT3,TPO-AB,TGAB and WHt R were increased;The levels of hirsute score,LH,LH/FSH,PRL,DHEAS,AND,SHBG,HDL and APOA were significantly decreased,with statistical significance(P<0.05).4.The incidence of insulin resistance in NWNT,HTG,EW and HTGW groups was 14.69%,58.82%,66.08% and 87.36%,respectively.5.The incidence of PCOS with abnormal glucose metabolism was28.6%.In different triglyceride waist circumference phenotype groups,the occurrence of abnormal glucose metabolism status showed differences,with statistical significance(P<0.05),impaired glucose regulation(IGR)and type 2diabetes mellitus(T2DM)were more common in HTGW phenotype,accounting for 43.87% and 6.32% respectively.6.In Logistic regression model,HTG,EW and HTGW phenotypes were the influencing factors of abnormal glucose metabolism in PCOS patients without adjusting related confounding factors.After adjusting for age,body weight,BMI,WC,HC,WHR and hypertension,HTGW phenotype was still an independent factor influencing the occurrence of abnormal glucose metabolism in PCOS patients.Conclusion:1.The phenotype distribution of PCOS patients was dominated by EW phenotype,followed by HTGW phenotype.HTGW phenotype PCOS patients with phlegm and blood stasis as the main syndrome.2.Compared with PCOS patients with NWNT phenotype,HTGW patients showed more obvious signs of obesity,higher incidence of IR,IGR,T2 DM and more severe acanthosis nigricans.3.Patients with HTGW phenotype PCOS showed severe glucose metabolism disorder.4.HTGW phenotype is an independent influencing factor of abnormal glucose metabolism in PCOS patients.