Analysis Of Clinical Features And Diagnostic Value Of LAP And VAI In Women With Phlegm Dampness Polycystic Ovary Syndrome Combined With Metabolic Syndrome

Objective:To analyze the differences in clinical and biochemical characteristics of MS in women with phlegm dampness PCOS,compared the differences of LAP and VAI levels,explored their relationship with the risk of MS,and evaluated the diagnostic efficacy o f different obesity indicators on the risk of MS in patients to provide a theoretical basis for future clinical diagnosis.Methods:A total of 624 women of childbearing age with phlegm-damp PCOS diagnosed in the information integration system of the gyneco logical research clinic of Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from January 2014 to December 2021 were selected.First,a total of624 cases were divided into 2 groups: 202 cases in the phlegm-damp PCOS+MS group and 422 cases in the phlegm-damp PCOS+NMS group with reference to the MS diagnostic criteria recommended by the Joint Committee for the Revision of the 2016 Guidelines for the Prevention and Treatment of Dyslipidemia in Adults in China.The differences in c linical characteristics between the two groups were compared.Next,the LAP and VAI values of women with phlegm-damp PCOS were calculated and grouped according to quartile levels,and each group was divided into 4 groups with 156 cases in each group.The differences in clinical characteristics,MS and the distribution of each component among the groups in the LAP and VAI quartiles were compared,and correlation analysis was performed.Finally,a multifactorial logistic regression analysis model was construc ted to explore the relationship between LAP and VAI quartile levels and the risk of MS in patients with phlegm-damp evidence of PCOS,and the area under the curve(AUC)of the subject working characteristic(ROC)curve was further used to assess the diagno stic value of LAP、 VAI、 BMI、 WC、 WHR and WHt R in predicting MS,and the Youden index was calculated to find the best cut-off value for each obesity index.Results:1.Comparison of clinical characteristics between the PCOS+MS group and the PCOS+NMS group with phlegm dampness: Age、 Body weight、 BMI、 WC、 HC、 WHR、 WHt R、 SBP、 DBP、 SHBG、 FAI、 FPG、 2h PG、 FINS、 2h INS、 HOMA-IR、TG、 TC、 LDL、 APO-B、 APO-B/APO-A、 LAP、 VAI were higher than PCOS +NMS group(P < 0.01).SHBG、 HDL and APO-A were lower in the PCOS+MS group than in the PCOS+NMS group,with statistically significant differences(P <0.01).2.Distribution of MS and its components in each level group of quartiles of LAP and VAI: with the increase of LAP and VAI levels,the incidence of MS and its components also increased.3.Comparison of clinical characteristics of LAP and VAI quartiles in women with phlegm dampness PCOS: with increasing LAP levels,weight 、 BMI、WC 、 HC 、 WHR 、 WHt R 、 FAI 、 2h PG 、 FINS 、 2h INS 、 HOMA-IR 、 TG 、 TC 、 LDL 、APO-B、 APO-B/APO-A increased and LH、 SHBG、 HDL decreased;weight 、 FAI、2h PG、 2h INS、 HOMA-IR、 TG、 TC、 LDL、 APO-B、 APO-A increased and SHBG、HDL、 APO-A decreased with increasing VAI levels,and the differences were statistically significant(P < 0.05).4.Correlation analysis of LAP 、 VAI and clinical characteristics of PCOS patients with phlegm dampness syndrome: LAP was positively correlated with age、 height、 weight、 BMI、 WC、 HC、 WHR、 WHt R、 SBP、 DBP、 T、 FAI、 FPG、 2h PG、FINS、2h INS、HOMA-IR、TG、TC、LDL、APO-B、APO-B/APO-A(P < 0.05)and negatively correlated with LH 、 DHEAS、 AND、 SHBG、 HDL and APO-A(P <0.05).VAI was positively correlated with age 、 weight 、 BMI 、 WC 、 HC 、 WHR 、WHt R 、 SBP 、 DBP 、 FAI 、 FPG 、 2h PG 、 FINS 、 2h INS 、 HOMA-IR 、 TG 、 TC 、 LDL 、APO-B、 APO-B/APO-A were positively correlated(P < 0.05)and negatively correlated with LH、 DHEAS、 SHBG、 HDL、 APO-A(P < 0.05).5.The results of multi-factor logistic regression analysis showed : after adjusting for relevant confounding factors,the risk of MS occurrence was still higher in the LAP level Q2 、 Q3 and Q4 groups than in the Q1 group,and the risk of MS occurrence was still higher in the VAI level Q3 and Q4 groups than in the Q1 group,using the Q1 group as a reference(P < 0.05).6.The results of ROC curves to predict the risk of MS in women with phlegm dampness PCOS showed : the AUC of LAP and VAI were higher than those of BMI、 WC、 WHR and WHt R.The AUC of VAI was 0.871,sensitivity was 79.2%,specificity was 83.9%,Youden index was 0.631,with a cutoff point of 2.79.The AUC of LAP was second only to VAI with 0.863,sensitivity was84.7%,specificity was 76.5%,Youden index was 0.612,with a cutoff point of56.05.Conclusions:1.Women with phlegm dampness PCOS combined with MS had higher levels of IR、 LAP and VAI compared to those without combined MS.2.LAP and VAI are closely related to the occurrence of MS in patients with phlegm dampness PCOS,and the risk of metabolic syndrome increases wi th increasing LAP and VAI levels.3.Compared with the traditional obesity indicators BMI 、 WC、 WHR、 WHt R,LAP and VAI may be the ideal obesity indicators to predict the occurren ce of MS in patients with PCOS,especially relative LAP、 VAI can better reflect the impact of obesity on MS.