Clinical Study On Pathogenesis Related Factors And Endocrine Metabolic Characteristics Of Polycystic Ovary Syndrome

Research objective: Polycystic ovary syndrome(PCOS)is a common gynecological disease,and its incidence is increasing gradually in recent years.PCOS is characterised by disrupted menstrual cycles,hirsutism,acne and polycystic ovarian changes,as well as obesity and infertility,which seriously affect women’s physical and mental health.Although scholars at home and abroad have conducted a lot of studies on PCOS,its pathogenesis is numerous and complex,and its pathogenesis has not been fully defined.In this paper,we analyzed the endocrine metabolic characteristics of PCOS patients,explored the factors associated with the development of PCOS,and initially constructed a regression model to assess the risk of PCOS development.Through the screening of risk factors,it is expected that early intervention and prevention of adverse consequences can be carried out on high-risk groups.Methods: 133 patients with complete data who were diagnosed as PCOS in the gynecological outpatient department of the First Affiliated Hospital of Jilin University from October 2021 to September 2022 were collected as the experimental group,also known as the PCOS group.During the same period,140 non-PCOS females who visited our hospital were selected as the control group.In this paper,we retrospectively analyzed the clinical characteristics of 133 patients with PCOS using questionnaires and a case-control study method,and also analyzed the relevant factors affecting the development of PCOS to screen out the high-risk factors contributing to the development of PCOS.Results: 一.Multifactorial logistic regression analysis of risk factors for PCOS 1.The results of the univariate analysis suggested that obesity,staying up late, frequent use of electronic devices,non-vegetarian diet,daily exercise duration,smoking,alcohol consumption,family history of PCOS,family history of menstruation,family history of premature alopecia,family history of diabetes,family history of obesity were the influencing factors of PCOS(P < 0.05).2.Multivariate Logistic regression analysis showed that obesity,staying up late,non-vegetarian diet,smoking,family history of premature baldness and family history of diabetes were the risk factors for PCOS,and exercise was the protective factor.3.The receiver operating characteristic curve(ROC curve)was constructed with the predictive variables of Logistic regression model as independent variables,and the following conclusions could be drawn: the area under the curve(AUC)was 0.883,and the sensitivity and specificity were 79.7% and 82.9%,respectively.二.Comparative analysis of clinical features between PCOS group and control group In this paper,the median AMH,T,LH,LH/FSH and FBG of the PCOS group were higher than those of the control group,but median FSH was lower in the PCOS group than in the control group.The incidence of menstrual cycle disturbance,hirsuty and acne in PCOS group was 97.7%,44.4% and 38.3%,while that in control group was 2.1%,32.1% and 17.9%,respectively.There was statistical significance between the two groups(P < 0.05).三.Comparison of clinical characteristics of PCOS patients in different groups 1.There were no significant changes in AMH,T,LH,FSH,FBG,FINS,FSH/LH and HOMA-IR in PCOS patients of different ages,and all showed consistency without statistical significance(P > 0.05).2.Among 133 patients with PCOS,the proportion of the obese group was 63.9% and 36.1% were the non-obese group,suggesting that women with PCOS appear to be at increased risk for obesity.The median FINS was 140.80 pmol/L and the median HOMA-IR was 4.55 in the obese group,while the median FINS was 99.81 pmol/L and the median HOMA-IR was 3.11 in the non-obese group,the comparisons between the two groups were statistically significant(P < 0.05).3.The median BMI,FBG,and FINS in the insulin-resistant group of PCOS patients(n=99,74.4%)were 27.46 kg/m2,5.27 mmol/L,and 148.2 pmol/L,respectively,while the median of the three indicators in the non-insulin-resistant group of PCOS patients(n=34,25.6%)were 23.71 kg/m2,5.00 mmol/L,and 66.87 pmol/L,and the comparisons between the two groups were statistically significant,P < 0.05.4.There were 84 cases(84.8%)of normal fasting glucose and 15 cases(15.2%)of abnormal fasting glucose in the insulin-resistant group of PCOS patients,and 34 cases(100%)of normal fasting glucose and 0 cases(0.0%)of abnormal fasting glucose in the non-insulin-resistant group.Meanwhile,there were 70 cases(82.4%)of normal fasting glucose and 15 cases(17.6%)of abnormal fasting glucose in the obese group of PCOS patients and 48 cases(100%)of normal fasting glucose and 0 cases(0.0%)of abnormal fasting glucose in the non-obese group,suggesting that the abnormal glucose in PCOS patients was related to both insulin resistance and obesity.5.The median LH and LH/FSH of PCOS patients in hyperandrogen group(n=14,10.5%)were 14.20 m IU/m L and 2.45,respectively,which were higher than those of PCOS patients in non-hyperandrogen group(n=119,89.5%),and there was statistical significance between the two groups(p < 0.05).Meanwhile,the percentages of hirsutism and acne in PCOS patients in the hyperandrogenic group were 85.7% and 71.4%,and their probabilities in PCOS patients in the non-hyperandrogenic group were 39.5% and 34.6%,respectively.There were statistical differences between the two groups(P < 0.05).6.There was no direct relationship between unilateral or bilateral ovarian morphology and the clinical features exhibited in patients with PCOS,which was not statistically significant(P > 0.05).7.Within the group of PCOS patients stratified by AMH percentile(<25%,25%-75%,>75%),the comparison of BMI and FSH in each stratum was not statistically significant though.Although the comparison of BMI and FSH in each layer was not statistically significant,the BMI and FSH values decreased with the increase of AMH percentile.Meanwhile,it was found that with the increase of AMH percentile,T and LH/FSH increased,and the comparisons among different layers were statistically significant(P < 0.05).Conclusion: 1.Obesity,staying up late,non-vegetarian diet,smoking,family history of early baldness and family history of diabetes were the risk factors for PCOS,and exercise was a protective factor.2.Obese patients with PCOS tended to have insulin resistance and abnormal glucose metabolism.3.Hyperandrogenism in PCOS patients is influenced by the level of LH in the body,and hyperandrogenic PCOS patients tend to exhibit hyperluteinizing hormoneemia and a high LH/FSH ratio.4.There is no significant difference in the clinical characteristics of polycystic ovarian changes in PCOS patients,whether unilateral or bilateral.