Analysis of clinical characteristics in large-scale Chinese women with polycystic ovary syndrome

Abstract

Objective: To analyze the clinical and metabolic characteristics of large-scale Chinese women with polycystic ovary syndrome (PCOS).

Design: Retrospective study.

Setting: Hospital-based IVF center.

Patient(s): Patients with PCOS.

Methods: In the present study, one thousand and forty PCOS patients were selected from women who visited the Reproductive Medicine Center at Shandong Provincial Hospital Shandong University between January 2002 and December 2006. All the patients had been performed a 75 g OGTT. Clinical characteristics, serum hormonal levels, glucose levels, insulin levels and lipid profiles were reviewed.

Interventions: An oral glucose tolerance test and insulin release test were performed for each woman. After overnight fasting, blood samples were collected to determine fasting blood glucose, blood glucose and insulin (30 min, 60 min, 120 min, 180 min) after digesting 75 g glucose, luteotrophic hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), prolactin (PRL), estradiol (E2), and blood lipid levels.

Main outcome measures: Height, weight, waistline, hip circumference, F-G grade for hirsutism, gonadal hormone results, blood lipid level, blood glucose tolerance, each-moment insulin level, and family history were determined.

Results: (i) The presence of oligomenorrhea was 62.6% while amenorrhea was 19.71%. Menstrual disorder of all the adult patients could be traced back to their adolescent menarche. There were 450 obesity cases of which 259 patients were central obesity. The incidence of acanthosis nigricans was 15.19%, 65.19% with obesity. (ii) Cholesterol (4.8 +/- 0.98 vs 4.61 +/- 0.86) and LDL (3.80 +/- 6.92 vs 2.88 +/- 1.01) were both significantly higher in the obesity patients than the non obesity patients. (iii) 173 patients were diagnosed as diabetes mellitus (DM), 179 IGT, 27 IFG and 9 (IFG and IGT). Those women with plasma glucose values abnormality of 0, 30 min, 60 min, 120 min, 180 min were 19 cases 0.98% (19/173), 74 cases 42.77% (74/173), 110 cases 63.58% (110/173), 42 cases 24.28% (42/173) and 12 cases 6.94% (12/173) respectively. Ten (10/173) patients would have been undetected if fasting plasma glucose levels were not evaluated, while omission of 30 min, 60 min, 120 min, or 180 min plasma glucose levels would have resulted in 16 cases (16/173), 50 cases (50/173), 28 cases (28/173) and 1 case (1/173) being missed respectively. If we took three times blood samples to evaluate plasma glucose levels, 39 cases (39/173) (0 min + 30 min +60 min), 102 cases (0 min + 30 min + 120 min), 21 cases (0 min + 30 min + 180 min), 34 cases (0 min + 60 min + 120 min), 45 cases (0 min + 60 min + 180 min), 123 cases (0 min + 120 min + 180 min) would be missed. Compared AUC of plasma glucose and insulin in 5 times with 3 times (0 min + 30 min + 60 min), the differences were statistically significant. Body mass index (BMI) was positively correlated with HOMA-IR (r = 0.29987 (P<0.01) as well as WHR (r = 0.12441, P<0.0001).

Conclusions: (i) The prevalence rate of obesity was higher in PCOS. The state of obesity had a positive relation with insulin resistance. (ii) The prevalence rate of lipid profiles abnormality in obesity group was higher than in non-obesity. (iii) OGTT was the essential examination for all the PCOS patients.