Zhongguo quanke yixue (Mar 2023)
Correlation between Adiponectin and Free Testosterone Index and Insulin Resistance in Patients with Polycystic Ovary Syndrome
Abstract
Background Polycystic ovary syndrome (PCOS) is closely related to insulin resistance and free testosterone index (FAI), but a large number of studies are still needed to provide a reference for its diagnosis and treatment. Objective To explore the correlation of adiponectin (ADPN) with FAI and insulin resistance at different testosterone concentrations in PCOS patients, and to further investigate the clinical value of adiponectin in PCOS. Methods From October 2017 to April 2020, 116 patients with PCOS and 45 healthy women of normal reproductive age (control group) who were treated in outpatient or inpatient hospital of Zunyi Medical University Affiliated Hospital were selected as the research objects. The general data of the research subjects were collected, and laboratory index examinations were conducted: on the 3rd to 5th day of the menstrual cycle of regular menstruation or when there was no dominant follicle in the B-ultrasound examination of irregular menstruation, and the patient's cubital venous blood was collected on an empty stomach after fasting for 12 hours to detect fasting blood glucose (FPG), fasting insulin (FINS), Glycated hemoglobin (HbA1c), triacylglycerol (TG), total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone, testosterone (TEST), sex hormone binding globulin (SHGB), dehydroepiandrosterone sulfate (DHEA-S), ADPN. The homeostasis model-assessed insulin resistance index (HOMA-IR) and FAI were calculated. PCOS patients were divided into PCOS with hyperandrogenemia group (HA group, n=65) and PCOS without hyperandrogenemia group (non-HA group, n=51) according to whether they had hyperandrogenism (TEST≥2.44 nmol/L). The HA and non-HA groups were further divided into 4 subgroups according to the quartile values of TEST levels. The correlation between ADPN and other indicators and the influencing factors of FAI and ADPN were analyzed. Results Compared with the control group, the body mass, BMI, waist circumference, hip circumference, WHR, FPG, FINS, HOMA-IR, HbA1c, TG, LDL, FSH, TEST, FAI were increased, and HDL was decreased in the non-HA and HA group of PCOS patients (P<0.05). Compared with the non-HA group, the TG, HOMA-IR, TEST and FAI of the HA group were increased, while the HDL, FSH, progesterone, SHBG and ADPN of the HA group were decreased (P<0.05). There were significant differences in ADPN between HA group and non-HA group with different TEST level subgroups (P<0.05). After adjustment for BMI, ADPN in PCOS patients was negatively correlated with HOMA-IR, FAI, and TEST (P<0.001). In the HA group, ADPN was negatively correlated with HOMA-IR, FAI, and TEST (P<0.05) ; in the non-HA group, ADPN in the group was negatively correlated with HOMA-IR, FAI (P<0.05), and had no correlation with TEST (P=0.061). In the non-HA group, ADPN and BMI were the influencing factors of FAI, and HOMA-IR, FAI and BMI were the influencing factors of ADPN (P<0.05). In the HA group, ADPN was the influencing factor of FAI and HOMA-IR, and FAI were the influencing factors of ADPN (P<0.05) . Conclusion ADPN is negatively correlated with and mutually affects free testosterone index, and this relationship is not affected by TEST concentrations, and by measuring serum ADPN levels can simultaneously reflect the high androgen levels and the degree of insulin resistance in PCOS patients, ADPN is expected to be an important reference index for the diagnosis and condition evaluation.
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