1. Graduate School of Heilongjiang University of Chinese Medicine, Harbin Heilongjiang 150040; 2. The Second Department of Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin Heilongjiang 150040; 3. Department of Gynecology, South Area of Qiqihar Traditional Chinese Medicine Hospital, Qiqihar Heilongjiang 161000, China
Abstract： Objective： To investigate the correlation between serum prolactin levels and sex hormones and glucose/lipid metabolism in patients with polycystic ovary syndrome (PCOS). Methods： A total of 657 women diagnosed with PCOS from Gynecology Outpatient Clinic of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from January 2015 to November 2018, and 60 healthy women without PCOS who were randomly selected to undergo physical examination during the same period were enrolled in the study. The anthropometric indicators, sex hormone indicators, glucose metabolism indicators and lipid metabolism indicators of PCOS patients were measured. According to the level of prolactin from low to high, PCOS patients were divided into 4 subgroups, Q1~Q4, the above indicators of the four groups were analysed and compared by non-parametric tests; the oral glucose tolerance test (OGTT) and insulin release test (IRT) were performed on the PCOS and control groups, and the glucose metabolism levels of PCOS patients in the PCOS and control groups and at different prolactin levels were analysed. Results： There were statistically significant differences in age, waist-to-hip ratio, estradiol, testosterone, sex hormone binding globulin (SHBG), triglyceride (TG) levels and homeostasis model assessment of β-cell (HOMA-β) among the four subgroups (P<0.05), among which age, waist-to-hip ratio, estradiol level and HOMA-β in Q4 group were significantly lower than those in Q1 group (P<0.05), and TG level was significantly lower than those in Q1 and Q2 group (P<0.05), testosterone was greatly lower than that of the other three groups (P<0.05), and SHBG level was markedly higher than that of Q3 group (P<0.05), the OGTT and IRT results showed that the blood glucose level in the PCOS group was higher than that in the control group on the whole, with the blood glucose levels at 60 min and 180 min significantly higher than those in the control group (P<0.05); the blood glucose level of the two groups reached the peak 30 min after oral glucose administration, and the IRT result was not statistically significant. The blood glucose of 120 min in group Q4 was significantly lower than that in group Q1 and Q2 (P<0.05), but no significant difference was observed at other times. IRT results showed that insulin secretion in the four subgroups decreased with time after 60 min, and the insulin level in group Q4 was lower than that in group Q1 and Q2 for a long time, and the performance was obvious at 60 and 120 min (P<0.05 or P<0.01). At 180 min, insulin value in groups Q1 to Q4 did not return to baseline level. After adjusting for age and BMI, multiple linear regression analysis showed that serum prolactin level was negatively correlated with LH/FSH ratio, testosterone, HOMA-β and TG levels, while positively correlated with SHBG level (P<0.05). Conclusion： PCOS patients with low-level prolactin showed significantly abnormal increase of androgen and decrease of glucose and lipid metabolism, and prolactin levels were negatively correlated with HOMA-β.
［Key words］polycystic ovary syndrome; prolactin; insulin resistance; oral glucose tolerance test (OGTT); insulin release test (IRT)
