Relationship between the age at menarche and traditional Chinese medicine syndrome and reproductive endocrine characteristics of infertility patients with polycystic ovary syndrome in childbearing age
Objective:To explore traditional Chinese medicine(TCM)syndromes,baseline characteries,and reproductive outcomes of infertility patients with polycystic ovary syndrome(PCOS)at different menarche ages.Methods:A total of 1 000 PCOS subjects were enrolled in the clinical trial project of acupuncture and Clomiphene in the treatment of PCOS infertility patients(PCOSAct).A total of 927 patients who did not drop out were selected in this study and divided into four groups according to their age of menarche:163 cases in group A(≤12 years old),290 cases in group B(13 years old),248 cases in group C(14 years old),and 226 cases in group D(≥15 years old).At baseline,the differences in TCM syndromes,anthropometric parameters,sex hormones,glucose and lipid metabolism levels,metabolic syndrome,and reproductive outcomes after intervention were compared among the four groups.Results:The patients diagnosed with kidney deficiency syndrome,and kidney deficiency and liver stagnation syndrome in group D were significantly higher than those in group A(P＜0.05).The patients diagnosed with phlegm dampness syndrome in group A and the patients diagnosed with spleen deficiency and phlegm dampness syndrome in groups B and C were significantly higher than those in group D(P＜0.05).The weight,body mass index(BMI),waist circumference and hip circumference of group B,C and D were significantly lower than those of group A(P＜0.01).The waist-to-hip ratio(WHR)of group B and group C was significantly lower than that of group A(P＜0.05,P＜0.01).The levels of apolipoprotein B(ApoB)in groups C and D were significantly lower than those in group A(P＜0.01,P＜0.05).The fasting insulin(FINS)and HOMA-IR in group B,C and D were significantly lower than those in group A(P＜0.05,P＜0.01).The incidence of metabolic syndrome and central obesity in group D and hypertriglyceridemia in group C were significantly lower than those in group A(P＜0.05,P＜0.01).Free testosterone(FT)in group A was significantly higher than that in group D(P＜0.05),and sex hormone binding globulin(SHBG)was significantly lower than that in group D(P＜0.01).The free androgen index(FAI)of group A and group B was significantly higher than that of group D(P＜0.01,P＜0.05).The luteinizing hormone(LH)and LH to FSH ratio(LFR)of group A,B and C were significantly lower than those of group D(P＜0.01).There were significant differences among the four groups in the indicators mentioned above(P＜0.05,P＜0.01).After adjustment for intervention,there were no statistically significant differences in reproductive outcomes among the four groups.Conclusion:PCOS women with advanced menarche were mostly diagnosed with phlegm dampness syndrome,accompanied by glucose and lipid metabolism disorders.PCOS women with delayed menarche age were mostly diagnosed as kidney deficiency and liver depression syndrome,accompanied by high LH and high LFR,but there was no significant relation to reproductive outcome.
Polycystic ovary syndrome(PCOS)MenarcheTraditional Chinese medicine syndromesMetabolic syndromeReproductive outcomesCorrelation
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