Analysis of baseline features of polycystic ovary syndrome patients with different hyperandrogenism phenotypes and pregnancy outcomes after acupuncture combined with medication for ovulation induction
Objective:To identify the most sensitive androgen index of polycystic ovary syndrome(PCOS)under different hyperandrogenemia(HA)phenotypes by comparing general clinical and biochemical indexes,the distribution of traditional Chinese medicine syndromes,and pregnancy outcomes after acupuncture combine with clomifene ciarate.Methods:The data of 948 cases of'clinical trial effect of acupuncture and clomiphene on the live birth of anovulatory women with polycystic ovary syndrome'were involved,and according to the total testosterone(TT)value and free androgen index(FAI)value,the patients were divided into 4 groups:group A(143 patients)with single TT increase,group B(160 patients)with single FAI increase,group C(295 patients)with both increases,and group D(350 patients)with neither increase.Results:Body mass index(BMI),waist circumference(WC),waist-hip ratio(WHR),acanthosis black score,FAI,fasting insulin(FINS),HOMA-IR,triglycerides(TG),apolipoprotein B(APOB),the incidence of insulin resistance(IR),hyperlipidemia and spleen deficiency and phlegm dampness syndrome in group A were significantly lower than in groups B and C;the levels of sex hormone binding globulin(SHBG),high density lipoprotein-cholesterol(HDL-c)and apolipoprotein Al(APOA1)and the incidence of kidney deficiency and liver depression type were significantly higher than groups B and C(P＜0.05).Group B had considerably greater SBP and DBP than group A,anti-Mtillerian hormone(AMH),luteinizing hormone(LH),LH/follicle stimulating hormone(FSH)and TT were significantly lower than groups A and C,BMI,FINS,homeostasis model assessment of insulin resistance(HOMA-IR),TG and the incidence of hyperlipidemia were significantly higher than those of group C,and total cholesterol(TC),HDL-c,low density lipoprotein-cholesterol(LDL-c)and APOA1 were significantly lower than those of group C,the incidence of phlegm-blood stasis syndrome was significantly higher than that of group D(P＜0.05).The menstrual cycle of group C was significantly longer than that of group A,the ovulation,conception and clinical pregnancy rate were significantly lower than those of groups A and D,and the live birth rate was significantly lower than that of group D(P＜0.05).The SBP,DBP,menstrual cycle,TT,free testosterone(FT),FAI were all lowest in group D,and the incidence of kidney deficiency and liver depression were significantly more common than that of groups B and C(P＜0.05).Conclusion:Elevated TT is often associated with more severe sex hormone disturbances,while FAI is connected with more serious obesity and disorders in the metabolism of glucose and lipid.When both of them are elevated at the same time,the metabolism is not worse than that of single FAI increase,but the ovulation,conception,clinical pregnancy and live birth rate are the worst in these groups.
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