ABSTRACT
Background: Polycystic ovary syndrome (PCOS) is an endocrine metabolic dysfunction closely associated with insulin resistance and obesity, which predisposes to pregnancy complications. Aim: To report a prospective clinical experience in PCOS patients who became pregnant after diet, exercise and metformin treatment intervention, and were followed up during the whole pregnancy. Patients and Methods: Seventy pregnant PCOS (PPCOS) women and forty normal pregnant (NP) women of similar age and with singleton pregnancies were included in the study. During gestational ages 10-16 and 22-28 weeks, a 2h, 75 g oral glucose tolerance test (OGTT) was performed with measurement of glucose and insulin in each sample. Results: No differences were found in duration of gestation, weight gain during pregnancy, or systolic and diastolic blood pressure between PPCOS and NP women. There were significant differences in body mass index (BMI) at the initiation and in the third trimester of pregnancy between both groups. The incidence of gestational diabetes was significantly higher (p <0.01) in the PCOS group (35.2 percent) compared to the control group (5.0 percent). The prevalence of small for gestational age (SGA) infants tended to be higher (p =0.09) in the PCOS group. During pregnancy, 2h glucose and insulin were significantly higher in PPCOS than in NP women. Conclusions: PCOS mothers showed a higher prevalence of gestational diabetes and SGA newborns, which cannot be attributed to the weight gain during pregnancy, and seems to be more related to the BMI at the initiation of pregnancy, and to the PCOS condition of the mothe.
Subject(s)
Adult , Female , Humans , Infant, Newborn , Pregnancy , Diabetes, Gestational , Polycystic Ovary Syndrome/complications , Prenatal Care , Birth Weight , Body Height , Body Mass Index , Diabetes, Gestational/diagnosis , Epidemiologic Methods , Infant, Small for Gestational Age , Insulin Resistance , Obesity/complications , Polycystic Ovary Syndrome/diagnosis , Polycystic Ovary Syndrome/therapy , Pregnancy OutcomeABSTRACT
Se estudió la eficacia de la terapia nutricional exclusiva sobre el perfil lipídico en pacientes dislipidémicos. A 43 individuos con dislipidemia mixta y a 29 con hipercolesterolemia aislada, se les indicó la fase 2 de la recomendación del National Cholesterol Education Program: 30 por ciento de las calorías como lípidos (<75 por ciento como grasas saturadas, 10 por ciento de poliinsaturadas y 13 por ciento de monoinsaturadas); ingesta de colesterol (200 mg/día). Al control (2 a 4 meses) se observó una disminución significativa del colesterol y triglicéridos; en un 20 por ciento se logró la normalización de estos parámetros. El 25 por ciento de los pacientes aumentó el colesterol y los triglicéridos (NS). Tanto los hombres como las mujeres con HDL en cifras de riesgo elevaron sus niveles (p < 0.01); las LDL disminuyeron significativamente en los hombres con dislipidemia mixta y en las mujeres con hipercolesterolemia aislada. Las tasas de riesgo colesterol/HDL y LDL/HDL no se modificaron. En un 35 por ciento de los sujetos los menores niveles de colesterol se asociaron a una reducción de las HDL, pero sin alcanzar tasas de riesgo. La dieta disminuyó la correlación negativa entre triglicéridos y HDL que presentaban los pacientes al ingreso. La terapia nutricional exclusiva es efectiva en modificar el perfil lipídico de los dislipidémicos; sin embargo, es necesario agregar otras medidas no farmacológicas (ejercicio, supresión del tabaco) y farmacológicos para obtener una real disminución de las tasas de riesgo cardiovascular