Evaluation of endocrine parameters and glucose tolerance status in obese subjects with polycystic ovary syndrome.

BACKGROUND: Severe insulin resistance is a key abnormality in obese women with polycystic ovary syndrome (PCOS). The purpose of this study was to evaluate the sex steroid hormone levels and glucose tolerance status in obese PCOS patients. METHODS: 104 obese patients with PCOS (BMI≥23Kg/m3) and 95 healthy control subjects were included in this study. Body mass index (BMI), waist-to-hip ratio (WHR), plasma sex steroid hormones, fasting insulin, fasting glucose were measured. Oral glucose tolerance test was also performed according to WHO criteria. Hirsutism score and acne were recorded. Insulin resistance was evaluated by using homeostasis model assessment for insulin resistance (HOMA-IR), Quantitative insulin sensitivity check index (QUICKI) and fasting glucose / fasting insulin ratio (Fasting G:I ratio). RESULTS: plasma LH, LH/FSH ratio, total Testosterone, adrostenedione and dehydroepiandrostenedione sulphate (DHEA-S) were higher where as SHBG was lower in patient with obese PCOS compared to controls (P<0.05). Compared with healthy women, those with obese PCOS had significantly elevated fasting insulin, HOMA-IR, and significantly decreased QUICKI and fasting G:I ratio. CONCLUSION: The results of the present study indicates, elevated androgen levels, high degree of glucose intolerance and insulin resistance in obese PCOS patients when compared with healthy control subjects.

Evaluation of insulin resistance and oxidative stress in obese patients with polycystic ovary syndrome.

BACKGROUND : Patient with Polycystic ovary syndrome (PCOS) are known to have high incidence of Insulin Resistance (IR) and oxidative stress and most of the patients are obese. The aim of this study was to evaluate the insulin resistance and oxidative stress in obese PCOS patients. METHODS : 104 obese patients with PCOS [BMI ≥23 Kg/m2] and 95 healthy control subjects were included in this study. Plasma sex steroid hormones, fasting insulin, fasting glucose, were measured in both the groups. Oral glucose tolerance test was also performed. Total antioxidant status (TAS), malonyldialdehyde (MDH), protein carbonylation (PC), erythrocyte reduced gluthathione (GSH) and antioxidant enzymes like erythrocyte catalase and erythrocyte glutathione peroxidase (GPx) activity were measured. Insulin resistance was evaluated by using homeostasis model assessment for insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI) and fasting glucose / fasting insulin ratio (fasting G:I ratio). RESULTS : Compared with healthy women, those with obese PCOS had significantly elevated HOMA-IR, plasma MDA, protein carbonylation, erythrocyte glutathione peroxidase activity and significantly decreased QUICKI, fasting G:I ratio, plasma TAS, GSH, catalase activity. CONCLUSION: The result of the present study indicates, high level of insulin resistance and significantly increased oxidative stress were observed in obese PCOS patients when compared with controls.

Perinatal outcome in relation to mode of delivery in meconium stained amniotic fluid.

Meconium staining of the amniotic fluid is a common complication during labour. When facilities like electronic monitoring, foetal blood sampling are not available, it is difficult to decide whether labour should be allowed to continue or caesarean section should be done. Even when caesarean section is done, meconium aspiration syndrome (MAS) can still occur and considerable morbidity and mortality may result in the newborn. Amino infusion is being considered as useful in decreasing MAS and its sequelae. Before resorting to amino infusion, we decided to analyse the perinatal outcome in meconium stained liquor to compare whether early caesarean section offered any advantage. This is a retrospective study of 150 labours complicated by thick meconium stained liquor, during a 12 month period (1992-93).