Asociación entre variables hormonales y clínicas y el resultado del ultrasonido ginecológico en mujeres con síndrome metabólico / Association among hormonal and clinical variables and the result of the gynecological ultrasound in females with metabolic syndrome

Determinar la asociación entre el resultado de ultrasonido y los valores de progesterona, índice LH/FSH, testosterona, antecedentes de infertilidad e hirsutismo en mujeres con síndrome metabólico. Se realizó un estudio descriptivo-transversal con 90 mujeres, entre 18 y 45 años de edad, con diagnóstico de síndrome metabólico. Se les realizó: FSH (3-5 días del ciclo menstrual si menstruaba), LH (3-5 días del ciclo menstrual si menstruaba), prolactina (3-5 días del ciclo menstrual si menstruaba), andrógenos (testosterona total, 3-5 días del ciclo menstrual si menstruaba), de lo contrario en cualquier momento y progesterona (21-23 días del ciclo menstrual si menstruaba), ultrasonido ginecológico transvaginal en la fase folicular temprana si menstruaban, y si estaban en amenorrea en cualquier momento. Además se les realizó una historia clínica que exploraba historia obstétrica, fórmula menstrual, antecedentes de infertilidad y examen físico. Se exploraron asociaciones entre las variables clínicas y hormonales y el resultado ultrasonográfico. El 83,1 por ciento de las pacientes anovuladoras mostraron imágenes sugestivas de poliquistosis ovárica. Cuando se asociaron los niveles de testosterona con el ultrasonido, en el 80 por ciento de las que tuvieron testosterona elevada el ultrasonido mostró imágenes de poliquistosis ovárica, sin embargo cuando la testosterona fue normal solo el 42,5 por ciento mostró dichas imágenes. De las 39 pacientes con un índice LH/FSH ³ 2, 32 (82,1 por ciento) tenían por imagen ultrasonográfica una poliquistosis ovárica, sin embargo cuando este fue <2, solo el 49 por ciento la presentó. El 75 por ciento de las mujeres con infertilidad exhibían un ultrasonido con signos de ovarios poliquísticos y el 25 por ciento no. De las 73 pacientes hirsutas, 48 (65,8 por ciento) tenían un ultrasonido positivo para poliquístosis ovárica, mientras que 25 (34,2 por ciento) no mostraron imágenes sugestivas de dicho trastorno, sin diferencia significativa.(AU)

To determine the association between the result of the ultrasound and the progesterone values, LH/FSH level, testosterone, history of infertility and hirsutism in females with metabolic syndrome. A descriptive cross-sectional study was undertaken among 90 females aged 18-45 with diagnosis of metabolic syndrome. FSH (3-5 days of the menstrual cycle), LH (3-5 days of the menstrual cycle), prolactin (3-5 days of the menstrual cycle), androgens (total testosterone, 3-5 days of the menstrual cycle), progesterone (21-23 days of the menstrual cycle) were determined if they were menstruating; otherwise they were established at any moment. A transvaginal gynecological ultrasound in the early follicular phase was performed if they had menstruation, but if they were amenorrheic it was carried out at any time. A medical history was also made to explore obstetric history, menstrual formula, history of infertility and physical examination. Associations between the clinical and hormonal variables and the ultrasonographic result were investigated. 83.1 percent of the anovulatory showed images suggestive of ovarian polycystosis. When the testosterone levels were associated with the ultrasound, in 80 per cent of those who had an elevated testosterone, the ultrasound showed images of ovarian polycystosis; however, when testosterone was normal, just 42,5 percent had such images. Of the 39 patients with an index ³ 2, 32 (82,1 percent) presented an ultrasonographic image of ovarian polycystosis; however, when it was <2, only 49 percent had them. 75 percent of the females with infertility showed an ultrasound with signs of polycystic ovaries and 25 percent did not. Of the 73 hirsute patients, 48 (65,8 percent) had a positive ultrasound for ovarian polycystosis, whereas 25 (34,2 percent) did not exhibit images suggestive of this disorder, without a significant difference. the association between anovulatory progesterone, elevated levels of testosterone(AU)

[Evaluation of sonogeraphic index for insulin resistance and metabolic syndrome in asymptomatic fatty liver disease]

The frequency of sonographic report of liver fat infiltration in asymptomatic person is increasing. The aim of this study was evaluation of liver function and detection of frequency of metabolic syndrome and Insulin resistance in asymptomatic persons with fatty liver in sonographic examinations. Seventy six patients with fatty liver in sonographic examination and 78 persons with normal sonographic examination who had similar sex, age and body weight were selected. Patients with history of diabetes mellitus, hyperlipidemia, hypertension who took drugs that induced fatty liver such as amiodaron, diltiazem, metotrexate, tamoxifen and patients with positiveserology for HBS-Ag and HCV-Ab were excluded. Blood pressure, BMI, weight, height, liverenzymes, blood lipids, and fasting insulin level and insulin resistance according to HOMAindex were evaluated. Results: Mean age was 44.8 +/- 9.79 and 42.54 +/- 10.7 years for fatty liver patients and normal persons, respectively. Mean systolic and diastolic blood pressures, weight, height, HDL triglyceride, FBS, ALT, 2-hour postprandial glucose level, fasting insulin level and insulin resistancewere significantly higher in fatty liver patients compared with normal persons Fifty percent of fatty liver patients but only%18 of normal persons had metabolic syndrome criteria. Insulin resistance andmetabolic syndrome are very common in fatty liver persons. It seems that fatty liver is one of the criteria of metabolic syndrome.Patients with fatty liver in sonographic examination should be further evaluated for metabolic syndrome and insulin resistance