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1.
Prensa méd. argent ; 107(3): 135-142, 20210000. tab
Article in English | LILACS, BINACIS | ID: biblio-1359564

ABSTRACT

Antecedentes: el síndrome de ovario poliquístico (SOP) es un trastorno endocrino reproductivo común, se puede identificar por hiperandrogenismo, oligomenorrea o anovulación y ovarios poliquísticos en la ecografía. Los polimorfismos de la metilentetrahidrofolato reductasa (MTHFR) C677T asociados con la hiperhomocisteinemia se encuentran entre los factores de riesgo del síndrome de ovario poliquístico. Objetivo: El presente estudio de casos y controles tiene como objetivo explorar la relación entre los polimorfismos C677T de la metilenotetrahidrofolato reductasa (MTHFR) como factor de riesgo y el síndrome de ovario poliquístico entre los pacientes jordanos que padecen esta enfermedad. Métodos: Se inscribieron en el estudio 306 sujetos (146 pacientes con SOP y 160 sujetos sanos como grupo de control). Se extrajo ADN de una muestra de sangre venosa extraída de cada participante para analizar los polimorfismos de MTHFR C677T utilizando la reacción en cadena de la polimerasa (PCR) en combinación con digestión con enzima de restricción (PCRRFLP). Posteriormente, los productos de PCR-RFLP se digirieron con la enzima HinfI, luego se sometieron a electroforesis en un gel de agarosa al 2%, se tiñeron y se examinaron bajo luz ultravioleta. Los niveles de homocisteína en plasma se analizaron utilizando el método ELISA. Resultados: Se observó una diferencia significativa en los niveles plasmáticos de homocisteína entre los pacientes con SOP frente a los sujetos de control y entre los diferentes polimorfismos de los pacientes con SOP. No se detectaron diferencias significativas en la distribución y frecuencia alélica de los polimorfismos MTHFR C677T en pacientes con SOP en comparación con los controles. El genotipo 677 / TT y el alelo T se asociaron con un aumento de 1,54 y 1,46 veces en la susceptibilidad al síndrome de ovario poliquístico. Conclusión: El estudio ha demostrado que el polimorfismo MTHFR T677T y el alelo T son posibles factores de riesgo de SOP entre las mujeres jordanas y pueden desempeñar un papel en la patogenia de la enfermedad


Background: Polycystic ovary syndrome (PCOS) is a common endocrine reproductive disorder, it can be identified by hyperandrogenism, oligomenorrhea or anovulation and polycystic ovaries on ultrasound. Methylenetetrahydrofolate Reductase (MTHFR) C677T polymorphisms associated with hyperhomocysteinemia are among the risk factors for PCOS. Objective: The present case control study aims to explore the relationship between Methylenetetrahydrofolate Reductase (MTHFR) C677T polymorphisms as a risk factor and PCOS among Jordanian patients suffering from this disease. Methods: 306 subjects (146 PCOS patients and 160 healthy subjects as a control group) were enrolled in the study. DNA was extracted from venous blood sample withdrawn from each participant for analyzing MTHFR C677T polymorphisms using Polymerase Chain Reaction (PCR) in combination with restriction enzyme fragment length polymorphism (PCR-RFLP). Later, PCR-RFLP products were digested with hinfI enzyme, then, electrophoresed on a 2% agarose gel, stained and examined under UV light. Plasma homocysteine levels were assayed using ELISA method. Results: A significant difference was observed in plasma homocysteine levels among PCOS patients versus the control subjects and in between the different polymorphisms of PCOS patients. No significant difference was detected in the distribution and allelic frequency of MTHFR C677T polymorphisms in PCOS patients compared to the controls. 677/TT genotype and T allele were associated with 1.54 and 1.46 folds increase in the susceptibility for PCOS. Conclusion: The study has shown that MTHFR T677T polymorphism and T allele are possible risk factors for PCOS among Jordanian women and may play a role in the pathogenesis of the disease.


Subject(s)
Humans , Female , Polycystic Ovary Syndrome/diagnosis , Polycystic Ovary Syndrome/pathology , DNA/analysis , Polymerase Chain Reaction , Risk Factors , Genotype , Homocysteine/blood
2.
Rev. cuba. endocrinol ; 32(1): e271, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1289386

ABSTRACT

Introducción: El síndrome de ovario poliquístico se asocia con frecuencia a alteraciones cardiometabólicas; y su asociación con el fenotipo hipertrigliceridemia-obesidad abdominal ha sido poco estudiada en Cuba. Objetivo: Identificar la frecuencia del fenotipo hipertrigliceridemia-obesidad abdominal en mujeres de edad mediana con síndrome de ovario poliquístico y su asociación con la resistencia a la insulina, trastornos del metabolismo de la glucosa y ateroesclerosis subclínica. Método: Estudio descriptivo, transversal, en 30 mujeres. Se tomaron variables clínicas: edad, peso, talla, índice de masa corporal, circunferencia de cintura y cadera, índice cintura/cadera, tensión arterial, además de concentraciones de glucosa, insulina, colesterol total, triglicéridos, HDL-c y LDL-c, e índice HOMA-IR. La aterosclerosis subclínica se evaluó por doppler carotideo y ecocardiograma (hipertrofia ventricular izquierda y grasa epicárdica). El fenotipo hipertrigliceridemia-obesidad abdominal se definió como triglicéridos elevados (≥ 1,7 mmol/L) y circunferencia de la cintura ≥ 80 cm. Resultados: La frecuencia del fenotipo hipertrigliceridemia-obesidad abdominal fue 43,3 por ciento (13/30). Los valores medios de circunferencia abdominal, tensión arterial, así como de glucemia (p < 0,003), insulinemia (p = 0,028), triglicéridos (p < 0,0001), e índice HOMA-IR (p = 0,012) fueron más elevados en el grupo de mujeres con esa condición. A pesar de no haber diferencias significativas la frecuencia de mujeres con incremento del grosor íntima-media carotídeo y de grasa epicárdica fue superior en aquellas con el fenotipo. Conclusiones: La presencia del fenotipo hipertrigliceridemia-obesidad abdominal es frecuente en mujeres con síndrome de ovario poliquístico, y se asocia con alteraciones del metabolismo de la glucosa y la resistencia a la insulina. Este pudiera ser utilizado en la práctica clínica como un marcador de riesgo para alteraciones cardiometabólicas(AU)


Introduction: The polycystic ovary syndrome is frequently associated to cardiometabolic alterations; and its relation with the hypertriglyceridemic waist phenotype has been poorly studied in Cuba. Objective: Identify the frequency of the hypertriglyceridemic waist phenotype in middle age women with polycystic ovary syndrome and its association with insulin resistance, disorders in the glucose metabolism and subclinical atherosclerosis. Methods: Descriptive, cross-sectional study in 30 women. As clinical variables there were used: age, weight, size, body mass index, waist-hip circumference, waist/hip index, blood pressure; glucose, insulin, total cholesterol, triglycerides, HDL-c and LDL-c concentrations, and HOMA-IR index. Subclinical atherosclerosis was assessed by a carotid doppler and an echocardiogram (left ventricular hypertrophy and epicardial fat). The hypertriglyceridemic waist phenotype was defined as high triglycerides levels (≥ 1.7 mmol/L) and CC ≥ 80 cm. Results: The frequency of the hypertriglyceridemic waist phenotype was 43.3 percent (13/30). The mean values of abdominal circumference, blood pressure, as well as glycemia (p < 0.003), insulinaemia (p = 0.028), triglycerides (p < 0.0001), and HOMA-IR index (p = 0.012) were higher in the group of women with that condition. Although there were not significant differences, the frequency of women with increase of the carotid intima-media thickness and epicardical fat was higher in those with the phenotype. Conclusions: The presence of the hypertriglyceridemic waist phenotype is frequent in women with the polycystic ovary syndrome, and it is associated with alterations of the glucose metabolism and insulin resistance. This can be used in the clinical practice as a marker of risk for cardiometabolic alterations(AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Polycystic Ovary Syndrome/diagnosis , Hypertriglyceridemia/diagnosis , Obesity, Abdominal/etiology , Insulin Resistance , Body Mass Index , Epidemiology, Descriptive , Cross-Sectional Studies
3.
Chinese Medical Journal ; (24): 79-85, 2021.
Article in English | WPRIM | ID: wpr-921242

ABSTRACT

BACKGROUND@#As one of the most common endocrinal disorders for women at childbearing age, the diagnostic criteria of polycystic ovary syndrome (PCOS) have been defined differently among different international health organizations. Phenotypic heterogeneity of PCOS also brings about difficulties for its diagnosis and management assessment. Therefore, more efficient biomarkers representing the progression of PCOS are expected to be integrated into the monitoring of management process using metabolomic approaches.@*METHODS@#In this prospective randomized controlled trial, 117 PCOS patients were enrolled from December 2016 to September 2017. Classical diagnostic parameters, blood glucose, and metabolome were measured in these patients before and at 2 months and 3 months of different medical interventions. The receiver operating characteristic (ROC) curves were built based on multivariate statistical analysis using data at baseline and 3 months' management, and combinational biomarkers with appreciable sensitivity and specificity were selected, which then validated with data collected at 2 months.@*RESULTS@#A set of metabolites including glutamic acid, aspartic acid, 1-methylnicotinamide, acetylcarnitine, glycerophosphocholine, and oleamide were filtered out with high performance in representing the improvement through 3-month management of PCOS with high sensitivity and specificity in ROC analysis and validation with other two groups showed an appreciable area under the curve over 0.96.@*CONCLUSIONS@#The six metabolites were representative of the remission of PCOS through medical intervention, making them a set of potential biomarkers for assessing the outcome of PCOS management.@*TRIAL REGISTRATION@#ClinicalTrials.gov, NCT03264638.


Subject(s)
Biomarkers , Female , Humans , Metabolomics , Polycystic Ovary Syndrome/diagnosis , Prospective Studies , ROC Curve
4.
Rev. cuba. endocrinol ; 30(2): e179, mayo.-ago. 2019. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1126427

ABSTRACT

RESUMEN Introducción: La resistencia a la insulina es frecuente en el síndrome de ovario poliquístico, con diferencias entre fenotipos y discrepancias sobre cómo medirla. Objetivo: Identificar trastornos de la sensibilidad y resistencia a la insulina en mujeres con síndrome de ovario poliquístico, y determinar si es mayor en el fenotipo clásico. Métodos: Incluyó 152 mujeres: 45 sin síndrome de ovario poliquístico (Grupo I); 46 con síndrome de ovario poliquístico clínico (Grupo II); 61 con síndrome de ovario poliquístico clásico (Grupo III). Se realizó prueba de tolerancia a la glucosa oral, se calcularon índices de sensibilidad o resistencia a la insulina en ayunas (HOMA-IR, I0/G0, FIRI, ISI, Belfiore, Bennet, Quicki, Raynaud) y en la prueba de tolerancia a la glucosa oral (Belfiore2, Ribel, Ins2glu2, ATI, IITotal, DATI/DATG, Matsuda, BetaHOMA). Se emplearon las pruebas de Kruskal-Wallis, Mann-Whitney y Chi cuadrado. Resultados: Las mujeres con síndrome de ovario poliquístico tenían más obesidad global y central (p / 0,05), más nivel de glucemia a los 30, 120 y 180 minutos de la prueba de tolerancia a la glucosa oral (p / 0,05) y de insulinemia a los 30, 60 y 120 (p / 0,0001), lo que fue mayor en el grupo III. Se diagnosticó intolerancia en ayunas en una mujer de cada grupo y tolerancia alterada en una del II y III. No hubo diferencias significativas entre grupos para los índices de sensibilidad o resistencia a la insulina en ayunas; ni del HOMA entre mujeres normopeso vs. sobrepeso-obesidad (p / 0,05). La mediana de los índices de la prueba de tolerancia a la glucosa oral fue menor para los de sensibilidad (Belfiore2, Ribel) y mayor para los de resistencia a la insulina (Ins2glu2, ATI, IITotal) en el Grupo III. El DATI/DATG, Matsuda y BetaHOMA no tuvieron diferencias significativas. Conclusiones: Las mujeres con síndrome de ovario poliquístico tienen mayor respuesta glucémica, resistencia a la insulina e hiperinsulinismo postsobrecarga de glucosa que las mujeres con función ovárica normal, más manifiesta en el fenotipo clásico. Los índices de ayuno son menos sensibles, independientemente del peso corporal. Tienen mayor utilidad: insulinemia a los 60 minutos de la prueba de tolerancia a la glucosa oral, Belfiore2, ATI e IITotal(AU)


ABSTRACT Introduction: Insulin resistance is common in polycystic ovary syndrome, with differences between phenotypes and discrepancies on how to measure it. Objective: To identify disorders of insulin sensitivity and resistance in women with polycystic ovarian syndrome and determine if the latter is greater in the classic phenotype. Methods: The study included 152 women. 45 of them had no polycystic ovary syndrome (Group I), 46 had clinical polycystic ovary syndrome (Group II) and 61 had classic polycystic ovary syndrome (Group III). Oral glucose tolerance test was performed, fasting insulin sensitivity or resistance indices (HOMA-IR, I0 / G0, FIRI, ISI, Belfiore, Bennet, Quicki, Raynaud) were calculated and the tolerance test to oral glucose (Belfiore2, Ribel, Ins2glu2, ATI, IITotal, DATI / DATG, Matsuda, BetaHOMA) was also assessed. Kruskal-Wallis, Mann-Whitney and Chi square tests were used. Results: Women with polycystic ovarian syndrome had more global and central obesity (p /0.05), more blood glucose level at 30, 120 and 180 minutes of the oral glucose tolerance test (p /0.05 ) and insulinemia at 30, 60 and 120 (p /0.0001), which was higher in group III. Fasting intolerance was diagnosed in one woman in each group and altered tolerance in one of group II and group III, respectively. There were no significant differences between groups for fasting insulin sensitivity or resistance indices, nor for HOMA among normal weight women vs. overweight-obesity (p / 0.05). The median indexes of the oral glucose tolerance test were lower for those of sensitivity (Belfiore2, Ribel) and higher for those of insulin resistance (Ins2glu2, ATI, IITotal) in Group III. The DATI / DATG, Matsuda and BetaHOMA had no significant differences. Conclusions: Women with polycystic ovarian syndrome have higher glycemic response, insulin resistance and post-overload glucose hyperinsulinism than women with normal ovarian function, which is more evident in the classical phenotype. Fasting rates are less sensitive, regardless of body weight. Tests such as insulinemia 60 minutes after the oral glucose tolerance, Belfiore 2, ATI and IITotal are most useful(AU)


Subject(s)
Humans , Female , Adult , Polycystic Ovary Syndrome/diagnosis , Insulin Resistance/physiology , Glucose Tolerance Test/methods , Hyperinsulinism/etiology , Epidemiology, Descriptive , Cross-Sectional Studies
6.
Rev. chil. obstet. ginecol. (En línea) ; 84(4): 263-276, 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058148

ABSTRACT

RESUMEN OBJETIVO: Determinar el efecto del aceite de linaza sobre las concentraciones plasmáticas de resistina en mujeres con diagnóstico de síndrome de ovarios poliquísticos. METODOS: se realizó un estudio en 195 mujeres con diagnóstico de SOPQ que fueron tratadas con aceite de linaza por 12 semanas (n = 97; grupo A) y controles tratados con placebo (n = 98, grupo B). Se compararon las características generales, concentraciones hormonales, perfil lipídico y resistina. RESULTADOS: No se encontraron diferencias significativas entre ambos grupos con relación a las características generales (p = ns). Tampoco se encontraron diferencias significativas en las concentraciones de hormonales, glicemia y HOMA entre los grupos (p = ns). Las mujeres del grupo A y B no mostraron diferencias estadísticamente significativas en la ingesta total, ingesta de carbohidratos, proteínas y grasas totales entre los valores al inicio y al final del estudio (p = ns). Las mujeres del grupo A presentaron disminución concentraciones de colesterol total lipoproteínas de baja densidad y triglicéridos (p < 0,0001). Los valores promedio de resistina mostraron disminución significativa luego del tratamiento (p < 0,0001). No se encontraron diferencias estadísticamente significativas en los valores promedio de las diferentes variables en las mujeres del grupo B (p = ns). CONCLUSION: El aceite de linaza produjo disminución significativa en las concentraciones plasmáticas de resistina en mujeres con síndrome de ovarios poliquísticos luego de 12 semanas de consumo.


ABSTRACT OBJECTIVE: To determine effects of flaxseed oil over plasma concentrations of resistin in women with diagnosis of polycystic ovary syndrome. METHODS: A research was performed in 195 women with diagnosis of polycystic ovary syndrome who were treated with flaxseed oil for 12 weeks (n = 97; group A) and controls treated with placebo (n = 98, group B). Overall characteristics, hormonal, metabolic, lipid profile and resistin concentrations were compared. RESULTS: There were no significant differences between the two groups in relation to the general characteristics (p = ns). There were also no significant differences in hormonal, glycemia and HOMA concentrations between the groups (p = ns). The women in group A and B did not show statistically significant differences in total calories intake, carbohydrate, protein and total fat intake between initial and final values of study (p = ns). Women in group A had decreased concentrations of total cholesterol, low-density lipoprotein and triglycerides (p < 0.0001). Mean values of plasma resistin showed a significant reduction after treatment (p < 0.0001). No statistically significant differences were found in the mean values of the different variables in women of group B (p = ns). CONCLUSION: Flaxseed oil produced a significant decrease in plasma resistin concentrations in women with polycystic ovary syndrome after 12 weeks of consumption.


Subject(s)
Humans , Female , Adult , Polycystic Ovary Syndrome/diagnosis , Polycystic Ovary Syndrome/diet therapy , Linseed Oil/pharmacology , Fatty Acids, Omega-3/pharmacology , Prospective Studies , Surveys and Questionnaires , Dietary Supplements , Inflammation
7.
Rev. fac. cienc. méd. (Impr.) ; 15(2): 17-23, jul.-dic. 2018. tab
Article in Spanish | LILACS | ID: biblio-988611

ABSTRACT

El síndrome de ovario poliquísticoes unaendocrinopatía frecuente en la mujer en edad fértil, causado por exceso de andrógenos y es causa de infertilidad anovulatoria. Actualmente uno de los criterios utilizados para el diagnóstico, son los de Rotterdam y para esto se necesita de la clínica (hiperandrogenismo y disfunción ovulatoria), exámenes de laboratorio (hiperandrogenismo) y/o ultrasonido característico de dicho síndrome. Objetivo:determinar el síndrome de ovario poliquístico confirmado por métodos laboratoriales e imágenes y tratamiento indicado en consulta externa del Hospital Escuela Universitario. Material y métodos: estudio retrospectivo, transversal, no aleatorio. Se revisaron 56 expedientes de pacientes con el diagnóstico de síndrome de ovario poliquístico valorados mediante criterios de Rotterdam, 31(55.4%) tenian diagnóstico ultrasonográfico. Se utilizó un instrumento de recolección de datos tipo cuestionario registrandose lo siguiente: edad, sintomatología, exámenes laboratoriales, diagnóstico con descripción ultrasonográficas y tratamiento farmacológico. Resultados: con el diagnóstico de síndrome ovario poliquístico, 31(55.4%) teníandiagnósticos1 Médico especialista en ginecología y obstetricia, Hospital Escuela Universitario2Estudiante de sexto año, Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras.Autor de correspondencia: Silder Moncada Correo electrónico: silderjavier78@gmail.comRecibido: 19/09/2017Aceptado: 07/02/2019ultrasonográficos, en 26(83.9%) pacientes no se encontró consignado en el expediente síntomas de hiperandrogenismo, se consignó acantosis nigricans en 2(6.5%), alopecia y acné 3(9.7%), respectivamente como signo hiperandrogénico. Los fármacos utilizados para tratar síndrome de ovario poliquístico fueron metformina y anticonceptivos orales. Conclusión: el diagnóstico y tratamiento de síndrome de ovario poliquístico no sigue protocolos estandarizados, ya que de los 31 expedientes con resultado por ultrasonido, solo 5(16.1%) reunían los criterios para el diagnóstico de dicha patología...(AU)


Subject(s)
Humans , Female , Adolescent , Adult , Polycystic Ovary Syndrome/diagnosis , Polycystic Ovary Syndrome/diagnostic imaging , Hyperandrogenism/complications , Contraceptives, Oral/pharmacology , Menstruation Disturbances/complications
8.
Rev. cuba. endocrinol ; 29(3): 1-11, set.-dic. 2018. tab
Article in Spanish | LILACS | ID: biblio-978393

ABSTRACT

Introducción: El síndrome de ovario poliquístico es el trastorno ovulatorio más frecuente en la mujer de edad reproductiva. Se asocia a trastornos metabólicos que pudieran tener relación con el hiperandrogenismo. Objetivo: Identificar los trastornos metabólicos en mujeres portadoras de síndrome de ovario poliquístico y su relación con el hiperandrogenismo. Métodos: Se realizó un estudio transversal, descriptivo, de diciembre 2016 a junio 2017 en el Centro de Reproducción Asistida de Baja Tecnología de Matanzas. Fueron incluidas todas las mujeres que asistieron a la consulta de infertilidad, que cumplieran los criterios de Rotterdam para el diagnóstico de síndrome de ovario poliquístico (n = 38). Se recolectaron los datos generales, antecedentes patológicos personales y examen físico. Se realizó prueba de tolerancia a la glucosa, se determinaron los valores de hormona folículo estimulante, hormona luteinizante, prolactina, testosterona, insulina, glucemia, hemoglobina glucosilada, triglicéridos, colesterol total, colesterol de lipoproteína de alta densidad, creatinina y ácido úrico. Se calculó el HOMA-IR y se identificaron las portadoras de síndrome metabólico. Para el análisis estadístico se crearon 2 grupos: uno con hiperandrogenismo (n = 17) y otro sin hiperandrogenismo (n = 21). Resultados: Los trastornos metabólicos fueron frecuentes en toda la serie. Las pacientes con hiperandrogenismo tuvieron mayor frecuencia de obesidad (82,4 por ciento; p = 0,013), circunferencia abdominal ≥ 88 cm (94,1 por ciento; p = 0,005), tolerancia a la glucosa alterada (41,2 por ciento; p = 0,001) e hiperuricemia (17,6 por ciento; p = 0,045). Conclusiones: Los trastornos metabólicos fueron frecuentes en este grupo de pacientes. Las portadoras de hiperandrogenismo tuvieron trastornos metabólicos más marcados que las no hiperandrogénicas, sobre todo tolerancia a la glucosa alterada e hiperuricemia, probablemente mediados por la obesidad(AU)


Introduction: Polycystic ovary syndrome is the most common ovulatory disorder among women of childbearing age. It is associated to metabolic disorders which might in turn be related to hyperandrogenism. Objective: Identify the metabolic disorders among women with polycystic ovary syndrome and their relationship to hyperandrogenism. Methods: A cross-sectional descriptive study was conducted at the Low-Technology Assisted Reproduction Center in Matanzas from December 2016 to June 2017. The study included all the women attending infertility consultation who met the Rotterdam criteria for polycystic ovary syndrome diagnosis (n = 38). General data and information on personal pathological antecedents were collected and physical examination performed. The glucose tolerance test was applied and determination was made of values for follicle-stimulating hormone, luteinizing hormone, prolactin, testosterone, insulin, glycemia, glycated hemoglobin, triglycerides, total cholesterol, high-density lipoprotein cholesterol, creatinine and uric acid. HOMA-IR was estimated and metabolic syndrome carriers were identified. Two groups were formed for statistical analysis: one with hyperandrogenism (n = 17) and one without hyperandrogenism (n = 21). Results: Metabolic disorders were common across the series. Patients with hyperandrogenism had a higher frequency of obesity (82.4 percent; p = 0.013), waist circumference ? 88 cm (94.1 percent; p = 0.005), impaired glucose tolerance (41.2 percent; p = 0.001) and hyperuricemia (17.6 percent; p = 0.045). Conclusions: Metabolic disorders were common in this group of patients. Hyperandrogenism carriers had more marked metabolic disorders than non-carriers, particularly as concerns impaired glucose tolerance and hyperuricemia, probably mediated by obesity(AU)


Subject(s)
Humans , Female , Adult , Polycystic Ovary Syndrome/diagnosis , Data Collection/statistics & numerical data , Hyperandrogenism/epidemiology , Metabolic Syndrome/epidemiology , Obesity/diet therapy , Epidemiology, Descriptive , Cross-Sectional Studies , Statistical Analysis
9.
Med. leg. Costa Rica ; 35(1): 94-101, ene.-mar. 2018. tab
Article in Spanish | LILACS | ID: biblio-894342

ABSTRACT

Resumen El síndrome de ovarios poliquísticos (SOPQ) es la disfunción endocrino- metabólica más frecuente en mujeres de edad reproductiva. El diagnostico de esta patología se basa en la presencia de anovulación, hiperandrogenismo y ovarios poliquísticos. La etiología del SOPQ es compleja y multifactorial; por lo cual el tratamiento se basa en tratar las manifestaciones clínicas y la inducción de la ovulación en el momento que se desee la concepción.


Abstract Polycystic ovary syndrome is the most common endocrinologic and metabolic disfunction in reproductive- aged women. The diagnosis of this pathology is based on the presence of ovulatory dysfunction, hyperandrogenism and polycystic ovaries. Its ethiology is complex and with multiple factors, therefore its treatment is based on fixing the clinical manifestations of the syndrome and in the case of women who would like to conceive, in inducing ovulation.


Subject(s)
Humans , Female , Oligomenorrhea , Polycystic Ovary Syndrome/diagnosis , Hyperandrogenism , Amenorrhea , Hyperinsulinism , Anovulation
10.
Rev. cuba. obstet. ginecol ; 43(3): 173-181, jul.-set. 2017.
Article in Spanish | LILACS, CUMED | ID: biblio-901325

ABSTRACT

Introducción: el síndrome de ovarios poliquísticos es un cuadro clínico caracterizado por la presencia de ovarios con pequeños quistes, amenorrea, hirsutismo y obesidad. Objetivo: proporcionar criterios diagnósticos vigentes y tendencias de tratamiento integral mediante una revisión sistemática de la literatura que permita un direccionamiento de los criterios médicos en atención a las mujeres con síndrome de ovario poliquístico. Métodos: estudio descriptivo retrospectivo, realizado mediante búsquedas en base de datos electrónicos como, Pubmed, Google Scholar, Cochrane Library, Science Direct y Elsevier. Se consultaron 25 artículos publicados desde el año 2011 para realizar esta revisión en torno al síndrome de ovario poliquístico, los cuales presentan evidencias científicas, en relación a la utilidad de la misma con contribuciones en el diagnóstico y manejo terapéutico de esta patología. Resultados: el abordaje diagnóstico implica ciertas dificultades en relación con el momento de presentación de los síntomas y la tendencia actual es considerar como un diagnóstico de exclusión, empleándose los cuatros fenotipos propuestos en Rotterdam. El estudio encontró que los cambios en el estilo de vida, la reducción del peso, dieta, ejercicios, medicina alternativa, tratamientos cosméticos, prevención de factores epigenéticos, la terapia quirúrgica y farmacológica contribuyen a mejorar la calidad de vida y sintomatología en las pacientes afectadas con esta entidad nosológica. Conclusión: el síndrome de ovario poliquístico sigue siendo una enfermedad con diagnóstico de exclusión, pero la tendencia actual es investigar la hormona antimulleriana como predictor de esta enfermedad. El tratamiento está orientado a corregir el hiperandrogenismo, los trastornos menstruales, las alteraciones metabólicas asociadas y la anovulación(AU)


Introduction: the polycystic ovarian syndrome (PCOS) is a clinical condition characterized by the presence of ovaries with small cysts, amenorrhea, hirsutism and obesity. Objective: Provide current diagnostic criteria and comprehensive treatment trends, through a systematic review, which allows addressing the medical criteria in care for women with polycystic ovarian syndrome (PCOS). Methods: A retrospective descriptive study was conducted by searching electronic database as Pubmed, Google Scholar, Cochrane Library, Science Direct and Elsevier. Twenty-five articles published since 2011 are addressed for this review on SOP, which present scientific evidence, in relation to its utility with contributions in the diagnosis and therapeutic management of this pathology. Results: the diagnostic approach implies certain difficulties in relation to the time of presentation of the symptoms. The current tendency is to consider it as a diagnosis of exclusion, using the four phenotypes proposed in Rotterdam. The study found that changes in lifestyle, weight reduction, diet, exercise, alternative medicine, cosmetic treatments, and prevention of epigenetic factors, surgical and pharmacological therapy contribute to improve the quality of life and symptoms in affected patients with this nosological entity. Conclusion: Polycystic ovarian syndrome remains a disease with a diagnosis of exclusion, but the current trend is to investigate the anti-mullerian hormone as a predictor of this disease. The treatment aimed at correcting hyperandrogenism, menstrual disorders, associated metabolic disorders and anovulation(AU)


Subject(s)
Humans , Female , Polycystic Ovary Syndrome/diagnosis , Anti-Mullerian Hormone , Polycystic Ovary Syndrome/surgery , Epidemiology, Descriptive , Retrospective Studies
11.
Rev. Hosp. Ital. B. Aires (2004) ; 37(1): 10-20, mar. 2017. tab
Article in Spanish | LILACS | ID: biblio-966680

ABSTRACT

El síndrome de ovario poliquísticos (SOP) representa una de las endocrinopatías más frecuentes en la mujer y es la principal causa de hiperandrogenismo (HA). Se trata de un trastorno complejo, multifactorial, poligénico con influencias ambientales. Aunque se han propuestos diferentes criterios para su diagnóstico, se prefiere el uso del más abarcativo (Criterio de Rotterdam) con la presencia de 2 de 3 de los siguientes: 1) HA clínico o bioquímico, 2) oligoanovulación crónica (OA), 3) poliquistosis ovárica por ecografía, excluyendo otras etiologías. Es frecuente su asociación con comorbilidades metabólicas (obesidad, diabetes 2, dislipidemia, apnea del sueño, etc.) y trastornos reproductivos (hiperplasia endometrial e infertilidad), sobre todo en los fenotipos clásicos, con HA y OA. El tratamiento estará orientado a las características clínicas de cada paciente y al deseo reproductivo. La pérdida de peso en aquellas con sobrepeso u obesidad o ambos factores puede restaurar los ciclos menstruales y disminuir el riesgo metabólico y representa la primera línea de tratamiento. Los anticonceptivos orales (ACO) son el tratamiento farmacológico de elección ya que atenúan las manifestaciones de HA y ofrecen protección endometrial. En las pacientes con oligoanovulación que buscan embarazo, el citrato de clomifeno es el tratamiento aconsejado en primera instancia. La metformina podría usarse en aquellas con intolerancia a la glucosa o diabetes 2 y también como segunda línea de tratamiento para restaurar los ciclos e inducir la ovulación. (AU)


Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women, the main cause of hyperandrogenism (HA). It is a complex, multifactorial polygenic disorder with environmental influences. Although there have been proposed different criteria for diagnosis, using the most comprehensive (Criteria Rotterdam) with the presence of 2 of 3 of the following is preferred: 1) HA clinical or biochemical, 2) oligo-anovulation chronic (OA), 3) polycystic ovaries by ultrasound, excluding other etiologies. It is frequently associated with metabolic comorbidities (obesity, type 2 diabetes, dyslipidemia, sleep apnea, etc.) and reproductive disorders (endometrial hyperplasia and infertility), especially in the classical phenotypes, with HA and OA. The treatment will be oriented to the clinical characteristics of each patient and reproductive desire. Weight loss in those who are overweight and / or obesity can restore menstrual cycles and decrease metabolic risk and represents the first line of treatment. Oral contraceptives (OC) are the pharmacological treatment of choice as it attenuates the manifestations of HA and offer endometrial protection. In patients seeking pregnancy with oligo-anovulation, clomiphene citrate would be used at first instance. Metformin may be used in those with impaired glucose tolerance or type 2 diabetes and also as a second-line treatment to restore cycles and induce ovulation. (AU)


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Young Adult , Ovulation Induction/methods , Polycystic Ovary Syndrome/diagnosis , Hyperandrogenism/etiology , Anovulation/diagnosis , Polycystic Ovary Syndrome/physiopathology , Polycystic Ovary Syndrome/drug therapy , Polycystic Ovary Syndrome/therapy , Polycystic Ovary Syndrome/diagnostic imaging , Comorbidity , Puberty/metabolism , Clomiphene/therapeutic use , Contraceptives, Oral, Combined/therapeutic use , Endometrial Hyperplasia/diagnosis , Infertility, Female/diagnosis
12.
Rev. Assoc. Med. Bras. (1992) ; 62(9): 867-871, Dec. 2016. graf
Article in English | LILACS | ID: biblio-829546

ABSTRACT

SUMMARY Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder with variable prevalence, affecting about one in every 15 women worldwide. The diagnosis of polycystic ovary syndrome requires at least two of the following criteria: oligoovulation and/or anovulation, clinical and/or biochemical evidence of hyperandrogenism and morphology of polycystic ovaries. Women with PCOS appear to have a higher risk of developing metabolic disorders, hypertension and cardiovascular disorders. The aim of this article was to present a review of the literature by searching the databases Pubmed and Scielo, focusing on publications related to polycystic ovaries, including its pathogenesis, clinical manifestations, diagnosis and therapeutic aspects, as well as its association with cardiovascular and arterial hypertensive disorders.


RESUMO A síndrome dos ovários policísticos (SOP) é uma desordem endócrina heterogênea com prevalência variável, que afeta cerca de uma em cada 15 mulheres no mundo. O diagnóstico da SOP requer, pelo menos, dois dos seguintes critérios: oligo-ovulação e/ou anovulação, evidência clínica e/ou bioquímica de hiperandrogenemia e morfologia dos ovários policísticos. As mulheres com SOP parecem ter um risco mais elevado de desenvolver distúrbios metabólicos, hipertensão e doenças cardiovasculares. O objetivo deste artigo foi apresentar uma revisão da literatura por meio de pesquisa nas bases de dados PubMed e Scielo, focada em publicações relacionadas com ovários policísticos, incluindo patogênese, manifestações clínicas, diagnóstico e aspectos terapêuticos, bem como associação com doenças cardiovasculares e hipertensão arterial.


Subject(s)
Humans , Female , Polycystic Ovary Syndrome/diagnosis , Polycystic Ovary Syndrome/etiology , Polycystic Ovary Syndrome/therapy , Insulin Resistance , Cardiovascular Diseases/complications , Hypertension/complications
13.
HU rev ; 42(3): 217-223, set.-out.2016.
Article in Portuguese | LILACS | ID: biblio-827159

ABSTRACT

Frequentemente alterações hormonais locais e sistêmicas em mulheres são oriundas da Síndrome do Ovário Policístico (SOP) e parecem acarretar prejuízos às estruturas orofaciais, incluindo as desordens temporomandibulares (DTM) e suas repercussões psicossociais. O objetivo deste estudo foi avaliar a prevalência de DTM em mulheres com SOP, além de avaliar o impacto da dor orofacial na manifestação de sintomas físicos inespecíficos (incluindo e excluindo dor) e de depressão. Para isso, foi utilizado o Critério de Diagnóstico para Pesquisa das Desordens Temporomandibulares (Eixos I e II). A análise e a interpretação dos dados foram feitas utilizando o software SPSS for Windows 14.0 e organizados no formato de tabelas, e a estatística foi a inferencial, apresentadas com médias e porcentagens. Entre 37 mulheres com SOP, 56,8% apresentavam DTM, sendo 16,1% com manifestação miofascial. Os sintomas depressivos estavam presentes em 28,6% das pacientes com DTM e SOP em nível moderado e 33,3% em nível severo. Sintomas físicos inespecíficos de nível severo estavam presentes em 52,4% das mulheres com DTM e SOP. Fatores hormonais inerentes à SOP e os níveis acentuados de sintomas inespecíficos e de depressão parecem influenciar na cronificação álgica relacionada à DTM.


Subject(s)
Polycystic Ovary Syndrome , Temporomandibular Joint Disorders , Pain , Polycystic Ovary Syndrome/diagnosis , Facial Pain , Temporomandibular Joint Disorders/diagnosis , Prevalence , Psychosocial Impact , Depression
14.
Article in English | LILACS | ID: lil-785235

ABSTRACT

ABSTRACT Objective The aim of the present study was to determine the prevalence of metabolic syndrome (MS) in infertile Iranian women with polycystic ovary syndrome (PCOS) using the ATPIII criteria. Subjects and methods In this cross-sectional study, 624 women with PCOS were enrolled at a tertiary referral center in Tehran, Iran, between April, 2012 and March, 2013. Diagnosis of MS was according to ATPIII criteria. Also, we divided PCOS patients into following two main groups: (i) with MS (n = 123) and (ii) without MS (n = 501), and then compared variables between two groups. Results The mean age, body mass index (BMI) and waist circumference were 28.6 ± 4.3 years, 26.7 ± 3.7 kg/m2 and 85.2 ± 8.7 cm, respectively. The prevalence of MS was 19.7%. Our findings showed that age, BMI, waist circumference and all metabolic parameters were higher in PCOS women with MS than related values in those without MS. The most and least prevalent forms of MS were low level of high density lipoprotein-cholesterol (HDL-C) and hypertension, respectively. Conclusion It seems the prevalence of metabolic syndrome in our country isn’t as high as western countries. The prevalence rate of MS increased with age and BMI. One of the major cardiovascular risk factors, low level of HDL-C, is the most prevalent metabolic abnormality in our participants.


Subject(s)
Humans , Female , Adult , Polycystic Ovary Syndrome/epidemiology , Metabolic Syndrome/epidemiology , Infertility, Female/epidemiology , Polycystic Ovary Syndrome/complications , Polycystic Ovary Syndrome/diagnosis , Insulin Resistance , Body Mass Index , Prevalence , Cross-Sectional Studies , Risk Factors , Age Factors , Practice Guidelines as Topic , Metabolic Syndrome/diagnosis , Waist Circumference , Infertility, Female/etiology , Iran/epidemiology , Cholesterol, HDL/blood
15.
Rev. cuba. endocrinol ; 27(1): 0-0, ene.-abr. 2016. ilus, tab
Article in Spanish | LILACS | ID: lil-780721

ABSTRACT

Introducción: el síndrome de ovarios poliquísticos es el trastorno endocrino más frecuente en la mujer en edad reproductiva. Se caracteriza por trastornos menstruales, hiperandrogenismo y ovarios poliquísticos por ultrasonido, y afecta la fertilidad y el metabolismo femeninos. Objetivo: determinar la frecuencia de aparición de los criterios diagnósticos de síndrome de ovarios poliquísticos en mujeres con sospecha de esta afección, y la posible correspondencia entre el diagnóstico clínico, hormonal y ecográfico. Métodos: se realizó un estudio descriptivo correlacional en 140 mujeres. Se les practicó interrogatorio y examen físico, ultrasonido diagnóstico y estudio de las hormonas folículo estimulante, luteinizante y testosterona. Para el análisis estadístico se utilizaron tablas de frecuencia y la prueba de chi cuadrado (p< 0,05). Resultados: la edad media fue 26,3 años. De 96 mujeres (68,5 por ciento) con alteraciones del ciclo menstrual, 76 (79,2 por ciento) refirieron oligomenorrea. Hubo sobrepeso en 64 pacientes (45,7 por ciento). La testosterona elevada fue la alteración hormonal predominante (52,7 por ciento). El 84,3 por ciento presentó volumen ovárico ≥ 10 cc. Hubo asociación significativa entre las alteraciones menstruales y la presencia de ovarios poliquísticos (p= 0,000), hirsutismo (p= 0,001) y acné (p= 0,000), pero no ocurrió así con las variables hormonales. Hubo coincidencia entre el diagnóstico ecográfico y la testosterona elevada en el 46,2 por ciento de las pacientes. Conclusiones: Existe asociación entre las variables clínicas y el diagnóstico de síndrome de ovarios poliquísticos, pero no así entre los criterios diagnósticos ecográficos y hormonales, ni entre las alteraciones hormonales y el diagnóstico clínico y ecográfico del síndrome de ovarios poliquísticos, en estas pacientes(AU)


Introduction: polycystic ovary syndrome is the most common endocrine disorder in a woman at reproductive age. It is characterized by menstrual disorders, hyperandrogenism and CT-detected polycystic ovaries and it has an effect on fertility and metabolism. Objective: to determine the frequency of occurrence of diagnostic criteria of polycystic ovary syndrome in women suspected of suffering this disease, and the possible correspondence among the clinical, hormonal and echographic diagnoses. Methods: a correlational descriptive study was conducted in 140 women. They were questioned and physically examined in addition to performing diagnostic ultrasound and study of the follicle-stimulating hormone, the luteinizing hormone and testosterone. For the statistical analysis, the frequency tables and the Chi-square test (p< 0.05) were used. Results: the average age was 26.3 years. Of 96 women (68.5 percent) with menstrual disorders, 76 (79.2 percent) said they had oligomenorrhea. Sixty four were overweighed (45.7 percent). Elevated testosterone was the predominant hormonal alteration (52.7 percent). In the group, the ovary volume was equal to or higher than 10 cc in 84.3 percent of the group. Significant association was observed between the menstrual disorders and the presence of polycystic ovaries (p= 0.000), hirsutism (p= 0.001) and acne (p= 0.000), but this did not occur with the hormonal variables. The echographic diagnosis and the elevated testosterone showed correspondence in 46.2 percent of patients. Conclusions: there is association between the clinical variables and the diagnoses of polycystic ovary syndrome, but neither the echographic and hormonal diagnostic criteria, nor the hormonal alterations and the clinical and echographic diagnosis of polycystic ovary syndrome were related(AU)


Subject(s)
Humans , Female , Adult , Clinical Diagnosis/statistics & numerical data , Follicle Stimulating Hormone/adverse effects , Polycystic Ovary Syndrome/diagnosis , Ultrasonography/statistics & numerical data , Epidemiology, Descriptive , Statistical Analysis
16.
Rev. Méd. Clín. Condes ; 26(1): 88-93, ene-feb. 2015. tab
Article in Spanish | LILACS | ID: biblio-1150772

ABSTRACT

La sospecha de Síndrome de Ovario Poliquístico es un motivo de consulta frecuente durante la adolescencia, esto probablemente está dado por la sobreposición de las características fisiológicas de este período con los criterios diagnósticos tradicionalmente usados para definir este síndrome, tales como ciclos menstruales irregulares, hiperandrogenismo y morfología ecográfica de ovario poliquístico. Es por esto que parece importante discutir si los criterios diagnósticos de Síndrome de Ovario Poliquístico aplicados en mujeres adultas pueden extrapolarse a los primeros años postmenarquia. En este artículo se discute el diagnóstico de Síndrome de Ovario Poliquístico en la adolescencia, sus controversias y su manejo.


The suspicion of polycystic ovary syndrome is a common complaint during adolescence, and is probably given by the overlap of physiological characteristics of this period of life with the diagnostic criteria traditionally used to define this syndrome, such as irregular menstrual cycles, hyperandrogenism and polycystic ovarian morphology. This is why it seems important to discuss whether these diagnostic criteria for polycystic ovary syndrome in adults can be extrapolated to the early years postmenarche. This article will discuss the diagnosis of polycystic ovary syndrome in adolescence, their controversies and their management.


Subject(s)
Humans , Female , Adolescent , Polycystic Ovary Syndrome/diagnosis , Polycystic Ovary Syndrome/epidemiology , Polycystic Ovary Syndrome/classification , Signs and Symptoms , Chile , Causality , Hyperandrogenism
17.
IJRM-Iranian Journal of Reproductive Medicine. 2015; 13 (4): 227-230
in English | IMEMR | ID: emr-166771

ABSTRACT

Polycystic ovarian syndrome [PCOS] is a common endocrinopathy that accompanied with long term complications. The early diagnosis of this syndrome can prevent it. The aim was to determine the role of anti-mullerian hormon [AMH] in PCOS diagnosis and to find cut off level of it. In this cross sectional study, 117 women between 20-40 years old were participated in two groups: 60 PCOS women [based on Rotterdam criteria consensus] as the case group and 57 normal ovulatory women as the control group. In day 2-4 of cycle, transvaginal sonography was performed and serum hormonal level of AMH, luteinizing hormone [LH], follicle stimulating hormone [FSH], estradiol [E[2]], testosterone, fasting blood sugar [FBS], thyroid stimulating hormone [TSH], and prolactin [PRL] were measured in all of participants. For all of them score of hirsutism [base on Freeman-Galloway scoring] was determined. There were statistically significant in irregular pattern of menstruation, AMH and FSH level, and presence of hirsutism between two groups. But regarding mean of age, body mass index, plasma level of PRL, TSH, LH, Testosterone, FBS, and E[2] differences were not significant. Construction by ROC curve present 3.15 ng/ml as AMH cut off with 70.37% sensitivity and 77.36% specificity in order to PCOS diagnosis. AMH with cut off level of 3.15 ng/ml with sensitivity 70.37% and specificity 77.36% could use for early diagnosis of PCOS patients


Subject(s)
Humans , Female , Polycystic Ovary Syndrome/diagnosis , Cross-Sectional Studies
18.
Rev. guatem. cardiol. (Impresa) ; 24(2): 18-20, jun.-dic. 2014. ilus
Article in Spanish | LILACS | ID: biblio-869912

ABSTRACT

El síndrome de ovario poliquístico (SOP) es la anormalidad metabólica más frecuente en mujeres en edad reproductiva, con una prevalencia global de 6% a 10%. La identificación de éstas mujeres es sumamente importante ya que constituye el grupo más grande de mujeres en riesgo de desarrollar enfermedad cardiovascular y diabetes mellitus tipo 2. En 2,003 se llega a un consenso en Rotterdam, en el que se propone que el diagnóstico debe de realizarse con la presencia de dos de los siguientes tres elementos: Oligo o anovulación, Hiperandrogenismo clínico y/o bioquímico. Ovarios poliquísticos.


Polycystic ovary syndrome (PCOS) is the most common metabolic abnormality in women of reproductive age,with an overall prevalence of 6% to 10%. The identification of these women is extremely important since it isthe largest group of women at risk of developing cardiovascular disease and diabetes mellitus type 2 2,003 wereach a consensus in Rotterdam, where it is proposed that the diagnosis should be performed with thepresence of two of the following three elements: Oligo or anovulation, clinical hyperandrogenism and / orbiochemical. Polycystic ovaries.


Subject(s)
Humans , Female , /diagnosis , Cardiovascular Diseases/complications , Metabolic Syndrome/complications , Polycystic Ovary Syndrome/complications , Polycystic Ovary Syndrome/diagnosis
19.
Rev. obstet. ginecol. Venezuela ; 74(3): 170-176, sep. 2014. ilus, tab
Article in Spanish | LILACS | ID: lil-740390

ABSTRACT

Objetivo: Evaluar perfil hormonal, índice de masa corporal y tensión arterial en 40 mujeres infértiles con ovario poliquístico. Métodos: En la consulta del Centro de Atención Integral de la Universidad de Los Andes se valoró talla, peso y tensión arterial. Durante la fase folicular del ciclo menstrual en ellas se midió en sangre las hormonas sexuales e insulina (basal y 2 horas poscarga glucosada) por electroquimioluminiscencia. Resultados: El índice de masa corporal se correlacionó directamente con el valor de tensión arterial sistólica, la relación LH/FSH y la testosterona sérica; e inversamente con las hormonas FSH y PRL. Los datos clínicos y de laboratorio se observaron dentro de los límites de referencia; sin embargo, la testosterona guardó relación directa con LH/FSH, índice de masa corporal y tensión arterial sistólica. Al compararse dos grupos de paciente con base al valor de la mediana poblacional, los grupos masa corporal > 24 kg/m2 y tensión arterial sistólica >120 mmHg mostraron niveles de DHEA-S e insulina (basal y 2 h) más elevados que en mujeres con índice de masa corporal y tensión arterial sistólica más bajos. Conclusiones: Existe correlación entre niveles séricos de andrógenos con sobrepeso e hipertensión arterial por mecanismos etiológicos interrelacionados. Síndrome de ovario poliquístico es de origen multicausal eventualmente con hiperandrogenemia. La falla metabólica debe controlarse en estas pacientes, lo que permitiría bajar el efecto de los andrógenos y favorecer el estado de fertilidad, pero sobre evita a largo plazo complicaciones como obesidad, diabetes mellitus tipo 2 e hipertensión arterial.


Objective: To evaluate hormonal profile, body mass index and blood pressure in 40 infertile women with polycystic ovary. Methods: In the out patien clinic of the Centro de Atencion Integral de la Universidad de Los Andes, height, weight and blood pressure were assessed. During follicular phase of the menstrual cycle in blood of them sex hormones and insulin (basal, 2 hours post glucose load) were measured by electrochemiluminescence. Results: The body mass index was directly correlated with the value of systolic blood pressure, ratio LH/ FSH and testosterone in serum, and it was inversely correlated with the hormones FSH and PRL. Clinical and laboratory data were observed within the reference limits, but kept directly related to testosterone LH / FSH, BMI and systolic blood pressure. When comparing two patient groups based on the value of the population median, body mass groups > 24 kg/m2 and systolic blood pressure > 120 mmHg, they showed levels of DHEA- S and insulin (basal and 2 h) higher than those women with lower values of BMI and systolic blood pressure. Conclusions: There is a correlation between serum androgen levels with overweight and hypertension by aetiological mechanisms interrelated. Polycystic ovary syndrome is multicausal origin eventually with hyperandrogenemia. Metabolic failure should be monitored in these patients, which would lower the effect of androgens and promote fertility status, but prevents long-term complications such as obesity, type 2 diabetes mellitus and high blood pressure.


Subject(s)
Humans , Female , Arterial Pressure , Body Mass Index , Body Weight , Infertility, Female/diagnosis , Polycystic Ovary Syndrome/diagnosis , Obesity , Obesity/complications
20.
Arq. bras. endocrinol. metab ; 58(2): 182-187, 03/2014. tab
Article in English | LILACS | ID: lil-709342

ABSTRACT

Polycystic ovary syndrome (PCOS) is a common condition in women at reproductive age associated with reproductive and metabolic dysfunction. Proposed diagnosed criteria for PCOS include two out of three features: androgen excess, menstrual irregularity, and polycystic ovary appearance on ultrasound (PCO), after other causes of hyperandrogenism and dysovulation are excluded. Based on these diagnostic criteria, the most common phenotypes are the “classic PCOS” – hyperandrogenism and oligomenorrhea, with or without PCO; the “ovulatory phenotype” – hyperandrogenism and PCO in ovulatory women; and the “non-hyperandrogenic phenotype”, in which there is oligomenorrhea and PCO, without overt hyperandrogenism. The presence of obesity may exacerbate the metabolic and reproductive disorders associated with the syndrome. In addition, PCOS women present higher risk for type 2 diabetes and higher prevalence of cardiovascular risk factors that seems to be associated with the classic phenotype. The main interventions to minimize cardiovascular and metabolic risks in PCOS are lifestyle changes, pharmacological therapy, and bariatric surgery. Treatment with metformin has been shown to improve insulin sensitivity, lowering blood glucose and androgen levels. These effects are more potent when combined with lifestyle interventions. In conclusion, besides reproductive abnormalities, PCOS has been associated to metabolic comorbidities, most of them linked to obesity. Confounders, such as the lack of standard diagnostic criteria, heterogeneity of the clinical presentation, and presence of obesity, make management of PCOS difficult. Therefore, the approach to metabolic abnormalities should be tailored to the risks and treatment goals of each individual woman.


A síndrome dos ovários policísticos (PCOS) é um distúrbio frequente em mulheres em idade reprodutiva, associado com disfunção reprodutiva e metabólica. Os critérios diagnósticos atuais para PCOS incluem pelo menos dois dos três seguintes: hiperandrogenismo, irregularidade menstrual e aparência policística dos ovários à ultrassonografia (PCO), após exclusão de outras causas de hiperandrogenismo e anovulação. Com base nesses critérios diagnósticos, os fenótipos mais comuns são “PCOS clássico”– hiperandrogenismo e oligomenorreia, com ou sem PCO; o “fenótipo ovulatório” – hiperandrogenismo e PCO em mulheres ovulatórias; e o “fenótipo não hiperandrogênico”– no qual ocorrem oligomenorreia e PCO sem hiperandrogenismo evidente. A presença de obesidade pode exacerbar os distúrbios metabólicos e reprodutivos associados com a síndrome. Além disso, mulheres com PCOS apresentam maior risco para diabetes tipo 2 e maior prevalência de fatores de risco cardiovascular, que parecem estar associados com o fenótipo clássico. As principais intervenções para minimizar riscos metabólicos e cardiovasculares em PCOS são mudanças de estilo de vida, tratamento farmacológico e cirurgia bariátrica. O tratamento com metformina melhora a sensibilidade à insulina, reduz a glicemia e os níveis de androgênios. Esses efeitos são mais evidentes quando a metformina é associada às mudanças de estilo de vida. Em conclusão, além das anormalidades reprodutivas, a PCOS tem sido associada com comorbidades metabólicas ligadas à obesidade. Fatores confundidores, como a falta de critérios diagnósticos padronizados, heterogeneidade da apresentação clínica e presença de obesidade, tornam difícil o manejo clínico de PCOS. Assim, a abordagem das anormalidades metabólicas deve ser individualizada para os riscos e objetivos terapêuticos de cada mulher.


Subject(s)
Adolescent , Female , Humans , Obesity/complications , Polycystic Ovary Syndrome/diagnosis , Polycystic Ovary Syndrome/therapy , Insulin Resistance , Life Style , Menopause , Metabolic Syndrome/complications , Metformin/therapeutic use , Ovary , Polycystic Ovary Syndrome/complications , Risk Factors
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