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1.
Rev. medica electron ; 41(4): 940-958, jul.-ago. 2019.
Article in Spanish | LILACS, CUMED | ID: biblio-1094100

ABSTRACT

RESUMEN El síndrome de ovario poliquístico se ha convertido en un problema de salud pública, siendo el más común de los desórdenes endocrinos en mujeres en edad reproductiva con estudios que reportan una prevalencia de hasta un 21%. El diagnóstico de esta entidad es importante debido a que representa riesgos metabólicos, cardiovasculares y afecta la capacidad reproductiva de estas pacientes. Se realizó una revisión bibliográfica de los principales artículos relacionados sobre el tema, resumiendo los aspectos fundamentales de este problema de salud.


ABSTRACT Polycystic ovary syndrome has become a public health problem, being the most common of the endocrine disorders in reproductive-age women, with studies reporting prevalence by 21 %. The diagnosis of this entity is important because it represents metabolic and cardiovascular risk, and affects the reproductive capacity of these patients. The authors carried out bibliographic review of the main articles related with the theme, summarizing the basic aspects of this health problem.


Subject(s)
Humans , Female , Polycystic Ovary Syndrome/complications , Polycystic Ovary Syndrome/etiology , Polycystic Ovary Syndrome/physiopathology , Polycystic Ovary Syndrome/diagnostic imaging , Preventive Health Services , Cardiovascular Diseases/diagnosis , Disease Management , Metabolic Syndrome/diagnosis , Endocrine System Diseases/diagnosis , Disease Prevention , Reproductive Health , Healthy Lifestyle , Genitalia/physiopathology , Insulin Resistance , Ultrasonography , Hirsutism/diagnosis , Hypertension/diagnosis , Menstruation Disturbances/diagnosis , Obesity/diagnosis
2.
Clinics ; 74: e836, 2019. tab
Article in English | LILACS | ID: biblio-1011915

ABSTRACT

OBJECTIVE: Follow-up studies of girls with premature adrenarche have reported the development of polycystic ovary syndrome, insulin resistance, and dyslipidemia and a propensity to cardiovascular disease. The aim of this study was to analyze the presence of these conditions in patients previously treated at the Universidade Federal do Triângulo Mineiro. METHODS: A total of 130 medical records reported premature adrenarche. One hundred and twenty-two patients were invited to participate, of whom 54 accepted; 34 patients were selected, as they had reached their final height. Anthropometric, blood glucose, insulin, and lipid and hormonal profile (LH, FSH, estradiol, 17α-OH-progesterone, androstenedione, dehydroepiandrosterone sulfate, testosterone) data were obtained, the HOMA-IR index was calculated, and pelvic ultrasonography was performed. To characterize polycystic ovary syndrome and metabolic syndrome, the Rotterdam and International Diabetes Federation criteria, respectively, were used. Data were analyzed according to measures of dispersion, frequency and correlations of interest. RESULTS: The age of the participants ranged from 15.2 to 28.2 years/months; 23.5% of the patients were overweight, 11.8% were obese, 29.4% had a large waist circumference, and 8.8% were hypertensive. None of the patients had altered glucose levels, and insulin levels and HOMA-IR were elevated in 29.4% and 38.2% of the participants, respectively; 14.7% of the patients exhibited acanthosis nigricans. The lipid profiles of the participants were variable, and one patient (2.9%) had metabolic syndrome. Polycystic ovary syndrome was found in 41.2% of patients. CONCLUSION: The percentage of patients with polycystic ovary syndrome who also had overweight, obesity and insulin resistance corroborates the literature data about the need for follow-up aiming at interventions, especially for conditions associated with cardiometabolic risk.


Subject(s)
Humans , Female , Adolescent , Adult , Young Adult , Polycystic Ovary Syndrome/etiology , Puberty, Precocious/complications , Puberty, Precocious/metabolism , Adrenarche/metabolism , Reference Values , Triglycerides/blood , Insulin Resistance , Cardiovascular Diseases/etiology , Cardiovascular Diseases/metabolism , Body Mass Index , Cholesterol/blood , Retrospective Studies , Risk Factors , Metabolic Syndrome/etiology , Metabolic Syndrome/metabolism , Dyslipidemias/etiology , Dyslipidemias/metabolism , Overweight/etiology , Overweight/metabolism , Hormones/blood
3.
Rev. argent. endocrinol. metab ; 55(1): 43-56, mar. 2018. graf.
Article in Spanish | LILACS | ID: biblio-1248114

ABSTRACT

Esta revisión fue realizada con el fin de evaluar nuestros resultados de laboratorio así como aquellos de la literatura que constituyen, a nuestro entender, aportes significativos en el síndrome de ovarios poliquísticos (SOP). Nuestro especial énfasis será presentar las limitaciones de las metodologías empleadas por nuestro grupo, comparativamente a las reportadas por otros investigadores. La determinación de andrógenos, en particular de Testosterona (TT), es quizá la de mayor complejidad dado que los resultados con los diferentes inmunoensayos empleados en nuestro medio producen resultados muy variables por los diferentes métodos y aún entre laboratorios que usan la misma metodología. La técnica de referencia es la cromatografía líquida en tándem con espectrometría de masa (LC-MSMS), de difícil aplicación en laboratorios de análisis clínicos debido a su alto costo y la imposibilidad de resolver numerosas muestras. En estudios previos demostramos que de los métodos habitualmente usados para evaluar la TT circulante, solo en 2 inmunoensayos los resultados obtenidos fueron satisfactoriamente validados indirectamente según el criterio del Consenso de los Centros para el Control y Prevención de Enfermedades (CDC, USA) contra LC-MSMS, los cuales fueron comparables a dicha metodología con niveles superiores a 0,5 ng/ml. El SOP puede presentar factores de riesgo aumentados para la enfermedad cardiovascular y la diabetes II. Estos factores no están debidamente categorizados en función de los distintos fenotipos del SOP. Se evaluarán los principales analitos empleados con este objetivo y los nuevos que aporten elementos de mayor especificidad en este sentido


This review was performed in order to evaluate our laboratory results as well as those of the literature that constitute, in our opinion, significant contributions in these pathophysiologies. Our special emphasis will be on presenting the limitations of the methodologies used by our group, compared to those reported by other researchers. The determination of androgens, in particular Testosterone (TT), is perhaps the most complex since the results with the different immunoassays used in our environment produce very variable results by the different methods and even between laboratories that use the same methodology. The reference technique is LC-MSMS, difficult to apply in clinical analysis laboratories because of its high cost and the inability to solve numerous samples. In previous studies, we demonstrated that, in comparison to LC-MSMS with the usual methods for evaluating circulating TT, the results obtained in only 2 immunoassays were satisfactorily validated indirectly according to the criteria of CDC against LC-MSMS, which were comparable to that methodology with levels higher than 0.5 ng/ml. PCOS may have increased risk factors for cardiovascular disease and diabetes II. These factors are not properly categorized according to the different phenotypes of PCOS. The main analytes used for this purpose will be evaluated and new ones that contribute elements of greater specificity in this sense


Subject(s)
Humans , Female , Polycystic Ovary Syndrome/etiology , Polycystic Ovary Syndrome/physiopathology , Testosterone/analysis , Phenotype , Mass Spectrometry/methods , Immunoassay/methods , Chromatography, Liquid/methods
4.
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
5.
Rev. cuba. med. gen. integr ; 31(4): 0-0, oct.-dic. 2015.
Article in Spanish | LILACS | ID: lil-778100

ABSTRACT

Introducción: el síndrome de ovario poliquístico es un desorden de etiología multifactorial, caracterizado por un cuadro clínico heterogéneo y a veces subclínico que dificulta su manejo y diagnóstico. Se vincula a varias comorbilidades sobre todo de tipo metabólicas, donde la insulinorresistencia puede jugar un papel relevante. Objetivo: describir la relación que existe entre la insulinorresistencia y la génesis del síndrome de ovario poliquístico y de algunas de sus comorbilidades metabólicas. Conclusiones: la insulinorresistencia guarda una estrecha relación con la génesis del síndrome de ovario poliquístico, así como en el desarrollo de algunas de sus comorbilidades metabólicas (diabetes mellitus tipo 2, dislipidemia, hígado graso no alcohólico y síndrome metabólico), las que deben ser identificadas y tratadas precoz y adecuadamente(AU)


Introduction: Polycystic ovary syndrome is a disorder of multifactorial etiology, characterized by a heterogeneous clinical and subclinical, which sometimes makes handling and diagnosis difficult, and it is linked to several metabolic comorbidities especially those insulin resistant that may play a significant role. Objective: Describe the relationship between insulin resistance and the genesis of polycystic ovarian syndrome and some of its metabolic comorbidities. Conclusions: Insulin resistance is closely related to the genesis of polycystic ovary syndrome, as well as the development of some of its metabolic comorbidities (diabetes mellitus Type 2, dyslipidemia, nonalcoholic fatty liver disease and metabolic syndrome), which must be identified and timely and properly treated(AU)


Subject(s)
Humans , Comorbidity , Metabolic Syndrome/physiopathology , Polycystic Ovary Syndrome/epidemiology , Polycystic Ovary Syndrome/etiology
7.
Article in Spanish | LILACS, BINACIS | ID: biblio-1170930

ABSTRACT

Polycystic ovary syndrome (PCOS), the most common gynecological endocrinopathy in women of reproductive age, is characterized by hyperandrogenism, chronic anovulation and /or polycystic ovaries. Although the cause of PCOS is still unknown, there are several hypotheses attempting to explain the primary defect; the most commonly accepted is insulin resistance. Due to its high prevalence, the patients have increased risk of developing metabolic and cardiovascular alterations. The compensatory hyperinsulinemia contributes to hyperandrogenism in different ways: by stimulating ovarian androgen synthesis and inhibiting hepatic production of sex hormone binding globulin. From the study of the intrauterine environment in recent years it has been suggested that PCOS may have an origin in utero associated with prenatal exposure to androgens. The aim of this paper is to review the main mechanisms proposed to cause the syndrome.


Subject(s)
Polycystic Ovary Syndrome/etiology , Female , Humans , Insulin Resistance/physiology , Polycystic Ovary Syndrome/physiopathology
8.
Medicina (B.Aires) ; 72(5): 389-392, oct. 2012. ilus, tab
Article in Spanish | LILACS | ID: lil-657534

ABSTRACT

El síndrome del ovario poliquístico (PCOS) es una afección de alta incidencia en mujeres en edad fértil. Si bien la etiología de la enfermedad se desconoce, se cree que la exposición a andrógenos durante la vida intrauterina generaría reprogramación fetal afectando vías endocrinas y metabólicas que, junto a alteraciones génicas y ambientales, inducirían la aparición de PCOS en etapas muy tempranas de la vida. Es por ello que se buscan marcadores tempranos del desarrollo de PCOS. Utilizando un modelo murino de hiperandrogenización prenatal (HA) recreamos dos fenotipos de PCOS: ovulatorio y anovulatorio. La HA no alteró el colesterol circulante pero disminuyó el colesterol HDL y aumentó el LDL y los triglicéridos (TG) con respecto a los controles. La relación colesterol total/HDL como marcador de riesgo cardiovascular y la relación TG/HDL se vieron incrementadas con respecto a los controles, resultando mayor en el grupo PCOS anovulatorio. El presente trabajo demuestra la importancia de la determinación del perfil lipídico a edades tempranas en poblaciones de riesgo (como es el caso de hijas de madres con PCOS).


Polycystic ovary syndrome (PCOS) is one of the commonest endocrine diseases that affect women in their reproductive ages; however, the etiology of the syndrome remains unknown. A hypothesis proposes that during gestation increased exposure of androgen would induce fetal programming that may increase the risk of PCOS development during the adult life. By means of a prenatally hyperandrogenized (HA) rat model we demonstrated the importance of determining the lipid profile at early ages. HA induced two different phenotypes: ovulatory and anovulatory PCOS. HA did not modify total cholesterol but decreased HDL cholesterol and increased both LDL and tryglicerides (TG) when compared with controls. Both, the ratio total cholesterol: HDL (marker of cardiovascular risk) and TG:HDL (marker of metabolic syndrome) were increased in the HA group with respect to controls. In addition, these abnormalities were stronger in the anovulatory than ovulatory phenotype. Our results point out the need to find early markers of PCOS in girls or adolescents with increased risk to develop PCOS (as in daughters of women with PCOS).


Subject(s)
Animals , Female , Pregnancy , Rats , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Hyperandrogenism/metabolism , Polycystic Ovary Syndrome/metabolism , Biomarkers/blood , Disease Models, Animal , Hyperandrogenism/complications , Insulin Resistance , Phenotype , Polycystic Ovary Syndrome/etiology , Rats, Sprague-Dawley , Risk Factors
9.
Annals of Saudi Medicine. 2011; 31 (2): 145-151
in English | IMEMR | ID: emr-123774

ABSTRACT

Primary hypothyroidism may be associated with ovarian enlargement and/ or cyst formation. We evaluated the effect of thyroid hormone replacement therapy on hormonal changes, ovarian volume and sonographic appearance. Open, prospective study of women admitted to university gynecology clinic. The study included 26 patients with untreated hypothyroidism who had polycystic [n=10] or normal-appearing [n=16] ovaries and 20 euthyroidic controls. Basal serum total testosterone, free testosterone, androstenedione, dehydroepiandosterone-sulfate, prolactin, estradiol, luteinizing hormone, follicle-stimulating hormone, free T3, free T4 and thyroid-stimulating horone, together with ovarian volumes, were determined and repeated after euthyroidism was achieved. Ovarian volumes of patients with hypothyroidism were significantly greater compared with controls, and their magnitudes diminished significantly during thyroid hormone replacement therapy. Hypothyroidic patients with polycystic ovaries had significantly higher serum free testosterone and dehydroepiandosterone-sulfate, but lower androstenodione levels compared with those who had normal-appearing ovaries. Serum total testosterone concentrations were significantly higher in hypothyroidic patients without polycystic ovaries, and thyroid hormone replacement therapy achieved a significant reduction in total as well as free testosterone. Severe longstanding hypothyroidism leads to increased ovarian volume and/or cyst formation. A decrease in ovarian volume, resolution of ovarian cysts and reversal of the polycystic ovary syndrome-like appearance, together with improvement in serum hormone levels, occurred after euthyroidism was achieved


Subject(s)
Humans , Female , Hypothyroidism/etiology , Thyroid Hormones , Thyroxine , Polycystic Ovary Syndrome/etiology , Ovary/drug effects , Androgens/blood , Prospective Studies , Severity of Illness Index , Organ Size/drug effects , Case-Control Studies
10.
Rev. cuba. obstet. ginecol ; 36(3): 368-381, jul.-sep. 2010.
Article in Spanish | LILACS | ID: lil-584648

ABSTRACT

La infertilidad es la incapacidad de lograr el embarazo con relaciones sexuales mantenidas durante un año. Entre el 10 y el 20 por ciento de las parejas presentan esta dificultad. La cirugía de mínimo acceso se ha convertido en piedra angular en el tratamiento de la infertilidad femenina. OBJETIVO: Describir los resultados de la cirugía de mínimo acceso en el tratamiento de los factores tubo-peritoneal, ovárico y la endometriosis entre agosto del año 2000 y abril de 2007. Se evaluaron 205 pacientes procedentes de la consulta de infertilidad. MÉTODOS: Investigación descriptiva, longitudinal, prospectiva. Bioética: Consentimiento in formado. Los datos fueron procesados con el paquete estadístico SPSS. RESULTADOS: Se obtuvieron 76 embarazos (37,07 por ciento) distribuidos en: 44 partos, 18 cesáreas, 9 ectópicos y 5 abortos. El rango de edades más frecuente fue de 26 a 30 años, predominó la infertilidad secundaria y el factor tubo-peritoneal (p<0,05). Las técnicas más aplicadas fueron: fimbrioplastia (78 por ciento), salpingoneostomÍa (32,2 por ciento) y salpingoovariolisis (29,3 por ciento). Con la punción múltiple de ovario y la salpingolisis se alcanzó un 50 por ciento de embarazos. La mayorÍa de las pacientes consiguieron embarazarse en menos de 6 meses. Se reportó un 4,3 por ciento de complicaciones. Estos resultados son comparables con los de otros autores. CONCLUSIONES: La cirugÍa de mínimo acceso constituye una opción asequible en el tratamiento de la infertilidad en casos seleccionados con satisfactorios resultados


Infertility is the inability or diminished ability to produce offspring with maintained intercourses for one year. Between the 10 percent and the 20 percent of couples has this difficulty. The minimum access surgery becomes in the cornerstone in treatment of female infertility. OBJECTIVE: To describe results of the minimum access surgery in the treatment of tuboperitoneal factors and ovarian as well as endometriosis between August, 2000 and April, 2007. A total of 205 patients were assessed from the infertility consultation. METHODS: A prospective, longitudinal and descriptive research. Bioethics: written informed consent. Data were processed with the SPSS statistical package. RESULTS: It was possible to achieve 76 pregnancies (37.07 percent) distributed in: 44 deliveries, 18 cesarean sections, 9 ectopic pregnancies and 5 abortions. The more frequent age rank was from 26 to 30 years with predominance of secondary infertility and the tuboperitoneal factor (p < 0.05). The more used techniques were: the fimbrioplasty (78 percent), salpingoneostomy (32.2 percent) and salpingoovariolysis (29.3 percent). With the multiple ovary puncture and the salpingolysis it was possible to achieve the 50 percent of pregnancies. Most of patients made pregnant in less than 6 months. There was a 4.3 percent of complications. Theses results are comparable with those of other authors. CONCLUSIONS: The minimum-access surgery is a feasible option in the treatment of infertility in selected cases with satisfactory results


Subject(s)
Humans , Female , Endometriosis/etiology , Infertility, Female/surgery , Minimally Invasive Surgical Procedures , Polycystic Ovary Syndrome/etiology , Epidemiology, Descriptive , Longitudinal Studies , Prospective Studies
11.
Article in English | IMSEAR | ID: sea-135514

ABSTRACT

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of unknown etiology. Insulin resistance is very common and plays a central pathogenic role in PCOS. During last decade several studies have been conducted to understand the mechanisms contributing to the state of insulin resistance and insulin-induced hyperandrogenemia in PCOS. Insulin signaling pathways have been dissected in different insulin responsive tissues such as skeletal muscles, adipose tissues, fibroblasts as well as ovaries to elucidate the mechanism. These studies suggest a post receptor signaling defect where metabolic action of insulin is affected but not the steroidogenic and mitogenic actions. Despite advancement in these studies gaps exist in our understanding of the mechanism of insulin resistance as well as insulin-induced steroidogenesis in PCOS. The syndrome is now considered as a complex multigenic disorder. Efforts are ongoing to dissect the variants of genes from multiple logical pathways which are involved in pathophysiology of the syndrome. But still today no gene has been emerged as universally accepted susceptibility gene for PCOS. This review briefly describes the lacunae along with the current status of molecular events underlying insulin resistance and the contribution of insulin signaling pathway genes in pathogenesis of PCOS along with future researchable areas.


Subject(s)
Adipocytes/cytology , Adipocytes/metabolism , Adipose Tissue/metabolism , Animals , Female , Fibroblasts/cytology , Fibroblasts/physiology , Genetic Variation , Humans , Hyperandrogenism/complications , Hyperandrogenism/physiopathology , Insulin/metabolism , Insulin Resistance/physiology , Muscle, Skeletal/cytology , Muscle, Skeletal/physiology , Polycystic Ovary Syndrome/etiology , Polycystic Ovary Syndrome/physiopathology , Signal Transduction/physiology
12.
Rev. Soc. Argent. Endocrinol. Ginecol. Reprod ; 16(1): 26-33, mayo 2009. graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1171274

ABSTRACT

El síndrome de poliquistosis ovárica (PCOs) es un desorden multisistémico heterogéneo de etiología aun no totalmente definida y comúnmente asociado a obesidad e insulino-resistencia. La insulino-resistencia y la consecuente hiperinsulinemia juegan un rol clave en la patogénesis de PCOs. La importancia de este rol clave en PCOs ha sido recientemente confirmada por estudios con drogas insulino-sensibilizantes que restauran la función ovárica y disminuyen la biosíntesis y secreción de andrógenos en ovario, estableciendo una relación causalidad desde la insulino-resistencia hacia el desorden en el eje hipotálamo-hipófisi-gonadal. PCOs desde el punto de vista genético, es considerado un síndrome poligénico de herencia no mendeliana como lo son la diabetes tipo 2, la obesidad, la hipertensión arterial, etc. La segregación familiar tanto del rasgo metabólico como del hiperandrogenismo funcional sugiere una base hereditaria. Este desorden, se desarrolla por la combinación de factores de riesgo genéticos y factores ambientales desencadenantes. En PCOs se considera que las vías metabólicas principalmente afectadas serían: la síntesis de hormonas esteroideas, la síntesis y acción de la insulina y otros caminos metabólicos involucrados en diferentes mecanismos de regulación. Teniendo en cuenta las vías metabólicas afectadas, se postulan como genes candidatos a aquellos involucrados en los mecanismos de síntesis o regulación mencionados...


Subject(s)
Female , Humans , Polycystic Ovary Syndrome/etiology , Polycystic Ovary Syndrome/genetics , Polycystic Ovary Syndrome/metabolism
13.
Femina ; 36(12): 743-747, dez. 2008.
Article in Portuguese | LILACS | ID: lil-511413

ABSTRACT

A síndrome dos ovários policísticos é a endocrinopatia mais comum presente no consultório do ginecologista. No passado, representava apenas um problema estético e de irregularidade menstrual. Atualmente, está intimamente ligada à resistência insulínica, que pode acometer gravemente a saúde dessas mulheres, com repercussões metabólicas e cardiovasculares. O tratamento da SOP com a metformina melhora o hiperandrogenismo e regulariza os ciclos menstruais, facilitando a gravidez. Nesse momento surge a dúvida da continuidade do tratamento durante a gestação. Vários autores são favoráveis, devido aos efeitos benéficos da metformina, como a diminuição nas taxas de abortamentos precoces e de diabetes gestacional. As conclusões são obtidas em grande parte de estudos retrospectivos e ainda não são definitivas.


Polycystic ovary syndrome is the most common endocrine disorder found in a Gynecologists office. In the past, it represented only an aesthetic problem and menstrual irregularity. Nowadays, it is closely related to insulin resistance, which can severely affect the health of these women with metabolic and cardiovascular effects. The treatment of PCOS with metformin improves hyperandrogenism and regulates menstrual cycles facilitating conception. It is not known if the treatment should be extended through pregnancy. Many authors are favorable, due to the beneficial effects of metformin, such as lower first-trimester abortion and gestational diabetes rates. The conclusions are mostly obtained from retrospective studies and are not yet definitive.


Subject(s)
Female , Pregnancy , Pregnancy , Insulin Resistance , Metformin/therapeutic use , Polycystic Ovary Syndrome/diagnosis , Polycystic Ovary Syndrome/etiology , Polycystic Ovary Syndrome/drug therapy
14.
Rev. chil. endocrinol. diabetes ; 1(4): 263-270, oct. 2008. tab, ilus, graf
Article in Spanish | LILACS | ID: lil-612485

ABSTRACT

Currently there are two definitions for polycystic ovary syndrome (PCOS). One was proposed by the NIH Consensus Conference (1990), which defined it as the presence of hyperandrogenism and oligo-ovulation in the absence of other specific causes of ovarian, adrenal, or hypophyseal origin. The other proposed by the Rotterdam ESHRE/ASRM Consensus Conference (2003), which incorporates ovarian morphology to the definition generating four different phenotypes. Most women with PCOS exhibit peripheral insulin resistance, which plays a major role in the long-term metabolic consequences of the syndrome, among which type 2 diabetes and cardiovascular disease should be highlighted. Therefore, this syndrome is currently defined as a mainly endocrine metabolic disorder. PCOS could have a genetic predisposition that may manifest itself even before menarche. On the other hand, environmental factors during prenatal or postnatal life could lead to clinical and biochemical expressions of the syndrome in adult life. At present, it is accepted that prenatal exposure to androgens during fetal life is implicated in the origin of this syndrome. We have demonstrated that PCOS mothers may offer a hyperandrogenic and hyperinsulinemic milieu to the female and male fetus. This adverse intrauterine milieu could induce fetal programming consequences, which are evidenced by a high frequency of low-birth weight infants and changes in the testicular and ovarian function. Moreover, some of the metabolic features of PCOS are present in the offspring of PCOS women. Therefore, these children are a high risk group for metabolic and reproductive alterations. Consequently the treatment for this syndrome must not only be symptomatic but also fundamentally preventive. For this reason, PCOS should be considered a marker of a family pathology, a pathway to type 2 diabetes, and a public health problem.


Subject(s)
Humans , Female , Polycystic Ovary Syndrome/diagnosis , Polycystic Ovary Syndrome/etiology , Polycystic Ovary Syndrome/therapy , Polycystic Ovary Syndrome/genetics
15.
Femina ; 36(8): 477-483, ago. 2008.
Article in Portuguese | LILACS | ID: lil-508540

ABSTRACT

Este trabalho trata-se de uma revisão da síndrome dos ovários policísticos (SOP) em relação aos seus aspectos etiopatogênicos, clínicos, diagnósticos e terapêuticos. Tecem-se considerações sobre a importância não só de efetivo tratamento médico como também de abordagem e apoio psicológico, no sentido de melhorar ainda mais o bem-estar e a qualidade de vida dessas mulheres


The authors have reviewed the main aspects of the polycystic ovary syndrome (PCOS) with respect to its etiopathogenic, clinical, diagnostic and therapeutic features. They also make considerations on the importance of an effective clinical treatment as well as on the approaches and psychological support, aiming to improve women's well-being and quality of life


Subject(s)
Female , Hyperandrogenism/diagnosis , Hyperandrogenism/physiopathology , Hyperandrogenism/therapy , Polycystic Ovary Syndrome/diagnosis , Polycystic Ovary Syndrome/etiology , Polycystic Ovary Syndrome/physiopathology , Polycystic Ovary Syndrome/therapy , Anovulation/etiology , Clinical Diagnosis , Physical Examination , Quality of Life
16.
Femina ; 36(4): 201-206, abr. 2008. tab
Article in Portuguese | LILACS | ID: lil-493956

ABSTRACT

A policistose ovariana (PCO) é entidade clínica muito frequente na ginecologia e bem conhecida pelos especialistas. Descrita há mais de dois séculos, tem ainda muitas características clínicas indefinidas. A síndrome metabólica (SM) é outra condição patogênica com roupagem clínica superponível à PCO. A SM teve identificação e descrição mais recente, apesar de já ser abordada há muito na prática clínica. A importância das duas condições mórbidas está relacionada aos distúrbios associados graves que, se não identificados e prontamente tratados, encurtarão a vida e comprometerão a qualidade de vida das portadoras. Diversos critérios foram elaborados para diagnóstico das duas condições patogênicas e o diagnóstico diferencial se impõe para exclusão de outras doenças. O ginecologista está em posição de destaque para identificação, tratamento ou envio das pacientes para outros especialistas quando requerido pelas condições clínicas das pacientes.


Subject(s)
Female , Diagnosis, Differential , Insulin Resistance , Metformin/therapeutic use , Metabolic Syndrome/diagnosis , Polycystic Ovary Syndrome/diagnosis , Polycystic Ovary Syndrome/etiology , Infertility, Female , Obesity/complications
17.
Arq. bras. endocrinol. metab ; 50(6): 1026-1033, dez. 2006. ilus, tab
Article in Portuguese, English | LILACS | ID: lil-439721

ABSTRACT

OBJETIVO: Avaliar a sensibilidade insulínica e o perfil metabólico em portadoras de SOP com peso normal e sobrepeso/obesas. MATERIAL E MÉTODOS: Foram avaliadas, retrospectivamente, 49 pacientes, entre 18 e 45 anos, divididas em 2 grupos, conforme o índice de massa corporal (IMC): grupo 1 (18,5-24,9 kg/m²) e grupo 2 (25-40 kg/m²). Dados coletados: pressão arterial sistólica (PAS) e diastólica (PAD); valores basais e após TOTG da glicose, insulina, e da relação glicose/insulina; área sob a curva para glicose e insulina; HOMA-IR, HOMA-beta; perfil lipídico; testosterona total (T) e livre (TL). RESULTADOS: Maiores médias de níveis pressóricos, insulina, triglicerídeos, TL e índices de resistência insulínica, além de menores níveis de HDL, foram encontrados no grupo 2. Não houve correlação entre o IMC com nenhum dos dados, nem da TL e dos índices de RI com o perfil lipídico. CONCLUSÕES: A obesidade está associada a maior prevalência de RI e DM na SOP, independentemente da história familiar de DM. A ausência de correlação entre os índices de RI e da TL com o perfil lipídico sugerem que outros fatores, como os ácidos graxos livres (AGL), possam estar envolvidos na patogênese da dislipidemia na SOP.


OBJECTIVE: To evaluate insulin sensitivity and the metabolic features in normal weight and overweight/obese patients with PCOS. SUBJETS AND METHODS: Forty-nine (49) patients from 18 to 45 years were retrospectively evaluated and divided into 2 groups, according to the body mass index (BMI): group 1 (18.5-24.9 kg/m²) and group 2 (25-40 kg/m²). Colected data: systolic and dyastolic blood pressure; fasting and after OGTT glucose, insulin and glucose/insulin ratio; area under the curve for glucose and insulin; HOMA-IR and HOMA-beta; lipidic profile; free (FT) and total testosterone (T) levels. RESULTS: Greater averages of pressoric levels, insulin resistance (IR) indices, triglycerides and the FT levels, in adition to lower HDL levels, were found in group 2. Neither correlation between the IMC with none of data nor of the FT and IR indices with the lipid profile were found. CONCLUSIONS: Obesity is associated with insulin resistance and diabetes mellitus in PCOS, independently on familiar history of DM. The absence of correlation between the IR indices and the FT with the lipidic profile suggests that other factors, such as the free fatty acids, can be involved in the pathogenesis of dyslipidemia in PCOS.


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Insulin Resistance/physiology , Insulin/metabolism , Lipid Metabolism/physiology , Obesity/metabolism , Polycystic Ovary Syndrome/metabolism , Body Mass Index , Blood Pressure/physiology , Cross-Sectional Studies , Dyslipidemias/etiology , Glucose Tolerance Test , Insulin/blood , Lipids/blood , Obesity/complications , Polycystic Ovary Syndrome/etiology , Retrospective Studies , Statistics, Nonparametric
19.
Rev. méd. Chile ; 134(1): 101-108, ene. 2006.
Article in Spanish | LILACS | ID: lil-426126

ABSTRACT

Both epidemiological and clinical evidence suggest a relationship between the prenatal environment and the risk of developing diseases during adulthood. The first observations about this relationship showed that prenatal growth retardation or stress conditions during fetal life were associated to cardiovascular, metabolic and other diseases in later life. However, not only those conditions may have lasting effects after birth. Growing evidence suggests that prenatal exposure to steroids (either of fetal or maternal origin) could be another source of prenatal programming with detrimental consequences during adulthood. We have recently demonstrated that pregnant women with polycystic ovary syndrome exhibit elevated androgen levels compared to normal pregnant women, which could provide an androgen excess for both female or male fetuses. We have further tested this hypothesis in an animal model of prenatal androgenization, finding that females born from androgenized mothers have a low birth weight and high insulin resistance, that starts at an early age. On the other hand, males have low testosterone and LH secretion in response to a GnRH analogue test compared to control males and alterations in seminal parameters. We therefore propose that our efforts should be directed to modify the hyperandrogenic intrauterine environment to reduce the potential development of reproductive and metabolic diseases during adulthood.


Subject(s)
Animals , Female , Humans , Male , Pregnancy , Androgens/metabolism , Fetal Growth Retardation/etiology , Hyperandrogenism/complications , Prenatal Exposure Delayed Effects , Polycystic Ovary Syndrome/etiology , Fetal Growth Retardation/metabolism , Hyperandrogenism/metabolism , Polycystic Ovary Syndrome/metabolism
20.
Article in Portuguese | LILACS | ID: lil-435538

ABSTRACT

Os autores fazem uma revisão da síndrome dos ovários policísticos (SOP) com relação aos seus aspectos etiopatogênicos, clínicos, diagnósticos e terapêuticos, dando ênfase aos transtornos de ordem psíquica que freqüentemente acompanham esse distúrbiio. Tecem considerações sobre a importância não só de um efetivo tratamento médico, mas também de uma abordagem e um apoio psicológico, no sentido de melhorar ainda mais o bem-estar e a qualidade de vida dessas mulheres.


The authors have reviewed the main aspects of the polycystic ovary syndrome (PCOS) with respect to its etiopathogenic, clinical, diagnostic and therapeutic features, highlighting the psychological distresses that frequently arise in the syndrome. They also make considerations on the importance of an effective clinical treatment as well as on the approaches and psychological support, aiming to improve womenÆs well-being and quality of life.


Subject(s)
Humans , Female , Anovulation/diagnosis , Polycystic Ovary Syndrome/etiology , Mental Disorders/psychology , Anovulation/classification , Anovulation/psychology , Anovulation/therapy , Chronic Disease , Quality of Life , Polycystic Ovary Syndrome/epidemiology , Polycystic Ovary Syndrome/psychology
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