Evaluation of dyslipidemia in polycystic ovary syndrome

Polycystic ovary syndrome[PCOS] is the most endocrinopathy in women and the most common causes of anovulatory infertility. Women with this disorder moreover the common manifestations such as, irregular menses, hirsutism and infertility, are susceptible to serious consequences like increase risk of endometrial carcinoma, dyslipidemia, hypertention, glocose intolerance, diabetes, cardiovascular problems and probably breast cancer. This study was conducted to demostrate the demographic, clinical, metabolic and hormonal conditions of the PCOS patients. A case-control study was performed on females with PCOS age group 15-40 years referring to endocrine and gynecology clinics. A control healthy woman was selected for each patient. The diagnosis of PCOS was made based upon the prescence of chronic anovolation and hyperandrogenemia .Other causes of hyperandrogenism were excluded by appropriate clinical and laboratory evalution .In all patients with PCOS and control women, appropriate medical history was taken and physical examination was done.Blood pressure, body weight, height, BMI, waist/hip ratio, score of hirsotism, acne, and other signs of androgen excess were determined.A venous blood sample were obtained at morning after 12'14hours fasting for measuring FBS, TG, Chol., LDL, HDL and hormonal profile, souch as:PROL, 17'OH Progestrone, Te, DHEA-S and TSH.Case of late onset adrenal hyperplasia, hypotyroidism and pituitary prolactinoma were excluded.The diagnosis of dyslipidemia was made upon the base of NCEP guidelines.Data was analyzed with Mann'Whitney U, T tests and Fisher's and Chi'Square Tests with SPSS-11. Mean age were similar in both patients and controls.Mean of BMI and diastolic pressure were significantly higher in PCOS women in comparison with controls. Hirsutism and oligomenorrhea were the most frequent clinical features[72.7% and 69.1% respectively]. SerumTG level was significantly higher in PCOS women in comparison with controls.There were no significant difference in FBS, Chol, LDL and HDL between patients and controls. The prevalence of high triglyceride, high cholesterol and high LDL levels were significantly higher in PCOS women in comparison with controls, but there were no significant difference in the prevalence of IFG and low HDL levels. The prevalence of high TG and high Chol level were significantly higher in obese PCOS women in comparison with non obese patients.There was no significant difference in the prevalence of high LDL and low HDL levels between obese and nonobese patients. Serum level of total Testostrone was significantly higher in PCOS women in comparison with controls.There were no significant difference in serum levels of DHEA-S, 17-OH Progestrone, Prolactine and TSH between patients and controls. The prevalence of obesity and dyslipidemia were higher in PCOS women in comparison with healthy women. For obese women with PCOS, behevioral weight management is the main component of overall treatment strategy and these patients counseling about the importance of life style management, diet and exercise shoud be emphasized. The patients should screened for dyslipidemia, diabetes and hypertension. In this study there was no significant difference in FBS between two groups and IGT and DM may be better detected by OGTT. In all PCOS women for detecting dyslipidemia a fasting lipid profile is indicated

[ effect of combination therapy with gliclazide and metformin in control of blood glucose of type 2 diabetics]

Background: gliclazide is a second generation sulfonylurea which its efficacy and safety in the treatment of diabetes has been established. Diamicron MR [30 mg] is a new formulation of gliclazide with modified release which offer once daily dosage administration. This study was designed to assess the effect of combination therapy with diamicron and metformin in the treatment of type 2 diabetes

Methods: 16 patients with type 2 diabetes [2 males, 14 females] more than 35 years old who despite treatment with glibenclamide and metformin had poor diabetes control participated in this clinical trial.HbA1c, lipid profile, liver and renal function tests at the end of study were compared with before

Results: no significant changes was found in FBS, BS2hpp, lipid profile and renal and liver function tests at the end of study. Patients' weight was stable during the study

Conclusion: regardless of well efficacy of diamicron in the treatment of new diabetics cases, it is not recommended for patients with poor diabetes control despite of combination therapy with metformin and glibenclamide