Correlation of Serum Anti-Mullerian Hormone with Clinical, Metabolic and Hormonal Parameters in Bangladeshi Women with Polycystic Ovary Syndrome: A Cross-sectional Study.

Metabolic dysfunctions are common in polycystic ovary syndrome (PCOS). Alongside its utility in PCOS diagnosis, anti-Mullerian Hormone (AMH) is emerging as a metabolic risk marker in PCOS. Data relating to the metabolic importance of AMH in Bangladeshi women with PCOS are lacking. This study aimed to evaluate serum AMH in newly diagnosed women with PCOS and correlate the AMH levels with their clinical, hormonal, and metabolic parameters. This cross-sectional study evaluated 150 newly diagnosed women with PCOS attending a tertiary hospital in Bangladesh from January 2020 to December 2020. Alongside clinical assessment, blood glucose, lipids, total testosterone (TT), thyroid-stimulating hormone (TSH), prolactin and AMH were measured. The median age of the study subjects was 21.5 years (interquartile range 18.0-26.0 years); the median AMH level was 5.09ng/dL (interquartile range 3.64-7.73ng/dL) and 52.0% had metabolic syndrome. Age, body mass index, waist circumference, systolic and diastolic blood pressure, fasting plasma glucose, plasma glucose 2 hours after oral glucose tolerance test, triglyceride, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, TT, TSH, and prolactin levels and the frequencies of hirsutism and metabolic syndrome were similar across the quartiles of AMH. AMH correlated with none of the variables except TT, with which a strong positive correlation was found. Participants with PCOS phenotype A had the highest AMH levels, and the difference in AMH across the phenotypes was statistically significant.

Frequency and Correlates of Albuminuria in Adult Bangladeshi Women with Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is associated with various metabolic risks imparting a higher risk for cardiovascular diseases (CVD) in affected women. Urinary albumin excretion (UAE) is a marker of endothelial leakiness and reflects early endothelial damage; thus is used as an important cardiovascular (CV) risk marker. UAE as a CV risk marker in PCOS patients is less well established. This cross-sectional study was done in a tertiary hospital of Bangladesh from January to December 2018 and 95 consecutive adult PCOS patients were screened for UAE. Clinical and anthropometric data were collected, and oral glucose tolerance test (OGTT), fasting lipid profile, serum creatinine, urine routine examination, total testosterone, prolactin, and TSH were measured. The urine albumin-to-creatinine ratio (UACR) was measured in a random single-voided urine sample. UACR cutoff ≥30mg/g was used to define albuminuria. The mean age of the subjects was 22.5±5.0 years; 72.6% were overweight/ obese; 68.4% had abdominal obesity; 94.7% had dyslipidemia and 40% of them had metabolic syndrome. Albuminuria was observed in 21.1% of the subjects. A higher frequency of metabolic syndrome was observed in albuminuric subjects than non-albuminuric ones (45% vs. 38.7%), though the difference was not statistically significant (p=0.617). Albuminuric subjects had higher plasma glucose (PG) value at 2 hours of OGTT and a higher frequency of acne. Other clinical, biochemical and hormonal parameters were similar in the two groups. PG 2 hours after OGTT and serum triglyceride (TG) showed positive correlations and LDL cholesterol showed a negative correlation with UACR. Our study emphasizes the need for screening PCOS women for UACR which may be helpful in identifying those subjects with future high risk of CVD.

Aetiological Factors of Female Genitourinary Fistula.

The purpose of this observational cross-sectional study was to evaluate the histories of women with urinary incontinence caused by genitourinary fistulae in Bangladesh. This is an exploratory analysis to investigate possible contributing factors to the development of urogenital fistulae. Sixty four (64) women who were treated for urogenital fistulae at the National Fistula Center, Dhaka Medical College Hospital, Dhaka, Bangladesh were interviewed from July 2013 to December 2013. Their average age was 35.91 years; majorities were illiterate; had early marriage and came from poor family. Majority had height less than 150 cm, body weight 50 Kg or less and 67.19% of the women were multigravid. Obstetrical aetiology predominated in fistula causation and vesicovaginal fistula was the most frequent fistula type. Most of the women with fistulas did not receive antenatal care (88.46%); had developed a fistula after laboring for 48 hours or longer (59.61%) with vaginal delivery (59.61%) at home (57.69%) and within seven days of delivery (63.45%). Most women who experienced fistulae also had poor obstetric outcomes. Increasing access to emergency obstetric care is of paramount importance to prevent fistula formation.