[Homocysteinemia in polycystic ovary syndrome women]. / Homocisteinemia em mulheres com síndrome dos ovários policísticos.

PURPOSE: To compare serum homocysteine levels in polycystic ovary syndrome (PCOS) and non-PCOS women and correlate them with clinical, hormonal and metabolic parameters. METHODS: Transverse study with carried out on 110 women, including 56 with PCOS and 54 normal controls. Patients were submitted to anamnesis, physical examination and pelvic sonograms and to the determination of homocysteine, C-reactive protein (CRP), glucose insulin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), free thyroxin (Free T4), prolactin, and testosterone. For the statistical analysis, we used the Student's t test, Pearson's product-moment correlation coefficient and the chi(2) test. The "enter" method was used to determine independent association between variables. RESULTS: There was a significant increase in the average serum homocysteine levels in the group of patients with PCOS compared to controls (5.97+/-2.95 versus 5,17+/-1.33 micromol/L; p=0,015). As expected, since they are affected by PCOS, values of body mass index (BMI), waist circumference, total cholesterol, HDL cholesterol, triglycerides, insulin and HOMA were significantly different between groups. Serum homocysteine levels, BMI and PCOS were correlated. Multivariate analysis showed that PCOS, by itself, does not correlate with high serum homocysteine levels. CONCLUSIONS: PCOS women have significantly higher serum levels of homocysteine that may increase their risk for cardiovascular disease. However, other intrinsic PCOS-related factors, not identified in this study, may be responsible for this alteration.

Homocisteinemia em mulheres com síndrome dos ovários policísticos / Homocysteinemia in polycystic ovary syndrome women

Objetivos: comparar os níveis sanguíneos de homocisteína em mulheres com e sem a síndrome dos ovários policísticos (SOP) e correlacioná-los com os parâmetros clínicos, hormonais e metabólicos. Métodos: estudo tipo corte transversal com 110 mulheres: 56 com SOP e 54 controles normais. As pacientes foram submetidas à anamnese, exame físico e ultrassonografia pélvica, dosagens de homocisteína, da proteína C reativa (PCR), glicose, insulina, hormônio folículo-estimulante (FSH), hormônio luteinizante (LH), hormônio tireoide-estimulante (TSH), tiroxina livre (T4L), prolactina e testosterona.. Para análise estatística, foram usados os testes t de Student, χ2 e a correlação de Pearson. A realização da análise multivariada, pelo método "enter", foi utilizada para verificar a associação independente entre as variáveis. Resultados: encontrou-se um aumento significativo na média dos níveis plasmáticos de homocisteína nas pacientes com SOP quando comparadas ao Grupo Controle (5,9±2,9 versus 5,1±1,3 µmol/L; p=0,01). Como era esperado, por fazerem parte do quadro clínico da SOP, o índice de massa corpórea, circunferência abdominal, colesterol total, colesterol HDL, triglicerídeos, insulina e HOMA também se mostraram com diferenças significativas entre os dois grupos. Houve correlação da SOP e do IMC com os níveis de homocisteína. A análise multivariada mostrou que a SOP por si só não se correlaciona com altos níveis de homocisteína. Conclusões: pacientes com SOP estão expostas a níveis significativamente altos de homocisteína, porém outros fatores intrínsecos à síndrome, e não identificados neste estudo, seriam os responsáveis por esta alteração.

Purpose: to compare serum homocysteine levels in polycystic ovary syndrome (PCOS) and non-PCOS women and correlate them with clinical, hormonal and metabolic parameters. Methods: transverse study with carried out on 110 women, including 56 with PCOS and 54 normal controls. Patients were submitted to anamnesis, physical examination and pelvic sonograms and to the determination of homocysteine, C-reactive protein (CRP), glucose insulin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), free thyroxin (Free T4), prolactin, and testosterone. For the statistical analysis, we used the Student's t test, Pearson's product-moment correlation coefficient and the χ2 test. The "enter" method was used to determine independent association between variables. Results: there was a significant increase in the average serum homocysteine levels in the group of patients with PCOS compared to controls (5.97±2.95 versus 5,17±1.33 µmol/L; p=0,015). As expected, since they are affected by PCOS, values of body mass index (BMI), waist circumference, total cholesterol, HDL cholesterol, triglycerides, insulin and HOMA were significantly different between groups. Serum homocysteine levels, BMI and PCOS were correlated. Multivariate analysis showed that PCOS, by itself, does not correlate with high serum homocysteine levels. Conclusions: PCOS women have significantly higher serum levels of homocysteine that may increase their risk for cardiovascular disease. However, other intrinsic PCOS-related factors, not identified in this study, may be responsible for this alteration.

Disfunção endotelial e síndrome dos ovários policísticos I. Marcadores inflamatórios / Endothelial dysfunction in polycystic ovarian syndrome I. Inflammation markers

A síndrome dos ovários policísticos (SOP) acomete 5 a 10 porcento das mulheres na idade reprodutiva. A associação com vários distúrbios, entre eles as alterações no metabolismo glicêmico e a dislipidemia, já foi amplamente comprovada. Como portadoras de SOP são sabidamente mais propensas a desenvolver hipertensão arterial, diabetes, obesidade e alterações no perfil lipídico, esse grupo de pacientes tem sido cada vez mais investigado quanto à questão de constituírem uma população de risco para doenças cardiovasculares (DCV). Entretanto, os estudos de longo prazo não demonstram de forma consistente aumento efetivo na mortalidade cardiovascular. Diversos marcadores são cada vez mais pesquisados no intuito de se detectarem precocemente aqueles pacientes que seriam efetivamente de risco para DCV. Marcadores inflamatórios, como proteína C Reativa, homocisteína, moléculas de adesão, interleucinas e leucócitos, já foram descritos e investigados nas pacientes com SOP, mostrando, em grande parte dos estudos, correlação positiva entre SOP e estes marcadores, o que corrobora a maior predisposição às DCV

A prevalence of 5-10 percent of Polycystic Ovarian Syndrome (PCOS) is reported in adult women of reproductive age. Its association with several diseases, including alteration in the glicemic metabolism and dyslipidaemia has been widely shown. Sice PCOS sufferers are more likely to develop hypertension, diabetes, obesity and alterations in the lipidic profile, an increasing number of studies have investigated whether these patients are at greater risk for cardiovascular disease (CVD). Nevertheless, long-term epidemiological studies do not consistently show a higher rate of cardiovascular mortality. Several markers are being researched to find out which patients are really at greater risk to CVD. Inflammation markers, like C-reative Protein, homocysteine, adhesion molecules, interleukins and leukocytes have already been investigated in PCOS patients showing, in most studies, a positive correlation between PCOS and these markers, which corroborates a greater predisposition to CVD