Main Article Content
Abstract
Objective: The Aim of the study was to determine the prevalence of metabolic syndrome, and it’s main determinants in women with PCOS.
Methods: Two –hundred twenty women , 105 patients with polycystic ovary syndrome ( PCOS) and 115 control , were included in this study to determine the prevalence of the metabolic syndrome & its main determinants among women with PCOS .
Results: The study revealed that 82.1% of women with PCOS were nulliparae compared to 8.91% of controls ( P < 0.001) . Blood pressure > 130/ 85 mm.Hg and waist circumference > 88 cm were found among 37.14% and 60% of patients with PCOS respectively in comparison to 12.17% and 25.2% of control women respectively ( P <0.001). Over weight and obesity were observed among 48.6% and 40% of PCOS women respectively compared to 25.2% and 12.2% of controls respectively ( P < 0.001) . Only 3.3% of patients with PCOS were fertile , 73.9% with primary infertility and 22.8% with secondary infertility . The comparative figures among controls were 82.3% , 4.2% and 13.5% ( P < 0.001) . The main menstrual disorder associated with PCOS was oligomenorrhoea , observed in 72.4 of patients , compared to 3.5% in control women ( P < 0.001) . Hirsutism was found among 62.9% of PCOS patients in comparison to 5.2% of controls ( P < 0.001) . Women with PCOS showed significantly higher FBG , TC, TG and LDL-C levels ( P < 0.001) and significantly lower HDL-C levels ( P < 0.01) compared to control women .
The frequency of metabolic syndrome in PCOS was 34.3% compared to 6.1% in conrol women ( P < 0.001) .
Conclusion : the prevalence of metabolic syndrome in PCOS is nearly 6 times higher than in controls . Women with PCOS share multiple cardiovascular risk factors , and thereby , more prone to cardiovascular events .
Article Details
References
- Beata Banszewska , Antoni J, Robert Z, Leszek P : Lipids in polycystic ovary syndrome ; Role of hyperinsulinemia and effects of metformin ; American Journal of obstetric and Gynaecology. ( 2006); 194: PP 1266-72 .
- Diamanti-Kandarakis E , Kouli CR, Filandraf A et al : A survey of the polycystic ovary syndrome in the Greek island of Lesbos ; hormonal and metabolic profile – J clin Endocrino Metab . 1999 ; 84(11) : PP 4006-11 .
- Elting MW, Korsen TJ, Schoemaker J : Obesity , rather than menstrual cycle pattern or follicle cohort size , determines hyperinsulinaemia, dyslipidaemia and hypertension in ageing women with polycystic ovary syndrome . Clinical Endocrinology 2001;55(6): PP 767-76 .
- Atiomo WV, Bates SA , condon JE. et al . The plasminogen activator system in women with polycystic ovary syndrome . Fertility sterility 1998; 69: PP 236-41 .
- Conway GS, Agrawal R, Betteridge DJ, Jacobs HS . Risk factors for coronary artery disease in lean and obese women with the polycystic ovary syndrome . Clinical Endocrinology 1992; 37: PP 119-25.
- Glueck CJ , Morrison JA, Friedman LA. et al. Obesity , free testosterone , and cardiovascular risk factors in adolescents with polycystic ovary syndrome and regularly cycling adolescents . Metabolism . 2006; 55: PP 508-14 .
- Silva Rdo C, Pardini DP, Kater CE. Polycystic ovary syndrome, metabolic syndrome, cardiovascular risk and the role of insulin sensitizing agents . Arq Bras Endocrinol Metabol . 2006; 50(2) : PP 281-90 .
- Sharma ST, Nestler JE. Prevention of diabetes and cardiovascular disease in women with PCOS : Treatment with insulin sensitizers. Endocrinology and Metablism . 2006; 20: PP 245-60 .
- Dokras A, Bochner M , Hollinrake E, Markham S, et al . Screening women with polycystic ovary syndrome for metabolic syndrome . 2005; 106(1) : PP 131-7 .
- Korhonen S, Hippelainen M, Niskanen L ; et al . Relationship of the metabolic syndrome and obesity to polycystic ovary syndrome : - a controlled , population – based study . Am . J Obstet Gynecol . 2001: 184( 3) : PP 289-96 .
- Federman DD. Ovary. In : Dale DC, Federman DD, Web MD Sciemtific American Medicine, 2003 edn. New York , Web MD Inc : 2003: 641-654 .
- Crowley WFJr, Hall JE, Martin KA, et al. An overview of the diagnostic consideration in polycystic ovary syndrome . Ann NY Acad Sci 1993; 687: 235 .
- Hayes FJ , Taylor AE, Martin KA, et al. Use of a gonadotropin – releasing hormone antagonist as a physiologic probe in polycystic ovary syndrome : assessment of neuroendocrine and androgen dynamics . J Clin Endocrinol Metab 1998; 83: 2343 .
- Ehrmann DA, Barnes RB, Rosenfield RL. Polycystic ovary syndrome as a form of functional ovarian hyperandrogenism due to dysregulation of androgen secretion . Endocr Rev 1995; 16: 322 .
- Azziz R, Black V, Hines GA, et al. Adrenal androgen excess in the poly cystic ovary syndrome: sensitivity and responsivity of the hypothalamic– pituitary – adrenal axis . J Clin Endocrinol Metab 1998; 83: 2317 .
- Barbieri RL. Hyperandrogenism , insulin resistance and a canthosis nigricans : 10 years of progress . J Reprod Med 1994; 93: 327 .
- Dunaif A. Insulin resistance and the polycystic ovary syndrome : mechanism and implications for pathogenesis . Endocr Rev 1997; 18: 774.
- Kazer RR. The polycystic ovary. Semin Reprod Endocrinol 1997; 15 (3).
- How lett TA. Endocrine disease . In : Kumar P, Clark M. Clinical Medicine , 6th edn. Edinburgh , Elsevier Saunders , 2005: 1035-1100 .
- Glueck CJ, Papanna R, Wang P et al . Incidence and treatment of metabolic syndrome in newly referred women with confirmed polycystic ovarian syndrome . Metabolism . 2003; 52: PP 908-15 .
- Ehrmann DA, Liljenquist DR, Kaszak et al . Prevalence and predictors of metabolic syndrome in women with polycystic ovary syndrome. J Clin. Endocrinology and Metabolism . 2006; 91: PP 48-53 .
- Faloia E, Canibus P, Gattic , et al. Body composition , fat distribution and metabolic characteristics in lean and obese women with polycystic ovary syndrome . J Endocrinol Invest . 2004; 27( 5): PP 424-9.
- Ricardo Azziz . How Prevalent is Metabolic Syndrome in Women With Polycystic Ovary Syndrome ? Nature clinical Practice Endocrinology and Metabolism. 2006; 2: PP 260-264 .
- Barbieri RL. Polycystic ovary syndrome. In : Dale DC, Federman DD. Web MD Scientific American Medicine , 2003 edn, New York ; web MD Inc: 2003: 962-972 .
- Sam S, Legro RS, Bentley-Lewis R, Dunsif A. Dyslipidemia and metabolic syndrome in the sisters of women with polycystic ovary syndrome . J Clin . Endocrinology and Metabolism .
- Rajkhowa M, Neary RH, Kumpatla P, et al. Altered composition of high density lipoproteins in women with the polycystic ovary syndrome. J clin . Endocrinology and Metabolism . 1997; 82(10): PP 3389-94 .
- Pirwany IR, Fleming R, Greer IA, et al . Lipids and lipoprotein subfractions in women with PCOS : relationship to metabolic and endocrine parameters . Clin . Endocrinol . 2001; 54(4): PP 447-53 .
- Carmina E, Napoli N, Longo RA, et al . Metabolic syndrome in polycystic ovary syndrome . ( PCOS) : lower prevalence in southern Italy than in the USA and the influence of criteria for the diagnosis of PCOS . Eur J Endocrinol . 2006; 154(1): 141-5 .
- Carmina E. Metabolic syndrome in polycystic ovary syndrome . Minerva Ginecol. 2006; 58(2): PP 109-14 .
References
Beata Banszewska , Antoni J, Robert Z, Leszek P : Lipids in polycystic ovary syndrome ; Role of hyperinsulinemia and effects of metformin ; American Journal of obstetric and Gynaecology. ( 2006); 194: PP 1266-72 .
Diamanti-Kandarakis E , Kouli CR, Filandraf A et al : A survey of the polycystic ovary syndrome in the Greek island of Lesbos ; hormonal and metabolic profile – J clin Endocrino Metab . 1999 ; 84(11) : PP 4006-11 .
Elting MW, Korsen TJ, Schoemaker J : Obesity , rather than menstrual cycle pattern or follicle cohort size , determines hyperinsulinaemia, dyslipidaemia and hypertension in ageing women with polycystic ovary syndrome . Clinical Endocrinology 2001;55(6): PP 767-76 .
Atiomo WV, Bates SA , condon JE. et al . The plasminogen activator system in women with polycystic ovary syndrome . Fertility sterility 1998; 69: PP 236-41 .
Conway GS, Agrawal R, Betteridge DJ, Jacobs HS . Risk factors for coronary artery disease in lean and obese women with the polycystic ovary syndrome . Clinical Endocrinology 1992; 37: PP 119-25.
Glueck CJ , Morrison JA, Friedman LA. et al. Obesity , free testosterone , and cardiovascular risk factors in adolescents with polycystic ovary syndrome and regularly cycling adolescents . Metabolism . 2006; 55: PP 508-14 .
Silva Rdo C, Pardini DP, Kater CE. Polycystic ovary syndrome, metabolic syndrome, cardiovascular risk and the role of insulin sensitizing agents . Arq Bras Endocrinol Metabol . 2006; 50(2) : PP 281-90 .
Sharma ST, Nestler JE. Prevention of diabetes and cardiovascular disease in women with PCOS : Treatment with insulin sensitizers. Endocrinology and Metablism . 2006; 20: PP 245-60 .
Dokras A, Bochner M , Hollinrake E, Markham S, et al . Screening women with polycystic ovary syndrome for metabolic syndrome . 2005; 106(1) : PP 131-7 .
Korhonen S, Hippelainen M, Niskanen L ; et al . Relationship of the metabolic syndrome and obesity to polycystic ovary syndrome : - a controlled , population – based study . Am . J Obstet Gynecol . 2001: 184( 3) : PP 289-96 .
Federman DD. Ovary. In : Dale DC, Federman DD, Web MD Sciemtific American Medicine, 2003 edn. New York , Web MD Inc : 2003: 641-654 .
Crowley WFJr, Hall JE, Martin KA, et al. An overview of the diagnostic consideration in polycystic ovary syndrome . Ann NY Acad Sci 1993; 687: 235 .
Hayes FJ , Taylor AE, Martin KA, et al. Use of a gonadotropin – releasing hormone antagonist as a physiologic probe in polycystic ovary syndrome : assessment of neuroendocrine and androgen dynamics . J Clin Endocrinol Metab 1998; 83: 2343 .
Ehrmann DA, Barnes RB, Rosenfield RL. Polycystic ovary syndrome as a form of functional ovarian hyperandrogenism due to dysregulation of androgen secretion . Endocr Rev 1995; 16: 322 .
Azziz R, Black V, Hines GA, et al. Adrenal androgen excess in the poly cystic ovary syndrome: sensitivity and responsivity of the hypothalamic– pituitary – adrenal axis . J Clin Endocrinol Metab 1998; 83: 2317 .
Barbieri RL. Hyperandrogenism , insulin resistance and a canthosis nigricans : 10 years of progress . J Reprod Med 1994; 93: 327 .
Dunaif A. Insulin resistance and the polycystic ovary syndrome : mechanism and implications for pathogenesis . Endocr Rev 1997; 18: 774.
Kazer RR. The polycystic ovary. Semin Reprod Endocrinol 1997; 15 (3).
How lett TA. Endocrine disease . In : Kumar P, Clark M. Clinical Medicine , 6th edn. Edinburgh , Elsevier Saunders , 2005: 1035-1100 .
Glueck CJ, Papanna R, Wang P et al . Incidence and treatment of metabolic syndrome in newly referred women with confirmed polycystic ovarian syndrome . Metabolism . 2003; 52: PP 908-15 .
Ehrmann DA, Liljenquist DR, Kaszak et al . Prevalence and predictors of metabolic syndrome in women with polycystic ovary syndrome. J Clin. Endocrinology and Metabolism . 2006; 91: PP 48-53 .
Faloia E, Canibus P, Gattic , et al. Body composition , fat distribution and metabolic characteristics in lean and obese women with polycystic ovary syndrome . J Endocrinol Invest . 2004; 27( 5): PP 424-9.
Ricardo Azziz . How Prevalent is Metabolic Syndrome in Women With Polycystic Ovary Syndrome ? Nature clinical Practice Endocrinology and Metabolism. 2006; 2: PP 260-264 .
Barbieri RL. Polycystic ovary syndrome. In : Dale DC, Federman DD. Web MD Scientific American Medicine , 2003 edn, New York ; web MD Inc: 2003: 962-972 .
Sam S, Legro RS, Bentley-Lewis R, Dunsif A. Dyslipidemia and metabolic syndrome in the sisters of women with polycystic ovary syndrome . J Clin . Endocrinology and Metabolism .
Rajkhowa M, Neary RH, Kumpatla P, et al. Altered composition of high density lipoproteins in women with the polycystic ovary syndrome. J clin . Endocrinology and Metabolism . 1997; 82(10): PP 3389-94 .
Pirwany IR, Fleming R, Greer IA, et al . Lipids and lipoprotein subfractions in women with PCOS : relationship to metabolic and endocrine parameters . Clin . Endocrinol . 2001; 54(4): PP 447-53 .
Carmina E, Napoli N, Longo RA, et al . Metabolic syndrome in polycystic ovary syndrome . ( PCOS) : lower prevalence in southern Italy than in the USA and the influence of criteria for the diagnosis of PCOS . Eur J Endocrinol . 2006; 154(1): 141-5 .
Carmina E. Metabolic syndrome in polycystic ovary syndrome . Minerva Ginecol. 2006; 58(2): PP 109-14 .
