Iranian Journal of

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Background: Polycystic ovary syndrome (PCOS) which is characterized by menstrual irregularities (due to chronic anovulation) and hyperandrogenism is one of the most common endocrine disorders of women at reproductive age. The precise cause of PCOS is unknown, but it seems that several factors may have role in its pathogenesis. Insulin resistance and impaired insulin secretion are common findings in PCOS patients. Approximately 30 – 40 % of women with PCOS have impaired glucose tolerance or type 2 DM. According to my knowledge, there is no published study about prevalence of IGT and type 2 Diabetes Mellitus (type 2 DM) in Iranian women with PCOS. The aim of this prospective, controlled study was to determine the prevalence of abnormal glucose metabolism in women from north west part of the country.
Methods: 302 PCOS women and 116 normal women as a control group were prospectively studied. The diagnosis of PCOS was made based upon the presence of chronic anovulation and hyperandrogenemia. Other causes of hyperandrogenism were excluded by appropriate clinical and laboratory evaluations. None of the patients were known diabetics prior to study. 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 hirsutism and other signs of androgen excess were determined. Serum concentrations of total testosterone and DHEA–S were measured by RIA methods in both patients and control group. Standard Oral Glucose Tolerance Test (OGTT) with 75 grams oral glucose was performed between 8 -9 AM after an overnight fast of 10 – 12 hours. Fasting and 2 – hour post - glucose plasma sugars were measured by glucose oxidase method. Results: Results of OGTT were interpreted according to WHO criteria. Mean age and mean BMI were similar in both patients and controls. Serum levels of total testosterone and DHEA – S were significantly higher in PCOS women in comparison with controls. 65% of patients and 68% of controls had BMI of ≥ 25 kg / m2. 55% of PCOS women and 51.6% of control women were obese (BMI ≥ 27kg/m2). 96 (31.7%) of PCOS women had impaired glucose tolerance (IGT) and 27 (8.9%) were diabetics. The prevalence of IGT and diabetes in controls were 14.6% and 5.1% respectively. In non-obese PCOS women the prevalence of IGT and DM were 17.2% and 3.6% respectively, while only 8.9% of control women had IGT and 1.7% were diabetics. Finally, 44.1% of obese PCOS women were glucose intolerant and 13.5% had diabetes mellitus in comparison with 20% and 10% of controls. Conclusion: It is concluded that the prevalence of IGT and DM in both obese and non–obese PCOS women were significantly higher than in control women. Screening of all PCOS women for IGT and DM is highly recommended.

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Background: 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. Methods: 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. Results: 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. Conclusion: 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

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Background : Women with polycystic overy syndrome (PCOS) are sussceptible for developing type 2 diabetes (T2DM) and cardiovascular diseases. In view increased prevalence of T2DM in patients with PCOS and priority of prescription agents capable to decrease insulin resistances for them, It is important to diagnose PCOS in T2DM patients. The aim of this study was to evaluate the prevalence of PCOS in T2DM women.
Methods : Using ‘1990 National Institute of Child Health and Human Development Conference of PCOS’ criteria, 157 premenopausal women with T2DM were assigned into PCOS and non – PCOS groups after they were examined for the evidences of clinical PCOS. A questionnaire on reproductive history was completed and the waist circumference, weight, height and BP were measured for each participant. Biochemical tests were performed in both groups, but hormonal measurements were requested only for PCOS group.
Results : The prevalence of PCOS was high (about 8%) among subjects. Patients with PCOS had significantly lower age at the onset of diabetes, higher BMI and waist circumference. The differences in BP, serum TG, HDL, LDL, cholesterol and HbA1c were non – significant between 2 groups and insulin resistance is more.
Conclusion : PCOS is prevalent in diabetic women and Insulin resistance is more likely in those with both PCOS and T2DM resistant than whom with diabetes alone. Emphasis on reducing insulin resistance may be of benefit to achieve a better diabetes control in these patients.

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  Background : PCOS (Polycystic Ovary Syndrome = PCOS) is a relatively common disease in women of childbearing age. Bisphenol s are chemical groups that are composed of two functional hydroxyl group and most of them are based on methane. In this study, the effects of phenolic compounds, (bisphenol A and AP) in polycystic ovary syndrome were investigated.

  Methods : mature Wister rats were classified in six groups . Healthy controls ( healthy rats that received Grape seed Oil as solvent ), PCOS Group ( disease induced by testosterone propionate ) experimental groups 1.2.3.4 , respectively. after induction of PCOS,they received bisphenol- A and AP in doses of25 mg / kg, 50mg/kg, by gavage . Blood samples were taken and the hormones LH, FSH was measured . Ovaries were also to be studied histologically .

  Results : The results showed that the amount of LH to FSH ratio increases after induction with bisphenol-A and bisphenols AP,. Furthermore the number of follicles and growing follicles were reduced significantly, and these concequences causing negative effects on polycystic ovary syndrome.

 

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Background: Considering the limited population-based studies and lack of a general consensus on the most sensitive and precise predictor of insulin resistance and metabolic syndrome in the women with polycystic ovary syndrome (PCOS), the present study was performed with the aim of comparing the validity of various available adiposity markers in these patients. Methods: In the national and population-based study of PCOS prevalence, 1772 girls and women, aged 18-45 years, were assessed for the diagnosis of PCOS based on Rotterdam criteria. Waist circumference, body mass index, waist to hip ratio, lipid accumulation product, visceral adiposity index (VAI) and homeostasis assessment model- insulin resistance (HOMA-IR) were calculated. The diagnosis of metabolic syndrome was based on Joint Interim Statement (JIS)criteria and HOMA-IR&ge 2.3 was considered as the resistance cutoff point. Results: In among different markers, VAI served as the best predictor of insulin resistance (sensitivity %60, positive predictive value %83) and metabolic syndrome (sensitivity %97, positive predictive value %95). ROC curve showed the cutoff points of 1.8 and 3.1 as the optimum values for insulin resistance and metabolic syndrome prediction, respectively. Conclusion: It seems that visceral adiposity index is a reliable marker for the screening of cardiometabolic disorders in the women with PCOS.