Clinical characteristics of polycystic ovary syndrome in Indian women (original) (raw)
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Hormonal Profile of Polycystic Ovary Syndrome (PCOS) In Indian Women
2012
Hormonal profile of PCOS was studied in 102 Indian women. Serum levels of Luteinizing hormone (LH), Follicle stimulating hormone (FSH), LH:FSH ratio, Prolactin (PRL), Thyroid stimulating hormone (TSH), Dehydroepiandrosterone (DHEA), Testosterone, fasting blood glucose (FBG), fasting insulin levels and Homeostasis Model Assessment (HOMA) value were estimated. The mean LH and FSH levels are 12.54 ± 5.87 and 5.70 ± 1.80 (IU/L) respectively. The mean LH : FSH ratio is reversed and is more than two (2.23±0.94). Mean PRL, TSH, and testosterone levels show normal ranges. Mean fasting insulin (16.27±13.27 mU/ml) and HOMA (3.509±2.621) are high with 79.31% prevalence of insulin resistance. In all the patients, both LH and FSH are positively correlated with testosterone. In normal weight patients, PRL and LH: FSH are positively correlated. In overweight/obese serum LH and DHEA are positively correlated. A positive correlation is observed between testosterone and PRL in overweight/obese. On su...
Polycystic ovaries and associated metabolic abnormalities in Indian subcontinent Asian women
Clinical Endocrinology, 1998
Asian women was obtained from the lists of local General Practitioners and a translating service. These women were invited to attend for a medical history questionnaire, examination, venous blood sample for hormonal assessment and transvaginal ovarian ultrasonography. Groups of women without PCO or NIDDM, with NIDDM but not PCO, with PCO but not NIDDM and with both NIDDM and PCO were drawn at random from this population and from Indian subcontinent Asian women attending the Diabetes Unit. They underwent further studies, including measurement of insulin sensitivity using a short intravenous insulin tolerance test. SUBJECTS 212 Indian subcontinent Asian women aged 18-40 took part in the initial study. Insulin sensitivity was measured in 13 women without PCO or NIDDM, 13 women with NIDDM but not PCO, 15 women with PCO but not NIDDM and 12 women with both NIDDM and PCO. MEASUREMENTS The main outcome measures were prevalence of polycystic ovaries, clinical features of hyperandrogenism, fertility, blood pressure, serum gonadotrophins, testosterone and sex hormone binding globulin, fasting blood lipids, glucose and insulin, and insulin sensitivity. RESULTS The prevalence of PCO in Indian subcontinent Asian women was 52% (110/212). There were significant associations between PCO and menstrual irregularity; infertility; the Ferriman and Gallwey score for body hair distribution; the presence of acanthosis nigricans and the fasting blood glucose concentration. There were no differences between women with PCO and those with normal ovarian morphology with respect to systolic and diastolic blood pressure, fasting total, HDL and LDL cholesterol and triglyceride concentrations. The subgroup of women without PCO or NIDDM had the highest insulin sensitivity (189·1 Ϯ 46·4 mmol glucose/l/min, mean Ϯ SD) and the women with both PCO and NIDDM had the lowest insulin sensitivity (80.5 Ϯ 30.9 mmol glucose/l/min). There was no significant difference in insulin sensitivity between those with PCO but not NIDDM (125.0 Ϯ 59.5 mmol glucose/l/min) and those with NIDDM but not PCO (120·8 þ 38·0 mmol glucose/l/min). The effects of NIDDM and PCO on insulin sensitivity were independent; the effect of PCO on insulin sensitivity was ¹60 mmol glucose/l/min (95% confidence interval ¹100 to ¹21, P ¼ 0·004) and the effect of NIDDM was ¹68 mmol glucose/l/min (95% confidence interval ¹105 to ¹31, P < 0·001). There were no significant relationships between insulin sensitivity and fasting plasma insulin, systolic or diastolic blood pressure, fasting serum cholesterol or triglyceride. CONCLUSIONS The prevalence of polycystic ovaries in Indian subcontinent Asian women is very high and it has significant clinical associations. Polycystic ovaries and non-insulin dependent diabetes mellitus are associated with similar degrees of reduced insulin sensitivity in this population. Their effects are independent suggesting that these changes in insulin sensitivity involve different mechanisms. Polycystic ovaries unlike non-insulin dependent diabetes mellitus, are not associated with a defect in the secretion of insulin.
international journal of endocrinology and metabolism, 2014
Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine conditions affecting women of reproductive age with a prevalence of approximately 5-10% worldwide. PCOS can be viewed as a heterogeneous androgen excess disorder with varying degrees of reproductive and metabolic abnormalities, whose diagnosis is based on anthropometric, biochemical and radiological abnormalities. To our knowledge, this is the first study investigating the anthropometric, biochemical and ultrasonographic characteristics of PCOS in Asian Indians of South India, using the Androgen Excess Society (AES-2006) diagnostic criteria. Objectives: To assess anthropometric, biochemical and ultrasonographic features of PCOS subgroups and controls among South Indian women using the AES-2006 criteria. Materials and Methods: Two hundred and four women clinically diagnosed with PCOS, and 204 healthy women controls aged 17 to 35 years were evaluated. PCOS was diagnosed by clinical hyperandrogenism (HA), irregular menstruation (IM), and polycystic ovary (PCO). PCOS was further categorized into phenotypic subgroups including the IM+HA+PCO (n = 181, 89%), HA+PCO (n = 23, 11%), IM+HA (n = 0), and also into obese PCOS (n = 142, 70%) and lean PCOS (n = 62, 30%) using body mass index (BMI). Anthropometric measurements and biochemical characteristics were compared among the PCOS subgroups. Results: The PCOS subgroups with regular menstrual cycles (HA+PCO), had more luteinizing hormone (LH), follicle stimulating hormone (FSH), fasting glucose, fasting insulin, and high insulin resistance (IR) expressed as the Homeostasis Model Assessment (HOMA) score, compared with the IM+HA+PCO subgroups and controls. Similarly, the obese PCOS had high BMI, waist to hip ratio (WHR), fasting glucose, LH, LH/FSH, fasting insulin, HOMA score (IR), and dyslipidemia, compared with lean PCOS and controls. Unilateral polycystic ovary was seen in 32 (15.7%) patients, and bilateral involvement in 172 (84.3%) patients. All the controls showed normal ovaries. Conclusions: Anthropometric, biochemical, and ultrasonographic findings showed significant differences among PCOS subgroups. The PCOS subgroups with regular menstrual cycles (HA+PCO), had high insulin resistance (IR) and gonadotropic hormonal abnormalities, compared with the IM+HA+PCO subgroups and controls.
Polycystic ovary syndrome in the Indian Subcontinent
Seminars in Reproductive Medicine, 2008
Polycystic ovary syndrome (PCOS) is a complex, multifaceted, heterogeneous disorder that affects $5 to 10% of women of reproductive age. It is characterized by hyperandrogenism, polycystic ovaries, and chronic anovulation along with insulin resistance, hyperinsulinemia, abdominal obesity, hypertension, and dyslipidemia as frequent metabolic traits (metabolic syndrome) that culminate in serious long-term consequences such as type 2 diabetes mellitus, endometrial hyperplasia, and coronary artery disease. It is one of the most common causes of anovulatory infertility. However, the heterogeneous clinical features of PCOS may change throughout the life span, starting from adolescence to postmenopausal age, largely influenced by obesity and metabolic alterations, and the phenotype of women with PCOS is variable, depending on the ethnic background. The etiology of PCOS is yet to be elucidated; however, it is believed that in utero fetal programming may have a significant role in the development of PCOS phenotype in adult life. Though a woman may be genetically predisposed to developing PCOS, it is only the interaction of environmental factors (obesity) with the genetic factors that results in the characteristic metabolic and menstrual disturbances and the final expression of the PCOS phenotype. Irrespective of geographic locations, a rapidly increasing prevalence of polycystic ovarian insulin resistance syndrome, excess body fat, adverse body fat patterning, hypertriglyceridemia, and obesity-related disease, such as diabetes and cardiovascular disease, have been reported in Asian Indians, suggesting that primary prevention strategies should be initiated early in this ethnic group. In lieu of the epidemic increase in the prevalence of obesity and diabetes mellitus in most industrialized countries including China and India owing to Westernization, urbanization, and mechanization, and evidence suggesting a pathogenetic role of obesity in the development of PCOS and related infertility, active intervention to combat the malice of these disorders is warranted. Pharmacologic therapy is a critical step in the management of patients with metabolic syndrome when lifestyle modifications fail to achieve the therapeutic goals, and studies in China and India have proved to be effective.
Metabolic and Endocrine Characteristics of Indian Women with Polycystic Ovary Syndrome
International Journal of Fertility and Sterility, 2016
Polycystic ovary syndrome (PCOS) is one of the most common endocrinological disorders among women of reproductive age and the leading cause of female infertility. This study intends to evaluate the lipid profile, hormonal levels [free T3 (fT3), free T4 (fT4), thyroid stimulating hormone (TSH), insulin, luteinizing hormone (LH), follicle stimulating hormone (FSH), and prolactin] in PCOS women from Nellore and its surrounding districts of Andhra Pradesh, India. This cross-sectional study included 80 newly diagnosed PCOS women and an equal number of age and body mass index (BMI) matched healthy controls. We used the photometry methods to determine serum glucose levels and the lipid profile. An immunoturbidometry method was employed to measure high sensitive C-reactive protein (hsCRP). All hormonal parameters were measured using chemiluminescence immunoassays. Insulin resistance was evaluated using the homeostatic model assessment-insulin resistance (HOMA-IR) method. Statistical analysi...
POLYCYSTIC OVARY SYNDROME Polycystic Ovary Syndrome: A study from West Bengal, India
The purpose was to compare the menstrual characteristics, anthropometric and lifestyle variables between women with PCOS and healthy women matched for age in both married and unmarried categories. This cross-sectional study involved a total of 80 PCOS cases and 80 healthy controls matched for age belonging to both married and unmarried categories. Women with PCOS were identified following " Rotterdam criteria " with the help of medical practitioners from two medical hospitals in Kolkata. The unmarried controls were the students selected from schools of Konnagar, Hooghly and University of Calcutta. The married controls were selected from households of Konnagar Municipality area. The age range of the participants (case and controls) for unmarried and married were 14-33 years and 18-38 years respectively. Women with PCOS reported menstrual health problems more than controls, irrespective of marital status. Anthropometric characteristics showed that the incidence of obesity was noticeably higher among PCOS patients than controls in both married and unmarried categories. The controls were found to be engaged in physical activity more frequently than cases; however, food consumption failed to show conspicuous differences between cases and controls in both married and unmarried categories. The present study revealed significant differences in menstrual and anthropometric characteristics between PCOS patients and controls.
Prevalence and Clinical Profile of Patients with Polycystic Ovary Syndrome- A Hospital Based Study
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Polycystic ovary syndrome (PCOS) is said to be the commonest endocrine disorder of women of reproductive age with a heterogeneous presentation, which includes elevated androgen levels, menstrual irregularities, and/or small cysts on one or both ovaries. (1) On an average, it is affecting 4-8% of women of reproductive age. (2) Despite being an endocrine disease, it is also influenced by obesity and sedentary lifestyle. It is greatly affecting an-ovulatory infertility status of women affected by PCOS. We wanted to study prevalence of polycystic ovarian syndrome in patients coming to OPD & to study the clinical profile of PCOS among women of reproductive age group along with the incidence of obesity & influence of sedentary lifestyle. METHODS This was a hospital based cross-sectional study conducted among women of reproductive age group (15-45 years) attending Gynae. OPD at PIMS, Jalandhar. Women of reproductive age group (15-45 years) attending Gynae. OPD at PIMS, Jalandhar were enrolled in the study. RESULTS Out of the total 1140 cases examined during the study period, PCOS was diagnosed in 107 cases, giving prevalence of PCOS as 9.38% in the present study. Most of the cases (39.25%) were in the age group of 13-20 years Prevalence of PCOS, in the age group of 21-30 years was 27.10% and in age group of 41-50 years, it was only 11.21%. Prevalence of overweight/obesity was 45.79% in cases of PCOS. Patter of education distribution showed highest prevalence in less educated (primary education) in 36.44% with less prevalence in higher education group as 13.08% (Table 4). Most common menstrual abnormality seen among cases of PCOS was delayed menses with (34.57%) or without (27.10%) hypo-menorrhoea. Isolated hypo-menorrhoea was seen in 20.56% cases (Table 5). Out of total 107 cases, 48 (44.85%) were married (Table 6). Out of 48 married females, prevalence of infertility was 66.66% with 58.33% cases of primary infertility while 8.33% cases of secondary infertility (Table 7). History of regular intake of junk foods was given by 57.94% cases (Table 8). Sedentary lifestyle was observed in 49.53% cases (Table 9). CONCLUSIONS Though PCOS is a heterogeneous endocrine disease having genetic factors, environmental and nutritional factors affect its incidence a lot. Eating high calorie food with sedentary lifestyle and obesity affect the incidence and severity of PCOS. We have found in the present study that incidence of an-ovulatory infertility is also high. Since PCOS is a lifestyle disease adversely affecting fertility and physical appearance of the person, it can be prevented by modification of lifestyle, enabling girls to live a healthy life.
Polycystic ovary syndrome (PCOS) is a common problem among Arab women and is the main cause of infertility due to anovulation. This study investigates insulin resistance (IR) and obesity in different PCOS phenotypes among infertile women (n = 213), of whom 159 had PCOS and 54 women without PCOS, recruited as a control group. Biometric, hormonal and clinical parameters were studied. IR was observed in 133 (83.6%) women with PCOS and in 25 (46.3%) women without PCOS (p < 0.001). IR was significantly associated with PCOS only among women with central obesity (χ 2 = 35.0, p < 0.001) and not for the normal category (χ 2 = 4.04, p < 0.058). The LH/FSH ratio was not significantly different among the PCOS group (n = 37, 23.3%) compared to the control group (n = 9, 16.7%) (p = 0.308). Among women with PCOS, the most common phenotype was type I (50.3%), with type III (29.6%), type II (14.5%) and type IV (5.7%). Type I had the highest values of fasting insulin (median = 12.98 mU/ mL) and HOMA IR values (significant difference among the four phenotypes, p = 0.009 and 0.006, respectively) and is associated with severity of the disease. There was no difference in glucose levels. Polycystic ovary syndrome (PCOS) is a heterogeneous condition, the pathophysiology of which appears to be a multifactorial, polygenic and multisystem endocrine disorder affecting 5–10% of women of reproductive age, characterised by hyperandrogenism and chronic anovulation 1. The prevalence of PCOS varies with ethnicity 2 , appearing in 6.6% in the population of the southeastern United States 3 , 6.8% in Greece 4 , 6.5% in Spain 5 , 13% among Mexican American women 6 , and 52% among South Asian female immigrants of Britain 7. Clinical features of PCOS include hirsutism; androgenic alopecia 8 menstrual irregularity, usually from the time of menarche 9 ; acne 10 ; hyperinsulinemia 11 ; insulin resistance (IR); early onset of type 2 diabetes mellitus 12 ; and dyslipidemia 13. According to the 1990 NICHD definition, women with PCOS may present three phenotypes: (i) oligo-ovulation, hyperandrogenemia and hirsutism (Oligo+ HA+ Hirsutism); (ii) oligo-ovulation and hyper-androgenemia, without frank hirsutism (Oligo+ HA); and (iii) oligo-ovulation and hirsutism, without measurable hyperandrogenemia (Oligo+ Hirsutism) 14. According to ESHRE guidelines 15 , women with PCOS present with four phenotypes: type I: hyperandrogenism, chronic anovulation, and polycystic ovaries; type II: hyperan-drogenism and chronic anovulation but with normal ovaries; type III: hyperandrogenism and polycystic ovaries but ovulatory cycles; and type IV: chronic anovulation and polycystic ovaries but no clinical or biochemical hyperandrogenism. The association between PCOS and hyperinsulinemia was first reported by Burghen et al. 16 , as it became clear that women with the syndrome have major metabolic as well as reproductive morbidities. Recently, more attention was focused on the degree of IR (insulin resistance) in women with PCOS. One report even considered all women with PCOS to have some degree of IR 17. Recent evidence suggests that obesity appears to exert an additive synergistic impact on the manifestations of PCOS, including a modifying effect on insulin sensitivity and gonadotrophin secretion and independently and negatively affecting insulin sensitivity, risk of diabetes, and cardiovascular impact 18 .