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"Medicina Sportiva" No.14 - 2008 The 15-th Sports Medicine Balkan Congress
CHRONIC DISEASE AND PHYSICAL ACTIVITY


NONFARMACOLOGIC TREATMENT EFFECTS ON ENDOCRINE AND METABOLIC PROFILES IN WOMEN WITH POLYCYSTIC OVARY SYNDROME

Danciulescu Miulescu Rucsandra1, Avramescu Taina Elena2, Danoiu Suzana3
1UMF Carol Davila Bucureşti, Endocrinology Dept.,
2University of Craiova, FEFS Faculty, Anathomy Dept.,
3UMF Craiova, Patophysiology Dept., Romania


INTRODUCTION. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of premenopausal women, affecting 6-8% of this population. It is characterized by hyperandrogenism and chronic anovulation. Independent of the presence of obesity, these women are frequently insulin resistant and therefore have hyperinsulinemia, which appears to play a pathogenic role in the disease. Consistent with the pathogenic role of hyperinsulinemia, it has been observed that the weight loss in obese patients with PCOS decreased insulin and androgen levels, with a significant improvement in fertility.
Materials and Methods. 14 obese and insulino-resistant women with PCOS were recruited for this study. Diagnosis of PCOS was based on the presence of hyperandrogenism and cronic anovulation; related disorders with similar clinical presentation were excluded.
Estimates of insulin resistance were derived from the HOMA index (basal glucose mmol/l x basal insulin μIU/ml/22.5); insulino-resistant women were defined by HOMA >3. Blood samples were drawn in the morning after on overnight fast, during the early follicular phase of the menstrual cycle or during amenorrhea. Serum LH, FSH, testosterone, free testosterone, IGF-I, insulin, glucose, cholesterol, triglicerides, LDL and HDL cholesterol were measured. Serum LH, FSH, testosterone, free testosterone were measured by chemiluminescence on an ACS 180 analyzer system (Bayer Diagnostic Ltd).
The women have normal glucose tolerance by the criteria of the World Health Orgatization. Patients were evaluated at baseline and after 6months. of nonfarmacologic treatment (the nonfarmacologic treatment included regular aerobic exercise and diet with 1000 cal).
Results. After treatment 6 women had their menstrual pattern substantially improved.
Pregnancy occurred in 3 patients (28,57%). Characteristics of patients before and after 6 months of  nonfarmacologic treatment:

  Baseline characteristics Characteristics of subjects after treatment p
LH (mUI/ml) 12.02 ± 2.98 10.93 ± 2.87 >0.05
FSH (mUI/ml) 5.04 ± 0.70 5.18 ± 0.54 >0.05
Testosteron total (ng/dl) 127.38 ± 21.74 123.34 ± 20.78 >0.05
Testosteron liber (pg/ml) 4.39 ± 0.55 3.05 ± 0.310.0E
DHEAS (μg/dl) 352.9 ± 31.34 323.83 ± 22.57 0.009
Androstendion (ng/ml) 3.86 ± 0.33 3.37 ± 0.35 0.008
Estradiol (pg/ml) 76.11 ± 5.56 77.67 ± 5.15 >0.05
Insulin (µUI/ml) 27.37 ± 2.85 21.34 ± 2.85 >0.05
IGF-I (ng/ml) 326.98 ± 24.85 304.53 ± 18.61 >0.05
Fasting blood glucose (mmol/l) 4.87 ± 0.39 4.52 ± 0.32 0.01
HDL-colesterol (md/dl) 49.5 ± 6.64 53.07 ± 4.96>0.05
LDL-colesterol (mg/dl) 135.57 ± 2.067 123.93 ± 16.01 >0.05
Trigliceride (mg/dl) 91.29 ± 16.39 88.00 ± 12.45 >0.05
Cholesterol total (mg/dl) 203.29 ±17.86 186.21 ± 24.58 0.04

Conclusions. Nonfarmacologic treatment improved insulin-resistance and decreased androgen levels, with improvement in fertility in obese women with PCOS.
Key words: polycystic ovary syndrome, hyperandrogenism, hyperinsulinemia.





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