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 ±
0.31 | 0.0E
| | 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
|
Key words:
polycystic ovary syndrome, hyperandrogenism, hyperinsulinemia.
|
