Revista Cubana de Endocrinología
On-line version ISSN 1561-2953
OVIES CARBALLO, Gisel; DOMINGUEZ ALONSO, Emma; VERDEJA VARELA, Olga L. and ZAMORA RECINOS, Hugo. Frequency and clinical, hormonal and ultrasonographic characteristics suggestive of polycystic ovarian syndrome in a group of females with metabolic syndrome. Rev Cubana Endocrinol [online]. 2008, vol.19, n.1, pp. 0-0. ISSN 1561-2953.
The polycystic ovarian syndrome is the most frequent endocrine affection in females at reproductive age. Nowadays, it is known that insulin resistance and consequent hyperinsulinism seem to be the basis of the disorders characterizing it. That's why, it is not erroneous to think that in females with metabolic syndrome, whose physiopathological bases are insulin resistance and hyperinsulinism, there may appear clinical, humoral and ultrasonographic elements of the polycystic ovarian syndrome. OBJECTIVE: to determine the frequency and clinical, hormonal and ultrasonographic characteristics suggestive of polycystic ovarian syndrome in a group of females with diagnosis of metabolic syndrome. METHODS: a cross-sectional study was undertaken among 90 females aged 18-45 with diagnosis of metabolic syndrome according to the modified criteria of the World Health Organization. They were interviewed and physically examined seeking clinical signs of polycystic ovarian syndrome (infertility, menstrual disorders, hirsutism, acne). Besides, the folliculostimulating hormone, the luteinizing hormone, prolactin and total testosterone were determined. A transvaginal gynecological ultrasound was performed between the third and the fifth day of the menstrual cycle, if they were menstruating or at any other moment, if they were not. Progesterone was also determined between the 21st and the 23rd day of the cycle, provided that they were menstruating. Patients were diagnosed polycystic ovarian syndrome when they had one or both clinical criteria, one or both hormonal criteria and the ultrasonographic criterion. RESULTS: 67.8 % of females presented oligomenorrhea; 81.1 %, hirsutism; 65.6 %, anovulatory progesterone values; and 55.6 % elevated testosterone. 63.3 % of the studied group had ultrasonographic signs suggestive of polycystic ovaries, and the most frequent sign was the presence of 10 or more follicles of ovarian periphery and stromal thickening. 51.1 % fulfilled the criteria for the diagnosis of polycystic ovarian syndrome. When we compared the behaviour of the group of females with polycystic ovarian syndrome and that without it, we observed that the mean of the insulin resistance index was higher in those that presented polycystic ovarian syndrome (7.5 vs. 6.5). As to the arterial tension, the systolic was significantly higher in the group with polycystosis (145.9 mmHg vs. 138.6 mmHg). As regards the body mass index, although there were not significantly statistical differences, the percentage of females with it ³ 30 kg/m2 was higher in the patients with polycystic ovarian syndrome than in those without it (54.1 % vs. 45.9 %). CONCLUSIONS: the frequency of polycystic ovarian syndrome is high in females with diagnosis of metabolic syndrome. The most common signs are hirsutism, elevated levels of testosterone and the presence of ³ 10 follicles under 10 mm in the periphery of the ovary. There is a greater trend to develop this syndrome in females with metabolic syndrome presenting higher levels of systolic arterial tension, higher index of insulin resistance and more body weight.
Keywords : Metabolic syndrome; polycystic ovaries.