Comparison Of Biochemical Markers and Insulin Resistance of Polycystic Ovary Syndrome Patients Diagnosed with the Criteria of Rotterdam, Androgen Excess Society and National Institutes of Health
Öz
Objective: There are different criteria to diagnose polycystic ovary syndrome (PCOS) such as Rotterdam Consensus, Androgen Excess Society (AES), and National Institutes of Health (NIH). We aimed to investigate the biochemical and insulin resistance-related markers of PCOS patients according to different diagnostic criteria.
Material and methods: 1299 patients admitted to our clinic retrospectively analyzed. Following the inclusion and exclusion criteria, 200 patients with Rotterdam (Group 1), 182 patients with AES (Group 2), and 180 patients with NIH (Group 3) criteria were included in the study. Results: Waist/hip ratio among all groups (p1 = 0.002; p2 = 0.0001; p3 = 0.0001), LH/FSH ratio between Group 1 and 3 (p2=0.017), AST between Group 2 and 3 (p3 =0.012), DHEA-S and modified Ferriman–Gallwey score between Group 1 and 2 (p1 = 0.041; p1 = 0.013, respectively) and Group 1 and 3 (p2= 0.003; p2 = 0.04, respectively) were significantly different. A significant difference was detected between Group 1 and 3 in body mass index ≥ 25 (kg/m2) (p = 0.006). A significant difference was detected among all groups in waist circumference ≥ 88 cm (p1 = 0.0001, p2 = 0.0012, p3 = 0.004).
Conclusion: The rate of metabolic syndrome was found to be higher in patients diagnosed with Rotterdam criteria, the rate of insulin resistance with NIH criteria, and the rate of dyslipidemia with AES criteria. However, these differences were not statistically significant.
Anahtar Kelimeler
AES NIH polycystic ovary syndrome metabolic syndrome dyslipidemia
Destekleyen Kurum
The funders had no role in the study design, data collection, analysis, conclusions, the writing of the article or the decision to submit for publication.
Proje Numarası
Ethics committee approval was received from clinical research ethics board of the Malatya University (Date: 15.05.2013, Approve No: 2013/61).
Kaynakça
- Saxena P, Prakash A, Nigam A, Mishra A. Polycystic ovary syndrome: Is obesity a sine qua non? A clinical, hormonal, and metabolic assessment in relation to body mass index. Indian J Endocrinol Metab 2012 ;16(6):996-9.
- Moran L, Teede H. Metabolic features of the reproductive phenotypes of polycystic ovary syndrome. Hum Reprod Update 2009;15(4):477-88.
- Chang WY, Knochenhauer ES, Bartolucci AA, Azziz R. Phenotypic spectrum of polycystic ovary syndrome: clinical and biochemical characterization of the three major clinical subgroups. Fertil Steril 2005;83(6):1717-23.
- Kumar A, Woods KS, Bartolucci AA, Azziz R. Prevalence of adrenal androgen excess in patients with the polycystic ovary syndrome (PCOS). Clin Endocrinol 2005;62(6):644-9.
- Stepto NK, Cassar S, Joham AE, et al. Women with polycystic ovary syndrome have intrinsic insulin resistance on euglycaemic-hyperinsulaemic clamp. Hum Reprod 2013; 28(3):777-84.
- Knobil E. On the control of gonadotropin secretion in the rhesus monkey. Recent Prog Horm Res 1974;30(0):1-46.
- Tsilchorozidou T, Overton C, Conway GS. The pathophysiology of polycystic ovary syndrome. Clin Endocrinol 2004; 60(1):1-17.
- Hall JE, Whitcomb RW, Rivier JE, Vale WW, Crowley WF, Jr. Differential regulation of luteinizing hormone, follicle-stimulating hormone, and free alpha-subunit secretion from the gonadotrope by gonadotropin-releasing hormone (GnRH): evidence from the use of two GnRH antagonists. J Clin Endocr Metab 1990;70(2):328-35.
- Dahlgren E, Johansson S, Lindstedt G, et al. Women with polycystic ovary syndrome wedge resected in 1956 to 1965: a long-term follow-up focusing on natural history and circulating hormones. Fertil Steril 1992 ;57(3):505-13.
- ESHRE. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004;81(1):19-25.
- Azziz R, Carmina E, Dewailly D, et al. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril 2009; 91(2):456-88.
- Zawadzki J, Dunaif A. Current issues in endocrinology and metabolism: Polycystic ovary syndrome. MA: Blackwell Scientific Publications Cambridge. 1992; 377-384.
- Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocr Metab 1961;21:1440-7.
- World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. Part 1, Diagnosis and classification of diabetes mellitus. No. WHO/NCD/NCS/99.2. World health organization, 1999.
- Talbert RL. Role of the National Cholesterol Education Program Adult treatment panel III guidelines in managing dyslipidemia. Am J Health Syst Pharm 2003; 9(1): Suppl: 2-5.
- Teede H, Deeks A, Moran L. Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Med 2010; 8(1), 1-10.
- Guastella E, Longo RA, Carmina E. Clinical and endocrine characteristics of the main polycystic ovary syndrome phenotypes. Fertil Steril 2010; 94(6):2197-201.
- Amato MC, Galluzzo A, Finocchiaro S, Criscimanna A, Giordano C. The evaluation of metabolic parameters and insulin sensitivity for a more robust diagnosis of the polycystic ovary syndrome. Clin Endocrinol 2008; 69(1):52-60.
- Apridonidze T, Essah PA, Iuorno MJ, Nestler JE. Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocr Metab 2005 ;90(4):1929-35.
- Tziomalos K, Katsikis I, Papadakis E, Kandaraki EA, Macut D, Panidis D. Comparison of markers of insulin resistance and circulating androgens between women with polycystic ovary syndrome and women with metabolic syndrome. Hum Reprod 2013;28(3):785-93.
- El-Mazny A, Abou-Salem N, El-Sherbiny W, El-Mazny A. Insulin resistance, dyslipidemia, and metabolic syndrome in women with polycystic ovary syndrome. Int J Gynaecol Obstet 2010;109(3):239-41.
- Diamanti-Kandarakis E, Papavassiliou AG, Kandarakis SA, Chrousos GP. Pathophysiology and types of dyslipidemia in PCOS. Trends Endocrinol Metab 2007;18(7):280-5.
- Austin MA, Breslow JL, Hennekens CH, Buring JE, Willett WC, Krauss RM. Low-density lipoprotein subclass patterns and risk of myocardial infarction. Jama 1988; 260(13):1917-21.
- Sjöholm A, Nyström T. Endothelial inflammation in insulin resistance. Lancet 2005; 365(9459):610-2.
- Tarkun I, Arslan BC, Cantürk Z, Türemen E, Sahin T, Duman C. Endothelial dysfunction in young women with polycystic ovary syndrome: relationship with insulin resistance and low-grade chronic inflammation. J Clin Endocr Metab 2004;89(11):5592-6.
- Athyros VG, Kakafika AI, Karagiannis A, Mikhailidis DP. Do we need to consider inflammatory markers when we treat atherosclerotic disease? Atherosclerosis 2008200(1):1-12.
- Türkçüoğlu I, Kafkasli A, Meydanli MM, Ozyalin F, Taşkapan C. Independent predictors of cardiovascular risk in polycystic ovarian syndrome. Gynecol Endocrinol 2011; 27(11):915-9.
Rotterdam, Androgen Excess Society ve National Institutes of Health Kriterlerine Göre Tanı Alan Polikistik Over Sendromlu Hastaların Biyokimyasal Değerleri ve İnsülin Direncinin Karşılaştırılması
Öz
Amaç: Polikistik over sendromu (PKOS) tanısında Rotterdam Consensus, Androjen Excess Society (AES), ve National Institutes of Health (NIH) gibi cemiyetlerin farklı kriterleri kullanılmaktadır. Biz bu çalışmada PKOS ön tanısıyla kliniğe başvuran hastaların farklı PKOS tanı kriterlerine göre biyokimyasal değerlerini ve insülin direncini karşılaştırmayı amaçladık. Gereç ve yöntemler: Kliniğimize PKOS ön tanısıyla başvuran 1299 hasta retrospektif olarak incelendi. Dahil edilme ve dışlama kriterlerinin uygulanmasını takiben Rotterdam kriterleri ile (Grup 1) 200, AES kriterleri ile (Grup 2) 182, ve NIH kriterleri ile (Grup 3) 180 hasta PKOS tanısı konularak çalışmaya dahil edildi. Bulgular: Bel/kalça oranında tüm gruplar arasında (p1=0,002; p2=0,0001; p3=0,0001), LH/FSH oranında Grup 1 ve Grup 3 arasında (p2=0,017), AST Grup 2 ve Grup 3 arasında (p3=0,012), DHEA-S ve modifiye Ferriman–Gallwey skoru Grup 1 ve Grup 2 (sırasıyla p1=0,041; p1= 0.013,) ile Grup 1 ve Grup 3 (sırasıyla p2= 0,003; p2=0,04) arasında istatistiksel olarak anlamlı farklı bulundu. Vücut kütle indeksi≥ 25 (kg/m2) olan hasta yüzdesi Grup 1 ile Grup 3 arasında istatistiksel olarak anlamlı farklı bulundu (p=0,006). Bel çevresi ≥ 88 cm olan hasta yüzdesinde tüm gruplar arasında istatistiksel olarak anlamlı fark saptandı (Grup 1 ve Grup 2 için p1=0,0001, Grup 1 ve Grup 3 için p2=0,0012, Grup 2 ve Grup 3 için p3=0,004).
Tartışma: Metabolik sendrom görülme sıklığı Rotterdam tanı kriterleri ile, insulin direnci görülme sıklığı NIH tanı kriterleri ile, dislipidemi görülme sıklığı ise AES tanı kriterleri ile PKOS tanısı alan kadınlarda istatistiksel anlama ulaşmasa da daha yüksek saptanmıştır.
Anahtar Kelimeler
Polikistik over sendromu Metabolik sendrom dislipidemi Rotterdam AES NIH polycystic ovary syndrome metabolic syndrome dyslipidemia
Proje Numarası
Ethics committee approval was received from clinical research ethics board of the Malatya University (Date: 15.05.2013, Approve No: 2013/61).
Kaynakça
- Saxena P, Prakash A, Nigam A, Mishra A. Polycystic ovary syndrome: Is obesity a sine qua non? A clinical, hormonal, and metabolic assessment in relation to body mass index. Indian J Endocrinol Metab 2012 ;16(6):996-9.
- Moran L, Teede H. Metabolic features of the reproductive phenotypes of polycystic ovary syndrome. Hum Reprod Update 2009;15(4):477-88.
- Chang WY, Knochenhauer ES, Bartolucci AA, Azziz R. Phenotypic spectrum of polycystic ovary syndrome: clinical and biochemical characterization of the three major clinical subgroups. Fertil Steril 2005;83(6):1717-23.
- Kumar A, Woods KS, Bartolucci AA, Azziz R. Prevalence of adrenal androgen excess in patients with the polycystic ovary syndrome (PCOS). Clin Endocrinol 2005;62(6):644-9.
- Stepto NK, Cassar S, Joham AE, et al. Women with polycystic ovary syndrome have intrinsic insulin resistance on euglycaemic-hyperinsulaemic clamp. Hum Reprod 2013; 28(3):777-84.
- Knobil E. On the control of gonadotropin secretion in the rhesus monkey. Recent Prog Horm Res 1974;30(0):1-46.
- Tsilchorozidou T, Overton C, Conway GS. The pathophysiology of polycystic ovary syndrome. Clin Endocrinol 2004; 60(1):1-17.
- Hall JE, Whitcomb RW, Rivier JE, Vale WW, Crowley WF, Jr. Differential regulation of luteinizing hormone, follicle-stimulating hormone, and free alpha-subunit secretion from the gonadotrope by gonadotropin-releasing hormone (GnRH): evidence from the use of two GnRH antagonists. J Clin Endocr Metab 1990;70(2):328-35.
- Dahlgren E, Johansson S, Lindstedt G, et al. Women with polycystic ovary syndrome wedge resected in 1956 to 1965: a long-term follow-up focusing on natural history and circulating hormones. Fertil Steril 1992 ;57(3):505-13.
- ESHRE. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004;81(1):19-25.
- Azziz R, Carmina E, Dewailly D, et al. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril 2009; 91(2):456-88.
- Zawadzki J, Dunaif A. Current issues in endocrinology and metabolism: Polycystic ovary syndrome. MA: Blackwell Scientific Publications Cambridge. 1992; 377-384.
- Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocr Metab 1961;21:1440-7.
- World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. Part 1, Diagnosis and classification of diabetes mellitus. No. WHO/NCD/NCS/99.2. World health organization, 1999.
- Talbert RL. Role of the National Cholesterol Education Program Adult treatment panel III guidelines in managing dyslipidemia. Am J Health Syst Pharm 2003; 9(1): Suppl: 2-5.
- Teede H, Deeks A, Moran L. Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Med 2010; 8(1), 1-10.
- Guastella E, Longo RA, Carmina E. Clinical and endocrine characteristics of the main polycystic ovary syndrome phenotypes. Fertil Steril 2010; 94(6):2197-201.
- Amato MC, Galluzzo A, Finocchiaro S, Criscimanna A, Giordano C. The evaluation of metabolic parameters and insulin sensitivity for a more robust diagnosis of the polycystic ovary syndrome. Clin Endocrinol 2008; 69(1):52-60.
- Apridonidze T, Essah PA, Iuorno MJ, Nestler JE. Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocr Metab 2005 ;90(4):1929-35.
- Tziomalos K, Katsikis I, Papadakis E, Kandaraki EA, Macut D, Panidis D. Comparison of markers of insulin resistance and circulating androgens between women with polycystic ovary syndrome and women with metabolic syndrome. Hum Reprod 2013;28(3):785-93.
- El-Mazny A, Abou-Salem N, El-Sherbiny W, El-Mazny A. Insulin resistance, dyslipidemia, and metabolic syndrome in women with polycystic ovary syndrome. Int J Gynaecol Obstet 2010;109(3):239-41.
- Diamanti-Kandarakis E, Papavassiliou AG, Kandarakis SA, Chrousos GP. Pathophysiology and types of dyslipidemia in PCOS. Trends Endocrinol Metab 2007;18(7):280-5.
- Austin MA, Breslow JL, Hennekens CH, Buring JE, Willett WC, Krauss RM. Low-density lipoprotein subclass patterns and risk of myocardial infarction. Jama 1988; 260(13):1917-21.
- Sjöholm A, Nyström T. Endothelial inflammation in insulin resistance. Lancet 2005; 365(9459):610-2.
- Tarkun I, Arslan BC, Cantürk Z, Türemen E, Sahin T, Duman C. Endothelial dysfunction in young women with polycystic ovary syndrome: relationship with insulin resistance and low-grade chronic inflammation. J Clin Endocr Metab 2004;89(11):5592-6.
- Athyros VG, Kakafika AI, Karagiannis A, Mikhailidis DP. Do we need to consider inflammatory markers when we treat atherosclerotic disease? Atherosclerosis 2008200(1):1-12.
- Türkçüoğlu I, Kafkasli A, Meydanli MM, Ozyalin F, Taşkapan C. Independent predictors of cardiovascular risk in polycystic ovarian syndrome. Gynecol Endocrinol 2011; 27(11):915-9.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Proje Numarası | Ethics committee approval was received from clinical research ethics board of the Malatya University (Date: 15.05.2013, Approve No: 2013/61). |
| Yayımlanma Tarihi | 20 Şubat 2023 |
| Gönderilme Tarihi | 15 Aralık 2022 |
| Kabul Tarihi | 8 Ocak 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 5 Sayı: 1 |
Kaynak Göster
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