ETIOPATHOGENETIC ASPECTS, CLINICAL AND DIAGNOSTIC CRITERIA AS WELL AS COMPREHENSIVE APPROACH TO TREATMENT OF METABOLIC SYNDROME IN WOMEN OF REPRODUCTIVE AGE

2020 ◽  
pp. 40-44
Author(s):  
O. V. Dolenko

The development of metabolic syndrome in women of reproductive age is one of the most common causes of anovulatory infertility, miscarriage in early pregnancy. In this pathology treatment in women there is used a comprehensive approach, which aims to restore specific functions, i.e. menstrual, secretory and reproductive ones. Important points are the detection of metabolic disorders in the patients before the formation of polycystic ovaries, normalization of body weight. In order to study the clinical effectiveness of the herbal drug "Glucemedin" in the combined treatment of metabolic syndrome in 40 women of reproductive age, a clinical and laboratory investigation was performed, also transvaginal ultrasound and body mass index were determined. In the first group of patients as the main treatment the metformin was prescribed hydrochloride as monotherapy in a dosage of 500 mg 2 times a day, in the second there was added phytodrug "Glucemedin" in a dosage of 1 capsule 3 times a day. The combined treatment showed a more pronounced dynamics of reduction of total and free cholesterol, low−density lipoprotein, triglycerides, atherogenic factor, decreased body mass index compared with the patients receiving metformin monotherapy. Based on analysis of the results of clinical and laboratory studies a high clinical efficiency of the herbal phytodrug "Glucemedin", which is stipulated with the pronounced effect on lipid spectrum of blood. The presence of natural components being a part of the phytodrug "Glucemedin", their high bioavailability, safety of the drug, no side effects and contraindications indicate its pronounced clinical effectiveness and feasibility of inclusion into the treatment of metabolic syndrome in women of childbearing age. Key words: metabolic syndrome, lipid profile, body mass index, transvaginal ultrasound, Glucemedin, clinical efficiency, combined treatment, women of reproductive age.

2017 ◽  
pp. 57-61
Author(s):  
O.A. Dyndar ◽  

The problem of obesity and metabolic syndrome among the female population of Ukraine is extremely important, given the current trend toward increasing age of realization of reproductive function,. The prevalence of metabolic syndrome among women of reproductive age is 6–35%, fertility problems are found in 30-35% of women. The objective: to study the characteristics of metabolic disorders and hormonal condition of the reproductive system in women with obesity and the metabolic syndrome on pregravidarity stage depending on the body mass index and severity of metabolic syndrome. Patients and methods. We examined a total of 124 women with obesity and metabolic syndrome that appealed on pregravidar stage and 53 women who had no history of somatic and gynecological pathology. Antropometric studies, determination of blood pressure, examination of carbohydrate and lipid metabolism, evaluation of the endocrine status of the reproductive system, ultrasound examination of small pelvis organs were done. Results. In women of reproductive age, we observed increase of total cholesterol, triglycerides, low-density lipoproteins and decrease high-density lipoproteins, with a predominance of IIb and IV types of dyslipidemia. Insulin resistance was diagnosed in 28.3% of women And 47.4% – II and in 69.7% with III degree of obesity. Metabolic syndrome was diagnosed in 79.2% of patients with obesity of I, in 94.7% – II 100% III. The number of components of metabolic syndrome correlate directly proportional to the severity of obesity. The index of fertility with III degree of obesity increased to 2.7, hypoestrogenia marked with And hyperestrogenia from 50.7% of women in II and III degree of obesity, progesterona failure identified at 66.9%, hyperandrogenism in 58.8%, reduced sex-binding globulin in 83.0% of the observations. Conclusion. Pathological changes of the hormonal status of the female reproductive system on prepregnansy stage is directly proportional to depend on the body mass index number of components of metabolic syndrome and dysmetabolic disorders. Key words: obesity, metabolic syndrome, pregnancy planning.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Oyinkansola Islamiyat Lawal ◽  
Jameelu-deen Omokunmi Yusuff

Abstract Background Anti-Müllerian hormone is a dimeric glycoprotein produced by the granulosa cells of preantral and small antral follicles of the ovaries. It is a reliable biomarker of ovarian reserve, ageing, and response in the management of women with infertility. However, there are few studies on the determinants of serum anti-Müllerian hormone in Nigerian women. This study aimed to investigate determinants of serum anti-Müllerian hormone among adult women of reproductive age. The study was a hospital-based cross-sectional study involving 161 women of reproductive age attending the gynaecology clinic and immunisation clinic of a Nigerian tertiary hospital. Baseline characteristics were collected using a semi-structured questionnaire. Serum anti-Müllerian hormone was quantified using enzyme-linked immunosorbent assay. Results In univariate analysis, age (B = − 0.035, P = 0.000), parity (B = − 0.080, P = 0.001), and infertility duration (B = − 0.050, P = 0.011) had a negative relationship with serum anti-Müllerian hormone, while ethnicity (B = 0.180, P = 0.040), body mass index (B = 0.015, P = 0.010), and cycle length (B = 0.042, P = 0.000) had a positive relationship with serum anti-Müllerian hormone. In multivariable analysis, all relationships except infertility duration persisted. Conclusion We found that age, ethnicity, parity, infertility duration, body mass index, and cycle length were associated with serum anti-Müllerian hormone. A large prospective population-based study is required to better understand factors that are associated with serum anti-Müllerian hormone in an ethnically diverse country like Nigeria.


2017 ◽  
Vol 56 (207) ◽  
pp. 352-356 ◽  
Author(s):  
Saraswati M Padhye

Introduction: High Body Mass Index is one of the risk factors for many chronic diseases and adverse health outcomes. It is associated with an increased risk of coronary heart disease, ischemic stroke, high blood pressure and type 2 diabetes mellitus. It also have many adverse effect on reproductive health of the women like sub fertility, polycystic ovarian disease, menstrual abnormality etc. The purpose of this study is to find Basal Metabolic Rate and the diseases pattern of reproductive age woman in Nepal. Methods: This is a descriptive study of women of reproductive age (15 to 49 years) attending a private gynaecology clinic in Kathmandu Valley from October 2016 to June 2017. Six hundred and eight women of current reproductive age group participated in this study. Women’s particulars and complaints were noted down. Detailed history was taken. Height, weight and blood pressure were recorded and general examination was done. BMI was calculated as BMI is weight in kilogram divided by height in meter square, and it was interpreted as per WHO guidelines. Results: Out of the total 608 participants, 243 (40%) were overweight, 96 (15.8%) were obese. Regarding the common health problems, 154 (25.3%) have sub fertility and 199 (32%) had genitourinary infection. Similarly, 90 (14.8%) had menstrual problems. Conclusions: Prevalence of overweight and obesity has risen significantly comparing to the study done decade ago in same setting. Similarly, sub fertility rate has also risen whereas the prevalence of genitourinary infections has decreased. Keywords: BMI; genitourinary infection; Nepal-reproductive age women; sub fertility.


2004 ◽  
Vol 10 (3) ◽  
pp. 437-441
Author(s):  
S. Esmaelzadeh ◽  
N. Rezaei ◽  
M. Hajiahmadi

Todetermine the efficacy of ultrasonographic assessment of uterus size in women of reproductive age, we conducted a cross-sectional analytic study of 231 women aged 15-45 years in Babol, northern Islamic Republic of Iran. Mean uterus size was 86.6 mm x 49.6 mm x 40.6 mm overall, 72.8 mm x 42.8 mm x 32.4 mm for nulliparous women and 90.8 mm x 51.7 mm x 43.0 mm for multiparous women. Mean age was 31.7 +/- 9.6 years and mean body mass index [BMI] was 24.7 +/- 4.0 kg/m2. Uterus size was significantly associated with parity and age; but not with BMI. Our findings show a greater mean uterus size than reported by others. Ultrasonographic measurement of uterus size is valuable for predicting pathologies associated with abnormal uterine size


GYNECOLOGY ◽  
2019 ◽  
Vol 21 (5) ◽  
pp. 65-68
Author(s):  
Natalia V Artymuk ◽  
Olga A Tachkova

Aim. To compare effects of the drug containing ethinylestradiol (EE) 0.03 mg and drospirenone (DRSP) 3 mg and the drug containing EE 0.02 mg and DRSP 3 mg on the skin and anthropometric parameters. Materials and methods. A prospective comparative randomized study included 40 women of reproductive age who didn’t have contraindications to use of combined oral contraceptive (COCs). The first group consisted of 20 women who were administrated EE 0.03 mg and DRSP 3 mg in the 21/7 regimen according to a prescribing information; the 2nd group included 20 patients who were administrated EE 0.02 mg and DRSP 3 mg in the 24/4 regimen according to a prescribing information. The study protocol included 8 visits: at the 0th visit, the inclusion and exclusion criteria were evaluated, at the 1st visit patient were randomized (envelope method) to receive one or another drug, at the 2nd - 7th visits (once a month) blood pressure was measured, anthropometric parameters were determined including body weight, height, waist, hips as well as body mass index, a degree of hirsutism (with Ferriman-Gallwey scale), skin and hair skin oiliness, acne (with a 10-point visual scale) were evaluated. Results. The use of EE 0.03 mg and DRSP 3 mg for 6 months did not significantly affect the body weight and body mass index, waist and hips. In the 6th month, the use of EE 0.03 mg and DRSP 3 mg lead to a statistically significant decrease in skin oiliness, severity of acne and hirsutism, which was comparable to a clinical effectiveness of EE 0.02 mg and DRSP 3 mg. Conclusions. EE 0.03 mg and DRSP 3 mg has a similar effect on skin oiliness, severity of acne and hirsutism with EE 0.02 mg and DRSP 3 mg, without significantly affecting the main anthropometric parameters. It is likely that the effect of DRSP-containing COCs on androgen levels and adipose tissue is due precisely to the effect of DRSP, and not to the dose of EE.


2015 ◽  
Vol 116 (1) ◽  
pp. 40-48 ◽  
Author(s):  
Luboslav Stárka ◽  
Beata Rácz ◽  
Monika Šrámková ◽  
Martin Hill ◽  
Michaela Dušková

Eight women of reproductive age with normal body mass index were given 5 standardised meals, and their hormonal milieu was determined during the course of the day. Plasma from 12 withdrawals was analysed for dehydroepiandrosterone and its 7- and 16-hydroxylated metabolites. Overall, there was a maximum in the levels of steroid hormones in the morning, followed by decreases throughout the day. There was also an additional significant decrease found for dehydroepiandrosterone and its 7α-hydroxyderivative in association with the consumption of main meals, but not for the 7β-isomer or 16α-hydroxyderivative.


2020 ◽  
Vol 5 (3) ◽  
pp. 77-84
Author(s):  
N. V. Artymuk ◽  
O. A. Tachkova ◽  
N. A. Sukhova

Aim. To assess the hormonal profile features in obese reproductive-age women. Materials and Methods. We consecutively enrolled 163 women of reproductive age (140 women with body mass index ≥ 30 kg/m2 and 23 women with normal body mass index) who have been admitted to Podgorbunskiy Regional Emergency Medicine Hospital. All patients of both groups underwent general and gynecological examination. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, estradiol, estrone, testosterone, dehydroepiandrosterone sulfate, thyroid-stimulating hormone, free triiodothyronine, total and free thyroxine, cortisol, leptin, immunoreactive insulin, and progesterone were assessed on days 5-6 and 21-22 of the menstrual cycle. Results. Obese women of reproductive age were characterised by higher values of LH, LH/ FSH ratio, testosterone, estradiol, estrone, leptin, IRI and by lower levels of FSH and progesterone compared with normal weight women. A direct correlation was found between the level of leptin and estrone (r = 0.21, p = 0.014), insulin resistance (r = 0.18, p = 0.039), triglycerides (r = 0.20, p = 0.030), and low-density lipoprotein cholesterol (r = 0.22, p = 0.016). There was a statistically significant inverse correlation between the level of leptin and high-density lipoprotein cholesterol (r = -0.18, p = 0.043). A direct correlation was established between insulin and LH (r = 0.24, p = 0.030), testosterone (r = 0.32, p = 0.037), dehydroepiandrosterone sulfate (r = 0.56, p = 0.003), insulin resistance (r = 0.95, p < 0.001), cholesterol (r = 0.20, p = 0.024), triglycerides (r = 0.29, p < 0.001). Conclusion. Obese women of reproductive age have certain hormonal features that underlie menstrual and reproductive disorders in these patients.


Author(s):  
Yhona Paratmanitya ◽  
Siti Helmyati ◽  
Detty S Nurdiati ◽  
Emma C Lewis ◽  
Hamam Hadi

<p><strong>ABSTRAK </strong></p><p><strong>Latar Belakang:</strong> Pemenuhan gizi pada masa prakonsepsi merupakan hal yang penting untuk memastikan kehamilan yang sehat, namun banyak wanita di negara-negara berkembang yang belum menyadari pentingnya hal tersebut. Informasi tentang kesiapan gizi prakonsepsi pada wanita usia subur, khususnya di negara berkembang, masih terbatas.</p><p><strong>Tujuan</strong>: Untuk mengetahui kesiapan gizi prakonsepsi pada calon pengantin wanita di Indonesia</p><p><strong>Metode:</strong> Penelitian ini merupakan bagian dari studi cluster randomized trial untuk meningkatkan status besi ibu hamil di Kabupaten Bantul, Yogyakarta, yang melibatkan 173 calon pengantin wanita. Data antropometri, asupan makan, dan pengetahuan tentang gizi prakonsepsi dikumpulkan oleh enumerator yang terlatih, yaitu mahasiswa di Fakultas Kesehatan, Universitas Alma Ata, dengan melakukan kunjungan ke rumah responden. Data kadar Hemoglobin (Hb) diperoleh melalui kuesioner. Kesiapan gizi prakonsepsi diukur menggunakan 10 indikator, yang meliput: (1) Indeks Massa Tubuh (IMT); (2) Lingkar Lengan Atas (LILA); (3) kadar Hb; (4) asupan energi; (5) asupan protein; (6) asupan kalsium; (7) asupan zat besi; (8) asupan folat; (9) pengetahuan tentang gizi prakonsepsi; dan (10) konsumsi suplemen zat besi dan/atau asam folat. Skor kesiapan akan berkisar antara 0-10.</p><p><strong>Hasil:</strong> Tidak ada satupun responden yang dapat memenuhi seluruh indikator kesiapan gizi prakonsepsi. Sebanyak 26% responden dapat memenuhi 2 indikator, dan median skor-nya adalah 3 (2.0-4.0). Kadar Hb, IMT, dan LILA merupakan 3 indikator terbanyak yang dapat dipenuhi, sementara asupan kalsium, zat besi, dan folat merupakan 3 indikator yang paling sedikit dapat dipenuhi oleh responden.</p><p><strong>Kesimpulan:</strong> Peningkatan kesadaran akan pentingnya mempersiapkan gizi prakonsepsi pada calon ibu merupakan hal yang sangat diperlukan. Program intervensi gizi kedepannya sebaiknya sudah dimulai sejak masa prakonsepsi, bukan hanya fokus pada kehamilan.</p><p><strong> KATA KUNCI:</strong> Indeks Massa Tubuh; asupan makan; prakonsepsi; wanita usia subur</p><p> </p><p><strong>ABSTRACT</strong></p><p><strong>Background:</strong> Proper nutrition during preconception is essential to ensuring a healthy pregnancy, however, women in developing countries may not be aware of its importance. Information is limited regarding nutrition readiness prior to conception among women of reproductive age in these settings.</p><p><strong>Objectives:</strong> To examine nutrition readiness prior to conception among premarital women living in Indonesia.</p><p><strong>Methods</strong>: This study was part of a cluster randomized trial which aimed to improve the iron status of pregnant women in Bantul District, Yogyakarta, Indonesia. A total of 173 premarital women were included in the study. Data were collected on anthropometry, dietary intake, and knowledge about preconception nutrition by trained nutrition students of the University of Alma Ata, and taking place in the participant’s home. Hemoglobin level data were obtained based on answers to a questionnaire. Preconception nutrition readiness for pregnancy was determined based on 10 indicators, including: (1) body mass index (BMI); (2) mid-upper arm circumference (MUAC); (3) hemoglobin (Hb) level; average daily intakes for (4) energy, (5) protein, (6) calcium, (7) iron, and (8) folic acid; (9) level of knowledge about preconception nutrition; and (10) folic acid and/or iron supplement consumption. Preconception nutrition readiness scores ranged from 0-10.</p><p><strong>Results:</strong> No study participants met all 10 indicators for preconception nutrition readiness. One-quarter (26.0%) of participants could only meet 2 indicators, and the median score was 3.0 (2.0-4.0). Hb level, BMI, and MUAC were the 3 indicators met most by participants, while iron, folic acid, and calcium intake were the least met indicators.</p><p><strong>Conclusion:</strong> Raising awareness about preconception nutritional preparation among women of reproductive age is urgent. Future nutrition intervention programs should target the preconception period.</p><p><strong> KEYWORDS:</strong> Body mass index; dietary intake; preconception; women of reproductive age.</p>


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