scholarly journals Phenotypic Variation of Insulin Resistance among Polycystic Ovarian Syndrome Patients in Semiurban North Indian Population

2021 ◽  
Author(s):  
Chaitali Maitra ◽  
Ramesh Chandra Gupta ◽  
Rishika Raj
Keyword(s):  
Insulin Resistance ◽  
Regression Analysis ◽  
Polycystic Ovarian Syndrome ◽  
Specific Treatment ◽  
Reproductive Age ◽  
Model Assessment ◽  
Cross Sectional ◽  
Significant Difference ◽  
Ovarian Syndrome ◽  
Rotterdam Criteria

Introduction: Polycystic Ovarian Syndrome (PCOS) is a common endocrine disorder in the women of reproductive age. Studies show that there is an intensive relationship between insulin and gonadal function. As per Rotterdam Criteria, there are four major phenotypes of PCOS with different presentation. Early detection of Insulin Resistance (IR) and consequential prevention of Metabolic Syndrome (MS) associated with PCOS may lead to better prospect for the disease. Aim: To find the pattern of IR in all the phenotypes of PCOS in relation to Waist Hip Ratio (WHR), Body Mass Index (BMI) and Testosterone and thereby, providing data for designing phenotype specific treatment of the disease. Materials and Methods: In this cross-sectional observational study, fasting insulin and fasting glucose were analysed to calculate Homeostasis Model Assessment (HOMA-IR) and Testosterone for total 144 female subjects of reproductive age group (18-40 years). Subjects were classified in to four groups as per Rotterdam Criteria. Complete PCOS (PCO-COM), PCO with Oligo/Anovulation (PCO-O), Anovulation with Hyperandrogenism (O-HA), and PCO with Hyperandrogenism (PCO-HA). Regression analysis was done to find the relation among the study variables. Analysis of Variance (ANOVA) was used to analyse the significant variance among the groups. Results: IR was found to be maximum among O-HA phenotype (2.4±0.37) and lowest among PCO-HA phenotypes (1.3±0.22). Regression analysis shows that there exist significant associations between IR and BMI (t=4.96, p=0.001) as well as between IR and WHR (t=2.97, p=0.003). No independent association between testosterone and IR was observed. Conclusion: Significant difference of IR, WHR, and BMI was observed among the four phenotypes of PCOS. Due to increased IR, O-HA and PCO-COM phenotypes are more predisposed to Cardiometabolic consequences of PCOS.

scholarly journals Disparity among Endocrinologists and Gynaecologists in the Diagnosis of Polycystic Ovarian Syndrome

2020 ◽  
Vol 20 (3) ◽  
pp. 323
Author(s):  
Hana Alzamil ◽  
Khawlah Aloraini ◽  
Reem AlAgeel ◽  
Aya Ghanim ◽  
Ruba Alsaaran ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Polycystic Ovarian Syndrome ◽  
Clinical Decision Making ◽  
Polycystic Ovary ◽  
Years Of Experience ◽  
Cross Sectional ◽  
Significant Difference ◽  
Ovarian Morphology ◽  
Ovarian Syndrome ◽  
Rotterdam Criteria

Objectives: This study aimed to compare endocrinologists’ versus gynaecologists’ approaches in using the Rotterdam criteria to diagnose polycystic ovarian syndrome (PCOS). Methods: This cross-sectional study was conducted at Physiology Department, King Saud University, Riyadh, Saudi Arabia, between December 2017 and April 2018. A validated self-administered questionnaire in English was used to obtain information from endocrinologists and gynaecologists regarding their approaches to diagnosing PCOS. Each group’s diagnostic use of the Rotterdam criteria, association between years of experience and clinical decision-making, clinical features leading to diagnosis and considerations in the diagnosis of biochemical parameters that define hyperandrogenism were evaluated. Results: A total of 132 physicians were included in this study (response rate: 27%); 77 (58.3%) were endocrinologists and 55 (41.7%) were gynaecologists. Most of the respondents (79.5%) had ≤20 years of experience. A statistically significant difference was detected between the endocrinologists and gynaecologists (98.7% versus 81.8%; P = 0.001) in their consideration of hyperandrogenism in the diagnosis. The gynaecologists relied more on ovarian morphology than the endocrinologists did (76.4% versus 45.5%, P <0.0001). Physicians with more experience used ovarian ultrasonography more compared to those with less experience (P = 0.006). Conclusion: There was disparity in the diagnostic approaches of endocrinologists, who rely more on androgen levels for diagnosis of PCOS versus gynaecologists, who more frequently use an ovarian morphology assessment. Increased years of experience increased the rate of ultrasonography use for PCOS diagnosis in both groups.Keywords: Polycystic Ovary Syndrome; Gynecology; Endocrinology; Diagnosis; Hyperandrogenism; Hirsutism; Healthcare Disparities; Saudi Arabia.

scholarly journals Study of cutaneous manifestations of polycystic ovarian syndrome

2020 ◽  
Vol 9 (4) ◽  
pp. 1627
Author(s):  
Sukhleen Kaur ◽  
Sunil K. Gupta ◽  
Sunil K. Juneja ◽  
Sukhjot Kaur ◽  
Monika Rani
Keyword(s):  
Insulin Resistance ◽  
Acanthosis Nigricans ◽  
Polycystic Ovarian Syndrome ◽  
Free Testosterone ◽  
Reproductive Age ◽  
Common Finding ◽  
Serum Prolactin ◽  
Endocrine Disorders ◽  
Cutaneous Manifestations ◽  
Ovarian Syndrome

Background: Polycystic ovarian syndrome (PCOS) is one of the most frequently encountered endocrine disorders that occurs in as many as 4 to 10% of women of reproductive age group. It presents with a series of skin changes including acne, hirsutism, seborrhea, androgenetic alopecia (AGA) and acanthosis nigricans. Aim of the study was to determine the prevalence and frequency of different cutaneous manifestations in PCOS patients and to correlate them with the degree of hormonal abnormalities.Methods: A total 100 patients with features of PCOS who presented to department of dermatology, gynecology (January 2018-December 2019) with cutaneous manifestations were recorded and diagnosis of PCOS was made using Rotterdam’s criteria. Pregnant women and diagnosed cases of any other endocrine disorder were excluded. Hirsutism was assessed using Ferriman-Gallwey score and AGA according to Ludwig’s classification. Serum hormonal profile including FSH, LH, prolactin, testosterone (free), DHEAS, TSH, FBS, fasting insulin were done. Insulin resistance was determined by calculating HOMA-IR score.Results: Among cutaneous manifestations of PCOS, hirsutism (85%) was the most common finding followed by acne (73%), seborrhea (50%), AGA (36%), acanthosis nigricans (29%) and acrochordons (9%). The most common hormonal abnormality was insulin resistance in 53% patients, followed by raised free testosterone in 19% and serum prolactin in 18% patients. A statistically significant association was present between AGA and insulin resistance, hirsutism and raised prolactin levels, seborrhea and raised body mass index (p < 0.05).Conclusions: Dermatological manifestations of PCOS play a significant role in making the diagnosis and constitute a substantial portion of the symptoms experienced by women with this syndrome.

scholarly journals Role of oral inositol supplementation in women with polycystic ovarian syndrome

2021 ◽  
Vol 10 (12) ◽  
pp. 4493
Author(s):  
Najma Malik ◽  
Navneet Dubey
Keyword(s):  
Insulin Resistance ◽  
Prospective Observational Study ◽  
Oocyte Quality ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Medical College ◽  
Good Medicine ◽  
Ovarian Syndrome ◽  
Rotterdam Criteria

Background: PCOS is one of the most common endocrine disorder in women of reproductive age, it affects about 5-10% of women of reproductive age. It is characterized by chronic anovulation, hyperandrogenism, and insulin resistance. 30-40% of PCOS women have impaired glucose tolerance.Methods: This was prospective observational study carried out on 100 patients of PCOS visiting outpatient Department of Obstetrics and Gynecology, BRD Medical College, Gorakhpur from 1st July 2018 to 30th June 2019. Patients were diagnosed as PCOS on basis of Rotterdam criteria. In these 100 patients, oral inositol 2 gm twice daily was given for 3 months to 6 months depending upon the response of the patient and patients were examined every 4 week for menstrual regularity, acne improvement, hirsutism, spontaneous ovulation and pregnancy.Results: With inositol supplementation, menstrual abnormality corrected in 80% cases, 45% cases having acne improved. Ovulation occurred in 75.5% cases and 66.6% cases conceived with inositol supplementation.Conclusions: Insulin resistance is the basic pathophysiology for PCOS hence inositol supplementation is supposed to be very good medicine for management of PCOS to improve insulin sensitivity. Inositol leads to improvement in regularity of menstrual cycle, insulin resistance, hyperandrogenic features like hirsutism, acne, restores ovulation and improves oocyte quality.

scholarly journals Study of clinical characteristics of women with polycystic ovarian syndrome

2020 ◽  
Vol 9 (6) ◽  
pp. 2424
Author(s):  
Jeevanthy P. Upadhya ◽  
Supriya Rai ◽  
Shrikrishna V. Acharya
Keyword(s):  
Clinical Characteristics ◽  
Acanthosis Nigricans ◽  
Polycystic Ovarian Syndrome ◽  
Tertiary Care ◽  
Vital Role ◽  
Reproductive Age ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Ovarian Syndrome

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrinal disorders of the reproductive age group causing anovulation, infertility incidence being 8.7-17.8%. It is associated with obesity, insulin resistance, dyslipidaemia and metabolic syndrome. This study was aimed to study the different clinical characteristics of women diagnosed with PCOS, attending a tertiary care hospital outpatient department.Methods: This was a hospital-based cross-sectional observational study of 200 patients with PCOS meeting the revised Rotterdam criteria from January 2018-June 2019 excluding pregnant and women with other systemic disorders. A detailed history and examination done, data collected regarding menstrual complaints, features of hyperandrogenism, hirsutism, acne, oily skin and Acanthosis Nigricans (AN) was documented. All data were statistically analyzed and compared using the chi-square or fissures’ exact test. p-value <0.05 considered significant.Results: A total of 200 patients with PCOS were included in the study, of which 41% were obese, 18% lean. The mean age was 24.44±5.62 years. Menstrual complaints were present in 88% -oligomenorrhea (49%) being the most common. 59% had hirsutism,38% of severe grade. Acanthosis nigricans was present in 33% of the patients. Correlation between hirsutism and alopecia, waist to hip ratio (WHR); acanthosis and WHR were statistically significant.Conclusions: PCOS is an ill-defined symptom complex where ethnicity plays a vital role, hence creating a greater need to know the characteristics of the syndrome in different populations and ethnicity. All women presenting with oligomenorrhea or other menstrual complaint should be investigated for PCOS and treated accordingly. The syndrome usually occurs with multiple characters. Though obesity is common in PCOS, non-obese are also at risk. The prevalence of AN and Hirsutism in PCOS were comparable. This mandates a need to increase awareness regarding the syndrome in the general population.

scholarly journals Study of Serum Chemerin in Patients of Polycystic Ovarian Syndrome and its Relation to Insulin Resistance

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M R Halawa ◽  
R S Abdelbaky ◽  
Y M Eid ◽  
M S Nasr ◽  
L M Hendawy ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Glucose ◽  
Polycystic Ovarian Syndrome ◽  
Fasting Blood Glucose ◽  
Control Group ◽  
Total Testosterone ◽  
Model Assessment ◽  
Fasting Insulin ◽  
Obese Women ◽  
Ovarian Syndrome

Abstract Background study of chemerin level in polycystic ovarian syndrome (PCO) patients and its relation to insulin resistance (IR). Upon chemerin on adipose tissue and glucose metabolism, serum chemerin has been recently studied in (PCO) women Aim We aimed to study the level of serum chemerin in PCO patients and its relation to insulin resistance. Methods The current study included 45 subjects with PCO syndrome and 45 healthy subjects as a control group. PCO subjects were divided into 27 obese PCO and 18 lean PCO. Control women were divided into 25 obese women and 20 lean women. Measurement of serum chemerin levels, fasting blood glucose (FBG),fasting insulin (FIN), total testosterone and pelvic ultrasonography Results Serum chemerin was significantly higher in the obese PCOS group (99.65 ± 13.72 ng/mL) compared with lean PCOS (87.99 ± 5,64 ng/mL) and the obese (76.82 ± 2.39 ng/mL) and non-obese (69.19 ± 8.40 ng/mL) control groups. In PCOS women, serum chemerin levels were positively correlated with Body mass index (BMI) (r = 0.835, P &lt; 0.001), Fasting blood glucose (FBG) (r = 0.493, P &lt; 0.005), Fasting insulin (FIN) (r = 0.913, P &lt; 0.001), Homeostasis model assessment of insulin resistance (HOMA-IR) (r = 0.9181, P &lt; 0.001). Conclusion There is an increase in serum chemerin level in PCOS patients with even more significant increase in patients with obese PCOS.

scholarly journals Insulin resistance and high molecular weight adiponectin in obese and non-obese patients with Polycystic Ovarian Syndrome (PCOS)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Farnaz Kamali Haghighi Shirazi ◽  
Zohre Khodamoradi ◽  
Marjan Jeddi
Keyword(s):  
Insulin Resistance ◽  
Molecular Weight ◽  
High Molecular Weight ◽  
Polycystic Ovarian Syndrome ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
High Molecular Weight Adiponectin ◽  
Cross Sectional ◽  
Free Androgen Index ◽  
Ovarian Syndrome

Abstract Background Polycystic ovarian syndrome (PCOS) is the most common endocrinopathy among young women. Insulin resistance is a key feature in the pathogenesis of PCOS; also high molecular weight adiponectin is a marker of insulin resistance. The aim of this study was to evaluate the insulin resistance, metabolic and androgenic profiles and high molecular weight adiponectin in obese and non-obese PCOS patients. Methods In this cross-sectional study in outpatient endocrinology clinics of Shiraz University of Medical Sciences, 80 women aged 17–43 years old with PCOS were enrolled. Biochemical and hormonal assay was done on fasting blood sample on the third day of follicular phase. Results The individuals had a mean age of 28.39 ± 6.56 years, mean weight of 65.41 ± 12.59 Kg, mean BMI of 25.5 ± 4.9, and mean waist circumference of 88.0 ± 13.1 cm. Of all individuals 20% had frank insulin resistance with HOMA-IR > 3.8. Although the obese PCOS patients had lower levels of high molecular weight adiponectin (P = 0.03) than the normal weight PCOS individuals, the level of insulin and insulin resistance was not different in them (P = 0.13, 0.13). Patients with classic PCOS phenotype significantly had higher levels of insulin resistance and free androgen index (P < 0.001, 0.001). We found a significant correlation between the insulin level and free androgen index (correlation coefficient: 0.266 and P = 0.018) after adjusting for BMI. Conclusion This cross-sectional study showed a high incidence of insulin resistance in PCOS patients independent of obesity, and determined BMI related lower level of high molecular weight adiponectin in obese PCOS individuals. More detailed studies are warranted for evaluation of insulin resistance and its pathophysiologic role in PCOS.

scholarly journals An attempt to understand the concept of PCOS w. s. r. to artavavaha sroto dusti

2018 ◽  
Vol 6 (04) ◽  
Author(s):  
Dharmaraj Nagorao Lone ◽  
Chitra Gawande ◽  
Pratibha Kulkarni ◽  
Nagorao Dattarao Lone
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovarian Syndrome ◽  
Modern Medicine ◽  
The Body ◽  
Reproductive Age ◽  
Fallopian Tubes ◽  
Women Of Reproductive Age ◽  
Androgen Excess ◽  
Hormonal Imbalance ◽  
Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is the most common endocrine ovarian disorder affecting 5 to 10% women of reproductive age. It is also known as stein- laventhal syndrome or hyper androgenic Anovulation. The main primary character of PCOS is irregular menstrual cycle which leads to improper ovulation. Exact pathogenesis of PCOS is not understood clearly, it may be discussed under following headings: Abnormality of Hypothalamic-pituitary compartment (Hormonal imbalance), androgen excess, anovulation, obesity and insulin resistance etc. Srotas are the circulatory channels through which Dosha’s, Dhatu’s and Mala’s moves from one part to another part of the body. Each srotas has srotomoola, srotomarga and srotomukha. The moolasthana of artavavaha srotas are garbhashaya(uterus) and artavavahi dhamani’s(uterine & ovarian arteries). Artavavaha srotas may be categorized into Shonita artavavaha srotas which carries menstrual blood through blood vessels and capillaries of the uterus & Beejartavavaha srotas which carries ovum through fallopian tubes. Abnormality of Artavavaha srotas causes Vandhyatva, Maithuna Asahishnuta and Artavanasha. Vandhyatva caused due to abnormality in chaturvidha garbhottpadaka(rutu, kshetra, ambu and beeja) samagri. Maithuna Asahishnuta related to vatala, paripluta, vipluta and shandi yoniyapada, while Artavanasha related to Vandhya, Arajaska and shushka yonivyapada. All these symptoms like Vandhyatva, Maithuna Asahishnuta and Artavanasha are correlated with common symptoms of PCOS which include Infertility, Dyspareunia & Amenorrhoea respectively. As there is no curative treatment available in modern medicine, understanding of PCOS with reference to Artavavaha sroto dusti may be a ray of hope to treat PCOS with Ayurvedic remedies. KEY WORDS: Artava, Srotas, PCOS, Vandhyatva, Yonivyapada.

scholarly journals A cross sectional study of polycystic ovarian syndrome among young women in Bhopal, Central India

2017 ◽  
Vol 5 (1) ◽  
pp. 95 ◽  
Author(s):  
Mahesh Gupta ◽  
Daneshwar Singh ◽  
Manju Toppo ◽  
Angelin Priya ◽  
Soumitra Sethia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Women ◽  
Polycystic Ovarian Syndrome ◽  
Cross Sectional Study ◽  
Reproductive Age ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Waist Hip Ratio ◽  
Ovarian Syndrome

Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder among women of reproductive age groups. It is one of the leading causes of poor fertility. Risk factors include obesity, not enough physical exercise, and a family history. Most studies in India report prevalence of PCOS as 9.13% to 36%. Behaviour and life style modifications are important part of treatment for PCOS. A number of cases in the community due to lack of awareness and proper guidance, it remains undiagnosed. Aim of this study was to find the prevalence of PCOS among the young females of Bhopal city. Thus, risk assessment in the form of a survey would be one of the strategies to identify this syndrome early so as to encourage young women to seek timely treatment and prevent its long term complications. Methods: Non comparative cross sectional study for duration of 8 month. Results: The prevalence of PCOS in this study was 8.20%. Among all the risk factors, BMI ≥25 (P value < 0.0001) and waist hip ratio ≥0.85 (<0.0001) were strongly associated with the presence of PCOS and Lack of awareness, there were in girls (78.4%). Conclusions: Women who were having BMI ≥25 and waist hip ratio ≥0.85 should be educated about its complications and should be advised weight loss. Girls who had irregularity of menses and signs of hyperandrogenism should be investigated and must be managed accordingly. Early diagnosis of PCOS and its prompt treatment will help the girls to improve quality of life. 

scholarly journals Effect of metformin in treating polycystic ovarian syndrome among women attending a tertiary care setting -A prospective observational study

2021 ◽  
Vol 8 (2) ◽  
pp. 188-193
Author(s):  
Suresh Chandra Mondal ◽  
Pinaki Sarkar
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Polycystic Ovarian Syndrome ◽  
Care Setting ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Significant Difference ◽  
Tertiary Care Setting ◽  
Ovarian Syndrome

To determine the efficacy of metformin on clinical profile and metabolic disorders in women with polycystic ovarian syndrome. Polycystic ovarian syndrome, is a heterogeneous endocrinological disorder affecting women of reproductive age and metformin was introduced to influence the pathogenesis.: A prospective observational study was conducted on 100 women with polycystic ovarian syndrome, attending department of gynaecology in a tertiary care setting and were divided into two group of 50 each. Metformin was used in 50 patients for one year. Rest 50 patients were advised about diet control and exercise. The parameters like body mass index (BMI), weight, hormonal imbalance, ovulation, and menstrual changes were analysed in both groups. Descriptive statistics for mean, SD were carried and chi-square test was used to test statistical significance using coGuide version V.1.0 and p value set at &#60; 0.05.: The mean age was 25±10 years. Both the groups were comparable with respect to BMI and weight. There was a significant difference between the groups with respect to fasting insulin, which reduced to 7.44±1.12 from 11.97±2mIU/ml, testosterone levels reduced to 0.59±0.1 from 0.76±0.3 mIU/ml, luteinizing hormone levels reduced to 8.55±2 from 20.01±7.3 mIU/ml, and LH:FSH ratio reduced to 1.11±0.1 from 2.31±0.2 mIU/ml. In the metformin group, 22 (44%) participants were anovulation before treatment, and ovulation started in 15 (30%) after treatment which was not seen other group.Clinical, hormonal, and biochemical changes in polycystic ovarian syndrome may effectively be treated by metformin.

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