Sachdeva Garima, Gainder Shalini, Suri Vanita, Sachdeva Naresh, Chopra Seema
Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Endocrinol Metab. 2019 Mar-Apr;23(2):257-262. doi: 10.4103/ijem.IJEM_637_18.
To study the clinical, metabolic, hormonal parameters, and differential response to clomiphene among the obese and non-obese PCOS (polycystic ovarian syndrome).
Prospective observational study.
Infertility OPD, a government hospital.
About 164 women with PCOS-related infertility.
Obese PCOS group [body mass index (BMI) ≥23 kg/m) and non-obese PCOS group (BMI <23 kg/m).
Of the total 164 PCOS women, 124 (75.61%) were in the obese group with BMI ≥23 kg/m and 40 (24.39%) were in the non-obese PCOS group. The prevalence of menstrual irregularity, hypertension, insulin resistance (IR), metabolic syndrome, endometrial hyperplasia, and clomiphene resistance in the PCOS women were 82.34%, 3.66%, 59.76%, 24.39%, 7.93%, and 53.7%, respectively. The Ferriman-Gallwey score, menstrual irregularity, IR [fasting insulin and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)], metabolic syndrome, deranged lipid profile, and clomiphene resistance were statistically more common in the obese PCOS group ( < 0.05). Hypertension, deranged blood sugar profile, testosterone, androstenedione levels, and endometrial hyperplasia were more common in obese PCOS group but the results were not statistically significant. No significant differences were found in the luteinizing hormone (LH), follicle-stimulating hormone (FSH), LH-FSH ratio, and 17-hydroxyprogesterone (17-OHP) levels between the two groups.
Obese PCOS have a higher risk of adverse outcomes like hypertension, IR, metabolic syndrome, and endometrial hyperplasia. So, targeting obesity in PCOS women will not only help to prevent adverse outcomes but also improve responsiveness to clomiphene citrate.
研究肥胖与非肥胖多囊卵巢综合征（PCOS）患者的临床、代谢、激素参数以及对克罗米芬的不同反应。
前瞻性观察性研究。
一家政府医院的不孕症门诊。
约164例与PCOS相关不孕症的女性。
肥胖PCOS组[体重指数（BMI）≥23kg/m²]和非肥胖PCOS组（BMI<23kg/m²）。
在164例PCOS女性中，124例（75.61%）属于BMI≥23kg/m²的肥胖组，40例（24.39%）属于非肥胖PCOS组。PCOS女性月经不规律、高血压、胰岛素抵抗（IR）、代谢综合征、子宫内膜增生和克罗米芬抵抗的患病率分别为82.34%、3.66%、59.76%、24.39%、7.93%和53.7%。肥胖PCOS组的费里曼-高尔韦评分、月经不规律、IR[空腹胰岛素和胰岛素抵抗稳态模型评估（HOMA-IR）]、代谢综合征、血脂异常和克罗米芬抵抗在统计学上更为常见（P<0.05）。高血压、血糖异常、睾酮、雄烯二酮水平和子宫内膜增生在肥胖PCOS组中更常见，但结果无统计学意义。两组之间的促黄体生成素（LH）、促卵泡生成素（FSH）、LH-FSH比值和17-羟孕酮（17-OHP）水平无显著差异。
肥胖PCOS患者发生高血压、IR、代谢综合征和子宫内膜增生等不良结局的风险更高。因此，针对PCOS女性的肥胖问题不仅有助于预防不良结局，还能提高对枸橼酸克罗米芬的反应性。
