Ahmed Alaa A, Moselhy Said S, Kumosani Taha A, Huwait Etimad A, Al-Ghamdi Maryam A, Al-Madani Khalid A, AlToukhi Majdi H, Kumosani Afnan T
Head of Radiology Department, Ghamra Armed Forces Hospital, Cairo-Egypt.
Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt.
Afr Health Sci. 2020 Jun;20(2):676-681. doi: 10.4314/ahs.v20i2.18.
Polycystic ovary syndrome (PCOS) is considered as a common cause of hormonal disturbance and obesity. The diagnosis of PCOS was done by different methods including clinical signs as anovulation, hyperandrogenism, biochemical markers and ultrasounographic investigation. This study investigated comparative outcomes of ultrasonographic and biochemical markers for early prediction of PCOS in obese women.
Seventy-five patients were clinically diagnosed with obese, PCOS and obese with PCOS and twenty-five normal age matched subjects were enrolled as control. Abdominal and transvaginal ultrasonographic for assessment of ovarian properties. In addition, BMI, serum free testosterone, dehydroepiandrosterone (DHEA), insulin, glycosylated hemoglobin (HbA1c) and LDL-c levels were evaluated.
In obese patients with PCOs (20%) ovaries revealed normal appearance in morphology while the rest (80%) showed PCOs in the form of cysts of 2-8 mm in diameter peripherally arranged around stroma. A significant elevation of free testosterone, DHEA and insulin in obese with or without PCOS compared with obese group (p<0.001). A positive correlation with hormonal abnormalities of increased HA1c, LDL-c, free testosterone, DHEA and insulin compared with obese only.
According to our study findings, ovarian morphology combined with biochemical markers is more reliable for early prediction and diagnosis of PCOS for interpretation and management.
多囊卵巢综合征(PCOS)被认为是激素紊乱和肥胖的常见原因。PCOS的诊断通过不同方法进行,包括无排卵、高雄激素血症等临床体征、生化标志物以及超声检查。本研究调查了超声和生化标志物在肥胖女性中早期预测PCOS的比较结果。
75例临床诊断为肥胖、PCOS以及肥胖合并PCOS的患者,另外招募25例年龄匹配的正常受试者作为对照。进行腹部和经阴道超声检查以评估卵巢特征。此外,评估体重指数(BMI)、血清游离睾酮、脱氢表雄酮(DHEA)、胰岛素、糖化血红蛋白(HbA1c)和低密度脂蛋白胆固醇(LDL-c)水平。
在肥胖合并PCOS的患者中(20%),卵巢形态外观正常,而其余(80%)表现为直径2 - 8毫米的囊肿形式的PCOS,囊肿周围排列在基质周围。与肥胖组相比,无论是否患有PCOS的肥胖患者中游离睾酮、DHEA和胰岛素均显著升高(p<0.001)。与仅肥胖者相比,HA1c、LDL-c、游离睾酮、DHEA和胰岛素升高与激素异常呈正相关。
根据我们的研究结果,卵巢形态与生化标志物相结合对于PCOS的早期预测和诊断在解读及管理方面更可靠。