Yalcin Bahat Pinar, Özel Alper, Demirci Alper
Obstetrics and Gynecology, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, TUR.
Radiology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, TUR.
Cureus. 2021 Jan 31;13(1):e13025. doi: 10.7759/cureus.13025.
Introduction The purpose of this study is to assess cardiovascular risk factors in patients diagnosed with polycystic ovary syndrome (PCOS) by comparing dyslipidemia, insulin sensitivity, hyperhomocysteinemia, carotid artery intima-media thickness (CIMT) between women diagnosed with PCOS and healthy subjects. Materials and Methods Hundred women diagnosed with PCOS aged between 18 and 35 years and who applied to tertiary center gynecology clinic were included in the study. Hundred women who applied for menstrual irregularity to the same outpatient clinic with no systemic diseases, who were not under medical treatment for any condition, were included in the control group. Physical examination, hormone profile tests on the second day of the patients' menstrual cycle, pelvic, and neck ultrasonography to evaluate CIMT were performed for all patients. CIMT values were compared with biochemical, hormonal, and anthropometric values. Sensitivity, specificity, Pearson correlation coefficient, mean, and standard deviation were calculated. Results In the PCOS group, there was no statistically significant difference in homeostatic model assessment for insulin resistance (HOMA-IR) (<2.5 and >2.5) among all parameters. When we evaluate body mass index (BMI) (<30 and >30) for this PCOS group patients, a very highly significant difference (p < 0.001) between waist-hip ratio and hemoglobin A1c (HbA1c) was established statistically, and there was a significant difference (p < 0,05) between waist-hip ratio and luteinizing hormone (LH). After this statistical analysis, dehydroepiandrostenedione sulfate (DHEAS), free androgen index (FAI), LH, low-density lipoprotein (LDL), Ferriman-Gallwey score (FGS), homocysteine, mean CIMT, and waist to hip ratio were significantly different in the two groups (p < 0.01). The difference between HbA1c and cholesterol high-density lipoprotein (HDL) was significant (p < 0.05). Conclusion As a result, in the PCOS group, when compared to the healthy subjects, dyslipidemia, HbA1c, waist to hip ratio, and CIMT were significantly different. It might be suitable to perform an ultrasound for CIMT in patients with higher Ferriman-Gallwey (FG) score.
引言 本研究的目的是通过比较多囊卵巢综合征(PCOS)患者与健康受试者的血脂异常、胰岛素敏感性、高同型半胱氨酸血症、颈动脉内膜中层厚度(CIMT),来评估确诊为PCOS的患者的心血管危险因素。
材料与方法 本研究纳入了100名年龄在18至35岁之间、前往三级中心妇科门诊就诊且被诊断为PCOS的女性。对照组纳入了100名因月经不规律前往同一门诊就诊、无全身性疾病且未接受任何疾病治疗的女性。对所有患者进行了体格检查、在患者月经周期第二天进行激素水平检测、盆腔及颈部超声检查以评估CIMT。将CIMT值与生化、激素及人体测量值进行比较。计算了敏感性、特异性、皮尔逊相关系数、均值和标准差。
结果 在PCOS组中,所有参数的胰岛素抵抗稳态模型评估(HOMA-IR)(<2.5和>2.5)之间无统计学显著差异。当我们评估该PCOS组患者的体重指数(BMI)(<30和>30)时,腰臀比与糖化血红蛋白(HbA1c)之间在统计学上存在非常显著的差异(p < 0.001),腰臀比与促黄体生成素(LH)之间存在显著差异(p < 0.05)。经过该统计分析,两组间硫酸脱氢表雄酮(DHEAS)、游离雄激素指数(FAI)、LH、低密度脂蛋白(LDL)、费里曼-加洛韦评分(FGS)、同型半胱氨酸、平均CIMT及腰臀比存在显著差异(p < 0.01)。HbA1c与高密度脂蛋白胆固醇(HDL)之间的差异显著(p < 0.05)。
结论 结果显示,与健康受试者相比,PCOS组的血脂异常、HbA1c、腰臀比及CIMT存在显著差异。对于费里曼-加洛韦(FG)评分较高的患者,进行CIMT超声检查可能是合适的。