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伴有和不伴有多囊卵巢形态外观的多囊卵巢综合征女性的临床表现、代谢谱、激素参数及炎症标志物的差异

Variation in Clinical Presentation, Metabolic Profile, Hormonal Parameters and Inflammatory Markers in Polycystic Ovary Syndrome Women with and without Polycystic Ovary Morphology Appearance.

作者信息

Jena Sweekruti, Mishra Ipsita, Baliarsinha Anoj Kumar, Jena Debarchan, Debata Madhumita

机构信息

Department of Endocrinology, SCB Medical College and Hospital, Cuttack, Odisha, India.

Department of Radiology, SCB Medical College and Hospital, Cuttack, Odisha, India.

出版信息

J Hum Reprod Sci. 2023 Apr-Jun;16(2):132-139. doi: 10.4103/jhrs.jhrs_60_23. Epub 2023 Jun 30.

Abstract

BACKGROUND

Polycystic ovary syndrome (PCOS) is a heterogeneous disorder with a spectrum of presentation. Studies have reported considerably different rates in terms of the incidence of polycystic ovary morphology (PCOM) in patients with PCOS with inconsistent results regarding the effects of PCOM in them.

AIMS

The aim of this study was to determine the differences in clinical presentation, metabolic profile, hormonal parameters and inflammatory markers in PCOS women with and without PCOM on ultrasonography (USG).

SETTINGS AND DESIGN

A total of 70 PCOS women were recruited. To analyse the differences between various parameters, the patients were divided into two groups based on the presence or absence of PCOM on USG of the pelvis as per the Rotterdam criteria.

MATERIALS AND METHODS

A total of 37 patients had PCOM as per the diagnostic criteria for PCOS (Group 1), while 33 patients did not have PCOM on USG and were designated as Group 2. All participants underwent a detailed clinical evaluation and biochemical investigations, including high-sensitivity C-reactive protein, serum adiponectin, luteinising hormone, follicle-stimulating hormone, total testosterone and serum anti-Mullerian hormone. The homeostasis model assessment of IR (HOMA-IR) was calculated using standard equations.

STATISTICAL ANALYSIS USED

The mean and Standard deviation were computed for all continuous variables. Frequencies and proportions were calculated for categorical variables. Comparisons of the mean scores between the study groups were assessed using the Unpaired Student's -test. The mean score of the subgroups was also compared using the unpaired Student's -test. < 0.05 was considered significant for all statistical inferences.

RESULTS

The mean LDL and mean triglyceride were higher in Group 2, which was statistically significant ( = 0.004 and ≤ 0.001, respectively). The mean hs-CRP was found to be higher in Group 2, which was statistically significant ( = 0.005). The mean AMH was higher in Group 1, which was statistically significant ( = 0.002). Group 1 had higher adiponectin levels, which was statistically significant ( = 0.04).

CONCLUSION

The above findings suggest that patients without diagnostic PCO morphology have a worse metabolic profile compared to those with PCO morphology on USG. Obese patients without PCO morphology probably have a higher cardiovascular risk compared to obese patients with PCO morphology.

摘要

背景

多囊卵巢综合征(PCOS)是一种具有多种表现形式的异质性疾病。研究报告了多囊卵巢形态(PCOM)在PCOS患者中的发生率差异很大,且关于PCOM对这些患者的影响结果并不一致。

目的

本研究的目的是确定超声检查(USG)显示有和没有PCOM的PCOS女性在临床表现、代谢谱、激素参数和炎症标志物方面的差异。

设置与设计

共招募了70名PCOS女性。为了分析各项参数之间的差异,根据鹿特丹标准,根据盆腔USG检查结果是否存在PCOM将患者分为两组。

材料与方法

根据PCOS诊断标准,共有37例患者存在PCOM(第1组),而33例患者在USG检查中没有PCOM,被指定为第2组。所有参与者均接受了详细的临床评估和生化检查,包括高敏C反应蛋白、血清脂联素、黄体生成素、卵泡刺激素、总睾酮和血清抗苗勒管激素。使用标准方程计算胰岛素抵抗的稳态模型评估(HOMA-IR)。

所用统计分析方法

计算所有连续变量的均值和标准差。计算分类变量的频率和比例。使用非配对学生t检验评估研究组之间的平均得分比较。亚组的平均得分也使用非配对学生t检验进行比较。所有统计推断中,P<0.05被认为具有统计学意义。

结果

第2组的平均低密度脂蛋白和平均甘油三酯较高,具有统计学意义(分别为P = 0.004和P≤0.001)。发现第2组的平均高敏C反应蛋白较高,具有统计学意义(P = 0.005)。第1组的平均抗苗勒管激素较高,具有统计学意义(P = 0.002)。第1组的脂联素水平较高,具有统计学意义(P = 0.04)。

结论

上述研究结果表明,超声检查显示没有诊断性PCO形态的患者与有PCO形态的患者相比,代谢谱更差。没有PCO形态的肥胖患者与有PCO形态的肥胖患者相比,可能具有更高的心血管疾病风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1fc/10404011/94bdb7694693/JHRS-16-132-g001.jpg

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