Characterization of university women with polycystic ovarian syndrome in Costa Rica

Authors

DOI:

https://doi.org/10.51481/amc.v65i2.1265

Keywords:

insulin, insulin resistance, polycystic ovary syndrome, obesity

Abstract

Aim: Describe some clinical findings and biochemical characterization of a sample of Costa Rican university women with polycystic ovarian syndrome.

Methods: Observational-descriptive study where 160 Costa Rican women between 17 and 28 years old participated. Some physical characteristics and clinical parameters (overweight, acne, hirsutism, spontaneous abortions, menstrual disorders, among others) and biochemical parameters (glucose, lipid profile, insulin, total testosterone, TSH, among others) associated with the syndrome were studied. Data was analyzed applying descriptive statistics. The t-Student test was used to compare the means of the variables with normal distribution, while the Mann-Whitney test was performed for non-parametric variables. A p value < 0.05 was considered significant. Spearman's coefficients were used to determine the levels of correlation between the different study variables.

Results: Women with Polycystic Ovarian Syndrome presented significantly higher values in relation to women without the syndrome in the variables of weight (p = 0.003), body mass index (p < 0.001), as well as blood total testosterone concentration (p < 0.001), LDL-cholesterol (p = 0.020), triglycerides (p < 0.001) and the Castelli index (p < 0.001). HDL-cholesterol concentration (p < 0.001) was significantly higher in women without the Syndrome. In addition, there was a significantly higher proportion of women with the syndrome who had insulin resistance (p = 0.007), LH/FSH ratio > 2.8 (p = 0.009), hirsutism (p = 0.001), menstrual disorders (p=0.029) and obesity (p=0.014) compared to women without the syndrome.

Conclusions: Hyperandrogenism, insulin resistance, altered lipid concentrations and high Castelli Indexes are the most prevalent biochemical parameters in the sample of Costa Rican women with Polycystic Ovarian Syndrome. The execution of projects with broader biochemical profiles together with ultrasound tests are the new challenges for future research on Polycystic Ovarian Syndrome in Costa Rica.

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References

Costello MF, Misso ML, Balen A, Boyle J, Devoto L, Garad RM, et al. Evidence summaries and recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome: assessment and treatment of infertility. Hum Reprod Open. 2019; 1:1-24. DOI:10.1093/hropen/hoy021/5272742

Rosenfield RL, Ehrmann DA. The Pathogenesis of Polycystic Ovary Syndrome (PCOS): The hypothesis of PCOS as functional ovarian hyperandrogenism revisited. Endocr Rev. 2016; 37:467-520. DOI: 10.1210/er.2015-1104

Fauser BCJM, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R, et al. Consensus on women's health aspects of polycystic ovary syndrome (PCOS): The Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril. 2012; 97:28-38. e25. DOI: 10.1016/j.fertnstert.2011.09.024

Norman RJ, Dewailly D, Legro RS, Hickey TE. Polycystic ovary syndrome. Lancet [Internet]. 2007; 370:685-697. DOI: 10.1016/S0140-6736(07)61345-2

De Medeiros SF. Risks, benefits size and clinical implications of combined oral contraceptive use in women with polycystic ovary syndrome. Reprod Biol Endocrinol. 2017; 15:93. DOI: 10.1186/s12958-017-0313-y

Aguirre-González C, Campos-Aguiar J. La metformina en el síndrome de ovario poliquístico. Med leg Costa Rica. 2007; 24:123-136.

Rodríguez Guarín M, Gempeler Rueda J, Pérez Muñoz V, Ribero Salazar O. Polycystic ovarian syndrome and its potential association with bipolar disorder in patients with eating disorder. Rev Mex Trastor Aliment. 2017; 8: 142-150. DOI: 10.1016/j.rmta.2016.12.003

Escobar-Morreale HF, Millán JLS. Abdominal adiposity and the polycystic ovary syndrome. Trends Endocrinol Metab. 2007; 18:266-272. DOI: 10.1016/j.tem.2007.07.003

Group RE-SPCW. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Human Reproduction. 2004; 19:41-47. DOI: 10.1093/humrep/deh098

Teede H, Misso M, Costello M, Dokras A, Laven J, Moran L, et al. International evidence-based guideline for the assessment and management of polycystic ovary syndrome 2018. National Health and Medical Research Council (NHMRC). 2018; 1-198

Sir P T, Preisler R J, Magendzo N A. Síndrome de ovario poliquístico. Diagnóstico y manejo. Rev Med Clin Condes 2013; 24:818-826.

Ladrón De Guevara A, Fux-Otta C, Crisosto N, Szafryk De Mereshian P, Echiburú B, Iraci G, et al. Metabolic profile of the different phenotypes of polycystic ovary syndrome in two Latin American populations. Fertil Steril. 2014; 101:1732-9.e1-2. DOI: 10.1016/j.fertnstert.2014.02.020

Cirik DA, Dilbaz B. What do we know about metabolic syndrome in adolescents with PCOS? J Turk Ger Gynecol Assoc. 2014; 15: 49-55. DOI: 10.5152/jtgga.2014.95776

Di Fede G, Mansueto P, Longo RA, Rini GB, Carmina E. Influence of sociocultural factors on the ovulatory status of polycystic ovary syndrome. Fertil Steril. 2009; 91:1853-1856. DOI: 10.1016/j.fertnstert.2008.02.16

Rojas J, Chávez M, Olivar L, Rojas M, Morillo J, Mejías J, et al. Polycystic Ovary Syndrome, Insulin Resistance, and Obesity: Navigating the Pathophysiologic Labyrinth. Int J Reprod Med. 2014; 2014: 1-17. DOI: 10.1155/2014/719050

Murri M, Insenser M, Escobar-Morreale HF. Metabolomics in polycystic ovary syndrome. Clin Chim Acta. 2014; 429:181-188. DOI: 10.1016/j.cca.2013.12.018

Trent M, Gordon CM. Diagnosis and Management of Polycystic Ovary Syndrome in Adolescents. Pediatrics. 2020; 145: S210-S218. DOI:10.1542/peds.2019-2056

Ng NYH, Jiang G, Cheung LP, Zhang Y, Tam CHT, Luk AOY, et al. Progression of glucose intolerance and cardiometabolic risk factors over a decade in Chinese women with polycystic ovary syndrome: A case-control study. PLoS Med. 2019; 16: e1002953. DOI: 10.1371/journal.pmed.1002953

Moran LJ, Misso ML, Wild RA, Norman RJ. Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: A systematic review and meta-analysis. Hum Reprod Update. 2010; 16:347-363. DOI: 10.1093/humupd/dmq001.

Peña-Cordero S, Salazar-Torres ZK, Cárdenas-Heredia FR, Ochoa-Zamora SP, Cumbe-Guerrero KM, Sánchez-Salazar GM. Prevalencia y factores asociados al Ovario Poliquístico en adultas de las parroquias urbanas de la ciudad de Cuenca-Ecuador, 2017. Arch. Venez. de Farmacol. y Ter. 2018; 37:184-189.

Sanchez N. A life course perspective on polycystic ovary síndrome. Int J Womens Health. 2014; 6:115-122. DOI: 10.2147/IJWH.S55748

Rasgon NL, Rao RC, Hwang S, Altshuler LL, Elman S, Zuckerbrow-Miller J, et al. Depression in women with polycystic ovary syndrome: Clinical and biochemical correlates. J Affect Disord. 2003; 74:299-304. DOI: 10.1016/s0165-0327(02)00117-9.

Mánsson M, Holte J, Landin-Wilhelmsen K, Dahlgren E, Johansson A, Landén M. Women with polycystic ovary syndrome are often depressed or anxious-A case control study. Psychoneuroendocrinology. 2008; 33:1132-1138. DOI: 10.1016/j.psyneuen.2008.06.003

Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetología. 1985; 28:412-419. DOI: 10.1007/BF00280883

Friedwald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without the use of the preparative centrifuge. Clin Chem. 1975; 18:499-502

Ben-Rafael Z, Orvieto R. Polycystic ovary syndrome: A single gene mutation or an evolving set of symptoms. Curr Opin Obstet Gynecol. 2000; 12:169-173. DOI: 10.1097/00001703-200006000-00002

Gómez G, Quesada D, Monge R. Perfil antropométrico y prevalencia de sobrepeso y obesidad en la población urbana de Costa Rica entre los 20 y 65 años agrupados por sexo: resultados del Estudio Latino Americano de Nutrición y Salud. Nutr Hosp. 2020; 37:534-542. DOI: 10.20960/nh.02899

Barber TM, McCarthy MI, Wass JAH, Franks S. Obesity and polycystic ovary syndrome. Clin Endocrinol. 2006; 65:137-145. DOI: 10.1111/j.1365-2265.2006.02587.x

Teede H, Deeks A, Moran L. Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Med. 2010; 8:1-10.

Coviello AD, Sam S, Legro RS, Dunaif A. High prevalence of metabolic syndrome in first-degree male relatives of women with polycystic ovary syndrome is related to high rates of obesity. J Clin Endocrinol Metab. 2009; 94:4361-4366. DOI:10.1210/jc.2009-1333.

Gibson-Helm M, Teede H, Dunaif A, Dokras A. Delayed diagnosis and a lack of information associated with dissatisfaction in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2017; 102:604-612. DOI:10.1210/jc.2016-2963.

Reckelhoff JF. Polycystic ovary syndrome: Androgens and hypertension. Hypertension. 2007; 49:1220-1221. DOI: 10.1161/HYPERTENSIONAHA.107.088138

Rodríguez-Rey JC. Lípidos y diabetes tipo 2. Desarrollo de nuevas terapias basadas en el metabolismo lipídico (Revisión). An Real Acad Farm. 2013; 79:412-433.

Dumesic DA, Oberfield SE, Stener-Victorin E, Marshall JC, Laven JS, Legro RS. Scientific statement on the diagnostic criteria, epidemiology, pathophysiology, and molecular genetics of polycystic ovary syndrome. Endocr Rev. 2015; 36:487-525. DOI: 10.1210/er.2015-1018.

Sir-Petermann T, Maliqueo M, Pérez-Bravo F, Angel B, Carvajal F, del Solar MP, et al. Polycystic ovary syndrome: the importance of establishing diagnosis. Rev Med Chil. 2001; 129:805-812. DOI: 10.4067/S0034-98872001000700015

Pérez C. J, Méndez R. MJ, Fuhrer F. J, Marquéz N. J, Cumsille MA, Fuhrer C. J. Síndrome de ovario poliquístico. Presentación clínica, bioquímica y ultrasonográfica. Rev Chil Obstet Ginecol. 2003; 68:471-476. DOI: 10.4067/S0717-75262003000600003

Chandrasekaran S, Sagili H. Metabolic syndrome in women with polycystic ovary syndrome. The Obstetrician & Gynaecologist. 2018; 20:245-252. DOI:10.1111/tog.12519

Published

2023-08-01

How to Cite

Characterization of university women with polycystic ovarian syndrome in Costa Rica. (2023). Acta Médica Costarricense , 65(2), 1-12. https://doi.org/10.51481/amc.v65i2.1265