Clinical, hormonal and metabolic characteristics of polycystic ovary syndrome among obese and nonobese women in the Croatian population [Kliničke, hormonske i metaboličke karakteristike PCOS pacijentica u Hrvatskoj u ovisnosti o tjelesnoj težini]

Pavičić Baldani, Dinka and Škrgatić, Lana and Šprem Goldštajn, Marina and Vrčić, Hrvoje and Čanić, Tomislav and Strelec, Mihajlo (2013) Clinical, hormonal and metabolic characteristics of polycystic ovary syndrome among obese and nonobese women in the Croatian population [Kliničke, hormonske i metaboličke karakteristike PCOS pacijentica u Hrvatskoj u ovisnosti o tjelesnoj težini]. Collegium Antropologicum, 37 (2). pp. 465-470. ISSN 0350-6134

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Abstract

Obesity has a deteriorating impact on women with PCOS, although prevalence and the impact of specific traits of PCOS remain inconstant in different populations. Therefore, the aim of this study was to explore the differences in clinical, hormonal and metabolic features between obese and nonobese Croatian women diagnosed as having PCOS according to Rotterdam consensus criteria. The study included 74 obese and 208 nonobese women with PCOS. Clinical, biochemical and metabolic variables were compared among those PCOS subgroups. Obese subjects with PCOS had a higher risk of developing oligo-amenorrhea (OR 3.7; 95% CI, 1.1-12.5) and lower risk for developing hirsutism and acne (OR 0.2; 95% CI, 0.1-0.3 and OR 0.8; 95% CI 0.5-1.4, respectively). Obese PCOS subjects also had a higher risk of developing hyperandrogenemia (OR 2.5; CI 95% 0.9-6.7), insulin resistance (OR 4.5; CI 95%, 2.6-7.9), hypercholesterolemia (OR 5.0, CI 95% 2.5-10.2), hypertriglyceridemia (OR 5.2; 95% CI, 2.9-9.2) as well as elevated serum CRP levels (OR 4.1; 95% CI 1.4-12.2) compared to nonobese PCOS women. In conclusion, nonobese Croatian women with PCOS are more inclined to cosmetic problems associated with PCOS then metabolic ones. This is the first study to report the impact of obesity on acne and irregular menses as a study outcome. Obesity deteriorates menstrual regularity, insulin sensitivity and lipid profile in Croatian women with PCOS; therefore one of the fundamental treatment strategies of PCOS should be obesity prevention.

Abstract in Croatian

Pretilost ima negativan utjecaj na žene s PCOS-om. Istraživanja o učestalost i utjecaju pretilosti na specifične simptome PCOS daju nedosljedne rezultate. Do sada nisu objavljene studije kojima je utjecaj debljine kod pacijentica s PCOS na redovitost menstruacija i akne bio krajni ishod. Cilj ovog rada bio je istražiti razlike u kliničkim, metaboličkim i hormonskim značajkama između pacijentica sa sindromom policističnih jajnika (PCOS) pretjerane i normalne tjelesne mase kod kojih je dijagnoza postavljena prema Rotterdamskim kriterijima. U istraživanje je uključeno 74 PCOS pacijentice pretjerane i 208 PCOS pacijentice normalne tjelesne mase. Uspoređivane su njihove kliničke, metaboličke i hormonske značajke. Zabilježili smo da PCOS pacijentice sa pretjeranom tjelesnom masom imaju viši rizik za razvoj oligo-amenoreje (OR 3,7; 95% CI, 1,1–12,5) te niži rizik za pojavu hirzutizma i akni (OR 0,2; 95% CI, 0,1–0,3 i OR 0,8; 95% CI 0,5–1,4). U skupini PCOS pacijentica sa pretjeranom tjelesnom masom također je zabilježen viši rizik za nastanak hiperandrogenemije (OR 2,5; CI 95% 0,9–6,7), inzulinske rezistencije (OR 4,5; CI 95%, 2,6–7,9), hiperkolesterolemije (OR 5,0, CI 95% 2,5–10,2), hipertriglicidemije (OR 5,2; 95% CI, 2,9–9,2) kao i povišenih vrijednosti C-reaktivnog proteina (CRP) u serumu (OR 4,1; 95% CI 1,4–12,2), u usporedbi s PCOS pacijenticama normalne tjelesne mase. U zaključku, PCOS pacijentice normalne tjelesne mase u Hrvatskoj sklonije su kozmetičkim značajkama PCOS-a u odnosu na metaboličke. Ovo istraživanje potvrđuje da pretjerana tjelesna masa pogoršava poremećaje ciklusa, osjetljivost na inzulin i lipidni profil kod PCOS pacijentica stoga prevencija pretjerane tjelesne mase mora biti jedna od temeljnih strategija liječenja PCOS-a.

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