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Artigos Originais
Cardiovascular risk markers in polycystic ovary syndrome in women with and without insulin resistance
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(3):111-116
06-08-2009
Summary
Artigos OriginaisCardiovascular risk markers in polycystic ovary syndrome in women with and without insulin resistance
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(3):111-116
06-08-2009DOI 10.1590/S0100-72032009000300002
Views118PURPOSE: to evaluate whether the presence of insulin resistance (IR) alters cardiovascular risk factors in women with polycystic ovary syndrome (POS). METHODS: transversal study where 60 POS women with ages from 18 to 35 years old, with no hormone intake, were evaluated. IR was assessed through the quantitative insulin sensitivity check index (QUICKI) and defined as QUICKI <0.33. The following variables have been compared between the groups with or without IR: anthropometric (weight, height, waist circumference, arterial blood pressure, cardiac frequency), laboratorial (homocysteine, interleucines-6, factor of tumoral-α necrosis, testosterone, fraction of free androgen, total cholesterol and fractions, triglycerides, C reactive protein, insulin, glucose), and ultrasonographical (distensibility and carotid intima-media thickness, dilation mediated by the brachial artery flux). RESULTS: Eighteen women (30%) presented IR and showed significant differences in the following anthropometric markers, as compared to the women without IR (POS with and without IR respectively): body mass index (35.56±5.69 kg/m² versus 23.90±4.88 kg/m², p<0.01), waist (108.17±11.53 versus 79.54±11.12 cm, p<0.01), systolic blood pressure (128.00±10.80 mmHg versus 114.07±8.97 mmHg, p<0.01), diastolic blood pressure (83.67±9.63 mmHg versus 77.07±7.59 mmHg, p=0.01). It has also been observed significant differences in the following laboratorial markers: triglycerides (120.00±56.53 mg/dL versus 77.79±53.46 mg/dL, p=0.01), HDL (43.06±6.30 mg/dL versus 40.45±10.82 mg/dL, p=0.01), reactive C protein (7.98±10.54 mg/L versus 2.61±3.21 mg/L, p<0.01), insulin (28.01±18.18 µU/mL versus 5.38±2.48 µU/mL, p<0.01), glucose (93.56±10.00 mg/dL versus 87.52±8.75 mg/dL, p=0.02). Additionally, two out of the three ultrasonographical markers of cardiovascular risk were also different between the groups: carotid distensibility (0.24±0.05 mmHg-1 versus 0.30±0.08 mmHg-1, p<0.01) and carotid intima-media thickness (0.52±0.08 mm versus 0.43±0.09, p<0.01). Besides, the metabolic syndrome ratio was higher in women with IR (nine cases=50% versus three cases=7.1%, p<0.01). CONCLUSIONS: POS and IR women present significant differences in several ultrasonographical, seric and anthropometric markers, which point out to higher cardiovascular risk, as compared to women without POS and IR. In face of that, the systematic IR evaluation in POS women may help to identify patients with cardiovascular risk.
Key-words Biological markersCardiovascular diseaseEndotheliumInsulin resistancePolycystic ovary syndromeRisk factorsSee morePlumX Metrics- Citations
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Artigo de Revisão
Etiological diagnosis of hirsutism and implications for the treatment
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(1):41-47
03-30-2009
Summary
Artigo de RevisãoEtiological diagnosis of hirsutism and implications for the treatment
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(1):41-47
03-30-2009DOI 10.1590/S0100-72032009000100008
Views57Hirsutism may be defined as the presence of terminal hair in the women, with a male pattern of distribution. The clinical presentation is variable, from isolated hirsutism to the presence of other signs of hyperandrogenism, menstrual irregularities and/or infertility. Hirsutism is related to serum androgens and to the cutaneous sensitivity to these hormones. The most prevalent causes of hirsutism are polycystic ovary syndrome and isolated hirsutism, in the presence of ovulatory cycles. Non-classical congenital adrenal hyperplasia (21-hydroxylase deficiency) and drug-induced hirsutism are less frequent causes. Androgen-secreting neoplasms and Cushing syndrome are rare etiologies related to hirsutism. Diagnostic evaluation should address on identifying the etiology and potential risk for associated comorbidities. The aims of the treatment are: to suppress androgen overproduction, if present; to block androgen action on hair follicles; to identify and treat patients at risk for metabolic disturbances or reproductive neoplasias.
Key-words Adrenal hyperplasia, congenitalAntiandrogensContraceptives, oralHirsutismPolycystic ovary syndromeSee morePlumX Metrics- Citations
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Artigos Originais
Evaluation of meiotic abnormalities of oocytes from polycystic ovary syndrome patients submitted to ovarian stimulation
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(5):241-247
08-15-2008
Summary
Artigos OriginaisEvaluation of meiotic abnormalities of oocytes from polycystic ovary syndrome patients submitted to ovarian stimulation
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(5):241-247
08-15-2008DOI 10.1590/S0100-72032008000500006
Views126PURPOSE: to evaluate the meiotic spindle and the chromosome distribution of in vitro matured oocytes obtained from stimulated cycles of infertile women with polycystic ovary syndrome (PCOS) and with male factor and/or tubal infertility (Control Group) and compare in vitro maturation (IVM) rates between the groups analyzed. METHODS: five infertile patients with PCOS and eight controls, submitted to stimulated cycles for intracytoplasmic sperm injection, were selected prospectively and consecutively, and respectively assigned to the study group and the Control Group. Immature oocytes (21 and 29, respectively, from PCOS and Control Group) were submitted to IVM. After IVM, oocytes with first polar body extruded were fixed and submitted to immunostaining and fluorescence microscopy for morphological evaluation of the spindle and of chromosome distribution. Statistical analysis was performed by the Fisher test with significance, when p<0.05. RESULTS: IVM rates were similar between groups (47.6 e 44.8%, respectively, for PCOS and Control Group). Six of the ten oocytes (60%) from the study group and four of the 12 oocytes (33.3%) from the Control Group presented meiotic anomalies of the spindle and/or anomalous chromosome distribution, without statistical difference between groups. CONCLUSIONS: data from the present study did not demonstrate significant difference neither in IVM rates nor in the proportions of meiotic anomalies between in vitro matured oocytes obtained from stimulated cycles from PCOS patients and control ones.
Key-words Infertility, femaleInfertility, maleOocytesOvulation InductionPolycystic ovary syndromeSperm injections, intracytoplasmicSee morePlumX Metrics- Citations
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Artigo de Revisão
Treatment of infertility in women with polycystic ovary syndrome
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(4):201-209
07-02-2008
Summary
Artigo de RevisãoTreatment of infertility in women with polycystic ovary syndrome
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(4):201-209
07-02-2008DOI 10.1590/S0100-72032008000400008
Views90See morePolycystic ovary syndrome (PCOS) occurs in 6 to 10% of women during the reproductive age. Insulin resistance and compensatory hyperinsulinemia are currently two of the main factors involved in the etiopathogenesis of PCOS. The objective of the present review was to discuss the controversies related to the treatment of infertile women with PCOS and during their pregnancy, focusing on the European Society of Human Reproduction and Embryology (ESHRE) and the American Society for Reproductive Medicine (ASRM) current consensus.
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Artigos Originais
beta-cell function evaluation in patients with polycystic ovary syndrome using HOMA model: a comparison between obeses e nonobeses
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(3):141-146
06-21-2007
Summary
Artigos Originaisbeta-cell function evaluation in patients with polycystic ovary syndrome using HOMA model: a comparison between obeses e nonobeses
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(3):141-146
06-21-2007DOI 10.1590/S0100-72032007000300005
Views133PURPOSE: to evaluate the effect of obesity on beta-cell function in patients with polycystic ovary syndrome (PCOS). METHODS: this cross-section study evaluated 82 patients with PCOS selected consecutively, at the moment of the diagnosis. We compared 31 PCOS obese women (BMI >30 kg/m²) to 51 age-matched PCOS nonobese patients (BMI <30 kg/m²). Using fasting glucose and insulin levels, homeostatic model assessment values for insulin resistance (HOMA-IR and QUICKI) and percent beta-cell function (HOMA-%beta-cell) were calculated. As secondary variables, the age at PCOS diagnosis, age of menarche, hormonal levels (testosterone, prolactin, FSH and LH), total cholesterol, triglycerides, HDL cholesterol and LDL cholesterol were also analyzed. RESULTS: menarche was significantly earlier in obese PCOS patients (11.7±1.8 years) than in nonobese patients (12.67±1.86 years) (p<0.05). Obese patients presented lower LH levels (7.9±5 mIU/mL) than did nonobese patients (10.6±6 mIU/mL) (p<0.05). Both groups presented mean HDL cholesterol levels below 50 mg/dL. Obese patients presented significantly higher baseline insulin levels (32.5±25.2 mIU/mL) and fasting blood glucose levels (115.9±40.7 mg/dL) than did nonobese patients (8.8±6.6 mIU/mL and 90.2±8.9 mg/dL, respectively) (p<0.01). Of the obese PCOS patients, 93% presented insulin resistance versus 25% of nonobese PCOS patients (p<0.01). Eighty-six perecent of the obese women had hyperfunction of beta-cell versus 41% of nonobese with PCOS (p<0.0001). CONCLUSIONS: obese PCOS patients presented higher prevalence of insulin resistance and hyperfunction of beta-cell than did nonobese PCOS patients.
Key-words Diabetes mellitusInsulinInsulin resistanceIslets of LangerhansObesityPolycystic ovary syndromeSee morePlumX Metrics- Citations
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Trabalhos Originais
Lipid Profile in Patients with Polycystic Ovary Syndrome
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):89-94
10-10-2000
Summary
Trabalhos OriginaisLipid Profile in Patients with Polycystic Ovary Syndrome
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):89-94
10-10-2000DOI 10.1590/S0100-72032000000200005
Views89See morePurpose: to evaluate the lipid profile (cholesterol, triglycerides, HDL and LDL) of women with polycystic ovary syndrome (PCO) and compare it to that of women with ovulatory menstrual cycles. Methods: the patients were divided into two groups, obese and nonobese, based on body mass index, so that it would be possible to determine the joint effect of PCO and obesity on the lipid metabolism of the studied women. We studied 117 women divided into 4 groups: group I (PCO--obese), n = 33; group II (PCO--nonobese), n = 27; group III (control--obese), n = 28; group IV (control--nonobese), n = 29. Results: cholesterol levels were elevated (179 mg/dl) in obese patients with ovulatory cycles (group III) compared to group I (147 mg/dl) and group II (149 mg/dl), as also were triglyceride levels (117 mg/dl) compared to group IV (77 mg/dl) and LDL levels (117 mg/dl) compared to group I (82 mg/dl). Conclusion: these data suggest that alterations in lipid profile are related to obesity only.
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