Artigos Originais Archives - Page 2 of 81 - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(6):291-296
DOI 10.1590/S0100-72032007000600003
PURPOSE: loss of cutaneous sensitivity has been related to lesions of the intercostobrachial nerve (ICBN) during the axillary lymph node dissection for breast cancer treatment. We evaluated pain and cutaneous sensitivity in the ICBN dermatome of patients in which the nerve was preserved during the axillary dissection. METHODS: we carried out a prospective cohort study of 77 patients divided into: NP group (n=34), patients without ICBN preservation, and ICB group (n=43), patients in which the nerve was preserved. Cutaneous sensitivity was evaluated one year after surgery using 1) a modified McGill Pain Questionnaire; 2) clinical examination including brachial perimetry and evaluation of pain and tactile sensitivity; 3) Semmes-Weinstein monofilaments which allow an objective, qualitative, and quantitative evaluation of peripheral nerve lesions. RESULTS: pain was more frequently reported in the NP group (23/33) than in patients from the ICB group (17/42); p=0,012. Painful sensitivity was preserved in the majority of patients from the ICB group (38/42) but in only 11/33 patients from the NP group (p<0,01). There was no significant difference in the number of lymph nodes dissected between the two groups (p=0,06). CONCLUSIONS: patients with ICBN preservation had less pain and more preservation of cutaneous sensitivity, with no decreased number of axillary lymph nodes removed during the axillary dissection.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(6):291-296
DOI 10.1590/S0100-72032007000600003
PURPOSE: loss of cutaneous sensitivity has been related to lesions of the intercostobrachial nerve (ICBN) during the axillary lymph node dissection for breast cancer treatment. We evaluated pain and cutaneous sensitivity in the ICBN dermatome of patients in which the nerve was preserved during the axillary dissection. METHODS: we carried out a prospective cohort study of 77 patients divided into: NP group (n=34), patients without ICBN preservation, and ICB group (n=43), patients in which the nerve was preserved. Cutaneous sensitivity was evaluated one year after surgery using 1) a modified McGill Pain Questionnaire; 2) clinical examination including brachial perimetry and evaluation of pain and tactile sensitivity; 3) Semmes-Weinstein monofilaments which allow an objective, qualitative, and quantitative evaluation of peripheral nerve lesions. RESULTS: pain was more frequently reported in the NP group (23/33) than in patients from the ICB group (17/42); p=0,012. Painful sensitivity was preserved in the majority of patients from the ICB group (38/42) but in only 11/33 patients from the NP group (p<0,01). There was no significant difference in the number of lymph nodes dissected between the two groups (p=0,06). CONCLUSIONS: patients with ICBN preservation had less pain and more preservation of cutaneous sensitivity, with no decreased number of axillary lymph nodes removed during the axillary dissection.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(6):297-302
DOI 10.1590/S0100-72032007000600004
PURPOSE: to identify the main characteristics of the diagnostic and surgical gynecological laparoscopies carried out in patients with reproductive difficulties at a teaching hospital in Recife, from 2000 and 2004. METHODS: a hospital based descriptive case-series study was carried out with 295 patients who had undergone gynecological laparoscopy for either infertility or tube recanalization in the Mother and Child Health Professor Fernando Figueira Institute. Information was obtained from the surgical records of the laparoscopies carried out from January 2000 to December 2004. The inclusion criteria was infertility or pre-recanalization study as a surgical indication. The information was typed twice into a data bank. Tables with central measurements and dispersion tendency were created for the quantitative variables and frequency distribution for the categorical variables. The statistical program, Epi Info 3.3.2., was used to analyze the data. RESULTS: along the study, 462 gynecological laparoscopies were analyzed, 295 (63.8%) of them having as an indication either infertility (41.1%) or the study of possible tube recanalization (18.8%). The patients’ average age in both groups was from 30 to 34 years old. Among the 87 patients with desire of tube recanalization, 55.2% had one or both tubes inadequate for the procedure, and from those, 52.1% was diagnosed with tube amputation (fimbrectomy). In the infertility cases, the most observed findings were adherences (60.6%), tube obstruction (40.9%) and endometriosis (36.1%). Among the procedures carried out, lysis of adherences (34.2%) and biopsies (21%) were the most frequent, followed by endometriosis treatment (10.8%) and salpingostomy (10.8%). CONCLUSION: videolaparoscopy is an important tool in the study and treatment of patients with infertility and before tube recanalization, especially in those hospitals where advanced reproductive techniques are not available.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(6):297-302
DOI 10.1590/S0100-72032007000600004
PURPOSE: to identify the main characteristics of the diagnostic and surgical gynecological laparoscopies carried out in patients with reproductive difficulties at a teaching hospital in Recife, from 2000 and 2004. METHODS: a hospital based descriptive case-series study was carried out with 295 patients who had undergone gynecological laparoscopy for either infertility or tube recanalization in the Mother and Child Health Professor Fernando Figueira Institute. Information was obtained from the surgical records of the laparoscopies carried out from January 2000 to December 2004. The inclusion criteria was infertility or pre-recanalization study as a surgical indication. The information was typed twice into a data bank. Tables with central measurements and dispersion tendency were created for the quantitative variables and frequency distribution for the categorical variables. The statistical program, Epi Info 3.3.2., was used to analyze the data. RESULTS: along the study, 462 gynecological laparoscopies were analyzed, 295 (63.8%) of them having as an indication either infertility (41.1%) or the study of possible tube recanalization (18.8%). The patients’ average age in both groups was from 30 to 34 years old. Among the 87 patients with desire of tube recanalization, 55.2% had one or both tubes inadequate for the procedure, and from those, 52.1% was diagnosed with tube amputation (fimbrectomy). In the infertility cases, the most observed findings were adherences (60.6%), tube obstruction (40.9%) and endometriosis (36.1%). Among the procedures carried out, lysis of adherences (34.2%) and biopsies (21%) were the most frequent, followed by endometriosis treatment (10.8%) and salpingostomy (10.8%). CONCLUSION: videolaparoscopy is an important tool in the study and treatment of patients with infertility and before tube recanalization, especially in those hospitals where advanced reproductive techniques are not available.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(6):303-309
DOI 10.1590/S0100-72032007000600005
PURPOSE: to assess the level of lipid peroxidation (LP) and vitamin E in the follicular fluid and serum of infertile patients, with or without endometriosis, submitted to induction of ovulation for assisted reproduction procedures. METHODS: infertile patients aged 20 to 38 years old were selected prospectively and consecutively and divided into Endometriosis Group (17 patients with pelvic endometriosis) and Control Group (19 patients with previous tubal ligation or with male factor). Blood samples were collected on: D1 (before the beginning of the use of gonadotrophins), D2 (day of human chorionic gonadotrofin application) and D3 (day of oocyte retrieval). On D3, follicular fluid samples free from blood contamination were also collected and stored. LP was assessed for malondialdehyde (MDA) quantification by spectrophotometry, and antioxidant status by measurement of vitamin E by HLPC. RESULTS: on D1, no significant difference in LP was observed between groups. However, vitamin E levels were significantly higher in the Control Group. On D2, LP levels were significantly higher in the Endometriosis Group compared to Control and vitamin E levels continued to be significantly higher in the Control Group. On D3, there was no significant difference in both serum and follicular fluid levels of LP or vitamin E between groups. However, on D3, vitamin E levels were found to be significantly higher in serum than in follicular fluid in both groups, whereas MDA levels were significantly lower in follicular fluid than in serum only in the Control Group. CONCLUSION: before the beginning of the induction of ovulation, a significant decrease in antioxidant status was observed in patients with endometriosis, perhaps because antioxidants are consumed during oxidation reactions. After the induction of ovulation with exogenous gonadotrophins, the group of patients with endometriosis presented not only increased lipid peroxidation compared to Control, but also maintained a lower antioxidant status than the Control Group. However, on the day of oocyte retrieval, both serum LP potential and the levels of vitamin E were found to be similar in both groups.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(6):303-309
DOI 10.1590/S0100-72032007000600005
PURPOSE: to assess the level of lipid peroxidation (LP) and vitamin E in the follicular fluid and serum of infertile patients, with or without endometriosis, submitted to induction of ovulation for assisted reproduction procedures. METHODS: infertile patients aged 20 to 38 years old were selected prospectively and consecutively and divided into Endometriosis Group (17 patients with pelvic endometriosis) and Control Group (19 patients with previous tubal ligation or with male factor). Blood samples were collected on: D1 (before the beginning of the use of gonadotrophins), D2 (day of human chorionic gonadotrofin application) and D3 (day of oocyte retrieval). On D3, follicular fluid samples free from blood contamination were also collected and stored. LP was assessed for malondialdehyde (MDA) quantification by spectrophotometry, and antioxidant status by measurement of vitamin E by HLPC. RESULTS: on D1, no significant difference in LP was observed between groups. However, vitamin E levels were significantly higher in the Control Group. On D2, LP levels were significantly higher in the Endometriosis Group compared to Control and vitamin E levels continued to be significantly higher in the Control Group. On D3, there was no significant difference in both serum and follicular fluid levels of LP or vitamin E between groups. However, on D3, vitamin E levels were found to be significantly higher in serum than in follicular fluid in both groups, whereas MDA levels were significantly lower in follicular fluid than in serum only in the Control Group. CONCLUSION: before the beginning of the induction of ovulation, a significant decrease in antioxidant status was observed in patients with endometriosis, perhaps because antioxidants are consumed during oxidation reactions. After the induction of ovulation with exogenous gonadotrophins, the group of patients with endometriosis presented not only increased lipid peroxidation compared to Control, but also maintained a lower antioxidant status than the Control Group. However, on the day of oocyte retrieval, both serum LP potential and the levels of vitamin E were found to be similar in both groups.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(6):310-316
DOI 10.1590/S0100-72032007000600006
PURPOSE: to evaluate the expression of cyclooxygenase-2 (COX-2) in ductal carcinoma in situ (DCIS), invasive ductal carcinoma (IDC), adjacent normal stroma, and epithelium. The correlation of expression levels with nuclear grade, histological grade, presence or absence of comedonecrosis, tumor size, and patient age was also analyzed. METHODS: forty-seven surgical samples obtained from mastectomy and quadrantectomy with simultaneous DCIS and IDC, stages I and II were included. Anti-COX-2 polyclonal antibodies were used to determine enzyme expression. Samples were classified from zero to three, in accordance with number and intensity of stained cells. RESULTS: COX-2 was positively expressed in IDC, DCIS, and normal epithelium in 86.7, 84.4, and 73.3% of the cases, respectively. Concerning nuclear grade (NG), COX-2 expression was positive in 80% of cases of NG-I; in 81.5 and 78.9% of NG II, and in 88.5 and 96.1% of NG III in DCIS and IDC, respectively. COX-2 expression occurred in 78.9% of DCIS with comedonecrosis and in 89.3% without comedonecrosis. As to histological grade (HG) of IDC, COX-2 was positive in 83.3% of HG-I; 89.9% of HG-II and 80% of HG-III. Concerning tumor diameter, COX-2 was present in 86.1% of IDC cases and in 83.3% of DCIS larger than 2 cm and in 11% of IDC and DCIS tumors ≤2 cm. The age range ≥50 years presented 90% expression for IDC and 86.7% for DCIS, and the expression was 92.5% for both IDC and DCIS in patients <50 years. CONCLUSIONS: our results demonstrated high correlation between COX-2 expression in IDC, DCIS and in the normal epithelium, which is consistent with the hypothesis that COX-2 over expression is an early event in breast carcinogenesis. There was no significant correlation between COX-2 expression in IDC and DCIS and nuclear grade, histological grade, presence of comedonecrosis, age group and tumor size.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(6):310-316
DOI 10.1590/S0100-72032007000600006
PURPOSE: to evaluate the expression of cyclooxygenase-2 (COX-2) in ductal carcinoma in situ (DCIS), invasive ductal carcinoma (IDC), adjacent normal stroma, and epithelium. The correlation of expression levels with nuclear grade, histological grade, presence or absence of comedonecrosis, tumor size, and patient age was also analyzed. METHODS: forty-seven surgical samples obtained from mastectomy and quadrantectomy with simultaneous DCIS and IDC, stages I and II were included. Anti-COX-2 polyclonal antibodies were used to determine enzyme expression. Samples were classified from zero to three, in accordance with number and intensity of stained cells. RESULTS: COX-2 was positively expressed in IDC, DCIS, and normal epithelium in 86.7, 84.4, and 73.3% of the cases, respectively. Concerning nuclear grade (NG), COX-2 expression was positive in 80% of cases of NG-I; in 81.5 and 78.9% of NG II, and in 88.5 and 96.1% of NG III in DCIS and IDC, respectively. COX-2 expression occurred in 78.9% of DCIS with comedonecrosis and in 89.3% without comedonecrosis. As to histological grade (HG) of IDC, COX-2 was positive in 83.3% of HG-I; 89.9% of HG-II and 80% of HG-III. Concerning tumor diameter, COX-2 was present in 86.1% of IDC cases and in 83.3% of DCIS larger than 2 cm and in 11% of IDC and DCIS tumors ≤2 cm. The age range ≥50 years presented 90% expression for IDC and 86.7% for DCIS, and the expression was 92.5% for both IDC and DCIS in patients <50 years. CONCLUSIONS: our results demonstrated high correlation between COX-2 expression in IDC, DCIS and in the normal epithelium, which is consistent with the hypothesis that COX-2 over expression is an early event in breast carcinogenesis. There was no significant correlation between COX-2 expression in IDC and DCIS and nuclear grade, histological grade, presence of comedonecrosis, age group and tumor size.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(6):317-323
DOI 10.1590/S0100-72032007000600007
PURPOSE: to evaluate the diagnostic efficacy of core needle biopsy in suspicious solid breast masses (Bi-Rads™ 4 or 5) up to 10 mm. METHODS: this study was conducted on 83 women diagnosed with 90 suspicious solid lumps, all measuring up to 10 mm, identified by mammography (41), sonography (47) or palpation (two), who visited our clinic from September 2003 to January 2006. The lesions were biopsied with automatic device and 14 gauge needle (Bard, Corington, GA), all of them ultrasound guided. According to the pathological report, the biopsies were classified as true-positives, false-positives, true-negatives, and false-negatives. The sensitivity and specificity of ultrasound-guided core biopsy in breast masses up to 1 cm were calculated. RESULTS: the mean patient age was 52.5 years, and the mean diameter of the lesions was 7.3 mm, ranging from 3 to 10 mm. The results yielded by the pathologist showed 40 benign lesions (44.4%), 49 malignant lesions (54.4%) and one case (1.1%) of inconclusive material. This patient was submitted to ultrasound guided core needle biopsy once again, this time with conclusive results. There was agreement between histology and radiology in 89 cases. Sensitivity of ultrasound guided core biopsy for the diagnosis of breast cancer was 98.8 % and specificity 100%. CONCLUSIONS: the results obtained by ultrasound-guided core biopsy in suspicious breast lesions up to 10 mm are comparable to the best results of any kind of biopsy in the literature. Therefore, even solid lesions smaller or equal to 10 mm can be safely evaluated pathologically by core biopsy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(6):317-323
DOI 10.1590/S0100-72032007000600007
PURPOSE: to evaluate the diagnostic efficacy of core needle biopsy in suspicious solid breast masses (Bi-Rads™ 4 or 5) up to 10 mm. METHODS: this study was conducted on 83 women diagnosed with 90 suspicious solid lumps, all measuring up to 10 mm, identified by mammography (41), sonography (47) or palpation (two), who visited our clinic from September 2003 to January 2006. The lesions were biopsied with automatic device and 14 gauge needle (Bard, Corington, GA), all of them ultrasound guided. According to the pathological report, the biopsies were classified as true-positives, false-positives, true-negatives, and false-negatives. The sensitivity and specificity of ultrasound-guided core biopsy in breast masses up to 1 cm were calculated. RESULTS: the mean patient age was 52.5 years, and the mean diameter of the lesions was 7.3 mm, ranging from 3 to 10 mm. The results yielded by the pathologist showed 40 benign lesions (44.4%), 49 malignant lesions (54.4%) and one case (1.1%) of inconclusive material. This patient was submitted to ultrasound guided core needle biopsy once again, this time with conclusive results. There was agreement between histology and radiology in 89 cases. Sensitivity of ultrasound guided core biopsy for the diagnosis of breast cancer was 98.8 % and specificity 100%. CONCLUSIONS: the results obtained by ultrasound-guided core biopsy in suspicious breast lesions up to 10 mm are comparable to the best results of any kind of biopsy in the literature. Therefore, even solid lesions smaller or equal to 10 mm can be safely evaluated pathologically by core biopsy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):230-234
DOI 10.1590/S0100-72032007000500002
PURPOSE: to analyze the factors associated with the reproductive future of patients wishing to become pregnant after having being submitted to tubal ligation (TL), attended at a public service. METHODS: a prospective study including 98 patients previously submitted to TL, who came to the Human Reproduction Center of the University Hospital of Brasilia (HUB), from January 1996 to January 2004, wishing to become pregnant again These patients were followed up from their first appointment till the end of the study, when they answered a structured questionnaire about the social demographic aspects at both the moment they asked for the TL and the reversion of the procedure. RESULTS: the patients’ average age at the TL procedure was 25 years old. Among them, 55.1% were younger than 25, 46.9% had three or more children, and ten of them had only one child. The most common reasons for the TL procedure were: contraception (48%), financial difficulties (25.5%) and marital problems (15.3%). The major causes for wishing a new pregnancy were: a new relationship/marriage (80.6%), the desire of having another child with the same partner (8.2%), and the death of a child (6.1%). The regret time informed by most of the patients was between two and four years, and the search for reversion was between six and ten years. About 83.6% of the sample referred lack of information about the procedure and the difficulties of reversion. Twenty patients were submitted to TL reversal procedure; from the ten who became pregnant, only six delivered babies, after a full-term pregnancy. Eight patients were referred to in vitro fertilization treatment, four of them became pregnant and two delivered healthy babies. CONCLUSIONS: TL in young vulnerable women, not informed about the definitive condition of the method, may increase the search for attended reproduction services and impair their reproductive future, as far as only 8.1% of the sample delivered babies and reached their goal.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):230-234
DOI 10.1590/S0100-72032007000500002
PURPOSE: to analyze the factors associated with the reproductive future of patients wishing to become pregnant after having being submitted to tubal ligation (TL), attended at a public service. METHODS: a prospective study including 98 patients previously submitted to TL, who came to the Human Reproduction Center of the University Hospital of Brasilia (HUB), from January 1996 to January 2004, wishing to become pregnant again These patients were followed up from their first appointment till the end of the study, when they answered a structured questionnaire about the social demographic aspects at both the moment they asked for the TL and the reversion of the procedure. RESULTS: the patients’ average age at the TL procedure was 25 years old. Among them, 55.1% were younger than 25, 46.9% had three or more children, and ten of them had only one child. The most common reasons for the TL procedure were: contraception (48%), financial difficulties (25.5%) and marital problems (15.3%). The major causes for wishing a new pregnancy were: a new relationship/marriage (80.6%), the desire of having another child with the same partner (8.2%), and the death of a child (6.1%). The regret time informed by most of the patients was between two and four years, and the search for reversion was between six and ten years. About 83.6% of the sample referred lack of information about the procedure and the difficulties of reversion. Twenty patients were submitted to TL reversal procedure; from the ten who became pregnant, only six delivered babies, after a full-term pregnancy. Eight patients were referred to in vitro fertilization treatment, four of them became pregnant and two delivered healthy babies. CONCLUSIONS: TL in young vulnerable women, not informed about the definitive condition of the method, may increase the search for attended reproduction services and impair their reproductive future, as far as only 8.1% of the sample delivered babies and reached their goal.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):235-240
DOI 10.1590/S0100-72032007000500003
PURPOSE: to establish the prevalence of thrombophilic factors in infertile women. METHODS: a cross-sectional study was performed, in which infertile women, seen in a private clinic with investigation for thrombophilia were included, according to the protocol of the clinic, between March 2003 and March 2005, after the approval of the Research Ethics Committee of the Universidade Estadual de Campinas (UNICAMP). One hundred and forty-four infertile women without any liver disease were evaluated. Infertility is defined as one year of unprotected sexual intercourse without conception. The acquired and/or inherited thrombophilic factors investigated were: anticardiolipin antibody (aCL), lupus anticoagulant (LA), protein C deficiency (PCD), protein S deficiency (PSD), antithrombin III deficiency (ATD), presence of the factor V Leiden, mutation G20 210A in the prothrombin gene, and C677T mutation of methylene tetrahydrofolate reductase (MTHFR). RESULTS: the prevalence values obtained for aCL and LA were 2%. The prevalence of the hereditary thrombophilic factors were: PCD=4%, PSD=6%, ATD=5%, factor V Leiden=3%, prothrombin mutation=3%, MTHFR mutation=57%. Conclusions: of the 144 patients selected, 105 women (72.9%) presented at least one thrombophilic factor. This reinforces the importance and justifies the need of investigation in this group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):235-240
DOI 10.1590/S0100-72032007000500003
PURPOSE: to establish the prevalence of thrombophilic factors in infertile women. METHODS: a cross-sectional study was performed, in which infertile women, seen in a private clinic with investigation for thrombophilia were included, according to the protocol of the clinic, between March 2003 and March 2005, after the approval of the Research Ethics Committee of the Universidade Estadual de Campinas (UNICAMP). One hundred and forty-four infertile women without any liver disease were evaluated. Infertility is defined as one year of unprotected sexual intercourse without conception. The acquired and/or inherited thrombophilic factors investigated were: anticardiolipin antibody (aCL), lupus anticoagulant (LA), protein C deficiency (PCD), protein S deficiency (PSD), antithrombin III deficiency (ATD), presence of the factor V Leiden, mutation G20 210A in the prothrombin gene, and C677T mutation of methylene tetrahydrofolate reductase (MTHFR). RESULTS: the prevalence values obtained for aCL and LA were 2%. The prevalence of the hereditary thrombophilic factors were: PCD=4%, PSD=6%, ATD=5%, factor V Leiden=3%, prothrombin mutation=3%, MTHFR mutation=57%. Conclusions: of the 144 patients selected, 105 women (72.9%) presented at least one thrombophilic factor. This reinforces the importance and justifies the need of investigation in this group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):241-247
DOI 10.1590/S0100-72032007000500004
PURPOSE: to evaluate the ultra-sensitive C-Reactive Protein level (us-CRP) in patients with Polycystic Ovary Syndrome (PCOS), and the correlation of clinical and laboratory parameters with the us-CRP level. Methods: in this cross-sectional study, 46 women with Polycystic Ovary Syndrome, according to the Rotterdam criteria, and 44 control women have been included. Serum was analyzed for C reactive protein (CRP) levels. Body mass index (BMI), age, circumference waist, HOMA-IR, total, low and high density lipoprotein cholesterol, triglycerides, glucose, testosterone and insulin levels were correlated to CRP level through a linear regression model. RESULTS: PCOS patients not only were older and had higher BMI, but their waist circumference, fasting insulin, HOMA-IR, total and LDL cholesterol were also higher, as compared to the women from the control group. A significant difference was observed in the us-CRP level between the PCOS (2.7 mg/dL±2.17) the control (1.6 mg/dL±1.49) groups. When us-CRP levels were categorized as of low (<1.0 mg/L), moderate (1-3.0 mg/L) and high (3.0 mg/L) risk for cardiovascular episodes, only 28.3% women with PCOS had us-CRP levels defined as low, 34.8% as moderate and 37% as high risk. The prevalence of Metabolic Syndrome was higher in the women with PCOS (30.4%) than in the women from the control group (6.8%). Through a stepwise linear regression model, only waist circumference, presence of metabolic syndrome and age had a confounding effect in the relation between us-CRP and PCOS. After adjustment for confounding factors, PCOS showed an independent effect on us-CRP level. CONCLUSIONS: the us-CRP levels were higher in the PCOS women than in the healthy controls. By a regression model, PCOS showed an independent effect on us-CRP level.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):241-247
DOI 10.1590/S0100-72032007000500004
PURPOSE: to evaluate the ultra-sensitive C-Reactive Protein level (us-CRP) in patients with Polycystic Ovary Syndrome (PCOS), and the correlation of clinical and laboratory parameters with the us-CRP level. Methods: in this cross-sectional study, 46 women with Polycystic Ovary Syndrome, according to the Rotterdam criteria, and 44 control women have been included. Serum was analyzed for C reactive protein (CRP) levels. Body mass index (BMI), age, circumference waist, HOMA-IR, total, low and high density lipoprotein cholesterol, triglycerides, glucose, testosterone and insulin levels were correlated to CRP level through a linear regression model. RESULTS: PCOS patients not only were older and had higher BMI, but their waist circumference, fasting insulin, HOMA-IR, total and LDL cholesterol were also higher, as compared to the women from the control group. A significant difference was observed in the us-CRP level between the PCOS (2.7 mg/dL±2.17) the control (1.6 mg/dL±1.49) groups. When us-CRP levels were categorized as of low (<1.0 mg/L), moderate (1-3.0 mg/L) and high (3.0 mg/L) risk for cardiovascular episodes, only 28.3% women with PCOS had us-CRP levels defined as low, 34.8% as moderate and 37% as high risk. The prevalence of Metabolic Syndrome was higher in the women with PCOS (30.4%) than in the women from the control group (6.8%). Through a stepwise linear regression model, only waist circumference, presence of metabolic syndrome and age had a confounding effect in the relation between us-CRP and PCOS. After adjustment for confounding factors, PCOS showed an independent effect on us-CRP level. CONCLUSIONS: the us-CRP levels were higher in the PCOS women than in the healthy controls. By a regression model, PCOS showed an independent effect on us-CRP level.