New approaches to early detection of polycystic ovary syndrome in obese women

Authors

DOI:

https://doi.org/10.18370/2309-4117.2022.66.20-25

Keywords:

polycystic ovary syndrome, obesity, early detection, Ferriman–Gallwey score

Abstract

Objectives: development of an algorithm for the early detection of comorbid pathology polycystic ovary syndrome (PCOS) in obese women.
Materials and methods. The study included 56 women aged 28.02 ± 2.25 years with a diagnosis of obesity who had no history of PCOS. The examination was carried out by a multidisciplinary group of doctors consisting of a family doctor, a gynecologist and an endocrinologist.
The patient’s history of life and diseases was studied, an anthropometric еxamination and a survey according to the modified Ferriman–Gallwey scale were performed with a further ultrasound examination and a gynecologist consultation.
Results. The majority of patients (55.36%) had acne, hirsutism and seborrhea occurred in 41.07 and 26.76% of women, respectively, and 14.29% of patients had alopecia. Often, the patient had not one, but several symptoms at the same time.
According to the modified Ferriman–Gallwey scale, the majority of women (58.92%) had no manifestations of hirsutism along with obesity, 17.8% had moderate manifestations of hirsutism, 16.07 and 7.14% had mild and moderate hirsutism, respectively.
The patients had no complaints and did not know whether they had PCOS. PCOS were diagnosed in 31 (55.36%) women after ultrasound examination and gynecologist consultation. It was also found that patients with longer obesity and a higher body mass index were more likely to have a diagnosis of PCOS (ρ = 0.77). The largest number of PCOS patients was among women with a body mass index over 40 kg/m2, i.e. with the III degree of obesity.
Conclusions. The algorithm we developed for the diagnosis of PCOS in obese patients allowed us to detect this disease early in 55.36% of cases. We consider it appropriate to recommend screening for PCOS to all obese patients of reproductive age. This tactic will help maintain the fertility of this category of patients.

Author Biographies

V.V. Artyomenko, Odesa National Medical University, Odesa

MD, professor, Obstetrics and Gynecology Department

V.I. Velychko, Odesa National Medical University; Association of Family Doctors of the Odesa Region, Odesa

MD, professor, head of the Department of Family Medicine and Polyclinic Therapy
Head of the Association of Family Doctors of the Odesa Region

D.O. Lahoda, Odesa National Medical University, Odesa

PhD, assistant, Department of Family Medicine and Polyclinic Therapy

References

  1. Guh, D.P., Zhang, W., Bansback, N., et al. “The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis.” BMC Public Health 9 (2009): 88.
  2. Barber, T.M., McCarthy, M.I., Wass, J.A., Franks, S. “Obesity and polycystic ovary syndrome.” Clin Endocrinol (Oxf) 65 (2006): 137–45.
  3. Saboor Aftab, S.A., Kumar, S., Barber, T.M. “The role of obesity and type 2 diabetes mellitus in the development of male obesity-associated secondary hypogonadism.” Clin Endocrinol (Oxf) 78 (2013): 330–7.
  4. Passarello, K., Kurian, S., Villanueva, V. “Endometrial cancer: an overview of pathophysiology, management, and care.” Semin Oncol Nurs 35 (2019): 157–65.
  5. Teede, H.J., Joham, A.E., Paul, E., et al. “Longitudinal weight gain in women identified with polycystic ovary syndrome: results of an observational study in young women.” Obesity (Silver Spring) 21 (2013): 1526–32.
  6. Wild, S., Pierpoint, T., McKeigue, P., Jacobs, H. “Cardiovascular disease in women with polycystic ovary syndrome at long-term follow-up: a retrospective cohort study.” Clin Endocrinol (Oxf) 52 (2000): 595–600.
  7. Barber, T.M., McCarthy, M.I., Franks, S., Wass, J.A. “Metabolic syndrome in polycystic ovary syndrome.” Endokrynol Pol 58 (2007): 34–41.
  8. Mohlig, M., Floter, A., Spranger, J., et al. “Predicting impaired glucose metabolism in women with polycystic ovary syndrome by decision tree modelling.” Diabetologia 49 (2006): 2572–9.
  9. Ramezani-Binabaj, M., Motalebi, M., Karimi-Sari, H., et al. “Are women with polycystic ovarian syndrome at a high risk of non-alcoholic Fatty liver disease; a meta-analysis.” Hepat Mon 14 (2014): e23235.
  10. Ehrmann, D.A. “Metabolic dysfunction in PCOS: relationship to obstructive sleep apnea.” Steroids 77 (2012): 290–4.
  11. Azziz, R., Woods, K.S., Reyna, R., et al. “The prevalence and features of the polycystic ovary syndrome in an unselected population.” J Clin Endocrinol Metab 89 (2004): 2745–9.
  12. Sanchon, R., Gambineri, A., Alpanes, M., et al. “Prevalence of functional disorders of androgen excess in unselected premenopausal women: a study in blood donors.” Hum Reprod 27 (2012): 1209–16.
  13. Yildiz, B.O., Bozdag, G., Yapici, Z., et al. “Prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome under different diagnostic criteria.” Hum Reprod 27 (2012): 3067–73.
  14. Asuncion, M., Calvo, R.M., San Millan, J.L., et al. “A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain.” J Clin Endocrinol Metab 85 (2000): 2434–8.
  15. Legro, R.S. “The genetics of obesity. Lessons for polycystic ovary syndrome.” Ann N Y Acad Sci 900 (2000): 193–202.
  16. Balen, A.H., Conway, G.S., Kaltsas, G., et al. “Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients.” Hum Reprod 10 (1995): 2107–11.
  17. Ollila, M.M., Piltonen, T., Puukka, K., et al. “Weight gain and dyslipidemia in early adulthood associate with polycystic ovary syndrome: prospective cohort study.” J Clin Endocrinol Metab 101 (2016): 739–47.
  18. Kiddy, D.S., Hamilton-Fairley, D., Bush, A., et al. “Improvement in endocrine and ovarian function during dietary treatment of obese women with polycystic ovary syndrome.” Clin Endocrinol (Oxf) 36 (1992): 105–111.
  19. Holte, J., Bergh, T., Berne, C., et al. “Restored insulin sensitivity but persistently increased early insulin secretion after weight loss in obese women with polycystic ovary syndrome.” J Clin Endocrinol Metab 80 (1995): 2586–93.
  20. Knochenhauer, E.S., Hines, G., Conway-Myers, B.A., Azziz, R. “Examination of the chin or lower abdomen only for the prediction of hirsutism.” Fertil Steril 74 (2000): 980–3.
  21. Cook, H., Brennan, K., Azziz, R. “Reanalyzing the modified Ferriman-Gallwey score: Is there a simpler method for assessing the extent of hirsutism?” Fertil Steril 96 (2011): 1266–70.e1261.
  22. Ministry of Health of Ukraine. Order from 05.08.2009 № 574 “On the approval of protocols for the appointment of medical care for patients with endocrine diseases.”
  23. Kirsi Pietiläinen. Guideline 00499. Assessment of the obese patient. Guidelines based on evidence-based medicine. Duodecim Medical Publications Ltd.
  24. Teede, H.J., Misso, M.L., Costello, M.F., et al. International evidence-based guideline for the assessment and management of polycystic ovary syndrome 2018. Available from: [https://www.monash. edu/__data/assets/pdf_file/0004/1412644/PCOS_ Evidence-Based-Guidelines_20181009.pdf].
  25. Artyomenko, V., Nastradina, N., Nitochko, K., Altyieva, M. “Hypomenstrual syndrome in adolescent girls as a result of reproductive dysfunction in their mothers: Literature review." Reproductive Endocrinology 6 (2021): 66-70. DOI: 10.18370/2309-4117.2021.61.66-70
  26. Velychko, V.I., Mankovskyi, B.M., Tatarchuk, T.F., et al. “A contemporary view on obesity treatment in adults. Literature review.” Reproductive Endocrinology 61 (2021): 45–50. DOI: 10.18370/2309-4117.2021.61.45-50
  27. Artyomenko, V.V., Chumak, Z.V., Shapoval, M.V. “The retrospective analysis results of the endometrial tissue pathological conditions development.” Reproductive Endocrinology 55 (2020): 48–52. DOI: 10.18370/2309-4117.2020.55.48-52
  28. Velychko, V.I., Mykhailenko, V.L., Lahoda, D.O., et al. “Screening for diabetes and prediabetes: the newest communication opportunities.” Reproductive Endocrinology 62 (2021): 92–5. DOI: 10.18370/2309-4117.2021.62.92-95

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Published

2022-08-10

How to Cite

Artyomenko, V., Velychko, V., & Lahoda, D. (2022). New approaches to early detection of polycystic ovary syndrome in obese women. REPRODUCTIVE ENDOCRINOLOGY, (66), 20–25. https://doi.org/10.18370/2309-4117.2022.66.20-25

Issue

No. 66 (2022)

Section

Gynecology

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Copyright (c) 2022 В.В. Артьоменко, В.І. Величко, Д.О. Лагода

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