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ABSTRACT: To assess the prevalence of metabolic syndrome and of its defining criteria in women with polycystic ovary syndrome from the Brazilian Southeast, who were stratified according to body mass index and compared to ovulatory controls.
This was a cross-sectional study conducted on 332 women of reproductive age, who were divided into two groups: Control, consisting of 186 women with regular menstrual cycles and ovulatory symptoms and without a diagnosis of polycystic ovary syndrome or other type of chronic anovulation, and the Polycystic ovary syndrome,Group, consisting of 146 women with a diagnosis of polycystic ovary syndrome (Rotterdam Consensus ASRM/ESHRE). Each group was stratified according to the body mass index, as follows: body mass index ( < 25 ≥25 and <30, and ≥ 30 kg/m²). The frequencies of metabolic syndrome and of its defining criteria and the clinical and hormonal characteristics (follicle stimulating hormone, total testosterone, dehydroepiandrostenedione sulfate) were analyzed.
The frequency of metabolic syndrome was six times higher in the obese Polycystic ovary syndrome Group than among control women with the same body mass index (Control with 10.5 versus Polycystic ovary syndrome with 67.9%, p<0.01); twice higher in the Polycystic ovary syndrome Group with body mass index ≥ 25 and <30 kg/m² (Control with 13.2 versus Polycystic ovary syndrome with 22.7%, p<0.01), and three times higher in the Polycystic ovary syndrome Group with body mass index <25 kg/m² (Control with 7.9 versus Polycystic ovary syndrome with 2.5%, p<0.01), compared to control women paired for the same body mass index. Regardless of the body mass index, women with polycystic ovary syndrome had a higher frequency of all the criteria defining metabolic syndrome.
Women with polycystic ovary syndrome have higher frequency of metabolic syndrome and of its defining criteria regardless of the body mass index. Hyperinsulinemia and hyperandrogenism are important characteristics of the origin of these alterations, especially in obese women with polycystic ovary syndrome.
Revista brasileira de ginecologia e obstetrićia: revista da Federação Brasileira das Sociedades de Ginecologia e Obstetrícia 01/2012; 34(1):4-10.
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ABSTRACT: Polycystic ovary syndrome (PCOS) has a heterogeneous phenotypic distribution that can potentially lead to variations in metabolic repercussions. A cross-sectional study was conducted with 372 women of reproductive age (146 of whom were ovulatory and 226 with PCOS) divided into groups according to PCOS phenotype: (i) complete phenotype involving menstrual irregularity (MI), hyperandrogenism (H), and ultrasound (US) findings of polycystic ovaries (132 patients); (ii) MI + H (18 patients); (iii) MI + US (51 patients); and (iv) H + US (25 patients). The frequencies of metabolic syndrome (MetS) were 45.4%, 38.9%, 33.3%, 36%, and 8.2% for the MI + H + US, MI + H, MI + US, H + US, and control groups (P < .01), respectively. In logistic regression, body mass index ([BMI] odds ratio [OR]: 1.1, 95% confidence interval [CI] 1.1-1.2) and the association of the complete phenotype with MI + H (OR: 5.8 CI95% [2.2-15.8) were independent predictors of the occurrence of MetS. The defining characteristics of MetS were more frequently found in women with PCOS than in controls, regardless of the phenotype (P < .01 for each variable). In conclusion, the frequency of MetS is similar for various PCOS phenotypes among young Brazilian women from the Southeast region of the country, although only BMI and the presence of MI + H, regardless of the presence of US findings, were more predictive of the development of MetS.
Reproductive sciences (Thousand Oaks, Calif.) 12/2011; 18(12):1230-6. · 2.31 Impact Factor
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ABSTRACT: To compare the metabolic characteristics of obese and non-obese young women with polycystic ovary syndrome (POS) from the Brazilian Southeast.
This was a cross-sectional study conducted on 218 women of reproductive age with a diagnosis of POS--90 non-obese women (BMI between 18.5 and 29.9 kg/m²), and 128 obese patients (BMI > 30 kg/m²) selected at the time of diagnosis. The frequency of insulin resistance (IR), glucose intolerance (GI), metabolic syndrome (MetS) and type 2 diabetes mellitus (DM2) and mean values of total cholesterol (TC), triglycerides (TG), high-density (HDL) and low-density lipoproteins (LDL), were compared between obese and non-obese patients with POS. The two groups were also compared in terms of clinical and hormonal characteristics (follicle stimulating hormone, prolactin, thyroid stimulating hormone, total testosterone, dihydroepiandrostenedione sulfate, and 17-hydroxyprogesterone). Statistical analysis was performed using the SAS 9.0 software. Quantitative variables were compared by the Student's t-test (data with normal distribution) or by the Mann-Whitney test (non-parametric distribution). Qualitative variables were compared by the Fisher test. The level of significance was set at 5% (p < 0.05) in all analyses.
The frequency of IR, GI and MetS was significantly higher in obese than non-obese patients with POS (66.7, 29.9, and 63% versus 24.7, 12.2, and 16.4%, respectively). Obese patients had higher TC and TG levels (189.8 ± 35.8 mg/dL and 145.4 ± 71.1 mg/dL, respectively) than non-obese patients (172.1 ± 38.4 mg/dL and 99.3 ± 54 mg/dL, respectively). Both groups had mean HDL levels below 50 mg/dL.
Young obese women with POS have a higher frequency of IR, GI and MS than non-obese. However, the occurrence of metabolic disorders is elevated also in the non-obese patients, suggesting that the presence of the syndrome may favor the development of metabolic comorbidities with potential medium- and long-term repercussions.
Revista brasileira de ginecologia e obstetrićia: revista da Federação Brasileira das Sociedades de Ginecologia e Obstetrícia 06/2011; 33(6):310-6.
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ABSTRACT: Leukostasis is a relatively uncommon but potentially catastrophic complication of acute myelogenous leukemia (AML). Prompt leukoreduction is considered imperative to reduce the high mortality rate in this condition. Leukapheresis, usually associated with chemotherapy, is an established approach to diminish blast cell counts. We report a single center experience in managing leukostasis with leukapheresis. Fifteen patients with leukostasis of 187 patients with AML (8.02%) followed at our institution were treated with leukapheresis associated with chemotherapy. The procedures were scheduled to be performed on a daily basis until clinical improvement was achieved and WBC counts were significantly reduced. Overall and early mortalities, defined as that occurred in the first 7 days from diagnosis, were reported. A high proportion of our patients with leukostasis (46.66%) had a monocytic subtype AML (M4/M5, according to French-American-British classification). The median overall survival was 10 days, despite a significant WBC reduction after the first apheresis procedure (from 200.7 × 10⁹/L to 150.3 × 10⁹/L). Almost half of patients (7/15) had an early death. Therapeutic leukapheresis, associated or not to chemotherapy, is an effective approach to reduce WBC counts in patients with AML and leukostasis; however, this therapeutic procedure does not appear to change significantly the sombre prognosis observed in the majority of patients with this complication. Other forms of treatment must be found to reduce the high mortality rate related to leukostasis.
Journal of Clinical Apheresis 05/2011; 26(4):181-5. · 1.93 Impact Factor
