Clinical and diagnostic features of polycystic ovary syndrome on the background of isulinresistance and hyperandrogenism

Aim of the study: to study the clinicodiagnostic features of polycystic ovarian syndrome (PCOS) against the background of insulin resistance (IR) and hyperandrogenism (HA).
Material and methods. We examined 120 women with PCOS and HA, 76 (63.3%) of the total number had IR. The average age of women was 28.54 ± 0.74 (20–44). In women with HA and PCOS against the background of IR, the levels of follicle-stimulating (hFSH), luteinizing (LH), thyrotropic (TТH) hormones were detected, as well as LH/hFSH ratio, prolactin (PRL), estradiol (E2), estrone (E1), total testosterone (T-total), DHEAS, androstenedione (Adione), cortisol (C), 17 hydroxyprogesterone (17-OPG), free triiodothyronine (T3), free thyroxine (T4), SHBG and Anti- Mullerian Hormone (AMH). The levels of carbohydrate metabolism, including glucose, insulin (on an empty stomach), after glucose loading, were determined as well as the HOMA and CARO indices.
Results. It was found that according to the Ferriman–Gallwey score, hirsutism was within the range of 16.15 ± 0.34 (11–24) points, hormones — 13.17 ± 0.30 (9–20) points in the examined patients. The indiff erent number was 2.93 ± 0.11 (2–4) points. The average weight of patients was 74.1 ± 1.79 (50–134) kg, height 1.62 ± 0.005 (1.52–1.78) m, Index of Mass Corporal was within 28.56 ± 0.66 (19.5–51.4) kg/m². In 81.5% of patients with HA and PCOS, absolute sterility was noted on the background of IR. According to hormones studies, there was a statistically signifi cant increase in LH (14.0 ± 0.87 mIU/ml), LH/hFSH (2.39 ± 0.15), TSH (2.83 ± 0.23 mIU/ml), DHEAS (3.32 ± 0.21 pg / ml), 17-OPG (1.0 ± 0.08 ng/ml), Adione (3.94 ± 0.1 ng/ml), T-total (1, 15 ± 0.006 ng/ml), K (125.39 ± 2.86 ng/ml), AMH (7.84 ± 0.36 ng/ml), E1 (153.36 ± 4.56 ng/ml) and decrease in E2 (65.32 ± 2.38 pg/ml), SHBG (36.1 ± 2.0 nmol/l). The study of carbohydrate metabolism and some anthropometric parameters revealed an increase in OB (100.66 ± 1.76 cm), OB / OT (0.86 ± 0.005), glucose and insulin (on an empty stomach) parameters and after glucose loading and HOMA index with a signifi cant decrease in the SAR index. According to the ultrasound data, patients with HA and PCOS against the background of IR revealed a statistically signifi cant decrease in the length and width of the uterus and an increase in the length, thickness, volume of the endometrium, the number of atresic follicles in both ovaries compared to similar data in practically healthy women (p <0.05).

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