DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20220735

Clinical, hormonal and ovarian morphological correlation in women with polycystic ovary syndrome

Rishi R. S. Saini, Smirti Gupta, Mamta Tyagi, Sachin Agrawal, Bharat K. Gupta

Abstract


Background: Aim of the study was to study the correlation between clinical, ultrasonographical and hormonal features in women diagnosed as polycystic ovary syndrome (PCOS) and association with vitamin D levels.

Methods: This prospective study was conducted among women attending gynecological outpatient department (OPD) of Subharti Medical College, Meerut over a period of two years among 100 patients with clinical diagnosis of PCOS/PCOD according to Rotterdam criteria (2013) were included in this study. All biochemical investigations to be carried out for levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), vitamin D levels, lipid profile to understand the endocrinal and metabolic derangements if any in the patient. Ultrasound pelvis for ovarian study was conducted to know the ovarian morphology, no of follicles if any and their size, which were helpful in the diagnosis of PCOS.

Results: Nulliparity and multiparity was reported among 32% and 68% of the subjects respectively. Most common complaint was hirsuitism (43%). According to ultrasonography (USG), PCOS was found to be positive and negative among 87% and 13% of the subjects respectively. Most of the subjects had vitamin D level of 20-50 while <20 vitamin D level was found among 27% of the subjects. Vitamin D deficiency was found to be more in subjects having morphological presence of PCOS as compared to subjects with morphological absence of PCOS with statistically significant difference.

Conclusions: On correlating ultrasonological findings with clinic hormonal changes in PCOS women we found that hirsuitism and vitamin d deficiency was significantly more common in women with sonological findings suggestive of PCOS.


Keywords


PCOS, Vitamin D, USG, Hirsuitism, LH, FSH

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References


Azziz R, Dumesic DA, Goodarzi MO. Polycystic ovary syndrome: An ancient disorder? Fertil Steril. 2011;95:1544-8.

Panda PK, Rane R, Ravichandran R, Singh S, Panchal H. Genetics of PCOS: A systematic bioinformatics approach to unveil the proteins responsible for PCOS. Genom Data. 2016;8:52-60.

Franks S, McCarthy MI, Hardy K. Development of polycystic ovary syndrome: Involvement of genetic and environmental factors. Int J Androl. 2006;29:278-85.

Diamanti-Kandarakis E, Panidis D. Unravelling the phenotypic map of polycystic ovary syndrome (PCOS): A prospective study of 634 women with PCOS. Clin Endocrinol (Oxf). 2007;67:735-42.

Gulseth HL, Gjelstad IM, Tierney AC. Serum vitamin D concentration does not predict insulin action or secretion in European subjects with the metabolic syndrome. Diabetes Care. 2010;33:923-5.

George PS, Pearson ER, Witham MD. Effect of vitamin D supplementation on glycaemic control and insulin resistance: A systematic review and meta-analysis. Diabet Med. 2012;29:142-50.

Dalgard C, Petersen MS, Weihe P, Grandjean P. Vitamin D status in relation to glucose metabolism and type 2 diabetes in septuagenarians. Diabetes Care. 2011;34:1284-8.

Pramyothin P, Biancuzzo RM, Lu Z, Hess DT, Apovian CM, Holick MF. Vitamin D in adipose tissue and serum 25- hydroxyvitamin D after roux-en-Y gastric bypass. Obesity (Silver Spring). 2011;19:2228-34.

Pinelli NR, Jaber LA, Brown MB, Herman WH. Serum 25- hydroxy vitamin d and insulin resistance, metabolic syndrome, and glucose intolerance among Arab Americans. Diabetes Care. 2010;33:1373-5.

Scragg R, Sowers M, Bell C. Third National Health and Nutrition Examination Survey. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey. Diabetes Care. 2004;27:2813-8.

Hutchinson MS, Grimnes G, Joakimsen RM, Figenschau Y, Jorde R. Low serum 25-hydroxyvitamin D levels are associated with increased all-cause mortality risk in a general population: The Tromsø study. Eur J Endocrinol. 2010;162:935-42.

Tao MF, Zhang Z, Ke YH, He JW, Fu WZ, Zhang CQ, Zhang ZL. Association of serum 25- hydroxyvitamin D with insulin resistance and beta-cell function in a healthy Chinese female population. Acta Pharmacol Sin. 2013;34:1070-4.

Bellia A, Garcovich C, D'Adamo M, Lombardo M, Tesauro M, Donadel G, et al. Serum 25- hydroxyvitamin D levels are inversely associated with systemic inflammation in severe obese subjects. Intern Emerg Med. 2013;8:33-40.

Kim JJ, Choi YM, Chae SJ, Hwang KR, Yoon SH, Kim MJ, et al. Vitamin D deficiency in women with polycystic ovary syndrome. Clin Exp Reprod Med. 2014;41:80-5.

Thomson RL, Spedding S, Buckley JD. Vitamin D in the aetiology and management of polycystic ovary syndrome. Clin Endocrinol (Oxf). 2012;77:343-50.

Naqvi SH, Moore A, Bevilacqua K, Lathief S, Williams J, Naqvi N, Pal L. Predictors of depression in women with polycystic ovary syndrome. Arch Womens Ment Health. 2014;18:95-101.

Raja-Khan N, Shah J, Stetter CM, Lott ME, Kunselman AR, Dodson WC, et al. High-dose vitamin D supplementation and measures of insulin sensitivity in polycystic ovary syndrome: A randomized, controlled pilot trial. Fertil Steril. 2014;101:1740-6.

elTabbakh GH, Lotfy I, Azab I, Rahman HA, Southren AL, Aleem FA. Correlation of the ultrasonic appearance of the ovaries in polycystic ovarian disease and the clinical, hormonal, and laparoscopic findings. Am J Obstet Gynecol. 1986;154(4):892-5.

Inan C, Karadag C. Correlation between ovarian morphology and biochemical and hormonal parameters in polycystic ovary syndrome. Pak J Med Sci. 2016;32(3):742.

Muralidhara KD, Adhikari PM, Muralidhara DV. A study on the clinical, biochemical and hormonal profile of polycystic ovary syndrome patients attending tertiary care hospital. Indian J Basic Appl Med Res. 2015;4(3):227-36.

Spandana JC, Shetty PKK. A study on the clinical, biochemical and hormonal profile of polycystic ovary syndrome patients attending tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2017;6:1986-92.

Gowri BV, Chandravathi PL, Sindhu PS, Naidu KS. Correlation of skin changes with hormonal changes in polycystic ovarian syndrome: A cross-sectional study clinical study. Indian J Dermatol. 2015;60:419.

Sidhmalswamy AG, Ghongdemath JS, Venkatesh S. Clinical, ultrasonographical and hormonal correlation in women with polycystic ovarian syndrome. Int J Reprod Contracept Obstet Gynecol. 2018;7:5134-9.

Mandrelle K, Kamath MS, Bondu DJ, Chandy A, Aleyamma T, George K. Prevalence of metabolic syndrome in women with polycystic ovary syndrome attending an infertility clinic in a tertiary care hospital in south India. J Hum Reprod Sci. 2012;5(1):26-31.

Thangavelu M, Godla UR, Godi S, Paul SF, Maddaly R. A Case-controlled Comparative Hospital-based Study on the Clinical, Biochemical, Hormonal, and Gynecological Parameters in Polycystic Ovary Syndrome. Indian J Pharm Sci. 2017;79(4):608-16.

Najem F, Elmehdawi R, Swalem A. Clinical and Biochemical Characteristics of Polycystic Ovary Syndrome in Benghazi- Libya; A Retrospective study. Libyan J Med. 2008;3(2):71-4.

Jia XZ, Wang YM, Zhang N, Guo LN, Zhen XL, Li H, Wei L. Effect of vitamin D on clinical and biochemical parameters in polycystic ovary syndrome women: A meta‐analysis. J Obstet Gynaecol Res. 2015;41(11):1791-802.