Association of polycystic ovarian syndrome and metabolic syndrome in Tripura, India
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20202328Keywords:
Cardio metabolic syndrome, Clinical hyperandrogenism, European society of human reproduction and embryology guidelines, Metabolic syndrome, Polycystic ovarian syndromeAbstract
Background: A total 4-11% of women in India are affected by PCOS. Studies show that incidence and prevalence is increasing. It is a constellation of metabolic and endocrine abnormalities with significant cost to quality and quantity of life. Aim of this study was to find out the association of metabolic syndrome with PCOS. Objectives of this study were identified subjects suffering from PCOS and measure strength of association of metabolic syndrome.
Methods: Case-control study conducted in the department of Obstetrics and Gynaecology Agartala Government Medical College, Agartala, Tripura from January 2017 to June 2018. Fifty cases were diagnosed by Rotterdam criteria and 50 cases age matched controls were recruited. Hundred subjects underwent evaluation for metabolic syndrome according to ESHRE/ASRM criteria. Statistical analysis was done using SPSS 17.0.
Results: Mean age was 19.4±3.5 years. Oligomenorrhea found in 42 out of 50 cases. Hirsutism found in 54% of cases. There is a statistically significant difference in weight, BMI and waist circumference among PCOS cases and controls. Hypertriglyceridemia was found to be significantly higher among PCOS cases. Fasting glucose and 2-hour OGTT were found to be statistically significantly different. No association was found between metabolic syndrome and clinical hyperandrogenism, but metabolic syndrome was significantly associated with higher BMI. BMI, Hip circumference and oral glucose tolerance test were independent predictors of polycystic ovarian syndrome. Metabolic syndrome was present in 34% of cases. The odds ratio of having metabolic syndrome in a case of PCOS is 5.92.
Conclusions: Association between PCOS and metabolic syndrome is statistically significant. The two entities are intrinsically linked to each other and early identification of one may lead to the diagnosis and management of the other.
References
Ehrmann DA. Polycystic ovary syndrome. N Engl J Med. 2005;352(12):1223-36.
Norman RJ, Mahabeer S, Masters S. Ethnic differences in insulin and glucose response to glucose between white and Indian women with polycystic ovary syndrome. Fertil Steril. 1995;63(1):58-62.
Apridonidze T, Essah PA, Iuorno MJ, Nestler JE. Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005;90:1929-35.
The Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic and long-term health risks related to polycystic ovary syndrome (PCOS). Human Reprod. 2004;19:41-7.
Coskun A, Ercan O, Arikan DC, Özer A, Kilinc M, Kiran G, et al. Modified Ferriman-Gallwey hirsutism score and androgen levels in Turkish women. Eur J Obstel Gynecol Reprod Biol. 2011;154(2):167-71.
Sharma R. Kuppuswamy's socioeconomic status scale - revision for 2011 and formula for real-time updating. Indian J Pediatr. 2012;79(7):961-2.
Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, Azziz R. Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: a prospective study. J Clin Endocrinol Metab. 1998;83(9):3078-82.
Shivaprakash G, Basu A, Kamath A. Acanthosis Nigricans in PCOS patients and its relation with type 2 diabetes mellitus and body mass at a tertiary care hospital in Southern India. J Clin Diagn Res. 2013;7(2):317-9.
Kalra A, Nair S, Rai L. Association of obesity and insulin resistance with dyslipidemia in Indian women with polycystic ovarian syndrome. Indian J Med Sci. 2006;60:447-53.
Li R, Yu G, Yang D. Prevalence and predictors of metabolic abnormalities in Chinese women with PCOS: a cross- sectional study. BMC Endocr Disord. 2014;14:76.
Jamil AS, Alalaf SK, Al-tawil NG, Al-shawaf T. A case-control observational study of insulin resistance and metabolic syndrome among the four phenotypes of polycystic ovary syndrome based on Rotterdam criteria. Reprod Health. 2015;12:7.