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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2004 April;163(2):43-8

Copyright © 2004 EDIZIONI MINERVA MEDICA

language: Italian

Evaluation of ovulation regularity in relation to insulin hematic levels, androgens and obesity in polycistic ovary syndrome

Gambardella V., D’Ettore A., Battista L., Vitelli A., Giannotti F., D’Antò V., Caccavale C., Sole E., Tolino A.

Dipartimento di Scienze Ostetrico-Ginecologiche Urologiche e Medicina della Riproduzione, Università degli Studi di Napoli, «Federico II», Napoli


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Aim. The ­ovary poly­cys­tic syn­drome (­PCOS) is prob­ably the ­most fre­quent endo­cri­nop­a­thy in repro­duc­tive age wom­en. It is char­ac­ter­ized by hyper­an­dro­gen­ism and chron­ic anov­u­la­tion, in ­absence of oth­er pathol­o­gies ­which can be the ­cause of ­these man­i­fes­ta­tions. The aim of ­this ­study was to eval­u­ate the ovu­la­to­ry reg­u­lar­ity con­sid­er­ing the hemat­ic lev­els of insu­lin, andro­gens and obes­ity in ­PCOS.
Meth­ods. A ­total of 238 wom­en ­with ­PCOS sub­di­vid­ed ­into 2 ­groups ­have ­been stud­ied: 214 ­patients ­with ano­vu­la­to­ry ­cycles and 24 ­with reg­u­lar and ovu­la­to­ry ­cycles. The ­high hemat­ic lev­els of insu­lin, insu­lin-resis­tance, ­body ­mass ­index (BMI), andros­te­ned­i­one, tes­tos­te­rone, ­free tes­tos­te­rone, sul­fate-Dehy­droe­pi­an­dros­te­rone, and irsut­ism ­have ­been eval­u­at­ed.
­Results. The ­results ­obtained ­showed ­that wom­en ­with ­PCOS ­with ovu­la­to­ry and reg­u­lar ­cycles ­have ­more nor­mal ­weight and insu­lin hemat­ic lev­els and are ­less ­over-­weight-­obese and ­irsute ­than ano­vu­la­to­ry wom­en. The low­est val­ues of insu­lin, andro­gens, tes­tos­te­rone and ­free tes­tos­te­rone are ­observed in ovu­la­to­ry wom­en.
Con­clu­sion. Obes­ity, ­which induc­es insu­lin-resis­tance and ­high hemat­ic lev­els of insu­lin, con­trib­utes to the devel­op­ment of ­PCOS in ­some wom­en, add­ing a ­type of insu­lin-resis­tance par­tic­u­lar obes­ity to the pre-exis­tent insu­lin-resis­tance asso­ciat­ed to ­PCOS. In ­PCOS ­patients obes­ity ­makes ­worse the syn­drome. In par­tic­u­lar, insu­lin-resis­tance ­proves to be asso­ciat­ed to BMI, ­while ­weight reduc­tion in ­obese ­patients ­with ­PCOS reduc­es LH-hyper­in­cre­tion and ­restores a nor­mal insu­lin-sen­sibil­ity.

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