en ارزیابی سندرم متابولیک در زنان نابارور مبتلا به سندرم تخمدان پلی کیستیک در جمعیت روستایی جنوب هند: یک مطالعه مقطعی Fertility & Infertility Original Article Original Article <div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">سندرم تخمدان پلی</span></span><span dir="LTR" style="font-size:11.0pt"><span arial="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">کیستیک (</span></span><span dir="LTR" style="font-size:10.0pt">PCOS</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) با سندرم متابولیک (</span></span><span dir="LTR" style="font-size:10.0pt">MS</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) مرتبط است. این سندرم با مقاومت به انسولین، هیپرانسولینمی، دیس لیپیدمی، چاقی و فشار خون بالا مشخص می</span></span><span dir="LTR" style="font-size:11.0pt"><span arial="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">شود. اطلاعات مربوط به سندرم متابولیک در زنان نابارور مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">PCOS</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در جمعیت هندی محدود است. </span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">این مطالعه با هدف مقایسه شیوع سندرم متابولیک در زنان نابارور مبتلا به سندرم تخمدان پلی&shy;کیستیک و بدون سندرم تخمدان پلی&shy;کیستیک در جمعیت روستایی جنوب هند انجام شد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مواد و روش &shy;ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در این مطالعه مقطعی 130 زن مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">PCOS</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">و 130 زن بدون </span></span><span dir="LTR" style="font-size:10.0pt">PCOS</span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> وارد مطالعه شدند. شرح حال دقیق گرفته شد و معاینه فیزیکی برای همه زنان انجام شد. پارامترهای تن</span></span><span dir="LTR" style="font-size:11.0pt"><span arial="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">سنجی، تست تحمل گلوکز، سطوح گلوکز/انسولین ناشتا، تری</span></span><span dir="LTR" style="font-size:11.0pt"><span arial="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">گلیسیرید، کلسترول لیپوپروتئین با چگالی بالا و فشار خون در همه شرکت‌کنندگان ارزیابی شد. معیارهای فدراسیون بین</span></span><span dir="LTR" style="font-size:11.0pt"><span arial="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">المللی دیابت برای ارزیابی سندرم متابولیک اعمال شد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">سندرم متابولیک در زنان نابارور مبتلا به </span></span>&nbsp;<span dir="LTR" style="font-size:10.0pt">PCOS</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">(3/42%)</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نسبت به زنان بدون </span></span><span dir="LTR" style="font-size:10.0pt">PCOS</span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> (3/19%) شیوع بیشتری داشت. 9/56% از زنان مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">PCOS</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">سطح پایین کلسترول لیپوپروتئین با چگالی بالا، 2/46% تری&shy;گلیسیرید بالا، 5/71% دور کمر بالا، 5/31% فشار خون بالا و 7/37% سطح گلوکز خون بالا داشتند. 0/26% از زنان مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">PCOS</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">وزن مناسبی داشتند و </span></span><span dir="LTR" style="font-size:10.0pt">MS</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در 9/6% از این زنان مشاهده شد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتیجه &shy;گیری:</span></span></b> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">شیوع </span></span><span dir="LTR" style="font-size:10.0pt">MS</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در زنان مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">PCOS</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">بیشتر از زنان بدون </span></span><span dir="LTR" style="font-size:10.0pt">PCOS</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">بود. در بین زنان مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">PCOS</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، شیوع </span></span><span dir="LTR" style="font-size:10.0pt">MS</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">با افزایش سن (بیش از 27 سال)، شاخص توده بدنی و دور کمر (5/71</span></span><span lang="FA" style="font-size:11.0pt"><span majalla="" sakkal="" style="font-family:">٪</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) افزایش یافت و حتی زنان سالم مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">PCOS</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در 7</span></span><span lang="FA" style="font-size:11.0pt"><span majalla="" sakkal="" style="font-family:">٪</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> موارد سندرم متابولیک داشتند. از این رو، غربالگری تمام زنان مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">PCOS</span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> از نظر عوامل خطر متابولیک در سنین پایین ضروری است تا از عوارض طولانی مدت قلبی عروقی جلوگیری شود.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></span></span></span></span></span><br> <br> <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><i><span lang="FA" style="font-size:10.0pt"><span b="" mitra="" style="font-family:">کلمات کلیدی: </span></span></i></b><i><span lang="FA" style="font-size:10.0pt"><span b="" mitra="" style="font-family:">سندرم تخمدان پلی&shy;کیستیک، سندرم متابولیک، هیپرآندروژنیسم، هورمون&shy;ها.</span></span></i></span></span></span></span></div> <div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span new="" roman="" style="font-family:" times=""><b>Background:</b> Polycystic ovary syndrome (PCOS) is known to be associated with metabolic syndrome (MS). It is characterised by Insulin Resistance, hyperinsulinemia, dyslipidemia, obesity and hypertension. Data related to MS in infertile women with PCOS are limited in Indian populations.</span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span new="" roman="" style="font-family:" times=""><b>Objective: </b>This study aims to compare the prevalence of MS in infertile women with and without PCOS in a rural population in South India.</span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span new="" roman="" style="font-family:" times=""><b>Materials and Methods: </b>130 women with PCOS and 130 women without PCOS were enrolled in this cross-sectional study. A detailed history was taken and a physical examination was done for all women. Anthropometric parameters, a glucose tolerance test, fasting glucose/ insulin levels, trigylcerides, high-density lipoprotein cholesterol and blood pressure were assessed in all participants. The International Diabetes Federation criteria were applied for assessment of MS.</span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><b>Results:</b> MS was more prevalent in infertile women with PCOS (42.3%) compared to women without PCOS (19.3%). 56.9% of women with PCOS had low high-density lipoprotein cholesterol levels, 46.2% had high triglycerides, 71.5% had a high waist circumference, 31.5% had high blood pressure and 37.7% had high blood glucose levels. 26.0% of the women with PCOS had a healthy weight, and MS was seen in 6.9% of these women.</span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><b>Conclusion: </b>The prevalence of MS was higher in women with PCOS in comparison to women without PCOS. Among the women with PCOS, the prevalence of MS increased with age (> 27 yrs), body mass index and waist circumference (71.5%), and even healthy women with PCOS contributed to 7% of MS. Hence it becomes necessary to screen all women with PCOS for metabolic profile risk factors at young age itself to prevent long term cardiovascular complications.</span></span></span></span></div> سندرم تخمدان پلی­کیستیک, سندرم متابولیک, هیپرآندروژنیسم, هورمون­ها. Polycystic ovary syndrome, Metabolic syndrome, Hyperandrogenism, Hormones. 161 168 http://ijrm.ir/browse.php?a_code=A-10-652-2&slc_lang=en&sid=1 Sreelalitha Kayali lalli.nagendra@gmail.com, 0000-0002-6030-7659 No 1. Department of Obstetrics and Gynecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. Thyagaraju Chitra drchitra@yahoo.com, 0000-0002-3224-9180 Yes Department of Obstetrics and Gynecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. Sadishkumar Kamalanathan sadishkk@gmail.com 0000-0002-2371-0625 No Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. Hanumanthappa Nandeesha nandijipmer@gmail.com 0000-0001-7152-1143 No Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.