Centeno I, Pizzi R , González N, Cáceres M, Mendoza A. MD
Gynecological Endocrinology Unit, Department of Endocrinology, “Hospital Universitario de Caracas”. Caracas, Venezuela.
Introduction: the Polycystic Ovary Syndrome (PCOS) is the most frequent endocrinopathy in women within reproductive age, with a 4-8% ofoccurrence. (1,2)
The definition of PCOS by Rotterdam consensus workshop criteria in 2003(3), answered the concerns about NIH/NICHC criteria.(4)The Rotterdam classification should be used to define PCOS in the event of: menstrual cycle anomalies; amenorrhoea, oligomenorrhoea or long cycles, clinical and/or biochemical hyperandrogenism (5)and ultrasound appearance of polycystic ovaries(6). The presenceof two of these three criteria is sufficient, once all other diagnoses have been ruled out. The ultrasound definition of PCOS contains precise criteria that must be included in the report: presence of at least 12 follicles in each ovary measuring 2-9mm in diameter, and/or increase in ovary volume>10ml (IOV).(7)
The inclusion of PCO morphology sparked a controversy as it broadens the populationof women who meet the criteria for PCOS and allows for the creation of two phenotypically different patient populations who would have been previously excluded.(8-10)
There is some reference relating Latin American population with PCOS diagnosis. (11,12) This study was performed to determine the correlation between ovarian volume versus biochemical and clinical parameters in a population ofVenezuelan women with PCOS.
Methods: a sample of 61 consecutive PCOS women was recruited from the Unit of Gynecological Endocrinology of the “Hospital Universitario de Caracas” (Caracas University Hospital) and was prospectively evaluated. Evaluation included an interview registering menstrual cycle lengths, a detailed physical examination (Ferriman-Gallwey hirsutism score (5); body mass index– BMI-(13)) and hormonal parameters including FSH, LH, serum androgens, oral glucose tolerance test with measure of insulin. Insulin sensitivity was determined by calculation of HOMA-IR.(14) Increased ovarian volume was established according to Rotterdam criteria.(3,7) Statistical analysis was performed using proportions and ANOVA (SPSS 14.00 software).
Results: we studied women aged 14-41years old (mean 24.38 yr). Age of menarche was 9- 15 years (mean 12.3yr). From this population we registered 80.33% of cycle irregularity with oligomenorrhoea. Hirsutism (40.98%) was the most frequent physical sign of hyperandrogenism. BMI ranged 19.9-40.2 kg/m2 (mean 25.14). Increased ovarian volume (IOV) >10ml was recorded at 52.46%. The value of HOMA-IR >2.5 ranged 44.38%, and LH/FSH ratio >2at 36.06%.(Table 1) Biochemical hyperandrogenism was significantly higher (49,2%) in women with IOV (p25 kg/m2 |59% |
|Biochemical hyperandrogenism |49.2% |
|LH/FSH >2 ratio|36.06% |
|HOMA-IR > 2,5 |44.3% |
Table 2. Ovarian Volume and Biochemical Hyperandrogenism .
| | | |Biochemical Hyperandrogenism ||
| | | |Present |Absent |Total |
|Ovarian Volume |> 10 cc |Yes |23 |9 |32 |
| | |% |71.9 |28.1...