Contribuição do hiperandrogenismo para o desenvolvimento de síndrome metabólica em mulheres obesas com síndrome dos ovários policísticos
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Data
2013-12-01
Autores
Rehme, Marta Francis Benevides
Pontes, Anaglória [UNESP]
Corrente, José Eduardo [UNESP]
Franco Junior, Jose Gonçalves [UNESP]
Pontes, Anaglória [UNESP]
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Editor
Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
Resumo
OBJETIVO: Avaliar a contribuição do hiperandrogenismo para o desenvolvimento da síndrome metabólica (SM) em mulheres obesas com ou sem Síndrome dos Ovários Policísticos (SOP). MÉTODOS: Estudo transversal retrospectivo no qual foram incluídas 60 mulheres obesas com fenótipo clássico da SOP - Consenso de Rotterdam - e 70 obesas sem SOP. A SM foi diagnosticada pelos critérios do NCEP-ATP III. A obesidade foi definida pelo índice de massa corpórea e o hirsutismo, pelo Índice de Ferriman-Gallwey (IFG). As dosagens realizadas foram: testosterona total, sulfato de dehidroepiandrosterona (SDHEA), insulina e glicose, colesterol total, HDL e triglicerídios. A resistência insulínica (RI) foi avaliada pelo HOMA-IR e pelo índice de sensibilidade à insulina de Matsuda e De Fronzo. A analise estatística foi realizada com o teste t de Student, teste do χ² e análise de regressão logística multivariada (p<0,05). RESULTADOS: As obesas com SOP apresentaram significativamente maiores valores de IFG (15,4±6,1), circunferência da cintura (105,6±11,4 cm), testosterona (135,8±71,4 ng/dL), SDHEA (200,8±109,2 µg/dL), HOMA-IR (8,4±8,5) e menores valores de ISI (2,0±1,8) quando comparadas às obesas não SOP (3,2±2,1; 101,4±9,2 cm; 50,0±18,2 ng/dL; 155,0±92,7 µg/dL; 5,1±4,7; 3,3±2,7, respectivamente) (p<0,05). A frequência de SM foi significativamente maior nas obesas com SOP (75%) do que nas obesas não SOP (52,8%) (p=0,01). A análise multivariada não demonstrou contribuição das variávies IFG, testoterona total e SDHEA para o desenvolvimento da SM (p>0,05). CONCLUSÃO: Mulheres obesas com SOP apresentam maior frequência de SM quando comparadas às obesas não SOP. O hiperandrogenismo não mostrou influência nesse grupo de mulheres estudadas.
PURPOSE: To assess the contribution of hyperandrogenism to the development of metabolic syndrome (MetS) in obese women with polycystic ovary syndrome (PCOS). METHODS: Retrospective cross-sectional study conducted on 60 obese women with classic PCOS phenotype - Rotterdam Consensus - and 70 non-PCOS obese women. MetS was diagnosed by the NCEP-ATP III criteria and obesity was defined by body mass index. The Ferriman-Gallwey score (mFG) was used to evaluate hirsutism. The following measurements were performed: total testosterone, dehydroepiandrosterone sulfate (DHEA-S), glucose and insulin, total cholesterol, HDL, and triglycerides. Insulin resistance was measured using the HOMA-IR and insulin sensitivity index of Matsuda and De Fronzo (ISI). Statistical analysis was performed using the Student's t-test, χ² test and multivariate logistic regression analysis (p<0.05). RESULTS: Obese women with PCOS had significantly higher mFG (15.4±6.1), waist circunference (105.6±11.4 cm), DHEA-S (200.8±109.2 µg/dL), testosterone (135.8±71.4 ng/dL), and HOMA-IR (8.4±8.5) values and lower ISI values (2.0±1.8) than non-obese PCOS women (3.2±2.1; 101.4±9.2 cm; 155.0±92.7 µg/dL; 50.0±18.2 ng/dL; 5.1±4.7 and 3.3±2.7, respectively) (p<0.05). The frequency of MetS was higher in PCOS obese (75%) than non-PCOS obese (52.8%) women (p=0.015). Multivariate analysis did not reveal the contribution of the variables IFG, testosterone, and DHEAS to the development of MetS (p>0.05). CONCLUSION: Obese women with PCOS have a higher frequency of metabolic syndrome than non-PCOS obese women, and hyperandrogenism does not contribute to the development of metabolic syndrome in this group of women.
PURPOSE: To assess the contribution of hyperandrogenism to the development of metabolic syndrome (MetS) in obese women with polycystic ovary syndrome (PCOS). METHODS: Retrospective cross-sectional study conducted on 60 obese women with classic PCOS phenotype - Rotterdam Consensus - and 70 non-PCOS obese women. MetS was diagnosed by the NCEP-ATP III criteria and obesity was defined by body mass index. The Ferriman-Gallwey score (mFG) was used to evaluate hirsutism. The following measurements were performed: total testosterone, dehydroepiandrosterone sulfate (DHEA-S), glucose and insulin, total cholesterol, HDL, and triglycerides. Insulin resistance was measured using the HOMA-IR and insulin sensitivity index of Matsuda and De Fronzo (ISI). Statistical analysis was performed using the Student's t-test, χ² test and multivariate logistic regression analysis (p<0.05). RESULTS: Obese women with PCOS had significantly higher mFG (15.4±6.1), waist circunference (105.6±11.4 cm), DHEA-S (200.8±109.2 µg/dL), testosterone (135.8±71.4 ng/dL), and HOMA-IR (8.4±8.5) values and lower ISI values (2.0±1.8) than non-obese PCOS women (3.2±2.1; 101.4±9.2 cm; 155.0±92.7 µg/dL; 50.0±18.2 ng/dL; 5.1±4.7 and 3.3±2.7, respectively) (p<0.05). The frequency of MetS was higher in PCOS obese (75%) than non-PCOS obese (52.8%) women (p=0.015). Multivariate analysis did not reveal the contribution of the variables IFG, testosterone, and DHEAS to the development of MetS (p>0.05). CONCLUSION: Obese women with PCOS have a higher frequency of metabolic syndrome than non-PCOS obese women, and hyperandrogenism does not contribute to the development of metabolic syndrome in this group of women.
Descrição
Palavras-chave
Síndrome dos ovários policísticos, Síndrome x metabólica, Obesidade, Hiperandrogenismo, Mulheres, Polycystic ovary syndrome, Metabolic syndrome X, Obesity, Hyperandrogenism, Women
Como citar
Revista Brasileira de Ginecologia e Obstetrícia. Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, v. 35, n. 12, p. 562-568, 2013.