Clinical and Demographic Characteristics of Patients Diagnosed with Polycystic Ovary Syndrome: A Cross-Sectional Observational Study
Yıl 2024,
Cilt: 6 Sayı: 1, 1 - 7, 25.03.2024
Özde Beren Tatar
,
Osmna Nuri Erginay
,
Yıldız Akdaş Reis
Öz
Objective: The aim of this study was to investigate the clinical and demographic characteristics of patients diagnosed with polycystic ovary syndrome (PCOS) who were followed up in our hospital.
Material and Methods: We conducted a retrospective, case-controlled observational study of patients treated at the PCOS Clinic of University of Health Sciences Etlik Zubeyde Hanim Women’s Health Training and Research Hospital between November 2023 and January 2024. The gynecologic history, demographic characteristics, and biochemical parameters of each patient were obtained from the hospital records.
Results: The number of patients who presented to our PCOS outpatient clinic and were enrolled in the study was 48, and the mean age of the patients was 23±5.6 years. The mean body mass index was 26.1± 4.9 kg/m2. The most common reason for presentation to the PCOS outpatient clinic was irregular menstruation (83.3%). The most frequently observed phenotypic group was group A (47.9%). The preferred treatment was lifestyle modification (75.0%), the second most common treatment was oral contraceptives (45.8%).
Conclusion: PCOS is one of the most common endocrine disorders worldwide and can affect women of all ages. In our study, the most common phenotype in our clinic was found to be group A. In addition to oral contraceptives, which are the treatment of first choice, lifestyle changes are also among the treatments used in patients.
Etik Beyan
The study was approved by the Ethics Committee for Noninterventional Studies of Etlik Zubeyde Hanım Women Health Education Research Hospital (Approval date: 28/02/2024 Issue No.: 02/12).
Kaynakça
- Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol. 1935;29:181. https://doi.org/10.1016/S0002-9378(15)30642-6
- Cannarella R, Condorelli RA, Mongioì LM, La Vignera S, Calogero AE. Does a male polycystic ovarian syndrome equivalent exist? J Endocrinol Invest. 2018;41(1):49-57. https://doi.org/10.1007/s40618-017-0728-5
- Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81:19-25. https://doi.org/10.1016/j.fertnstert.2003.10.004
- World Health Organization. The second decade: improving adolescent health and development (No. WHO/FRH/ADH/98.18 Rev. 1). 2001. Available at: https://apps.who.int/iris/bitstream/ handle/10665/64320/WHO_FRH_?sequence=1
- Huffman J. Gynecologic problems that beset the adolescent. Contemporary Obstetrics and Gynecolog. 1976;81-7.
- Christensen SB, Black MH, Smith N, et al. Prevalence of polycystic ovary syndrome in adolescents. Fertil Steril. 2013;100(2):470-7. https://doi.org/10.1016/j.fertnstert.2013.04.001
- Recabarren SE, Sir-Petermann T, Rios R, et al. Pituitary and testicular function in sons of women with polycystic ovary syndrome from infancy to adulthood. J Clin Endocrinol Metab. 2008;93(9):3318-24. https://doi.org/10.1210/jc.2008-0255
- Teede HJ, Misso ML, Costello MF, et al; International PCOS Network. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod. 2018;33(9):1602-18.
- Güngör ES, Güngör Ş, Zebitay AG. Assessment of semen quality in patients with androgenetic alopecia in an infertility clinic. Dermatologica Sinica. 2016;34(1):10-3. https://doi.org/10.1016/j.dsi.2015.06.003
- Witchel SF, Oberfield S, Rosenfield RL, et al. The Diagnosis of Polycystic Ovary Syndrome during Adolescence. Horm Res Paediatr. 2015. https://doi.org/10.1159/000375530
- Ibáñez L, Oberfield SE, Witchel S, et al. An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence. Horm Res Paediatr. 2017;88(6):371-95. https://doi.org/10.1159/000479371
- Rosenfield RL. Perspectives on the International Recommendations for the Diagnosis and Treatment of Polycystic Ovary Syndrome in Adolescence. J Pediatr Adolesc Gynecol. 2020;33(5):445-7. https://doi.org/10.1016/j.jpag.2020.06.017
- Screening and Management of the Hyperandrogenic Adolescent: ACOG Committee Opinion, Number 789. Obstet Gynecol. 2019;134:e106-14. https://doi.org/10.1097/AOG.0000000000003475
- Legro RS, Arslanian SA, Ehrmann DA, et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013;98(12):4565-92. https://doi.org/10.1210/jc.2013-2350
- Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2016;31(12):2841-55. https://doi.org/10.1093/humrep/dew218
- Azziz R, Carmina E, Dewailly D, et al. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab. 2006;91(11):4237-45. https://doi.org/10.1210/jc.2006-0178
- Dewailly D, Pigny P, Soudan B, et al. Reconciling the definitions of polycystic ovary syndrome: the ovarian follicle number and serum anti-Müllerian hormone concentrations aggregate with the markers of hyperandrogenism. J Clin Endocrinol Metab. 2010;95(9):4399-405. https://doi.org/10.1210/jc.2010-0334
- Dewailly D, Gronier H, Poncelet E, et al. Diagnosis of polycystic ovary syndrome (PCOS): revisiting the threshold values of follicle count on ultrasound and of the serum AMH level for the definition of polycystic ovaries. Hum Reprod. 2011;26(11):3123-9. https://doi.org/10.1093/humrep/der297
- de Medeiros SF, de Medeiros MAS, Barbosa BB, Yamamoto MMW, Maciel GAR. Comparison of metabolic and obesity biomarkers between adolescent and adult women with polycystic ovary syndrome. Arch Gynecol Obstet. 2021;303(3):739-749. https://doi.org/10.1007/s00404-020-05867-x
- Yuce E, Pabuccu R, Keskin M, Arslanca T, Pabuçcu EG. Polikistik Ovary Sendromlu Ergen ve Yetişkin Hastalar Arasındaki Klinik, Endokrinolojik ve Biyokimyasal Farkların Değerlendirilmesi. TJRMS. 2020;4:15-23. https://doi.org/10.24074/tjrms.2020-80616
- Topçu HO, Topçu S, Oskovi A, et al. Comparison of the clinical and laboratory outcomes in adolescent and adults with polycystic ovary syndrome. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi. 2014;11:82-4.
- Jain S, Jain M, Shukla RC. Correlation of Clinical, Hormonal, Biochemical and Ultrasound Parameters Between Adult and Adolescent Polycystic Ovarian Syndrome: Adult and Adolescent PCOS. J Obstet Gynaecol India. 2022;72(Suppl 1):274-80. https://doi.org/10.1007/s13224-021-01557-z
- Katulski K, Podfigurna A, Czyzyk A, Meczekalski B, Genazzani AD. Kisspeptin and LH pulsatile temporal coupling in PCOS patients. Endocrine. 2018;61(1):149-57. https://doi.org/10.1007/s12020-018-1609-1
- Cimino I, Casoni F, Liu X, et al. Novel role for anti-Müllerian hormone in the regulation of GnRH neuron excitability and hormone secretion. Nat Commun. 2016;7:10055. https://doi.org/10.1038/ncomms10055
- Filho RB, Domingues L, Naves L, Ferraz E, Alves A, Casulari LA. Polycystic ovary syndrome and hyperprolactinemia are distinct entities. Gynecol Endocrinol. 2007;23(5):267-72. https://doi.org/10.1080/09513590701297708
- Vilar L, Vilar CF, Lyra R, Freitas MDC. Pitfalls in the Diagnostic Evaluation of Hyperprolactinemia. Neuroendocrinology. 2019;109(1):7-19. https://doi.org/10.1159/000499694
- Barber TM, McCarthy MI, Wass JAH, Franks S. Obesity and polycystic ovary syndrome. Clin Endocrinol (Oxf). 2006;65(2):137-45. https://doi.org/10.1111/j.1365-2265.2006.02587.x
- Ollila MM, Piltonen T, Puukka K, et al. Weight Gain and Dyslipidemia in Early Adulthood Associate With Polycystic Ovary Syndrome: Prospective Cohort Study. J Clin Endocrinol Metab. 2016;101(2):739-47. https://doi.org/10.1210/jc.2015-3543
- Brower MA, Hai Y, Jones MR, et al. Bidirectional Mendelian randomization to explore the causal relationships between body mass index and polycystic ovary syndrome. Hum Reprod. 2019;34(1):127-36. https://doi.org/10.1093/humrep/dey343
- Ezeh U, Yildiz BO, Azziz R. Referral bias in defining the phenotype and prevalence of obesity in polycystic ovary syndrome. J Clin Endocrinol Metab. 2013;98(6):E1088-96. https://doi.org/10.1210/jc.2013-1295
Polikistik Over Sendromu Tanısı Alan Hastaların Klinik ve Demografik Özellikleri: Kesitsel Gözlemsel Çalışma
Yıl 2024,
Cilt: 6 Sayı: 1, 1 - 7, 25.03.2024
Özde Beren Tatar
,
Osmna Nuri Erginay
,
Yıldız Akdaş Reis
Öz
Amaç: Bu çalışmada polikistik over sendromu (PKOS) tanısı alan ve hastanemizde takipli hastaların klinik ve demografik özelliklerinin değerlendirilmesi planlanmıştır.
Gereç ve Yöntem: Kasım 2023- Ocak 2024 tarihleri arasında Ankara Etlik Zübeyde Hanım Araştırma ve Eğitim Hastanesi PKOS Kliniğinde takip edilen hastalar üzerinde retrospektif vaka kontrollü gözlemsel bir çalışma gerçekleştirdik. Her hastanın jinekolojik öyküsü, demografik özellikleri, biyokimyasal parametreleri hastane kayıtlarından elde edilmiştir.
Bulgular: PKOS polikliniğimize başvurup, çalışmaya dahil edilen hasta sayısı 48’dir. Hastaların yaş ortalaması 23±5.6 yıldır. Vücut kitle indeksi ortalaması 26,1± 4.9 kg/m2’dir. PKOS polikliniğine en sık başvuru nedeni düzensiz menstrüasyondur (83.3%). En sık gözlemlenen fenotipik grup ise A grubudur (47.9%). Kliniğimize başvuran hastalar en çok yaşam tarzı değişikliği tercih etmiştir (75.0%), ikinci en sık tercih edilen tedavi oral kontraseptif kullanımı (45.8%) olmuştur.
Sonuç: PKOS tüm dünyada en sık görülen ve her yaştan kadını etkileyebilen endokrin bozukluklardan biridir. Çalışmamızda kliniğimizde en sık görülen fenotip A grubu olarak bulunmuştur. First line tedavi olan oral kontraseptiflerle birlikte, yaşam tarzı değişşiklikleri de hastalara uygulanan tedavilerimiz arasındadır.
Etik Beyan
Bu araştırma için Etlik Zübeyde Hanım Kadın Sağlığı Eğitim ve Araştırma Hastanesi Girişimsel Olmayan Çalışmalar Etik Kurulundan onay alınmıştır (Karar no: 28/02/2024, 02/12).
Kaynakça
- Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol. 1935;29:181. https://doi.org/10.1016/S0002-9378(15)30642-6
- Cannarella R, Condorelli RA, Mongioì LM, La Vignera S, Calogero AE. Does a male polycystic ovarian syndrome equivalent exist? J Endocrinol Invest. 2018;41(1):49-57. https://doi.org/10.1007/s40618-017-0728-5
- Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81:19-25. https://doi.org/10.1016/j.fertnstert.2003.10.004
- World Health Organization. The second decade: improving adolescent health and development (No. WHO/FRH/ADH/98.18 Rev. 1). 2001. Available at: https://apps.who.int/iris/bitstream/ handle/10665/64320/WHO_FRH_?sequence=1
- Huffman J. Gynecologic problems that beset the adolescent. Contemporary Obstetrics and Gynecolog. 1976;81-7.
- Christensen SB, Black MH, Smith N, et al. Prevalence of polycystic ovary syndrome in adolescents. Fertil Steril. 2013;100(2):470-7. https://doi.org/10.1016/j.fertnstert.2013.04.001
- Recabarren SE, Sir-Petermann T, Rios R, et al. Pituitary and testicular function in sons of women with polycystic ovary syndrome from infancy to adulthood. J Clin Endocrinol Metab. 2008;93(9):3318-24. https://doi.org/10.1210/jc.2008-0255
- Teede HJ, Misso ML, Costello MF, et al; International PCOS Network. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod. 2018;33(9):1602-18.
- Güngör ES, Güngör Ş, Zebitay AG. Assessment of semen quality in patients with androgenetic alopecia in an infertility clinic. Dermatologica Sinica. 2016;34(1):10-3. https://doi.org/10.1016/j.dsi.2015.06.003
- Witchel SF, Oberfield S, Rosenfield RL, et al. The Diagnosis of Polycystic Ovary Syndrome during Adolescence. Horm Res Paediatr. 2015. https://doi.org/10.1159/000375530
- Ibáñez L, Oberfield SE, Witchel S, et al. An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence. Horm Res Paediatr. 2017;88(6):371-95. https://doi.org/10.1159/000479371
- Rosenfield RL. Perspectives on the International Recommendations for the Diagnosis and Treatment of Polycystic Ovary Syndrome in Adolescence. J Pediatr Adolesc Gynecol. 2020;33(5):445-7. https://doi.org/10.1016/j.jpag.2020.06.017
- Screening and Management of the Hyperandrogenic Adolescent: ACOG Committee Opinion, Number 789. Obstet Gynecol. 2019;134:e106-14. https://doi.org/10.1097/AOG.0000000000003475
- Legro RS, Arslanian SA, Ehrmann DA, et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013;98(12):4565-92. https://doi.org/10.1210/jc.2013-2350
- Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2016;31(12):2841-55. https://doi.org/10.1093/humrep/dew218
- Azziz R, Carmina E, Dewailly D, et al. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab. 2006;91(11):4237-45. https://doi.org/10.1210/jc.2006-0178
- Dewailly D, Pigny P, Soudan B, et al. Reconciling the definitions of polycystic ovary syndrome: the ovarian follicle number and serum anti-Müllerian hormone concentrations aggregate with the markers of hyperandrogenism. J Clin Endocrinol Metab. 2010;95(9):4399-405. https://doi.org/10.1210/jc.2010-0334
- Dewailly D, Gronier H, Poncelet E, et al. Diagnosis of polycystic ovary syndrome (PCOS): revisiting the threshold values of follicle count on ultrasound and of the serum AMH level for the definition of polycystic ovaries. Hum Reprod. 2011;26(11):3123-9. https://doi.org/10.1093/humrep/der297
- de Medeiros SF, de Medeiros MAS, Barbosa BB, Yamamoto MMW, Maciel GAR. Comparison of metabolic and obesity biomarkers between adolescent and adult women with polycystic ovary syndrome. Arch Gynecol Obstet. 2021;303(3):739-749. https://doi.org/10.1007/s00404-020-05867-x
- Yuce E, Pabuccu R, Keskin M, Arslanca T, Pabuçcu EG. Polikistik Ovary Sendromlu Ergen ve Yetişkin Hastalar Arasındaki Klinik, Endokrinolojik ve Biyokimyasal Farkların Değerlendirilmesi. TJRMS. 2020;4:15-23. https://doi.org/10.24074/tjrms.2020-80616
- Topçu HO, Topçu S, Oskovi A, et al. Comparison of the clinical and laboratory outcomes in adolescent and adults with polycystic ovary syndrome. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi. 2014;11:82-4.
- Jain S, Jain M, Shukla RC. Correlation of Clinical, Hormonal, Biochemical and Ultrasound Parameters Between Adult and Adolescent Polycystic Ovarian Syndrome: Adult and Adolescent PCOS. J Obstet Gynaecol India. 2022;72(Suppl 1):274-80. https://doi.org/10.1007/s13224-021-01557-z
- Katulski K, Podfigurna A, Czyzyk A, Meczekalski B, Genazzani AD. Kisspeptin and LH pulsatile temporal coupling in PCOS patients. Endocrine. 2018;61(1):149-57. https://doi.org/10.1007/s12020-018-1609-1
- Cimino I, Casoni F, Liu X, et al. Novel role for anti-Müllerian hormone in the regulation of GnRH neuron excitability and hormone secretion. Nat Commun. 2016;7:10055. https://doi.org/10.1038/ncomms10055
- Filho RB, Domingues L, Naves L, Ferraz E, Alves A, Casulari LA. Polycystic ovary syndrome and hyperprolactinemia are distinct entities. Gynecol Endocrinol. 2007;23(5):267-72. https://doi.org/10.1080/09513590701297708
- Vilar L, Vilar CF, Lyra R, Freitas MDC. Pitfalls in the Diagnostic Evaluation of Hyperprolactinemia. Neuroendocrinology. 2019;109(1):7-19. https://doi.org/10.1159/000499694
- Barber TM, McCarthy MI, Wass JAH, Franks S. Obesity and polycystic ovary syndrome. Clin Endocrinol (Oxf). 2006;65(2):137-45. https://doi.org/10.1111/j.1365-2265.2006.02587.x
- Ollila MM, Piltonen T, Puukka K, et al. Weight Gain and Dyslipidemia in Early Adulthood Associate With Polycystic Ovary Syndrome: Prospective Cohort Study. J Clin Endocrinol Metab. 2016;101(2):739-47. https://doi.org/10.1210/jc.2015-3543
- Brower MA, Hai Y, Jones MR, et al. Bidirectional Mendelian randomization to explore the causal relationships between body mass index and polycystic ovary syndrome. Hum Reprod. 2019;34(1):127-36. https://doi.org/10.1093/humrep/dey343
- Ezeh U, Yildiz BO, Azziz R. Referral bias in defining the phenotype and prevalence of obesity in polycystic ovary syndrome. J Clin Endocrinol Metab. 2013;98(6):E1088-96. https://doi.org/10.1210/jc.2013-1295