TITLE:
Insulin Sensitivity and Gynaecological Features of Infertile Cameroonian Females with Polycystic Ovary Syndrome: A Cross-Sectional Study
AUTHORS:
Julius Sama Dohbit, Eugene Sobngwi, Jean Dupont Kemfang, Pascal Foumane, Joel Noutakdie Tochie, Felix A. Elong, Betsy Bate, Emile T. Mboudou
KEYWORDS:
Gynaecological Features, Insulin Sensitivity, Impaired Fasting Blood Sugar, Infertility, PCOS
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.7 No.13,
December
8,
2017
ABSTRACT: Background: Polycystic ovary syndrome (PCOS), characterized by ovulatory dysfunction,
polycystic ovary(PCO),hyperandrogenism
and insulin resistance is the commonest endocrine disorder in women of
reproductive age. It is an intriguing pathology that involves the perpetuation
of a vicious circle with reproductive, endocrine and metabolic components. We
aimed to assess the reproductive features and insulin sensitivity (IS) in
infertile women with or without PCOS. Materials and Methods: We carried
out a cross-sectional analytic study at the outpatient Obstetrics and
Gynaecology Department of the Yaounde Gyneco-obstetric and Pediatrics Hospital,
Cameroon from September 1st 2012 to March 31st 2013
giving total study duration of 07 months. Laboratory analyses were carried out
at the National Obesity Centre(NOC)of
the Yaounde Central Hospital, Cameroon. Results: Overall, 36 infertile females
were enrolled, which included 15 diagnosed cases of PCOS according to Rotterdam
consensus meeting of 2003 and 21 non PCOS subjects as control. PCOS women were
younger than non PCOS women (28.8 ± 5.5 vs. 35.0 ± 4.2
years; p = 0.0004). The majority of
the women in the PCOS group were spaniomenorrheic (11/15), and ultrasonographic
findings were typical of PCOS. Hirsutism score was higher in the PCOS group
with a median of 9 (7 - 13). Insulin sensitivity was impaired in two-thirds
of the study population, with 12 women found to be insulin resistant(6 PCOS, 6 non PCOS), 12 patients had intermediate
insulin sensitivity(2 PCOS, 10 non PCOS)and 12 insulin sensitive(7 PCOS, 5 non PCOS).
Apart from blood glucose levels (p = 0.007),
all other anthropometric and biological parameters were not significant. Spearman’s
correlation identified fasting plasma glucose and total cholesterol as factors
associated with insulin sensitivity in females with PCOS. Impaired fasting
glucose was observed in 13 patients with 08 from the PCOS group. Conclusion: We conclude that young age, spaniomenorrhea and hirsutism are common
findings in PCOS. Furthermore, our
findings suggest that PCOS may be more of systemic metabolic disease than
solely a purely gynecologic disorder as described hitherto. Despite normal fasting
plasma glucose levels, a good proportion of these women has impaired
insulin sensitivity and it is associated with a metabolic syndrome.