Bulletin of Clinical and Experimental Endocrinology MS-02 Insulin Resistance in the Development of Metabolic Syndrome in Females with Abnormalities in Reproductive Sphere
R.M.Mamedgasanov, G.R.Fatalieva, S.S.Safarova, S.E.Meshadieva
Azerbaijan Medical University, Baku, Azerbaijan Backgrounds and aims: The aim of present investigation was the relation of hyperandrogenemia with existance and degree of insulin resistance (IR), also the determination of Metformin influence on clinics, metabolism and hormonal parameters in obese females. Materials and Methods: 30 females (17-34 years) with abnormal menstrual cycle and obesity have been investigated. They filled in questionnaire for accurate definition of anamnesis data, medical examination. BMI, waist to hip ratio, the number of hirsuties (by Ferryman scale), BP, duration of menstrual cycle were included in evaluated parameters. Luteinizing hormone (LH), follicle-stimulating hormone (FSH), index LH/FSH, prolactin, E2, progesterone, 17- hydroxyprogesterone, T, DGEA-c, cortisol, sex hormone binding globulin (SHBG), total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, FPG, insulin (IRI), “insulin to glucose” ratio have been determined. For indirect assessment of IR Caro index =FPG/IRI and HOMA IR = FPG (mmol/l) * fasting IRI (µIU/ml) / 22,5. Metformin (500 mg) was prescribed to patients 3 times per day during 8 weeks, after that re-examination of patients has been carried out. Results: The obtained results shown that FPG of all investigated females were in normal range. fasting IRI (IRI0) level was increased in 10 patients. Postload IRI level (IRI120) was higher than normal level in 12 patients. 8 patients had both increased IRI0 and IRI120 levels. IRI0 mean level was significantly lower in patients with androgen normal level in comparison with patients with DGEA-c increased level (9,75±0,58 µIU/ml and 9,83±0,47 µIU/ml vs. 12,47±1,04 µIU/ml, respectively, p=0,005). IRI120 level was significantly lower in patients with testosterone normal level in comparison with patients with DGEA-c increased level (22,92±2,20 µIU/ml and 22,02±1,61 µIU/ml vs. 30,43±2,26 µIU/ml, respectively, p=0,021). Fasting Caro index was in normal range in all patients. However, in the group with increased DGEA-c level Index Caro was significantly lower than in groups with normoandrogenemia (0,49±0,03, 0,63±0,05 and 0,57±0,02, respectively, p=0,026), which indicates on higher insulin sensitivity in patients with hyperandrogenemia. HOMA IR in patients with normoandrogenemia was 2,21±0,13; in patients with DGEA-c increased level - 2,85±0,28. After Metformin treatment it was observed essential decrease IR and testosterone, also BMI reduction, normalization of menstrual cycle, reduction acne and number of hirsuties. We could not observe essential changes of DGEA-c, prolactin, FSH, LH, and FSH/LH levels. Effect of Metformin in patients with DGEA-c increased level was different than in patients with DGEA-c normal level. In last group the essential decrease of menstrual cycle duration, BMI reduction and decrease of DGEA-c and T took place. Conclusion: According to our observations IR and compensatory hyperinsulinemia significantly often take place in patients with hyperandrogenemia. Moreover, taking into account that IR is key pathogenetic feature of metabolic syndrome development, hyperandrogenemia can be considered as risk factor of metabolic syndrome development as a whole. Treatment by Metformin led to essential reduction of clinical expressions of metabolic syndrome and hyperandrogenemia. These results also were depended on the adrenal function.
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CONCURSO PÚBLICO Procedimento adotado pelo Estado para selecionar os candidatos profissionalmente mais qualificados ao exercício de cargos e empregos públicos, por meio da aferição de suas aptidões pessoais. Nesta aferição pessoal, verifica-se a capacidade física e intelectual dos interessados, submetendo-os a testes de conhecimentos e exames de aptidão física, segundo as exigê