English abstracts.doc

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.


BCEE, 2004, 1(1): 47

Source: http://www.sge.org.ge/bcee/2004-1/eng/47.pdf