Endocrine Abstracts (2002) 3 P117

Ultrasound features of polycystic ovaries (PCO) and metabolic syndrome X

WU Atiomo1, DP Mikhalides2, R Morris3 & P Hardiman1

1University Department of Obstetrics and Gynaecology, Royal Free and University College Medical School, Royal Free Hospital, London, UK; 2Department of Chemical Pathology and Human Metabolism, Royal Free and University College Medical School, Royal Free Hospital, London, UK; 3Department of Primary Care and Population Sciences, Royal Free and University College Medical School, Royal Free Hospital, London, UK.

Objective: To establish the prevalence of Syndrome X in women with Polycystic Ovary Syndrome (PCOS) and determine which sonographic features of PCO best predict syndrome X.

Background: Recently, the third report of the USA national cholesterol education program expert-panel on the detection, evaluation and treatment of high blood cholesterol in adults specifically identified syndrome X, a combination of insulin resistance and compensatory hyperinsulinaemia, as a target for therapy to reduce the risk for coronary heart disease. The Syndrome was defined as the presence of 3 or more of the following features; waist circumference greater than 88cm, triglycerides greater/equal to 1.7 mmol/L, HDL < 1.3mmmol/L, blood pressure greater/equal to 130/ 85mmHg and glucose > 6.0 mmol/L. The prevalence of syndrome X (as defined above) in women with PCOS is unknown and the correlation between an ultrasound finding of PCO and syndrome X has never been evaluated.

Methods: In this study, data collected from a previous study looking at the plasminogen activator system in 41 women with PCOS and 25 controls were re-analysed. The prevalence of Syndrome X was determined in each group and a multiple logistic regression was used to determine which combination of the classic sonographic features of PCO best predicted syndrome X.

Results: Nine (22%) women with PCOS had Syndrome X (compared with 2 controls (8%). Only the presence of small follicles in both ovaries and follicles distributed throughout the right ovary (rather than peripherally) had significant associations with syndrome X . Small follicles in the left ovary were the strongest independent predictor.

Conclusions: These results may explain the apparent contradiction between morbidity and mortality in PCOS, where the subset of women with Syndrome X are those at increased risk of cardiovascular disease. The isolated finding of on ultrasound of PCO may therefore be of no metabolic significance.

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