Introduction: Polycystic ovary syndrome (PCOS) is a common disorder in women. Hyperandrogenism and chronic oligo-anovulation are the prominent clinical features. The aim of our study was to determine the prevalence and the predictive factors of PCOS in a group of women with morbid obesity.
Methods: We performed a cross sectional study in 50 women with a body mass index (BMI) ≥ 40 kg /m2 collected over a period of 6 months (October 2017March 2018). Anthropometric assessment and review of medical records were performed. The ovarian morphology was evaluated by sus-pubic ultrasound. All patients had their metabolic and hormonal profiles evaluated. PCOS was diagnosed according to Rotterdam criteria.
Results: The average age of our patients was 34.2±7.51 years.The mean BMI was 44.53±3.97 kg /m2 and the mean waist circumference was of 123.38±10.89 cm. PCOS was identified in 40% of cases.There was no statically significant difference in anthropometric parameters in patients with or without PCOS. Menstrual irregularity and hirsutism were higher in patients with PCOS comparing with patients without PCOS (80% vs 20%; P<0.001 and 80% vs 23%; P<0.001; respectively). Ovarian ultrasound revealed that 36% had polycystic ovaries (65% in PCOS vs 17.9% in non PCOS; P=0.04). As for hormonal tests, a significant difference between the PCOS and non PCOS women was found regarding LH levels and LH/FSH (4.8±2.1 vs 3.3±2.02; P=0.01 and 0.9±0.3 vs 0.5±0.2; P=0.001, respectively). Predictive factors of PCOS in morbid obesity were the presence of menstrual disturbance (OR=22.6; P<0.001), hirsutism (OR =13.1; P<0.001), LH/FSH >1 (OR=6.8; P=0.007) and an ovary volume > 10 ml (OR=11; P=0.001).
Conclusion: Our study showed a high prevalence of PCOS in women with morbid obesity. In fact, due to the hyperinsulinemia, obesity causes a reduction in SHBG levels responsible of the signs of hyperandrogenemia. Furthermore, PCOS is characterized by abnormalities in the gonadotropin hormone releasing hormone, or GnRH, pulse generator leading to preferential increase in LH release over follicle stimulating hormone (FSH). Thus, a routine screening by obtaining at least a menstrual history and a careful evaluation for hyperandrogenism may be indicated in severely obese women.
18 - 21 May 2019
European Society of Endocrinology