32.3.38 Lifestyle Intervention on Feature of Polycystic Ovarian Syndrome in Obese Adolescent Girls

Original Article

 

Polycystic Ovarian Syndrome

Lifestyle Intervention on Feature of Polycystic Ovarian Syndrome in Obese Adolescent Girls

Mahwish Pervaiz1, Shazia Munir2, Urfa Taj1, Samreen Shabbir2, Faheema Rasul2 and Shazia Jabeen2

ABSTRACT

Objective: To study the lifestyle intervention on feature of polycystic ovarian syndrome in obese adolescent girls.

Study Design: Prospective study

Place and Duration of Study: This study was conducted at the Obstet and Gynecology Department, Jinnah Hospital Lahore and Sardar Begum Teaching Hospital Sialkot during Jan 2019 to April 2020.

Materials and Methods: One twenty five patients of polycystic ovarian syndrome in obese adolescent girls were selected for recent study. The informed consent of every patient was taken before history examination and Ultrasonography. The permission of Ethical Committee was taken before collecting data and get publishing in Medical Journal. The data was analyzed for results by SPSS verison20.

Results: One hundred twenty five girls (mean age fourteen point nine ± zero point eight yr) reduced their Body Mass Index Standard Deviation Status higher than zero point two in the lifestyle intervention, whereas fifty girls demonstrated an increase of Body Mass Index Standard Deviation Status or a reduction of Body Mass Index Standard Deviation Status less than or equal to zero point two  (mean age fifteen point one ± zero point seven yr).

Conclusion: The prevalence of ovarian syndrome was maximum seventy five (sixty percent) at age group twelve to fourteen and was minimum fifty (forty percent) at age group fifteen to seventeen.

Key Words: Lifestyle intervention, polycystic ovarian syndrome, fatty adolescent girls

Citation of article: Pervaiz M, Munir S, Taj U, Shabbir S, Rasul F, Jabeen S. Lifestyle Intervention on Feature of Polycystic Ovarian Syndrome in Obese Adolescent Girls. Med Forum 2021;32(3):151-154.

 

 

INTRODUCTION

Polycystic ovarian syndrome is a common disorganization affecting as many as five to ten percent of female of reproductive age1,2,4. Being a complex functional disorganization, Polycystic ovarian syndrome is furthermore associated with the metabolic syndrome1,5–9, perhaps predisposing to heart and blood vessels diseases1,9,10.

Lifestyle intervention is regarded as treatment of choice for both Polycystic ovarian syndrome and related to metabolism syndrome1,11–15,16, 17.

A further benefit of examinations of adult girls is that there is usually no capacity uncertain with other sickness or drugs.

Therefore, we determined the benefit of a one-yr style of life stopping on the features of Polycystic ovary

 

 

1. Department of Obstetrics & Gynecology, Allama Iqbal Memorial Medical College, Lahore.

2. Department of Obstetrics & Gynecology, Sardar Begum Teaching Hospital, Sialkot.

 

 

Correspondence: Dr Mahwish Pervaiz Assistant Professor Obstetrics & Gynecology Department Allama Iqbal Memorial Medical College, Lahore.

Contact No: 03337121004

Email: mahwishazfar@hotmail.com

 

 

Received:  September, 2020

Accepted:  November, 2020

Printed:      March, 2021

 

 

syndrome (increase androgen in blood and cycles of menses) and related to metabolism syndrome (damaged tolerance of glucose, increase lipid in blood, high blood pressure, and increased circumference of waist).18,14,19,20

MATERIALS AND METHODS

One twenty five patients of polycystic ovarian syndrome in obese adolescent girls were selected for recent study. The informed consent of every patient was taken before history examination and Ultrasonography. The permission of Ethical Committee was taken before collecting data and get publishing in Medical Journal. The data was analyzed for results by SPSS verison20.

RESULTS

One hundred twenty five girls (mean age fourteen point nine ± zero point eight yr) reduced their Body Mass Index Standard Deviation Status higher than zero point two in the lifestyle intervention, whereas fifty girls demonstrated an increase of Body Mass Index Standard Deviation Status or a reduction of Body Mass Index Standard Deviation Status less than or equal to zero point two (mean age fifteen point one ± zero point seven yr) (Table 1).

The prevalence of ovarian syndrome was maximum seventy five (sixty percent) at age group twelve to fourteen and was minimum fifty (forty percent) at age group fifteen to seventeen.

 

 

 

Table No. 1: Factor of the metabolic syndrome and carotid Immune Modulated Thrombocytopenia in the course of one year in seventy five girls with and fifty girls without successful weight loss in a one year lifestyle intervention

Variable

Successful weight loss (Body Mass Index Standard Deviation Status reduction>0.2)

No Successful weight loss(increase or reduction≤0.2 of Body Mass Index Standard Deviation Status

Baseline

1year later

P value

Baseline

1year later

P value

BMI (kg/m2) 

32.1 (3.7) 

28.2 (3.4) 

<0.001 

33.8 (6.8) 

34.4 (6.9) 

0.031

BMI-SDS 

2.54 (0.50) 

1.91 (0.60) 

<0.001 

2.64 (0.74) 

2.74 (0.75) 

0.011 

Waist circumference (cm) 

96.8 (16) 

94.9 (10) 

0.033 

97.98 (11) 

101.99 (11) 

NS 

Triglycerides (mg/dl) 

137.99 (39) 

111.98 (39) 

0.022 

135.98 (67) 

147.96 (77) 

NS 

HDL-cholesterol (mg/dl) 

44.9 (9) 

52.94 (13) 

<0.001 

45.96 (9) 

47.98 (15) 

NS 

Fasting glucose (mg/dl) 

84.96 (7) 

84.98 (6) 

NS 

85.96 (9) 

87.98 (9) 

NS 

Insulin (mU/liter) 

22.96 (15) 

16.98 (10) 

0.037 

24.96 (14) 

32.99 (13) 

NS 

HOMA 

4.7 (3.7) 

3.56 (2.0) 

0.049 

4.7 (3.3) 

4.7 (3.1) 

NS 

2-h glucose in oGTT (mg/dl) 

129.96(23) 

107.98 (19) 

0.009 

125.96 (24) 

127.98 (28) 

NS 

Systolic blood pressure (mm Hg) 

122.96 (15) 

113.98 (11) 

0.016 

124.97 (16) 

124.96 (16) 

NS 

Diastolic blood pressure (mm Hg) 

73.96 (12) 

65.95 (13) 

0.029 

69.96 (9) 

70.99 (12) 

NS 

Metabolic syndrome (IDF definition) 

34.96% 

3.98% 

0.008 

35.98% 

38.96% 

NS 

Intima-media thickness (cm) 

0.066 (0.005) 

0.054 (0.002) 

<0.001 

0.063 (0.008) 

0.064 (0.008) 

NS 

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Table No. 2: Factors of the polycystic ovarian syndrome in the course of one year in seventy five girls with and fifty girls without successful weight loss in a one year lifestyle intervention

Variable

Successful weight loss (Body Mass Index Standard Deviation Status reduction>0.2)

No Successful weight loss(increase or reduction≤0.2 of Body Mass Index Standard Deviation Status

Baseline

1year later

P value

Baseline

1year later

P value

Testosterone (nmol/liter) 

1.97 (0.7) 

1.49 (0.5) 

0.036 

1.79 (0.7) 

1.59 (0.6) 

NS 

DHEA-S (μg/liter) 

1681 (861) 

1824 (757) 

NS 

2078 (166) 

2152 (1277) 

NS 

SHBG (nmol/liter) 

16.98 (9) 

24.98 (11) 

<0.001 

13.96 (5) 

12.99 (4) 

NS 

Androstendione (ng/ml) 

2.7 (1.3) 

2.7 (1.6) 

NS 

3.59 (2.1) 

3.29 (1.4) 

NS 

Free testosterone index 

34.96 (14) 

25.98 (10) 

0.004 

36.87 (10) 

34.96 (21) 

NS 

LH (mU/ml) 

9.49 (7.5) 

5.19 (4.3) 

0.005 

10.5 (7.4) 

7.78 (4.0) 

NS 

FSH (mU/ml) 

4.49 (2.7) 

5.29 (3.1) 

NS 

5.59 (2.7) 

4.69 (2.1) 

NS 

LH/FSH 

2.29 (1.5) 

1.09 (0.8) 

0.002 

2.29 (1.6) 

1.89 (1.2) 

NS 

Amenorrhea (%) 

68.99 

26.96 

<0.001 

60.99 

54.98 

NS 

Oligomenorrhea (%) 

30.98 

11.96 

 

38.98

35.96 

 

 

 

 

 

Table No. 3: Age distribution

Sr. #

Age (years)

Number of cases

Percentage %

1

12-14

75

60%

2

15-17

50

40%

Total

125

100%

The prevalence of ovarian syndrome was maximum 75(60%) at age group 12-14 and was minimum 50(40%) at age group 15-17 as shown in table no 3

DISCUSSION

Loss of weight due to style of life stoppage was associated with an provement of steroid hormones and irregularities of blood loss during menstrual period. These results are in resemblances with studies in adults14, 15. Ornstein and colleagues19 also showed in a small study an development of irregularities of menses in weight loss of fatty girls with Polycystic ovary syndrome. Hoeger et al14 noted a decrease of testosterone and an increase of Sex hormone-binding globulin in twenty four adolescent fatty girls treated with lifestyle prevention.

The recent study resulted that, testosterone levels lowered and SHBG concentration elevated notably in the females with PCOS and decrease in weight, so that independent testosterone levels decreased, on the other hand DHEA-S concentration was unchanged. The results of current research were in collaboration with previous studies in which it was indicated that females having PCOS, indicated that decrease in body weight caused a relieve in clinical features of  hyper androgenism but caused no effect upon DHEA-S15. The results of these studies indicated that testosterone and SHBG are basic important criteria to diagnose PCOS. The previous studies have concluded that both these hormones are linked to increased insulin levels. Testosterone increases and SHBG decreases when insulin increases1. So it can be concluded that levels of insulin either decreased or increased leads to increased levels of sex hormones in the polycystic ovary syndrome1,2. Insulin and Leutnizing Hormone both co act to elevate the levels of sex hormones. Another action of Insulin is not letting the liver cells to form Sex hormone-binding globulin, which is the most important factor to carry the male sex hormone. This leads to elevated levels of independent male sex hormone. The results of this research also prove it correct that insulin immunity has connection with between obesity and polycystic ovary syndrome and not mass of fat1.

On the other hand, the androstenedione hormone concentration was not changed in females in whom the weight had decreased level as compared to concentrations of testosterone as explained in previous researches.15-20

 

CONCLUSION

The prevalence of ovarian syndrome was maximum seventy five (sixty percent) at age group twelve to fourteen and was minimum fifty (forty percent) at age group fifteen to seventeen.

Author’s Contribution:

Concept & Design of Study:

Mahwish Pervaiz

Drafting:

Shazia Munir, Urfa Taj

Data Analysis:

Samreen Shabbir,  Faheema Rasul, Shazia Jabeen

Revisiting Critically:

Mahwish Pervaiz,
Shazia Munir

Final Approval of version:

Mahwish Pervaiz

Conflict of Interest: The study has no conflict of interest to declare by any author.

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