Journal of pediatric and adolescent gynecology · 2014
Menstrual cycle alterations during adolescence: early expression of metabolic syndrome and polycystic ovary syndrome.
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Bouzas Isabel Cristina da Silva, Cader Samária Ali, Leão Lenora, Kuschnir Maria Cristina, Braga Claudia
Аннотация
STUDY OBJECTIVE: To assess the importance of the menstrual pattern as a marker for clinical and laboratory alterations related to metabolic syndrome (MS) and polycystic ovary syndrome (PCOS) among Brazilian adolescents.
DESIGN: A cross-sectional study.
SETTING: Endocrine Gynecology Outpatient Clinic of the Adolescent Health Studies Center (NESA) at the Pedro Ernesto University Hospital.
PARTICIPANTS: 59 girls (12-19 years old) were classified by their menstrual cycles as regular (n = 23) and irregular (n = 36).
INTERVENTION: None.
MAIN OUTCOME MEASURES: Biochemical collections were made of peripheral blood after fasting for 12 hours, and the oral glucose tolerance test with 75 g of anhydrous glucose.
RESULTS: PCOS, MS, and the criteria for MS were significantly more frequent (P < .05) in the subgroup with irregular menstruation. Adolescents with irregular cycles presented a significant increase in waist circumference, glycemia 2 hours after oral glucose overload (2 h), fasting and 2-h insulin, HOMA-IR, and triglycerides. In contrast, the glucose/insulin ratio, quantitative insulin-sensitivity check index, and HDL serum levels were significantly lower among patients with irregular menstruation, compared to those with regular cycles. In the logistic regression, we noted that insulin 2 h ≥ 75 μIU/mL (r = 1.90; P = .018), waist circumference > 95 cm (r = 2.21; P = .006) and diagnosis of PCOS (r = 1.93; P = .023) were significantly correlated to irregular cycles.
CONCLUSIONS: We concluded that close observation of menstrual cycle patterns is an important tool for identifying adolescents at higher risk of developing PCOS and MS.
DESIGN: A cross-sectional study.
SETTING: Endocrine Gynecology Outpatient Clinic of the Adolescent Health Studies Center (NESA) at the Pedro Ernesto University Hospital.
PARTICIPANTS: 59 girls (12-19 years old) were classified by their menstrual cycles as regular (n = 23) and irregular (n = 36).
INTERVENTION: None.
MAIN OUTCOME MEASURES: Biochemical collections were made of peripheral blood after fasting for 12 hours, and the oral glucose tolerance test with 75 g of anhydrous glucose.
RESULTS: PCOS, MS, and the criteria for MS were significantly more frequent (P < .05) in the subgroup with irregular menstruation. Adolescents with irregular cycles presented a significant increase in waist circumference, glycemia 2 hours after oral glucose overload (2 h), fasting and 2-h insulin, HOMA-IR, and triglycerides. In contrast, the glucose/insulin ratio, quantitative insulin-sensitivity check index, and HDL serum levels were significantly lower among patients with irregular menstruation, compared to those with regular cycles. In the logistic regression, we noted that insulin 2 h ≥ 75 μIU/mL (r = 1.90; P = .018), waist circumference > 95 cm (r = 2.21; P = .006) and diagnosis of PCOS (r = 1.93; P = .023) were significantly correlated to irregular cycles.
CONCLUSIONS: We concluded that close observation of menstrual cycle patterns is an important tool for identifying adolescents at higher risk of developing PCOS and MS.