بررسی بیماری تخمدان پلی‌کیستیک در خانم‌های 15 تا 45 ساله مراجعه کننده به کلینیک فوق تخصصی غدد و کلینیک تخصصی زنان بیمارستان امام خمینی شهرستان ساری (78-79)

Background and purpose: Polycystic ovarian disease is infact a chronic anovulation with broad spectrum of causes and clinical manifestations such as, hyper- insulinemia, insulin resistant and hyperendrogenism. Women with this disease excluding the common complications such as, irregular menses, hirsutism and infertility, are susceptible to serious consequences like, increase risk of endometrial carcinoma, possibly breast cancer, cardiovascular and diabetes problems. Çonsidering the above mentioned conditons. The women complain of anovulation, as a first decision must under go treatment on the basis age, fertility status and clinical manifestations. Ïn this study it was decided to evaluate the demographic, clinical, hormonal and sonographic conditions of the patients and also the relation between bormone disorders with body weight and blood insulin level. Materials and methods : This was a descriptive and cross-sectional study, done on females with age group of 15-45 years, referring to endecrine and gynaecology clinics. 80 patients with polycystic syndrome were under investigation. Demographic data were recorded in questionnair. Hormonal examinations (PRL, 17-ÔHP, FBS, Ïnsulin, Testesterone, LH, FSH, GTT) were done by Radio immunoassay method. Ând the patients were studied for sonography, in order to study the relation between body weight, blood insulin level and hyperendrogenism. The patients were divided in two obese and non obese (BMÏ>30 and BMÏ<30) and on the basis of presence and absence of functional hyperendrogenism manifestations were divided in FH+and FH-groups. Mann-withny and kruskal-wallis tests were used for analysis of the data. Results : The most common clinical findings were as follow: irregular mense (100%), family history (62.5%),hirsutism (62%), and obesity (95%). The most common hormonal abnormalities were as follow: increased testestrone (39.5%), increase in ratio of LH/FSH (25%), insulin resistance (21.2%), GTT disorder (17.5%) and hyperinsulinism (10%). Results of sonography was abnormal in 18.7%. Ït was shown that, in 17.5% (50% in obese group) there was abnormal level of GTT as compare to non obese group. There was insulin resistant in 21% (52% in obese group), fast hyperinsulinemia was noticed in 10% (50% in obese group). Â comparison between FH+ dan FH- in obese patients for Hyperinsulinemia and abnormal GTT, the statistical difference was significant p=0.033. Â comparison between FH+ obese patients and FH+ non obese patients from abnormal GTT point of veiw, the statistical difference was significant (P=0.0311). Çonclusion : Since the diagnosis of polycystic ovarian disease is possible by clinical symptoms, hence laboratory examinations except for ruling out rare diseases such as, hyperthyroidism and hyperprolactemia have no role in diagnosis. Performing such examinations must be confined to certain diseases. Ôn the other hand, unwanted complications such as, hyperinsulinemia, insulin resistant, hyperglycemia have direct relation with obesity and hyperendrogenism in such patients. Ôbese individuals with hyperendrogenism must be more investigated, and special treatment measurement must be considered for them. Sonography has no diagnostic value, and should not be considered as a routine method for diagnosis of such disease.