الفهرس 
Polycystic Ovary SyndromeOnly 14 pages are availabe for public view
 |  | from | 154 |  |  |
| | | from | 154 | | |
Abstract
Polycystic ovary syndrome (PCOS) is a common clinical, endocrine disorder characterized by infertility, menstrual disturbance, hirsutism, acne and obesity.
Polycystic ovary syndrome is defined as; the presence of two of the following three criteria: oligo-ovulation or anovulation; clinical and/or biochemical hyper androgenism; and polycystic ovaries on ultrasound examination
Polycystic ovary syndrome (PCOS), the main androgen disorder in women, has been suggested to be associated with a high risk of developing cardiovascular disease and type 2 diabetes. In many PCOS patients, overweight or central obesity is generally associated with increases in fasting insulin levels and glucose intolerance, and has been identified as a target for new therapeutic strategy, including early change in lifestyle. Early biochemical marker(s) for identifying at-risk patients will be useful for prevention studies.
Excess circulating insulin influences the clinical presentation of PCOS by directly increases ovarian androgen secretion, reduces insulin-like growth factor-binding protein-1 production by the liver and consequence, increasing bioavailable insulin like growth factor-I. Elevation in insulin and bioavailable IGF-I influencing gonadotropin-secretion, adrenal androgen secretion and also contributing to abnormalities in lipids and lipoproteins and inhibits hepatic synthesis of sex hormone-binding globulin (SHBG).
Women with PCOS are profoundly insulin resistance (IR), and the resultant hyperinsulinemia plays a role in the pathogenesis of the reproductive abnormalities of the syndrome. Agents that ameliorate insulin resistance and reduced circulating insulin levels could provide a new therapeutic modality for PCOS.
Special attention is given to the role of insulin resistance and the potential utility of insulin sensitizers in management. The benefit and utmost importance of lifestyle modification for the long-term health of these women is stressed as well. It is hoped that some clarity in this regard will allow more women to not only be diagnosed and managed properly for their presenting symptoms (hirsutism, irregular menses, etc.), but also to be educated and managed for the continuing health risk of insulin resistance throughout their live.
A fasting glucose to insulin (G/I) ratio is a simple and reliable measurement of insulin sensitivity and is useful test for identification of IR in women with PCOS, who have to be treated with insulin sensitizers.
Metformin is a biguanide used in the treatment of PCOS via decrease of hepatic gluconeogenesis and insulinemia; improvement peripheral glucose utilization and metabolism and intracellular glucose transport. Such effects, when this drug is administered alone during 3 to 6 months, increase sex hormone binding globulin (SHBG), reduce free androgens index and hirsutism, decrease insulin resistance, and regulate menses in 60 to 70% of cases. Thiazolidinodiones are drugs that decrease insulin resistance in the liver with hepatic glucose production. Their mechanism of action is through the peroxisome proliferator-activated receptors gamma (PPAR-gamma), that help to decrease plasmatic concentrations of free fatty acids, pre and postprandial glucose, insulin, triglycerides, increased HDL cholesterol and decreased LDL, menses return to normality, with improvement of ovulation and decreased hirsutism. It seems that by modulation and attenuation of insulin resistance, hypoglycemic agents such as metformin and thiazolidinodiones can be used effectively to treat anovulation, infertility and hyperandrogenemia.
So this study was designed to measure the frequency of IR in a cross section of Egyptian women with PCOS. And for this purpose, 50 patients in the reproductive age diagnosed with PCOS according to the diagnostic criteria from Rotterdam .