0.829
IF
20
MNiSW
166.26
ICV
RESEARCH PAPER
 
CC BY-NC-ND 3.0
 
 

Clinical and hormonal features of women with polycystic ovary syndrome living in rural and urban areas

Adam Czyzyk 2,  
Sylwia Slawek 2,  
 
1
Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
2
Students Scientific Society of the Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
3
Division of Gynecological Surgery, Poznan University of Medical Sciences, Poznan, Poland
Ann Agric Environ Med 2017;24(3):522–526
KEYWORDS:
ABSTRACT:
Introduction:
Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies among women at reproductive age, but its pathology remains unknown. From epidemiological studies it is known that endogenous, mainly genetic and exogenous, environmental factors are of importance.

Objective:
The aim of the study was to compare the phenotype of women diagnosed with PCOS from urban and rural areas of Poland. According to the knowledge of the authors, this is first such study.

Material and Methods:
The retrospective study included 3,877 PCOS patients: 2511 women living in cities and 1,366 village inhabitants, aged between 18 – 45 years. Clinical data, including medical history, body mass, height and hirsutism severity was obtained from each patient. Hormones were also tested in each patient: follicle stimulating hormone, luteinizing hormone, prolactin, estradiol [E2], testosterone, dehydroepiandrosterone sulphate [DHEAS], thyroid stimulating hormone, free thyroxin, insulin [INS], 17 hydroxyprogesterone, cortisol [CORT]) and metabolic (75g oral glucose tolerance test, Chol – total cholesterol, HDL-C – high density lipoprotein cholesterol, LDL-C low density lipoprotein cholesterol, and the TG (triglicerides) profile.

Results:
PCOS women from urban areas had a higher mean serum concentration of E2 in comparison to the inhabitants of rural areas. Women from cities had a lower mean level of DHEAS, CORT, and INS measured in the morning than rural residents. Insulin-resistance, using homeostasis model assessment, was more pronounced among women from villages. The prevalence of menstrual disorders, in general, was higher in PCOS women living in rural comparing to urban areas.

Conclusions:
The clinical and biochemical indices differed significantly between women diagnosed with PCOS living in cities and villages. In general in Poland, the PCOS phenotype is more severe in women living in rural areas. This study shows that different living conditions significantly affect the PCOS phenotype.

CORRESPONDING AUTHOR:
Blazej Meczekalski   
Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
 
REFERENCES (17):
1. Fauser BC, Tarlatzis BC, Rebar RW et al. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril. 2012; 97(1): 28–38.
2. Baird DT, Balen A, Escobar-Morreale HF. Health and fertility in World Health Organization group 2 anovulatory women. Hum Reprod Update. 2012; 18(5): 586–99.
3. Kozakowski J, Zgliczyński W. Body composition, glucose metabolism markers and serum androgens – association in women with polycystic ovary syndrome. Endokrynol Pol. 2013; 64(2): 94–100.
4. Nawrocka-Rutkowska J, Ciećwież S, Marciniak A, Brodowska A, Wiśniewska B, Kotlega D, Starczewski A. Insulin resistance assessment in patients with polycystic ovary syndrome using different diagnostic criteria--impact of metformin treatment. Ann Agric Environ Med. 2013; 20(3): 528–32.
5. Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004; 19(1): 41–52.
6. Diamanti-Kandarakis E,Piperi CH, Argyrakopoulou G, Spina J, Papanastasiou L, Bergiele A, Panidis D. Polycystic Ovary Syndrome: The influence of environmental and genetic factors. Hormones 2006; 5(1): 17–34.
7. Brzozowska M, Karowicz-Bilińska A.The role of vitamin D deficiency in the etiology of polycystic ovary syndrome disorders. Ginekol Pol. 2013; 84(6): 456–60.
8. Xita N, Tsatsoulis A. Review: fetal programming of polycystic ovary syndrome by androgen excess: evidence from experimental, clinical, and genetic association studies. J Clin Endocrinol Metab. 2006; 91(5): 1660–6.
9. Katulski K, Czyzyk A, Meczekalski B. The controversies in the diagnosis of polycystic ovary syndrome. Pol Merkur Lek. 2012 Jul; 33(193): 32–7.
10. Vaggopoulos V, Trakakis E, Chrelias C, Panagopoulos P, Basios G, Makridima S, Sioulas VD, Simeonides G, Labos G, Boutati E, Kassanos D. Comparing classic and newer phenotypes in Greek PCOS women: the prevalence of Metabolic Syndrome and their association with Insulin Resistance. J Endocrinol Invest. 2012 Nov 27.
11. Cai H, Huang J, Xu G, Yang Z, Liu M, Mi Y, Liu W, Wang H, Qian D. Prevalence and determinants of metabolic syndrome among women in Chinese rural areas. PLoS One. 2012; 7(5): e36936.
12. Gu D, Reynolds K, Wu X, Chen J, Duan X, Reynolds RF, Whelton PK, He J. Prevalence of the metabolic syndrome and overweight among adults in China. Lancet. 2005; 365: 1398–1405. doi: 10.1016/S0140–6736(05)66375–1.
13. Das M, Pal S, Ghosh A. Rural urban differences of cardiovascular disease risk factors in adult Asian Indians. Am J Hum Biol. 2008 Jul-Aug; 20(4): 440–5.
14. Vassiliadi DA, Barber TM, Hughes BA, McCarthy MI, Wass JA, Franks S, Nightingale P, Tomlinson JW, Arlt W, Stewart PM. Increased 5 alpha-reductase activity and adrenocortical drive in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2009; 94(9): 3558–66.
15. Valkenburg O, Uitterlinden AG, Themmen AP, de Jong FH, Hofman A, Fauser BC, Laven JS. Hum Reprod. Genetic polymorphisms of the glucocorticoid receptor may affect the phenotype of women with anovulatory polycystic ovary syndrome. 2011; 26(10): 2902–11.
16. Huisman HW, van Rooyen JM, Malan NT, Eloff FC, Malan L, Laubscher PJ, Schutte AE. Prolactin, testosterone and cortisol as possible markers of changes in cardiovascular function associated with urbanization. J Hum Hypertens. 2002 Dec; 16(12): 829–35.
17. Panidis D, Tziomalos K, Chatzis P. Association between menstrual cycle irregularities and endocrine and metabolic characteristics of the polycystic ovary syndrome. Eur J Endocrinol. 2013; 168(2): 145–52.
eISSN:1898-2263
ISSN:1232-1966