Revista Cubana de Endocrinología (Aug 2008)
Asociación entre variables hormonales y clínicas y el resultado del ultrasonido ginecológico en mujeres con síndrome metabólico. Association among hormonal and clinical variables and the result of the gynecological ultrasound in females with metabolic syndrome.
Abstract
OBJETIVO: determinar la asociación entre el resultado de ultrasonido y los valores de progesterona, índice LH/FSH, testosterona, antecedentes de infertilidad e hirsutismo en mujeres con síndrome metabólico. MÉTODOS: se realizó un estudio descriptivo-transversal con 90 mujeres, entre 18 y 45 años de edad, con diagnóstico de síndrome metabólico. Se les realizó: FSH (3-5 días del ciclo menstrual si menstruaba), LH (3-5 días del ciclo menstrual si menstruaba), prolactina (3-5 días del ciclo menstrual si menstruaba), andrógenos (testosterona total, 3-5 días del ciclo menstrual si menstruaba), de lo contrario en cualquier momento y progesterona (21-23 días del ciclo menstrual si menstruaba), ultrasonido ginecológico transvaginal en la fase folicular temprana si menstruaban, y si estaban en amenorrea en cualquier momento. Además se les realizó una historia clínica que exploraba historia obstétrica, fórmula menstrual, antecedentes de infertilidad y examen físico. Se exploraron asociaciones entre las variables clínicas y hormonales y el resultado ultrasonográfico. RESULTADOS: el 83,1 % de las pacientes anovuladoras mostraron imágenes sugestivas de poliquistosis ovárica. Cuando se asociaron los niveles de testosterona con el ultrasonido, en el 80 % de las que tuvieron testosterona elevada el ultrasonido mostró imágenes de poliquistosis ovárica, sin embargo cuando la testosterona fue normal solo el 42,5 % mostró dichas imágenes. De las 39 pacientes con un índice LH/FSH ³ 2, 32 (82,1 %) tenían por imagen ultrasonográfica una poliquistosis ovárica, sin embargo cuando este fue OBJECTIVE: to determine the association between the result of the ultrasound and the progesterone values, LH/FSH level, testosterone, history of infertility and hirsutism in females with metabolic syndrome. METHODS: a descriptive cross-sectional study was undertaken among 90 females aged 18-45 with diagnosis of metabolic syndrome. FSH (3-5 days of the menstrual cycle), LH (3-5 days of the menstrual cycle), prolactin (3-5 days of the menstrual cycle), androgens (total testosterone, 3-5 days of the menstrual cycle), progesterone (21-23 days of the menstrual cycle) were determined if they were menstruating; otherwise they were established at any moment. A transvaginal gynecological ultrasound in the early follicular phase was performed if they had menstruation, but if they were amenorrheic it was carried out at any time. A medical history was also made to explore obstetric history, menstrual formula, history of infertility and physical examination. Associations between the clinical and hormonal variables and the ultrasonographic result were investigated. RESULTS: 83.1 % of the anovulatory showed images suggestive of ovarian polycystosis. When the testosterone levels were associated with the ultrasound, in 80 % of those who had an elevated testosterone, the ultrasound showed images of ovarian polycystosis; however, when testosterone was normal, just 42.5 % had such images. Of the 39 patients with an index ³ 2, 32 (82.1 %) presented an ultrasonographic image of ovarian polycystosis; however, when it was <2, only 49 % had them. 75 % of the females with infertility showed an ultrasound with signs of polycystic ovaries and 25 % did not. Of the 73 hirsute patients, 48 (65.8 %) had a positive ultrasound for ovarian polycystosis, whereas 25 (34.2 %) did not exhibit images suggestive of this disorder, without a significant difference. CONCLUSIONS: the association between anovulatory progesterone, elevated levels of testosterone, LH/FSH index ³ 2, infertility and hirsutism, with ultrasound images of polycystosis is very high in the studied women with metabolic syndrome.
