Complex assessment of the effect of glycosaminoglycans on the system of haemostasis in patients with polycystic ovary syndrome

Lapina, I A; Ozolinya, Lyudmila A.; Dobrokhotova, Yu.E.; Гаврилов, М В; Taranov, Vladislav V.; Кольтинова, Т. Г.

doi:10.20953/1726-1678-2019-5-35-41

Cited by 3 publications

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“…Он участвует в опосредованной активации сигнального пути инсулина, а также препятствует увеличению продукции андрогенов. Активность обеих изоформ инозитола включает различные биологические механизмы, что приводит к синергическому усилению эффекта от их совместного применения [6][7][8][9][10].…”

Section: Introductionunclassified

New prospects of the integrative therapy for polycystic ovary syndrome in women with the disorders of carbohydrate and lipid metabolism: a comparative study

Dobrokhotova¹,

Lapina²,

Chirvon³

et al. 2020

Russian Journal of Woman and Child Health

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Background: long-term combined estrogen-progestin oral contraceptive pills (COCPs) are the first-line treatment for polycystic ovary syndrome (PCOS). However, this therapeutic option does not affect metabolic disorders that are more severe in women with the second PCOS phenotype thus increasing the risk of cardiometabolic complications.Aim: to assess the effect of myo-inositol and D-chiro-inositol at a 5:1 ratio on metabolic parameters in women of reproductive age with the second PCOS pathogenetic type and the disorders of carbohydrate and lipid metabolism. Patients and Methods: 60 overweight and obese women with PCOS were enrolled in this randomized prospective study. Group 1 women (n=30) received COCP and a drug containing two isoforms of inositol at a 5:1 ratio (myo-inositol 1,000 mg plus D-chiro inositol 200 mg). Group 2 women (n = 30) received COCP only. Hemostasis, lipid panel, fasting glucose level, body mass index (BMI), and waist circumference were measured before and 90 days after treatment begins. Results: in group 1, the significant (p<0.05) improvement of lipid parameters was reported as demonstrated by the reduction of the levels of total cholesterol (TC) by 16.9%, triglycerides by 15.7%, low-density lipoprotein cholesterol (LDL–C) by 17.8%, fibrinogen by 15.8%, and fasting glucose by 16.9% as well as the increase of high-density lipoprotein cholesterol (HDL–C) by 28.5%. Meanwhile, no significant changes were seen in group 2. Additionally, the reduction of waist circumference by 4.5% and BMI by 9.1% was reported in group 1. Conclusions: a medication containing myo-inositol and D-chiro-inositol at a 5:1 ratio is promising for the prevention of cardiometabolic complications in women with PCOS. Further large studies of the investigated drug are needed to demonstrate its efficacy and to assess its properties. KEYWORDS: polycystic ovary syndrome (PCOS), treatment, prevention, obesity, metabolic syndrome, lipid panel, inositol, oral contraceptive pills. FOR CITATION: Dobrokhotova Yu.E., Lapina I.A., Chirvon T.G., Taranov V.V. New prospects of the integrative therapy for polycystic ovary syndrome in women with the disorders of carbohydrate and lipid metabolism: a comparative study. Russian Journal of Woman and Child Health. 2020;3(3):169–173. DOI: 10.32364/2618-8430-2020-3-3-169-173.

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Section: Introductionunclassified

New prospects of the integrative therapy for polycystic ovary syndrome in women with the disorders of carbohydrate and lipid metabolism: a comparative study

Dobrokhotova¹,

Lapina²,

Chirvon³

et al. 2020

Russian Journal of Woman and Child Health

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An integrated approach to the management of patients with endometrial hyperplasia and metabolic syndrome

et al. 2021

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Despite the achieved success in the treatment of endometrial hyperplasia processes, some issues related to the treatment of these diseases have not been completely resolved, especially in the presence of metabolic syndrome. Aim. To optimize the management of patients with endometrial hyperplasia and metabolic syndrome. Materials and methods. The study included 50 women with a verified diagnosis of recurrent endometrial hyperplasia. As a control value, a BMI of 25.0 kg/m2 was taken, two subgroups were identified with normal body weight and with overweight and obesity of the 1st degree. Treatment with GnRH was carried out in the following regimen: intramuscular injection of the drug at a dose of 3.75 mg once every 4 weeks with an assessment of the results after 3 and 6 months. In the course of the study, we assessed metabolic parameters, parameters of the hemostasis and fibrinolysis system before and during therapy. The baseline studied parameters were compared with the control group of healthy women without endometrial hyperplastic processes and overweight as well as patients of the control group with metabolic syndrome. Results. Hormonal treatment of recurrent endometrial hyperplasia without atypia using GnRH a positive effect on the dynamics of clinical manifestations, which is confirmed by the data of ultrasound and histological research methods and does not cause a sharp procoagulant shift, regardless of the patients body weight. Conclusion. Our results allow GnRH to be the drugs of choice in the treatment of endometrial hyperplasia in overweight patients, since they have a fairly safe and effective effect. It is necessary to remember about an integrated approach to patient management and to carry out the prevention of endothelial dysfunction in this group of patients due to the high risk of complications to potentiate a beneficial effect on hemostasiological and metabolic parameters.

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Options for the prevention of endothelial dysfunction and atherosclerotic vascular lesions in perimenopausal patients: A prospective study

Lapina,

Dobrokhotova,

Nikitenko

et al. 2024

Gynecology

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Introduction. Cardiovascular diseases are still the leading cause of death worldwide. In contrast to men, in women, cardiovascular diseases, such as coronary artery disease, acute cerebrovascular accident, and thrombosis of various localization, develop later in life. A fold rise in risk begins during the menopausal transition. Given the increase in the postmenopausal period of a woman's life, it seems interesting to search for new methods of early prevention of cardiometabolic complications already in perimenopause. Aim. To optimize early non-hormonal prevention of endothelial dysfunction and perimenopausal cardiovascular complications. Materials and methods. A prospective study included 50 patients aged 45–55 years in perimenopause without obesity and other somatic or gynecological disorders with menopausal syndrome of varying severity. Patients in group 1 (n=25) received combined non-hormonal treatment of menopausal symptoms and prevention of cardiovascular complications [sulodexide 250 lipasemic units (LU) 2 times a day + phytoestrogen (cimicifuga extract) 1 capsule 2 times a day]. In group 2 (n=25), patients received only phytoestrogen according to the same regimen. Results. After 1 year of observation, the mean thickness of the intima-media complex of the common carotid artery in group 1, in which patients received complex course therapy including sulodexide (Vessel Due F), decreased by 3.7%, and in group 2 increased by 26.8%. In group 1, it was found that after 1 year of regular use, treatment contributed to a decrease in blood fibrinogen level by 11.8% and an increase in thrombin time by 24.5%, which, in combination with a decrease in prothrombin concentration and an increase in activated partial thromboplastin time by 4.7 s, indicates a pronounced therapeutic effect on the hemostasis system. Conclusion. All markers of early atherosclerosis and vascular complications progress during postmenopause and with increasing age. However, complex protective therapy, including glycosaminoglycans sulodexide), can slow down this progression while improving patients' quality of life. Non-hormonal complex therapy can not only neutralize menopausal symptoms but also prevent long-term vascular complications caused by increasing age and the lack of estrogen-protective effect.

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Complex assessment of the effect of glycosaminoglycans on the system of haemostasis in patients with polycystic ovary syndrome

Cited by 3 publications

References 0 publications

New prospects of the integrative therapy for polycystic ovary syndrome in women with the disorders of carbohydrate and lipid metabolism: a comparative study

New prospects of the integrative therapy for polycystic ovary syndrome in women with the disorders of carbohydrate and lipid metabolism: a comparative study

An integrated approach to the management of patients with endometrial hyperplasia and metabolic syndrome

Options for the prevention of endothelial dysfunction and atherosclerotic vascular lesions in perimenopausal patients: A prospective study

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