Polycystic ovarian syndrome: Clinical correlation with biochemical status among Indian females

Abstract

Background: Polycystic ovary syndrome is a common and heterogeneous endocrine disorder characterized by hirsutism, amenorrhea, infertility, and obesity. Our primary aim to conduct this study was to find out the correlation between various biochemical and clinical features of polycystic ovarian syndrome and to determine the best hormonal marker for the same among Indian women at an early age. Materials & Methods:The study was done on outdoor patients over seventy women with PCOS diagnosed by history and hormonal levels (LH: FSH ratio>2, total testosterone>0.76 ng/mL) and ultrasonogrpahy (USG) (cortical cysts each 5 mm in diameter, >5 in number in a single ovary) were compared with 10 normal women who served as control at a tertiary care teaching hospital, Kolkata. Obesity was measured by body mass index (BMI) (>25 kg/m 2 taken as overweight). Waist: hip ratio (WHR) was used as a marker of abdominal obesity (measured at ASIS). Ferriman-Gallway (FG) scoring was done and a score of > 8 was taken as significant hirsutism. Results: Hormonal status and BMI in PCOS individuals, who were overweight (BMI > 25 kg/m 2 ). They had a mean BMI 28.98 kg/m 2 , mean basal insulin (BI) 33.49 μ IU/ ml, mean LH: FSH ratio 2.01, mean testosterone level 1.38 ng/ml. Mean body mass index (BMI) was 21.6 kg/m 2 in normal women, 27.44 kg/m 2 in overweight subjects(n=44) and 31.86 kg/m 2 in obese subjects (n=21). When FG score>8 was considered, it was found that overweight subjects were 35.4% and obese 40%. Increased value of basal insulin was found in 14 subjects (40%). Family history of hirsutism was positive in 7 subjects (22.5%). In this group, mean BMI 29.24 kg/m 2, mean basal insulin 32.94 m-IU/ml, mean LH/FSH Ratio 1.96 and mean testosterone 1.96 ng/ml. Conclusion: Most of the PCOS patients of this city are overweight rather than obese. In PCOS there was increased LH and there by increased LH-FSH ratio, which is usually used as a single hormonal estimation for diagnosis. In accordance to previous studies it may be suggestable that the free or total testosterone level can be a singular and vital hormonal marker for diagnosis. Both LH-FSH ratio and testosterone can be taken for accuracy of diagnosis.