Особливості метаболічних і гормональних порушень у жінок з метаболічним синдромом на прегравідарному етапі

Abstract

The problem of obesity and metabolic syndrome among the female population of Ukraine is extremely important, given the current trend toward increasing age of realization of reproductive function,. The prevalence of metabolic syndrome among women of reproductive age is 6–35%, fertility problems are found in 30-35% of women. The objective: to study the characteristics of metabolic disorders and hormonal condition of the reproductive system in women with obesity and the metabolic syndrome on pregravidarity stage depending on the body mass index and severity of metabolic syndrome. Patients and methods. We examined a total of 124 women with obesity and metabolic syndrome that appealed on pregravidar stage and 53 women who had no history of somatic and gynecological pathology. Antropometric studies, determination of blood pressure, examination of carbohydrate and lipid metabolism, evaluation of the endocrine status of the reproductive system, ultrasound examination of small pelvis organs were done. Results. In women of reproductive age, we observed increase of total cholesterol, triglycerides, low-density lipoproteins and decrease high-density lipoproteins, with a predominance of IIb and IV types of dyslipidemia. Insulin resistance was diagnosed in 28.3% of women And 47.4% – II and in 69.7% with III degree of obesity. Metabolic syndrome was diagnosed in 79.2% of patients with obesity of I, in 94.7% – II 100% III. The number of components of metabolic syndrome correlate directly proportional to the severity of obesity. The index of fertility with III degree of obesity increased to 2.7, hypoestrogenia marked with And hyperestrogenia from 50.7% of women in II and III degree of obesity, progesterona failure identified at 66.9%, hyperandrogenism in 58.8%, reduced sex-binding globulin in 83.0% of the observations. Conclusion. Pathological changes of the hormonal status of the female reproductive system on prepregnansy stage is directly proportional to depend on the body mass index number of components of metabolic syndrome and dysmetabolic disorders. Key words: obesity, metabolic syndrome, pregnancy planning.