Polycystic ovary syndrome in the presence of undifferentiated connective tissue dysplasia

Tereshchenko I.V.

LLC “Professorial Clinic”, Perm, Russia
Objective. To analyze the clinical, hormonal, and metabolic features of polycystic ovary syndrome (PCOS) in patients with undifferentiated connective tissue dysplasia (UCTD)
Subjects and methods. The clinical, hormonal, and metabolic characteristics were analyzed in 87 patients of childbearing age with PCOS and UCTD.
Results. The observed patients had a normally low body weight, blood C-peptide and insulin levels, as well as HOMA IR and CARO indices in health. All had been previously treated with Metformin without any effect. Opsomenorrea, anovulation, and symptoms of hyperandrogenism occurred at menarche; abnormal ovarian morphology and the manifestations of UCTD increased with age.
Conclusion. In many cases, PCOS is concurrent with UCTD and is accompanied by abnormalities not only of the ovaries, but also of other organs. The patients do not have insulin resistance, obesity, or hypertriglyceridemia; it is inadvisable to use Metformin. At 5 weeks of embryogenesis when the hypothalamic-pituitary system, ovaries, and connective tissue are simultaneously laid, unfavorable genetic and/or environmental factors contribute to the occurrence of such a concurrent pathology.

Keywords

polycystic ovary syndrome
connective tissue dysplasia
opsomenorrea
hyperandrogenism

References

  1. Адамян Л.В., Андреева Е.Н., Гаспарян С.А., Геворкян М.А., Гри-горян О.Р., Гринева Е.Н., Густовалова Е.А., Дедов И.И., Демидова Т.Ю., Зайдиева Я.З., Карахалис М.Ю., Лизиева Л.Е., Мельниченко Г.А., Спиридонова Н.Е., Сутурина Л.В., Тарасова М.А., Уварова Е.В., Филиппов О.С., Хамощина М.С., Чернуха Г.Е., Шереметьева Е.В., Ярмолинская М.В., Соболева Е.Л., Ярмолинская М.И. Синдром поликистозных яичников в репродуктивном возрасте (современные подходы к диагностике и лечению). Клинические рекомендации (протокол лечения). М.; 2015. 22 с. [Adamyan L.V., Andreeva E.N.,Gasparyan S.A., Gevorkyan M.A., Grigoryan O.R., Grineva E.N. et al. Polycystic ovary syndrome in reproductive age (modern approaches to diagnosis and treatment). Clinical recommendations (treatment protocol). M.; 2015. 22 p. (in Russian)].
  2. Геворкян М.А., Блинов Д.В., Смирнова С.О. Комбинированные оральные контрацептивы в лечении пациенток с синдромом поликистозных яичников. Акушерство, гинекология, репродукция. 2012; 1: 39-49. [Gevorkyan M.A., Blinov D.V., Smirnova S.O. Combined oral contraceptives in the treatment of patients with polycystic ovary syndrome. Obstetrics, gynecology, reproduction. 2012; 1: 39-49. (in Russian)].
  3. Панарина О.В., Рашидова М.А., Беленькая Л.В., Трофимова Т.А., Шолохов Л.Ф. Современные представления о патогенезе синдрома поликистозных яичников (обзор литературы). Acta biomedical scientifica. 2017; 2(4): 9-14. [Panarina O.V., Rashidova M.A., Belenkaya L.V., Trofimova T.A., Sholokhov L.F. Current views on the pathogenesis of polycystic ovary syndrome (literature review). Acta biomedical scientifica. 2017; 2(4): 9-14 (in Russian)].
  4. Goodman N.F., Cobin R.H., Futterweit W., Glueck J.S., Legro R.S., Carmina E. American association of clinical endocrinologists, American college of endocrinology, and androgen excess and PCOS society disease state clinical review: guide to the best practices in the evaluation and treatment of polycystic ovary syndrome – part 2. Endocr. Pract. 2015; 21(12): 1415-26. https://dx/doi.org/10.4158/EP15748.DSCPT2.
  5. Buccola J.M., Reynolds E.E. Polycystic ovary syndrome. Prim. Care. 2003; 30(4): 697-710. https://dx/doi.org/10.1016/s0095-4543(03)00089-7.
  6. Mortada R., Williams T. Metabolic syndrome: polycystic ovary syndrome. FP Essent. 2015; 435: 30-42.
  7. Azziz R. Polycystic ovary syndrome. Obstet. Gynecol. 2018. 132(2): 321-36. https://dx/doi.org/10.1097/AOG.0000000000002698.
  8. Гуриев Т.Д. Синдром поликистозных яичников. Акушерство, гинекология, репродукция. 2010; 4(2): 10-5. [Guriev T.D. Polycystic ovary syndrome. Obstetrics, gynecology, reproduction. 2010; 4 (2): 10-5 (in Russian)].
  9. Обухова Ю.Д. Морфология яичников в различные периоды онтогенеза. Обзор литературы. Вестник новых медицинских технологий. 2010; 27(2): 301-5. [Obukhova Yu.D. Morphology of the ovaries in different periods of ontogenesis. Literature review. Bulletin of new medical technologies. 2010; 27 (2): 301-5. (in Russian)].
  10. Тышкевич О.С., Кравченко Е.Н. Дисплазия соединительной ткани – актуальная проблема современного акушерства. Обзор литературы. Мать и дитя в Кузбассе. 2014; 56(3): 4-8. [Tyshkevich O.S., Kravchenko E.N. Connective tissue dysplasia is an urgent problem of modern obstetrics. Literature review. Mother and child in Kuzbass. 2014; 56 (3): 4-8 (in Russian)].
  11. Rotterdam ESM RE/ASRM-Sponsored PCOS Consensus Work-shop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum. Reprod. 2004; 19: 41-7.
  12. Teede H.J., Misso M.L., Costello M.F., Dokras A., Laven J., Moran L. et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil. Steril. 2018; 110(3): 364-79. https://dx/doi.org/10.1016/j.fertnstert.2018.05.004.
  13. Соснова Е.А. Синдром поликистозных яичников. Архив акушерства и гинекологии им. В.Ф. Снегирева. 2016; 3(3): 116-29. [Sosnova E.A. Polycystic ovary syndrome. V.F. Snegirev Archives Obstetrics and Gynecology. 2016; 3(3): 116-29. (in Russian)]. https://dx/doi.org/10.18821/2313-8726-2016-3-3-116-129.
  14. Minooee S., Tehruni F.R., Mirmiran P., Azizi F. Low birth weight may increase body fat mass in adult women with polycystic ovary syndrome. Int. J. Reprod. Biomed. (Vazd.). 2016; 14(5): 335-40.
  15. Papadakis G., Kandarakis E.A., Diamanti-Kandarakis E. Polycystic ovary syndrome and NC-CAH: distinct characteristics and common findings. A systematic review. Front. Endocrinol. (Lausanne). 2019; 10: 388. https://dx/doi.org/10.3389/fendo.2019.00.388.
  16. Иванова Л.А., Король И.В., Коваленко Ю.С., Кокова Е.А., Мезинова А.В., Липницкая Я.А. Развитие синдрома поликистозных яичников у пациентки с классическим вариантом врожденной дисфункции коры надпочечников. Кубанский научный медицинский вестник. 2017; 24(6):177-83. [Ivanova L.A., Korol I.V., Kovalenko Yu.S., Kokova E.A., Mezinova A.V., Lipnitskaya Y.A. The development of polycystic ovarian syndrome in a patient with the classic version of congenital adrenal cortical dysfunction. Kuban. Scientific medical messenger. 2017; 24(6):177-183. (in Russian)]. https://dx/doi.org/10.25207/1608-6228-2017-24-6-177-183
  17. Дисплазии соединительной ткани (МКБ-10). Клинические рекомендации. М.; 2017. 175 с. [Connective tissue dysplasia (ICD-10). Clinical recommendations. M.; 2017. 175 p. (in Russian)].

Received 12.02.2020

Accepted 22.06.2020

About the Authors

Irina V. Tereshchenko, MD, Professor, endocrinologist of the MC «Professorial clinic». Tel.: +7(964)192-11-20. E-mail: i_v_t@bk.ru. ORCID: 0000-0002-0390-3649.
15A Druzhby str., Perm, 614000, Russian Federation.

For citation: Tereshchenko I.V. Polycystic ovary syndrome in the presence of undifferentiated connective tissue dysplasia.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 11: 184-189 (in Russian).
https://dx.doi.org/10.18565/aig.2020.11.184-189

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