THE DINAMICS OF THE CARBOHYDRATEAND LIPID METABOLISM PARAMETERS AND HORMONAL STATE OF PATIENTS WITH OVARIAN DISFUNCTION AT THE INITIAL STAGE OF OBESITY TREATMENT
Purpose: To determine the degree of weight loss leading to a significant improvement of the carbohydrate, lipid and hormone metabolism parameters in patients with obesity and menstrual irregularities. Materials and methods: This prospective study included 30 obese women aged 20 to 35 years old (31,1 ± 2,85). The inclusion criteria - the menstrual cycle (in 15 (50%), irregular menstruation, 8 (26,6%) - scarce irregular menstruation, 7 (23,1%) with giperpolimenoreya, including abnormal uterine bleeding). The body weight of the women before treatment ranged from 77 to 115 kg (89,15 ± 1,75kg), body mass index ranged from 27 to 44 kg / m2 (34,3 ± 2,1). Results: It was revealed that fasting hyperinsulinemia occurred in 26,6% of women, while in the first and/or second post-exercise samples in the glucose tolerance test, it was 100%. The insulin resistance was identified in 90% of cases, and impaired glucose tolerance in 16,6%. Hypercholesterolemia was found in 53,3%, hypertriglyceridemia - 23,3%, and increasing of the LDL concentration in 6,6% of women. The ncreased concentrations of LH and ratio of LH/FSH more than 2,5 was observed in 16,6% of cases, the increase of testosterone and/or androstenedione - in 36,6%, the increase in the concentration of cortisol and DHEA sulfate in 13,3% of cases. The low concentration of PSSG in the blood was found in 2 (6.6%) patients. The normal hormonal spectrum was identified in 26,6% of women. The patients were administered orlistat in a dose of 120 mg 3 times a day combined with a hypocaloric diet. Conclusion: After weight loss by 2 BMI in 53% of women it was found the normalization of menstruation rate/duration/script together with the restored ovulation. After weight loss by 3 BMI the normalization of these indicators was achieved in 86,6% of cases. In the course of the treatment a significant improvement in the carbohydrates and fats metabolism is reached after the decrease of BMI by 2 points. Significant reduction in concentrations of testosterone, androstenedione, and a significant increase in the concentration of PSSG are also found after the decrease of BMI by 2.