Impact of Obesity on Frequency and Pattern of Disease in Polycystic Ovarian Syndrome (PCOS)

Abstract

Background:  Obesity plays an important role in the genesis and maintenance of polycystic ovarian disease. PCOD is the leading cause of anovulatory infertility in females and affects 1 in 10 women of reproductive age. PCOD is strongly associated with obesity.

Aims and Objectives:  To study frequency of weight distribution and differences in disease pattern of PCOD in obese and non obese females.

Study Design:  Cross-sectional analytical Study.

Place and Duration of Study:  The study was conducted in Qassim University Clinic, College of Medicine, Buraida (King-dom of Saudi Arabia) over 2 years (June 2007-June 2009).

Materials and Methods:  A sample of 500 non pregnant Saudi females of reproductive age presenting with different gyne-cological complaints was included in the study. Body Mass Index was calculated for all 500 patients after recording height and weight using formula; BMI = Weight (Kg)/Height (m)². The sample was divided into two groups depending upon their i.e. BMI = 18.5-24.9 (Normal weight) and BMI > 25 (overweight/obese).Frequency of PCOD was calculated in both groups in the first step and in the 2^nd step obese PCOD patients (Study group) were compared with normal weight PCOD patients (control group) regarding clinical manifestations, endocrine profile, metabolic profile, ovarian morphology and difficulties encountered in the management. Data were collected on a structured proforma and analyzed using computer programme SPSS Version 14 for windows and a p-value of < 0.05 was used as statistically significant.

Results:  Out of 500 patients 344 (68.8%) had BMI > 25 (overweight and obese) while 156 (31.2%) had BMI between 18.5-24.9 (normal weight). A significantly increased frequency of PCOD was found in obese patients; 152 (44%) as compared to those with normal weight; 14 (9%). All manifestations of PCOD (infertility, menstrual irregularity, skin problems like hirsui-tism acne and Acanthosis nigricans) as well as disturbance in endocrine and metabolic profile were present with higher fre-quency and severity in obese as compared to non obese patients. Greater difficulties were encountered in the management of obese as compared to non obese PCOD patients.

Conclusion:  Saudi females have high frequency of obesity which is the most important risk factor for PCOD. All manifes-tations of PCOD are more frequent and severe in obese patients making PCOD with obesity a big medical as well as a social issue and a real challenge to manage. The study stresses on the need to control weight as the cornerstone of management of obese patients with PCOD.

Key words:  Obesity, Polycystic ovarian disease, disease pattern, obese, non obese Saudi females.