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Interrelation of the values of prolactin and obesity degree in women with disorders of reproductive health
and grasped from the other side arm. At the time of the needle under the thumb muscles were pushed posteriorly intestine.
• Stage XI — continued the connection of edges of the vaginal wound continuous catgut sutures to the boundary of the skin. Passing to perineal muscles and suturing them.
• Stage XII — suturing perineal code by Dyutsman. As a control, to 30 patients were held DCA in the first stage, before the vaginal surgery, according to the standard technique of minilaparotomy.
The marked tendency towards improving the quality of sexual life, shows the positive impact of elimination of geni-
tal prolapse with simultaneous DCA on the quality of life of women.
Conclusion
1. Optimization of surgical correction of genital prolapse with simultaneous transvaginal tubal ligation in women of reproductive age eliminates the basic pathology and provides a reliable method of contraception.
2. The given method of surgical treatment of prolapse with simultaneous transvaginal DCA does not affect the duration of the operation, and is an effective method of contraception.
References:
1. Adamyan L.V. Modern concepts of surgical treatment of descent and prolapse of female genital mutilation//Proceedings of the International Congress: Endoscopy in the diagnosis, treatment and monitoring ofwomen's diseases. - M., 2000. - P. 622-635.
2. Benagiano G., Primiero F., Farris M. Clinical profile of contraceptive progestins//Eur J Contracept Reprod Health Care. -2004. - P. 182-193.
3. Dovlatyan A.A. Reconstructive-reparative surgery of the urinary tract injury in obstetric, gynecological and abdominal surgery//Urology. - 2002. - № 6. - P. 19-26.
4. Dzanaeva D.B. Complex treatment of complicated forms of descent and prolapse of internal genital organs: Disser... cand. of medical sciences. - Rostov-on-Don, 2008. - 136 c.
5. Gracheva O.N. Connective dysplasia and reproductive function//Materials 9 All-Russian Scientific Forum «Mother and Child». - Moscow, 2007. - P. 370.
6. Ionis E.I., Plechev VV., Bulgakov Ya.U. Alloplastic when damaged esophagus//Actual questions of clinical surgery. - Ufa, 2003. - P. 120-123.
7. Ioseliani M.N., Gotsiridze A. I., Helaya A. V. The role of the ethio pathological approach to surgery of prolapse of pelvic/Georgia, Med.novosti. - 2006. - Vol.139. - P. 64-66.
8. Ishchenko A.I., Gorbalenko O.Yu. The combined method of surgical treatment of descent and prolapse of internal genital organs//Modern technologies in the diagnosis and treatment of gynecological diseases. - M., 2006. - P. 164-165.
9. Zemtsovsky E.V. Not differentiated dysplasia of connective tissue//State and prospects of view about hereditary disorders of connective tissue. - 2008. - № 1. - P. 5-9.
Nidjmutdinova Dilorom Kamaritdinovna, DM, Professor, Tashkent Medical Academy Tu E-mail: [email protected] Rasuleva Takhmina Abduvaliyevna, Republican center of reproductive health of population, endocrinologist E-mail: [email protected] Adkhamova Negina Pulatovna, Republican center of reproductive health of population, endocrinologist
Interrelation of the values of prolactin and obesity degree in women with disorders of reproductive health
Abstract: We determined dependence of BWI values and obesity degree on the amount of prolactin in blood, testifying its role in the development of obesity and disorders of reproductive health. Keywords: prolactin, obesity, women, reproductive health.
Topicality. According to the data of WHO, nowadays prognosis to 2025 the number of people with obesity will in-there is more than 1.7 billion people in the world who have crease almost 2 times [7]. According to the results of epidemio-excessive body weight or obesity. In compliance with the expert logical studies women suffer obesity more often than men [4].
Section 7. Medical science
Excessive body mass is a state of abnormal or excessive accumulation of fat in organism with the degree harmful for organism. Though for women it is more than just size problem. First of all, it is chronic diseases, which cannot be hidden from others, and for women it is reason of constant stress and often episodes of depression and low self-estimation. Secondary, that disease is often accompanied by metabolic alterations and increase of the risk of appearance of disorders in other organs and systems [6]. In gynecological endocrinology excessive body mass in women of reproductive age is considered to be risk factor for the development of several metabolic disorders, such as hyper insulinemia (HI), insulin resistance (IR), and hyper androgenia (HA). It can be accompanied by dysfunction of ovaries, sterility, various hyper plastic processes, and high risk of development of cancer of endometrium, ovaries, and mammary glands [2].
Epidemic of obesity is linked with availability of very tasty and cheap caloric food in the present time, and serious changes in the style of life. At the same time genetic factors play important role in the regulation of energetic balance and, according to multiple studies with participation of twins, he-reditability of overweight composes from 40% to 70% [9].
Hyper prolactinemia, i. e. increase of prolactin level in blood, is a biochemical marker of hypothalamus-pituitary dysfunction, observed by endocrinologist, gynecologists, urologists, sexual pathologists and psychiatrists in their practice. According to the literature references, in the total population the prevalence of this status is about 0.5% in women and 0.07% in men, and up to 80% of the cases are observed among women in the age from 25 to 40 years old [1].
Prolactin plays an important role in the survival of human as a species, as it provides not only lactation function, but also effects other important processes, including ones conditioned by its effect on metabolism and reproduction system, formation of food and maternal behavior [3].
In hyper prolactinemia besides disorders of menstrual cycle, patients have other clinical symptoms. Among these patients obesity is most often met, and some patients complain fast gaining weight [5].
Hyper prolactinemia can be observed in hyper thyroids, and 20-30% in women with polycystic ovaries syndrome. In some cases hyper prolactinemia is combined with hyper androgenia, as high level of prolactin intensifies secretion of androgens in adrenals [1; 8].
Taking into account the topicality of that problem, we performed clinical study of reproductive age women with obesity.
Objective of the study was definition of interrelation between obesity and hyper prolactinemia in women of reproductive age.
Material and methods: we studied 65 women of reproductive age with overweight and obesity (main group, average age was 29.8±0.79) with menstrual dysfunction and infertility; control group — 20 women without problems of reproductive health with normal values of BWI (BWI below 25 kg/m 2; average age was 29.1±0.56).
All patients of the main group complained gaining weight and menstrual dysfunction, 27 (41.5%) were diagnosed with primary infertility, 17 (26.1%) had disorders of menstrual cycle opso menorrhea type, 13 (20%) oligo menorrhea cases, and 8 (12.3%) secondary amenorrhea cases.
In both groups we estimated the character of menstrual cycle, anthropometric parameters (body weight, BWI, WL, HL, WL/HL).
Originally we determined amount of prolactin in blood serum using immune enzyme method. Tests were performed at 3-7th days of independent or induced menstrual cycle.
In the clinical checking we determined the following: type of constitution, degree of secondary sexual traits development, character of hair growth, and presence of galactorrhea. From anamnesis we defined the time of menarche start. We performed ultra sound checking of thyroid gland, womb and ovaries.
Results of the research. In the analysis of anthropometric characteristics the average body weight of the examined women of the main group was equal to 84.7±2.3 kg, the average value of BWI was 31.2±0.61.
In healthy women of the control group average body weight was 64.3±1.7 kg, BWI — 24.2±0.66. In the main group women had reliable high anthropometric values (P<0.05).
In the control group the average value of waistline (WL) was equal to 78.45±1.37cm, hipline (HL) to 97.53±1.85cm, WL/HL-0.80±0.06; in the main group the average value of waistline (WL) was equal to 96.77±1.85cm (P<0.01), hipline (HL) to 110.53±1.72cm (P<0.01), WL/HL — 0.97+0.05 (p<0.01).
At the moment of primary check-up body weight was fixed in 25 (38.4%) women of the main group, obesity I stage (BWI 30-35 kg/m 2) in 23 (35.4%), obesity II stage (BWI — 35-40 kg/m 2) in 10 (15.4%), and obesity III stage (BWI>40 kg/m 2) in 7 (10.8%) patients. In the control group 9 women (45%) had BWI equal to 25 kg/m 2, i. e. the values were at the lower border normal range.
On the basis of the achieved data we determined that, majority of the women of the main group (74.3%) had abdominal and only 25.7% gluteo-femoral (mixed) type of obesity.
At the performance of ultra sound checking ofwomb and ovaries we revealed echo graphic signs of polycystic ovaries syndrome in 43 (66.1%) (according to the criteria of international consensus, Rotterdam, 2003) women. It should be noted that, that category of women obesity was observed in the majority of the cases (88.4%; 38 patients).
In hormonal profile of the patients of the main group there were some disorders. Rise of LH level and ratio LH/FSH above 2.5 folds with formation of polycystic ovary syndrome was observed in 20 (31%) women. We revealed subclinical hypothyroids in the analysis of TTH and T4 in 5 (8%).
In the study of prolactin and obesity stage interrelation in women with problems of reproductive health we revealed that, prolactin in blood increases together with the rise of EBW value.
