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Samoan women menstrual cycle function and reproductive endocrine status.
– Reported, January19 2013
American Samoa and Samoa are now characterized by one of the world’s highest levels of adult overweight and obesity. Our objective was to investigate patterns of menstrual cyclicity reported by Samoan women and examine the relationship to adiposity and select hormone levels.
A recent population-level study has demonstrated that increased BMI, FAI, serum T and insulin, as well as decreased levels of serum SHBG, are all independently associated with increased likelihood of menstrual irregularity in reproductive age women.
Adiponectin levels are inversely related to serum insulin and androgens, and are reduced in women diagnosed with PCOS, especially those with obesity. Among the variables studied presently, BMI, adiponectin and insulin levels were significantly associated with reports of menstrual irregularity.
PCOS is defined by anovulatory menstrual cycles with either polycystic ovary morphology on ultrasound or biochemical or clinical hyperandrogenism. Women in American Samoa and Samoa rarely have ovarian ultrasounds and data on clinical evidence of hirsutism were not available. We therefore assessed serum androgens in this population. There is no standard definition for biochemical hyperandrogenism in women with PCOS.Numerous recent studies suggest that serum levels of the glycoprotein MIS may be used as an indirect biomarker for polycystic ovaries, through a close relationship with ovarian antral follicle count.
Regardless of limitations, this study of Samoan women shows a high rate of menstrual irregularity associated with high serum insulin, BMI and abdominal circumference measurements, and with low serum adiponectin levels. The FAI was correlated with obesity, and MIS levels declined more slowly with age in those with irregular versus regular menstrual cycles. These findings corroborate earlier work demonstrating a high level of metabolic syndrome among Samoan women, and suggest possible reproductive dysfunction. This group may serve as a model population for further study of the impact of obesity on susceptibility genes for adverse reproductive conditions, especially those complicated by metabolic dysfunction, such as PCOS.
CREDITS:G. Lambert-Messerlian, M.B. Roberts, S.S. Urlacher, J. Ah-Ching, S. Viali,4 M. Urbanek and S.T. McGarvey
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3157623/
