تأثیر برخی هورمون‌های مرتبط با سندرم تخمدان پلی کیستیک بر کیفیت زندگی وابسته به سلامت

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دانشجوی دکترای پژوهشی مذهب و سلامت، مرکز تحقیقات ناباروری، دانشکده پزشکی، دانشگاه علوم پزشکی شیراز، شیراز، ایران.

2 دانشجوی کارشناسی ارشد مامایی، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شیراز، شیراز، ایران.

3 استادیار گروه زنان و مامایی، مرکز تحقیقات ناباروری، دانشکده پزشکی، دانشگاه علوم پزشکی شیراز، شیراز، ایران.

4 کارشناس ارشد مهندسی بهداشت حرفه ای، دانشکده بهداشت، دانشگاه علوم پزشکی شهید صدوقی یزد، یزد، ایران.

5 دانشجوی دکترای آمار زیستی، کمیته تحقیقات دانشجویی، دانشکده پزشکی، دانشگاه علوم پزشکی شیراز، شیراز، ایران.

6 مربی گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی همدان، همدان، ایران.

7 کارشناس ارشد آموزش بهداشت و ارتقاء سلامت، مرکز تحقیقات عوامل اجتماعی مؤثر بر سلامت، دانشکده بهداشت، دانشگاه علوم پزشکی شهید صدوقی یزد، یزد، ایران.

چکیده

مقدمه: سندرم تخمدان پلی کیستیک یکی از اختلالات شایع آندوکرینی زنان است که به دلایل مختلف از جمله تغییرات هورمونی می‌تواند باعث آشفتگی روانی و افت کیفیت زندگی شود. با مروری بر مطالعات انجام شده در ایران فقدان توجه به کیفیت زندگی افراد مبتلا به عنوان یک چالش بزرگ به چشم می‌خورد، لذا مطالعه حاضر با هدف بررسی اثر برخی هورمون‌های مرتبط با سندرم تخمدان پلی کیستیک بر کیفیت زندگی مبتلایان انجام شد.
روش کار: این مطالعه مقطعی در سال 1391 بر روی 60 نفر از زنان مراجعه کننده به درمانگاه شهید مطهری شهر شیراز که مبتلا به سندرم تخمدان پلی کیستیک بودند، انجام گرفت. برای سنجش کیفیت زندگی افراد از پرسشنامه PCOSQ استفاده شد. همچنین جهت بررسی تأثیر PCOS بر هورمون‌های استرادیول، تستوسترون و FSH، 10 میلی لیتر خون در روزهای سوم تا پنجم سیکل قاعدگی از افراد گرفته شد و با روش‌های رادیوایمونواسی و الکتروایمونواسی، میزان هورمون‌ها اندازه‌گیری شد. تجزیه و تحلیل داده‌ها با استفاده از نرم افزار آماری SPSS (نسخه 18) و آزمون‌های کای اسکوئر، همبستگی پیرسون، تی زوجی و آنالیز واریانس سه طرفه انجام شد. میزان p کمتر از 05/0 معنی دار در نظر گرفته شد.
یافته ها: اختلالات قاعدگی کم‌ترین میانگین نمره را از میان حیطه‌های پرسشنامه PCOSQ کسب کرد که نشانه مهم‌ترین نگرانی افراد مبتلا می باشد و حیطه های بعدی به ترتیب از ضعیف‌ترین امتیاز شامل: حیطه وزن، مشکل ناباروری، عاطفی و هیرسوتیسم بود. در بررسی رابطه بین پارامترهای اندازه‌گیری شده با حیطه‌های مختلف کیفیت زندگی، تنها بین حیطه عاطفی با تستوسترون همبستگی معکوس و معنی‌داری مشاهده (049/0=p، 355/0-=r)، در سایر موارد ارتباط معنی‌داری مشاهده نشد (05/0<p).
نتیجه‌گیری: با توجه به وجود ارتباط معکوس و معنی دار بین هورمون تستوسترون و حیطه عاطفی کیفیت زندگی، پیشنهاد می شود که بر اساس روند تغییرات هورمون تستوسترون، به این بُعد از کیفیت زندگی نیز توجه ویژه داشت و برای آن جلسات آموزشی و مشاوره ای مناسب را طراحی و اجرا نمود.

کلیدواژه‌ها


عنوان مقاله [English]

Effect of some hormones related to polycystic ovary syndrome on health-related quality of life

نویسندگان [English]

  • Sedigheh Forouhari 1
  • Zhaleh Heidari 2
  • Zohreh Tavana 3
  • Hamideh Mihanpour 4
  • Mehrab Sayadi 5
  • Arezoo Shayan 6
  • Noushin Yoshany 7
1 PhD student of Religion and Health Research, Infertility Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
2 M.Sc. Student in Midwifery, Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
3 Assistant Professor, Department of Obstetrics and Gynecology, Infertility Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
4 M.Sc. in Occupational Health Engineering, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
5 PhD student in Biostatistics, Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
6 Instructor, Department of Midwifery, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
7 M.Sc. in Health Education & Health Promotion, Social Determinants of Health Research Center, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd , Iran.
چکیده [English]

Introduction: Polycystic Ovarian Syndrome (PCOS) is one of the most common endocrine disorders that due to different factors such as hormonal changes can cause mental distress and decreased quality of life. A review of the studies conducted in Iran shows the lack of attention to the quality of life in these patients as a big challenge. Therefore, this study was performed with aim to assess the effect of some polycystic ovary syndrome-related hormones on quality of life in these women.
Methods: This cross-sectional study was performed on 60 women with Polycystic Ovarian Syndrome referred to Shiraz Shahid Motahari clinic in 2012. PCOSQ questionnaire was used to assess the patients' quality of life. To evaluate the effect of PCOS on FSH, testosterone and estradiol, 10 ml blood samples were taken from the participants on days 3-5 of the menstrual cycle. Serum levels of hormones were determined by radioimmunoassay (RIA) and electroimmunoassay (EIA). Data was analyzed by SPSS software (version 18) and chi-square, Pearson correlation, t-test and Three-Way ANOVA. PResults: Menstrual disorders obtained lowest mean score in the areas of PCOSQ that indicates the most important concern of patients, and the areas including weight, infertility, emotional disorders, and hirsutism were the next weakest areas, respectively. In the evaluation of relationship between various measured parameters with different areas of quality of life, inverse significant correlation was found only between testosterone and emotional area (P=0.049, r=-0.355) and no significant relation was observed in other cases (P>0.05).
Conclusion: Regarding inverse significant correlation between testosterone and emotional area of quality of life, it is recommended that based on the hormonal changes of testosterone, special attention be paid to this dimension of quality of life and appropriate educational and counselling sessions be designed and implemented.

کلیدواژه‌ها [English]

  • Polycystic ovary syndrome
  • Quality of life
  • Sexual hormones
  • Hyperandrogenemia
  1. Novak E. Berek & Novak's Gynecology. Philadelfia: Lippincott Williams & Wilkins; 2007.
  2. Amini L, Ghorbani B, Montazeri A. Iranian version of health-related quality of life for women with polycystic Ovary Syndrome (PCOSQ): translation, reliability and validity. Payesh 2012; 11(2):227-33. (Persian).
  3. Amer SA. Polycystic ovarian syndrome: diagnosis and management of related infertility. Obstet Gynaecol Reprod Med 2009; 19(10):263-70.
  4. Toscani MK, Mario FM, Radavelli-Bagatini S, Spritzer PM. Insulin resistance is not strictly associated with energy intake or dietary macronutrient composition in women with polycystic ovary syndrome. Nutr Res 2011; 31(2):97-103.
  5. Ghazeeri GS, Nassar AH, Younes Z, Awwad JT. Pregnancy outcomes and the effect of metformin treatment in women with polycystic ovary syndrome: an overview. Acta Obstet Gynecol Scand 2012; 91(6):658-78.
  6. Amiri FN, Tehrani FR, Simbar M, Montazeri A, Thamtan RA. The experience of women affected by polycystic ovary syndrome: a qualitative study from Iran. Int J Endocrinol Metab 2014; 12(2):e13612.
  7. Mehrabian F, Khani B, Kelishadi R, Ghanbari E. The prevalence of polycystic ovary syndrome in Iranian women based on different diagnostic criteria. Endokrynol Pol 2011; 62(3):238-42.
  8. Parsanezhad ME, Jahromi BN, Zare N, Keramati P, Khalili A. Epidemiology and etiology of infertility in Iran, systematic review and meta-analysis. J Womens Health 2013; 6:2-8.
  9. Azziz R. Diagnostic criteria for polycystic ovary syndrome: a reappraisal. Fertil Steril 2005; 83(5):1343-6.
  10. McCartney CR, Prendergast KA, Chhabra S, Eagleson CA, Yoo R, Chang RJ, et al. The association of obesity and hyperandrogenemia during the pubertal transition in girls: obesity as a potential factor in the genesis of postpubertal hyperandrogenism. J Clin Endocrinol Metab 2006; 91(5):1714-22.
  11. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004; 81(1):19-25.
  12. Forouhari S, Heidari Z, Tavana Z, Salehi M, Sayadi M. The effect of soya on some hormone levels in women with polycystic ovary syndrome (balance diet): a cross over randomized clinical trial. Bull Env Pharmacol Life Sci 2013; 3(1):246-50.
  13. Kilicdag EB, Bagis T, Tarim E, Aslan E, Erkanli S, Simsek E, et al. Administration of B-group vitamins reduces circulating homocysteine in polycystic ovarian syndrome patients treated with metformin: a randomized trial. Hum Reprod 2005; 20(6):1521-8.
  14. Hosseini SF, Jahromi MS, Sayadi M. Effect of vitamin C supplementation on the levels of related hormones in infertile women with polycystic ovary syndrome (PCOS) in Shiraz City. Int J Health Sci 2014; 2(1):61-70.
  15. Parsanezhad ME, Alborzi S, Jahromi BN. A prospective, double-blind, randomized, placebo-controlled clinical trial of bromocriptine in clomiphene-resistant patients with polycystic ovary syndrome and normal prolactin level. Int J Fertil Womens Med 2001; 47(6):272-7.
  16. Guyatt G, Weaver B, Cronin L, Dooley JA, Azziz R. Health-related quality of life in women with polycystic ovary syndrome, a self-administered questionnaire, was validated. J Clin Epidemiol 2004; 57(12):1279-87.
  17. Cronin L, Guyatt G, Griffith L, Wong E, Azziz R, Futterweit W, et al. Development of a health-related quality-of-life questionnaire (PCOSQ) for women with polycystic ovary syndrome (PCOS) 1. J Clin Endocrinol Metab 1998; 83(6):1976-87.
  18. Traub ML. Assessing and treating insulin resistance in women with polycystic ovarian syndrome. World J Diabetes 2011; 2(3):33-40.
  19. Bazarganipour F, Ziaei S, Montazeri A, Foroozanfard F, Faghihzadeh S. Health-related quality of life and its relationship with clinical symptoms among Iranian patients with polycystic ovarian syndrome. Iran J Reprod Med 2013; 11(5):371-8.
  20. Mohiti-Ardekani J, Taarof N. Comparison of leptin blood levels and correlation of leptin with LH and FSH in PCOS patients and normal individuals. SSU J 2010; 17(5):353-7. (Persian).
  21. Tofighi A, Tartibian B, Najafi Eliasabad S, Asemi A, Shargh A. Effect of aerobic exercise on hormone levels and lipid profile in polycystic ovary syndrome women. Urmia Med Sci J 2010; 21(4):332-8. (Persian).
  22. Jones GL, Hall JM, Balen AH, Ledger WL. Health-related quality of life measurement in women with polycystic ovary syndrome: a systematic review. Hum Reprod Update 2008; 14(1):15-25.
  23. McCook JG, Reame NE, Thatcher SS. Health-related quality of life issues in women with polycystic ovary syndrome. J Obstet Gynecol Neonatal Nurs 2005; 34(1):12-20.
  24. Jedel E, Kowalski J, Stener‐Victorin E. Assessment of health‐related quality of life: Swedish version of polycystic ovary syndrome questionnaire. Acta Obstet Gynecol Scand 2008; 87(12):1329-35.
  25. Amini L, Sydfatmy N, Montazeri A, Mahmoodi Z, Arefi S, Hosseini F, et al. Quality of life in women with polycystic ovary syndrome. Qual Monitoring 2011; 6:857-62. (Persian).
  26. Bazarganipour F, Ziaei S, Montazeri A, Foroozanfard F, Kazemnejad A, Faghihzadeh S. Psychological investigation in patients with polycystic ovary syndrome. Health Qual Life Outcomes 2013; 11:141.
  27. Hashimoto DM, Schmid J, Martins FM, Fonseca AM, Andrade LH, Kirchengast S, et al. The impact of the weight status on subjective symptomatology of the polycystic ovary syndrome: a cross-cultural comparison between Brazilian and Austrian women. Anthropol Anz 2003; 61(3):297-310.
  28. Schmid J, Kirchengast S, Vytiska-Binstorfer E, Huber J. Infertility caused by PCOS--health-related quality of life among Austrian and Moslem immigrant women in Austria. Hum Reprod 2004; 19(10):2251-7.
  29. Jones GL, Palep-Singh M, Ledger WL, Balen AH, Jenkinson C, Campbell MJ, et al. Do South Asian women with PCOS have poorer health-related quality of life than Caucasian women with PCOS? A comparative cross-sectional study. Health Qual Life Outcomes 2010; 8:149.
  30. Turner-McGrievy G, Davidson CR, Billings DL. Dietary intake, eating behaviors, and quality of life in women with polycystic ovary syndrome who are trying to conceive. Hum Fertil 2015; 18(1):16-21.
  31. Nasiri Amiri F, Ramezani Tehrani F, Simbar M, Montazeri A, Mohammadpour Thamtan RA. The experience of women affected by polycystic ovary syndrome: a qualitative study from Iran. Inte J Endocrinol Metab 2014; 12(2):e13612.
  32. Pekhlivanov B, Kolarov G, Kavurdzhikova S, Stoikov S. Determinants of health related quality of life in women with polycystic ovary syndrome. Akush Ginekol 2006; 45(7):29-34.
  33. Moran L, Gibson-Helm M, Teede H, Deeks A. Polycystic ovary syndrome: a biopsychosocial understanding in young women to improve knowledge and treatment options. J Psychosom Obstet Gynaecol 2010; 31(1):24-31.
  34. Micskei O, Deli T, Jakab A, Bugan A. Body image and quality of life in women with polycystic ovary syndrome. Orv Hetil 2014; 155(27):1071-7.
  35. Barnard L, Ferriday D, Guenther N, Strauss B, Balen AH, Dye L. Quality of life and psychological well being in polycystic ovary syndrome. Hum Reprod 2007; 22(8):2279-86.
  36. Coffey S, Bano G, Mason HD. Health-related quality of life in women with polycystic ovary syndrome: a comparison with the general population using the Polycystic Ovary Syndrome Questionnaire (PCOSQ) and the Short Form-36 (SF-36). Gynecol Endocrinol 2006; 22(2):80-6.
  37. Harris-Glocker M, Davidson K, Kochman L, Guzick D, Hoeger K. Improvement in quality-of-life questionnaire measures in obese adolescent females with polycystic ovary syndrome treated with lifestyle changes and oral contraceptives, with or without metformin. Fertil Steril 2010; 93(3):1016-9.
  38. Thomson RL, Buckley JD, Lim SS, Noakes M, Clifton PM, Norman RJ, et al. Lifestyle management improves quality of life and depression in overweight and obese women with polycystic ovary syndrome. Fertil Steril 2010; 94(5):1812-6.
  39. Shobeiri F, Nazari M. Patterns of weight gain and birth weight amongst Indian women. Iranian Journal of Medical Sciences. 2006 Jun 1;31(2):94-7.
  40. Shobeiri F, Nazari M. Assessment of cervical erosion in Hamedan city, Iran. Pakistan journal of biological sciences: PJBS. 2007 Oct;10(19):3470-2.