Significance of measuring anthropometric and atherogenic indices in patients with polycystic ovary syndrome.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a prevalent hormonal disorder affecting 5-15% of women of reproductive age, characterized by ovulatory dysfunction, hyperandrogenism, and polycystic ovarian morphology. PCOS is associated with metabolic disturbances such as dyslipidemia, insulin resistance (IR), and an increased risk of type 2 diabetes (T2DM) and cardiovascular disease. OBJECTIVE: The aim of this study is to apply new anthropometric indices [body adiposity index (BAI), visceral adiposity Index (VAI), lipid accumulation product (LAP), body roundness index (BRI), a body shape index (ABSI)] and new atherogenic indices [Castelli index-I, Castelli index-II, atherogenic risk of plasma (AIP), atherogenic coefficient (AC), lipoprotein combined index (LCI), triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio, metabolic score for insulin resistance (METS-IR), triglyceride glucose (TyG) index, triglyceride glucose-dody mass (TyG-BMI) index, triglyceride glucose-waist circumference (TyG-WC) index] metabolic score of insulin resistance to patients with PCOS. METHODS: A retrospective analysis was conducted on 248 women diagnosed with PCOS based on the 2003 Rotterdam criteria. Anthropometric measurements, biochemical parameters, and atherogenic indices were collected from patient records. Statistical analyses were performed using Statistical Package for the Social Sciences software version 28.0. RESULTS: Significant correlations were found between fasting glucose and various anthropometric indices, such as Body mass index (BMI), waist-height ratio (WHtR), and BAI, indicating a link between adiposity and glucose metabolism in PCOS. Atherogenic indices like Castelli's risk indices, AIP, and AC showed positive correlations with glucose and insulin levels, reinforcing their role in assessing cardiovascular risk. Novel indices such as METS-IR and TyG demonstrated strong correlations with both glucose and insulin profiles, highlighting their potential as reliable markers for IR and cardiometabolic risk. CONCLUSION: The study underscores the importance of using a range of anthropometric and atherogenic indices for comprehensive metabolic assessment in women with PCOS. Indices like METS-IR and TyG offer valuable insights into insulin sensitivity and cardiovascular risk, potentially aiding in better management and prognosis of PCOS.

The effect of experience on the outcomes of total laparoscopic hysterectomy surgery: 1295 cases.

OBJECTIVES: To reveal the effect of surgeon's experience on the outcomes of the total laparoscopic hysterectomy (TLH) surgery. MATERIAL AND METHODS: Design: Retrospective case series. SETTING: A tertiary care university hospital. PATIENTS: 1295 cases with an indication for hysterectomy. INTERVENTIONS: Total laparoscopic hysterectomy. RESULTS: All cases were grouped according to the surgeon's experience. For 30 different surgeons, their first 20 operations constituted Group A, 21st-50th operations Group B, 51st-100th operations Group C, and their operations after the 100th surgery Group D. Demographic data and post-operative results were compared between the groups. There were no statistical differences in terms of demographic data and major complications. A statistically significant decrease was observed in the post-operative fall in hemoglobin level and the duration of hospitalization in the groups with increased experience (p = 0.021, p < 0.001, respectively). There wasn't an increase in uterine specimen weight with increased experience (p = 0.267). CONCLUSIONS: We obtained that the peak value in the learning curve cannot be evaluated according to the operation time or complication rates. Although the complication rate seems unaffected by surgical experience, concerns about complications may decrease as experience increases. Since the trend of minimally invasive surgery will continue increasingly in the next century because of higher patient comfort, all gynecologists should gain competence in endoscopic surgery.