Adiponectin levels and its relation with insulin secretion and insulin sensitivity in a group of sub-Saharan African women with polycystic ovary syndrome.

OBJECTIVES: Low levels of adiponectin have been reported in Polycystic Ovary Syndrome (PCOS). In sub-Saharan Africa, little data are available on the topic. We aimed to investigate the levels of adiponectin and its relation with insulin secretion and insulin sensitivity in women with PCOS in Yaoundé, Cameroon. A comparative cross-sectional study was conducted in 32 women presenting PCOS and 32 controls matched for age and Body Mass Index. For each participant, adiponectin levels were measured. We estimated insulin sensitivity using Homeostasis model index (HOMA-IR) and insulin secretion with C-peptide levels. RESULTS: Women with PCOS had higher insulin secretion levels than controls (C-peptide: 4.98 ± 3.83 vs 3.25 ± 1.62 mUI/l; p = 0.02). Also, the HOMA-IR index was higher compared to that of women without PCOS (1.15 ± 0.90 vs 0.77 ± 0.38; p = 0.03) suggesting greater insulin resistance. The median [25th-75th percentile] values of adiponectin concentrations were similar between the two groups (22.68 [21.72-23.41] µg/ml vs 22.03 [21.40-22.93] µg/ml; p = 0.1). There was no association between insulin sensitivity and adiponectin levels in the PCOS group. PCOS is not associated with changes in adiponectin in a population of sub-Saharan African women. Further studies are needed to shed more light on this condition.

Inflammation and Insulin Resistance in a Group of Sub-Saharan African Women with Polycystic Ovary Syndrome.

BACKGROUND: Studies report high levels of inflammatory markers in women with polycystic ovary syndrome (PCOS), reflecting chronic low-grade inflammation. This inflammation is thought to be associated with insulin resistance. We aim to evaluate inflammatory markers [high sensitivity C reactive protein (CRP) and interleukin 6] and insulin resistance in women with PCOS in Yaoundé, Cameroon. METHODS: We conducted a comparative cross-sectional study including 32 women with PCOS aged between 18 and 44 years and 32 controls matched for age and body mass index (BMI). Homeostasis model assessment of insulin resistance (HOMA-IR) index calculated using C peptide levels was used to evaluate insulin resistance. Serum levels of high sensitivity CRP (hsCRP) and interleukin 6 (IL-6) were measured. Comparisons were made using the Student's T-test and non-parametric tests (Mann-Whitney U-test, Kruskal-Wallis test). RESULTS: We found that the median [25th-75th percentile] level of hsCRP was significantly higher in women with PCOS compared to the controls (0.63 [0.32-3.81] mg/L vs. 0.47 [0.15-1.04] mg/L; p=0.01), while IL-6 levels were not different (8.61 [4.1-33.79] pg/mL for PCOS vs. 8.80 [5.28-38.85] pg/mL for controls; p=0.51). We noted that women with PCOS had a higher HOMA-IR index (1.15±0.90 vs. 0.77±0.38; p=0.03). However, there was no correlation between hsCRP level and the HOMA-IR index (Spearman correlation coefficient=0.10; p=0.62). CONCLUSION: PCOS is associated with an increased level of hsCRP and insulin resistance in Cameroonian women. This exploratory study provides baseline evidence for larger-scale studies.

Aspects épidémiologiques, cliniques et thérapeutiques des algies pelviennes aiguës de la femme à l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé (HGOPY)

Introduction: les algies pelviennes aiguës sont responsables d'une morbi-mortalité importante. L'objectif de ce travail était de décrire leurs aspects épidémiologiques, cliniques et thérapeutiques à Yaoundé.Méthodes: nous avons mené une étude transversale descriptive avec collecte prospective des données au Service de Gynécologie-Obstétrique de l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé du 1er avril au 31 juillet 2015. Nous avons inclus toutes les femmes admises pour douleur pelvienne dont l'évolution était inférieure à un mois et ayant accepté de participer à l'étude. Nous avons exclu les femmes qui étaient au troisième trimestre de grossesse ou en post-partum. Le logiciel Epi info version 3.5.4 a servi à l'analyse des données. Ces données ont été présentées sous forme de fréquence et de pourcentage.Résultats: au total 5915 femmes ont consulté pendant la période de l'étude dont 125(2,11%) étaient des algies pelviennes aiguës. La moyenne d'âge était de 29,5 ± 6,9 ans. Les étiologies des douleurs étaient les infections génitales hautes (36,8%) et la grossesse extra-utérine (18,4%). Le traitement surtout médical (92,8%), associait antibiotiques (65,5%), anti-inflammatoires (56,9%) et antalgiques (39,7%). La chirurgie a été réalisée chez 25(20%) patientes par laparotomie (80%) et cœlioscopie (20%)L'indication chirurgicale était la grossesse extra-utérine dans 76% des cas. La régression de la douleur était obtenue chez 99% des cas. Conclusion: les d'algies pelviennes aigues survenaient chez les femmes jeunes, dues aux infections génitales hautes et à la grossesse extra-utérine étaient principalement. En cas de grossesse extra-utérine le traitement chirurgical était surtout la laparotomie