Аннотация

Резюме

To study clinical and metabolic characteristics in adolescent girls with MCD and IR and to evaluate the effectiveness of complex pathogenetic therapy with metformin combined with non-pharmacological correction.

Материал и методы

A prospective cohort study was conducted in 52 girls aged 15–18 years with MCD and BMI ≥25 kg/m², divided into two groups: with emerging polycystic ovary syndrome (PCOS, n=22) and with hypothalamic syndrome of puberty (HSPP, n=30). The control group consisted of 14 healthy peers. All patients in the main groups received metformin (1000–1500 mg/day), a hypocaloric diet (1000–1500 kcal/day) and aerobic exercise ≥150 min/week for 6–9 months. Anthropometric, metabolic (glucose, insulin, HOMA-IR), hormonal parameters and restoration of menstrual function were assessed before and after therapy.

Результаты

Initially, both groups showed significantly elevated BMI (thus in group 1 28,4±2.1 and in 2 group 31,2±3.0 kg/ m²), insulin (20,8±0.9 and 28,3±0.3 μIU/mL) and HOMA-IR (3,5±0,2 and 2,9±0,4) compared with controls (p<0,001). After therapy, a significant decrease in BMI (Δ –1,6 and –2,1 kg/m²), insulin (Δ –4,3 and –6,9 μIU/mL) and HOMA-IR (Δ –0,8 and –0,7) was noted in both groups (p<0,05). Testosterone levels decreased in the PCOS group from 4,8±0.4 to 3,9±0,5 nmol/L (p<0,05). Regular menstrual cycles were restored in 54,5% of PCOS patients and in 60,0% of HSPP patients.

Заключение

 In adolescent girls with menstrual dysfunction due to insulin resistance, disorders manifested as symptoms of hyperandrogenism associated with obesity. Combined pathogenetic therapy with metformin, lifestyle modification, and a hypocaloric diet resulted in significant improvements in metabolic parameters and restoration of menstrual function.

Ключевые слова

adolescent girls menstrual cycle disorders insulin resistance hyperandrogenism metformin hypothalamic syndrome of pubertal period polycystic ovary syndrome pathogenetic therapy

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Список литературы

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