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Title: Hyperplastic changes of the endometrium during pharmacological correction of insulin sensitivity

Abstract:

Introduction: Hyperplastic changes of the endometrium constitute one of the most fundamental clinical problems of perimenopausal and postmenopausal women. The spectrum of pathological endometrial changes connected with proliferation includes endometrial polyps, endometrial hyperplasia and endometrial cancer. The connection between endometrial cancer and endometrial hyperplasia with type 2 diabetes and insulin resistance has been known for long.Study objective: Assessment of frequency of carbohydrate disorders as well as hormonal and receptor status in perimenopausal and postmenopausal women with hyperplastic changes of the endometrium; Comparison of the efficiency of treatment with insulin-sensitizing agents (metformin) and progestagens (lynestrenol) with the efficiency of treatment only with progestagens (lynestrenol) in women with endometrial hyperplasia.Material and methods: Group of 100 perimenopausal and postmenopausal patients who displayed abnormal uterine bleeding and/or thickened endometrium in transvaginal ultrasonography. The population of women under study was divided into four groups (non-atypical endometrial hyperplasia, endometrial polyp, endometrial cancer, control group). Patients with endometrial hyperplasia were randomly divided into 2 groups of patients depending on the administered treatment (progestagens + metformin vs only progestagens).Conclusions: Insulin resistance occurs in approximately half of the women with hyperplastic changes of the endometrium. Insulin level in the 120th minute of the OGTT is the best parameter in predicting endometrial hyperplasia. Androgens play a role in premenopausal women and estrogens in postmenopausal women with endometrial hyperplasia. IGFBP-3 may contribute to pathogenesis of endometrial hyperplasia. In all patients with endometrial hyperplasia, regardless of the implemented treatment, in the 6 month period regression ofhyperplastic changes occurred. In case of women with abnormal insulin resistance markers who experience pathological uterine bleeding and/or thickened endometrium, there is clinical basis for recommending modification of life style or for introduction of pharmaceutical insulin-sensitizing agents.

Place of publishing:

Kraków

Level of degree:

2 - studia doktoranckie

Degree discipline:

endokrynologia ; ginekologia

Degree grantor:

Uniwersytet Jagielloński. Collegium Medicum. Wydział Lekarski.

Promoter:

Józef Krzysiek

Date issued:

2011

Format:

application/pdf

Identifier:

oai:dl.cm-uj.krakow.pl:3425

Call number:

ZB-115825

ControlNumberVIRTUA:

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Language:

pol

Access rights:

tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego- Collegium Medicum

Object collections:

Last modified:

Oct 16, 2019

In our library since:

Mar 6, 2013

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2

Number of object content views in PDF format

2

All available object's versions:

http://dl.cm-uj.krakow.pl:8080/publication/3425

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ZB-115825 Oct 16, 2019
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