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"Polycystic Ovarian Syndrome (PCOS) is the number one cause of irregular periods and infertility in women - yet most gynecologists fail to diagnose it. The disorder causes irregular cycles, infertility, weight gain, acne, and unsightly hair growth -- symptoms that can ultimately prove life-threatening as well as uncomfortable, humiliating, and emotionally disruptive.Only recently have women realized the danger lurking in what they thought were stress-induced problems. While researchers haven't determined the cause of PCOS, they know it is linked to insulin resistance, which can be controlled fairly easily with a low-carb diet.Most PCOS cases are diagnosed by reproductive endocrinologists when a woman's infertility has led her to seek a specialist. WHAT TO DO WHEN THE DOCTOR SAYS IT'S PCOS gives sufferers a diet and nutritional treatment program that goes beyond the usual regimen of birth control pills and fertility drugs. The millions of women victimized by this debilitating and demoralizing disorder will undoubtedly welcome this new program as an alternative or as a supplement to their current treatment plan."

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Sindrom Ovarium Polikistik (SOPK) merupakan gangguan pada sistem reproduksi wanita yang menjadi penyebab umum terjadinya infertilitas pada usia reproduktif. Etiologi dari SOPK belum diketahui dengan pasti, namun lebih dari 50% wanita SOPK mengalami obesitas. Single Nucleotide Polymorphism (SNP) rs9939609 gen Fat Mass and Obesity Associated (FTO) merupakan kandidat genetik yang dapat memengaruhi perkembangan obesitas dan kerentanan terhadap SOPK. Tujuan dari penelitian ini untuk mengetahui asosiasi SNP rs9939609 gen FTO dengan SOPK. Penelitian ini menggunakan 120 sampel darah dengan masing-masing 30 sampel untuk setiap kelompok, yaitu kelompok wanita normal obesitas, normal non-obesitas, SOPK obesitas, dan SOPK non-obesitas. Metode yang digunakan yaitu amplifikasi sekuens target dengan Polymerase Chain Reaction (PCR), validasi dengan elektroforesis, dan sekuensing dengan menggunakan Automated Sanger. Hasil sekuensing dianalisis menggunakan perangkat lunak Bioedit dan FinchTV. Hasil penelitian ini menunjukkan adanya frekuensi minor alel A sebesar 29,6% serta frekuensi genotipe AA, AT, dan TT secara berurutan sebesar 10%, 39,20%, dan 50,80%. Studi ini juga menunjukkan hasil tidak adanya asosiasi (p>0,05) antara SNP rs9939609 gen FTO dengan sindrom ovarium polikistik.

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Polycystic Ovarian Syndrome (PCOS) is a female reproductive disorder which is a common cause of infertility at reproductive age. The etiology of PCOS is still unclear, however more than 50% of PCOS women are obese. Single Nucleotide Polymorphism (SNP) rs9939609 Fat Mass and Obesity Associated (FTO) gene is a genetic candidate that can affect the development of obesity and susceptibility to PCOS. This study aims to determine the association of FTO gene SNP rs9939609 with PCOS. Samples in this study was 120 blood samples divided into 30 samples for each group, normal with obesity, normal lean, PCOS with obesity, and PCOS lean. Amplification of target sequences using the PCR method, validation with electrophoresis, and sequencing was carried out using an Automated Sanger. Sequencing results were analyzed with Bioedit and FinchTV software. The results of this study showed that a minor allele A frequency was 29.6% and the genotype frequencies of AA, AT, and TT were 10%, 39.20%, and 50.80%, respectively. This study also showed no association (p>0.05) between SNP rs9939609 with polycystic ovarian syndrome.

 

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Sindrom ovarium polikistik (SOPK) merupakan kelainan reproduksi yang ditandai dengan anovulasi, menstruasi tidak teratur, dan hirsutisme yang seringkali menyebabkan infertilitas. Meski etiologinya belum sepenuhnya dipahami, namun telah diketahui bahwa sebagian besar wanita dengan SOPK mengalami obesitas dengan prevalensi mencapai 40—80%. Obesitas merupakan kelebihan akumulasi lemak tubuh yang dicirikan dengan hipertrofi. Salah satu gen yang diduga terkait dengan obesitas adalah gen fat mass and obesity associated (FTO). Gen FTO menyebabkan peningkatkan nilai BMI. Penelitian ini bertujuan untuk mengetahui perbedaan ekspresi mRNA gen FTO dan korelasinya dengan BMI pada wanita SOPK dan normal dengan obesitas dan non-obesitas. Jaringan darah digunakan sebagai sumber mRNA yang diambil pada 30 wanita non obesitas, 30 wanita normal obesitas, 30 wanita SOPK non-obesitas, dan 30 wanita SOPK obesitas. Kuantitas ekspresi mRNA gen FTO ditentukan dengan menggunakan quantitative real-time PCR. Hasil penelitian menunjukkan terdapat perbedaan ekspresi mRNA gen FTO pada kelompok wanita SOPK dan normal dengan obesitas, serta tidak terdapat korelasi antara ekspresi mRNA gen FTO dengan BMI. Gen FTO merupakan gen yang bertanggung jawab terhadap obesitas akan tetapi tidak memiliki keterkaitan dengan sindrom ovarium polikistik, serta tidak memiliki korelasi dengan BMI.

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Polycystic ovary syndrome (PCOS) is a reproductive disorder characterized by anovulation, irregular menstruation, and hirsutism which often causes infertility. Although the etiology is not fully understood, it is well known that most women with PCOS are obese with a prevalence of 40-80%. Obesity is an excess of body fat accumulation which is characterized by hypertrophy. Fat mass and obesity associated gene (FTO) is known to correlate with obesity. The study found that FTO gene causes an increase in the BMI. This reserach aim to determine the differences in FTO mRNA gene expression and its correlation with BMI in normal and PCOS woman with obesity and lean. This study used blood tissue as a source of mRNA taken in 30 normal lean woman, 30 normal obese women, 30 PCOS lean women, and 30 PCOS obese women. The quantity of FTO mRNA gene expression was determined using quantitative real-time PCR. The result shows that there is differences in FTO mRNA gene expression in PCOS and normal woman with obesity dan non-obesity. FTO mRNA expression in PCOS and normal obesity woman is higher than those in the PCOS and normal lean women, and there is no correlation between FTO gene mRNA expression and BMI. Thus, the FTO gene is a gene responsible for obesity but has no association with polycystic ovary syndrome, and does not have a correlation with BMI. 

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"Pendahuluan: Sindrom Ovarium Polikistik SOPK merupakan gangguan endokrin tersering penyebab infertifilitas pada wanita usia reproduktif. Wanita-wanita dengan SOPK diketahui memiliki tingkat apoptosis yang rendah dibandingkan dengan wanita tanpa SOPK dan memiliki kadar Anti-Muellerian Hormone AMH yang lebih tinggi dibandingkan dengan wanita tanpa SOPK. Akan tetapi, belum ada penelitian yang menghubungkan kadar AMH dengan apoptosis yaitu adanya atresia folikel pada ovarium wanita penderita SOPKTujuan: Untuk mengetahui hubungan antara kadar AMH yang tinggi dengan tingkat apoptosis sel granulosa yang terjadi pada pasien SOPK sehingga dapat diketahui salah satu patogenesis kelainan folikulogenesis pada pasien SOPKMetodologi: Studi cross sectional dengan mengambil sampel sel granulosa wanita SOPK dan tanpa SOPK atau kelainan ovarium yang mengikuti program Fertiisasi In Vitro FIV di Yasmin dan SMART-IVF, klinik dr. Sander B Jakarta. Jumlah sampel yaitu 40 sampel yang terdiri dari 20 wanita dengan SOPK dan 20 wanita tanpa SOPK. Tingkat apoptosis dievaluasi dengan mengukur ekspresi mRNA dari gen pengkode protein keluarga apoptotic Bcl2 Bax dan Bcl2 menggunakan metode kuantitatif absolut qPCR. Pengukuran kadar AMH di serum dilakukan dengan metode ELISA.Hasil: Terdapat perbedaan bermakna secara statistik antara kadar AMH wanita SOPK dan kontrol pABSTRACT Background Polycystic Ovary Syndrome PCOS is a common endocrine abnormality in causing infertility in reproductive aged women. Women with PCOS were reported have lower apoptosis rate compared to women without PCOS and have higher level Anti Muellerian Hormone compared to women without PCOS. However, there are no reported studies which directly study to know correlation between AMH level in serum and apoptosis result in follicle atresia in ovarium of PCOS patients.Objective To analysis correlation between serum AMH level and apoptosis in granulosa cell in PCOS pasien that may underlie the folliculogenesis abnormality in PCOS.Methods Cross sectional study of sample from granulose cells women with PCOS and without PCOS or with ovarian abnormalities that following Fertility In Vitro FIV program in Yasmine and SMART ndash IVF, dr. Sander B clinic, Jakarta. Sample number were 40 consisting 20 women with PCOS and 20 women without PCOS. Apoptosis level were evaluated with measuring mRNA expression from gene that of coding apoptotic Bcl2 family Bax and Bcl2 using quantitave absolute method qPCR. AMH level in serum were measured using ELISA method.Results There was a statistical significance difference AMH level between PCOS group and control group p"

"Polycystic Ovary Syndrome (PCOS) menjadi salah satu kondisi keabnormalan hormon yang paling umum terjadi pada wanita dan berdampak terhadap sistem reproduksi dan kesehatan secara keseluruhan. PCOS tidak dapat disembuhkan secara total, namun gejalanya dapat dikontrol dengan menerapkan gaya hidup sehat. Penerapan gaya hidup sehat pada perempuan PCOS dapat berkaitan dengan tingkat literasi kesehatan mereka. Penelitian ini bertujuan untuk mengidentifikasi hubungan literasi kesehatan dengan penerapan gaya hidup sehat. Penelitian ini berjenis kuantitatif dengan metode desain cross sectional yang melibatkan 108 perempuan dengan PCOS di dalam komunitas PCOS Fighter Indonesia dengan menggunakan convenience sampling. Instrumen yang digunakan adalah Indonesian version of electronic Health Literacy Scale (Ie-HEALS) dan Health Promoting Lifestyle Profile-II (HPLP-II). Hasil penelitian menunjukkan p-value <0,05 yang berarti terdapat hubungan yang positif, semakin tinggi literasi kesehatan perempuan PCOS, akan cenderung menerapkan gaya hidup sehat yang lebih baik. Temuan data ini sesuai dengan hipotesis penelitian yang diambil. Hasil penelitian ini merekomendasikan peningkatan pendekatan tenaga kesehatan dalam mengedukasi serta melakukan bimbingan konseling yang bermanfaat dalam manajemen kesehatan perempuan dengan PCOS.

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Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal abnormalities in women, affecting the reproductive system and overall health. PCOS cannot be completely cured, but its symptoms can be managed by adopting a healthy lifestyle. The adoption of a healthy lifestyle in women with PCOS can be related to their level of health literacy. This study aims to identify the relationship between health literacy and the adoption of a healthy lifestyle. This quantitative study employs a cross-sectional design involving 108 women with PCOS within the PCOS Fighter Indonesia community using convenience sampling. The instruments used are the Indonesian version of the electronic Health Literacy Scale (Ie-HEALS) and the Health Promoting Lifestyle Profile-II (HPLP-II). The study results show a p-value <0.05, indicating a positive relationship: the higher the health literacy of women with PCOS, the more likely they are to adopt a healthier lifestyle. These findings align with the research hypothesis. The study recommends enhancing healthcare professionals' approaches in educating and providing counseling that is beneficial in the health management of women with PCOS."

"Sindrom ovarium polikistik (SOPK) merupakan kelainan yang ditandai oleh hiperandrogenemia, ovarium disfungsi, dan polikistik ovarium yang dapat menyebabkan infertilitas. Meski etiologi pastinya belum diketahui, obesitas merupakan ciri khas umum pada SOPK di mana sekitar 40--80% wanita SOPK meningkatkan obesitas. Kej Vitamin D Receptor (VDR) terkait dengan SOPK melalui peradangan kronik tingkat rendah. Tujuan penelitian adalah mempelajari ekspresi mRNA gen VDR pada wanita obesitas dan non-obesitas dengan SOPK dan normal. Sampel darah dari 120 subjek dibagi menjadi empat kelompok, yaitu 30 normal non-obesitas (BMI <25), 30 normal non-obesitas (BMI> 25), SOPK non-obesitas (BMI <35), dan 30 SOPK obesitas (BMI> 25) kemudian dianalisis menggunakan kuantitatif Real-Time PCR (qPCR) dengan metode kurva standar. Hasil penelitian menunjukkan bukti mRNA gen VDR pada subjek obesitas dan SOPK secara signifikan lebih tinggi dibandingkan kedua kontrol. Hasil ini menunjukkan bahwa gen VDR terkait dengan obesitas dan SOPK.

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Polycystic ovary syndrome (PCOS) is a disorder characterized by hyperandrogenemia, ovarian dysfunction, and polycystic ovaries that can cause infertility. Although the exact etiology is unknown, obesity is a hallmark common in PCOS where about 40-80% of PCOS increase obesity. Vitamin D Receptor (VDR) is associated with PCOS through low-level chronic inflammation. The aim of the study was to study the expression of VDR gene mRNA on obese and non-obese women with PCOS and normal. Blood samples from 120 subjects were divided into four groups, namely 30 normal non-obese (BMI <25), 30 normal non-obese (BMI> 25), non-obese PCOS (BMI <35), and 30 obese PCOS(BMI> 25) was then analyzed using quantitative Real-Time PCR (qPCR) with the standard curve method. The results showed evidence of VDR gene mRNA in obese and PCOS subjects was significantly higher than the two controls. These results indicate that the VDR gene is associated with obesity and PCOS."

"Latar Belakang: SOPK dijumpai pada 5-20% perempuan usia reproduksi. AMH digunakan sebagai penanda SOPK karena pada penderita SOPK salah satu gejalanya adalah terjadinya anovuasi yang menyebabkan peningkatan kadar AMH. SOPK juga berkaitan dengan adanya resistensi insulin dan hiperandrogen yang berkorelasi dengan obesitas dan inflamsi kronik yang dapat menyebabkan risiko terjadinya sindrom metabolik.Tujuan: Mengetahui hubungan peningkatan kadar AMH pada penderita SOPK dan fenotip SOPK dengan kejadian Sindrom Metabolik.Metode: Penelitian ini menggunakan disain potong lintang di RSUPN Cipto Mangunkusumo pada penderita SOPK pada bulan Januari 2013 hingga Desember 2017. Data penderita SOPK yang memenuhi kriteria inklusi dicatat dan dilakukan analisis statistik.Hasil: Dari pengumpulan data Januari 2013 hingga Desember 2017 di RSUPN Cipto Mangunkusumo didapati 109 kasus SOPK yang memenuhi kriteria inklusi. Penderita SOPK tesebut memiliki median kadar AMH 7.10 ng/ml (3.11-34.06) dan yang mengalami sindrom metabolik 21% dengan median kadar AMH 7.21ng/ml (2.83-20.20) yang lebih tinggi dibandingkan yang tidak sindrom metabolik (p=0.387). Sedangkan untuk fenotip yang terbanyak adalah fenotip 4 (OA dan PCOM) yaitu 41.3% dan yang mengalami sindrom metabolik terbanyak adalah fenotip 1 (OA+PCOM+HA)  sebanyak 56.5% dengan median kadar AMH  yang tertinggi sebesar 13.92ng/ml.Kesimpulan: Kadar AMH pada penderita SOPK yang mengalami sindrom metabolik  trend nya lebih tinggi dibandingkan yang tidak sindrom metabolik. Fenotip 1 (OA+PCOM+HA) adalah kelompok fenotip yang paling banyak mengalami sindrom metabolik.

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Background: PCOS is present in 5-20% women of reproductive age. AMH is used as a marker because one of the sign is anovulation that cause elevated AMH level. PCOS is also associated with the presence of insulin resistance and hyperandrogen that correlate with obesity and chronic inflammation that will increase the risk of metabolic syndrome.Purpose: To evaluate the correlation between AMH level in PCOS patients with the incidence of Metabolic Syndrome.Method: This research used cross sectional design with consecutive sampling. Data that fulfilled the inclusion criteria were collected and analyzed.Result: Data collection from January 2013 to December 2017 at RSUPN Cipto Mangunkusumo found 109 cases of PCOS meet the inclusion criteria. Patients with PCOS have median level of AMH 7.10 ng/ml (3.11-34.06). Twenty one percent of the patient had metabolic syndrome with median level of AMH 7.21ng/ml (2.83-20.20) higher than non-metabolic syndrome (p = 0.387). The largest number of phenotypes on PCOS patients is phenotype 4 (OA and PCOM) which is 41.3%. Most metabolic syndrome is phenotype 1 (OA + PCOM + HA) as much as 56.5% with median highest AMH level of 13.92 ng/ml.Conclusion: AMH levels in patients with PCOS who have metabolic syndrome are higher than non-metabolic syndrome. Phenotype 1 (OA + PCOM + HA) is a group of phenotypes with the most metabolic syndrome."

"Sindrom ovarium polikistik (SOPK) merupakan suatu kondisi umum endokrinopati yang ditandai dengan adanya oligoovulasi atau anovulasi, produksi androgen berlebih, dan adanya kista ovarium kecil multipel yang diidentifikasi secara sonografis (kriteria Rotterdam, 2004). SOPK ditemukan pada 10% populasi wanita usia reproduksi dan berhubungan erat dengan disfungsi ovulasi sehingga menurunkan angka fertilitas. Tujuan penelitian ini adalah untuk mengetahui pengaruh terapi kombinasi elektroakupunktur dan medikamentosa terhadap SOPK. Uji klinis acak tersamar ganda dengan kontrol dilakukan terhadap 44 subjek dengan SOPK yang dialokasikan secara acak ke dalam kelompok elektroakupunktur sejati dan medikamentosa (n=22), serta kelompok elektroakupunktur sham dan medikamentosa (n=22). Penilaian menggunakan pencitraan USG transvaginal dan perhitungan panjang siklus menstruasi sebelum dan sesudah perlakuan. Hasil penelitian menunjukkan terdapat perbedaan bermakna rerata volume ovarium antara kedua kelompok sebelum dan sesudah perlakuan (p=0,002); penurunan jumlah folikel antral (p=0,005); angka kejadian menstruasi (p=0,001); dan pemendekan siklus menstruasi (p=0,003). Kesimpulan penelitian ini elektroakupunktur dan medikamentosa memberikan perbaikan terhadap keluhan dan gambaran ovarium pada pasien SOPK.

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Polycystic Ovarian Syndrome (PCOS) is a general endocrinopathy condition that signed with oligoovulation or anovulation cycle, excess androgen production, and an image of multiple small cysts identified by transvaginal ultrasound (Rotterdam criteria, 2004). PCOS found in 10% of reproductive women and highly corresponded with ovulation dysfunction and finally decrease the fertility rate. The goal of this study is to know the effect of electroacupuncture combined with medical treatment in PCOS. A double blind randomized controlled trial is performed in 44 subjects with PCOS and divided into true electroacupuncture combined with medical treatment group (n=22) and sham electroacupuncture combined with medical treatment group (n=22). Ovarian volume and antral follicle are evaluated with transvaginal ultrasound and the length of menstrual cycle is counted before and after the treatment. The results show there are significant mean differences between ovarian volume in two groups before and after treatment (p=0,002); antral follicle count (p=0,005); menstrual incidence during the treatment (p=0,001); and shortened menstrual cycle (p=0,003). The conclusion of this study is electroacupuncture combined with medical treatment could improve PCOS patients’ compaint and ovarian image."

"ABSTRAK Latar Belakang: Sindrom Ovarium Polikistik (SOPK) merupakan penyebab 40%infertilitas pada wanita usia reproduksi. Resistensi insulin sebagai salah satupatofisiolofi yang mendasari SOPK, berkaitan erat dengan jaringan adiposaviseral dan ditemukan pada 30-50% pasien SOPK dengan indeks masa tubuhnormal serta lingkar pinggang kurang dari 80 cm. Retinol Binding Protein-4(RBP-4) yang disekresi oleh jaringan adiposa viseral diketahui sebagai salah satuadipokin yang menyebabkan resistensi insulin. Pengukuran IMT dan lingkarpinggang tidak dapat mewakili akumulasi jaringan adiposa viseral pada SOPKdengan IMT normal serta lingkar pinggang kurang dari 80 cm. Dengandiketahuinya titik potong optimal kadar serum RBP-4 sebagai penanda jaringanadiposa viseral, diharapkan dapat memprediksi risiko kejadian resistensi insulinyang bermanfaat dalam menentukan penatalaksanaan kasus SOPK dengan IMTnormal terkait strategi pengurangan akumulasi jaringan adiposa viseral. Tujuan: Diketahuinya titik potong optimal kadar serum RBP-4 sebagai penandajaringan adiposa viseral untuk memprediksi risiko kejadian resistensi insulin padapenderita SOPK dengan IMT normal. Metode: Studi observasional dengan desain potong lintang selama periode Juli2014 hingga Maret 2015 di Poliklinik Yasmin, RSCM, Jakarta. Hasil: Sejumlah 40 subjek SOPK dengan IMT normal yang memenuhi kriteriainklusi didapatkan 16 subjek (40%) yang mengalami resistensi insulin dan 24subjek (60%) nir resistensi insulin. Sejumlah 23 subjek (57.5%) memiliki lingkarpinggang kurang dari 80 cm, dimana 6 subjek (26%) diantaranya mengalami resistensi insulin. Kadar serum RBP-4 pada kelompok resistensi insulin bermakna lebih tinggi dibandingkan nir resistensi insulin (p 0.008). Dengan analisis ROCdidapatkan AUC kadar serum RBP-4 78.8% (IK 95% -8445.59 ? -1447.98)dengan nilai p 0.002. Titik potong optimal kadar serum RBP-4 adalah 24133ng/mL dengan sensitivitas sebesar 75% dan spesifisitas sebesar 75%. Dengananalisis regresi logistik biner didapatkan pemeriksaan serum RBP-4 menambahnilai diagnostik dari parameter demografis dan klinis AUC 85.7% menjadi 91.1%. Kesimpulan: Kadar serum RBP-4 sebagai penanda jaringan adiposa viseral dapat digunakan untuk memprediksi risiko kejadian resistensi insulin pada penderita SOPK dengan IMT normal. ABSTRACT Background: Polycystic ovarian syndrome (PCOS) contributes to fourty percent

of infertility?s issues on reproductive women. Insulin resistance as one of

important pathophysiology in PCOS, correlates with visceral adipose tissue and is

found on 30-50% PCOS patients with normal body mass index and waist

circumference less than 80 cm. Retinol Binding Protein-4 (RBP-4), which is

secreted by visceral adipose tissue, known as one of adipokines that cause insulin

resistance. The measurement of body mass index and waist circumference could

not represent visceral adiposity on PCOS with normal body mass index and waist

circumference less than 80 cm. Determination of serum RBP-4 cut off level as

visceral adipose tissue marker hopefully could predict the risk of insulin

resistance on polycystic ovarian syndrome with normal body mass index,

therefore it will be useful on its management related to reduction of visceral

adiposity.

Objective: To obtain serum RBP-4 cut off level as visceral adipose tissue marker

to predict the risk of insulin resistance on PCOS with normal body mass index.

Method: This was an observational study with cross sectional design conducted at

Yasmin Clinic, RSCM, Jakarta during a period of July 2014 until March 2015.

Result: Fourty PCOS patients with normal body mass index were participated on

this study. There were 16 subjects (40%) who were insulin resistance and 24

subjects (60%) who were not insulin resistance. There were 23 subjects (57.5%)

who had waist circumference less than 80 cm, where 6 of them (26%) were

insulim resistance. Serum RBP-4 level was significantly higher on insulin

resistance group (p 0.008). After ROC analysis was performed, AUC of serum

RBP-4 was 78.8% (CI 95% -8445.59 ? -1447.98, p 0.002). The cut off level of

serum RBP-4 was 24133 ng/mL with sensitivity 75% and specificity 75%. After

logistic regression analysis was performed, it was found that serum RBP-4 increase diagnostic value of demographic and clinical parameter with AUC 85.7% to 91.1%. ;Background: Polycystic ovarian syndrome (PCOS) contributes to fourty percent

of infertility?s issues on reproductive women. Insulin resistance as one of

important pathophysiology in PCOS, correlates with visceral adipose tissue and is

found on 30-50% PCOS patients with normal body mass index and waist

circumference less than 80 cm. Retinol Binding Protein-4 (RBP-4), which is

secreted by visceral adipose tissue, known as one of adipokines that cause insulin

resistance. The measurement of body mass index and waist circumference could

not represent visceral adiposity on PCOS with normal body mass index and waist

circumference less than 80 cm. Determination of serum RBP-4 cut off level as

visceral adipose tissue marker hopefully could predict the risk of insulin

resistance on polycystic ovarian syndrome with normal body mass index,

therefore it will be useful on its management related to reduction of visceral

adiposity.

Objective: To obtain serum RBP-4 cut off level as visceral adipose tissue marker

to predict the risk of insulin resistance on PCOS with normal body mass index.

Method: This was an observational study with cross sectional design conducted at

Yasmin Clinic, RSCM, Jakarta during a period of July 2014 until March 2015.

Result: Fourty PCOS patients with normal body mass index were participated on

this study. There were 16 subjects (40%) who were insulin resistance and 24

subjects (60%) who were not insulin resistance. There were 23 subjects (57.5%)

who had waist circumference less than 80 cm, where 6 of them (26%) were

insulim resistance. Serum RBP-4 level was significantly higher on insulin

resistance group (p 0.008). After ROC analysis was performed, AUC of serum

RBP-4 was 78.8% (CI 95% -8445.59 ? -1447.98, p 0.002). The cut off level of

serum RBP-4 was 24133 ng/mL with sensitivity 75% and specificity 75%. After

logistic regression analysis was performed, it was found that serum RBP-4 increase diagnostic value of demographic and clinical parameter with AUC 85.7% to 91.1%. "