Metabolic markers associated with anovulation in obese patients with oligo/amenorrhea

Dikke G.B., Mudrov V.A., Efendieva R.M., Abusueva Z.A.

1) F.I. Inozemtsev Academy of Medical Education, St. Petersburg, Russia; 2) Chita State Medical Academy, Chita, Russia; 3) Dagestan State Medical University, Makhachkala, Russia

Objective: Assessment of the impact of metabolic disorders on ovulatory function, identification of the most significant metabolic markers associated with anovulation, and development of the management algorithm for women with obesity and oligo/amenorrhea.
Materials and methods: A retrospective case-control study was conducted. The analysis included 85 patients divided into two groups: Group I (n=55) – with obesity, oligo/amenorrhea, and anovulation; Group II (n=30) – with normal body weight, regular menstrual cycles, and ovulation. The examination included anthropometry, pelvic ultrasound, and laboratory tests (blood parameters for carbohydrate and lipid metabolism, amino acids and peptides, hormonal status, cytokines, inflammatory markers, and micronutrients).
Results: The median age of patients in Group I was 28.0 (26.0–30.5) years, while in Group II it was 27.5 (25.5–29.8) years (p=0.20). Using multivariate regression analysis, the most significant markers of anovulation were identified: waist-to-hip ratio (WC/HIR, OR=5.21), insulin resistance index (HOMA-IR, OR=3.46), high levels of triglycerides (OR=2.39) and body mass index (BMI, OR=2.18), low-density lipoproteins, homocysteine, leptin, C-reactive protein, interleukins 1β and 8 (OR from 1.35 to 1.04). Low levels of 25-hydroxycalciferol, folate and high-density lipoproteins were independent risk factors for anovulation. The results showed a high diagnostic value of all markers, with leptin, BMI, WC/HIR, and HOMA-IR (AUC>0.97) being the most accurate. Based on the analysis results, a two-stage strategy for determining the risk of anovulation in women with obesity and oligomenorrhea/amenorrhea was developed, along with a management algorithm based on the likelihood of anovulation.
Conclusion: This integrated approach allows for the highly accurate identification of anovulation markers in patients with obesity and oligomenorrhea/amenorrhea. Since these indicators reflect the patient’s metabolic profile, interventions to restore ovulation should primarily focus on it’s correction.

For citations: Dikke G.B., Mudrov V.A., Efendieva R.M., Abusueva Z.A. Metabolic markers associated with anovulation in obese patients with oligo/amenorrhea. Pharmateca. 2026;33(2):99-111. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.2.99-111

Authors’ contribution: G.B. Dikke – development of the concept, design and program of the study, supervision during the study, analysis of the results of statistical processing of clinical material and their interpretation, search for literary sources, writing of article and its editing after review. V.A. Mudrov – development of a research program, statistical processing of clinical material, analysis of results, development of a forecasting model and its interpretation, writing fragments of the article and editing it after peer review. R.M. Efendieva – collection of clinical material, formation of an electronic database. Z.A. Abusueva – organizationn of the study at the clinical site, supervision during the study.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was carried out at the company’s own expense.
Ethical Approval: The research protocol met the requirements of the Helsinki Declaration of the World Medical Association (revision of the 64th General Assembly of the World Medical Association, Fortaleza, Brazil, 2013), regulations of the International
Ethical Guidelines for Biomedical Research Involving Human Subjects (ed. 2002), the National Standard of the Russian Federation R52379-2005 “Good Clinical Practice” (2005), other legislative and regulatory documents of the Russian Federation. The permission of the local Ethics Committee was not required (the funds were used in accordance with the instructions of the manufacturers).
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors’ Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.

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About the Authors

G.B. Dikke, Dr. Sci. (Med.), Professor, Department of Obstetrics and Gynecology with a Course in Reproductive Medicine, F.I. Inozemtsev Academy of Medical Education, St. Petersburg, Russia; galadikke@yandex.ru, ORCID: https://orcid.org/0000-0001-9524-8962 (corresponding author)
V.A. Mudrov, Dr. Sci. (Med.), Associate Professor, Professor, Department of Obstetrics and Gynecology, Faculty of Pediatrics and Faculty of Continuous Professional Education, Chita State Medical Academy, Chita, Russia; mudrov_viktor@mail.ru, ORCID: https://orcid.org/0000-0002-5961-5400
R.M. Efendieva, Postgraduate Student, Department of Obstetrics and Gynecology, Faculty of General Medicine, Dagestan State Medical University, Makhachkala, Russia; romidok@mail.ru, ORCID: https://orcid.org/0009-0002-1729-4781
Zu.A. Abusueva, Dr. Sci. (Med.), Professor, Department of Obstetrics and Gynecology, Faculty of General Medicine, Dagestan State Medical University, Makhachkala, Russia; zuhraabusueva@mail.ru, ORCID: https://orcid.org/0000-0002-7729-1606

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