Anthropometric measurements and biochemical parameters in black women at the unit for reproductive care at Universitas Hospital, Bloemfontein
| dc.contributor.advisor | Slabber, M. | |
| dc.contributor.advisor | Nortjé | |
| dc.contributor.author | Motseke, Lucia | |
| dc.date.accessioned | 2015-11-24T07:10:00Z | |
| dc.date.available | 2015-11-24T07:10:00Z | |
| dc.date.copyright | 2004-11 | |
| dc.date.issued | 2004-11 | |
| dc.date.submitted | 2004-11 | |
| dc.description.abstract | English: The prevalence of infertility in Africa is overshadowed by the high population growth rate in this continent. The number of infertile black African women seeking treatment is on the increase due to the fact that more black women are concentrating on their careers and postponing having children. The desire to reproduce is a highly motivating factor in most marriages and failure to do so places a lot of stress on the couple. Infertile women in most parts of Africa are treated as outcasts due to their infertile status. In most cases these women are either abused or divorced by their husbands. In sub-Saharan Africa, sexually transmitted diseases are the most common causes of infertility. Other causes of infertility in women include endometriosis, anovulation, tubal diseases, cervical factors and unexplained infertility. Anorexia and bulimia nervosa, as well as obesity, produce alterations in the reproductive system of women. Obesity has an effect on ovulation and on the outcomes of in vitro fertilization and assisted reproduction therapy. Anorexia nervosa on the other hand, has also been associated with amenorrhoea and oligoamenorrhoea. Insulin resistance is another factor that is linked to polycystic ovarian syndrome and infertility. Insulin resistance has also been shown to be prevalent in obese individuals, especially those with android fat distribution. Lowering insulin resistance by weight loss, results in spontaneous ovulation. The main objective of this study was to determine the anthropometrical and biochemical parameters in infertile black South African women. A total of sixty participants attending the Unit for Reproductive Health, Universitas Hospital, Bloemfontein were included in the study. Anthropometrical data measured included: body mass index; waist-to-hip ratio; waist circumference; neck circumference and body fat percentage. Blood samples were also obtained to determine the levels of fasting insulin, glucose, thyroid-stimulating hormone, luteinizing hormone, follicle-stimulating hormone, leptin, prolactin, progesterone, testosterone and C-reactive protein. The results of this study show that tubal factor infertility was the most prevalent cause of infertility and the second highest cause of infertility was male factors. The median age of the subjects of this study was 32 years. Sixty percent of the subjects had a gynoid fat distribution. More than a third of the subjects had a body mass index of more than 25 kg/m² and none of the subjects in this study had a body mass index of less than 18.5 kg/m². Eighty five percent of the subjects had a body fat percentage of more than 32 percent. These results indicate that obesity is a problem among these subjects. Biochemical parameters indicate that the median concentrations of the reproductive hormones were normal. Only 35 percent of the subjects had hyperinsulinaemia. Almost all of the subjects (83.6%) had leptin concentrations above normal. Median C-reactive protein level was also normal. No association was found between body mass index and C-reactive protein and insulin. An association was established between leptin concentrations and body mass index and the correlation between these two parameters was very strong. An association was also found between android fat distribution and hyperinsulinaemia. The high rate of obesity among the subjects of this study, places the subjects of this study at a risk of developing metabolic syndrome and other obesity-related factors. Their obesity status may also be a contributory factor to their infertile status. There should, be increased awareness of the impact of obesity on infertility and on their general health. Increased physical activity and healthy food choices should be encouraged among black infertile women. Black women should still be made aware of the fact that there are facilities available for treatment of infertility. | en_ZA |
| dc.description.abstract | Afrikaans: Die voorkoms van infertiliteit in Afrika word oorskadu deur die hoë populasiegroeitempo in hierdie kontinent. Die aantal swart vroue in Afrika wat aanmeld vir behandeling vir infertiliteit is aan die toeneem as gevolg van die feit dat swart vroue tans meer op hul beroepe konsentreer en later me t gesinne begin. Seksueel oordraagbare siektes is die vernaamste oorsaak van infertiliteit in sub-Sahara Afrika. Ander oorsake van infertiliteit in vroue sluit endometriose, anovulasie, buisfaktore, servikale faktore en ander onverklaarbare faktore in. Vetsug veroorsaak veranderinge in die vroulike reproduktiewe stelsel. Vetsug beïnvloed ovulasie en toon ‘n invloed op die uitkoms van in vitro bevrugtiging en geassisteerde reproduksie terapie. Hiperinsulinemie en insulienweerstandigheid word meer algemeen in vetsugtige persone, veral in diegene met androïde vetsug, aangetref. Insulienweerstandigheid is ‘n faktor wat met polisistiese ovariële sindroom en infertiliteit geassossier word. Die verlaging van insulienweerstandigheid deur middel van massaverlies lei tot spontane ovulasie. Min navorsing is tot hede oor die kwessie van infertiliteit in die swart gemeenskap gedoen en geen fokus word deur Gesondheidsorgstelsel daarop geplaas. In Suid-Afrika is baie min navorsing oor infertiliteit in die swart bevolking, asook die verband tussen vetsug en infertiliteit in swart vroue gedoen. Die hoofdoel van hierdie studie was om die antropometriese en biochemiese parameters van infertiele swart Suid-Afrikaanse vroue te bepaal. Die steekproef het bestaan uit sestig swart vroue wat die Reproduktiewesorgeenheid van die Universitas hospitaal, Bloemfontein tussen 1 Maart 2003 en 31 Julie 2004 besoek het. Die volgende antropometriese metings is gedoen: massa, lengte, middel-heup omtrekverhouding, middel en nekomtrek en liggaamsvetpersentasie. Vastende bloedmonsters is ontleed vir insulien, glukose, tiroïedstimuleringshormoon, luteïniseringshormoon, follikelstimuleringshormoon, leptien, prolaktien, progesteroon, testosteroon en Creaktiewe proteïne. Die mediaan ouderdome van die vroue was 32 jaar (20.3 – 41.6 jaar). Buisfaktor was die mees algemene oorsaak van infertiliteit terwyl manlike faktore ook ‘n belangrike rol by die fertiliteit van die groep vroue gespeel het. Meer as een derde van die vroue het ‘n liggaamsmassa indeks (LMI) van meer as 25 kg/m² getoon terwyl geen vroue ondergewig was (LMI< 18.5 kg/m²). Sestig persent van die vroue het ginoïede vetverspreiding getoon. ‘n Liggaamsvetpersentasie groter as 32 persent is by 85 persent van die vroue gevind. Hierdie resultate het bewys dat vetsug ‘n groot probleem onder hierdie vroue is. Biochemiese parameters het aangedui dat die mediaankonsentrasies van al die voorplantingshormone normaal was. Vyf-en-dertig persent van die vroue het egter hiperinsulinemie getoon. Omtrent al die vroue (83.6%) het verhoogde leptienkonsentrasies getoon. Die mediaan C-reaktiewe proteïenkonsentrasies was binne die normale reikwydte. Geen statistiesbetekenisvolle verband is tussen LMI en C-reaktiewe proteïnkonsentrasie asook s- insulienkonsentrasies gevind nie. ‘n Statisties betekenisvolle verband (95% CI: - 17.9; -5.3) is tussen leptienkonsentrasies en LMI en ‘n sterk korrelasie (r = 0.77) is ook tussen hierdie twee parameters gevind. Die verband tussen androïede vetsug en hiperinsulinemie was ook statisties betekenisvol (95% CI: -46.7; -0.4) in hierdie vroue. Vetsug blyk ‘n vername rol te speel in die voorkoms van infertiliteit by hierdie groep vroue in hierdie studie. Die hoë voorkoms van vetsug (46.7%) beklemtoon hul hoë risiko om lewenstyl siektes soos kardiovaskulêre siektes, Tipe 2 diabetes mellitus, hipertensie en polisistiese ovariële sindroom te ontwikkel. ‘n Bewusmakings veldtog moet geloods word waar die publiek bewus gemaak moet word omtrent die impak van vetsug op infertiliteit asook op algemene gesondheid. Verhoogde fisiese aktiwiteit en gesonde voedselkeuses moet aangemoedig word onder swart onvrugbare vroue. Swart vroue moet steeds ook bewus gemaak word van fasiliteite waar infertiliteit behandel kan word. Verdere navorsing oor die voorkoms van infertiliteit by swart vroue in Suid-Afrika word benodig. Daar word aanbeveel dat sodanige studie(s) ‘n groter steekproef infertiele swart Suid-Afrikaanse vroue insluit, asook ‘n dieetingreep wat sal bepaal wat die invloed van massaverlies by hierdie vroue sal wees. Die verband tussen anovulasie en vetsug moet ondersoek word sowel as die verband tussen verhoogde leptienkonsentrasies en infertiliteit by swart vroue. | af |
| dc.identifier.uri | http://hdl.handle.net/11660/1760 | |
| dc.language.iso | en | en_ZA |
| dc.publisher | University of the Free State | en_ZA |
| dc.rights.holder | University of the Free State | en_ZA |
| dc.subject | Dissertation (M.Sc. (Dietetics))--University of the Free State, 2004 | en_ZA |
| dc.subject | Reproductive health -- South Africa | en_ZA |
| dc.subject | Obesity in women -- South Africa | en_ZA |
| dc.subject | Infertility, Female -- South Africa | en_ZA |
| dc.title | Anthropometric measurements and biochemical parameters in black women at the unit for reproductive care at Universitas Hospital, Bloemfontein | en_ZA |
| dc.type | Dissertation | en_ZA |