Dissertations / Theses: 'PCOS'

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Karlson, Johan, and Pernilla Vedenbrant. "Att leva med PCOS." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap, HV, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-12004.

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Aim: To describe the lived experience of women with polycystic ovary syndrome (PCOS). Method: Eight scientific articles of appropriate quality were found, analyzed, condensed and synthesized. Different experiences by women with PCOS were found and ordered into themes. The findings were then anchored in associated literature and discussed. Results: Four different themes were found: Feeling different; Disturbing symptoms; Searching for answers; Care treatment. Each of these themes offered areas of improvement in regard to nursing care. Conclusions: Extra attention to the psychosocial aspects of health for women with PCOS should be taken to improve nursing care. The exchange of information between nursing staff and patients needs to be better adapted to the individual informational needs of women with PCOS.

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Badji, Aisha. "A PCOS-like Drosophila Melanogaster model." Thesis, Högskolan i Skövde, Institutionen för hälsa och lärande, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-17845.

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Polycystic ovary syndrome (PCOS) is a female endocrine disorder defined by high androgen levels and presence of polycystic ovaries. PCOS is characterized by menstrual irregularities, anovulation, infertility, hyperandrogenism, insulin resistance, abdominal obesity, chronic inflammation and increased hair growth. The diagnosis is based on 2003/2004 Rotterdam criteria, which is based on the presence of the following phenotypes: anovulation, clinical and biochemical marks of hyperandrogenism and polycystic ovarian morphology. Theoretical causes could be genetical, environmental or maternal imprinting. Drosophila Melanogaster, a model used broadly in disease research, could bear promising insights to this syndrome. Besides having a lifecycle characterized by a 12 days metamorphism, these species of flies have the ecdysone (steroid) hormone, similar to the human testosterone and the body systems similar to those of the human body. This laboratory work involved the development of a PCOS-like drosophila fly model through exposure to 10mg/ml of testosterone after 24 hours of starvation. Data collection comprised measurements of weight and length, anovulation, triglyceride quantification and RT-qPCR for quantification of inflammatory and PCOS-related genes. Results showed significant differences in response to physical stress among the four groups of flies. Variation in weight and length values, as well as in fecundity, triglyceride assay and relative expression levels were also observed. Although the expression levels of inflammatory and PCOS- related genes were not significantly affected, homeostasis was clearly affected by metabolic disturbances. These observations lead to the conclusion that further experiments should be done in order to establish a more comprehensive definition of the syndrome.

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Wood, David L. "Abnormal Uterine Bleeding, Amenorrhea and PCOS." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/5172.

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Koivunen, R. (Riitta). "Endocrine and metabolic changes in women with polycystic ovaries and polycystic ovary syndrome." Doctoral thesis, University of Oulu, 2001. http://urn.fi/urn:isbn:9514264266.

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Abstract The prevalence of the isolated ultrasonographic finding of polycystic ovaries (PCO) in the Finnish population and among women with a history of gestational diabetes (GDM) and changes in the present carbohydrate metabolism were investigated in the present study. One aim of this study was to investigate the prevalence of the recently discovered variant type LH (v-LH) in PCOS and to compare patient cohorts from Finland, the Netherlands, the United Kingdom and the United States of America. In addition, this study attempted to evaluate the nature of the ovarian streoidogenic response of women with PCOS to exogenously administered human chorionic gonadotrophin (hCG), human menotrophin (hMG) and follicle stimulating hormone (FSH). The effect of metformin on ovarian steroidogenesis was also studied. The prevalence of PCO was significantly higher in younger (≤ 35 years, 21.6%) than among older women (in ≥ 36 years, 7.8%). The overall prevalence of PCO in Finnish women was 14.2%. Women with previous GDM revealed a high prevalence of PCO (39.4%). The carrier frequency of the v-LHb allele in the entire study population was 18.5%. The frequency of the v-LH carrier was significantly lower in obese PCOS subjects in the Netherlands (2.0%) and Finland (4.5%). Women with previous GDM had impaired insulin sensitivity and β-cell function. They also had higher adrenal androgen secretion than the control women. Women with PCO and previous GDM had marked hyperinsulinemia which was not explained by obesity. Obese PCOS women achieved peak peripheral serum T concentrations at 48 hours after a hCG injection, preceded by peak levels of 17-OHP and E2 at 24 hours. In contrast, all steroids measured in the control women reached their maximum serum concentrations at 96 hours. HMG stimulated the production of ovarian androgens more efficiently than a urinary FSH after pituitary suppression with a gonadotrophin releasing hormone agonist (GnRHa). In conclusion, the prevalence of PCO is common in healthy Finnish women and even more common in women with a history of GDM. The ultrasonographic appearance of PCO may be a predictive factor with regards abnormal glucose tolerance during and after pregnancy and, these women should therefore be advised as to possible consequences. The high overall frequency of the v-LH allele in women in general and its low frequency in obese PCOS patients suggests that v-LH plays a role in reproductive functions and may counteract the pathogenesis of PCOS in obese individuals. The differences observed in steroid responses to hCG between normal and PCOS women might be explained by higher theca cell activity or mass in polycystic ovaries. Women with PCOS did not show a distinctly exaggerated steroidogenic response to hMG or FSH administration compared with control women. FSH administration also resulted in increased A and T production.

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Davis, Kimberly D. "Out of Order." Thesis, University of North Texas, 2013. https://digital.library.unt.edu/ark:/67531/metadc271800/.

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Out of Order is a documentary film that explores the emotional and physical aspects of living with polycystic ovarian syndrome. This reproductive disorder affects between 5 and 10% of all women of reproductive age. This film features an animated, autobiographical look at director Kimberly Davis' personal experience with this condition.

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Kilpatrick, Kaylon Ann. "Starvation induces Polycystic Ovarian Syndrome (PCOS) like symptoms in Drosophila melanogaster." Thesis, Mississippi College, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10128977.

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Polycystic Ovarian Syndrome (PCOS) is a metabolic and endocrine disorder that is the most common cause of infertility. PCOS can manifest itself as a long and short term disability and is characterized by insulin resistance (IR), hyperandrogenism, anovulation, hyperinsulinaemia and polycystic ovaries. Our lack of understanding of this disorder and its long term effects has complicated the treatment of the disorder; yet, it is clear that PCOS involves the intricate interaction between genetics, environments and behaviors. To study this disease, scientists have used various animal models. Since the Drosophila model for PCOS has only been postulated,in this work, we determined whether starvation along with the addition of steroid hormones would induce a PCOS-like disorder in D. melanogaster after 24 hour exposure.

In women with PCOS, testosterone levels and the expression of the androgen receptor are elevated. In fruit flies, ecdysone (E) and its “active” form, 20-hydroxyecdysone (20E), are homologous to the human testosterone and 20-hydroxytestosterone, respectively. This hormone is required for circadian cycles, molting, and maturation in insects. More specifically, this hormone is also located in ovarian tissue and aids in follicular development. The receptor for ecdysone is the ecdysone receptor (EcR). In this work, we examined the expression of the ecdysone receptor (EcR) upon starvation for up to 24 hours by immunofluorescence microcopy. Using qRT-PCR, we determined the levels of expression of genes usually associated with inflammation. Ovarian dysfunction was examined by measuring the fecundity of the females. Starvation increases the expression of the EcR and pro-inflammatory gene expression and decreases fecundity, suggesting that Drosophila melanogaster is a potentially useful model organism in the study of PCOS.

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McCook, Judy G., Beth A. Bailey, Stacey L. Williams, Sheeba Anand, and Nancy E. Reame. "Differential Contributions of Polycystic Ovary Syndrome (PCOS) Manifestations to Psychological Symptoms." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/7172.

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The purpose of this study was to investigate the relative contributions of previously identified Polycystic ovary syndrome (PCOS) manifestations (infertility, hirsutism, obesity, menstrual problems) to multiple psychological symptoms. Participants were 126 female endocrinology patient volunteers diagnosed with PCOS who completed a cross-sectional study of PCOS manifestations and psychological symptoms. Participants had significantly elevated scores on nine subscales of psychological symptoms. Menstrual problems were significantly associated with all symptom subscales as well as the global indicator, while hirsutism and obesity were significantly related to five or more subscales. After controlling for demographic factors, menstrual problems were the strongest predictor of psychological symptoms. Findings suggest features of excess body hair, obesity, and menstrual abnormalities carry unique risks for adverse psychologic symptoms, but menstrual problems may be the most salient of these features and deserve particular attention as a marker for psychological risk among women with PCOS.

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Rautio, K. (Katriina). "Effects of insulin-lowering drugs in PCOS: endocrine, metabolic and inflammatory aspects." Doctoral thesis, University of Oulu, 2006. http://urn.fi/urn:isbn:951428268X.

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Abstract Most women with polycystic ovary syndrome (PCOS) exhibit features of metabolic syndrome, including insulin resistance, abdominal obesity, dyslipidaemia, glucose intolerance and low-grade chronic inflammation, reflected in elevated levels of serum C-reactive protein (CRP), placing these women at increased risk of cardiovascular disease and type 2 diabetes (type 2 DM). The aim of this study was to investigate the effects of two well-known insulin-lowering drugs used in the treatment of type 2 DM, metformin and rosiglitazone, on traditional cardiovascular risk factors and inflammation in women with PCOS. In addition, the impact of rosiglitazone was evaluated as regards clinical, endocrine and metabolic aspects of PCOS. Six-months of metformin treatment in women with PCOS had beneficial effects on levels of CRP, lipid profile and blood pressure, expressed as increased levels of high-density lipoprotein cholesterol (HDL-C), and decreased levels of triglycerides (TGs), decreased ratio of total cholesterol/HDL-C, decreased levels of CRP, and decreased systolic and diastolic blood pressures. Four-month treatment with rosiglitazone in a randomised, double-blind, placebo-controlled study in overweight women with PCOS resulted in significant improvements in menstrual cyclicity, hyperandrogenism, insulin resistance and hyperinsulinaemia. In addition, rosiglitazone decreased levels of markers of low-grade inflammation, CRP and white blood cell (WBC) count, and the liver function marker alanine aminotransferase (ALAT), while having neutral effects on levels of lipids, and blood pressure. In conclusion, metformin treatment, in accordance with the known beneficial metabolic effects of this drug, could be useful in the prevention of cardiovascular complications in women with PCOS. Rosiglitazone represents an alternative treatment for overweight anovulatory women with PCOS. It could be useful in the prevention of type 2 DM in overweight women with PCOS and for those suffering from possible side-effects related to metformin treatment. In addition, alleviation of inflammation and improvement of liver function during rosiglitazone treatment may indicate decreased future risks of cardiovascular diseases and non-alcoholic fatty liver disease (NAFLD).

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Barry, John Anthony. "Exploration of biological causes of psychological problems in polycystic ovary syndrome (PCOS)." Thesis, City University London, 2011. http://openaccess.city.ac.uk/11666/.

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Background: Polycystic ovary syndrome (PCOS) affects up to 10% of women, and is characterised by elevated testosterone (T) levels. Women with PCOS have higher scores than healthy women on a range of measures of psychological problems. Objective: To test the hypotheses that: 1/ The female fetus in a PCOS pregnancy experiences elevated T levels; 2/ T causes mood disturbance in women with PCOS. 3/women with PCOS show more signs of mood disturbance typical of symptoms of reactive hypoglycaemia than healthy controls. Design: Mainly between-groups cross-sectional studies. Also two meta-analyses. Setting: The research took place mainly in two London gynaecology clinics, University College London Hospital (UCLH) and the Royal Free Hospital, Hampstead (RFH). Some of the research was conducted online, and at three other gynaecology and fertility clinics. Participants: Participants were recruited from hospital clinics, support groups for women with PCOS, or the internet. Most participants were women aged 18-40. Outcome Measures: Testosterone; psychometric measures of mood disturbance. Results: 1/ Elevated T was found in the umbilical cord blood of the female fetus in PCOS pregnancies; 2/ Mood problems in PCOS were not directly caused by T. 3/ Women with PCOS showed higher levels of mood problems typical of hypoglycaemia than controls. Conclusions: The findings suggest the female fetus in a PCOS pregnancy may be exposed to relatively high levels of T. Mood problems in adults with PCOS are possibly caused by the direct effects of low blood glucose and indirect effects of T (e.g. obesity) than direct effects of T. Further research using the gold-standard biochemical assessment methods is required for any replications of these findings.

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Patterson, Moneka Angilene. "Polycystic Ovary Syndrome Treatment." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4319.

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Polycystic ovary syndrome (PCOS) is an endocrine system disorder that affects women of reproductive age. If not treated properly, PCOS can lead to infertility. Lack of proper treatment of PCOS may also result in medical complications such as diabetes or heart disease. The rural clinic where this project took place did not have a mandatory guideline for treatment of PCOS; therefore, no standardized method of diagnosis or treatment of PCOS existed. The purpose of this project, guided by the IOWA evidence-based practice model, was to educate providers on the evidence-based guideline for diagnosis and treatment of PCOS outlined by the Endocrine Society Taskforce. The guideline was selected after a comprehensive literature review and was used to develop an educational program that was provided to 5 nurse practitioners, the medical director and staff. A pre-test post-test design was used to determine if the participants understood the content from the guideline that was presented. Results showed that the researcher-developed test administered to participants yielded scores of 74 on the pre-test and increased after the education program with all participants scoring 100 on the post-test. The guideline used for the education was then presented to the clinic for implementation with the assistance of the medical director's support. The project provided an evidence-based guideline for diagnosing and treating PCOS and raised awareness of PCOS among all staff in a rural clinic where many patients with PCOS are treated. Positive social change may result as providers are better prepared to deliver evidence-based care for PCOS and as infertility and complications of untreated PCOS are reduced.

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Yassir, Tartil Jasmine. "Metformin som alternativ förstahandsbehandling vid infertilitet vid Polycystiskt ovarialsyndrom." Thesis, Linnéuniversitetet, Institutionen för kemi och biomedicin (KOB), 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-45201.

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Polycystisktovarialsyndrom (PCOS) förekommer hos 5-10% av alla kvinnor och är den vanligaste orsaken till anovulatorisk infertilitet. Andra delar av syndromet är hyperandrogena och metabola symtom. Infertilitet behandlas med klomifencitrat. Akne och hirsutism behandlas i första hand med kombinerade p-piller med östrogenprofil. Förhöjda blodsockernivåer, hypertoni, dyslipidemi och övriga komplikationer till syndromet behandlas farmakologiskt vid behov. Hyperandrogenism och insulinresistens tycks spela en huvudroll i uppkomsten av sjukdomen. Då metformin förbättrar insulinkänsligheten, och tros kunna påverka patofysiologin, har det föreslagits som en alternativ förstahandsbehandling. Denna litteraturstudie syftade till att undersöka vilket vetenskapligt underlag som finns för att ändra behandlingsrekommendationerna vid PCOS. De studier som jämfört resultatet av metformin och klomifencitrat vid anovulatorisk infertilitet visar att klomifencitrat mer effektivt framkallar ovulation och graviditet hos kvinnor med PCOS och övervikt, men att metformin är lika effektivt hos normalviktiga kvinnor. Medan metforminbehandling är en välbeprövad och säker behandling med få biverkningar har klomifencitrat allvarliga biverkningar i form av risk för flerbörd och ovarialthyperstimuleringssyndrom. De få studier som undersökt metformins påverkan på fostret finner inga belägg för teratogena effekter. Metformin har positiva effekter på hyperandrogena symtom vid PCOS, och man har inte kunnat se någon signifikant skillnad i effekt mellan metformin och p-piller då det gäller att minska akne och hirsutism. Dessutom finns det belägg för att metformin kan ha en positiv påverkan på BMI och blodtryck, förbättra lipidprofilen genom att sänka nivåerna av LDL kolesterol, samt minskar risken hos denna patientgrupp att utveckla typ 2 diabetes. Sammantaget kan dock sägas att det vetenskapliga underlaget ännu är för svagt för att man ska ändra den rådande behandlingsrekommendationen. Det finns behov av större, blindade studier där man jämför metforminbehandling med klomifencitrat och tittar på en kombination av faktorer och utfall kopplade till symtombilden vid PCOS.

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Phelan, Bastian Fox Francis. "Beard the Bully: Confronting binary gender norms in narratives of female facial hair." Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/20840.

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Beard the Bully is an extract of a literary memoir about female facial hair. This work explores the decision to grow instead of remove facial hair, in opposition to social norms about gender. It also traces the development of a non-binary gender identity as a way to accommodate this highly visible form of marginal sex variance. This extract looks at how engagement in sex and gender diverse political activism, immersion in the culture of Sydney’s queer community, the experience of stigma and harassment, and conflict with family of origin challenges the narrator to develop a narrative of female facial hair that is unique to them. Female facial hair has not previously been explored in literary memoir, and very little academic work exists, either by or about females with facial hair. A desire for a deeper investigation of gender in narratives of female facial hair led me to the work of gender theorists Judith Butler and Jennifer Germon, and to a number of sociological and medical studies on the experiences of women with hirsutism linked to Polycystic Ovarian Syndrome (PCOS). The theoretical framework arose from themes within this research: images of freaks and mirrors, debates about terminology and self-definition, and the voice’s ability to articulate the human have informed my creation of an alternative narrative of female facial hair. In my research into narratives of female facial hair, I mapped two main ‘genres’: the cosmetic narrative, in which facial hair is removed for aesthetic reasons; and the medical narrative, in which facial hair is diagnosed as a symptom of illness, and then removed. While hair removal is intended to reduce stigma, I argue that both narratives are unable to address the source of stigma: binary gender norms. In Beard the Bully, I present female facial hair as primarily an issue of gender: the hair confronts the gender binary, and it demands that the bearer find a way to articulate their non-binary subjectivity. This extract of Beard the Bully concludes with the idea that a female beard is “all possibility”, countering the widely accepted belief that a beard is a thing that a female body does not or should not have. By offering my own experiences in this literary memoir, I hope to contribute to a shift in the conversations around female facial hair, allowing for the possibility of discussion, representation, and growth.

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Siemienowicz, Katarzyna Joanna. "Fetal programming of adult disease : causes and consequences of metabolic dysregulation in an ovine model of PCOS." Thesis, University of Edinburgh, 2018. http://hdl.handle.net/1842/28977.

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Polycystic ovary syndrome (PCOS) is a common and complex endocrine condition with reproductive and metabolic complications, affecting up to 10% of reproductive-age women. Hyperandrogenemia, ovulatory dysfunction, and luteinising hormone hypersecretion are characteristic traits of PCOS however, it seems that the most concerning long-term key issues are metabolic problems associated with the syndrome, such as hyperinsulinemia, insulin resistance, obesity, dyslipidaemia and non-alcoholic liver disease. Despite the numerous studies on PCOS, its origin and pathophysiology are still not fully understood. However, there is increasing evidence that the adult PCOS phenotype is programmed in fetal life by androgen excess. Exposure to increased levels of testosterone in utero in rodents, sheep and monkeys result in adult reproductive and metabolic pathologies that parallel those seen in PCOS women. Since hyperandrogenemia is a hallmark of PCOS and daughters of PCOS mothers have elevated levels of androgens at birth, it is likely that prenatal androgenisation during early life predispose to the future development of PCOS. Animal models of PCOS provide an opportunity to examine the developmental aetiology and molecular mechanisms underlying the pathogenesis of this condition. Over last 10 years our lab has successfully utilised a well-established ovine model of PCOS, where pregnant ewes were treated with testosterone propionate (TP) through mid-gestation. From this model, we had a large sample bank of fixed and frozen tissues from the fetal, lamb and adolescent prenatally androgenised animals that allowed to carry a broad range of experiments. In addition, a new cohort of prenatally androgenised adult sheep enabled additional in vivo analysis. Past research documented that prenatal androgenisation result in hyperinsulinemia with altered pancreas structure and function, and early fatty liver without difference in body weight in adolescent sheep. This thesis examines the effects and consequences of increased in utero androgen exposure on metabolic dysregulation in adolescent and adult female sheep. During puberty, but not fetal or early life, there was decreased adipogenesis in subcutaneous adipose tissue (SAT), but not visceral adipose tissue (VAT), accompanied by decreased circulating concentrations of fibroblast growth factor 21 (FGF21), leptin and adiponectin, and increased concentrations of fasting free fatty acids (FFA) in prenatally androgenised sheep. This was countered by upregulated expression of FFA transporters in liver. As adults, TP-exposed animals had increased body weight, elevated fasting insulin and FFA concentrations but normal FGF21, leptin and adiponectin levels. Histological analysis revealed that adult TP-exposed animals had SAT hypertrophy, which was associated with increased expression of inflammatory markers and correlated with increased fasting FFA. Therefore, it is likely that impaired preadipocyte differentiation in SAT during adolescence resulted in hypertrophy and inflammation of adult SAT. This consequently lowered capacity of SAT to safely store fat and potentially explains metabolic perturbations observed in PCOS-like female sheep. To further investigate potential causes of obesity in adult PCOS-like sheep postprandial thermogenesis (PPT), an important constituent of energy expenditure, was measured through implantation of datalogger thermometers into interscapular adipose tissue. Adult prenatally androgenised sheep had decreased amplitude of PPT, without difference in basal body temperature, despite receiving the same caloric intake, and independent of obesity. These findings indicate that adult PCOS-like sheep have reduced capacity for energy expenditure, which is mirrored in women with PCOS. This reduced capacity for postprandial thermogenesis was correlated with hyperinsulinemia decreased noradrenaline levels and reduced thermogenic potential of brown and/or beige adipose tissue. This suggests that women with PCOS might be prenatally programmed to become obese. In summary, findings documented in this thesis provide better understanding into the pathophysiology of PCOS from puberty to adulthood and give opportunities for early clinical intervention to ameliorate the metabolic phenotype of PCOS.

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Bagatini, Simone Radavelli. "Polimorfismos do gene da adiponectina e variáveis clínicas, metabólicas e hormonais em mulheres com ou sem a síndrome dos ovários policísticos (PCOS) e investigação de um modelo animal para o estudo da PCOS." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2010. http://hdl.handle.net/10183/25530.

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A Síndrome dos Ovários Policísticos (PCOS) é uma endocrinopatia freqüente em mulheres em idade reprodutiva, sendo caracterizada por uma variedade de manifestações clínicas, incluindo resistência à insulina (RI). A adiponectina está associada com a sensibilidade à insulina e as variantes do gene desta adipocina podem estar envolvidas com aspectos fisiopatológicos da RI. No estudo 1, o objetivo foi verificar possíveis associações entre polimorfismos de nucleotídeos únicos (SNPs) do gene da adiponectina (SNPs G276T, T45G, C11377G e G11391A) e a composição corporal, presença de comorbidades relacionadas à obesidade, bem como perfil hormonal e metabólico, em 80 mulheres com PCOS e 37 controles da região sul do Brasil. A análise genotípica foi avaliada por PCR convencional e digestão enzimática para os SNPs T45G e G276T, localizados no éxon 2 e íntron 2, respectivamente, e PCR em tempo real para os SNPs da região promotora, C11377G e G11391A. As pacientes com PCOS eram mais jovens do que as participantes do grupo controle (21,30 ± 6,01 e 29,86 ± 5,15 anos, p=0,0001). Pressão arterial sistólica e diastólica (p<0,03), escore de Ferriman para hirsutismo (p=0,0001) e relação cintura/quadril (p=0,002) foram mais elevados nas mulheres com PCOS, bem como triglicerídeos, colesterol total e LDLc comparado às controles (p<0,02). Os níveis de insulina em jejum, HOMA, testosterona e IAL foram também significativamente maiores em mulheres com PCOS e a concentração de SHBG mostrou-se significativamente menor do que nas controles (p=0,0001). A freqüência dos genótipos do SNP G276T para mulheres com PCOS foi de 52,6% G/G, 33,3% G/T, 14,1% T/T e para controles foi de 27% G/G, 62,2% G/T, 10,8% T/T. Para o SNP T45G a freqüência dos genótipos T/T, T/G e G/G foi de 79,5%, 17,9% e 2,6%, respectivamente, em mulheres com PCOS, e de 62,2%, 37,8% e 0%, respectivamente, nas controles. Ambos os SNPs foram associados à PCOS, sendo o genótipo polimórfico G/T+T/T do SNP G276T menos freqüente em mulheres com PCOS (p=0,010; Odds ratio: 2,992; 95% Intervalo de Confiança: 1,278-7,006) comparado a controles, enquanto que para o SNP T45G o genótipo selvagem mostrou-se mais freqüente em mulheres com PCOS (p=0,048). Na amostra estudada as freqüências dos SNPs foram similares às freqüências observadas em outras populações. Em relação aos polimorfismos da região promotora, para o SNP C11377G a freqüência genotípica foi de 52,2% para C/C, 36,2% para C/G e 11,6% para G/G em pacientes com PCOS, e em controles foi de 64,9% para C/C, 32,4 para C/G e 2,7% para G/G. A freqüência dos genótipos do SNP G11391A foi G/G 89%, G/A 9,6% e A/A 1,4% em mulheres com PCOS; e G/G 75,7%, G/A 24,3% e A/A 0% em mulheres sem a síndrome. Foram consideradas alterações polimórficas a presença de genótipos C/G+G/G para o SNP C11377G e o genótipo C/C como ausência de polimorfismo. Para o SNP G11391A considerou-se G/A+A/A a presença de polimorfismo e G/G a ausência de alteração polimórfica. Todos os SNPs estão em equilíbrio de Hardy-Weinberg. Os SNPs da região promotora do gene da adiponectina não mostraram associação com a PCOS, e não houve diferença estatisticamente significativa entre os genótipos nas variáveis clínicas, antropométricas, metabólicas e hormonais em ambos os grupos. Para o estudo 2, foi utilizada uma linhagem de camundongos obesos Neo-Zelandeses (New Zealand Obese mouse ou NZO mouse), modelo poligênico de obesidade, RI e hiperinsulinemia. As fêmeas apresentam também fertilidade reduzida. Por apresentarem características similares às observadas em pacientes com PCOS, estabeleceu-se a hipótese que estes camundongos poderiam ser um modelo promissor para o estudo da síndrome, que pudesse expressar tanto as características reprodutivas quanto metabólicas da PCOS. Os objetivos deste estudo foram caracterizar as alterações metabólicas relacionadas com resistência insulínica, os aspectos morfológicos da estrutura ovariana e os níveis de hormônios reprodutivos em fêmeas de camundongos obesos, em três diferentes etapas da vida: jovens, adultos e de meia idade, e em animais controles. As fêmeas de camundongos foram pesadas e submetidas ao teste de tolerância à insulina, e à coleta de sangue para dosagens hormonais. Os ovários foram removidos para a análise histológica. Como esperado, as fêmeas NZO apresentaram maior peso corporal (p=0,001), aumento dos níveis de glicose (p=0,007) e insulina (p=0,001) basais, bem como RI, comparado a controles. Nas NZO observou-se também um aumento no volume ovariano, menor número de corpus lúteos e número mais elevados de folículos totais (p=0,0001), representados principalmente por folículos atrésicos (p=0,03), e associados com níveis diminuídos de LH e aumentados de Estradiol, em relação as controle. Concluímos que fêmeas de camundongos obesos apresentaram ambas as características, ovariana e metabólica da PCOS humana, sugerindo ser um modelo adequado na investigação de mecanismos patofisiológicos ligados a alterações metabólicas com anormalidades reprodutivas.
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. It is characterized by many clinic manifestations, including insulin resistance (IR). Adiponectin is associated to insulin sensitivity and adiponectin polymorphisms might be related to pathophysiological aspects of IR in PCOS. In study 1, we aimed to verify the association between Single Nucleotide Polymorphisms (SNPs) of the adiponectin gene (SNPs G276T, T45G, C11377G and G11391A) and the body composition, obesity-associated comorbities and the hormonal and clinical profile, in 80 women with PCOS and 37 controls from south of Brazil. Genotypic analyses were evaluated by Conventional PCR and Cleavage for the G276T and T45G polimorphisms and Real Time PCR for the SNPs C11377G and G11391A. PCOS patients were younger than controls (21.30 ± 6.01 and 29.86 ± 5.15 years old, p=0.0001). Systolic and diastolic blood pressure (p<0.03), Ferriman score for hirsutism (p=0.0001) and waist/hip ratio (p=0.002) were higher in PCOS group as well as TG, CT and LDLc compared to control group (p<0.02). Fasting insulin levels, HOMA-IR index, testosterone concentrations and FAI were also significantly greater in PCOS women, but SHBG concentration was lower (p=0.0001). Genotype frequency for SNP G276T in women with PCOS was 52.6% G/G, 33.3% G/T, 14.1% T/T and for controls was 27% G/G, 62.2% G/T, 10.8% T/T. In SNP T45G the frequency for genotypes T/T, T/G and G/G was 79.5%, 17.9% and 2.6%, respectively, in PCOS women, and 62.2%, 37.8% e 0%, respectively, in controls. Both SNPs G276T and T45G were associated to PCOS, being less frequent in this group compared to controls (p=0.010 and p=0.048, respectively). Our study showed similar genotypic frequency distribution compared to other populations. For the SNP C11377G, genotypic frequency distribution was 52.2% for C/C, 36.2% for C/G and 11.6% for G/G in women with PCOS, and in controls it was 64.9% for C/C, 32.4 for C/G and 2.7% for G/G. Genotypic frequency distribution of SNP G11391A was G/G 89%, G/A 9.6% and A/A 1.4% in women with PCOS; and G/G 75.7%, G/A 24.3% and A/A 0% in healthy women. Polymorphisms were in Hardy-Weinberg equilibrium. SNPs C11377G and G11391A of the adiponectin gene were not associated to PCOS or other clinical, anthropometric, metabolic and hormonal variables in both groups. In the study 2, we studied New Zealand Obese (NZO) mice, a polygenic model of obesity, IR and hyperinsulinemia. Importantly NZO mice are poor breeders; Since they display similar metabolic features of human PCOS we hypothesized they might be a suitable model to study PCOS further. The aim of this study was to assess sex hormone levels and ovarian structure in female NZO and lean C57BL/6J control mice in three different ages: young, adult and middle age. Twenty-five NZO and twenty female control mice at three different ages (young, adult and aged) were studied. The animals were weighed, an insulin tolerance test (ITT) was carried out and the blood was collected for hormonal level measurement. The ovaries were removed for histological analysis. As expected, NZO mice presented higher BW (p=0.001), increased basal plasma glucose (p=0.007) and insulin levels (p=0.001), as well as insulin resistance compared with control mice. NZO mice showed an increased ovarian volume, reduced numbers of corpora lutea, higher total follicles numbers (p=0.0001), but an increased amount of atretic follicles (p=0.03) associated with reduced plasma luteinising hormone levels and increased estradiol levels. In conclusion, NZO mice presented both the ovarian and metabolic features of human PCOS suggesting that they are suitable for investigating pathophysiological mechanisms linking metabolic alterations with reproductive defects.

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Williams, Sophie. "The impact of Polycystic Ovary Syndrome (PCOS) on quality of life : exploration, measurement and intervention." Thesis, University of Derby, 2016. http://hdl.handle.net/10545/620535.

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Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders amongst women, estimated to affect one out of 10 women. Symptoms include infertility, obesity, alopecia, acne, hirsutism and menstrual irregularities. Women with the syndrome are also more likely to experience co-morbid physical and psychological conditions such as diabetes, heart disease, endometrial cancer and also depression and anxiety. PCOS has also been found to have a negative impact on quality of life. This thesis aimed to further understanding, and improve quality of life of women with PCOS in the UK. To achieve this, the thesis aimed to investigate and identify how women with PCOS in the UK perceive and define their quality of life and to further understanding of the day-to-day experience of living with PCOS. Moreover, in order to measure quality of life, it aimed to develop and validate a UK disease-specific quality of life measure for women with PCOS. It also aimed to identify, develop and test a pilot intervention to increase quality of life in women with PCOS. To achieve these aims a mixed-methods approach was taken employing a variety of data generation and collection methods including: photovoice, online Skype™ interviews; LimeSurvey and Qualtrics. The findings of this thesis emphasise that PCOS has a negative impact on quality of life; encompassing psychological, social, environmental, and physical domains of quality of life. Women with PCOS who experienced the symptoms of infertility, hirsutism, weight, alopecia, skin discolouration, skin tags and mood swings had significantly lower scores of overall quality of life than those women who did not experience the symptoms. In addition, those women with PCOS who had a diagnosis of anxiety and/or depression had reduced quality of life. The dissemination of these findings will enable health care professionals to better understand the experience of living with PCOS and its impact on quality of life. Moreover, this thesis identifies many areas for future research which will enable a better understanding of the impact of PCOS on quality of life. Finally, this thesis makes recommendations for clinical practice which include improvement of support from health care professionals for women with PCOS in order to help them better manage their symptoms, and therefore improve their overall quality of life.

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Ding, Tao. "Epidemiological investigation and economic analysis of Polycystic Ovary Syndrome (PCOS) for women in the UK." Thesis, University College London (University of London), 2018. http://discovery.ucl.ac.uk/10045238/.

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BACKGROUND: Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting millions of women worldwide. The pathophysiology of this condition is unclear but is believed to be caused by some genetic and environmental factors. PCOS is associated with a range of reproductive, metabolic and dermatological disorders and therefore, the economic burden of this condition can be potentially significant for the public health system in the UK. METHODS: The methodology used for this research includes several parts. Firstly, I conducted literature reviews to identify studies reporting the prevalence of PCOS and morbidities associated PCOS. The Bayesian hierarchical model was then applied to model data from the published studies. This forms the rst part of this research for which the analysis was based on aggregate data. In the second part, I investigated the incidence and prevalence of PCOS under the specific UK context using data from The Health Improvement Network (THIN), a primary care database with over 500 general practices contributing data each year. I then used a multi-state Markov model to simulate the population dynamics of PCOS and evaluated the associated economic burden of care as well as the quality of life for the entire population with this condition in the UK. RESULTS: The prevalence estimates from community studies are generally much higher compared with that from database studies. The prevalence of PCOS varies for different diagnostic criteria and across distinct ethnic groups. Women with PCOS are at higher risk of type 2 diabetes, obesity, cardiovascular diseases and pregnancy complications and are more likely to experience psychological disorders. The prevalence of PCOS in the UK is estimated to be approximately 2% based on the primary care data, with an annual incidence rate of 2 per 1000 person-year. There is wide variation in the prescriptions initiated for the PCOS patients. The prevalence of type 2 diabetes in the PCOS population is estimated to increase to approximately 26% in the next 25 years in the UK, which significantly reduces the quality of life for individual patients and incurs massive amount of healthcare-related costs for the National Health Service (NHS). CONCLUSIONS: The large gap between the prevalence rates estimated from community and database studies suggests that PCOS is a condition without much public awareness and under-reporting is often observed. The differences in prevalence rates estimated according to different diagnostic criteria indicates the potential issue of under- and over-diagnosis of the condition at present. The ethnic variation in terms of the diagnostic criteria, disease monitoring and management may need to be considered carefully. The prescribing patterns of PCOS in the primary care suggest that currently, there is lack of most effective treatment for this condition and patients generally receive treatments tailored to their external symptoms. The prevalence of type 2 diabetes among PCOS patients is estimated to be high, resulting in massive amount of healthcare costs and reduced quality of life for PCOS population in the UK. Early screening is likely to help reduce the adverse outcomes associated with PCOS for this selected population and it may be cost effective to include them in the current Diabetes Prevention Programme. This may help improve the detection of symptoms indicative of diabetes in PCOS patients to allow early interventions and save significant amount of healthcare costs for the NHS from the country perspective.

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Nilsson, Hedvig, and Nikolina Trlin. "Symtomen som begränsar livet : Kvinnors upplevelser och erfarenheter av att leva med polycystiskt ovarialsyndrom (PCOS)." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-41316.

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Polycystic ovary syndrome (PCOS) is a chronic condition that affects 6-18 % of all fertile women, PCOS manifests itself through various clinical symptoms, such as hirsutism and obesity. It is also a contributing factor to irregular menstrual cycles, which has an impact on life and future pregnancies. The aim of the literature study was to describe the experiences of women living with PCOS. A systematic literature review was conducted, which resulted in the selection of ten scientific articles. The result of the study is based on three categories: The women’s self-image, the women’s physical and mental well-being and the women’s experience of support. The results of the literature study describe the way the women perceived themselves based on clinical symptoms such as hirsutism and obesity. The experience of the symptoms, the reduced fertility and the constant comparisons made with other women were based on society’s norms. This later on had an emotional impact on women´s physical and mental well-being. In conclusion the women found support through support groups, family members and information online. However, the women perceived a lack of support from healthcare professionals. If healthcare professionals can gain a greater understanding of how women with PCOS experience their symptoms, they can in this way contribute to more person-centred care.
Polycystiskt ovarialsyndrom (PCOS) är ett kroniskt syndrom som drabbar 6-18 % av alla fertila kvinnor. PCOS visar sig genom olika kliniska symtom, såsom hirsutism, övervikt och är en bidragande faktor till oregelbundna menstruationer, vilket kan påverka livet samt bidra till svårigheterna att bli gravid. Litteraturstudiens syfte var att beskriva kvinnors upplevelser och erfarenheter av att leva med PCOS. En systematisk litteratursökning genomfördes vilket resulterade i tio utvalda vetenskapliga artiklar. I resultatet framkom tre kategorier: Kvinnornas självbild, Kvinnornas fysiska och psykiska mående och Kvinnornas upplevelse av stöd. Kategorierna beskriver hur kvinnorna såg på sig själva utifrån hirsutism, övervikt och andra kliniska symtom. Kvinnorna beskrev upplevelsen kring symtomen, infertiliteten samt de ständiga jämförelserna kvinnorna gjorde med andra kvinnor utifrån samhällets normer. Den emotionella upplevelsen bidrog till en fysiskt och psykisk påfrestning på kvinnornas mående. Sammanfattningsvis fann kvinnorna stöd genom bland annat stödgrupper, familj och information på internet, däremot upplevde de brist på stöd från hälso- och sjukvårdspersonal. Genom denna litteraturstudie kan hälso- och sjukvårdspersonal få en ökad förståelse över vad kvinnor med PCOS upplever gällande sina symtom och på detta sätt bidra till en mer personcentrerad omvårdnad.

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SHREYA. "PREDICTION OF EPITOPE BASED VACCINE CANDIDATES FOR PERIODONTAL DISEASE." Thesis, DELHI TECHNOLOGICAL UNIVERSITY, 2021. http://dspace.dtu.ac.in:8080/jspui/handle/repository/18421.

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Periodontal disease is a multifactorial dental complication that has an impact on the supporting tooth structures like the gingiva, cementum and alveolar bone. Various studies conclude PD is associated with several systemic diseases like cardiovascular, neuronal, autoimmune, and respiratory. It is seen that periodontal disease is also allied with PCOS, infertility, age, obesity, adverse pregnancy outcomes, erectile dysfunction, and diabetes. The individuals suffering from PD are more likely to have dental caries. The initiation is due to dysbiosis of commensal microbes present in the oral cavity releasing a large extent of proinflammatory cytokines including IL-6, TNF-α, and IL-1. The preliminary stage is reversible gingivitis and if proper treatment of gingivitis is not done then it can progress to periodontitis which can lead to alveolar bone loss and is irreversible. There are approximately 700 different bacterial species associated with periodontal disease. This disease immensely affects the daily activities of organisms. There are several risk factors allied with periodontal diseases such as poor oral hygiene, medical diseases, smoking, age, blood group, obesity, orthodontic treatments, heredity, and stress. Several periodontal therapies have been shown to improve the status of PD in individuals. A functionally active vaccine is required for this disease. The proposed study aims to identify vaccine candidates from multiple different species of pathogens involved with periodontal disease. 20 peptides were screened for epitope prediction based on various physicochemical criteria like antigenicity, dependency of the pathogen on the virulence factor. Comprehensive analysis of these antigens revealed that they have several potential B and T-Cell epitopes. 3 epitopes NYFKSQVIFQRLPEI, ASRRLYRGYEALFVP, ELEKAIEMEDLALNP exhibited more than 90% population coverage in the both Indian and Global context. Therefore, this analysis suggests that the predicted epitopes might be suitable vaccine candidates and can be used for further in vivo and in-vitro studies.

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McCook, Judy G., Stacey Williams, Beth Bailey, Sheeba Anand, and Nancy Reame. "Differential Contributions of the Reproductive and Metabolic Features of Polycystic Ovary Syndrome (PCOS) to Psychological Symptoms." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/7183.

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Objective: Although women with PCOS have elevated levels of psychological distress, findings regarding which aspects of PCOS contribute to psychological symptoms are inconsistent. The purpose of this study was to investigate the independent and differential contributions of the previously identified key PCOS manifestations (infertility, hirsutism, obesity, menstrual problems) to multiple psychological symptoms. Methods: Participants were 126 endocrinology patient volunteers diagnosed with PCOS who completed a cross-sectional study of key manifestations of PCOS (including the PCOSQ) and psychological symptoms (BSI). Results: Participants had significantly elevated scores on all nine BSI subscales of psychological symptoms. Menstrual problems were significantly associated with all symptom subscales as well as the global indicator, while hirsutism and obesity were significantly related to five or more subscales. Neither infertility status nor infertility concerns significantly predicted any of the psychological symptoms. After controlling for demographic factors, menstrual problems remained the strongest predictor of psychological symptoms. Conclusions: Findings suggest that for women with PCOS, the features of excess body hair, obesity and menstrual abnormalities are especially troubling and carry unique risks for serious adverse psychologic symptoms including depression, anxiety, somatization and interpersonal sensitivity. Specific manifestations of PCOS were differentially related to psychological symptoms suggesting that the predictive value of PCOS for depression and other mental health problems may vary according to the specific symptoms experienced. Menstrual problems may be the most salient of these features and deserve particular attention as a marker for psychological risk among women with PCOS.

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McCook, Judy G., Stacey Williams, Beth Bailey, Sheeba Anand, Nancy Reame, and Samuel Thatcher. "Differential Contributions of the Reproductive and Metabolic Features of Polycystic Ovary Syndrome (PCOS) to Psychological Symptoms." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/7184.

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Objective: Although women with PCOS have elevated levels of psychological distress, findings regarding which aspects of PCOS contribute to psychological symptoms are inconsistent. The purpose of this study was to investigate the independent and differential contributions of the previously identified key PCOS manifestations (infertility, hirsutism, obesity, menstrual problems) to multiple psychological symptoms. Methods: Participants were 126 endocrinology patient volunteers diagnosed with PCOS who completed a cross-sectional study of key manifestations of PCOS (including the PCOSQ) and psychological symptoms (BSI). Results: Participants had significantly elevated scores on all nine BSI subscales of psychological symptoms. Menstrual problems were significantly associated with all symptom subscales as well as the global indicator, while hirsutism and obesity were significantly related to five or more subscales. Neither infertility status nor infertility concerns significantly predicted any of the psychological symptoms. After controlling for demographic factors, menstrual problems remained the strongest predictor of psychological symptoms. Conclusions: Findings suggest that for women with PCOS, the features of excess body hair, obesity and menstrual abnormalities are especially troubling and carry unique risks for serious adverse psychologic symptoms including depression, anxiety, somatization and interpersonal sensitivity. Specific manifestations of PCOS were differentially related to psychological symptoms suggesting that the predictive value of PCOS for depression and other mental health problems may vary according to the specific symptoms experienced. Menstrual problems may be the most salient of these features and deserve particular attention as a marker for psychological risk among women with PCOS.

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Hamilton, Angela M. "The Relationship of Food Insecurity to Health Parameters in Adult Women with Polycystic Ovary Syndrome (PCOS)." Ohio University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1417013554.

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22

Mimouni, Nour El Houda. "Elevated prenatal anti-Müllerian hormone reprograms the fetus and induces polycystic ovary syndrome (PCOS) in adulthood." Thesis, Lille, 2019. http://www.theses.fr/2019LILUS051.

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Le syndrome des ovaires polykystiques (SOPK) est la principale cause d’infertilité feminine à travers le monde, associé à un risqué élevé de comorbidités avec des conséquences économiques non négligeables. Ce syndrome est caractérisé par une oligo-anovulation, une hyperandrogénie, et un aspect échographique d’ovaires polykystiques. De plus, la plupart des femmes atteintes de SOPK présentent des concentrations élevées de LH suggérant une libération accrue de GnRH. De plus, les patientes SOPK ont habituellement des concentrations en Hormone Anti Müllerienne (AMH) 2 à 3 fois plus élevés que les femmes non atteintes.Alors que l’origine exacte du SOPK demeure inconnue, des études de clustering familial et portant sur des jumeaux ou des ascendants de femmes atteintes du SOPK ont mis en évidence une forte composante héréditaire. Cependant, les gènes candidats identifiés n’expliquent qu’à peine 10% des cas de SOPK suggérant qu’une origine développementale et que des facteurs environnementaux tels que des modifications hormonales durant la vie foetale pourrait être à l’origine du SOPK.Dans cette étude, nous avons d'abord comparé les concentrations d'AMH dans un groupe de femmes atteintes de SOPK et chez des femmes témoins pendant la grossesse. Les concentrations d’AMH se sont révélées significativement plus élevées chez les SOPK par rapport aux témoins. Nous avons ensuite utilisé ces résultats cliniques pour développer un modèle animal murin de SOPK en exposant les souris gestantes à une concentration élevée d’AMH au cours d'une fenêtre temporelle spécifique. Nous avons montré que cette exposition foetale conduisait à une cascade d'altérations affectant le cerveau maternel, les ovaires et le placenta, entrainant une reprogrammation du cerveau foetal et induisant l'acquisition des principaux critères diagnostiques retrouvés dans le SOPK, à savoir l'hyperandrogénie, l'augmentation de la pulsalitié de la LH et de l'oligo-anovulation, ainsi qu’une augmentation persistante de l'activité électrique de la GnRH à l'âge adulte. De plus, nos résultats montrent que les conséquences à long terme d'une exposition courte à des niveaux élevés d'AMH pendant la gestation s'étendent au-delà de la première génération exposée et que les manifestations de type SOPK semblent être transmises d’une génération à l’autre chez les femelles.De manière intéressante, en utilisant une approche pharmacologique, nous avons démontré que l’inhibition partielle de la voie de signalisation de la GnRH permettait de restaurer chez les animaux SOPK un phénotype neuroendocrinien normal, en rétablissant des concentrations hormonales normales, la cyclicité oestrale et leur morphologie ovarienne.Enfin, nous avons cherché à comprendre comment une exposition précoce à un excès d'AMH affecterait les caractéristiques neuroendocriennes et reproductives de la progéniture mâle. Ici, nous avons démontré que le traitement par AMH en période prénatale modifiait la fonction de l'axe hypothalamo-hypophyso-gonadique (HPG) chez les mâles, qui ne parviennent pas à engager le pic de testostérone néonatal normalement observé chez les nouveau-nés mâles témoins, conduisant à une féminisation des circuits sexuellement dimorphiques cérébraux, à une augmentation de la LH, et finalement à une diminution drastique des niveaux de testostérone à l’âge adulte, à des altérations sévères de la stéroïdogenèse et de la spermatogenèse ainsi qu'à un risque plus élevé de développer une cryptorchidie à l'âge adulte. Ainsi, il pourrait être intéressant de relier les résultats de cette étude au phénotype reproductif des garçons de femmes atteintes du SOPK, qui ont été exposés pendant la grossesse mais qui ne sont habituellement pas suivis plus tard à l'âge adulte [...]
Polycystic ovary syndrome (PCOS) is the main cause of female infertility worldwide with high comorbidity and economic burden. It is mainly characterized by hyperandrogenism, oligo/anovulation and polycystic appearing ovaries. Moreover, most women with PCOS exhibit higher levels of circulating luteinizing hormone (LH), suggestive of heightened gonadotropin-releasing hormone (GnRH) release. Additionally, PCOS patients also exhibit 2-3x higher levels of Anti-Müllerian Hormone (AMH) as compared to healthy controls.While the exact origin of PCOS is unknown, familiar clustering and twin studies of PCOS patients and their relatives suggest a strong heritable component in PCOS. However, the candidate genes identified account for only <10% of the estimated 70% heritability of PCOS, implying that it may originate during intrauterine development and that environmental factors, such as hormonal imbalances during fetal life, could be involved in the onset of PCOS.In this study, we first measured AMH levels in a cohort of pregnant women with PCOS and control women which revealed that AMH is significantly more elevated in the former group versus the latter, we then modelized our clinical findings by exposing pregnant mice to high concentration of AMH during a specific temporal window and showed that this fetal exposure leads to a cascade of alterations impacting the maternal brain, the ovaries, and the placenta, which consequently reprogram the fetal brain and induce the acquisition of the major PCOS cardinal neuroendocrine reproductive features, namely hyperandrogenism, elevation in LH pulse frequency and oligo-anovulation, and a persistent rise in the GnRH neuronal firing activity in adulthood. Moreover, our results show that the long-term consequences of a short exposure to elevated AMH levels during gestation expand beyond the first generation exposed and that PCOS-like manifestations seem to be transmitted across subsequent generations of females.Intrestingly, using a pharmacological approach, we demonstrate that tempering GnRH signaling pathway rescues the neuroendocrine phenotype of PCOS-like animals, restoring their normal hormonal levels, estrus cyclicity and ovarian morphology.Lastly, we sought to understand how early exposure to AMH excess would affect the neuroendocrine and reproductive features of the male offspring. Here, we demonstrate that prenatal AMH treatment profoundly impacts the Hypothalamic-Pituitary-Gonadal (HPG) axis function in males, which fail to engage the testosterone surge at birth observed in control newborns, leading to a feminization of sexually dimorphic circuitries of their brains, an increase in LH, a drastic decrease in testosterone levels, severe alterations in the testicular steroidogenesis and morphology as well as a higher risk of developing cryptorchidism in adulthood. Thus, it could be of clinical interest to relate findings from this study to the reproductive phenotype of sons of PCOS women, who are exposed during gestation but not systematically investigated in adulthood.Collectively, our results challenge the concept of PCOS originating in utero and appear to consolidate the role of AMH as a trigger of the pathogenesis, suggesting that an altered hormonal milieu during early life associated with PCOS may not only affect the female fetus but also the male fetus exposed and that these alterations could be transmitted across multiple generations.These findings point to PAMH mouse model as an excellent preclinical tool to investigate both neuroendocrine disturbances of PCOS and how developmental programming effects are transmitted, while offering a therapeutic avenue for the treatment of the disease

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Matsson, Janna. "Metformin mot infertilitet vid Polycystisk ovariesyndrom : Vilken plats bör metformin ha i behandlingen av smala kvinnor med PCOS som inte lyckas bli gravida?" Thesis, Umeå universitet, Farmakologi, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-122024.

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Tyndall, Victoria. "Androgens and the ovary." Thesis, University of Edinburgh, 2011. http://hdl.handle.net/1842/5591.

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Between 10-15% of women suffer from polycystic ovary syndrome (PCOS), making it the most common cause of female infertility. Clinical features of PCOS include high circulating levels of ovarian androgens (T and A4), anovulation and obesity. The aetiology of this reproductive endocrinopathy is likely to be multifactorial, through the interplay of genetics, epigenetics and environmental factors. Primate research into sexual behaviour development noted that fetally androgenised monkeys developed symptoms like those of PCOS. There are now multiple animal models of PCOS using primates, sheep, rats and transgenic mice. The investigations described in this thesis use rodent models to examine the role of androgens in the pathogenesis of female infertility. An attempt to generate a granulosa cell specific androgen receptor knockout mouse model will first be described, followed by several studies into the developmental programming of female Wistar rat infertility and metabolism by steroid hormones. Initial investigations showed that testosterone proprionate (TP) administered to female rats during different windows of fetal and neonatal life alters the reproductive and metabolic axes of the adult animals. Fetal plus neonatal TP exposure led to complete ovarian dysgenesis, while postnatal exposure produced a PCOS-like phenotype. Animals which received TP postnatally were heavier and had an increased proportion of primordial follicles in their ovaries by postnatal day (pnd) 90 of life. Evaluation of this PCOS model showed that neonatally androgenised rats had ovarian follicles with larger antra and a greater ovarian stromal compartment. In addition, these animals were heavier when compared to controls. However, unlike human studies, neonatally androgenised rats showed no differences in circulating gonadotrophin or ovarian androgen levels. Nor did they show any programming effect of neonatal TP upon the theca interna by pnd 90. Further investigations to narrow the windows and dose of TP required to produce a PCOS phenotype showed that TP administered in an early window of neonatal life, between postnatal days (pnd) 1-6 not only led to anovulation, but potentially reprogrammed the hypothalamic-pituitary axis, as there was minimal gonadotrophin response to reduced ovarian negative feedback (inhibin B and estradiol) in these rats. Neonatal TP also affected the rat metabolic axis with adult animals becoming heavier after weaning without any change in food intake. Animals developed mesenteric and retroperitoneal obesity along with insulin resistance (IR). Increased hepatic glucocorticoid turnover and altered adipokine expression were also noted in neonatally androgenised females, possibly contributing to the pathogenesis of obesity. No effect of TP dose upon the severity of infertility or metabolic abnormalities in adult animals was observed. To delineate which features of the rat PCOS model resulted from androgenic, estrogenic or corticosteroid action, a final study used administration of different steroids during the early window of postnatal life: TP, estradiol valerate (EV), dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA) and dexamethasone (DEX). The anovulatory PCO-like phenotype observed with TP was also seen in animals which received EV, but not those which received DHT, DHEA or DEX. TP and EV treatment also resulted in a reduction of ovarian follicle numbers and activated follicle proportions, with an increase in primordial follicle proportions. Although glucose tolerant, animals treated with TP and EV were highly IR. Unlike dexamethasone, DHT and DHEA also produced IR in adult animals, to a lesser extent than TP and EV. Taken collectively, the results described in this thesis demonstrate that the PCOS-like phenotype observed in the neonatally androgenised female rat is likely to be due to the estrogenic actions of testosterone, potentially through as yet unknown epigenetic mechanisms. The programming of the metabolic components described may additionally be due to the actions of androgens. Furthermore, these studies demonstrate a novel estrogenic effect of neonatal steroids upon primordial follicle populations and show that the neonatally androgenised rat may be a rational PCOS model in a poly-ovulatory species.

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Hogg, Kirsten. "Novel approaches to the development and assessment of an ovine model of polycystic ovary syndrome." Thesis, University of Edinburgh, 2011. http://hdl.handle.net/1842/5916.

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Polycystic ovary syndrome (PCOS) is a common reproductive, endocrine and metabolic disorder present in women of reproductive age. Despite the widespread prevalence and heritability of PCOS, the heterogeneous and polygenic traits have made the successful identification of candidate genes difficult. Animal models have been developed on the premise that early exposure to sex steroids can programme epigenetic changes that predispose the fetus to the adult features of PCOS. Past research has modelled ovarian dysfunction, endocrine abnormalities and metabolic perturbances in rodent, non-human primate and sheep PCOS models, through the enhanced neonatal or prenatal exposure to the male sex hormone, testosterone. The modelling of PCOS in a large domestic species such as the sheep is advantageous due to similar biological reproductive function as the human. In this regard the sheep has been extensively used to model PCOS by the treatment of pregnant ewes from early to midgestation with androgens such as testosterone propionate (TP). These experiments have demonstrated the fetal programming effects of androgens on offspring that go on to develop PCOS-like characteristics in adulthood. One of the caveats of assessing steroid effects in this way is the effect of the placenta in mediating the transfer of these hormones. TP is an aromatisable androgen and thus some of its effects in the fetus may be attributable to placental by-products such as estrogens. This thesis describes the development and assessment of a novel model of prenatal androgenisation. Two models were compared: the indirect maternal exposure to TP (the current model) and the direct fetal injection of TP. In directly treating the fetus this allowed control over the dose of TP administered and avoidance of secondary effects that androgens may exert in the mother that could be transferred to the fetus. For the maternal model, pregnant Scottish Greyface ewes were administered TP twice weekly from day (d)62-102 of a 147 day gestation. For the fetal model, fetuses were injected twice while the ewe was anaesthetised with graded doses of TP during the same period of treatment as the maternal model. The effects of prenatal androgenisation were assessed in the female fetus shortly after treatment and also in young adult sheep. Fetal ovarian and adrenal steroidogenic gene expression was monitored and found to be altered in response to elevated levels of sex steroids. At d90 the morphology of the developing ovary was not changed by prenatal androgens. In the adult a detailed ovarian and endocrine assessment was undertaken, by examination of ovarian morphology, hormone levels, ovulatory cycles, hypothalamic pituitary ovarian function and follicle steroidogenesis, during the first breeding season. In addition, the metabolic effects of prenatal androgens were monitored by measuring body fat, insulin and glucose homeostasis and liver function. Neither maternal nor fetal prenatal androgenisation during mid-gestation resulted in a perturbed hormonal milieu or polycystic ovaries in young adults. These treatments did however programme a clear ovarian phenotype demonstrated by the increased capacity of follicles to secrete androgens, independently of an abnormal endocrine environment and disordered folliculogenesis. Furthermore, animals that were exposed maternally to TP developed fatty liver and had increased insulin secretion in response to glucose load. A major outcome of this study was the finding that the fetally injected control animals were phenotypically different than the maternal control animals. In fact, some of the reproductive and metabolic features of maternal TP exposure were found in the fetal control group. This unexpected finding has raised the possibility that it is the fetal exposure to stress, that is secondary to elevated maternal androgens, rather than androgens per se that is responsible for at least some of the multitude of anomalies encountered in PCOS.

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Caldwell, Aimee Sarah Lee. "Unravelling The Role Of Androgens In Polycystic Ovary Syndrome." Thesis, The University of Sydney, 2017. http://hdl.handle.net/2123/18129.

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Polycystic Ovary Syndrome (PCOS) is a multifaceted hormonal disorder which affects 5-15% of reproductive-aged women worldwide. While classically recognised as an ovarian disorder, PCOS is associated with a variety of reproductive, endocrine and metabolic features including ovulatory dysfunction, infertility, hyperandrogenism, obesity, and an increased risk of type 2 diabetes mellitus and cardiovascular disease. The most consistently present of these is hyperandrogenism – supraphysiological levels of androgens such as testosterone (T) and dihydrotestosterone (DHT). Typically thought of as male steroid hormones, androgens have been shown to play important role in the maintenance of normal female reproductive function. Despite the high prevalence of hyperandrogenism amongst patients, the role of androgens in the etiology and pathogenesis of PCOS has yet to be determined. The aim of this work was to unravel the association between excess androgen exposure and the development and advancement of the PCOS phenotype in mouse model of androgen-induced PCOS. The first study contained within this work (Chapter Three) provides the first comprehensive characterization of a range of reproductive, endocrine and metabolic traits associated with PCOS in four distinct mouse models: a model of prenatal androgenisation utilising the potent non-aromatizable androgen DHT administered during days 16-18 of gestation, and three diverse models of postnatal androgen exposure employing a long-term treatment with either DHT, the proandrogen dehydroepiandrosterone (DHEA), or letrozole (an aromatase inhibitor) for 90 days beginning at 3 weeks of age. Prenatal androgenisation produced some reproductive and endocrine traits, but failed to induce the metabolic abnormalities seen in PCOS. DHEA treatment did not reproduce any features associated with PCOS while treatment with letrozole produced few PCOS-like characteristics and some aberrant changes not typical of the syndrome. Additionally, letrozole treatment did not reproduce any metabolic attributes of PCOS. On the other hand, postnatal exposure to excess androgen, by way of DHT treatment, produced a breadth of reproductive, endocrine and metabolic traits that mimic those seen in human PCOS. This study revealed that a treatment regime of long-term postnatal exposure to DHT reproduced the strongest PCOS-like phenotype in our mice and provides a robust animal model in which to study the pathogenesis of PCOS. The second study (Chapter Four) aimed to explore the involvement of genomic androgen receptor (AR)-mediated actions in the development of these PCOS traits. As a prenatally androgenised mouse model of PCOS had previously been reported to exhibit impaired neuroendocrine hypothalamic feedback of the hypothalamic-pituitary-gonadal (HPG) axis, we took this opportunity to utilise mice from our own prenatal model to investigate the neuroendocrine regulation of the HPG axis in PCOS in addition to the effects of AR inactivation on the PCOS phenotype. PCOS was induced in wild-type (WT) and androgen receptor knockout (ARKO) mice using DHT administered on days 16-18 of gestation. A subset of these mice were also exposed to 17β-estradiol for 7 days prior to collection, via a subdermal implant, to investigate the impaired estradiol negative feedback on the hypothalamus. WT mice with DHT-induced PCOS displayed several reproductive abnormalities including aberrant cycling and ovulatory dysfunction in addition to adipocyte hypertrophy and hepatic steatosis. However, diestrus serum luteinising hormone and follicle stimulating hormone, and estradiol-induced negative feedback as well as hypothalamic expression of several neuropeptides were unaffected by DHT treatment in WT mice. Mice both homozygous and heterozygous for the global inactivation of the AR (ARKO), did not display any PCOS traits when exposed to excess androgens during prenatal life. This study showed the importance of AR signalling in the development of PCOS and revealed that even AR haplosufficiency is adequate to prevent induction of PCOS by prenatal hyperandrogenism. Finally, the third study (Chapter Five) aimed to shed further light on the AR-mediated androgen actions in PCOS with a focus on identifying the tissue-specific targets of these actions. Employing our postnatal model of PCOS induction, this study investigates the effects of: 1) global loss of AR signalling (ARKO), 2) neuronal knockout (NeurARKO) and 3) granulosa cell-specific AR inactivation (GCARKO) on the development of the PCOS phenotype induced by exposure to exogenous DHT. As in our prenatal model, ARKO mice were fully protected from all DHT-induced features of PCOS. Neuron-specific AR signaling was required for the development of a variety of reproductive and metabolic traits including classic polycystic ovaries, dysfunctional ovulation, obesity and dyslipidemia. In contrast, loss of AR signalling in granulosa cells did not impede the pathogenesis of PCOS-like features in GCARKO mice. To further examine the role of extra-ovarian AR signalling in PCOS, reciprocal ovary transplants were carried out in WT and ARKO mice. Results from ARKO hosts with transplanted WT ovaries revealed that excess androgen exposure requires functional extra-ovarian, and not intra-ovarian, AR signalling in order to produce features of PCOS. This study provides strong evidence that neuroendocrine genomic AR signaling is an important mediator in the development of PCOS. The studies contained within this thesis are the first to provide a comprehensive analysis of a mouse model of PCOS encompassing a breadth of reproductive, endocrine and metabolic features. This work has identified the optimal model in which to study this complex, multifactorial condition which affects a significant number of women worldwide. Additionally, our results have shown that the effects of androgens on the pathogenesis of PCOS are mediated via the androgen receptor in a dose-dependent manner such that two functional copies are required for DHT to reproduce features of PCOS in the mouse. Finally, in a crucial study to investigate the locus of androgen actions we have revealed the previously overlooked importance of extra-ovarian neuroendocrine androgen action in the origins and progression of PCOS, despite it being thought of primarily as an ovarian disorder. Overall, these studies have provided valuable insights into both the role of androgens in Polycystic Ovary Syndrome and potential new targets for the development of mechanism-based treatments of this disorder.

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Brotherton, Emily J. "Vascular and Haemorheological Responses following Acute Exercise in Lean and Active women with Polycystic Ovary Syndrome." Thesis, Griffith University, 2019. http://hdl.handle.net/10072/389734.

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Polycystic Ovary Syndrome (PCOS) is associated with an increased risk of cardiovascular disease (CVD), which is suggested to be largely due to vascular endothelial dysfunction. Endothelial dysfunction is typically represented as an impaired vasodilatory response to an appropriate shear stimulus which is dictated by the flow of blood and its components as well as vessel diameter. Notably, both vascular and haemorheological parameters have been well-documented to improve following long-term exercise in many disease states that share similar characteristics to PCOS. As such, high levels of cardiorespiratory fitness have been associated with healthy vascular function and blood characteristics in various populations. In contrast to long-term exercise, vascular and haemorheological responses to acute exercise would provide insight into the mechanisms that may stimulate beneficial long-term exercise-induced adaptions. Therefore, the current study aimed to examine the vascular and haemorheological responses in PCOS to two acute exercise bouts (moderate and heavy-intensity) compared to controls matched for cardiorespiratory fitness. The findings of the present study may provide an understanding to the influence of exercise training on vascular function and haemorheology in women with PCOS and whether prolonged adaptations or impairments to these variables are observed in this population. Methods: Endothelial function and haemorheological measurements were performed at baseline and following moderate and heavy-intensity exercise in eight women with PCOS (age: 26 ± 4 years) and ten controls (age: 28 ± 6 years), matched for BMI (23.8 ± 3.1; 21.2 ± 3.1 kg·m-2) and cardiorespiratory fitness (V̇O2max: 39.33 ± 6.07; 40.70 ± 5.74 mL·kg-1·min-1). Endothelial function was assessed by flow-mediated dilation (FMD), and normalised for the shear stimulus (FMD:SRAUC). FMD variables measured at baseline and following exercise were expressed as absolute and magnitude in change values. Haemorheology was assessed by measurement of blood viscosity (at native and standardised haematocrit), red blood cell (RBC) aggregation (at native and standardised haematocrit), plasma viscosity and RBC deformability. Cardiorespiratory fitness and metabolic, hormone and cardiovascular profiles were also assessed. Results: At baseline, there were no significant differences in FMD variables between groups, however RBC aggregation indices in both native and standardised haematocrit (p = 0.001) and plasma viscosity (p = 0.026) were elevated in PCOS women compared to controls. FMD and haemorheological parameters were not different between groups following moderate-intensity exercise (p > 0.05). Following heavy-intensity exercise, the baseline to post-exercise change in SRAUC (p = 0.04) and SR max (p = 0.009) were significantly greater in women with PCOS compared to controls. In contrast, women with PCOS demonstrated a significantly lower baseline to post exercise change in FMD:SRAUC (p = 0.021) following heavy-intensity exercise in comparison to controls. Conclusion: The findings of the present study demonstrated that at rest, women with PCOS exhibited preserved vascular function, however haemorheology (as demonstrated by elevations in RBC aggregation and plasma viscosity) was altered despite being young, healthy weight and fit. Furthermore, vascular reactivity was similar between groups following moderate-intensity exercise. In contrast, women with PCOS demonstrated an altered vasodilatory response in comparison to controls following heavy-intensity exercise. These findings provide new evidence that despite being young, lean and fit, women with PCOS exhibit altered baseline haemorheology parameters and an altered vasodilatory response to heavy-intensity exercise ─ factors that can further exacerbate endothelial dysfunction, potentially increasing the risk of CVD.
Thesis (Masters)
Master of Medical Research (MMedRes)
School of Medical Science
Griffith Health
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Fink, Sandra. "Outcome von Patientinnen mit Polyzystischem Ovar-Syndrom (PCOS) und Einfluss von Metformin im Rahmen der assistierten Reproduktion." Diss., lmu, 2008. http://nbn-resolving.de/urn:nbn:de:bvb:19-96759.

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Turandar, Jasmine. "Polycystisk ovarialsyndrom: Se kvinnan bakom diagnosen : En kvalitativ metasyntes." Thesis, Högskolan Dalarna, Sexuell, reproduktiv och perinatal hälsa, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:du-35647.

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Bakgrund: Polycystisk ovarialsyndrom (PCOS) är den vanligaste hormonella rubbningen hos fertila kvinnor, ändå är den okänd för många. Det finns ett flertal symtom där dessa varierar från kvinna till kvinna. Okunskap kring PCOSförekommer både i vården liksom i samhället och diagnosen kan därför vara svåratt upptäcka. Att leva med symtomen från PCOS kan påverka negativt både kroppsligt och psykiskt. Hur kvinnor med diagnosen upplever PCOS behöverlyftas fram och förståelsen för dem behöver ökas både inom vården liksom förkvinnorna med PCOS. Med ökad förståelse kan ett bättre bemötande och vård ges.Syfte: Syftet är att beskriva kvinnors upplevelser av att leva med Polycystiskovarialsyndrom. Metod: Kvalitativ metasyntes med metaetnografisk analysmetod.16 kvalitativa artiklar är inkluderade i resultatet och samtliga artiklar hargenomgått en kvalitetsgranskning. Tre databaser användes vid insamling av data; Cinahl, Medline och PubMed. Resultat: Resultatet lyfter fram att flertalet kvinnorfick diagnos efter en lång tid och där kvinnorna ibland behövde vara påstridiga,medan i andra fall diagnosticerades PCOS som bifynd. Vissa kvinnor kände inte till att deras symtom kunde vara något avvikande och sökte sig därför inte till vården. Information om PCOS från vården mötte inte alltid patienternas behov.Fertilitetsaspekten ansågs vara det som fokuserades mest på från vårdens sida ochatt de psykologiska aspekterna glömdes bort. Symtom som övervikt och hirsutism påverkade det sociala livet negativt och psykisk ohälsa är vanligt förekommande.Slutsats: PCOS behöver uppmärksammas mer och normaliseras. En mer holistiskvård där fokus inte enbart ligger på det medicinska aspekterna, utan även ser till individens behov av stöd och information hade gynnat bemötandet och vårdandet till kvinnor med PCOS.
Background: Polycystic ovary syndrome (PCOS) is the most common hormonal condition amongst fertile women, yet it is still unknown for many. There are several symptoms that may vary from woman to woman. Ignorance of polycystic ovary syndrome occurs in healthcare and in society and can be difficult to detect.Living with the symptoms of PCOS can have a negative effect both physically andmentally. How women with the diagnosis experience PCOS needs to be highlighted and the understanding of them needs to be increased, both inhealthcare and for the women with PCOS. With increased understanding, bettertreatment and care can be provided. Aim: The purpose was to describe women’sexperiences of living with Polycystic ovary syndrome. Method: Qualitative meta synthesis with meta ethnographic analysis method. A total of 16 articles wereincluded and all passed through a quality critique checklist. The articles werecollected from three databases: Cinahl, Medline and PubMed. Findings: It couldtake a long time for a diagnosis to be made and sometimes the women had to be persistent, while others could be diagnoses as an incidental finding. Some womendid not know that their symptoms were not normal and therefore did not seekmedical care. Information about PCOS from the health care did not always meetthe patient’s needs. The fertility aspect was thought to be the main focus from the health care providers and that the phycological aspects were forgotten. Symptoms like overweight and hirsutism affected the social life in a negative way and mental illness was common. Conclusion: Polycystic ovary syndrome needs to be brought more attention to and to be normalized. A more holistic care where not only the main focus is on the medical aspects of PCOS, but instead also sees that the individuals need for support and information can be met.

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Edelstein, Sascha. "Familial association of polycystic ovary syndrome (PCOS) in women attending the gynaecological endocrinology clinic at Groote Schuur Hospital." Master's thesis, University of Cape Town, 2010. http://hdl.handle.net/11427/10437.

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Includes bibliographical references (leaves 60-65).
Polycystic ovary syndrome (PCOS) is the commonest endocrinopathy in women of reproductive age, affecting 5-10% of women in the general population. Patients present with menstrual disturbances, infertility and clinical hyperandrogenism. While the pathophysiology is not completely delineated, a strong familial association has been demonstrated, suggesting a genetic component. From January 2007 until February 2009, a total of 83 probands were recruited from the Gynaecological Endocrinology Clinic (GEC) at GSH. These were all women with PCOS according to the Rotterdam criteria who presented for management at the GEC. With their consent, first degree female family members were contacted and 57 mothers, 108 sisters and 8 daughters agreed to participate in the study.

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Schulz, Hasmik [Verfasser]. "Asymmetrisches Dimethylarginin, inflammatorische und metabolische Parameter bei Frauen mit PCOS und deren Beeinflussung durch eine Metformintherapie / Hasmik Schulz." Lübeck : Zentrale Hochschulbibliothek Lübeck, 2010. http://d-nb.info/1008508934/34.

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Samino, Gené Sara. "Mass spectrometry and nuclear magnetic resonance based metabolomics applied to the study of polycystic ovary syndrome." Doctoral thesis, Universitat Rovira i Virgili, 2013. http://hdl.handle.net/10803/128209.

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Objectives: Three objectives of this thesis have been: (i) Mastering of the main analytical platforms used in metabolomics, (ii) Developing an untargeted metabolomic workflow, involving novel aspects of sample preparation, and data processing for metabolite identification, (iii) Implementing our untargeted metabolomic workflow to the study of human patients with Polycystic Ovary Syndrome (PCOS) and their response to drug treatment Results: In Work 1: Optimization metabolite extraction conditions for NMR analysis, followed by LC/ESI-MS by using the same sample extract with no need for solvent exchange or further pretreatment. In Work 2: Investigate the impact of different aspects of univariate statistical analysis on untargeted LC-MS based metabolomic experiments. In Work 3: Implementation of GC-MS untargeted metabolomic approach to provide new insights on the impact that obesity exerts on the metabolic derangements associated with PCOS. In Work 4: Implementation of multiplatform metabolomics approach based on NMR and LC-MS to provide new insights in PCOS disease in a cohort of young lean PCOS patients. In Work 5: Implementation of multiplatform metabolomics approach based on NMR, GC-MS and LC-MS to provide new insights on the action of drug polytherapy to PCOS disorder. Conclusion: Metabolomics can be consider as a powerful tool for the study of metabolic disorders. Furthermore, metabolite profiling has demonstrated feasibility and flexibility for revealing new mechanistic insights in metabolic disorders that are not been consider when classical analysis is used. Therefore, our metabolomic analysis have demonstrated a great potential as a useful diagnostic technique and can facilitate monitoring of both disease progression and effects of therapeutic treatment.
Objetivos: El presente trabajo tiene dos objetivos generalizables que han sido estudiados con más detalle en la presente tesis doctoral. El primero de ellos es mejorar aspectos metodológicos en el ámbito de la metabolómica y el segundo ha sido la aplicación de la metabolómica en el estudio del síndrome del ovario poliquístico (PCOS). Resultados: Del primer objetivo se han realizado dos trabajos: en el primero, la optimización de un método de extracción común para analizar muestras biológicas en dos plataformas analíticas complementarias utilizadas en metabolómica como son la resonancia magnética nuclear y la espectrometría de masas. Del segundo trabajo realizado se han obtenido unas pautas para abordar los retos que surgen del análisis de datos de metabolómica en espectrometría de masas. Del segundo objetivo también han sido realizados dos trabajos: en ambos se ha utilizado la metabolómica no dirigida para abordar el estudio del PCOS. En el primer trabajo, se ha utilizado la metabolómica para conocer el impacto que ejerce la obesidad en los trastornos metabólicos asociados al PCOS. En el segundo trabajo, se ha utilizado la metabolómica no dirigida para evaluar como afecta la aplicación de una politerapia con medicamentos al metabolismo de pacientes con PCOS. Conclusión: La metabolómica puede ser utilizada como una nueva herramienta para estudiar los trastornos metabólicos.

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Rehme, Marta Francis Benevides [UNESP]. "O hiperandrogenismo influencia no desenvolvimento de síndrome metabólica em pacientes com síndrome dos ovários policísticos?" Universidade Estadual Paulista (UNESP), 2009. http://hdl.handle.net/11449/106373.

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Made available in DSpace on 2014-06-11T19:35:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-08-20Bitstream added on 2014-06-13T19:24:59Z : No. of bitstreams: 1 rehme_mfb_dr_botfm.pdf: 2280081 bytes, checksum: b44989e75865f4acff4695729feffce0 (MD5)
A síndrome dos ovários policísticos (SOP) afeta 5 a 8% das mulheres no menacme e é caracterizada pela anovulação crônica e hiperandrogenismo. A obesidade central e a resistência insulínica (RI) são freqüentes na SOP e desempenham um papel fundamental na etiopatogenia da síndrome metabólica (SM). O hiperandrogenismo tem sido questionado como um fator importante no desenvolvimento da SM em mulheres com SOP. Verificar se o hiperandrogenismo influencia no desenvolvimento de síndrome metabólica em pacientes com SOP. Foram avaliados retrospectivamente os dados clínicos, bioquímicos e ultrassonográficos de 180 mulheres com SOP diagnosticadas pelos critérios de Rotterdam e de 70 mulheres com obesidade simples. As pacientes com SOP foram classificadas de acordo com o índice de massa corporal (IMC) em SOP não obesas e SOP obesas. As pacientes obesas simples não apresentaram hiperandrogenismo clínico nem bioquímico. O índice de sensibilidade à insulínica (ISI) foi avaliado pelo HOMA-IR e ISI de Matsuda e DeFronzo. A SM foi diagnosticada pelos critérios do NCEP-ATP III com modificações sugeridas pelo consenso de Rotterdam. A média de idade das pacientes foi de 27,3 + 4,7 no grupo das pacientes SOP não obesas; 28,8 + 5,0 nas SOP obesas e 27,4 + 5,2 nas obesas simples (p=0, 0773), e o IMC foi de 25,1+3,0 kg/m2; 37,0+ 5,5 kg/m2 e 36,0+ 4,2 kg/m2 respectivamente (p<0, 001). A prevalência de RI e SM não diferiu entre as pacientes obesas com e sem SOP e foi significativamente maior do que nas SOP não obesas (p<0, 001). Entretanto a prevalência de SM foi maior nas SOP obesas com hiperandrogenismo...
Polycystic ovary syndrome (PCOS) affects 5-8% of women at menacme and is characterized by chronic anovulation and hyperandrogenism. Central obesity and insulin resistance (IR) are frequent in PCOS and play a leading role in the etiopathogeny of metabolic syndrome (MS). Hyperandrogenism has been suggested as an important factor in the development of MS in women with PCOS. To determine whether hyperandrogenism influences the development of metabolic syndrome in patients with PCOS. Clinical, biochemical and ultrasonographic data on 180 women with PCOS, as diagnosed by the Rotterdam criteria, and 70 women with simple obesity were retrospectively analyzed. According to body mass index, PCOS patients were classified as nonobese with PCOS and obese with PCOS. No clinical or biochemical hyperandrogenism was observed in patients with simple obesity. Insulin sensitivity indices (ISI) were assessed as proposed by HOMA-IR and ISI (Matsuda and De Fronzo). MS was diagnosed based on NCEP-ATP III criteria with modifications suggested by the Rotterdam consensus. Mean age was 27.3 + 4.7 among non-obese patients with PCOS, 28.8 + 5.0 in obese patients with POS, and 27.4 + 5.2 in those with simple obesity (p=0.0773), while BMI was 25.1+3.0 kg/m2, 37.0+ 5.5 kg/m2 and 36.0+ 4.2 kg/m2, respectively (p<0.001). The prevalence of IR and MS did not differ between obese patients with and without PCOS, and was significantly higher in these patients than in non-obese women with PCOS (p<0.001). The prevalence of MS, however, was higher... (Complete abstract click electronic access below)

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Sobirova, Kamola. "Jämförelse av effekten av letrozol och klomifen vid behandling av kvinnlig infertilitet." Thesis, Linnéuniversitetet, Institutionen för kemi och biomedicin (KOB), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-104462.

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Bakgrund: Infertilitet är ett sjukdomstillstånd som innebär att ett par inte kan uppnå en klinisk graviditet under mer än ett år av försök. Det är mellan 10-15 % av alla par i fertil ålder som drabbas av tillståndet i varje land. Orsaken som hittas i 90 procent av fallen är antingen manliga, kvinnliga eller gemensamma faktorer. När ingen orsak hittas kallas det för oförklarlig-, eller idiopatisk infertilitet. Innan diagnostisering och eventuell behandling utförs därför noga utredningar med analyser på både kvinnan och mannen. Behandlingen bestäms därefter utifrån orsak. Vid kvinnlig infertilitet är in vitro-fertilisering (IVF) den mest vanliga icke-farmakologiska proceduren som används framför allt vid oförklarlig infertilitet och åldersfaktorer. Antiöstrogenet klomifencitrat har i många decennier varit farmakologiska förstahandsbehandlingen vid anovulatorisk infertilitet men vid de senaste 10 åren har den ersätts med aromatashämmaren letrozol som med en liknande mekanism kunnat ge upphov till ovulationsstimulering. Syfte: Syftet med examensarbetet var att utvärdera och jämföra effekterna av antiöstrogenet klomifencitrat med aromatashämmaren letrozol vid infertilitetsbehandling hos kvinnor. Metod: För att uppnå syftet utfördes litteratursökningar av relaterade vetenskapliga studier i den medicinska databasen PubMed. Nyckelorden som användes vid sökning var “female infertility”, “clomiphene” och “letrozole” och därefter hämtades fem randomiserade kontrollerade vetenskapliga artiklar (RCT) som granskades i resultatdelen av arbetet. Resultat: Samtliga studier, utom studie 5, visade att aromatashämmaren letrozol hade bättre effekt på ovulationstimuleringen och därmed också att uppnå klinisk graviditet än vad klomifencitrat hade. Administrering av letrozol ledde också till större tjocklek av endometrium och fler antalet mogna folliklar. Å andra sidan visade sig letrozol ge högre sannolikhet till multipla graviditet i studie 5. Det förekom ett par fall av allvarliga biverkningar under administrering av samtliga läkemedel, dock var majoriteten av biverkningarna milda och förekom i form utav huvudvärk, illamående, gastrointestinala besvär, trötthet och värmevallningar. Slutsats: Resultaten tyder på att letrozol är ett mer effektivt alternativ till infertilitetsbehandling av kvinnor. Eftersom den dessutom har mycket lägre halveringstid än klomifencitrat gör den mer säker att använda då det låg östrogennivå är ej optimal hos kvinnor i fertil ålder.
Background: Infertility is a condition that is based on a couple not being able to achieve a clinical pregnancy for more than a year of trying. Between 10-15 % of all heterosexual couples of childbearing age are affected by the condition in each country. The cause that is found in 90 percent of cases is either male-, female- or common factors. When no cause is found, it is called unexplained or idiopathic infertility. Before diagnosis and possible treatment, careful investigations are therefore performed with analysis on both the woman and the man. The treatment is then determined based on the cause. In female infertility, in vitro fertilization (IVF) is the most common non-pharmacological procedure used primarily for unexplained infertility and age factors. The antiestrogen clomiphene citrate has for many decades been the first-line parmacological treatment for anovulatory infertility, but in the last 10 years it has been replaced by the aromatase inhibitor letrozole, which with a similar mechanism have effect on ovulation stimulation. Aim: The aim of this thesis was to evaluate and compare the treatment effects of the antiestrogen clomiphene citrate with the aromatase inhibitor letrozole in female infertility. Method: A literature search of related scientific studies was implemented in the medical database PubMed. The keywords used in the searchfield were ”female infertility”, ”clomiphene” and ”letrozole” and then five randomized controlled trial articles (RCT) were selected to be reviewed in the results part of the thesis. Results: All studies, except for study 5, showed that the aromatase inhibitor letrozole had a better effect than clomiphene citrate on ovulation stimulation and thus also to achieve a clinical pregnancy. Administration of letrozole also led to greater endometrial thickness and increased numer of mature follicles. In study 5 on the other hand, letrozole was shown to increase the likelihood of multiple pregnancies. There were a couple of cases of serious side effects during the administration of these drugs, however, the majority of the side effects were mild and occured in the form of headaches, nausea, gastrointestinal disorders, fattigue, and hot flashes. Conclusion: In conclusion, the results suggest that letrozole is a more effective alternative to infertility treatment for women. In addition, since it has a much lower half-life than clomiphene citrate, it is safer to use as low estrogen levels are not optimal in women of childbearing potential.

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Wiltgen, Denusa. "Polimorfismos do gene da calpaína 10 (CAPN10) e associação com síndrome metabólica em pacientes com síndrome de ovários policísticos (PCOS)." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2005. http://hdl.handle.net/10183/10848.

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Wiltgen, Denusa. "Polimorfismos do gene da calpaína 10 (CAPN10) e associação com síndrome metabólica em pacientes com síndrome dos ovários policísticos (PCOS)." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2005. http://hdl.handle.net/10183/178629.

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Edelstein, Sascha. "The impact of body mass index (BMI) on metabolic and endocrine parameters in women with the polycystic ovary syndrome (PCOS)." Master's thesis, University of Cape Town, 2008. http://hdl.handle.net/11427/3042.

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Ollila, M. M. (Meri-Maija). "The role of polycystic ovary syndrome (PCOS) and overweight/obesity in women’s metabolic and cardiovascular risk factors and related morbidities." Doctoral thesis, Oulun yliopisto, 2019. http://urn.fi/urn:isbn:9789526222592.

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Abstract Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting reproductive aged women, with reproductive, metabolic and cardiovascular implications across the life span. The typical features of PCOS include irregular menstruation, androgen excess and polycystic ovaries in ultrasonography. The majority of women with PCOS are overweight or obese, and, at least partly, obesity-driven metabolic abnormalities often coexist with PCOS. Despite intensive research, it has remained unclear whether PCOS per se is a risk factor of metabolic abnormalities, and cardiovascular disease and events. The main aim of the current work was to investigate whether PCOS is an independent risk factor of metabolic abnormalities and cardiovascular diseases. The study population consisted of the prospective population-based Northern Finland Birth Cohort 1966, and we used data collected at ages 14, 31 and 46. The definition of PCOS was based on self-reported PCOS symptoms at age 31 and/or PCOS diagnosis by age 46. The results revealed that weight gain in early life was a risk factor for the development of PCOS. As for metabolic outcomes, at age 46, normal-weight women with PCOS did not display increased odds of abnormal glucose metabolism. However, weight gain during early adulthood was significantly associated with abnormal glucose metabolism in women with PCOS by age 46. Interestingly, PCOS per se was already associated with elevated blood pressure at age 31 and hypertension at age 46, independently of obesity. Women with PCOS also displayed reduced cardiac vagal activity, which was associated with metabolic abnormalities and hypertension. Furthermore, even though no major anatomical or functional impairments were observed in echocardiography, women with PCOS displayed a significantly greater prevalence of myocardial infarction and a two-fold higher prevalence of cardiovascular events than controls. In conclusion, our findings indicate that even though PCOS is an independent risk factor of metabolic derangements, related obesity is a major metabolic risk factor in these women. The role of PCOS in cardiovascular events per se remains controversial and requires follow-up of this cohort. Given all this, maintaining normal weight and preventing weight gain, especially during early adulthood, should be the main priority in the prevention of adverse metabolic changes in women with PCOS
Tiivistelmä Munasarjojen monirakkulaoireyhtymä (polycystic ovary syndrome, PCOS) on lisääntymisikäisten naisten yleisin hormonaalinen häiriö aiheuttaen runsaasti sairastavuutta ja terveydenhuollon kustannuksia. PCOS:n diagnostisiin kriteereihin kuuluvat epäsäännöllinen kuukautiskierto, lisääntynyt miessukupuoli-hormonivaikutus sekä monirakkulaiset munasarjat. Merkittävä osa oireyhtymää sairastavista naisista on ylipainoisia tai lihavia ja oireyhtymän kanssa yhtä aikaa esiintyykin useita, ainakin osittain ylipainosta johtuvia, metabolisia häiriöitä. Lukuisista tutkimuksista huolimatta on kuitenkin epäselvää, altistaako PCOS itsessään metabolisille häiriöille sekä sydän- ja verisuonisairauksille. Väitöskirjatutkimuksen tavoitteena oli selvittää, onko PCOS itsenäinen metabolisten ja sydän- ja verisuonisairauksien riskiä lisäävä tekijä. Tutkimus pohjautui Pohjois-Suomen syntymäkohortti 1966 tutkimuksen 14-, 31- ja 46-vuotisseurantoihin. PCOS luokittelu perustui 31- ja 46-vuotiskyselyissä itse ilmoitettuihin tyypillisiin PCOS oireisiin ja/tai diagnoosiin. Tutkimuksessa havaittiin, että 14- ja 31-ikävuoden välillä tapahtuva painonnousu oli yhteydessä PCOS diagnoosiin myöhemmällä iällä. 46-vuotiaana normaalipainoisilla PCOS naisilla ei ollut suurentunut tyypin 2 diabetes riski, mutta painonnousu varhaisaikuisuudessa oli merkittävästi yhteydessä sokeriaineenvaihdunnan häiriöön PCOS naisilla. PCOS oli yhteydessä kohonneeseen verenpaineeseen 31-vuotiaana ja hypertensioon 46-vuotiaana ylipainosta riippumatta. Oireyhtymään liittyvät metaboliset häiriöt olivat tärkein sydämen autonomisen hermoston säätelyyn vaikuttava tekijää, kun taas PCOS itsessään ei vaikuttanut autonomisen hermoston toimintaan. PCOS:ään sairastavien naisten sydämen rakenne ja funktio eivät merkitsevästi poikenneet kontrolloiden vastaavista muuttujista. Kuitenkin suhteellisen nuoresta iästä huolimatta PCOS naisilla esiintyi enemmän sydäninfarkteja ja kaksi kertaa enemmän sydän- ja verisuonitapahtumia, kuin kontrolleilla. Tutkimuksen tulokset osoittavat, että vaikkakin PCOS on itsenäinen riskitekijä metabolisille häiriöille, oireyhtymään liittyvä ylipaino vaikuttaa merkittävästi metabolisten häiriöiden esiintymiseen. PCOS:n ja sydän- ja verisuonitautitapahtumien yhteyden tarkempi tutkiminen vaatii kohortin jatkoseurantaa. Painonhallinnan tukemisen tulisi olla PCOS:ää sairastavien naisten hoidon kulmakivi

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Siebert, T. I. "A study of different clinical and biochemical parameters in polycystic ovary syndrome affecting ovulation induction outcome and fertility potential." Thesis, Stellenbosch : Stellenbosch University, 2008. http://hdl.handle.net/10019.1/4076.

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Thesis (DMed (Obstetrics and Gynaecology))--Stellenbosch University, 2008.
Chapter 1 presents a literature study on the diagnostic debate of PCOS. The literature study includes a discussion of the recent Rotterdam consensus statement regarding the diagnosis of PCOS. This is followed by a discussion on the essential work-up of the patient presenting with PCOS. Finally, chapter 1 presents a discussion on the complexity of the different variations in women presenting with PCOS. Chapter 2 is a literature review on ovulation induction methods in patients who present with PCOS. This literature study puts special emphasis on the different available methods used for ovulation induction in women with PCOS and the profounding effect weight loss will have in managing these patients. This chapter also addresses the use of newer agents, like aromatase inhibitors (Letrozole), and the current role of each of these agents in ovulation induction protocols. Chapter 3 is a literature overview on the effect of Metformin in Clomiphene-resistant PCOS women. The inclusion criteria of this review was all prospective randomized trials where Metformin was added for ovulation in the Clomiphene-resistant PCOS patient. The data is presented as a metaanalysis. Chapter 4 is a prospective randomise control trial to evaluate the benefit of metformin if added to Clomiphene in a primary ovulation induction protocol in comparison to Clomiphene alone. This chapter also evaluates all factors influencing ovulation outcome. Finally in the discussion section all the recent studies published addressing this topic were reviewed. Chapter 5 is a literature review to evaluate the classification systems for semen parameters and the in vivo fertility potential. This data is also used to establish fertility/subfertility thresholds for semen parameters. This chapter also presents the results of a prospective and retrospective study of the semen analysis of the partners of women with PCOS. We believe that this population presents the best reference group to study the semen profile of the general male population. Chapter 6 is a summary of the results of these studies and serves as an evidence based approach for ovulation induction in women with PCOS.

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Shwarz, Michelle. "Addressing Polycystic Ovary Syndrome in Outpatient Mental Health Practices: A Brief Intervention to Increase Awareness." Diss., Temple University Libraries, 2015. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/326149.

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Public Health
Ph.D.
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting up to 18% of all women, yet only 1.5% have been formally diagnosed. Untreated, PCOS is associated with the early onset of diabetes mellitus type II, heart disease, and cancer. One of the most common clinical symptoms of PCOS is mental health illness. The estimated lifetime prevalence of mental illness in women with PCOS is 80%. Therefore, mental health professionals may be especially poised to screen, refer, and address PCOS in their practices. This study was used to develop a survey tool as well as a brief educational intervention using framing theory to boost PCOS knowledge of diagnostic criteria and clinical symptoms, screening practices, and referrals for PCOS evaluation. The survey assessed mental health providers' knowledge about PCOS, estimates of PCOS prevalence in their practices, and evaluated attitudes about screening for PCOS in order to identify other potential barriers and facilitators to screening. This study was conducted using a randomized, two-group (experimental vs. attention control) design with three measurement periods: pre-intervention, 4-weeks, and 12-weeks. Participants were stratified by whether or not they had medical degrees. One-hundred and sixty three (N=163) participants completed the first survey and were randomized and completed one of the two educational interventions (PCOS related or attention control). Knowledge outcomes included number of correctly identified PCOS diagnostic criteria and clinical symptoms. Behavior outcomes included whether or not participants screened or referred clients for PCOS in the last 3 months. Fourteen attitude measures and two confidence measures were also separately evaluated as potential influencing factors of knowledge and behavior. The study resulted in no change in PCOS knowledge of diagnostic criteria or clinical symptoms or behavior based on intervention assignment in medical professionals; however, baseline knowledge in this group was high. Confidence in PCOS knowledge was associated with screening behavior. The PCOS educational intervention appears to have potential efficacy at increasing non-medical professional clinical symptom knowledge of PCOS (Chi-square(1)=5.341, p=0.021) but did not improve screening or referring behavior. The PCOS intervention resulted in greater confidence in PCOS knowledge in the PCOS intervention group than in the attention control group (p=.003). Framing theory appears to be a promising framework for messaging designed to increase knowledge about PCOS only in non-medical mental health practitioners. Results of this study should be interpreted with caution because sample size goals were not met and there was high attrition among medical mental health practitioners. Future intervention strategies should consider the inherent differences in the type of professional that are targeted (i.e. medical vs. non-medical) and the presence of specific barriers to screening and referral behavior. These strategies should improve upon the intensity of the intervention and the timing of the intervention to occur during provider training (i.e. during residency or early internships) in order to increase screening and referring behaviors for PCOS.
Temple University--Theses

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Kahal, Hassan. "GLP-1R, a novel receptor in platelets, and the use of liraglutide in the treatment of obesity in women with PCOS." Thesis, University of Hull, 2013. http://hydra.hull.ac.uk/resources/hull:8911.

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Studies investigating atherothrombotic risk in women with polycystic ovary syndrome (PCOS), in particular platelet function and carotid intima-media wall thickness (cIMT), have been confounded by not adequately accounting for obesity. Liraglutide is a glucagon like peptide-1 (GLP-1) analogue that causes weight loss and may have favourable effects on atherothrombotic risk and liver fibrosis in preclinical and animal studies. The aims of this study was to investigate whether atherothrombotic risk was increased in obese women with PCOS independently of obesity; whether GLP-1 receptor (GLP-1R) is expressed in human platelets; and whether 6 months treatment with liraglutide would improve weight and markers of atherothrombosis and liver fibrosis in obese young women with PCOS and/or normal controls. Our results suggest that PCOS, independent of obesity, is associated with increased levels of insulin resistance, inflammation, oxidative stress, non-alcoholic fatty liver disease (NAFLD) and the liver fibrosis marker PIIINP. However, PCOS was not independently associated with increased atherothrombotic risk markers including cIMT, platelet function, clot function/lysis, and endothelial function. Treatment for 6 months with liraglutide, 1.8mg daily, resulted in 3 – 4% weight loss in obese women with PCOS and controls. This was associated with a significant reduction in insulin resistance, oxidative stress, and several markers of atherothrombosis including inflammation, serum biochemical markers of endothelial function and clot lysis. Although basal platelet activation was reduced in the control group only and the liver fibrosis marker PIIINP was only reduced in the PCOS group, between groups comparisons were not significant. No change was observed in cIMT. In addition, we demonstrated for the first time that platelets express the GLP-1R. Liraglutide inhibited collagen- and thrombin-induced aggregation in isolated platelets and the effects were at least partly mediated by the GLP-1R, although an additional GLP-1R independent pathway is also likely. In conclusion, cardiovascular risk in young obese women with PCOS can either be attributed to obesity or is not yet apparent at this early stage of the condition. Our data support the use of liraglutide as a weight loss medication in simple obesity and suggest a potential beneficial effect on atherothrombotic risk and markers of liver fibrosis at 6 months of treatment. GLP-1R is a novel receptor in platelets and its function and clinical effect are worth further evaluation.

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Fait, Vladimir. "Präventivmedizinisches Konzept zur Früherkennung und Behandlung metabolischer Anomalien bei Frauen mit polyzystischem Ovarsyndrom." Master's thesis, Dresden International University, 2017. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-231229.

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Das polyzystische Ovarsyndrom (PCOS) mit einer Prävalenz von 5 % – 10 % ist eine der häufigsten Endokrinopathien bei Frauen vor der Menopause. Wie bisher vermutet, handelt es sich bei PCOS um ein sogenanntes multifaktorielles Krankheitsgeschehen. Einzelne Manifestationen des Metabolischen Syndroms (MetS), wie Hyperandrogenämie, Insulinresistenz (IR) und damit verbundene Hyperinsulinämie, Dyslipidämie und ein erhöhter CRP-Spiegel, werden bereits als Risikofaktoren für Typ 2 Diabetes mellitus (DM-II) und kardiovaskulären Krankheiten (KVK) bei den Patientinnen mit PCOS verwendet. Die Konzentrationen von Leptin und Adiponektin könnten nützliche und zuverlässige Marker für das Ausmaß der metabolischen Störung bei PCOS-Patientinnen sein. In zahlreichen Studien wurde davon berichtet, dass eine additive Gabe von Metformin die IR und andere Surrogat-Parameter des MetS in gleicher Weise bei adipösen und normalgewichtigen Probandinnen verbessert. In dieser Studie wurde der Insulin-Spiegel im Rahmen eines oralen Glukose-Toleranz-Test bei der Erstdiagnose und ca. ein bis eineinhalb Jahren nach der Metformintherapie bestimmt. Die Nüchtern-Insulinwerte der Vor-Therapie-Gruppe sind im Vergleich zur Nach-Therapie-Gruppe bei 75 % der Teilnehmerinnen signifikant aus dem hyperinsulinämischen Bereich in den normoinsulinämischen Bereich abgesunken (29.7 ± 6.7 µU/ml bzw. 13.7 ± 2.7 µU/ml, P = 0.045). Vergleichbar signifikant haben sich die Werte nach ein und zwei Stunden verbessert (154.5 ± 13.6 µU/ml vs. 96.2 ± 13.9 µU/ml, P = 0.0096 bzw. 128.0 ± 19.0 µU/ml vs. 59.2 ± 13.3 µU/ml, P = 0,0104). Konsistent damit senkte sich der HOMA-Index (5.9 ± 1.4 vs. 2.8 ± 1.6, P = 0,521). Die Leptin-Konzentration sank um 50 % (39.9 ± 9.7 vs. 20.3 ± 2.9 ng/ml, P = 0.0737 bzw. (mittlere Insulinspiegel nüchtern) 29.7 ± 6.7 µU/ml vs. 13.7 ± 2.7 µU/ml, P = 0,045), und die Adiponektin-Konzentration der Nach-Therapie-Gruppe im Vergleich zur Vor-Therapie-Gruppe stieg deutlich an (5.34 ± 0.6 vs. 6.35 ± 0.8 ug/ml, P = 0.4666, ns). Somit sind die Plasmaspiegel von Leptin und Adiponektin günstige Marker zur Risikoabschätzung und Diagnostik eines PCOS, zweitens eine metabolische Frühdiagnostik, und eine frühere Erwägung und Anwendung einer Strategie zur Senkung der Insulinresistenz sind aus präventiver Sicht ratsam.

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Hehl, Nicola Julia [Verfasser]. "Einflussfaktoren auf die Fertilität beim Syndrom der polyzystischen Ovarien (PCOS) in einem Kinderwunschzentrum und Chancen auf Erfüllung des Kinderwunsches / Nicola Julia Hehl." Ulm : Universität Ulm. Medizinische Fakultät, 2014. http://d-nb.info/1064365566/34.

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Lindholm, Åsa Maria. "Metabolic Aspects in the Polycystic Ovary Syndrome." Doctoral thesis, Uppsala universitet, Institutionen för kvinnors och barns hälsa, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-120235.

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Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of childbearing age and is associated with a number of metabolic disturbances. It has been hypothesised these women carry an increased risk of developing cardiovascular diseases (CVD) with advancing age. The first aim of this thesis was to establish the prevalence of PCOS-related symptoms in Northern Sweden. The Northern part of the WHO MONICA project was used for this purpose. Based on self-reported menstrual disturbances and hirsutism together with biochemical analyses of free androgen index, the estimated prevalence of PCOS in Northern Sweden was 4.8%, which corresponded with previous prevalence studies. Disturbances in the fibrinolytic system are predictors of future cardiovascular events and measurements of plasminogen activator inhibitor 1 (PAI-1) activity and tissue plasminogen activator (tPA) mass concentration may be used to assess fibrinolytic activity in women with PCOS. From the findings, over-weight women with PCOS had impaired fibrinolysis, especially if they displayed objective biochemical markers of hyperandrogenism. Conversely, lean women with PCOS, displayed no signs of disturbed fibrinolysis. The adipose tissue is an active endocrine organ that produces and releases hormones, pro- and anti-inflammatory cytokines, and chemoattractant cytokines. Proinflammatory molecules produced by adipose tissue can be active participants in the development of insulin resistance and the increased risk of cardiovascular disease associated with obesity. The findings suggested being overweight, rather than the PCOS diagnosis per se, was the main explanatory variable for elevated adipose tissue inflammation in PCOS patients. Weight reduction is the primary target for intervention in overweight and obese women with PCOS. When this thesis was planned, no placebo-controlled trials on anti-obesity drugs in women with PCOS had been conducted. Sibutramine in combination with lifestyle intervention resulted in significant weight reduction in overweight women with PCOS. In addition to the weight loss, sibutramine appeared to have a beneficial effect on metabolic and cardiovascular risk factors.

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Connolly, Fiona. "Reproductive and metabolic programming by exogenous steroids." Thesis, University of Edinburgh, 2014. http://hdl.handle.net/1842/17606.

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Polycystic ovary syndrome (PCOS) is a heterogeneous disorder encompassing reproductive and metabolic phenotypes. Genetic analysis, targeting candidate genes has to date proven unsuccessful in the search for a truly dominant genetic link. Another hypothesis to explain the etiology of PCOS is that of fetal programming in the context of developmental origins of health and disease. Extensive animal studies, validated by human data, support the fetal origins hypothesis of PCOS and highlight that PCOS may arise due to excess androgen exposure in fetal life. Previous reports from our laboratory found metabolic dysfunction in 11 month old prenatally androgenised females (d62-102 of fetal life), which included pancreatic and hepatic alterations. The pancreatic alterations seemed to result from gene expression changes induced in fetal life. Therefore, chapter 3 focuses on the gluconeogenic response in the day 90 fetus following maternal androgenisation from day 62 of gestation. Interestingly hepatic gluconeogenic enzymes, specifically phosphoenolpyruvate caboxykinase (PEPCK) and glucose 6 phosphatase (G6PC), were not altered. However they were decreased in the kidney, in a sex specific manner with PEPCK significantly decreased (P<0.01) and G6PC showing a strong trend toward reduction (P=0.056) in females only. This chapter progresses to explore regulatory pathways involved in gluconeogenic regulation. It seems probable that the female specific increase in circulating testosterone (P<0.001), with increased renal androgen reception (P<0.01), may be accountable for the altered expression of gluconeogenic enzymes in the kidney. Chapter 4 investigates why testosterone concentrations were not increased in the male fetus, after maternal androgenisation, by focusing on the site of testosterone production, the fetal testis. Results demonstrate that the day 90 fetus is capable of responding to prenatal androgenisation by decreasing luteinising hormone (P<0.01) and thus testicular testosterone production, such that there was a global down regulation in steroidogenic enzyme expression, in vivo testosterone production (P<0.001) and Leydig cell morphology was altered (P<0.001). As prenatal androgenisation is administered through the maternal route and placental aromatisation may occur, a novel method whereby the fetus was directly injected was utilised to assess the effects of control oil (C), testosterone (TP) or diethylstilboestrol (DES) on the fetal testis. Unlike DES, direct fetal injection with TP mimics the results found from maternal androgenisation. When the testis are examined at a later date, day 112, ten days after androgen treatment ceases, Leydig cell morphology and steroidogenic gene expression return to control values, although fascinatingly, an overshoot of in vivo testosterone production (P<0.01) was observed. When the maternal androgenisation window is extended to begin at day 30 of fetal life, further changes are noted including increased circulating testosterone (P<0.01), a strong trend toward decreased testis weight (P=0.0519) and altered expression of Sertoli and germ cell specific markers. These studies are followed up by assessing the legacy effect of testosterone on the peripubertal male testis in Chapter 5. At ten weeks of postnatal life, males, exposed to androgens from day 62-102 of fetal life had reduced testis weight (P<0.05). However, functional or cellular alterations were not observed and by 12 weeks of age, when LH had normalised, testicular weight and stimulated testosterone secretion of prenatally TP-treated males was comparable to controls. This highlights the remarkable plasticity of the testis and the unremarkable legacy of altered prenatal androgen exposure. The legacy effect of testosterone on the fetal ovary is examined in Chapter 6. Previous studies from our laboratory found minor functional alterations but no structural alterations in the fetal ovary at day 90 following androgenisation from day 62. However, as this was at a time of a highly androgenic environment we assessed the function and morphology of the ovary ten days after the removal of testosterone at day 112. In marked contrast to the normalisation of the male gonad, we observe structural changes with an increase in recruited follicles from the primordial to primary stage in the testosterone treated group (P<0.01). The chapter continues with an investigation of pathways involved in the altered follicular dynamics that may account for the change in follicular recruitment. Furthermore, the functional changes which were previously noted in the day 90 ovary were also examined in response to direct exogenous steroid treatment including, C, TP, DES and dexamethasone (DEX) and also when the window of maternal androgenisation was extended to begin at day 30. Interesting changes are observed such that the direct fetal injection treatments induce similar changes to each other, regardless of the steroid, whilst maternal androgenisation induces a different response. This highlights the complexity of the pathways involved in female gonadal development.

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Rehme, Marta Francis Benevides. "O hiperandrogenismo influencia no desenvolvimento de síndrome metabólica em pacientes com síndrome dos ovários policísticos?" Botucatu : [s.n.], 2009. http://hdl.handle.net/11449/106373.

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Orientador: Anaglória Pontes
Banca: Tamara Goldberg
Banca: Marcos Felipe Silva de Sá
Banca: José Alcione Macedo Almeida
Banca: Cleusa Cascaes Dias
Resumo: A síndrome dos ovários policísticos (SOP) afeta 5 a 8% das mulheres no menacme e é caracterizada pela anovulação crônica e hiperandrogenismo. A obesidade central e a resistência insulínica (RI) são freqüentes na SOP e desempenham um papel fundamental na etiopatogenia da síndrome metabólica (SM). O hiperandrogenismo tem sido questionado como um fator importante no desenvolvimento da SM em mulheres com SOP. Verificar se o hiperandrogenismo influencia no desenvolvimento de síndrome metabólica em pacientes com SOP. Foram avaliados retrospectivamente os dados clínicos, bioquímicos e ultrassonográficos de 180 mulheres com SOP diagnosticadas pelos critérios de Rotterdam e de 70 mulheres com obesidade simples. As pacientes com SOP foram classificadas de acordo com o índice de massa corporal (IMC) em SOP não obesas e SOP obesas. As pacientes obesas simples não apresentaram hiperandrogenismo clínico nem bioquímico. O índice de sensibilidade à insulínica (ISI) foi avaliado pelo HOMA-IR e ISI de Matsuda e DeFronzo. A SM foi diagnosticada pelos critérios do NCEP-ATP III com modificações sugeridas pelo consenso de Rotterdam. A média de idade das pacientes foi de 27,3 + 4,7 no grupo das pacientes SOP não obesas; 28,8 + 5,0 nas SOP obesas e 27,4 + 5,2 nas obesas simples (p=0, 0773), e o IMC foi de 25,1+3,0 kg/m2; 37,0+ 5,5 kg/m2 e 36,0+ 4,2 kg/m2 respectivamente (p<0, 001). A prevalência de RI e SM não diferiu entre as pacientes obesas com e sem SOP e foi significativamente maior do que nas SOP não obesas (p<0, 001). Entretanto a prevalência de SM foi maior nas SOP obesas com hiperandrogenismo... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Polycystic ovary syndrome (PCOS) affects 5-8% of women at menacme and is characterized by chronic anovulation and hyperandrogenism. Central obesity and insulin resistance (IR) are frequent in PCOS and play a leading role in the etiopathogeny of metabolic syndrome (MS). Hyperandrogenism has been suggested as an important factor in the development of MS in women with PCOS. To determine whether hyperandrogenism influences the development of metabolic syndrome in patients with PCOS. Clinical, biochemical and ultrasonographic data on 180 women with PCOS, as diagnosed by the Rotterdam criteria, and 70 women with simple obesity were retrospectively analyzed. According to body mass index, PCOS patients were classified as nonobese with PCOS and obese with PCOS. No clinical or biochemical hyperandrogenism was observed in patients with simple obesity. Insulin sensitivity indices (ISI) were assessed as proposed by HOMA-IR and ISI (Matsuda and De Fronzo). MS was diagnosed based on NCEP-ATP III criteria with modifications suggested by the Rotterdam consensus. Mean age was 27.3 + 4.7 among non-obese patients with PCOS, 28.8 + 5.0 in obese patients with POS, and 27.4 + 5.2 in those with simple obesity (p=0.0773), while BMI was 25.1+3.0 kg/m2, 37.0+ 5.5 kg/m2 and 36.0+ 4.2 kg/m2, respectively (p<0.001). The prevalence of IR and MS did not differ between obese patients with and without PCOS, and was significantly higher in these patients than in non-obese women with PCOS (p<0.001). The prevalence of MS, however, was higher... (Complete abstract click electronic access below)
Doutor

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Ali, Momenpour. "Raman Biosensors." Thesis, Université d'Ottawa / University of Ottawa, 2017. http://hdl.handle.net/10393/36468.

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This PhD thesis focuses on improving the limit of detection (LOD) of Raman biosensors by using surface enhanced Raman scattering (SERS) and/or hollow core photonic crystal fibers (HC-PCF), in conjunction with statistical methods. Raman spectroscopy is a multivariate phenomenon that requires statistical analysis to identify the relationship between recorded spectra and the property of interest. The objective of this research is to improve the performance of Raman biosensors using SERS techniques and/or HC-PCF, by applying partial least squares (PLS) regression and principal component analysis (PCA). I began my research using Raman spectroscopy, PLS analysis and two different validation methods to monitor heparin, an important blood anti-coagulant, in serum at clinical levels. I achieved lower LOD of heparin in serum using the Test Set Validation (TSV) method. The PLS analysis allowed me to distinguish between weak Raman signals of heparin in serum and background noise. I then focused on using SERS to further improve the LOD of analytes, and accomplished simultaneous detection of GLU-GABA in serum at clinical levels using the SERS and PLS models. This work demonstrated the applicability of using SERS in conjunction with PLS to measure properties of samples in blood serum. I also used SERS with HC-PCF configuration to detect leukemia cells, one of the most recurrent types of pediatric cancers. This was achieved by applying PLS regression and PCA techniques. Improving LOD was the next objective, and I was able to achieve this by improving the PLS model to decrease errors and remove outliers or unnecessary variables. The results of the final optimized models were evaluated by comparing them with the results of previous models of Heparin and Leukemia cell detection in previous sections. Finally, as a clinical application of Raman biosensors, I applied the enhanced Raman technique to detect polycystic ovary syndrome (PCOS) disease, and to determine the role of chemerin in this disease. I used SERS in conjunction with PCA to differentiate between PCOS and non-PCOS patients. I also confirmed the role of chemerin in PCOS disease, measured the level of chemerin, a chemoattractant protein, in PCOS and non-PCOS patients using PLS, and further improved LOD with the PLS regression model, as proposed in previous section.

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Nascimento, Areana Diogo. "Efeitos da metformina nos níveis séricos de insulina, de hormônio anti-mulleriano e no hiperandrogenismo em pacientes com Síndrome dos Ovários Policísticos." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/17/17145/tde-26092013-163330/.

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A síndrome dos ovários policísticos (SOP) constituia causa mais freqüente de infertilidade, anovulação e hiperandrogenismo atualmente. Sua fisiopatogenia é em parte obscura. O hormônio anti-mülleriano (HAM),uma glicoproteína produzida pelas células da granulosa dos folículos pré-antrais e folículos antrais pequenos, parece exercer papel fundamental para seu surgimento, exacerbando o hiperandrogenismo intra-folicular e interferindo no mecanismo de seleção do folículo dominante. Além das alterações ovulatórias, há repercussões metabólicas decorrentes da síndrome, como a resistência à insulina (RI), que afeta entre 45 a 70% das mulheres com SOP em idade reprodutiva. Estratégias para aumentar a sensibilidade à insulina poderiam reduzir o impacto reprodutivo e metabólico da RI. Entre elas, destaca-se a metformina, uma droga anti-diabética oral, cuja utilização levaria a uma melhora dos padrões metabólicos e restabelecimento da ovulação. No presente estudo, foram avaliados a relação entre os níveis séricos de HAM e resistência insulínica antes e após o tratamento com metformina, comparados os níveis séricos de HAM na fase folicular precoce entre pacientes com e sem SOP e correlacionados os níveis de HAM com os níveis séricos de insulina, gonadotrofinas e androgênios. Foram realizadas dosagens séricas de HAM, androgênios e gonadotrofinas em 36 pacientes (16 com SOP e resistência insulínica e 20 eumenorreicas, sendo grupos pareados quanto à idade e índice de massa corpórea). No grupo SOP, foram avaliados níveis de HAM, insulina, glicemia e QUICKI (quantitative insulin check index) antes e depois do tratamento com metformina 1500 mg/dia por oito semanas. Foram encontrados níveis de HAM mais elevados no grupo SOP do que no grupo controle (49,9 ± 6,1 pmol/L versus 4,5 ± 2,1 pmol/L, p < 0,0001), assim como os níveis de hormônio luteinizante (LH) (10,3± 1,5 mUI/L versus 3,5 ±0,5 mUI/L, p=0,0004), testosterona (64,9 ± 5 ng/mL versus 41,1 ±4,7 ng/mL, p=0,0017) e 17-hidroxiprogesterona (17OHP) ( 90 ±16,8ng/ml versus 49,1 ±6,6 ng/ml; p= 0,03). Nas pacientes com SOP, houve correlação positiva forte entre os níveis de HAM pré-tratamento e testosterona (coeficiente r dePearson - R - de 0,83; p<0,0001). Também foi encontrada correlação positiva e significativa entre HAM e LH (R = 0,51; p = 0,04). As demais variáveis não apresentaram correlação significativa com o HAM pré-tratamento. Após o tratamento, houve redução significativa dos níveis de insulina (16,4 ± 2,6 mUI/ml versus 12 ± 1,9 mUI/ml; p=0,0132). Os níveis de HAM tiveram redução, porém sem diferença estatística (49,9 ± 6,1 versus 41,5 ± 5,6 pmol/L; p=0,06). Houve redução significativa nos níveis de testosterona (64,9 ± 5 ng/mL versus 49,3 ± 14 ng/mL). A correlação do HAM com os níveis de testosterona não persistiu após o tratamento com a metformina (R=0,08 e p=0,76). Assim, a manutenção dos níveis séricos de HAM após o uso da metformina, mesmo com a comprovada melhora metabólica e redução dos níveis de gonadototrofinas sugere que o papel do HAM na SOP baseia-se num mecanismo intrínseco ovariano, independente do eixo hipotálmo-hipófise-ovário e não influenciado pela resistência insulínica.
Polycystic ovary syndrome (PCOS) is the most frequent cause of infertility, anovulatory disordes and hyperandrogenism in young women. Its pathophisiology remains unclear and anti-mullerian hormone (AMH), a glycoprotein produced by the granulose cells of early developing follicles, seems to be fundamental to its development, by enhancing the intra-follicular hyperandrogenism and interfering in the selection of a dominant follicle. PCOS also causes metabolic disorders, such as insulin resistance (IR), that affects 45 to 70% of women with PCOS. Strategies to improve insulin sensitivity could reduce the reproductive and metabolic impact of IR.Metformin, a insulin-sensitizing agent, appears to improve the metabolicparameters and reestablish ovulatory cycles. In this study, we evaluated the relationship between anti-mullerian hormone serum levels and IR before and after protracted treatment with meformin; we also compared the anti-mullerian hormone levels in PCOS in the early follicular phase to normo-ovulatory women. The correlation of anti-mullerian hormone levels to insulin, gonatotropins and androgen serum levels was also evaluated. The study included 36 pacients (20 with PCOS and IR and 16 with ovulatory cycles). Anti-mullerian hormone serum levels, insulin, glucose and QUICKI (quantitative insulin check index) were evaluated in patients with PCOS before and after treatment with metformina 1500 mg/day during eight weeks. Anti-mullerian hormone serum levels were higher in PCOS (49,9 ± 6,1 pmol/L versus 4,5 ± 2,1 pmol/L, p < 0,0001), as well as luteinizing hormone (LH) levels (10,3± 1,5 mUI/L versus 3,5 ±0,5 mUI/L, p=0,0004), testosterone (64,9 ± 5 ng/mL versus 41,1 ±4,7 ng/mL, p=0,0017) and 17-ydroxyprogesterone (17OHP) ( 90 ±16,8ng/ml versus 49,1 ±6,6 ng/ml; p= 0,03). In PCOS, there is a positive correlation between anti-mullerian hormoneserum levels and testosterone (R= 0,83; p<0,0001) before treatment; this correlation did not persisted after treatment (R=0,08 e p=0,76). There is also a positive correlation between anti-mullerian hormone serum levels before metformin treatment and LH (R= 0,83; p<0,0001). No correlations were found between anti-mullerian hormone serum levels before treatment and other parameters. After treatment, insulin serum levels reduced (16,4 ± 2,6 mUI/ml versus 12 ± 1,9 mUI/ml; p=0,0132). AMH serum levels also reduced, but therewas no statically significant difference (49,9 ± 6,1 versus 41,5 ± 5,6 pmol/L; p=0,06). Testosterone serum levels decreased significantly (64,9 ± 5 ng/mL versus 49,3 ± 14 ng/mL). No correlation between AMH and testosterone levels was found after treatment (r=0, 08 e p=0, 76). The maintenance of AMH serum levels after treatment with metformin, despite the enhance of metabolic parameters and reduction of the gonadrotopins levels, suggests that AMH acts in the pathophisiology of PCOS by a intra-ovarian mechanism, that does not depend on the neuroendrocine axis and that is not influenced by IR.

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Linzbach, Aissa [Verfasser], and Hertha [Akademischer Betreuer] Richter-Appelt. "Diagnose und Therapie des Polyzystischen Ovar Syndroms (PCOS) : eine Fragebogenstudie zur Wahrnehmung der Symptome und der medizinischen Maßnahmen / Aissa Linzbach. Betreuer: Hertha Richter-Appelt." Hamburg : Staats- und Universitätsbibliothek Hamburg, 2016. http://d-nb.info/1107545013/34.

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Linzbach, Aissa Verfasser], and Hertha [Akademischer Betreuer] [Richter-Appelt. "Diagnose und Therapie des Polyzystischen Ovar Syndroms (PCOS) : eine Fragebogenstudie zur Wahrnehmung der Symptome und der medizinischen Maßnahmen / Aissa Linzbach. Betreuer: Hertha Richter-Appelt." Hamburg : Staats- und Universitätsbibliothek Hamburg, 2016. http://nbn-resolving.de/urn:nbn:de:gbv:18-79534.

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