Dissertations / Theses: 'Polycystic ovarian syndrome'

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Alzanati, Nadia. "Polycystic ovarian syndrome and adipose tissue : contribution of peripheral androgen synthesis to hyperandrogenism in polycystic ovarian syndrome." Thesis, University of Nottingham, 2017. http://eprints.nottingham.ac.uk/39390/.

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Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine, reproductive, metabolic and psychological disorder in women of childbearing age, affecting 6-10% of premenopausal women. Hyperandrogenism is the most important biochemical feature of the syndrome, which is responsible for the clinical features of PCOS, and is frequently associated with metabolic disturbance, such as insulin resistance, dyslipidaemia, glucose intolerance and hypertension, regardless of the presence of obesity. In several studies, attention has focused on androgen as the main factor for development of metabolic disturbance, which observed in women with PCOS. The relationship between adipose tissue and the pathophysiology of PCOS, in terms of development of hyperandrogenism and its relation to development of insulin resistance with compensatory hyperinsulinemia still not fully understood. Based on epidemiological studies, the association between circulating androgen levels and insulin resistance, as well as central obesity is a direct correlation. Although ovaries and adrenal glands are the main sources of androgens, adipose tissue is also one of the most important peripheral tissues involved in the production of androgens. Adipose tissue is not just an organ with energy storage; it also has endocrine, paracrine and autocrine functions, due to secretion of active peptides, known as adipokines, and hormones, such as androgens. In order to understand the role of adipose tissue in the development of hyperandrogenism, we hypothesised that “Androgen metabolic pathways leading to testosterone production in subcutaneous adipose tissue are altered in women with PCOS.” The excess adipose tissue androgen synthesis plays an important role in PCOS pathogenesis. Aims: The main aim of this study was to analyse and compare the expression level of the two key enzymes in androgens synthesis, 17-α-hydroxylase/17.20-lyase (CYP17A1) and 17-β-hydroxysteroid dehydrogenase type 5 (AKR1C3) in adipose tissue of women with and without PCOS. These are responsible for locally synthesised sex steroid hormones, mainly androgens; CYP17A1 is responsible in the production of the precursors of androgens and AKR1C3 is responsible in the conversion of inactive androgen (androstenedione) to its active form, testosterone. In addition, to understand the mechanism of androgen production this study employed isolated pre-adipocytes cultures and in vitro differentiated to mature adipocytes with close regulation of the impact of insulin and LH as the most two hormones which have effect in sex steroid synthesis. In doing so, we investigated androgen synthesis by activation and expression of the main steroidogenic enzymes CYP17A1 and AKR1C3 in adipocytes of non-PCOS and PCOS women. This enabled us to study the difference in the CYP17A1 mRNA and AKR1C3 mRNA expression levels, as well as the concentration of testosterone secretion across non-PCOS and PCOS cultures. This also indicated the probability of a pathway leading to localised synthesis of adipocytes and to investigate if there is a role for PI3-K signaling pathway in insulin regulation of testosterone synthesis in peripheral adipose tissue of women with and without PCOS. Methods: In order to achieve these aims, subcutaneous adipose tissue samples (SC) were surgically obtained during gynecological surgery from women with and without PCOS. All participants were of reproductive age (20-45) with a BMI of 20-35kg/m2. Total RNA was isolated from frozen adipose tissue samples of non-PCOS (n=8) and PCOS (n=8) after matching, using Trizol reagent method, followed by reverse transcription. Quantitative RT-PCR was performed to determine the expression of a panel of reference genes (GAPDH, ACTB, and LPR10), and target genes (CYP17A1 and AKR1C3). Data were analysed with GenEx and compared using ΔΔCt method. AKR1C3 protein expression in non-PCOS (n=3) and PCOS (n=3) was measured and compared by using western blot (WB) technique. Pre-adipocytes were isolated from fresh adipose tissue samples by enzyme digestion (collagenase) method and in vitro differentiated to mature adipocytes, which were cultured in FCS-free medium, Recombinant insulin +/-LH+/-PI3-k inhibitor (LY294002) was added to the cell culture at different concentrations, in preparation for investigating any change in the expression of steroidogenic enzymes (CYP17A1, AKR1C3) by RT-PCR, after extraction of total RNA The supernatant was collected for testosterone measurement before and after treatment using enzyme-linked immunosorbent assay (ELISA). Results: Of the reference genes testes, GABDH, ACTB, and LRP10 were shown to be consistently expressed across the PCOS and non-PCOS women. The mean± SEM relative expression level of AKR1C3 mRNA in PCOS adipose tissue was 15.1± 2.0, which was significantly (P=0.0003) greater than that (3.3±1.1) of non-PCOS women. However, the expression level of CYP17A1 mRNA was not significantly (p=0.56) different between the two groups. AKR1C3 protein expression level was less expressed in PCOS and there was no significant (P > 0.05) difference in the protein expression between two groups. CYP17A1, AKR1C3 and testosterone were significantly higher in PCOS (n=5) versus the non-PCOS (n=5) in treated and un-treated cultures. Insulin did not alter CYP17A1 or AKR1C3 mRNA expression in PCOS group. In the non-PCOS, AKR1C3 significantly increased with gradual increase in insulin concentrations, 1nM/l (P=0.001), 10 nM/l (P=0.004), and 100 nM/l (P=0.0003). Insulin up regulates AKR1C3 mRNA expression (no treatment (0), 1, 10,100) (0.96±0.21) (1.59±0.84) (2.39±1.23) and (7.42±0.85) respectively. LH± insulin did not alter the expression of either of the enzymes in PCOS Insulin increased testosterone concentration in non-PCOS but not in the PCOS, testosterone concentration in the supernatant of untreated cultured PCOS (n=5) adipocytes (mean± SEM, 129.3±2.5 pg /ml) was significantly higher (P < 0.0001) than that (33.7±4.6 pg /ml) of non-PCOS (n=5) adipocytes. Insulin addition in different concentrations (1nM/l, 10nM/l, 100nM/l) resulted in a significant increase in testosterone concentrations (94.1±7.1; 118.2±18.2, 200.0±7.3 pg/ml, respectively) in the supernatant of cultured non-PCOS adipocytes, but not in the PCOS adipocytes (118.1±1.8, 90.5±6.4, 89.3±7.6 pg/ml, respectively). The increase of testosterone levels in the non-PCOS adipocyte culture supernatant followed a dose dependent fashion. The magnitude of increase in testosterone concentrations in non-PCOS adipocyte culture supernatant was markedly increased when LH was added to insulin. Adding PI3-K inhibitor (LY294002, 10ng/ml) to insulin did not change the magnitude of insulin effects on testosterone concentrations in non-PCOS adipocyte culture supernatant. Conclusion: The data obtained suggests that adipose tissue has the ability to produce its own steroid hormone after detection of the main key enzymes of androgen biosynthesis, and it revealed a 5-fold increase in the expression level of AKR1C3 mRNA in subcutaneous adipose tissue of PCOS women. It is therefore possible to postulate that peripheral adipose tissue plays an important role as a source of excess androgen production in women with PCOS. This could potentially pave the way for the development of innovative therapeutic targets for the management of this very common syndrome. In addition, we show a markedly higher CYP17A1, AKR1C3 and testosterone in peripheral adipose tissue of PCOS vs. non-PCOS women. This supports the hypothesis that peripheral adipose tissue plays an important role in the pathogenesis of hyperandrogenaemia and PCOS. Insulin and LH seem to play a role in the increased androgen synthesis in adipose tissue of PCOS women, but not through the PI3-K signaling pathway. PI3-K signaling pathway does not seem to be involved in insulin regulation of testosterone synthesis in peripheral adipose tissue of women with or without PCOS.

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Hudecova, Miriam. "Reproductive and Metabolic Consequences of the Polycystic Ovarian Syndrome." Doctoral thesis, Uppsala universitet, Institutionen för kvinnors och barns hälsa, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-123248.

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Polycystic ovary syndrome (PCOS) is a complex clinical condition characterized by hyperandrogenism and chronic oligo/anovulation. Infrequent ovulation and metabolic alterations in women with PCOS are associated with subfertility and probably increased miscarriage rates compared with normal fertile women. The overall risk of developing type 2 diabetes and impaired glucose tolerance (IGT) is three- to sevenfold higher in PCOS women, and the onset of glucose intolerance seems to occur at an earlier age than in healthy controls. Women with PCOS also have several risk factors for cardiovascular disease, although it is unclear whether they actually experience more cardiovascular events than other women. Very few studies assessing the long-term reproductive and metabolic consequences in older women with previously confirmed PCOS have been conducted. In this long-term follow-up of women with PCOS, 84 women with a diagnosis of PCOS between 1987 and 1995 and age at the follow-up > 35 years and an age-matched population-based group of control women participated. Data on reproductive outcome, ovarian reserve, endothelial function, insulin sensitivity and beta-cell function were collected. According to our results most women with PCOS had given birth and the rate of spontaneous pregnancies was relatively high. The rate of miscarriages was not increased in PCOS patients and the ultrasound findings together with increased levels of anti-müllerian hormone suggested that their ovarian reserve is superior to women of similar age. PCOS women displayed signs of endothelial dysfunction, but this was largely due to the increased prevalence of independent risk factors for cardiovascular disease such as increased BMI, triglycerides and blood pressures. IGT and type 2 diabetes occurred more often in PCOS women. Free androgen levels and beta-cell function decreased over time whereas insulin sensitivity remained unchanged. Obesity at young age and progressive weight-gain rendered them more prone to be insulin resistant at the follow-up. Beta-cell function was increased in PCOS women in comparison with control subjects but declined over time. Independent of PCOS phenotype at the index assessment and persistence of PCOS symptoms at the follow-up investigation, premenopausal women with PCOS had lower insulin sensitivity and increased beta cell function in comparison with control subjects. Conclusion: The long-term reproductive outcomes of PCOS are similar compared to women with normal ovaries. Although symptoms and androgen levels are normalized over time, women with PCOS continue to display reduced insulin sensitivity and increased beta-cell function and they also have an increased risk of IGT and type 2 diabetes.

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Marsden, Philippa Jane. "Insulin action and ovarian function in polycystic ovary syndrome." Thesis, University of Newcastle Upon Tyne, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.313272.

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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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Desjardins, G. Clarissa (Gina Clarissa). "Role of the hypothalamic opioid system in estradiol-induced polycystic ovarian syndrome." Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=41015.

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The intrahypothalamic distribution of mu, delta and kappa opioid receptor types was examined by in vitro radioautography using the opioid ligands $ sp{125}$I-FK-33 824, $ sp{125}$I-DTLET and $ sp{125}$I-DPDYN, respectively as selective markers. The density and distribution of these receptors in the hypothalamus of normal rats was then compared to that of rats injected with estradiol valerate in order to verify the location of the described increase in $ sp3$H-naloxone binding and to identify the specific opioid receptor type involved. Analysis of opioid receptor changes following long-term exposure to estradiol revealed that mu opioid binding densities were significantly increased in the medial preoptic area of EV-treated animals. Delta and kappa opioid binding densities were unchanged in the medial preoptic area although a slight decrease in delta sites was observed in the suprachiasmatic nucleus. Hypothalamic $ beta$-endorphin concentrations were concomitantly decreased in EV-treated animals, suggesting that observed increases in mu opioid binding were due to a compensatory up-regulation of receptors secondary to loss of $ beta$-endorphin input from the arcuate nucleus. To confirm this interpretation, mu opioid receptor binding was measured in the MPOA of animals treated with monosodium glutamate, which destroys the arcuate nucleus. Results indicated that mu opioid receptor binding densities were inversely proportional to hypothalamic $ beta$-endorphin concentrations in the same animals supporting the existence of a causal relationship between chronic reductions in hypothalamic $ beta$-endorphin concentrations and mu opioid receptor upregulation in the medial preoptic area.
To further document the decreased concentrations of $ beta$-endorphin in the hypothalamus of EV-treated animals, light microscopic immunocytochemistry for $ beta$-endorphin was performed in colchicine treated control and EV-injected rats. Eight weeks following EV treatment, a 60% decrease in the total number of $ beta$-endorphin-immunoreactive neurons was detected in the arcuate nucleus, while neuron numbers for nearby neuronal populations were unchanged. These results were confirmed in biochemical experiments demonstrating reduced hypothalamic $ beta$-endorphin concentrations in the absence of changes in neuropeptide-Y and met-enkephalin in EV-treated rats as compared to controls. Cell counts performed in Nissl-stained material using unbiased stereological methods revealed a reduction in the total number of neurons in the EV-treated group as compared to controls. Furthermore, the estimated number of neurons lost ($ sim$3500) corresponded precisely with the total number of $ beta$-endorphin neurons lost ($ sim$3600) as estimated using quantitative immunocytochemistry. Together, these findings strongly suggest that $ beta$-endorphin neurons are selectively destroyed following long-term exposure to estradiol. Results demonstrated that EV-treated animals co-treated with vitamin E displayed hypothalamic $ beta$-endorphin concentrations similar to controls. In addition, these animals maintained regular estrous cycles and displayed normal ovarian morphology. These findings suggest that estradiol-induced neurotoxicity of $ beta$-endorphin neurons involves the production of free radicals and further supports the notion that the loss of these neurons is important to the induction of chronic anovulation and polycystic ovaries resulting after EV treatment. (Abstract shortened by UMI.)

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Wang, Qi. "Chemerin and Prohibitin in the Regulation of Ovarian Follicular Development and their Potential Involvement in Polycystic Ovarian Syndrome." Thèse, Université d'Ottawa / University of Ottawa, 2013. http://hdl.handle.net/10393/24098.

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Follicular growth and maturation are tightly regulated processes, which involve the participation of endocrine, autocrineparacrine factors and intracellular molecules. Due to the numerous research efforts, a large number of regulators and their mechanisms of regulation of follicular growth and differentiation have been established. Although the abnormal expression and activities of some of these regulators are believed to be associated with ovarian dysfunction diseases, such as polycystic ovarian syndrome (PCOS), the etiology and pathogenesis of this syndrome are not completely understood. In this thesis, we have identified two novel regulators of follicular growth and differentiation and examined the cellular and molecular mechanisms that contribute to the folliculogenesis. We present here that chemerin reduces FSH-induced steroidogenic enzyme expression and steroid hormone production in follicles and granulosa cells. Prohibitin expression is upregulated by chemerin and knockdown of prohibitin attenuates the suppressive role of chemerin on steroidogenesis, an action regulated by Akt. Using an androgenized rodent model, we also present the dysregulation of chemerin and prohibitin and their association with dysregulated follicular steroidogenesis. Our data and preliminary clinical studies demonstrate the potential involvement of chemerin and prohibitin in the etiology of PCOS. These studies significantly improve the knowledge of ovarian functions and the pathophysiology of PCOS, and provide important clues for the development of novel diagnosis biomarkers and new treatment strategies for this complex syndrome.

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Sprung, Victoria Spencer. "The impact of obesity and fitness on endothelial function in polycystic ovarian syndrome." Thesis, Liverpool John Moores University, 2012. http://researchonline.ljmu.ac.uk/6119/.

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Polycystic ovarian syndrome (PCOS) is a highly prevalent heterogeneous syndrome associated with abdominal obesity, insulin resistance and the metabolic syndrome. This clustering of risk factors could translate into an adverse cardiovascular disease (CVD) risk profile. Endothelial dysfunction, an early barometer of CVD, has been exhibited by women with PCOS; however, it remains unclear whether endothelial dysfunction is independent of CVD risk factors in this population. Exercise training has been found to enhance conduit artery and cutaneous microvessel endothelial function in various populations. Nevertheless, limited research exists regarding the cardiovascular effects of exercise in PCOS, and its impact on endothelial function in conduit arteries and cutaneous microvessels, has not been explored. The primary aim of this thesis was to examine nitric oxide (NO)-mediated endothelial function at different levels of the vascular tree in women with PCOS and to establish whether supervised exercise training induces a therapeutic effect on endothelial function. A systematic review of published studies comparing FMD in PCOS and control women was conducted. Twenty-one published studies were identified for inclusion (pCOS n=908; controls n=566). Differences in FMD between PCOS and controls were synthesised and meta-regressed against BMI and age. The pooled mean FMD was 3.5% lower (95% CI=3.4, 3.7%; P < 0.001) in women with PCOS compared with controls; and the PCOS-mediated reduction in FMD was most evident in studies involving less obese women. PCOS [n=35, 28y (95% CI=26, 30), 31kg/m2 (95% CI=27, 35)] and control women [n=16, 32y (95% CI=30, 35), 30kg/m2 (95% CI=25, 32)] were recruited. Brachial artery endothelial function was assessed using flow-mediated dilation (FMD). Internal adipose tissue (lAT), subcutaneous (SAT), visceral (VAT) and abdominal SAT was quantified using whole body magnetic resonance imaging and IH magnetic resonance spectroscopy quantified liver and skeletal muscle fat. Cardiorespiratory fitness, glycaemic control, reproductive hormone and lipid profiles were also assessed. FMD was impaired in PCOS when compared with control women [-4.5% (95% CI=-6.3, -2.8), P < O.OOl]. When FMD was adjusted for individual differences in IAT [-4.3% (95% CI=-6.l, -2.4), P < O.OOl], VAT [-4.4% (95% CI=-6.3, -2.5), P < O.OOl] and insulin resistance [-3.9% (95% CI=-5.6, -2.1), P < O.OO 1], the difference in FMD between groups remained. Ten women with PCOS [27y (95% CI=23, 32), 31 kg/rrr' (95% CI=28, 34)] completed a 16-week supervised exercise programme while 7 women with PCOS [29y (95% CI=24, 35), 35kg/m2 (95%CI=31, 40)] opted for conventional care and followed simple lifestyle advice. Exercise training improved FMD to a greater degree than conventional care [3.4% (95% CI=1.8, 5.1), P > 0.0005] and in parallel greater improvements in cardiorespiratory fitness were observed with exercise [4.7ml/kg/min (95% CI=1.4, 7.9), P=0.005]. These changes with exercise occurred independently of changes in VAT, SAT or insulin resistance. NO-mediated vasodilation in the cutaneous microvessels was examined in 11 PCOS [29y (95% CI=25, 34), 34kg/m2 (95% CI=30, 38)] and 6 control women [29y (95% CI=21, 37), 34kg/m2 (95% CI=28, 39)] using laser Doppler flowmetry combined with intra-dermal microdialysis of L-NG-monomethyl arginine to assay the NO dilator system in response to incremental local heating of the forearm. Six women with PCOS [30y (95% CI=22, 37), 31kg/m2 (95% CI=25, 37)] then undertook a 16-week exercise-training programme. Nitric oxide contribution was attenuated in women with PCOS at peak heating [-16.0CVCmax (95% CI=-32.5, 0.6), P=0.05] and during prolonged maximal heating [-15.4CVCmax (95% CI=- 29.6, -1.3), P=0.04], compared with control women. Cardiorespiratory fitness improved by 5.0ml/kg/min (95% CI=0.9, 9.2) following exercise training (P=0.03). This was accompanied by increased NO contribution to cutaneous blood flow between 36.5-42°C (P < 0.05), at peak heating [19.6CVCmax (95% CI=4.3, 34.9), P=0.02] and during prolonged maximal heating [17.1CVCmax (95% CI=2.2, 32.2), P=0.03]. The findings from this thesis suggest that endothelial dysfunction is an intrinsic characteristic of PCOS and that supervised exercise training enhances endothelial function in both conduit vessels and cutaneous microvessels, independent of adiposity or traditional CVD risk factors. The direct impact of exercise training on the vasculature of women with PCOS may decrease the risk of CVD morbidities, such as hypertension, and consequently reduce cardiovascular mortality in post-menopausal years.

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El, Mahdi E. "Studies to investigate a possible association between Polycystic Ovary Syndrome and Epithelial Ovarian Cancer." Thesis, University College London (University of London), 2013. http://discovery.ucl.ac.uk/1397057/.

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Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders, affecting 5 % to 10 % of women of reproductive age. The Syndrome is associated with Type II diabetes and endometrial carcinoma but an association with epithelial ovarian cancer has also been suggested. The studies described in this thesis were designed to investigate this association at population, cellular and molecular levels. In the first study, a cross sectional questionnaire survey was conducted of 121 women aged between the ages of 20 and 40, with or without PCOS. Analysis of the replies from 52 women with PCOS and 82 controls, showed that women with PCOS were significantly more likely to give a positive family history of breast cancer and myocardial infarction (20% vs 5%, p<0.05 and 35% vs 15%, p, 0.05, respectively). The second study was performed on 102 formalin fixed, paraffin embedded ovarian biopsies. In this study the surface epithelium of PCOS ovaries was compared with controls. The results showed significant epithelial changes in the PCOS group, with a higher prevalence of Psammoma bodies and mitoses (p< 0.01 and p < 0.02, respectively). Expression of cell cycle and apoptotic (p53, Cyclin D, Ki67 and bcl2) proteins in the ovarian surface epithelium was assessed using immunohistochemistry in 15 PCOS subjects and 15 controls. P53 expression was significantly (p= 0.003) increased in the PCOS women compared with controls. The third project was performed to identify gene expression in ovaries from women with PCOS, ovarian cancer and healthy controls (three ovaries from each group were utilized). 34(2%) genes consistently varied in abundance between normal and PCOS samples, 12 genes were over expressed in PCOS and 22 under expressed. One of the over expressed genes identified is human alpha 2 smooth muscle actin. It was 15 fold higher in PCOS ovary, than in normal ovary p< 0.001. Conclusions: the results of these studies do not provide convincing evidence of a correlation between PCOS and ovarian cancer.

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Al-Mizyen, Ebtisam S. S. "Unilateral versus bilateral laparoscopic ovarian diathermy in the management of infertile women with clomiphene citrate resistant polycystic ovarian syndrome." Thesis, Queen Mary, University of London, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.538365.

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Konecki, Angela. "A Retrospective Analysis of the Effect Weight Loss and Metformin use in Polycystic Ovarian Syndrome." The University of Arizona, 2006. http://hdl.handle.net/10150/624469.

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Class of 2006 Abstract
Objectives: To determine if Polycystic Ovarian Syndrome (PCOS) patients treated with lifestyle changes and metformin resulted in ovulation after six months of treatment. Methods: A retrospective chart review of initial patient visits at an infertility clinic were obtained. Patients that were given a diagnosis of PCOS were further reviewed for age at initial diagnosis, weight, height, ovarian cysts, lifestyle recommendations (diet, exercise, and vitamin use), metformin recommendations and usage, and if ovulation occurred after six months of treatment. Results: A total of 1011 charts were reviewed. At the initial office visit, 206 (20.38%) of these patients were classified as having PCOS. Of PCOS patients, 113 (54.85%) patients ovulated after six months of treatment. In the average initial weight, ovulators averaged slightly less weight than did non-ovulators (171.77 pounds ± 44.26 vs. 188.65 pounds ± 51.37, p=0.0121). This also follows true for the initial BMI of ovulators vs. non-ovulators (29.53 kg/m2 ± 10.14 vs. 32.69 kg/m2 ± 13.03, p=0.0521). There was a significant difference in metformin use between ovulators and non-ovulators (90.27% vs. 73.12%, p=0.0024). More ovulators were found to continue metformin treatment as compared to non-ovulators. Conclusions: In this specific infertility clinic setting, 20.3% of patients were diagnosed with PCOS at the initial office visit. Of these PCOS patients, treatment with lifestyle changes and metformin use resulted in 55% of patients achieving ovulation at six months. This study shows that weight loss, through lifestyle modification and metformin treatment, increases this population’s chances of ovulation within six months of therapy.

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Piltonen, T. (Terhi). "Age-related androgen secretion in healthy women and in women with polycystic ovary syndrome." Doctoral thesis, University of Oulu, 2004. http://urn.fi/urn:isbn:9514274369.

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Abstract The number of ovarian follicles declines with age resulting in a significant decrease of fertility by the age of 40. However, the age when follicle loss starts to affect ovarian endocrine function is not well recognized. The purpose of the present study was to investigate age-related ovarian/adrenal androgen secretion, which is crucial for estrogen biosynthesis in healthy women and in women with polycystic ovarian syndrome (PCOS). Another aim of the study was to compare the usefulness of different serum markers in assessing ovarian aging and in diagnosing polycystic ovaries (PCOs) and PCOS. The human chorionic gonadotropin (hCG) test was used to study the endocrine potential of ovaries/adrenals. The ovarian capacity to secrete and synthesize androgens was found to be decreased as early as at the age of 30 in regularly menstruating women. In women with PCOS, both basal and hCG-stimulated androgen levels were about 50% higher than in healthy women and they remained high until late reproductive age. Similarly to regularly menstruating women, the androgen secretion capacity in PCOS subjects decreased with age, and estradiol concentrations remained unchanged until the age of 44 years. Adrenal androgen synthesis was not changed during hCG-tests. Since serum antimüllerian hormone (AMH) and follicle stimulating hormone (FSH) levels were changed significantly after the age of 25 years in regularly menstruating women, they may be considered as useful serum markers reflecting the ovarian aging process. In women with PCOS, AMH levels were continuously 2- to 3-fold higher than in healthy women possibly reflecting high follicle number in these women. A decline in ovarian endocrine function before the age of 30 is one of the first signs of ovarian aging. However, in women with PCOS ovarian androgen secretion capacity is markedly increased and remain high throughout the reproductive years. The results of the present studies also indicate that LH/hCG does not play a role in adrenal androgen synthesis, since LH/hCG did not stimulate adrenal androgen synthesis. The measurement of AMH is a useful tool to estimate ovarian aging process as well as to diagnose PCOs/PCOS.

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Ellerman, Jennifer Lynn. "Don't Blame It on My Ovaries: Exploring the Lived Experience of Women with Polycystic Ovarian Syndrome and the Creation of Discourse." Scholar Commons, 2012. http://scholarcommons.usf.edu/etd/4034.

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Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder among females of childbearing age, affecting between 6-8% of the population. It is also the most common cause of infertility. Females with PCOS may have two or more of a constellation of symptoms that can potentially leave them at odds in terms of normative ideals of femininity. This study examines how feminist theory interrogates and analyzes knowledge about the body and PCOS, integrating the lived experiences of women to provide a deeper, more meaningful understanding of what it means to be a woman with PCOS.

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Hamadi, Caroline. "Public health nutrition intervention to enhance healthy eating and lifestyle modification among Lebanese women with Polycystic Ovarian Syndrome." Thesis, University of Westminster, 2018. https://westminsterresearch.westminster.ac.uk/item/q947q/public-health-nutrition-intervention-to-enhance-healthy-eating-and-lifestyle-modification-among-lebanese-women-with-polycystic-ovarian-syndrome.

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Polycystic ovary syndrome (PCOS) is the most common endocrinopathy disorder in reproductive age women. The symptoms of this disorder are the androgen excess seen with anovulation/oligoovulation or morphologically ovarian cysts. The aim of the study was to assess the efficacy of public health nutrition intervention designed to enhance healthy eating and lifestyle modification among PCOS patients attended the obstetrics and gynecology clinic at the American University of Beirut Medical Centre (AUB-MC) in Beirut, Lebanon. A prospective hospital based public health nutrition intervention was proposed in which 76 women with PCOS were recruited in the pilot study and 588 women were recruited in the scale-up intervention divided between PCOS and non-PCOS. During the scale up phase non-PCOS women were recruited to study the effect of the nutritional counseling on them as a way to compare the outcome with PCOS women. Recruited population were divided into 8 groups; group A: overweight/obese PCOS patient’s intervention (received weight management program with nutritional guidelines). Group B: overweight/ obese PCOS controls (received the usual heath care by the gynecologist), Group C: lean PCOS controls (received the usual heath care by the gynecologist), Group D: lean PCOS intervention (received weight maintenance program with nutritional guidelines ), Group E: overweight/obese non-PCOS patient’s intervention (received weight management program with nutritional guidelines) ,Group F: overweight/ obese non-PCOS controls, Group G: lean non- PCOS intervention (received weight maintenance program with nutritional guidelines), Group H: lean non-PCOS controls. Data were collected using a pre-validated questionnaire to capture sociodemographic variables, nutritional status, and physical activity, psychological and medical status. Blood analysis was carried out to determine biochemical indices. Assessment of study indicators were carried out at baseline, after 3 and 6 months from inception of intervention (pilot as well scale up). Patients in intervention groups attended a 6 month tailored nutrition counseling/education program (2 sessions per month), to enhance their understanding of their dietary intake and assist them with weight management, physical activity, healthy cooking, lifestyle, and food shopping. Following a six months pilot study intervention results have shown that 7% weight loss was achieved in overweight/ obese intervention groups and weight maintenance in lean intervention groups( Group A,B,C and D). There was a significant reduction in waist (-4.2 cm (±5.6)) and hip circumference (-3.1cm (±3.5)) with P < 0.001. There was no significant biochemical markers change (fasting blood sugar, CRP, LDL-C,HDL-C,TG,total cholesterol, fasting insulin, total testosterone,Vit D), however there was an increase in physical activity (3.1 hours/week (±1.5)) , and decrease in anxiety and depression score ( BDI-II and BAD-7); -0.8 (±0.8) and -0.7 (±0.7) with P < 0,001 compared to interventions. Following six months scale up intervention, the results have shown a weight reduction among overweight/obese PCOS women (group A) who lost, on average, 8.2 kg (P=0.001). Whilst non-PCOS women lost, on average 11.6 kg (P < 0.001)(Group E). Controls gained weight (Group B, D F and H). The biochemical, psychological and reproductive profile showed significant improvements among PCOS women (P < 0.001). Pregnancy rate increased to 70% among women trying to conceive. The results of this study have shown this intervention to be effective in Lebanese women with PCOS, decreasing their initial body weight by 5%- 10% and improving their reproductive, metabolic and endocrine profiles. This suggests the need for a nutritional intervention (nutritional guidelines) for women diagnosed with PCOS patients as a first line treatment. The study results support the effectiveness of lifestyle modification diet for PCOS women.

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Weidemann, Annchen. "The role of fructose restriction in addition to dietary modifications for weight loss and lifestyle improvement, on fertility outcome and other markers of metabolic syndrome (MS), in obese women with polycystic ovarian syndrome (PCOS)." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71878.

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Thesis (MNutr)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: The role of fructose restriction in addition to dietary modifications for weight loss and lifestyle improvement, on fertility outcome and other markers of metabolic syndrome, in obese women with polycystic ovarian syndrome (PCOS) Introduction: At the time at which the current study was undertaken no data, as yet, existed on whether restriction of fructose, while treating obese patients with PCOS for weight loss, improves the clinical symptoms and metabolic/anthropometric profile so as to promote fertility. Objectives: To evaluate the baseline intake of fructose, as well as the effect of restricting fructose intake from fruit and soft beverages to less than 20 g daily, as well as to provide guidelines for weight loss on anthropometric measurements, for improving subjective clinical symptoms, and for promoting fertility outcome in obese patients with PCOS, who seek to become fertile. Methods: The study was conducted in the Tygerberg Hospital Infertility Clinic, as an experimental cohort. Patients with a body mass index (BMI) higher than 27, seeking fertility after diagnosis with PCOS, were referred for dietary consultation, and followed up 3 monthly over 1 year. At each visit anthropometric measurements and a detailed dietary history were taken and a questionnaire for clinical symptoms was completed. Results: Baselinely, 86 patients were included in the study. Averages for weight and BMI were 99.8 ± 24.3 kg and 39.2 ± 8.7kg/m2, respectively. Average baseline daily fructose intake was 167 ± 116.8g. At baseline, significant relationships were shown between fructose intake and burning feet (ρ=0.02) and frequent waking (ρ=0.02), with a trend towards nightly eating (ρ=0.07). The dropout rate after visit 1 was 50%, with a further dropout of 41% after visit 2. After 3 visits (n=18), fructose intake significantly reduced (ρ=0.018), with the significant relationships with clinical symptoms having disappeared by visit 2. After 3 visits (n=18), both weight and BMI decreased significantly (ρ=0.017) and (ρ=0.019), respectively. Fructose was tested as a covariate to BMI, with high significance (ρ=0.006) in said population group. Conclusion: Dietary intervention to reduce fructose intake proved significant for weight loss and BMI after 3 visits. Reduced fructose intake was associated with reduced clinical symptoms. With fructose being a significant covariate to BMI, it can be concluded that fructose overconsumption could possibly contribute to both clinical symptoms and elevated BMI in said study population.
AFRIKAANSE OPSOMMING: Die rol wat die beperking van fruktose speel bykomend tot dieetaanpassings en lewenstylverbetering vir gewigsverlies by oorgewig vroue met polisistiese ovariële sindroom (PCOS) in die uitkoms van fertiliteit en ander merkers van metaboliese sindroom. Inleiding: Met die aanvang van hierdie studie was daar is geen data beskikbaar oor die invloed van die beperking van fruktose in die dieet van oorgewig pasiënte met PCOS wat vir gewigsverlies behandel word nie. Dit was ook nie bekend of laasgenoemde pasiënte se kliniese simptome en metaboliese/antropometriese profiel sou verbeter met die beperking van fruktose sodat fertiliteit by hierdie pasiënte terselfdertyd ook bevorder word nie. Doelwitte: Die evaluering van die aanvanklike inname van fruktose, sowel as die beperking van fruktose afkomstig van eetbare vrugte en versoete drankies en sap tot ’n inname van minder as 20 g daagliks, tesame met riglyne vir gewigsverlies. Die uitkoms hiervan is bepaal deur antropometriese metings, die verbetering in subjektiewe kliniese simptome en die fertiliteituitkoms by oorgewig pasiënte wat hulp met fertiliteit verlang. Metodes: Die studie het as ’n eksperimentele kohort by die Infertiliteitskliniek by Tygerberg Hospitaal plaasgevind. Pasiënte wat na diagnose met PCOS fertiliteitsbehandeling verlang het en ’n BMI hoër as 27 gehad het , is vir dieetbehandeling verwys en driemaandeliks oor ’n tydperk van een jaar opgevolg. Tydens elke besoek is antropometriese metings en ’n omvattende dieetgeskiedenis geneem en ’n vraelys oor kliniese simptome ingevul. Resultate: Aanvanklik is 86 pasiënte by die studie ingesluit. Gemiddeldes vir gewig en BMI was 99.8 ± 24.3 kg en 39.2 ± 8.7 kg/m2 respektiewelik. Gemiddelde aanvanklike daaglikse inname van fruktose was 167 ± 116.8 g. Oorspronklik het betekenisvolle verhoudings tussen fruktose en die volgende bestaan: brandvoete (ρ=0.02) en veelvuldige episodes van nagtelike wakkerheid (ρ=0.02), met ’n neiging na nagtelike etery (ρ=0.07). Die uitvalsyfer na een besoek was 50% met ’n verdere uitvalsyfer van 41% na die tweede besoek. Na drie besoeke (n=18) het sowel die gewig as die BMI betekenisvolle afname getoon (ρ= 0.017) en (ρ=0.019), respektiewelik. Fruktose is as ’n belangrike kovariant vir BMI (ρ= 0.006) vir hierdie populasiegroep geïdentifiseer. Gevolgtrekking: Dieetintervensie vir die vermindering van die inname van fruktose was beduidend vir gewigsverlies en afname in BMI na drie besoeke. Verminderde fruktose-inname het gelei tot die vermindering van kliniese simptome. Met fruktose as beduidende kovariant vir BMI kan die gevolgtrekking gemaak word dat die oor-inname van fruktose by hierdie studiepopulasie waarskynlik tot sowel kliniese simptome as BMI bygedra het.

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Nemade, Rashmi Vithal. "THE DISRUPTION OF THE BLOOD FOLLICLE BARRIER IN OVARIAN FOLLICULAR CYST DEVELOPMENT: REGULATION BY NITRIC OXIDE." University of Cincinnati / OhioLINK, 2000. http://rave.ohiolink.edu/etdc/view?acc_num=ucin976039111.

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Mazier, Hannah. "Role of Mitochondrial Dynamics and Cell Death in a Dihydrotestosterone-induced Rat Model of Polycystic Ovarian Syndrome, and its Regulation by Gonadotropin." Thesis, Université d'Ottawa / University of Ottawa, 2016. http://hdl.handle.net/10393/35572.

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Polycystic ovarian syndrome (PCOS) is a multi-factorial infertility disorder whose etiology and pathogenesis is not completely understood. Although there is an association between dysregulation of mitochondrial fission and fusion to cell death (apoptotic and autophagic) and the pathogenesis of various diseases, this had not been reported in the context of granulosa cell death, follicular growth arrest and PCOS. Follicle-stimulating hormone (FSH), a granulosa cell survival factor, is used during gonadotropin therapy to assist in follicular maturation and ovulation in women with PCOS. Whether FSH can modulate the possible dysregulation of granulosa cell mitochondrial dynamics and cell death in PCOS had not been elucidated. Chemerin is an adipokine that has been associated with PCOS and granulosa cell apoptosis in follicle cultures. Its role in cell death (apoptotic and autophagic) of primary granulosa cells had not been confirmed. In this thesis, we investigated the dysregulation of granulosa cell mitochondrial dynamics in PCOS pathogenesis by using an androgenized rat model, and its modulation by exogenous gonadotropin. The mechanisms involved in gonadotropic regulation were investigated using primary granulosa cells. Our data suggest that increased mitochondrial fission leads to early antral granulosa cell death, follicular growth arrest and anovulation in women with PCOS. FSH can regulate the phosphorylation of mitochondrial fission protein Drp1, which may lead to its suppression of mitochondrial fission and apoptosis in PCOS. Finally, chemerin had no effect on cell death in granulosa cell cultures. These findings provide a greater understanding of the processes involved in PCOS pathogenesis and the regulatory role of FSH in granulosa cells, laying the foundation for future study into the development of potential biomarkers and new treatment strategies.

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Philbois, Stella Vieira. "Estudo dos efeitos da Síndrome dos Ovários Policísticos sobre o controle autonômico cardiovascular, com enfoque na sensibilidade barorreflexa e na variabilidade da frequência cardíaca e da pressão arterial - análises pelos métodos linear e não-linear." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/17/17152/tde-26042018-115231/.

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A Síndrome dos Ovários Policísticos (SOP) afeta uma grande parcela da população feminina em idade reprodutiva. Além das alterações morfológicas, hormonais e metabólicas, essas mulheres também apresentam uma alta prevalência de obesidade e alterações no controle autonômico cardiovascular de acordo com a literatura, principalmente modificações na modulação autonômica da variabilidade da frequência cardíaca (VFC). No entanto, pouco sabemos sobre outros parâmetros do controle autonômico, como a variabilidade da pressão arterial (VPA) e a sensibilidade barorreflexa (SBR). Portanto, o principal objetivo do estudo foi investigar em mulheres com a SOP as alterações na modulação autonômica da VPA e na SBR, bem como avaliar se essas alterações são decorrentes da SOP ou do aumento da gordura corporal. Para tanto, foram estudadas 30 mulheres voluntárias eutróficas (IMC ? 25 kg/m2) sem a SOP e 60 mulheres voluntárias com a SOP divididas em dois grupos: eutróficas (IMC ? 25 kg/m2; N=30) e obesas (IMC ? 30 kg/m2; N=30). Todas as mulheres foram submetidas aos seguintes protocolos; coleta de sangue para hemograma completo; avaliação antropométrica e avaliação de parâmetros metabólicos e hormonais em repouso; registro de parâmetros hemodinâmicos e cardiorrespiratórios em repouso e durante o exercício físico; análise da VFC e da VPA; e análise da SBR espontânea. A comparação entre os grupos eutróficos com e sem SOP não apresentou qualquer diferença nos parâmetros autonômicos avaliados. No entanto, a comparação entre os grupos SOP mostrou que o grupo SOP obeso apresentou menores valores de VO2 e testosterona, e maiores valores de triglicerídeos e da pressão arterial em relação ao grupo SOP eutrófico. Quanto aos parâmetros autonômicos, os grupos obeso e eutrófico não diferiram na análise da VPA. Entretanto, o grupo SOP obeso apresentou menores valores da SBR espontânea e das oscilações de baixa frequência (LF) da VFC em unidades absolutas. Por fim, nossos resultados sugerem que a obesidade pouco alterou a VFC em mulheres com SOP, entretanto reduziu sensivelmente a SBR espontânea. Esses achados podem estar associados com diferenças hormonais encontradas nessas mulheres, como os níveis séricos de testosterona mais elevados no grupo eutrófico.
Polycystic Ovarian Syndrome (PCOS) affects a large proportion of the female population at reproductive age. In addition to morphological, hormonal and metabolic alterations, these women also present a high prevalence of obesity and alterations in cardiovascular autonomic control according to the literature. Mainly modifications in the autonomic modulation of heart rate variability (HRV). However, we do not know much about other parameters of autonomic control, such as blood pressure variability (APV) and baroreflex sensitivity (SBR). Therefore, the main objective of the study was to investigate in women with PCOS changes in the autonomic modulation of APV and SBR, as well as to assess whether these alterations are due to PCOS or increased body fat. In order to do, 30 eutrophic non-PCOS voluntary women (BMI ? 25 kg / m2) and 60 voluntary PCOS women who were studied in two groups: PCOS eutrophic (BMI ? 25 kg / m2, N = 30) and PCOS obese women (BMI ? 30 kg / m2, N = 30). All the women were submitted to the following protocols; collection of blood for complete blood count; anthropometric evaluation and evaluation of metabolic and hormonal parameters at rest; recording of hemodynamic and cardiorespiratory parameters at rest and during physical exercise; analysis of HRV, APV and spontaneous SBR analysis. The comparison between the eutrophic PCOS and nonPCOS groups showed no difference in the autonomic parameters evaluated. However, the comparison between the PCOS groups showed that the PCOS obese group presented lower values of VO2 and testosterone, and higher triglyceride values and blood pressure in relation to the PCOS eutrophic group. Regarding the autonomic parameters, the PCOS obese and eutrophic groups did not differ in the APV analysis. However, the PCOS obese group presented lower values of spontaneous SBR and low frequency oscillations (LF) of HRV in absolute units. Finally, our results suggest that obesity did not significantly alter HRV in women with PCOS, but it significantly reduced spontaneous SBR. These findings may be associated with hormonal differences found in these women, such as higher serum testosterone levels in the PCOS eutrophic group.

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Costa, Beber Carla. "Diferenças no reconhecimento de osteoporose e da síndrome dos ovários policísticos entre os endocrinologistas e ginecologistas na cidade de Santa Maria – RS." Universidade Federal de Santa Maria, 2017. http://repositorio.ufsm.br/handle/1/11879.

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Chronic diseases such as systemic arterial hypertension, type 2 diabetes mellitus, osteoporosis and polycystic ovarian syndrome are prevalent in Brazil and are responsible not only for considerable morbidity and mortality in specific segments of the population, but also for high financial costs. Despite all their relevance, the diagnosis of these health problems in our country is not performed in an ideal way. As a consequence, there is a difficulty to act preventively in these pathologies, generating unwanted clinical complications. The difficulty of establishing diagnoses uniformly in common pathologies is not unique to our country. There are studies that demonstrate that the recognition of polycystic ovary syndrome is under-registered in developed countries such as Australia, as well as osteoporosis in China. At these sites, a variation in the identification of these pathologies has been demonstrated according to the physician's specialty. The objective of this study was to evaluate, through a questionnaire, the awareness regarding the diagnosis and management of polycystic ovarian syndrome and osteoporosis among the specialized physicians whom works in these areas (gynecologists and endocrinologists) in the city of Santa Maria, southern Brazil, where has a population of about 300,000 inhabitants. To improve this comparison, two other prevalent diseases (type 2 diabetes mellitus and systemic arterial hypertension) were included in the same questionnaire. A crosssectional study was carried out between July and August 2015 (Approval of CAAE 43401415.3.0000.5346). In total, 90% of endocrinologists and 75% of gynecologists out of a total of 97 physicians registered in the Regional Council of Medicine completed the questionnaire that was applied by a trained interviewer. No differences related to age, gender and time of work experience were observed among these specialists. In general, the responses of endocrinologists and gynecologists were consistent. Considering the questions about polycystic ovarian syndrome, the decision to include total testosterone, 17OHP, and prolactin was significantly higher in the group of endocrinologists than gynecologists. Regarding osteoporosis, the inclusion of the history of low-impact fractures in the diagnosis of osteoporosis was significantly more reported by gynecologists than endocrinologists. As expected, sequential identification of secondary causes of osteoporosis was more frequently performed by endocrinologists than gynecologists, who also identified a greater number of drug treatment options. To our knowledge, this is the first initiative to estimate differences in the recognition of polycystic ovarian syndrome and osteoporosis among gynecologists and endocrinologists using a medium-sized Brazilian city. It is believed that the information coming from this study will enable in the future the development of strategies and production of technical support materials directed to an improvement in the quality of the health care service.
Doenças crônicas como hipertensão arterial sistêmica, diabetes mellitus tipo 2, osteoporose e síndrome dos ovários policísticos são prevalentes no Brasil e se tornam responsáveis não somente por considerável morbi-mortalidade em segmentos específicos da população, mas também por elevados custos financeiros. Apesar de toda a sua relevância, o diagnóstico destes problemas de saúde em nosso meio não é realizado de uma maneira ideal. Como consequência, existe uma dificuldade para atuar preventivamente nestas patologias, gerando complicações clínicas indesejadas. A dificuldade para estabelecer diagnósticos de uma maneira uniforme em patologias comuns não é exclusiva do nosso país. Existem estudos que demonstram que o reconhecimento da síndrome dos ovários policísticos é subregistrado em países desenvolvidos como a Austrália, assim como a osteoporose na China. Nesses locais, demonstrou-se uma variação na identificação destas patologias de acordo com a especialidade do médico. O presente estudo teve como objetivo avaliar através de questionário o conhecimento relativo ao diagnóstico e manejo pontual da síndrome dos ovários policísticos e osteoporose entre os médicos especialistas que mais atuam nestas áreas (ginecologistas e endocrinologistas) no município de Santa Maria, sul do Brasil, que tem uma população de cerca de 300.000 habitantes. Para melhor comparação, outras duas doenças prevalentes (diabetes mellitus tipo 2 e hipertensão arterial sistêmica) foram incluídas no mesmo questionário. Foi realizado um estudo transversal entre os meses de julho e agosto de 2015 (Aprovação do CAAE 43401415.3.0000.5346). Ao todo, 90% dos endocrinologistas e 75% dos ginecologistas de um total de 97 médicos registrados no Conselho Regional de Medicina completaram o questionário que foi aplicado por um entrevistador treinado. Nenhuma diferença relacionada à idade, gênero, tempo de experiência de trabalho foram observadas entre estes especialistas. De maneira geral, as respostas de endocrinologistas e ginecologistas foram similares. Considerando as questões sobre síndrome dos ovários policísticos, a decisão de incluir testosterona total, 17OHP, e prolactina foi significativamente maior no grupo de endocrinologistas que ginecologistas. Em relação à osteoporose, a inclusão da história de fraturas de baixo impacto no diagnóstico de osteoporose foi significativamente mais referida por ginecologistas que endocrinologistas. Como esperado, a identificação sequencial de causas secundárias de osteoporose foi mais frequentemente realizada por endocrinologistas que ginecologistas, que também identificaram um maior número de opções de tratamento medicamentoso. Consideramos que esta seja a primeira iniciativa de estimar as diferenças de reconhecimento de síndrome dos ovários policísticos e osteoporose entre ginecologistas e endocrinologistas utilizando uma cidade brasileira de tamanho médio. Acredita-se que as informações advindas deste estudo possibilitarão no futuro o desenvolvimento de estratégias e produção de materiais técnicos de apoio direcionados a uma melhoria na qualidade do serviço assistencial de saúde.

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Pimentel, Anita Mylius. "Diatermia ovariana guiada por ecografia transvaginal utilizando animais como modelo experimental." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2012. http://hdl.handle.net/10183/117140.

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Introdução: A Síndrome dos Ovários Policísticos (SOP) afeta 5 a 10% de mulheres em idade reprodutiva. O tratamento da infertilidade de causa anovulatória em pacientes com SOP envolve a indução da ovulação, sendo o citrato de clomifeno (CC) a medicação de primeira escolha. Nos casos resistentes ao CC, a segunda linha de tratamento pode ser medicamentosa (gonadotrofinas) ou cirúrgica (cauterização ou diatermia ovariana), realizada por videolaparoscopia (VLPC). A indução com gonadotrofinas aumenta muito o risco de multigestação, o que não ocorre com a diatermia ovariana, que restaura a ovulação fisiológica (monovulação). A ecografia transvaginal é um procedimento simples, menos invasivo do que aVLPC, que permite a punção ovariana através do fórnice vaginal. Objetivos: desenvolver uma técnica minimamente invasiva de cauterização ovariana monopolar guiada por ecografia transvaginal, utilizando animais (ovelhas e vacas) como modelo experimental. Métodos: em um primeiro experimento foram utilizadas ovelhas (15 Corriedale e 2 Suffolk) e no segundo experimento foram utilizadas 11 vacas Angus, todos animais em idade reprodutiva e com integridade ovariana anatômica e funcional. Para a cauterização monopolar foi utilizado o eletrocautério Valleylab Force FX e uma agulha especialmente desenvolvida para esse fim. Os animais tiveram os ovários cauterizados em 4 pontos cada e foram abatidos 2 dias após para coleta dos ovários e inspeção do trajeto da agulha. Resultados: Nas ovelhas, dos 34 ovários cauterizados, apenas 3 apresentaram a lesão característica. Dos 22 ovários cauterizados nas vacas, 20 apresentaram a lesão característica, tanto macro quando microscopicamente. Nas duas espécies animais, não houve lesões no trajeto da agulha. Conclusão: A cauterização ovariana se mostrou segura nos dois modelos experimentais, nenhum animal apresentou lesões térmicas ou pela punção no trajeto da agulha. Nas vacas, a identificação ecográfica e a cauterização, além de segura, foram efetivas. A eficiência e segurança dessa técnica devem ser estudadas em mulheres com anovulação por SOP.
Introduction: The Polycystic Ovary Syndrome (PCOS) affects 5-10% of women at reproductive age. Treatment of anovulatory infertility in patients with PCOS involves the induction of ovulation, with clomiphene citrate (CC) the drug of first choice. In cases resistant to CC, the second line of treatment can be medicated (gonadotropins) or surgery (ovarian diathermy or cautery), performed by laparoscopic video (LPCV). The induction with gonadotrophins increases the risk of multi pregnancy, which does not occur with ovarian diathermy, which restores physiological ovulation (monovulation). The transvaginal ultrasound is a simple procedure, less invasive than the LPCV allowing ovarian puncture through the vaginal fornix. Objectives: To develop a minimally invasive technique of monopolar ovarian cauterization guided by transvaginal ultrasound, using animals (sheep and cattle) as an experimental model. Methods: In a first experiment were used sheep (15 Corriedale and 2 Suffolk). In the second experiment were used 11 cows Angus, all animals at reproductive age with anatomic and funcional ovarian integrity. For cauterized were used Valleylab Force FX electrocautery and a needle specially developed for this purpose. The animals had ovaries cauterized at 4 points each and were slaughtered 2 days after for collection of the ovaries and inspection of the needle path. Results: In sheep, from the 34 ovaries cauterized, only 3 showed the characteristic lesion. From the 22 ovaries cauterized in cows, 20 had the characteristic lesion, both macro and microscopically. In both species, there were no injuries in the path of the needle. Conclusion: The ovarian cauterization proved safe in experimental models, no animal showed thermal injury or puncture in the path of the needle. In cows, the sonographic identification and cauterization, beyond safe, were effective. The efficiency and safety of this technique should be studied in women with SOP anovulatory.

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Müller, Susanne. "Molekulargenetische, endokrinologische und klinische Untersuchungen bei Patientinnen mit polyzystischem Ovar Syndrom und ovariellem Überstimulationssyndrom." Doctoral thesis, Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité, 2003. http://dx.doi.org/10.18452/14929.

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Das Ziel der Arbeit war es, mittels biochemischer und molekulargenetischer Untersuchungen die Rolle des partiellen 21-Hydroxylase-Mangels in der Pathogenese des Polyzystischen Ovar Syndroms (PCOS) und des Ovariellen Überstimulationssyndroms (OHSS) zu beleuchten sowie ein charakteristisches biochemisches Profil für Patientinnen mit erhöhtem Risiko zur Ausbildung eines OHSS aufzudecken. In die Studie wurden 62 Patientinnen eingeschlossen, 23 Kontrollpersonen und 39 PCOS-Patientinnen, von denen 17 Patientinnen anamnestisch mindestens eine Episode eines OHSS aufwiesen. Umfangreiche biochemische Analysen dienten zur Bestimmung der partiellen 21-Hydroxylase-Insuffizienz, zur Untersuchung des Ursprungs des Androgenüberschusses (ACTH und LHRH-Test) und zur Charakterisierung des metabolischen Profils (Leptin, Insulin, SHBG, IGF-1). Zur Darstellung des Gentotyps führten wir die lückenlose Untersuchung des CYP21A2-Gens auf Mutationen und Polymorphismen durch. Die androgenen Steroide wiesen ein bei den PCOS-Patientinnen im Vergleich zu den Kontrollpatientinnen erhöhtes Niveau auf, ohne dass sich ein klare Unterscheidung zwischen adrenalem und ovariellem Ursprung abzeichnete. Bei den OHSS-Patientinnen dominierten die ovariellen Androgene. Die Leptinwerte waren in der PCOS-Gruppe erhöht, besonders bei den Patientinnen mit OHSS. Die Frequenz heterozygoter Punktmutationen lag in unserer PCOS-Gruppe mit 23% deutlich höher als in der Kontrollgruppe mit 8%. Es ergab sich kein signifikanter Unterschied zwischen PCOS-Patientinnen mit und ohne OHSS. Die Allelfrequenz der detektierten Polymorphismen unterschied sich nicht zwischen PCOS-Patientinnen und Kontrollen. Von insgesamt 17 Patientinnen mit biochemischen Auffälligkeiten waren 8 Trägerinnen einer heterozygoten Mutation. Im Gegensatz dazu wiesen nur 8 der 11 Patientinnen mit Punktmutation biochemische Abweichungen auf. Es ergab sich also nicht für jeden Fall eine eindeutige Genotyp-Phänotyp-Korrelation.
This study was designed to evaluate the possible role of partial 21-Hydroxylase Deficiency in the pathogenesis of the Polycystic Ovary Syndrome (PCOS) and the Ovarian Hyperstimulation Syndrome (OHSS) by means of biochemical and molecular genetic investigations, as well as to identify the biochemical profile typical of patients with an elevated risk of developing an OHSS. 62 female patients were included in the study, 23 controls and 39 PCOS patients. 17 of these had at least one anamnestic episode of OHSS. Extensive biochemical investigations were used to determine partial 21-OHase Deficiency as well as the source of the androgen excess (ACTH and LHRH tests) and to describe the metabolic profile (leptin, insulin, SHBG and IGF-1). For genotypic characterization, we screened the CYP21A2 gene for any mutation or polymorphism. Androgens were elevated in the PCOS group without a clear differentiation into adrenal or ovarian origin. Amongst patients with OHSS, the ovarian androgens were dominant. Higher leptin levels were measured in the PCOS group, especially in patients with OHSS. The frequency of heterozygous point mutations was 23% in our PCOS group, compared to 8% amongst control patients. There was no relevant difference between PCOS patients with or without an OHSS. The frequency of polymorphisms did not differ between the groups. We found relevant heterozygous point mutations in 8 of the 17 patients with biochemical deviations. In contrast to this only 8 of the 11 patients with point mutations showed biochemical derangements indicating no clear Genotype-Phenotyp-correlation.

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Wippel, Cássia dos Santos. "Hirsutismo autorreportado e comorbidades na pós-menopausa." Universidade Federal de Santa Maria, 2017. http://repositorio.ufsm.br/handle/1/11880.

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Polycystic Ovarian Syndrome (PCOS) is the most frequent metabolic disorder in the female population. It affects 10% of women of childbearing age, and its pathophysiology, although not completely known, is associated with insulin resistance, hyperandrogenism and gonadotropin alteration. The diagnosis is of exclusion and is difficult due to the multiple phenotypes found, being fundamental the presence of menstrual dysfunction and alteration of the levels of androgens. Hirsutism, increased pilification in androgen-dependent areas, is a frequent complaint and correlates with PCOS in up to 95% of cases. Women with PCOS are at greater risk for developing metabolic syndrome and cardiovascular disease. These comorbidities usually manifest with aging and there are no guidelines for diagnosing PCOS after menopause. Because of this, we have attempted to prove the hypothesis that the history of self-reported hirsutism and / or oligomenorrhea influences the calculation of risk for comorbidities after menopause (type 2 diabetes mellitus, asthma, chronic bronchitis or emphysema, osteoarthritis, stroke, Heart failure, angina or myocardial infarction, multiple sclerosis, neoplasia, and Parkinson's disease). This cross-sectional study investigated women (1057) with at least 55 years of age, post-menopausal, with no cognitive deficit and / or communication difficulty who were seen in primary care services in a municipality in the south of Brazil during the 24-month period, Through a structured questionnaire that collected self-reported data on the presence of comorbidities, reproductive history and complaint of hirsutism in menacme. A significantly higher prevalence of comorbidities was found in women with a history of hirsutism and / or oligomenorrhea [OR = 1.6 (95% CI 1.1-2.4), or = hirsutism [OR 2.0 95% CI 1.3-3.2), P = 0.004]. As well as the prevalence of stroke, angina or myocardial infarction, heart failure, chronic obstructive pulmonary disease and osteoarthritis were significantly higher (p <0.03). Therefore, the presence of hirsutism and oligomenorrhea in menacing are risk factors for comorbidities, mainly cardiovascular, these alterations are possibly associated with the presence of PCOS, so its correct diagnosis in the menacme could avoid the reduction of quality of life in senectude.
Síndrome dos Ovários Policísticos (SOP) é a desordem metabólica mais frequente na população feminina, acomete 10% das mulheres em idade fértil e cuja fisiopatologia, apesar de não ser completamente conhecida, associa-se a resistência à insulina, hiperandrogenismo e alteração das gonadotropinas. O diagnóstico é de exclusão e dificultado devido aos múltiplos fenótipos encontrados, sendo fundamental a presença de disfunção menstrual e alteração dos níveis de androgênios. O hirsutismo, pilificação aumentada em áreas andrógeno-dependentes, é queixa frequente e correlaciona-se a SOP em até 95% dos casos. Mulheres portadoras de SOP tem maior risco para desenvolver síndrome metabólica e doenças cardiovasculares. Essas comorbidades costumam manifestar-se com o envelhecimento e inexistem diretrizes para diagnosticar SOP após a menopausa. Devido a isso, tentamos comprovar a hipótese de que a história de hirsutismo e/ou oligomenorreia autorrelatada na menacme influencia no cálculo do risco para comorbidades após a menopausa (diabetes mellitus tipo 2, asma, bronquite crônica ou enfisema, osteoartrite, acidente vascular cerebral, insuficiência cardíaca, angina ou infarto do miocárdio, esclerose múltipla, neoplasia e doença de Parkinson). Esse estudo transversal investigou mulheres (1057) com pelo menos 55 anos, na pós-menopausa, sem déficit cognitivo e/ou dificuldade de comunicação que foram atendidas em serviços de atenção primária de um município do sul de Brasil durante o período de 24 meses, através de um questionário estruturado que coletou dados autorrelatados da presença de comorbidades, história reprodutiva e queixa de hirsutismo na menacme. Identificou-se prevalência de comorbidades significativamente maior nas mulheres com história de hirsutismo e/ou oligomenorreia [OR = 1,6 (95% IC 1,1-2,4), p = 0,002] ou hirsutismo isolado [OR 2,0 (IC 95% 1,3-3,2), P = 0,004]. Assim como a prevalência de acidente vascular cerebral, angina ou infarto do miocárdio, insuficiência cardíaca, doença pulmonar obstrutiva crônica e osteoartrite foram significativamente maiores (p <0,03). Portanto, a presença de hirsutismo e oligomenorreia na menacme são fatores de risco para comorbidades, principalmente cardiovasculares, essas alterações são possivelmente associadas a presença de SOP, por isso seu correto diagnóstico na menacme poderia evitar a redução da qualidade de vida na senectude.

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Gonçalves, Thiago Hideki. "Avaliação do estresse oxidativo e expressão de genes envolvidos com síntese e oxidação de ácidos graxos em modelo animal de síndrome dos ovários policísticos tratado com metformina e submetida ao exercício físico." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5139/tde-21022018-104859/.

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Introdução: A síndrome dos ovários policísticos (SOP) é um distúrbio endócrino complexo com aspectos reprodutivos e metabólicos. Alterações do tecido adiposo participam da fisiopatologia da síndrome e anormalidades do metabolismo de ácidos graxos, bem como o estresse oxidativo, parecem ter papel importante nesse processo. Assim, tanto o exercício físico como a metformina são comumente recomendadas. O objetivo deste estudo foi avaliar a expressão de genes envolvidos com a síntese e oxidação dos ácidos graxos e com os níveis de estresse oxidativo no tecido adiposo de ratas com modelo experimental de SOP tratadas com metformina (Met), submetidas ou não a exercício físico em esteira (Ex). Métodos: Foram utilizadas 46 ratas, Wistar, que receberam no 2º dia de vida, uma única injeção subcutânea de propionato de testosterona (1,25 mg) para a indução de estado de estro permanente e óleo de sésamo (controles). Com 80 dias de idade iniciou-se o experimento e os animais foram divididos em 5 grupos: 1) Controle; 2) SOP ; 3) SOP+Met; 4) SOP+Ex; 5) SOP+Met+Ex.Os tratamentos tiveram duração de 6 semanas. Os animais foram sacrificados aos 120 dias de vida e foram retirados os depósitos das gorduras inguinal e mesentérica. Os depósitos de gordura inguinal e mesentérica foram utilizados para análise da expressão dos genes Acaca, Srebp1, Cpt1 e Cd36, por PCR quantitativo em tempo real, e dos níveis de estresse oxidativo pela dosagem das glutationas reduzida (GSH) e oxidada (GSSG). Adicionalmente, o tamanho dos adipócitos foi analisado por histomorfometria. Resultados: Na análise histomorfométrica dos adipócitos da gordura mesentérica, houve diminuição significativa no grupo SOP+Met+Ex em relação ao grupo SOP. O grupo SOP apresentou hipertrofia em relação ao grupo controle. A análise na gordura inguinal não apresentou nenhuma diferença entre os grupos.Não houve diferença estatística entre os grupos nas análises de expressão gênica das gorduras mesentérica e marrom. Não identificamos diferenças nas medidas de estresse oxidativo (razões GSH/GSSG ,GSH, GSH total, GSSG e razão GSH/GSSG) no tecido adiposo subcutâneo, mesentérico, perigonadal e marrom entre os depósitos de gordura dos animais em nenhum dos grupos avaliados
Introduction: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder, affecting both reproductive and endocrine systems. Changes in adipose tissue are involved in the pathophysiology of the syndrome, and abnormalities of fatty acid metabolism, as well as oxidative stress, appear to play an important role in this process. Thus, both physical exercise and metformin are commonly recommended. The objective of this study was to evaluate the expression of genes involved in the synthesis and oxidation of fatty acids and oxidative stress levels in adipose tissue of in an experimental model of PCOS using Wistar rats. Methods: 46 rats, Wistar, treated with a single subcutaneous injection of testosterone propionate (1.25 mg) for the induction of permanent estrus status (PCOS model) or sesame oil (controls) on the 2nd day of life. Experimental phase of the study was started when animals completed 80 days of age. They were divided into 5 groups: 1) Control; 2) PCOS; 3) PCOS+ Met; 4) PCOS + Ex; 5) PCOS + Met + Ex. Intervention lasted 6 weeks. Animals were sacrificed at 120 days of age and the deposits of inguinal and mesenteric fat were removed. Inguinal and mesenteric fat deposits were used to analyze the expression of Acaca, Srebp1, Cpt1 and Cd36 genes by quantitative realtime PCR and oxidative stress levels by reduced (GSH) and oxidized glutathione (GSSG). In addition, adipocyte size was analyzed by histomorphometry. Results: In the histomorphometric analysis of mesenteric fat adipocytes, there was a significant decrease in the PCOS + Met + Ex group in relation to the PCOS group. PCOS group presented hypertrophy in relation to the control group. Inguinal fat analysis did not present any differences between the groups. There was no statistical difference between groups in analyzes of gene expression of mesenteric and brown fats. We did not identify differences in oxidative stress measurements (GSH / GSSG, GSH, total GSH, GSSG and GSH / GSSG ratio) in the subcutaneous, mesenteric, perigonadal and brown adipose tissue among the fat deposits of the animals in any of the evaluated groups

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Araujo, Carlos Henrique Medeiros de. "Maturação in vitro de oócitos de mulheres com síndrome dos ovários policísticos: comparação entre dois meios de cultivo." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/17/17145/tde-27092013-152326/.

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Objetivo:Comparar a eficácia dos meios de cultivo HTF (Human Tubal Fluid) e TCM 199 (Tissue Culture Medium) na maturação in vitro. Métodos:Estudo experimental controlado e randomizado no qual foram avaliadas as taxas de maturação oocitária, fertilização, clivagem e produção de embriões de boa qualidade em 23 ciclos não estimulados de maturação oocitária, com 119 oócitos coletados, de 13 mulheres com Síndrome dos Ovários Policísticos. Os oócitos de cada paciente foram transferidos randomicamente para cada um dos meios de cultivo sendo que, 61 (51%) foram colocados no meio TCM 199 e 58 (49%) no meio HTF. Os dois meios de cultivo receberam suplementação hormonal. Resultados:Diferenças significativas foram encontradas entre os meios de cultivo TCM 199 e HTF em relação à taxa de maturação oocitária (82% vs. 56.9%, p = 0.005), taxa de fertilização (70% vs. 39.4%, p = 0.007) e taxade produção de embriões de boa qualidade (81.3% vs. 41.7%, p= 0.023). Conclusão:O meio de cultivo HTF embora seja utilizado para manutenção de embriões em técnicas de fertilização assistida e em procedimentos de maturação in vitrocom ciclos estimulados, não é o meio mais apropriado paramaturação de oócitos obtidos de mulheres com Síndrome dos Ovários policísticosem ciclos não estimulados.
Objective:Compare oocytes human culture in human tubal fluid (HTF) and Tissue Culture Medium (TCM 199) invitromaturation cycles. Methods:Randomized controlled trial which oocyte maturation, fertilization, cleavage rates and embryo quality in 23 in vitromaturation cycles no stimulation were evaluated, resulting in 119 oocytes retrieved from 13 patients withpolycystic ovarian syndrome. The oocytes from each patient were assigned randomly to the two culture media, 61 (51%) to the TCM 199 and 58 (49%) to the HTF using the same hormonal supplementation. Results:Significant differences were observed between TCM 199 and HTF regarding maturation rate (82% vs. 56.9%, p = 0.005), fertilization rate (70% vs. 39.4%, p = 0.007) rates and embryo quality (81.3% vs. 41.7%, p= 0.023). Conclusion:The HTF medium, although widely employed for oocyte fertilization and embryo maintenance in IVF techniques, is not an appropriated medium to maturation oocytes obtained from PCOS patients innon - stimulated cycles.

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Pedroso, Daiana Cristina Chielli. "Comprimento do telômero e atividade da telomerase em células do cumulus de mulheres com Síndrome dos Ovários Policísticos." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/17/17145/tde-19072018-102713/.

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A Síndrome dos Ovários Policísticos (SOP) representa um dos distúrbios endócrinos reprodutivos mais comuns em mulheres em idade reprodutiva. As mulheres com SOP normalmente respondem bem ao tratamento de reprodução assistida (TRAs), mas frequentemente apresentam oócitos de baixa qualidade e capacidade reprodutiva, a qual está correlacionado com a interação do oócito com as células do cumulus. A baixa qualidade oocitária pode estar relacionada a perda de estabilidade genômica do oócito, ou até mesmo das células do cumulus, o que pode levar a uma redução gradativa da fertilidade feminina. Os telômeros e a atividade da telomerase possuem um papel fundamental na manutenção da estabilidade genômica e são considerados importantes marcadores de viabilidade celular, podendo ser um indicativo da qualidade oocitária. O objetivo do estudo foi avaliar o comprimento do telômero e atividade da telomerase nas células do cumulus de mulheres com SOP. Neste estudo prospectivo caso-controle foram incluídas 110 voluntárias, sendo 43 mulheres com SOP e 67 controles no período de Setembro de 2015 a Junho de 2017. Foram avaliados os dados como idade, Índice de massa corporal (IMC), hormônio luteinizante (LH), hormônio folículo estimulante (FSH), globulina de ligação de hormônios sexuais (SHBG), prolactina, estradiol, insulina, testosterona total, androstenediona, índice de androgênio livre (FAI), homocisteína e proteína c-reativa. Foi avaliado o comprimento do telômero nas células do cumulus de oócitos imaturos (CCI), nas células do cumulus de oócitos maduros (CCM), nos oócitos imaturos no estágio de vesícula germinativa (VG), nos oócitos imaturos em metáfase I (MI) e nos leucócitos pelo método quantitativo da reação em cadeia da polimerase (qPCR). A atividade da telomerase das CCI, CCM, dos oócitos VG e MI foram avaliadas pelo Kit TRAPeze® XL. A análise estatística foi determinada pelo teste Mann-Whitney, regressão linear múltipla e correlação de Spearman. Os resultados foram que as variáveis IMC (p=0,001), LH (p=0,015), estradiol (p=0,004), insulina (p=0,002), testosterona (p<0,0001), androstenediona (p=0,001), FAI (p<0,0001) e proteína c-reativa (p=0,003) foram maiores no grupo SOP. FSH (p=0,0002) foi menor no grupo SOP. A prolactina e a homocisteína não diferiram entre os grupos. O comprimento do telômero nas CCI não diferiu entre os grupos SOP e controle (1,60±0,56 vs 1,58±0,33; p=0,649, respectivamente), bem como o comprimento do telômero nas CCM não diferiu entre os grupos SOP e controle (1,61±0,47 vs 1,70±0,43; p=0,378, respectivamente). Entretanto, nos leucócitos o comprimento do telômero foi menor no grupo SOP (p=0,025). A atividade da telomerase nas CCI foi maior no grupo SOP do que no grupo controle (1,62±1,49 vs 0,30±0,42; p=0,003, respectivamente) e a atividade da telomerase nas CCM também foi maior no grupo SOP do que no grupo controle (1,39±1,63 vs 0,55±0,84; p=0,022, respectivamente). O comprimento do telômero e a atividade da telomerase nos oócitos VG e MI não diferiu entre os grupos. Uma correlação positiva foi observada entre a atividade da telomerase e o comprimento do telômero nas CCI no grupo controle (p=0,051). O grupo SOP apresentou uma correlação positiva entre a atividade da telomerase e o comprimento do telômero, porém nas CCM (p=0,048). Foi observada uma correlação positiva do comprimento do telômero entre as células (leucócitos, CCI e CCM) em ambos os grupos. Os dados sugerem que a SOP parece não afetar o comprimento do telômero nas CCI e CCM, apenas nos leucócitos. Por outro lado, uma maior atividade da telomerase nas CCI e CCM pode ser necessária para a manutenção do comprimento telomérico à nível reprodutivo nas mulheres com SOP.
Polycystic Ovarian Syndrome (PCOS) represents one of the most common reproductive endocrine disorders in women of reproductive age. Women with PCOS, despite responding well to Assisted Reproduction Treatments (ART), the oocytes usually have low quality and reproductive capacity, which is correlated to oocyte interaction with cumulus cells. The low oocyte quality may be related to loss of genomic stability of oocytes, or even cumulus cells, and may lead to a reduction of female fertility. The telomere length and telomerase activity play a fundamental role in maintaining genomic stability, which is considered an important molecular marker of cell viability, whose alterations are related to apoptosis and/or senescence, maybe also an indicative of oocyte quality. The aim of the study was to evaluate the telomere length and telomerase activity in cumulus cells of women with PCOS. In this prospective case-control study, 110 volunteers were included, 43 women with PCOS and 67 controls from September 2015 to June 2017. Data were evaluated as age, body mass index (BMI), luteinizing hormone (LH), follicle stimulating hormone (FSH), sex hormone binding globulin (SHBG), prolactin, estradiol, insulin, total testosterone, androstenedione, index of free androgen (FAI), homocysteine and c-reactive protein. Telomere length in cumulus cells from immature (ICC) and mature (MCC) oocytes, leukocytes and immature oocytes in the germinal vesicle stage (VG) and in metaphase I (MI) were evaluated by quantitative real-time polymerase chain reaction (qPCR). Telomerase activity of ICC, MCC, VG and IM oocytes were evaluated by TRAPeze® XL Kit. Statistical analyses were determined by the MannWhitney test, multiple linear regression and Spearman\'s correlation. The results were that the variables BMI (p=.001), LH (p=.015), estradiol (p=.004), insulin (p=.002), testosterone (p<.0001), androstenedione (p=.001), FAI (p<.0001) and c-reactive protein (p=.003) was increased in PCOS group. FSH (p=.0002) was smaller in PCOS group. Prolactin and homocysteine were not different between the groups. The telomeres length in ICC did not differ between PCOS and control groups (1.60±0.56 vs 1.58±0.33; p=.649, respectively). The telomeres length in MCC did not differ between PCOS and control groups (1.61±0.47 vs 1.70±0.43; p=.378, respectively). However, in leukocytes reduced telomeres were observed in the PCOS (p=.025), respectively. The telomerase activity in ICC was higher in the PCOS group than in the control group (1.62±1.49 vs 0.30±0.42; p=.003, respectively) and the telomerase activity in MCC was higher in the PCOS group than in the control group (1.39±1.63 vs 0.55±0.84; p=.022, respectively). The telomere length and telomerase activity in VG and MI oocytes did not differ between groups. A positive correlation between telomerase activity and telomere length in the ICC was observed in control group (p=.051). PCOS also presented a positive correlation between telomerase activity and telomere length in MCC (p=.048). Telomere length of leukocytes, ICC and MCC were a positive correlated in both groups. The data suggest that PCOS does not appear to affect telomere length in ICC and MCC, only in leukocytes. On the other hand, a greater activity of telomerase in CCI and CCM may be necessary for the maintenance of telomere length at the reproductive level in women with PCOS.

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Oliveira, Marina Pereira Ybarra Martins de. "Avaliação da prevalência e das características da síndrome dos ovários policísticos em adolescentes obesas." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5141/tde-23082016-105819/.

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Introdução: o diagnóstico da Síndrome do Ovário Policístico (SOP) na adolescência é desafiador e vem sendo alvo de intensas discussões. Sua prevalência em mulheres adultas em idade fértil varia de 5-10%. Entretanto, a prevalência em adolescentes obesas ainda não foi descrita na literatura. Somado a isso, ainda não é bem estabelecida a relação da SOP com alterações metabólicas e cardiovasculares nesta população. Dessa maneira, objetivamos avaliar a prevalência e as características da SOP na população de adolescentes obesas acompanhadas em um centro hospitalar quaternário. Métodos: realizamos um estudo transversal com 49 adolescentes obesas pós-menarca, com idade média de 15,6 anos. Foi realizada avaliação antropométrica e revisão de prontuários médicos. O hiperandrogenismo clínico e laboratorial foram quantificados utilizando o índice de Ferriman-Gallwey e as dosagens androgênicas, respectivamente. A morfologia ovariana foi avaliada por ultrassonografia suprapúbica. Todas as pacientes tiveram seus perfis metabólicos analisados. Resultados: ao adotarmos a nova Diretriz para SOP na adolescência da Sociedade de Endocrinologia Pediátrica Americana, encontramos uma prevalência de 18,4% de SOP em nossa população de adolescentes obesas. Quando utilizamos os critérios de Rotterdam, da Sociedade de Excesso Androgênico e SOP e do Instituto Nacional de Saúde Americano, as prevalências foram de 26,4%, 22,4% e 20,4%, respectivamente. A irregularidade menstrual foi constatada em 65,3% das pacientes. O hiperandrogenismo clínico foi observado em 16,3% das meninas, e 18,4% tinham concentrações de testosterona total acima do valor de normalidade. A ultrassonografia revelou que 18,4% das meninas tinham ovários policísticos. Adolescentes obesas com SOP apresentaram maior prevalência de síndrome metabólica. Conclusão: a prevalência de SOP em adolescentes obesas é alta quando comparada àquela observada na literatura
Background: polycystic ovary syndrome (PCOS) in adolescence is a challenging diagnosis and therefore has raised intense discussions. Its prevalence in childbearing age women ranges from 5 to 10%. However, the prevalence in obese adolescents has not yet been reported. Besides, the relationship of PCOS with metabolic and cardiovascular disorders in this specific population has not been established. Thus, we aimed to assess the prevalence and characteristics of PCOS in a population of obese adolescents followed at a quarternary hospital. Methods: we performed a cross-sectional study with 49 postmenarcheal obese adolescents with a mean age of 15.6 years. Anthropometric assessment and review of medical records were performed. Clinical and laboratory hyperandrogenism were evaluated using Ferriman-Gallwey index and serum androgens, respectively. The ovarian morphology was evaluated by supra-pubic ultrasound. All patients had their metabolic profile evaluated. Results: the prevalence of PCOS in obese adolescents, according to the new guideline for PCOS in adolescence of the American Pediatric Endocrinology Society, was 18.4%. When assessed by the Rotterdam, the Androgen Excess and PCOS Society and the National Institute of Health criteria, the prevalence of PCOS was 26.4%, 22.4% and 20.4%, respectively. Menstrual irregularity was found in 65.3% of the patients. Clinical hyperandrogenism was observed in 16.3% while 18.4% had total testosterone concentrations above the normal range. Ultrasonography revealed that 18.4% had polycystic ovaries. Obese adolescents with PCOS had higher prevalence of metabolic syndrome. Conclusion: the prevalence of PCOS in obese adolescents is high compared to that observed in the literature

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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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Sova, H. (Henri). "Oxidative stress in breast and gynaecological carcinogenesis." Doctoral thesis, Oulun yliopisto, 2014. http://urn.fi/urn:isbn:9789526204062.

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Abstract Cancer is the leading cause of death worldwide. Despite the significant research effort, underlying mechanisms of carcinogenic processes are still poorly understood. In recent decades, a group of extremely reactive oxygen metabolites, reactive oxygen species (ROS), have been linked closely to carcinogenesis. Levels of ROS are constantly controlled by antioxidants to ensure stable redox balance in our cells. An aberrant cellular redox balance is thought to be connected to carcinogenesis by inflicting damage to cellular macromolecules and disturbing normal cellular signalling. In this work, the role of ROS in carcinogenesis was studied by observing the ROS-derived DNA damage marker 8-hydroxydeoxyguanosine (8-OHdG) in breast cancer and endometriosis-associated ovarian cancer. This marker was also measured in connection with endometriosis and PCOS to study the early stages of the carcinogenic process. In addition, peroxiredoxin antioxidant enzymes were studied in endometriosis-associated ovarian cancer to explore their impact on the carcinogenic process and relationship with ROS-derived DNA damage. There seems to be a decreasing trend in the expression of 8-OHdG in the development of breast cancer and endometriosis-associated ovarian cancer. In breast cancer, low levels of 8-OHdG in serum and in tumour tissue were found to be associated with more aggressive disease. In endometriosis-associated ovarian cancer, 8-OHdG and Prx II expressions in tissue decreased with malignant transformation from benign endometriosis tissue to ovarian cancer. Patients with PCOS were found to have lower levels of 8-OHdG in serum compared with healthy controls and metformin treatment further decreased 8-OHdG levels in obese patients. These results, together with observations is previous studies indicate that in breast cancer and endometriosis-associated ovarian cancer, a high level of ROS-derived DNA damage could be significant factor in the initiation stage of carcinogenesis, whereas in later stages carcinomas benefit from lower ROS levels that support tumour growth and survival via cellular signalling. In endometriosis, there seem to be high amounts of ROS-derived DNA damage, which could explain the increased ovarian cancer risk, while in PCOS, aberrant ROS levels could contribute to the pathogenesis of the disease itself and also to possible cancer incidence by inducing abnormal cellular signalling
Tiivistelmä Syöpä on nykyisin maailman yleisin kuolinsyy. Vaikka syöpätutkimukseen kohdistetaan maailmanlaajuisesti huomattavia resursseja, syövän kehittymisen perimmäinen syy on edelleen heikosti tunnettu. Yhä kasvavan todistusaineiston perusteella happiradikaalien epäillään liittyvän läheisesti syövän kehittymiseen. Nämä erittäin reaktiiviset hapen aineenvaihduntatuotteet ovat välttämättömiä solujemme normaalille toiminnalle, mutta liian suurina määrinä ne voivat vaurioittaa solun rakenteita ja häiritä solun normaalia viestintää. Solut sisältävät useita antioksidantteja, joiden tärkeimpänä tehtävänä on kontrolloida happiradikaalien määrää ja näin ylläpitää solun hapetus-pelkistys -tasapaino. Tässä väitöskirjatutkimuksessa tutkittiin happiradikaalien yhteyttä syövän kehittymiseen tarkastelemalla niiden aiheuttaman DNA-vaurion merkkiainetta, 8-hydroksideoksiguanosiinia (8-OHdG), rintasyövässä ja endometrioosiin liittyvässä munasarjasyövässä sekä peroksiredoksiiniperheen antioksidanttientsyymejä endometrioosiin liittyvässä munasarjasyövässä. 8-OHdG:n avulla selvitettiin myös munasarjojen monirakkulaoireyhtymän (PCOS) ja endometrioosin yhteyttä syövän kehittymiseen. Lisäksi tutkittiin metformiinin vaikutusta happiradikaalien aiheuttamaan DNA-vaurioon. Väitöskirjatutkimuksen tulosten perusteella 8-OHdG:n määrä vähentyy rintasyövän edetessä ja endometrioosiin liittyvän munasarjasyövän kehittyessä. Matalat 8-OHdG -tasot syöpäkudoksessa ja verinäytteissä ovat yhteydessä aggressiivisempaan taudinkuvaan rintasyövässä. Endometrioosiin liittyvässä munasarjasyövässä kudoksen ilmentämä 8-OHdG ja Prx II vähentyi asteittain siirryttäessä hyvänlaatuisesta endometrioosista munasarjasyöpään. Munasarjojen monirakkulaoireyhtymässä potilaiden verinäytteiden 8-OHdG -tasot olivat merkittävästi matalammat terveisiin verrokkeihin verrattuna. Korkeilla happiradikaalipitoisuuksilla ja niistä aiheutuvalla DNA-vauriolla on väitöskirjatutkimuksen tulosten perusteella tärkeä rooli syövän syntyvaiheessa, kun taas syövän myöhemmissä kehitysvaiheissa matalat happiradikaalipitoisuudet tukevat syövän kasvua ja selviytymistä soluviestinnän avulla. Endometrioosipotilaiden kohonnut munasarjasyöpäriski vaikuttaisi olevan seurausta runsaasta happiradikaalien aiheuttamasta DNA-vauriosta endometrioosikudoksessa. Munasarjojen monirakkulaoireyhtymässä poikkeavien happiradikaalitasojen aiheuttama puutteellinen soluviestintä liittyy mahdollisesti taudin patogeneesiin ja syöpäriskiin

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Lopes, Irís Palma. "Efeitos do treinamento físico aeróbio sobre a função sexual em mulheres com síndrome dos ovários policísticos: ensaio clínico controlado." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/17/17145/tde-17042018-154801/.

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Introdução: A Síndrome dos Ovários Policísticos (SOP) é uma doença que acomete de 5 a 10% das mulheres. A SOP tem sido relacionada em alguns estudos à disfunção sexual, ao aumento da ansiedade e depressão e à redução da qualidade de vida. Essas alterações podem estar relacionadas às alterações fenotípicas da SOP como o aumento do peso e das circunferências de quadril e cintura resultantes do hiperandrogenismo. A alteração no estilo de vida, principalmente envolvendo a prática de exercícios físicos, tem sido relevante na melhora das condições de saúde. Até o momento, há poucos estudos avaliando os efeitos do treinamento físico aeróbio sobre a função sexual em mulheres com SOP. Objetivo: Avaliar o efeito do treinamento físico aeróbico na função sexual de mulheres com a Síndrome dos Ovários Policísticos. Métodos: Trata-se de um ensaio clínico controlado com alocação aleatória e randomização estratificada pelo índice de massa corporal (IMC) em 3 grupos paralelos: grupo treinamento aeróbio contínuo (GAC), grupo treinamento aeróbio intermitente (GAI) e grupo controle sem treinamento (GC), sendo GAC com 23 voluntárias, o GAI com 22 voluntárias e o GC com 24 voluntárias. As avaliações ocorreram antes e após o período de 16 semanas de intervenção do treinamento físico aeróbio ou de observação no grupo controle. Foi realizada dosagem plasmática de testosterona, antes e após a intervenção. A função sexual, o risco de ansiedade e depressão e a qualidade de vida foram avaliados respectivamente, por meio dos questionários validados para o Português: Índice de Função Sexual Feminina (IFSF), Escala de Ansiedade e Depressão Hospitalar (HAD), e Questionário de Qualidade de Vida - SF-36. Resultados: Houve diferença significante na RCQ no grupo GAI (p = 0.047) e redução nos níveis de testosterona nos grupos GAC (p < 0.01) e GAI (p = 0.04). Na avaliação do IFSF no GC não houve qualquer alteração antes e após as 16 semanas. Contudo no GAC ocorreu aumento nos escores IFSF total (p = 0.048), satisfação (p = 0.049) e dor (p = 0.03). No GAI foram observados aumentos nos escores: IFSF total (p < 0.01), desejo (p < 0.01), excitação (p < 0.01), lubrificação (p < 0.01), orgasmo (p < 0.01) e satisfação (p = 0.02). Já na avaliação do questionário HAD observou- se diminuição tanto na ansiedade (p = 0.01) e (p < 0.01), quanto na depressão (p < 0.01) e (p = 0.02) nos grupos GAC e GAI respectivamente. Com relação ao SF-36 no GAC foram identificados aumento do escores: aspectos físicos (p = 0.01); estado geral de saúde (p = 0.02); vitalidade (p < 0.01); aspectos sociais (p < 0.01); aspectos emocionais (p = 0.03) e saúde mental (p < 0.01). No GAI houve elevação dos escores: capacidade funcional (p < 0.01); estado geral de saúde (p < 0.01); vitalidade (p < 0.01); aspectos sociais (p < 0.01); aspectos emocionais (p = 0.03) e saúde mental (p < 0.01). Conclusão: Ambos os protocolos de treinamento físico aeróbio foram eficazes na melhora da função sexual, ansiedade e depressão e qualidade de vida, observando maior efetividade no treinamento físico aeróbio intermitente.
Introduction: Polycystic Ovarian Syndrome (PCOS) is a disease that affects 5 to 10% of women. PCOS has been linked in some studies to sexual dysfunction, increased anxiety and depression, and reduced quality of life. These changes may be related to phenotypic changes in PCOS such as increased weight and hip and waist circumferences resulting from hyperandrogenism. The change in lifestyle, mainly involving the practice of physical exercises, has been relevant in improving health conditions. To date, there are few studies evaluating the effects of aerobic exercise training on sexual function in women with PCOS. Objective: To evaluate the effect of aerobic physical training on the sexual function of women with Polycystic Ovarian Syndrome. Methods: This is a controlled clinical trial with random allocation and randomization stratified by body mass index (BMI) in 3 parallel groups: continuous aerobic training group (GAC), intermittent aerobic training group (GAI) and control group without training (GC), GAC with 23 volunteers, GAI with 22 volunteers and GC with 24 volunteers. Evaluations occurred before and after the 16-week intervention period of aerobic or observational physical training in the control group. Testosterone plasma levels were measured before and after the intervention. Sexual function, risk of anxiety and depression, and quality of life were evaluated, respectively, using validated questionnaires for Portuguese: Female Sexual Function Index (IFSF), Hospital Anxiety and Depression Scale (HAD), and Questionnaire Quality of Life - SF-36. Results: There was a significant difference in WHR in the GAI group (p = 0.047) and reduction in testosterone levels in the groups GAC (p <0.01) and GAI (p = 0.04). In the evaluation of IFSF in the CG there was no change before and after 16 weeks. However, in GAC, there was an increase in total IFSF (p = 0.048), satisfaction (p = 0.049) and pain (p = 0.03). GAI showed increases in scores: total IFSF (p <0.01), desire (p <0.01), excitation (p <0.01), lubrication (p <0.01), orgasm (p <0.01) and satisfaction (p = 0.02). In the evaluation of the HAD questionnaire, both anxiety (p = 0.01) and (p <0.01) and depression (p <0.01) and (p = 0.02) in the GAC and GAI groups respectively. Regarding the SF-36 in the GAC was identified increase of the scores: physical aspects (p = 0.01); general health status (p = 0.02); vitality (p <0.01); social aspects (p <0.01); emotional aspects (p = 0.03) and mental health (p <0.01). In GAI there was elevation of the scores: functional capacity (p <0.01); general health status (p <0.01); vitality (p <0.01); social aspects (p <0.01); emotional aspects (p = 0.03) and mental health (p <0.01). Conclusion: Both aerobic physical training protocols were effective in improving sexual function, anxiety and depression and quality of life, observing greater effectiveness in intermittent aerobic physical training.

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王詩琦. "多囊卵巢綜合征的中醫藥研究進展." HKBU Institutional Repository, 2017. https://repository.hkbu.edu.hk/etd_oa/457.

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【目的】从整体上把握多囊卵巢综合征的发生、发展及其规律, 为临床进一步诊断治疗提供整体思路和文献学基础。【方法】收集整理近10 年与多囊卵巢综合征研究相关的中、英文献，归纳和总结该病的病因病机、诊断、治疗，找出存在问题，提出发展方向。【结果】①多囊卵巢综合征主要病因为：肾虚、脾虚、肝郁、痰湿、痕血，并与饮食、环境、精神、遗传具有相尖性；②多囊卵巢综合征基本病机：本虚标实，肾虚、脾虚为本’肝郁、气滞、血痕、痰浊、痰湿为标；③PCOS 的分型大致有：肾虚血脐型、肾虚血痕痰浊型；脾肾阳虚型；痕血内阻型；肝气郁结型；脾肾阳虚型；痰湿阻滞型；④PCOS 的治疗以辨证分型论治为主，参考名老中医经验、专方专药、针灸、周期疗法、辨体质进行诊治，重视中西医结合在治疗中的应用。⑤PCOS 仍存在病因、病机认识不一，诊断存在争议’辨证分型众说纷纭等问题。⑥PCOS 发展方向：找出与PCOS 相尖性最强的病因，明确中西医发病机制，规范PCOS 诊断’研发有效药物，加强临床及实验研究，注重基础治疗和健康宣敦。【结论】多囊卵巢综合征的病因、病机、诊断及治疗研究已取得可喜的成绩，形成了完整的体系。但仍存在具体病因不明’发病机制不清，缺乏有效治疗方法等问题。今后应加强高级别基础和临床研究’尽快明确病因病机’找出有效治疗方案。关键词：多囊卵巢综合征；中医；病因病机；证治规律；药物

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劉宇慈. "中醫治療多囊卵巢綜合征近十年的文獻研究." HKBU Institutional Repository, 2017. https://repository.hkbu.edu.hk/etd_oa/448.

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目的： PCOS 是女性最常见的内分泌疾病, 其症状与并发症严重危害了女性的身心健康。本研究通过收集整体近10 年关于PCOS 的中医临床研究类文献，对本病的证型、治法，尤其是用药处方进行统计、归纳、分析’从而总结出该病的病因病机分布及治疗规律，为PCOS 下一步的临床治疗及用药提供思路和依据。方法：以“多囊卵巢综合征”、“PCOS”、“多囊卵巢”、“不孕症”、“闭经”“中医” 、“中医治疗”、“中医药”等为关键词’搜索2006 年1 月至2016 年12 月刊登在中文学术期刊上有关多囊卵巢综合征中医临床研究类文献，通过建立数据库，对其中医证型及使用方药进行统计分析’归纳总结出多囊卵巢综合征的主要病因病机及治疗用药规律。结果：经过筛选最终得到120 篇文献，共记录病例5670 例，明确治法4616 例，明确证型3778 例。肾虚证型2598 例（ 68. 8% ）；痰湿阻滞型613 例(16. 2%)占84.8% 侨肾3172 例（ 68. 7% ）补肾法中辅以活血化痰之法者也497 例（ 78. 7% ）。药物使用频共中’补虚药（ 43. 7% ）、活血化痕药（ 16.1% ），占59.8% 。归纳的两种疗效评判标准中，总有效率分别为87.9% 、88.9% 。结论： 1. 肾、肝、脾功能失调为PCOS 的发病之源。2. 肾虚、痰湿、血痕是PCOS 的基本病机。3. 补肾健脾，活血化痰是治疗PCOS 的根本大法。4. 补虚药、活血化寐药为治疗PCOS 的主导药物类别。5 中医药治疗PCOS 有副作用小基本黛痛苦璧幢调筒H p O 轴的功能。6. 不同年龄段治疗目的不同导致疗效评判标准尚不统一。关键词：多囊卵巢综合征，中医，用药规律，文献研究

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McCook, Judy G., Nancy E. Reame, and Samuel S. Thatcher. "Health-Related Quality of Life Issues in Women with Polycystic Ovary Syndrome." Digital Commons @ East Tennessee State University, 2005. https://dc.etsu.edu/etsu-works/7174.

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Objective: To evaluate the influence of obesity, fertility status, and androgenism scores on health-related quality of life in women with polycystic ovary syndrome (PCOS). Design: Cross-sectional, correlational. Setting: Private reproductive endocrinology practice in two southeast U.S. cities. Participants: Convenience sample of 128 women with PCOS, half of whom were attempting to conceive in addition to being treated for PCOS. Most were White (97%), married (78%), with a mean age of 30.4 years (SD ± 5.5). Main Outcome Measures: The Health-Related Quality of Life Questionnaire (PCOSQ) for women with polycystic ovary syndrome. A laboratory panel and clinical measures, including body mass index, waist-to-hip ratio, and degree of hirsutism. Results: The most common health-related quality of life concern reported by women with PCOS was weight, followed in descending order by menstrual problems, infertility, emotions, and body hair. Conclusions: The psychological implications of PCOS are easily underestimated and have been largely ignored. Nursing has a pivotal role in recognizing these concerns and implementing therapy to improve quality of life in women with PCOS.

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Kurt, Ayse, and Zakieh Suleiman. "Kvinnors upplevelser av att leva med Polycystiskt ovarial syndrom : En litteraturöversikt." Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-21459.

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Polycystiskt ovarial syndrom (PCOS) är en hormonstörning som drabbar kvinnor där 5-10 % lider av syndromet och det finns betydligt fler kvinnor som ännu inte blivit diagnostiserade. PCOS ger symtom som menstruationsrubbningar, infertilitet, övervikt, hirsutism och psykisk ohälsa. Författarna har valt att studera upplevelsen av att leva med PCOS för att de anser att det finns för lite forskning kring detta ämne. Syftet med litteraturstudien är att undersöka upplevelsen av att leva med PCOS. Studien är en litteraturstudie som baserades på nio vetenskapliga artiklar som hämtades från databaserna Cinahl och Primo som sedan kategoriserades in i fyra huvudteman. Studien visar att upplevelsen av kunskapsbrist och informationsbrist bland vårdgivare och vårdtagare varit bristfällig och tunn. Majoriteten av kvinnorna upplevde även en hotad kvinnlighet orsakad av symtomen som syndromet orsakat vilket kvinnorna åtgärdar med hjälp av egenvård. Kvinnorna upplevde även begränsningar i sitt liv på grund av symtomen vilket leder till ett lidande och minskat välbefinnande i deras tillvaro. I diskussionen tas den bristande kunskapen och informationen upp som ett problem men även som ett område som vårdgivarna kan arbeta med. Detta kan leda till en ökad social, ekonomisk och ekologisk hållbarhet.

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Cirilo, Priscila Daniele Ramos. "Estudo caso-controle em genes polimórficos das vias esteróide (ER-alfa e ER-beta) e da insulina (INSR, PA-1 e IGF2) na síndrome do ovário policístico /." Botucatu : [s.n.], 2006. http://hdl.handle.net/11449/92464.

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Orientador: Silvia Regina Rogatto
Banca: Ilce Mara de Syllos Colus
Banca: Maria Inês M. Campos Pardini
Resumo: A Síndrome do Ovário Policístico (SOP) é uma doença heterogênea que acomete principalmente mulheres em idade reprodutiva e é caracterizada por alterações clínicas como hiperandrogenismo, anovulação crônica e irregularidades menstruais e metabólicas, como resistência insulínica, obesidade, hiperlipidemia e diabetes mellitus tipo 2. Esta síndrome está associada com o risco aumentado de desenvolvimento de doenças cardiovasculares e tromboembólicas. A síndrome HAIR-AN possui manifestações clínicas semelhantes a SOP, porém por critérios de classificação atuais, compõe diagnóstico diferencial apresentando resistência insulínica severa e hiperandrogenismo. Considerando o fenótipo heterogêneo destas patologias, polimorfismos em genes da via de esteróides e da insulina podem estar associados com hiperandrogenismo e hiperinsulinemia. Foram genotipadas para os polimorfismos nos genes ER-α, ER-β, INSR, IGF2 e PAI-1 41 mulheres com fenótipo SOP, 16 com fenótipo HAIR-AN e 49 controles livres da doença. As regiões polimórficas dos genes ER-α e ER-β foram submetidas a análise automatizada no seqüenciador ABI Prism 377 DNA Sequencer para determinação do número de repetições [TA]n e [CA]n, respectivamente. Os alelos foram classificados em curtos ou longos (ER-α - alelos curtos: <15 e longos ≥15 repetições; ER-β - os alelos curtos: ≤22 e longos >22 repetições). A genotipagem de INSR e IGF2 contendo os polimorfismos C/T e A/G, respectivamente, foi realizada por PCR-RFLP com as enzimas de restrição PmlI e ApaI, respectivamente. Para a observação do polimorfismo 5G/4G do gene PAI-1, utilizou-se a técnica de PCR-SSCP e seqüenciamento direto. Não foram observadas diferenças estatísticas significativas entre os genótipos dos genes ER-α, ER-β, INSR, IGF2 e PAI-1 entre casos e controles... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Polycystic Ovary Syndrome (PCOS) is a heterogeneous disorder which is common in reproductive age women and characterized by reproductive and clinical manifestations as hyperandrogenism, anovulatory infertility, increased ovarian secretion, and hyperinsulinaemia, as insulin resistance, type 2 diabetes mellitus, and obesity. The PCOS have been associated with increased risk for development cardiovascular and thromboembolic events. The syndrome of hyperandrogenism, insulin resistance, and acanthosis nigricans (HAIR-AN syndrome) was included in the PCOS subset. However, actually HAIR-AN syndrome shows a differential diagnosis with severe insulin resistance and hyperandrogenism. Genetic polymorphisms in insulin action and steroid pathways genes can be associated with hyperinsulinaemia and hyperandrogenism in PCOS and HAIR-AN patients. The ER-alfa, ER-ß, INSR, IGF2, and PAI-1 genes polymorphisms were evaluated in 41 women with PCOS, 16 women with HAIR-AN, and 49 disease-free control women. The ER-alfa and ER-ß genes polymorphisms were investigated by automated analysis (ABI Prism 377 DNA Sequencer) to determine the [TA]n and [CA]n repeats number, respectively. The alleles were classified as short and long (ER-alfa: <15 and .15 repeats, respectively; and ER-alfa: .22 and >22 repeats, respectively). The INSR and IGF2 genes polymorphisms (C/T and A/G, respectively) were performed by PCR-RFLP methodology using the PmlI and ApaI restriction enzymes, respectively. The PAI-1 gene polymorphisms (5G/4G) were detected by PCR- SSCP and direct sequencing methodologies. No statistical differences were observed between cases and controls for all genes analyzed. However, the comparison between clinical and laboratorial data with the genotypes showed statistical differences (p<0,05). The grouped polymorphisms analysis performed by NeoGene Analysis software defined genotypic classes that can be associated with pathophysiology of the PCOS.
Mestre

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Steinheim, Elena. "Effects of insulin sensitizing drug metformin on clinical features, endocrine and metabolic profiles in obese women with polycystic ovary syndrome." Doctoral thesis, Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité, 2007. http://dx.doi.org/10.18452/15631.

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Metformineinnahme scheint reproduktive und metabolische Funktionen bei Frauen mit PCOS zu verbessern. Die zwiespältige aktuelle Studienlage kann bisher keine konkrete Aussage liefern, ob Metformin eine erfolgreiche therapeutische Möglichkeit des Syndroms darstellt. Ziel der vorliegenden randomisierten, placebo-kontrollierten Studie war es, die Auswirkung des antihyperglykämischen Medikaments Metformin in Kombination mit Ernährungsberatung und Sport auf übergewichtige Frauen mit PCOS zu ermitteln. Besondere Aufmerksamkeit galt der Wirkung des Medikaments hinsichtlich Insulin und Glukose-Stoffwechsel, endokrinologischen und biochemischen Parametern, sowie dem Menstruationszyklus. 46 adipöse Frauen mit PCOS im Alter von 22 bis 39 Jahren und mit einem mittleren BMI von 38,1 nahmen an der Studie teil. Die verabreichte Dosis von Metformin betrug 1,5 g (3x500 mg) täglich über einen Zeitraum von 16 Wochen. Gemessen wurden Veränderungen von FSH, LH, Oestradiol, Testosteron, DHEA-S, SHBG, Cholesterol, Triglyzeriden, Insulin, Glukose, HbA1c, Leptin und IGF-I im Serum. Monatlich wurde eine Ernährungsberatung angeboten. Jede Teilnehmerin erhielt darüber hinaus individuelle dietätische Beratung. Signifikante Gewichtsreduktion (P
Use of metformin seems to improve reproductive and metabolic abnormalities in women with PCOS. However, the disparity of results in clinical studies cannot give us a conclusive answer if metformin is a new line therapy of the syndrome. The present randomised, placebo-controlled study was designed to compare the antihyperglycemic drug metformin vs. placebo combined with lifestyle modification in the treatment of polycystic ovary syndrome in obese women. Special attention was paid to the effects of this medication on insulin and glucose metabolism, endocrine and biochemical parameters, and menstrual function. Forty six obese women with PCOS, aged between 22-39 years and mean BMI 38.1 were randomized to receive either metformin (500 mg three times a day for 16 weeks) or placebo. The metformin and placebo groups were matched for age, endocrinological and metabolic parameters. Changes in FSH, LH, estradiol, testosterone, DHEA-S and SHBG, total cholesterol, triglycerides, insulin, glucose, HbA1c, leptin and IGF-I were assessed. Group therapy with aspects in nutrition and physical activity was conducted monthly. Each woman received individual counselling by a dietician. Significant (P

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Köse, Seyit Ali Kaya Hakan. "Polikistik over sendromlu hastalarda laparoskopik ovaryan multineedle intervention (Lomni) yönteminin hirsutizm, adet düzeni ve hormon düzeylerine etkisi /." Isparta : SDÜ Tıp Fakültesi, 2004. http://tez.sdu.edu.tr/Tezler/TT00167.pdf.

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Cirilo, Priscila Daniele Ramos [UNESP]. "Estudo caso-controle em genes polimórficos das vias esteróide (ER-alfa e ER-beta) e da insulina (INSR, PA-1 e IGF2) na síndrome do ovário policístico." Universidade Estadual Paulista (UNESP), 2006. http://hdl.handle.net/11449/92464.

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A Síndrome do Ovário Policístico (SOP) é uma doença heterogênea que acomete principalmente mulheres em idade reprodutiva e é caracterizada por alterações clínicas como hiperandrogenismo, anovulação crônica e irregularidades menstruais e metabólicas, como resistência insulínica, obesidade, hiperlipidemia e diabetes mellitus tipo 2. Esta síndrome está associada com o risco aumentado de desenvolvimento de doenças cardiovasculares e tromboembólicas. A síndrome HAIR-AN possui manifestações clínicas semelhantes a SOP, porém por critérios de classificação atuais, compõe diagnóstico diferencial apresentando resistência insulínica severa e hiperandrogenismo. Considerando o fenótipo heterogêneo destas patologias, polimorfismos em genes da via de esteróides e da insulina podem estar associados com hiperandrogenismo e hiperinsulinemia. Foram genotipadas para os polimorfismos nos genes ER-α, ER-β, INSR, IGF2 e PAI-1 41 mulheres com fenótipo SOP, 16 com fenótipo HAIR-AN e 49 controles livres da doença. As regiões polimórficas dos genes ER-α e ER-β foram submetidas a análise automatizada no seqüenciador ABI Prism 377 DNA Sequencer para determinação do número de repetições [TA]n e [CA]n, respectivamente. Os alelos foram classificados em curtos ou longos (ER-α - alelos curtos: <15 e longos ≥15 repetições; ER-β - os alelos curtos: ≤22 e longos >22 repetições). A genotipagem de INSR e IGF2 contendo os polimorfismos C/T e A/G, respectivamente, foi realizada por PCR-RFLP com as enzimas de restrição PmlI e ApaI, respectivamente. Para a observação do polimorfismo 5G/4G do gene PAI-1, utilizou-se a técnica de PCR-SSCP e seqüenciamento direto. Não foram observadas diferenças estatísticas significativas entre os genótipos dos genes ER-α, ER-β, INSR, IGF2 e PAI-1 entre casos e controles...
Polycystic Ovary Syndrome (PCOS) is a heterogeneous disorder which is common in reproductive age women and characterized by reproductive and clinical manifestations as hyperandrogenism, anovulatory infertility, increased ovarian secretion, and hyperinsulinaemia, as insulin resistance, type 2 diabetes mellitus, and obesity. The PCOS have been associated with increased risk for development cardiovascular and thromboembolic events. The syndrome of hyperandrogenism, insulin resistance, and acanthosis nigricans (HAIR-AN syndrome) was included in the PCOS subset. However, actually HAIR-AN syndrome shows a differential diagnosis with severe insulin resistance and hyperandrogenism. Genetic polymorphisms in insulin action and steroid pathways genes can be associated with hyperinsulinaemia and hyperandrogenism in PCOS and HAIR-AN patients. The ER-alfa, ER-ß, INSR, IGF2, and PAI-1 genes polymorphisms were evaluated in 41 women with PCOS, 16 women with HAIR-AN, and 49 disease-free control women. The ER-alfa and ER-ß genes polymorphisms were investigated by automated analysis (ABI Prism 377 DNA Sequencer) to determine the [TA]n and [CA]n repeats number, respectively. The alleles were classified as short and long (ER-alfa: <15 and .15 repeats, respectively; and ER-alfa: .22 and >22 repeats, respectively). The INSR and IGF2 genes polymorphisms (C/T and A/G, respectively) were performed by PCR-RFLP methodology using the PmlI and ApaI restriction enzymes, respectively. The PAI-1 gene polymorphisms (5G/4G) were detected by PCR- SSCP and direct sequencing methodologies. No statistical differences were observed between cases and controls for all genes analyzed. However, the comparison between clinical and laboratorial data with the genotypes showed statistical differences (p<0,05). The grouped polymorphisms analysis performed by NeoGene Analysis software defined genotypic classes that can be associated with pathophysiology of the PCOS.

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Kent, Andrew. "Comorbid bulimia and polycystic ovary syndrome : a controlled study of physical and physiological characteristics and the impact of a brief psychotherapy targeting eating behaviour." Thesis, St George's, University of London, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.391621.

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Santos, Ana Gabriela Pontes [UNESP]. "Prevalência de resistência à insulina, intolerância à glicose e diabetes mellitus tipo 2 em pacientes com síndrome doa ovários policísticos(SOP)." Universidade Estadual Paulista (UNESP), 2009. http://hdl.handle.net/11449/99263.

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A síndrome dos ovários policísticos (SOP) é uma endocrinopatia comum em mulheres no menacme, com prevalência variando entre 5 a 10%. Em vários estudos, pacientes com SOP apresentam risco aumentado para o desenvolvimento das anormalidades do metabolismo da glicose. O diabetes mellitus está entre as 10 maiores causas de mortalidade no Brasil decorrente das complicações micro e macrovasculares. Avaliar a prevalência de resistência à insulina (RI), intolerância à glicose (IG) e diabetes mellitus tipo 2 (DM) nas pacientes com diagnóstico de SOP. Foram avaliados retrospectivamente os dados clínicos, bioquímicos e ultra-sonográficos de 247 pacientes com o diagnóstico de SOP. Para a avaliação do grau de RI, utilizou-se um grupo de 101 mulheres com ciclos menstruais regulares sem hiperandrogenismo. O diagnóstico de RI foi obtido utilizando-se os seguintes valores de corte: insulinemia > 12 μIU/ml, HOMA-IR > 2,71, QUICKI < 0,333, ISI < 4,75 e relação glicemia / insulina < 6,4. O diagnóstico de IG e DM tipo 2 foi realizado por meio do teste de tolerância à glicose oral (TTGO) de acordo com os critérios do WHO, 1985 e comparado ao diagnóstico pela glicemia de jejum (ADA, 2003). Para a análise estatística dos resultados, foi utilizado o teste de qui-quadrado para a associação entre as variáveis, e para as variáveis quantitativas foram utilizadas a estatística descritiva e análise de variância seguida do método de Tukey ou t de student. As pacientes com SOP apresentaram idade entre 12 a 40 anos (24,8 ± 6,3) e índice de massa corpórea entre 18,3 a 54,9 Kg/m² (32,5 ± 7,6). O percentual de pacientes obesas foi de 64%. A RI foi detectada em 54,2% das pacientes pela relação glicemia / insulina, em 59,9% pelos índices de HOMA-IR e QUICKI, em 70,6% pelo ISI e 61,9% apresentaram insulinemia > 12 μIU/ml. A RI foi maior quanto...
The polycystic ovary syndrome (PCOS) is a common endocrinopathy in women during menacme, with a prevalence ranging from 5 to 10%. In several studies, patients with PCOS have shown increased risk for developing glucose metabolism abnormalities. Diabetes mellitus is among the 10 major causes of mortality resulting from micro and macrovascular causes in Brazil. To evaluate the prevalence of insulin resistance (IR), impaired glucose tolerance (IGT) and type-2 diabetes mellitus (DM) in patients diagnosed with PCOS. The clinical, biochemical and ultrasonographic data of 247 patients diagnosed with PCOS were retrospectively analyzed. To compare IR levels, a group of 101 women with regular cycles without hyperandrogenism was used. IR diagnosis was performed by using the following cutoff values: insulinemia > 12 μIU/ml, HOMA-IR > 2.71, QUICK < 0.333, ISI < 4.75 and glycemia / insulin ratio < 6.4. The GI and type-2 DM diagnosis was performed by means of the oral glucose tolerance test (OGTT), according to WHO criteria, 1985 and compared with fasting plasma glucose diagnosis (ADA, 2003). The results were interpreted by the chisquare test for association between variables, and descriptive statistics and analysis of variance followed by Tukey’s or Student’s t tests were used for quantitative variables... (Complete abstract clic, electronic access below)

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Neves, Erika Mendonça das. "Síndrome dos ovários policísticos: correlação dos fenótipos com as manifestações metabólicas." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/5/5139/tde-05112013-123657/.

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A síndrome dos ovários policísticos (SOP) é o distúrbio endócrino-metabólico mais frequente na menacme, com prevalência de 7 a 10 %, contribuindo com o aumento do risco cardiovascular e/ou diabetes mellitus tipo II nessas mulheres. OBJETIVOS: Identificar as características epidemiológicas e os diferentes fenótipos da SOP, a prevalência da síndrome metabólica encontrada em cada fenótipo e os fatores associados ao risco metabólico dessas pacientes. CASUÍSTICA E MÉTODO: Estudo observacional com 566 mulheres entre 14 e 39 anos portadoras de SOP, segundo o consenso de Rotterdam. O risco metabólico foi avaliado pela análise descritiva com intervalo de confiança de 95%. As variáveis quantitativas foram testadas pelo método de Shapiro-Wilk e teste não paramétrico de Mann-Whitney. Para a análise multivariada usou-se a razão de prevalências entre as diversas variáveis independentes e o desfecho risco metabólico. Identificamos os fatores associados ao risco metabólico empregando a regressão de Cox com variância robusta. RESULTADOS: Das 566 pacientes, 27,9% tinham entre 20 e 24 anos; 84,5% eram afrodescendentes; 90,6% apresentavam irregularidade menstrual; 91,8% hirsutismo; 77,7% ovários aumentados e/ou policísticos; 15,7% com pelo menos um filho; IMC elevado em 66,5%; CA superior a 88 em 51%; pressão arterial sistólica e diastólica elevadas em 38,9% e 20% das pacientes respectivamente; 7,7% intolerância a carboidratos, 40,8% de HDL-colesterol reduzido, 8,8% de triglicerídeos elevados. Encontramos risco metabólico em 21%, com predomínio dos fenótipos E (28,4%), B (25%) e A (22%). Antecedentes familiares de diabete, hipertensão arterial, câncer ginecológico e câncer não ginecológico não contribuíram, com significância estatística, para o aumento de eventos metabólicos. O acréscimo de um ano na idade elevou o risco em 5%. A cada subida de uma unidade no IMC foram adicionados 8%. A presença de hirsutismo triplicou o risco. Pacientes com pelo menos um filho apresentaram duas vezes mais síndrome metabólica do que as sem filhos. CONCLUSÕES: Foi observada maior frequência de síndrome metabólica entre os fenótipos que apresentam em comum oligoanovulação e hirsutismo (E, B e A). Em pacientes com SOP a idade, a paridade, a presença de hirsutismo e obesidade foram os fatores independentemente relacionados ao aumento do risco metabólico
Polycystic ovary syndrome (PCOS) is an endocrine and metabolic disorder that is more frequent in premenopausal, affecting 7 to 10% of women, contributing to the increase of cardiovascular and/or type II diabetes mellitus risk. OBJECTIVES: To identify the epidemiological characteristics and different phenotypes of PCOS, the prevalence of metabolic syndrome found in each phenotype and metabolic risk factors associated with these patients. PATIENTS AND METHODS: Observational study of 566 women between 14 and 39 years with PCOS according to the Rotterdam criteria. The metabolic risk was assessed by descriptive analysis with a confidence interval of 95%. Quantitative variables were tested by using Shapiro-Wilk method and nonparametric Mann-Whitney test. For the multivariate analysis the prevalence ratio between several independent variables and the outcome metabolic risk were used. Factors associated with the metabolic risk were identified by using Cox regression with a robust variance. RESULTS: Of 566 patients, 27.9% were between 20 and 24 years, 84.5% were of African descents; 90.6% had oligoanovulation; 91.8% hirsutism; 77.7% enlarged ovaries and/or polycystic, 15.7% with at least one child in high BMI 66.5%, CA 88 exceeding 51%; systolic and diastolic blood pressure elevated by 38.9% and 20% of patients, respectively, 7.7% carbohydrate intolerance, 40.8% HDL-cholesterol changed, 8.8% triglyceride levels. Metabolic risk found in 21%, with a predominance of E phenotypes (28.4%), B (25%) and A (22.1%). Family history of diabetes, hypertension, gynecological cancer and gynecological cancer does not contribute with statistical significance for increased metabolic events. The one-year increase in age raised the risk by 5%. Every increase of one unit in BMI 8% were added. Presence of hirsutism tripled the risk. Patients with at least one child were twice as metabolic syndrome than those without children. CONCLUSIONS: A higher frequency of metabolic syndrome phenotypes that have in common oligoanovulation and hirsutism (E, B and A) were observed. Independently associated factors with the metabolic risk in PCOS patients were age, parity, hirsutism and obesity

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Santos, Ana Gabriela Pontes. "Prevalência de resistência à insulina, intolerância à glicose e diabetes mellitus tipo 2 em pacientes com síndrome doa ovários policísticos(SOP) /." Botucatu : [s.n.], 2009. http://hdl.handle.net/11449/99263.

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Orientador: Anaglória Pontes
Banca: Júlio Cesar Rosa e Silva
Banca: Walquíria de Paula Pimenta
Resumo: A síndrome dos ovários policísticos (SOP) é uma endocrinopatia comum em mulheres no menacme, com prevalência variando entre 5 a 10%. Em vários estudos, pacientes com SOP apresentam risco aumentado para o desenvolvimento das anormalidades do metabolismo da glicose. O diabetes mellitus está entre as 10 maiores causas de mortalidade no Brasil decorrente das complicações micro e macrovasculares. Avaliar a prevalência de resistência à insulina (RI), intolerância à glicose (IG) e diabetes mellitus tipo 2 (DM) nas pacientes com diagnóstico de SOP. Foram avaliados retrospectivamente os dados clínicos, bioquímicos e ultra-sonográficos de 247 pacientes com o diagnóstico de SOP. Para a avaliação do grau de RI, utilizou-se um grupo de 101 mulheres com ciclos menstruais regulares sem hiperandrogenismo. O diagnóstico de RI foi obtido utilizando-se os seguintes valores de corte: insulinemia > 12 μIU/ml, HOMA-IR > 2,71, QUICKI < 0,333, ISI < 4,75 e relação glicemia / insulina < 6,4. O diagnóstico de IG e DM tipo 2 foi realizado por meio do teste de tolerância à glicose oral (TTGO) de acordo com os critérios do WHO, 1985 e comparado ao diagnóstico pela glicemia de jejum (ADA, 2003). Para a análise estatística dos resultados, foi utilizado o teste de qui-quadrado para a associação entre as variáveis, e para as variáveis quantitativas foram utilizadas a estatística descritiva e análise de variância seguida do método de Tukey ou t de student. As pacientes com SOP apresentaram idade entre 12 a 40 anos (24,8 ± 6,3) e índice de massa corpórea entre 18,3 a 54,9 Kg/m² (32,5 ± 7,6). O percentual de pacientes obesas foi de 64%. A RI foi detectada em 54,2% das pacientes pela relação glicemia / insulina, em 59,9% pelos índices de HOMA-IR e QUICKI, em 70,6% pelo ISI e 61,9% apresentaram insulinemia > 12 μIU/ml. A RI foi maior quanto... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: The polycystic ovary syndrome (PCOS) is a common endocrinopathy in women during menacme, with a prevalence ranging from 5 to 10%. In several studies, patients with PCOS have shown increased risk for developing glucose metabolism abnormalities. Diabetes mellitus is among the 10 major causes of mortality resulting from micro and macrovascular causes in Brazil. To evaluate the prevalence of insulin resistance (IR), impaired glucose tolerance (IGT) and type-2 diabetes mellitus (DM) in patients diagnosed with PCOS. The clinical, biochemical and ultrasonographic data of 247 patients diagnosed with PCOS were retrospectively analyzed. To compare IR levels, a group of 101 women with regular cycles without hyperandrogenism was used. IR diagnosis was performed by using the following cutoff values: insulinemia > 12 μIU/ml, HOMA-IR > 2.71, QUICK < 0.333, ISI < 4.75 and glycemia / insulin ratio < 6.4. The GI and type-2 DM diagnosis was performed by means of the oral glucose tolerance test (OGTT), according to WHO criteria, 1985 and compared with fasting plasma glucose diagnosis (ADA, 2003). The results were interpreted by the chisquare test for association between variables, and descriptive statistics and analysis of variance followed by Tukey's or Student's t tests were used for quantitative variables... (Complete abstract clic, electronic access below)
Mestre

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LEMOS, Ana Janaina Jeanine Martins de. "Administração associativa do cloridrato de metformina e melatonina na reversão da policistose ovariana e os efeitos sobre o fígado e reprodução em ratas albinas." Universidade Federal Rural de Pernambuco, 2013. http://www.tede2.ufrpe.br:8080/tede2/handle/tede2/5586.

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The polycystic ovary syndrome (PCOS) is endocrine disorder in women of reproductive age extremely common and heterogeneous clinical features. In cases of patients with ovarian polycystic wishing to treat infertility, metformin hydrochloride is the drug most widely used and considered safer compared to the other treatments. When diagnosing the syndrome, it has been observed that women have a high prevalence of nonalcoholic fatty liver disease, steatosis, fibrosis, abnormal liverenzyme factors and increased indicators of oxidative stress in plasma, raising concern among doctors about the disease in the liver. Furthermore, recent studies have linked oxidative stress in the pathogenesis of diseases which cause infertility, for this reason, research has suggested the use of antioxidants such as melatonin, due to liver protecting effect in the pharmacological treatment or supplementation to combat these types of disease. However, there are no reports in the literature about association of metformin hydrochloride and melatonin for the treatment of PCOS. The objective of this work was to investigate the effects of combination therapy of these drugs in rats induced to PCOS on to reproductive and liver. Thus, we used 75 albino rats were divided randomly into five groups of 15 animals. All rats except those in group I were subjected to induction of PCOS by constant illumination, and the rats of groups III, IV and V received treatment with the drug melatonin, metformin hydrochloride and the drug combination, respectively. After confirmation of PCOS and treatments, we analyzed the effects of plasma biochemical and hormonal treatments, and rats were mated and monitored during pregnancy for analysis of implantation sites, ovarian, weight gain, reproductive viability and levels of oxidative stress. At the end of the experiment was conducted histopathology, and immunohistochemistry staining of liver of rats and analysis of the puppies. Pharmacological treatments decreased the time allowed copulation, increased plasma levels of progesterone, the number and weight of pups and reduced plasma levels of estrogen and endometrial content of collagen fibers. In the liver, treatment with metformin hydrochloride, melatonin and more significantly the association of these drugs reduced plasma levels of the liver enzyme alanine trasaminase, nitric oxide and total glutathione, leading to results similar to the control group, were also observed similarities between those of control rats and rats that received a combination of drugs for the content of hepatic polysaccharide, and of proinflammatory cytokines. Thus, we conclude that the association of metformin with melatonin provides the best results compared to the other treatments, in order to regulate hormonal and histochemical the reproductive system and increase the chance of conception resembling the control group, and the liver, the combination of drugs works more effectively against liver toxicity produced by PCOS, favoring normalization of biochemical parameters and oxidative stress during pregnancy, compared to therapies only these drugs.
A síndrome do ovário policístico (SOP) é um distúrbio endócrino feminino extremamente comum na idade reprodutiva e apresenta quadro clínico bastante heterogêneo, entre eles os cistos foliculares ovarianos aumentados, hiperandrogenismo, infertilidade resistência à insulina, e dislipidemia. Em casos de pacientes com policistose ovariana que desejam tratar a infertilidade, o cloridrato de metformina é a droga mais utilizada e considerada mais segura em comparação com os demais tratamentos. Ao diagnosticar a síndrome, tem-se observado que mulheres apresentam grande prevalência a doença hepática gordurosa não alcoólica, esteatose, fibrose, alterações hepático-enzimáticas e aumento do estresse oxidativo plasmático, elevando a preocupação dos médicos quanto às patologias hepáticas. Além disso, recentes estudos têm relacionado o estresse oxidativo na patogênese de doenças que causam a infertilidade, por esta razão, pesquisas tem sugerido a utilização de antioxidantes como a melatonina como suplemento a outras drogas. No entanto, não há relatos na literatura sobre a associação do cloridrato de metformina e melatonina para o tratamento da policistose ovariana. Assim, o objetivo deste trabalho foi investigar os efeitos da combinação terapêutica desses fármacos em ratas induzidas à SOP sobre os aspectos reprodutivos e hepáticos. Para tanto, foram utilizadas 75 ratas albinas, divididas aleatoriamente em cinco grupos de 15 animais. Todas as ratas, exceto as do grupo I, foram submetidas à indução da SOP pela iluminação constante, e as ratas dos grupos III, IV e V receberam tratamentos com os fármacos melatonina, cloridrato de metformina e a associação destes, respectivamente. Após a confirmação da SOP e tratamentos, foram analisados os efeitos plasmáticos bioquímicos e hormonais dos tratamentos, e as ratas foram acasaladas para análise dos sítios de implantação e acompanhamento gestacional dos níveis de estresse oxidativo. Ao final do experimento foi analisada a histopatologia e imunohistoquímica do fígado das ratas. Os tratamentos farmacológicos diminuíram o número de dias para confirmação do acasalamento, aumentaram os níveis séricos de progesterona, bem como o número e o peso dos filhotes. Reduziram os níveis plasmáticos de estrógeno e teor de fibras colágenas. No fígado, os tratamentos com cloridrato de metformina, melatonina, e mais significativamente a associação destes fármacos, reduziram os níveis plasmáticos da enzima hepática alanina transaminase, do óxido nítrico e da glutationa total, levando a resultados semelhantes aos animais do grupo controle, mais uma vez, as ratas que receberam associação dos fármacos quanto assemelhou-se ao grupo controle quanto ao conteúdo hepático de polissacarídeos, e aos de citocinas próinflamatórias. Desta forma, pôde-se concluir que a associação do cloridrato de metformina com melatonina proporciona os melhores resultados em comparação aos demais tratamentos, de forma a regular hormonal e histoquimicamente o sistema reprodutor e aumentar as chances de concepção de forma semelhante ao grupo controle. No fígado a associação dos fármacos atuou de forma mais eficaz contra a toxicidade hepática produzida pela SOP experimental, favorecendo uma normalização dos parâmetros bioquímicos e estresse oxidativo durante a gestação, quando comparada às monoterapias destas drogas.

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Loureiro, Lilian da Silva. "Geniosas e determinadas: mapeando o estilo de vida de portadores da sindrome dos ovários policísticos sob o olhar da psicologia analítica - um estudo de caso." Pontifícia Universidade Católica de São Paulo, 2007. https://tede2.pucsp.br/handle/handle/15650.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico
The objectives of this research were to 1. Understand the concept of lifestyle from the perspective of analytical psychology. 2. Verify which psychological aspects reflect the lifestyle of the women diagnosed with PCOS. For this research five women diagnosed with PCOS were interviewed. The criteria used for the PCOS diagnose was the Rotterdam 2003. The interviewees were patients from a dermatology specialist who has a private practice. The instruments used were a semi-structured interview and a lifestyle questionnaire (WHOQOL-bref). In the bibliographical research it was observed that the researches that deal with lifestyle changes related to PCOS patients omitted important questions which compromised their results. Prior researches have not defined conceptually what is understood by lifestyle. These researches are also at fault because they adopt a conception of lifestyle which is partial. They take into consideration that medicine has a specific perspective of the human being, which is to intervene in any aspect considered an obstacle or that interferes negatively in an individual s health. In these cases the emphasis is given to behavioral changes, being that the intervention occurs in two levels: changing dietary habits and introducing physical activity. However the introduction of new dietary habits does not take into consideration the psychological aspects involved. On the other hand the analyses that take into consideration the psyche, the psychological perspective used seems to be mechanized, as if it was a pill. Using the perspective of analytical psychology we propose to look at the lifestyle chosen by an individual as a personal resource. This is equivalent to a well adapted persona which is flexible and nourishes the individual, it does not massacre the ego restricting it to social expectations. The studied population, that received the PCOS diagnose directly or indirectly, saw in the diagnose a possibility of ending with their repetitious lifestyle. These women diagnosed with PCOS started to incorporate new habits, especially related to their eating and daily routine. However the changes brought by the diagnosis were not maintained because the values and beliefs that were attached to their lifestyle had still not changed. The choice for a specific lifestyle may be or may not be conscious. This choice may be influenced by the persona and by the shadow. When looking at this issue from an analytical psychological perspective it is observed that wanting to change one s lifestyle does not mean being able to change it. This occurs because the influence of the unconscious in our lives should be taken into consideration when we analyze how we put ourselves in the world. Therefore the difficulty of these women to maintain their lifestyle changes may have happened because their unconscious was not taken into consideration. These women who may be too attached to their professional persona, for example, forget about other aspects of their lives, and even about themselves, all this may compromise their health. As a consequence of not being able to look at themselves they are not aware that unconscious aspects may be influencing their behavior and choices. Therefore it is important that the researches of PCOS and lifestyle conceptualize the lifestyle. In this manner all the different aspects involved in the concept of the lifestyle will be taken in consideration and better results can be found. Our contribution is that any program which envisions to change a lifestyle must incorporate the psychological dimension. The comprehension of the psychological dimension of a lifestyle may be very helpful. The programs must take into consideration the psychological particularities of each participant: what are their values, beliefs, personalities, and how they see life. These characteristics will interfere positively or negatively in the lifestyle change results
A presente pesquisa teve como objetivos: 1. Fazer leitura do conceito de estilo de vida a partir do olhar da psicologia analítica e 2. Verificar quais aspectos psicológicos refletem no estilo de vida das portadoras de SOP. Participaram deste estudo cinco portadoras de SOP, de acordo com o critério diagnóstico de Rotterdam de 2003, pacientes de um médico dermatologista especialista, particular. Os instrumentos utilizados foram entrevista semidirigida e questionário de qualidade de vida (WHOQOL-bref). Em levantamento bibliográfico, observamos uma falha que compromete todos os trabalhos que pretendem modificar o estilo de vida de portadoras de SOP. Em primeiro lugar, porque nenhum deles define conceitualmente o que entendem por estilo de vida e, em segundo, porque adotam uma concepção totalmente parcial, deixando subentendido que o referencial adotado pela medicina é o de interferir em qualquer aspecto que atrapalhe, ou interfira negativamente na saúde do indivíduo. A ênfase é dada em mudanças comportamentais, sendo que a intervenção ocorre em dois níveis: modificação alimentar e introdução de atividades físicas. Contudo, a introdução de hábitos, novos comportamentos, não leva em consideração os aspectos psicológicos envolvidos. Nos trabalhos que apontam tal dimensão, a visão do psicológico parece ser mecanicista, como um remédio a ser tomado. Sob o olhar da psicologia analítica propomos olhar o estilo de vida como um recurso mais pessoal do indivíduo. Seria equivalente a uma persona bem adaptada, flexível, que não massacra o eu, restringido a expectativas sociais, mas que o alimenta. Na população estudada, ter recebido o diagnóstico da SOP, seja direta ou indiretamente, pareceu uma possibilidade de ponto de ruptura da repetição para o estilo de vida das portadoras. Passaram a atentar para o fato de adotarem novos hábitos, relativos à alimentação e rotina, principalmente. Contudo, a mudança não se consolidou, pois os valores e crenças não foram mudados ainda. A escolha por um determinado estilo de vida pode ser consciente ou não, podendo ser influenciada tanto pela persona, quanto pela sombra. Adotando a possível leitura do estilo de vida a partir da psicologia analítica, observamos que querer modificar o estilo de vida, não é sinônimo de poder modificá-lo. Isso porque devemos levar em consideração a atuação do inconsciente na maneira como nos colocamos no mundo. De forma que a dificuldade em manter, a longo prazo, as modificações do estilo de vida de portadoras de SOP pode ser devida a essa negligência. Presas à persona profissional, por exemplo, mulheres esquecem outros aspectos de suas vidas, e até de si mesmas, trazendo diversos comprometimentos à saúde. Não olhando para si, não percebem que aspetos inconscientes podem estar atuando em seus comportamentos e escolhas. É importante que as pesquisas de SOP e estilo de vida o conceituem. Dessa forma, serão levados em consideração todos os aspectos envolvidos pelo conceito e assim resultados mais satisfatórios podem vir a serem encontrados. Nossa contribuição é a de que em qualquer programa de modificação de estilo de vida, a dimensão psicológica deve ser incorporada. A compreensão da dimensão psicológica do estilo de vida pode ser de grande valia. Os programas devem levar em consideração as particularidades psicológicas de cada participante: quais são seus valores, crenças, personalidade, como vêem a vida, tais características podem interferir positiva ou negativamente nos resultados da modificação

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Vieira, Rodolpho Cruz. "Avaliação do fuso meiótico e distribuição cromossômica de oócitos maturados in vitro de portadoras da Síndrome dos Ovários Policísticos submetidas à estimulação ovariana: estudo piloto." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/17/17145/tde-27092013-110023/.

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Objetivos: Avaliar o fuso meiótico e a distribuição cromossômica de oócitos maturados in vitro obtidos de ciclos estimulados de mulheres inférteis com Síndrome dos Ovários Policísticos (SOP) e fatores masculino e/ou tubário de infertilidade. Métodos: Vinte e seis pacientes inférteis com SOP e 48 pacientes com fator tubário e/ou masculino de infertilidade, submetidas a ciclos estimulados para captação oocitária para injeção intracitoplasmática de espermatozóide, foram selecionadas prospectiva e consecutivamente e divididas em grupos de estudo e controle, respectivamente. Oócitos imaturos (34 e 56 oócitos) foram obtidos de 13 e 27 pacientes, respectivamente, dos grupos SOP e controle, sendo submetidos à maturação in vitro (MIV), respectivamente, por 19 horas ± 1 hora (VG) e 4 horas ± 30 minutos (MI), conforme curva de MIV previamente realizada no presente serviço. Oócitos em metáfase II (MII) após MIV, foram fixados, submetidos a imunocoloração e microscopia de fluorescência para avaliação morfológica do fuso e da distribuição cromossômica. Resultados: Não observamos diferença significativa nas taxas de MIV entre os dois grupos avaliados (50% e 42,8%, respectivamente, para os grupos SOP e controle). Na análise por microscopia de imunofluorescência, detectaram-se 3 e 2 oócitos, respectivamente, no grupo de estudo e no grupo controle, em estágio de Telófase I e 3 oócitos ativados partenogeneticamente no grupo controle. Ocorreu a impossibilidade de análise de 4 oócitos do grupo controle em virtude de dificuldades técnicas durante o processo de imunocoloração. Não houve diferença significativa nas proporções de anomalias meióticas entre os grupos SOP e controle (57,1 e 46,7%, respectivamente). Conclusões: Os dados preliminares do presente estudo, apesar de não demonstrarem aumento significativo na incidência de anomalias meióticas nas portadoras de SOP, sugerem uma tendência a maior ocorrência de anomalias meióticas nos oócitos deste grupo de pacientes, quando comparados aos de portadoras de fator masculino e/ou tubário de infertilidade, o que deverá ser mais bem avaliado em estudos com maiores casuísticas. Estes achados têm potencial clínico para apontar uma possível explicação para as controversas menores taxas de fertilização observadas em pacientes com SOP submetidas às Técnicas de Reprodução Assistida.
Objectives: To evaluate the meiotic spindle and the chromosome distribution of in vitro matured oocytes obtained during stimulated cycles from infertile women with Polycystic Ovary Syndrome (PCOS) and with male factor and/or tubal infertility. Methods: Twenty six infertile patients with PCOS and 48 patients with infertility due to tubal and/or male factor, submitted to stimulated cycles for oocyte retrieval for intracytoplasmic sperm injection, were selected prospectively and consecutively and respectively assigned to the study group and the control group. Imature oocytes (34 and 56 oocytes) were obtained from 13 and 27 patients, respectively, of PCOS and control groups, and submitted to in vitro maturation (IVM) for 19 hours ± 1 hour (GV) and 4 hours ± 30 minutes (MI) according to the IVM curve previously constructed in the present service. After IVM, oocytes in metaphase II (MII) were fixed and submitted to immunostaining and fluorescence microscopy for morphological evaluation of the spindle and of chromosome distribution. Results: IVM rates were similar between the two analyzed groups (50% e 42.8%, respectively, in PCOS e control groups). By immunofluorescence analysis, there were 3 and 2 oocytes, respectively, in PCOS e control groups, in telophase I stage, and 3 parthenogenetic activated oocytes in control group. Because of technical difficulties during the execution of the immunofluorescence protocol, 4 oocytes from the control group could not be analyzed. The difference in the proportions of meiotic anomalies between the two groups was not statistically significant (57.1 e 46.7%, respectively, in PCOS e control groups). Conclusions: The present preliminary data, although not showing a significant increase in the incidence of meiotic anomalies in women with PCOS, suggest a tendency to a higher occurrence of meiotic anomalies in the oocytes of this group of patients compared to women with male and/or tubal infertility, a fact to be better evaluated in studies on larger patient series. The present findings have the clinical potential to provide a possible explanation for the controversial lower fertilization rates observed in patients with PCOS submitted to Assisted Reproduction Techniques

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Luo, Shiu-Chen, and 羅旭辰. "Application of data mining techniques used in polycystic ovarian syndrome blood samples." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/2426p8.

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碩士
國立臺北科技大學
工業工程與管理系碩士班
100
Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders. In Taiwan, There are 23 million to 45 million women affected by PCOS. This is a complex, heterogeneous disorder of uncertain etiology. PCOS is also one of the major problems of infertility. We examine one such PCOS data, showing a method of applying data mining techniques, and our experiment, and results. The PCOS data is form a northern regional teaching hospital in Taiwan with 499 women. We used the decision tree algorithm in C4.5 and the Classification Base on Association (CBA) with a target variable which women is (or is not) PCOS and 7 predictors: Age, AMH, BMI, Testosterone, AC Sugar, AC Insulin, PC Sugar. Unexpectedly, the most important variable associated with PCOS is AMH, and the most important rule is {AMH, Testosterone}. Data mining can discover novel associations that are useful to clinicians and administrators.

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Rampally, Neha. "Potential of utilizing specific miRNAs as biomarkers for polycystic ovarian syndrome (PCOS)." Thesis, 2020. https://hdl.handle.net/2144/42186.

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Polycystic Ovarian Syndrome is the one of the leading causes of infertility among women who are of child-bearing age. The syndrome’s vast range of phenotypes has made it challenging for researchers to not only consistently diagnose but also discover a cure. Currently, there are several proposed treatments being looked into, however, much of the research focuses on employing promising biomarkers, micro ribonucleic acids (miRNAs), that can potentially aid in diagnosis. The four prominent locations of research for these biomarkers include: ovarian tissues specifically looking into granulosa cells (GC), adipose tissue, follicular fluid, and the serum. My goal is to determine which of these areas holds the most promise to diagnose this syndrome in the years to come. This study reviewed a large collection of the current polycystic ovarian syndrome literature evaluating both reported miRNAs and how viable those would be as potential biomarkers to use for the future. The data showed that a majority of these promising biomarkers were found in granulosa cells, adipose tissue, and follicular fluid. Although there were miRNAs that were deemed promising in the serum, research is still far from conclusive in using these miRNAs as biomarkers for diagnosis of polycystic ovarian syndrome. By comparing the miRNAs selected from each type of location, I was able to conclude that miR-21, miR-93, miR-223, and miR-let-7b hold the most promise for the potential to become biomarkers for polycystic ovarian syndrome in the near future. Currently, there is a lot of research particularly surrounding these miRNAs and how they were shown to have been expressed in statistically significant levels among women with the syndrome. However, because of their complexity, miRNAs do not regulate one single pathway, it is hard to describe a mechanism that explains the pathophysiology of the syndrome. I believe we are still far away from successfully zooming in on one biomarker. By determining the most potential biomarker(s), we can focus resources and efforts towards finding a better diagnostic tool for this syndrome.

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Wu, Yi-fan, and 吳一凡. "Skin-surface Microcirculatory Effect following Different Traditional-Chinese-Medicine Treatment in Polycystic Ovarian Syndrome Patients." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/7eghsm.

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碩士
國立臺灣科技大學
醫學工程研究所
100
Polycystic ovary syndrome(PCOS) is a heterogeneous endocrine disorder but the detailed etiology of PCOS remains unknown. Polycystic ovary syndrome may result in several health complications such as menstrual dysfunction, infertility, hirsutism, acne, obesity, and metabolic syndrome. Some studies suggested that PCOS contributes to the development of cardiovascular disease. The present aim is to verify if laser doppler measurement and time-domain waveform analysis can help to monitor the microcirculatory conditions in PCOS patients. We performed four months of the Traditional-Chinese-Medicine treatment and three times Laser Doppler flowmetry (LDF) measurement. The locations of LDF measurement sites are the bilateral SanYinJiao(SP-6) acupoints. Time-domain parameters of LDF waveform were calculated to elucidate the microcirculatory effects induced in PCOS patients. The present result revealed: 1.The time-domain LDF index can help to discriminate the PCOS and control subjects. 2.The time-domain LDF index can help to monitor the microcirculatory-blood-supply condition of flux-flow in PCOS patients following Chinese-herb administration. The present finding may have meaning in noninvasive early detection and disease-progress monitoring for PCOS.

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Chan, Wai Ping Alicia. "Cardiovascular risk assessment in women : impact of ageing, polycystic ovarian syndrome and menopause on nitric oxide signalling." Thesis, 2013. http://hdl.handle.net/2440/82439.

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Ageing represents an independent and strong risk factor for cardiovascular disease (Lakatta and Levy 2003), and in women, menopause appears to trigger a substantial increase in cardiovascular disease incidence (Castelli 1984). One potential basis for this observation is impairment of vascular endothelial function (Yasue, Matsuyama et al. 1990; Egashira, Inou et al. 1993). However no stratified comparisons of endothelial function or tissue responsiveness to nitric oxide (NO) with increasing age have previously been reported in either gender. The objectives of the experiments contained in this thesis were therefore to:- 1) Characterise the putative variability in platelet and vascular responsiveness to NO in women of ages 18 to 60 years. 2) Compare this variability with that in vascular endothelial function and its biochemical determinants. 3) Compare the above-mentioned putative fluctuations to those present in age-matched patients with PCOS, a condition characterised by presence of impaired NO signalling in early adult life. 4) Determine the possible impact of menopause on NO signalling in vessels and platelets. Methods In order to examine these objectives, we conducted a case-control study of women aged between 18 and 60 years, which allowed us to firstly, examine NO signalling and various parameters in normal ageing women and then secondly, to compare these with women with PCOS. A subset of 40 perimenopausal women was studied prospectively to assess the relationship between menopause and platelet and vascular parameters. PCOS women were selected based on Rotterdam criteria and women who were pregnant or on clopidogrel were excluded from the study. Inhibition of platelet aggregation by nitric oxide was the primary outcome measure. Vascular endothelial function utilizing applanation tonometry, plasma concentrations of NG,NG-dimethyl-L-arginine (ADMA) and endothelial progenitor cell count (EPC) were assessed as markers of endothelial dysfunction. High-sensitivity Creactive protein (hs-CRP) was measured as a marker of inflammation. Results The key findings from this thesis are: (1) With increasing age in normal women, there was progressive attenuation of platelet responses to NO (ANOVA, P<0.0001) with no significant changes in vascular NO responses. (2) There was also evidence of endothelial dysfunction with increasing age (p<0.0001) which was accompanied by elevation of ADMA concentrations with increasing age (p=0.003). (3) Irrespective of age, PCOS women exhibited greater impairment of platelet NO responses and endothelial function (p<0.05, 2 way ANOVA) compared to normal women. Furthermore, these anomalies were evident in PCOS women from an early age but had a tendency to converge with normal women above the age of 40 years. (4) The changes in platelet and endothelial function in normal women were not correlated with oestradiol levels. Conclusions Normal ageing in women is associated with attenuation of NO-based signalling in platelets and blood vessels. In women with PCOS, these changes are present from early adult life, which may form the pathophysiological basis for premature atherogenesis seen in these individuals. The changes in NO signalling are not totally attributable to the onset of menopause.
Thesis (Ph.D.) -- University of Adelaide, School of Medicine, 2013

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Chen, Mei-Jou, and 陳美州. "Hyperandrogenism in Relation to Metabolic Disorder, Ovarian Morphology and Ovulatory Dysfunction in Women with Polycystic Ovary Syndrome." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/30366600715596416816.

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博士
臺灣大學
臨床醫學研究所
98
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age with a probable prevalence of 5% to 10%. PCOS is characterized by chronic anovulation, menstrual irregularities, evidence of hyperandrogenism (either clinical, manifested as hirsutism, acne, male pattern balding, or biochemical, manifested by elevated serum adrenal and/or ovarian androgen concentration). Fifty percent of all patients with PCOS are overweight or obese, and the presence of obesity affects the clinical manifestations of PCOS. The underlying pathogenic mechanisms appear to involve insulin resistance and hyperinsulinemia, the magnitude of which is greater in obese than in non-obese women with PCOS. Basically, the hyperandrogenism was considered as a core manifestation for women with PCOS. However, because of the effects of different dietary culture, genetic background and environment factors, there has been a very big difference of the phenotypic expression of insulin resistance and the prevalence of metabolic syndrome in women with PCOS among the different ethnicities. Previous studies already showed that although the Asian women have less severity of phenotypic hyperandrogenism and obesity than the Caucasian women, while the degree of insulin resistance, hyperandrogenemia, and polycystic ovary were comparable between Asian and Caucasian women. However, studies concerning the Asian women with PCOS, with special emophasis on Taiwanese women are rare. Therefore, in the present study, we may focus to work on the issues of hyperandrogenism on the metabolic dysfunction, phenotypic expression and ovulatory dysfunction for women with PCOS. Since the Rotterdam consensus meeting in 2003, the ultrasound criteria of increased ovarian volume (>10 ml) and/or the presence of 12 or more follicles (2-9 mm in size) in at least a single ovary has become one of the triad definitive criteria for the diagnosis of the polycystic ovary syndrome (PCOS). However, this criteria for the definition of PCOS is still a controversy, owing to the fact that the significance of the polycystic ovary morphology and the characteristic endocrine syndrome for women with PCOS is still conflicting. Insulin-sensitizing agents and/or weight loss have been demonstrated to improve the recovery of spontaneous ovulation in obese women with PCOS. Whether or not the obesity or insulin resistance contributes to the polycystic ovary morphology and function of ovulation has not been reported. Anti-Mullerian hormone, as a gate-kepper to prevent the multiple selection of dominant follicle in natural cycle was also considered as an important to regulate the regulation in women with PCOS. In our study, we found that not only, anti-Mullerian hormone, the hyperandrogenism and insulin resistance may lead to the polycystic ovary morphology in women with PCOS. Furthermore, the relationship between PCOS and cardiovascular disease is always controversial. Wild et al. proposed that the association between PCOS and CVD might disappear after consider the confounding effect of obesity. Metabolic syndrome was well-known to increase the future risk of diabetes and cardiocascular disease. Dyslipidemia and hypertension which are parts of metabolic syndrome were reported to have high prevalence in women with PCOS. Previous reports focused on the obesity and insulin resistance of women with PCOS. Here, we aim to investigate the roles of hyperandrogenemia in association with the metabolic abnormalities in women with PCOS. In our study, we found that the low sex-hormone binding globulin in women with PCOS which might aggravate the hyperandrogenemia was associated with low HDL-C levels and the occurrence of metabolic syndrome. In addition, the hyperandrogenism in women with PCOS was independently and significantly correlated to both systolic and diastolic blood pressure after further adjustment for the age, obesity, insulin resistance and dyslipidemia. Previous studies already provide a a lot of evidence to show that the insulin resistance may lead to chronic low-grade inflammation in human beings. In addition, the increased level of C-reactive protein was currently considered to be a biomarker to predict the risk of future cardiovascular disease. There were also several reports that level of CRP was significantly higher in women with PCOS than those without PCOS. Two previous studies reported that the follistatin level was specifically higher in women with PCOS than control subjects. In our studies, we found that the high follistatin level in women with PCOS might be a reflection of their chronic low grade inflammatory status. From our study results, we found the most evident characteristic for women with PCOS was the hyperandrogenism, no matter in biochemical or clinical aspects. We found different origins of androgen may lead to different phenotypic expressions of biochemistry, metabolism and ovulatory function that might even represent the different clinical phenotypic expression of women with PCOS. Rat that treated with dihydrotestosterone may lead to obesity, insulin resistane, dyslipidemia, abnormal liver function tests and decreased spontanerous ovulatory cycles that mimic the obese women with PCOS. However, rats that treated with dehydroepiandrostenedione, on the contrary, may not lead to the obesity but still lead to the dyslipidemia and abnormal liver function tests. This might represent another clinical subgroup of women with PCOS. Conclusivly, in this project, our investigation in women with PCOS was found: 1. The characteristic hyperandrogenism in women with PCOS was related to the dyslipidemia, insulin resistance, metabolic syndrome and cardiovascular disease. 2. The characteristic hyperandrogenism in women with PCOS has also impact for hypertension in women with PCOS. 3. Not only the characteristic hyperandrogenemia, but also the insulin resistance and anti-mullerian hormone were related to the polycystic ovary morphology and the anovulation for women with PCOS. Besides, the anovulation in women with PCOS might through the dysregulation of anti-mullerian hormone by insulin resistance. 4. Follistatin as representation for the low-grade inflammation was related to the insulin resistance in women with PCOS. 5. From hyperandrogenic rat models, we found the different origins of androgen might lead to different metabolic phenotypes as clinical presented in women with PCOS.

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Seow, Kok-Min, and 蕭國明. "The effect of laparoscopic ovarian electrocautery on the amelioration of insulin resistance in women with polycystic ovary syndrome." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/88647671520082663085.

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博士
國立陽明大學
臨床醫學研究所
95
Polycystic ovary syndrome (PCOS) is a heterogeneous syndrome characterized by chronic anovulation, hyperandrogenism, and polycystic ovary on ultrasonography, which affects 5–10% of women of reproductive age. PCOS is frequently associated with insulin resistance accompanied by compensatory hyperinsulinemia. Insulin resistance is thus thought to play an important role in the etiology of PCOS. The molecular mechanism of insulin resistance in PCOS is unknown. In vivo and in vitro studies demonstrated that insulin resistance in PCOS represents post-binding defects in signal transduction in which increased Ser312 phosphorylation of insulin receptor substrate (IRS)-1 is the possible molecular mechanism of insulin resistance in PCOS. On the other hand, resistin, a hormone secreted by adipocytes, is suggested to be a hormonal link between obesity and insulin resistance, may play an important role in the pathogenesis of PCOS. In clinical practice, approximately 75% of women with PCOS experience infertility, caused mainly by the anovulation. Clomiphene citrate is the first-line of treatment for the induction of ovulation in infertility PCOS women, with an ovulation rate of 75-85%. Laparoscopic ovarian electrocautery (LOE) is an alternative treatment for women who are clomiphene citrate-resistant, with a mean ovulation rate of 83%. Moreover, there is a marked decreased in serum androgen levels, an increase in FSH levels, a reduction in the amplitude of LH pulses, a reduction in the LH/FSH ratio, and a reduction in ovarian volume following LOE. However, the mechanism of action of LOE is unclear. In this study, we assess the relationship between resistin and insulin resistance in women with PCOS, and investigate whether LOE improved insulin sensitivity in women with PCOS and examined the underlying molecular mechanism of LOE. Adipose tissue and blood sampling from twelve women with PCOS before, and three months after, LOE was analyzed. Before LOE, women with PCOS were found to have significantly higher testosterone, luteinizing hormone (LH), LH-to-FSH ratio, 2h glucose, fasting and 2h insulin levels, homeostasis model insulin resistance index (HOMAIR) and ovarian volume, and lower fasting glucose-to-insulin ratio (G0/I0) than healthy, lean, age-matched controls. Serum levels of LH, LH-to-FSH ratio, ovarian volume, glucose and insulin, and HOMAIR were significantly decreased, and G0/I0 ratio was significantly increased three months after LOE. Levels of activated extracellular signal-regulated kinase (ERK) 1/2 in PCOS women were higher than in controls, but were significantly decreased after LOE. Levels of insulin receptor, glucose transporter-4, and phosphatidylinositol 3-kinase were lower in PCOS patients before LOE than in controls, and increased after LOE. Levels of Ser312 phosphorylated IRS-1 in PCOS women before LOE were higher than in controls and decreased significantly after LOE, whereas IRS-1 tyrosine phosphorylation in PCOS women before LOE was lower than in controls and increased significantly after LOE. No difference was found in serum resistin levels between women with PCOS before LOE and controls or between PCOS before, and after LOE. However, adipocyte resistin mRNA expression in women with PCOS before LOE was significantly higher than in controls, and was decreased significantly after LOE to control levels. In conclusion, over the short observation period of this study, our results demonstrated that LOE effectively ameliorated insulin resistance in women with PCOS via decreased IRS-1 Ser312 phosphorylation, and downregulated adipocyte resistin mRNA expression.

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50

Magan, Nitasha. "The frequency of insulin resistance and hyperlipidaemia in women with polycystic ovarian syndrome (PCOS) attending Inkosi Albert Luthuli Central Hospital." Thesis, 2010. http://hdl.handle.net/10413/9564.

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BACKGROUND. Polycystic ovarian syndrome is one of the commonest endocrinopathies in women of reproductive age. The prevalence of the disease is estimated to be around 5 % in general population (Azziz, 2004). Literature on the prevalence of PCOS in Black women is limited (Knochenhauer, 1998). This syndrome is a diagnostic conundrum due to the phenotypic variability of these women. The PCOS woman also has a greater disposition for impaired glucose homeostasis as well as hyperlipidaemia. OBJECTIVE. The hormonal and metabolic profiles of South African women with PCOS have not been described. Ethnic differences in the prevalence of PCOS have also not been well explored. Our study aims to describe and compare the phenotypic profile of African and Indian women with PCOS and to determine the frequency of insulin resistance and hyperlipidaemia in these women. METHODS. A retrospective audit of all patients attending gynaecology endocrine and infertility clinics over the period June 2005 to June 2009 was carried out. The biochemical and clinical profiles were analysed and a comparative analysis between the two largest groups, Indian and Black women were done. All women that attended these clinics were subjected to a fasting lipogram and fasting serum glucose. An abnormal fasting serum glucose would have necessitated a full glucose tolerance test. RESULTS. A total of 110 patients were analysed in this study. There were 87 Indian patients, 16 Black patients, 5 Coloured patients and 2 White patients. Eighty nine percent of PCOS women studied had an increased body mass index (>25). There was an increased LH:FSH in 66 (75.9%) of Indian women and 13 (81.3%) of Black women. Increased androgens were present in 26 (30.2%) in Indian women and 6 (37.5%) of Black women. An increase in fasting insulin was found in 48 (55.2%) of the Indian women and 5 (31.3%) of the Black women. Twenty five (29.1%) Indian women had an increase in fasting serum glucose compared to 1 (6.3%) in Black women. In the Indian population, 13 (14.9%) were found to have Diabetes Mellitus, and 9 (10.3%) had an impaired glucose tolerance test. In the Black population only 1 patient had impaired glucose tolerance. There were no Black patients with Diabetes Mellitus. No Black women were found to have hyperlipidaemia, however 12 (14.3%) Indian women were affected. None of these differences between the races were statistically significant. The major limitation of the study was the sample size of Black women. This is an ongoing study, and aims to recruit more Black women. This will be able to adequately address the correct perspective regarding the metabolic and cardiovascular abnormalities in these women. CONCLUSION. The prevalence of insulin resistance and hyperlipidaemia in local women with PCOS was 50.9%.and 11.3% respectively. Menstrual irregularities and infertility are the most frequent presenting complaints of women with PCOS. Features of hyperandrogenism are not common presenting complaints in South African women. There are no differences in the hormonal and clinical profile of South African Indian and Black women with PCOS, however, there is a trend toward Indian women having a greater prevalence of glucose abnormalities than Black women. We recommend further studies in the management of the metabolic abnormalities in local women with PCOS, in an attempt to develop a protocol to manage the metabolic complexities of PCOS.
Thesis (M.Med)-University of KwaZulu-Natal, Durban, 2010.

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