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Spinedi, Eduardo, and Daniel P. Cardinali. "The Polycystic Ovary Syndrome and the Metabolic Syndrome: A Possible Chronobiotic-Cytoprotective Adjuvant Therapy." International Journal of Endocrinology 2018 (July 25, 2018): 1–12. http://dx.doi.org/10.1155/2018/1349868.
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Polycystic ovary syndrome is a highly frequent reproductive-endocrine disorder affecting up to 8–10% of women worldwide at reproductive age. Although its etiology is not fully understood, evidence suggests that insulin resistance, with or without compensatory hyperinsulinemia, and hyperandrogenism are very common features of the polycystic ovary syndrome phenotype. Dysfunctional white adipose tissue has been identified as a major contributing factor for insulin resistance in polycystic ovary syndrome. Environmental (e.g., chronodisruption) and genetic/epigenetic factors may also play relevant roles in syndrome development. Overweight and/or obesity are very common in women with polycystic ovary syndrome, thus suggesting that some polycystic ovary syndrome and metabolic syndrome female phenotypes share common characteristics. Sleep disturbances have been reported to double in women with PCOS and obstructive sleep apnea is a common feature in polycystic ovary syndrome patients. Maturation of the luteinizing hormone-releasing hormone secretion pattern in girls in puberty is closely related to changes in the sleep-wake cycle and could have relevance in the pathogenesis of polycystic ovary syndrome. This review article focuses on two main issues in the polycystic ovary syndrome-metabolic syndrome phenotype development: (a) the impact of androgen excess on white adipose tissue function and (b) the possible efficacy of adjuvant melatonin therapy to improve the chronobiologic profile in polycystic ovary syndrome-metabolic syndrome individuals. Genetic variants in melatonin receptor have been linked to increased risk of developing polycystic ovary syndrome, to impairments in insulin secretion, and to increased fasting glucose levels. Melatonin therapy may protect against several metabolic syndrome comorbidities in polycystic ovary syndrome and could be applied from the initial phases of patients’ treatment.
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Jasti, Prathima, and Andrea Dunaif. "Reproduction and Metabolism: Insights from Polycystic Ovary Syndrome." Endocrinology and Metabolism 27, no. 3 (2012): 180. http://dx.doi.org/10.3803/enm.2012.27.3.180.
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Oguz, Seda Hanife, and Bulent Okan Yildiz. "An Update on Contraception in Polycystic Ovary Syndrome." Endocrinology and Metabolism 36, no. 2 (April 30, 2021): 296–311. http://dx.doi.org/10.3803/enm.2021.958.
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Popova, P. V., I. V. Gorelova, and E. N. Grineva. "Polycystic ovary syndrome and cardiovascular risk." "Arterial’naya Gipertenziya" ("Arterial Hypertension") 24, no. 6 (January 26, 2019): 654–65. http://dx.doi.org/10.18705/1607-419x-2018-24-6-654-665.
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Polycystic ovary syndrome (PCOS) is a common endocrine disease in women of reproductive age. In addition to hyperandrogenism, impaired ovulation and fertility, PCOS is associated with an increased detection of cardiovascular risk factors such as obesity, insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus, arterial hypertension, and obstructive sleep apnea. The initial stages of the atherosclerotic process are also well documented in women with PCOS. However, data from prospective studies on the end points of cardiovascular morbidity and mortality are scarce and controversial. Perhaps this is due to the fact that PCOS is a heterogeneous group of endocrine, metabolic and reproductive disorders, and different authors consider various combinations of these disorders as the syndrome. Different phenotypes of PCOS may be associated with different cardiovascular risk. Women with a “complete” phenotype (a combination of all three PCOS diagnostic criteria) and with the predominant hyperandrogenism have higher risk. According to a number of studies, obesity affects more than half of women with PCOS and contributes the most to the increased risk of type 2 diabetes mellitus. Despite the weakness of the evidence regarding the association of PCOS with cardiovascular morbidity and mortality, most international organizations recommend active screening for cardiovascular risk factors in women with PCOS.
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Artymuk, N. V., and O. A. Tachkova. "New about the pathogenesis and treatment of polycystic ovary syndrome." Russian Journal of Woman and Child Health 4, no. 1 (2021): 17–22. http://dx.doi.org/10.32364/2618-8430-2021-4-1-17-22.
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Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age that is characterized by reproductive and metabolic disorders. Mental issues, hypothalamic-pituitary dysfunction, ovarian dysfunction, mitochondrial dysfunction, obesity, and vitamin D deficiency account for infertility in PCOS. This paper reviews recent studies on pathogenesis and treatment approaches to this disease. Recognized therapeutic modalities for PCOS are addressed, i.e., rational diet, combined hormonal contraceptives, ovulation induction using clomiphene citrate and/or metformin, ovarian drilling, assisted reproductive technology, and alternative approaches (e.g., herbal therapy, traditional Chinese medicine, vitamin D, coenzyme Q, salubrinal, and the combination of simvastatin and metformin). Inositols are a promising therapeutic modality that improves menstrual and reproductive function (presumably via their impact on carbonic and lipid metabolism) and the quality of oocytes and embryos. KEYWORDS: polycystic ovary syndrome, pathogenesis, treatment, myo-inositol, ovulation induction, drilling, combined oral contraceptives, lifestyle changes. FOR CITATION: Artymuk N.V., Tachkova O.A. New about the pathogenesis and treatment of polycystic ovary syndrome. Russian Journal of Woman and Child Health. 2021;4(1):17–22. DOI: 10.32364/2618-8430-2021-4-1-17-22.
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Kozica-Olenski, Samantha, Helena Teede, and Rhonda Garad. "Evaluation of a Center of Research Excellence in Polycystic Ovary Syndrome as a Large-Scale Collaborative Research Translation Initiative, Including Evaluating Translation of Guideline Impact." Seminars in Reproductive Medicine 36, no. 01 (January 2018): 042–49. http://dx.doi.org/10.1055/s-0038-1667308.
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AbstractResearch translation and evaluation are often underconsidered in research design and implementation thus limiting research benefit to the end user. In this article, we first describe a best practice approach to evaluation, for a center of research excellence in polycystic ovary syndrome. Within this, we outline a comprehensive research translation program with inbuilt evaluation of the first International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (2018). We seek to provide a real-world example of comprehensive approaches to evaluation and research translation.
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Li, Xinrong, Beili Lv, Haiyan Wang, and Qiaohong Qian. "Dioscin Ameliorates Polycystic Ovary Syndrome by Inhibiting PI3K/Akt Pathway-Mediated Proliferation and Apoptosis of Ovarian Granulosa Cells." Current Topics in Nutraceutical Research 18, no. 4 (April 15, 2020): 331–36. http://dx.doi.org/10.37290/ctnr2641-452x.18:331-336.
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To understand the mechanism underlying Dioscin inhibition of polycystic ovary syndrome, we have examined its effects on ovarian granulosa cells from letrozole-treated rats. To this end, Western blot was utilized to determine changes in the levels of Bcl-2, cleaved caspase-3, caspase-3, and phosphatidylinositol 3-kinase (PI3K)/protein kinase B pathway after Dioscin treatment in letrozole-treated rats. Dioscin ameliorated polycystic ovary syndrome by reducing the serum level of testosterone and increasing progesterone levels. It also inhibited proliferation and induced apoptosis of ovarian granulosa cells in the rat model by decreasing the level of Bcl-2 and elevating cleaved caspase-3. Western blot analysis revealed that Dioscin suppressed the PI3K/Akt pathway by inhibiting p-AKT/AKT. SC79, a p-AKT/AKT activator, reversed the effects of Dioscin on the proliferation and apoptosis of ovarian granulosa cells. In conclusion, Dioscin might present a novel therapeutic opportunity for patients with polycystic ovary syndrome.
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Lathief, Sanam, and Lubna Pal. "Advances in Treatment Options for Polycystic Ovary Syndrome." US Endocrinology 08, no. 01 (2012): 57. http://dx.doi.org/10.17925/use.2012.08.01.57.
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Polycystic ovary syndrome (PCOS) is the most common endocrinopathy seen in women of reproductive age. Clinical concerns relating to PCOS range from ovulatory infertility and menstrual disorders to risk of diabetes and cardiovascular disease. Hormonal contraceptives have been the mainstay of the management of common PCOS symptoms, such as menstrual irregularity and clinical stigmata of androgen excess (i.e., hirsutism and acne). An appreciation of the relevance of metabolic pathways in the pathophysiology of PCOS is relatively recent, and has translated into an expansion of the therapeutic strategies available for the management of PCOS. Insulin sensitizers were one of the first metabolic modulators to be incorporated in the clinical management paradigm, albeit with mixed results. Recognizing that insulin resistance is central to the pathophysiology of PCOS, newer agents—e.g., thiazolidinediones— followed, with almost comparable efficacy to metformin. Statins and most recently incretins constitute novel therapies with distinct metabolic targets that seem to hold promise in the management of PCOS. In tandem with the expansion in pharmaceuticals, a host of complementary and alternative medical therapies have generated interest for purported promise in the management of PCOS, including vitamin D, acarbose, and myo-inositol. The therapeutic options for managing PCOS-related infertility have also expanded. Clomiphene citrate (CC) has long been the first-line strategy for ovulation induction in the setting of anovulatory infertility; however, aromatase inhibitors are fast gaining acceptance as an ovulation induction strategy, with results comparable or even better than those seen with CC. An increasing level of therapeutic sophistication is reflected in ovarian stimulation protocols judiciously using gonadotropins, gonadotropin-releasing hormone antagonists, the procedure of ovarian drilling, and assisted reproductive technologies within vitrooocyte maturation.
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Sung, Yeon-Ah. "Polycystic Ovary Syndrome in Korean Women: Clinical Characteristics and Diagnostic Criteria." Endocrinology and Metabolism 26, no. 3 (2011): 203. http://dx.doi.org/10.3803/enm.2011.26.3.203.
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ALhabardi, Nadiah A., Osama Al-Wutayd, Khalid M. Eltayieb, Yasir S. Shiha, Ahmad I. AL-Shafei, and Ishag Adam. "Peripheral hematological parameters in women with polycystic ovary syndrome." Journal of International Medical Research 48, no. 9 (September 2020): 030006052095228. http://dx.doi.org/10.1177/0300060520952282.
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Objective There have been few studies on hematological parameters (e.g., hemoglobin, red cell distribution width, white blood cells, and mean platelet volume), and polycystic ovary syndrome (PCOS). This study aimed to compare hematological parameters between women with PCOS and controls. Methods We performed an age-matched case–control study in Faisal bin Mishal Center for Infertility, Buraidah (Kingdom of Saudi Arabia). The cases were women with PCOS and an equal number of healthy women were enrolled as controls. The basic gynecological history was recorded and blood samples were analyzed for blood parameters using an automated hematology analyzer. Results The two groups (60 women in each arm of the study) were similar in age. However, body mass index was significantly higher in women with PCOs compared with controls. There were no significant differences in any of the hematological parameters (hemoglobin, red blood cells, red cell distribution width, white blood cells, platelets, and mean platelet volume) between the two groups. Conclusion There does not appear to be a significant difference in hematological parameters in Saudi women with PCOS and healthy controls. A larger study on this issue is required in the future.
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Lewandowski, Krzysztof C., Justyna Płusajska, Wojciech Horzelski, Ewa Bieniek, and Andrzej Lewiński. "Limitations of insulin resistance assessment in polycystic ovary syndrome." Endocrine Connections 7, no. 3 (March 2018): 403–12. http://dx.doi.org/10.1530/ec-18-0021.
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Background Though insulin resistance (IR) is common in polycystic ovary syndrome (PCOS), there is no agreement as to what surrogate method of assessment of IR is most reliable. Subjects and methods In 478 women with PCOS, we compared methods based on fasting insulin and either fasting glucose (HOMA-IR and QUICKI) or triglycerides (McAuley Index) with IR indices derived from glucose and insulin during OGTT (Belfiore, Matsuda and Stumvoll indices). Results There was a strong correlation between IR indices derived from fasting values HOMA-IR/QUICKI, r = −0.999, HOMA-IR/McAuley index, r = −0.849 and between all OGTT-derived IR indices (e.g. r = −0.876, for IRI/Matsuda, r = −0.808, for IRI/Stumvoll, and r = 0.947, for Matsuda/Stumvoll index, P < 0.001 for all), contrasting with a significant (P < 0.001), but highly variable correlation between IR indices derived from fasting vs OGTT-derived variables, ranging from r = −0.881 (HOMA-IR/Matsuda), through r = 0.58, or r = −0.58 (IRI/HOMA-IR, IRI/QUICKI, respectively) to r = 0.41 (QUICKI/Stumvoll), and r = 0.386 for QUICKI/Matsuda indices. Detailed comparison between HOMA-IR and IRI revealed that concordance between HOMA and IRI was poor for HOMA-IR/IRI values above 75th and 90th percentile. For instance, only 53% (70/132) women with HOMA-IR >75th percentile had IRI value also above 75th percentile. There was a significant, but weak correlation of all IR indices with testosterone concentrations. Conclusions Significant number of women with PCOS can be classified as being either insulin sensitive or insulin resistant depending on the method applied, as correlation between various IR indices is highly variable. Clinical application of surrogate indices for assessment of IR in PCOS must be therefore viewed with an extreme caution.
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Kelly, CJ, and D. Gordon. "The effect of metformin on hirsutism in polycystic ovary syndrome." European Journal of Endocrinology 147, no. 2 (August 1, 2002): 217–21. http://dx.doi.org/10.1530/eje.0.1470217.
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OBJECTIVE: Polycystic ovary syndrome (PCOS) is a common reproductive disorder characterised by insulin resistance and often associated with hirsutism. Insulin sensitising agents, such as metformin, improve both the biochemical and reproductive parameters; however, no study has been designed to specifically assess the effect of metformin on hair growth. DESIGN AND PATIENTS: Sixteen women with PCOS and hirsutism were enrolled into a 14 month (two 6 month phases with a 2 month washout) double-blind placebo-controlled cross over study. MEASUREMENTS: Hirsutism was assessed using the Ferriman and Gallwey (F-G) score, patient self-assessment and growth velocity. Weight, height and waist-hip ratio were recorded. Gonadotrophins, androgens, plasma glucose and lipids were also measured. RESULTS: Ten women completed the full 14 month study. There was a significant improvement in hirsutism at the end of the metformin phase compared with placebo: F-G score 15.8+/-1.4 vs 17.5+/-1.2 (P=0.025) and patient self-assessment 2.4+/-0.1 vs 3.3+/-0.3 (P=0.014). Growth velocity, in millimetres per day at the end of each phase also improved (0.67+/-0.17 vs 0.77+/-0.11; P=0.03). There was a non-significant improvement in both sex hormone binding globulin (SHBG) and free androgen index (FAI), although there was a significant difference between baseline and metformin treatment for SHBG (P=0.023) and FAI (P=0.036). Metformin treatment also reduced weight significantly (91.5+/-7.6 vs 94.0+/-9.8 kg; P=0.009) and led to a significant improvement in cycle frequency (0.53+/-0.12 vs 0.35+/-0.08 cycles per month; P=0.008). CONCLUSION: We have demonstrated that metformin treatment in a group of women with PCOS results in a clinically and statistically significant improvement in hair growth compared with placebo.
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Carvalho, Laura M. L., Fernando M. dos Reis, Ana Lucia Candido, Fernanda F. C. Nunes, Claudia N. Ferreira, and Karina B. Gomes. "Polycystic Ovary Syndrome as a systemic disease with multiple molecular pathways: a narrative review." Endocrine Regulations 52, no. 4 (October 1, 2018): 208–21. http://dx.doi.org/10.2478/enr-2018-0026.
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AbstractPolycystic Ovary Syndrome (PCOS) is characterized by hyperandrogenism, amenorrhea, and polycystic ovaries. This endocrinopathy is associated with many metabolic disorders such as dyslipidemia and insulin resistance, with increased risk of type 2 diabetes mellitus, metabolic syndrome, and cardiovascular complications. Inflammation is likely to play an important role in the promoting these metabolic imbalances, while prothrombotic and pro-oxidative mechanisms further contribute to the cardiovascular risk of these patients. The etiology of PCOS is still not fully understood, but there is evidence of genetic and environmental components. This review aims to discuss some molecular pathways associated with PCOS that could contribute to the better understanding about this syndrome. Recent evidence suggests that intrauterine exposure of female mice to an excess of anti-Müllerian hormone may induce PCOS features in their post-natal life. High cytokine levels and cytokine gene polymorphisms also appear to be associated with the pathophysiology of PCOS. Furthermore, high levels of microparticles may contribute to the altered hemostasis and enhanced inflammation in PCOS. All these mechanisms may be relevant to clarify some aspects of PCOS pathogenesis and inspire new strategies to prevent the syndrome as well as treat its symptoms and mitigate the risk of long-term complications.
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Sadeghi, Fatemeh, Amirmansour Alavi-Naeini, Farahnaz Mardanian, Mohammad Reza Ghazvini, and Behzad Mahaki. "Omega-3 and vitamin E co-supplementation can improve antioxidant markers in obese/overweight women with polycystic ovary syndrome." International Journal for Vitamin and Nutrition Research 90, no. 5-6 (October 2020): 477–83. http://dx.doi.org/10.1024/0300-9831/a000588.
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Abstract. Background: Polycystic ovary syndrome is one of the most important factors in female infertility. Oxidative stress is likely to contribute to increased insulin and androgen production in the ovaries, as well as probably impairing follicle production. Aims: This study aims to determine the complementary effects of omega-3 and vitamin E supplements on certain oxidative stress indices in obese and overweight women with polycystic ovary syndrome. Materials and Methods: This double-blind, randomized clinical trial was performed on polycystic ovary syndrome subjects with BMI > 25. Patients were randomly allocated into two groups to receive either 2 g of omega-3 plus 400 IU of vitamin E, or a placebo, for 8 weeks. At the beginning and the end of the study, total antioxidant capacity, glutathione levels, catalase activity, malondialdehyde concentrations, as well as dietary intake and physical activity were evaluated. Statistical analysis was performed using SPSS. Results: 32 patients in the intervention group and 30 patients in the placebo group completed the study. Co-supplementation of omega-3 and vitamin E significantly increased total antioxidant capacity (mg/dl) (1.15 ± 0.93 vs −0.6 ± 0.72; P < 0.001), catalase activity (IU/L) (1.19 ± 1.06 vs 0.12 ± 0.36; P < 0.001) and glutathione levels (μmol/L) (1.5 ± 1.06 vs 0.23 ± 1.43; P = 0.028). Additionally, a significant reduction of malondialdehyde levels (nmol/L) (−0.34 ± 0.32 vs 0.57 ± 2.20; P = 0.008) was observed, in comparison with placebo. Conclusion: Co-supplementation with omega-3 and vitamin E had beneficial effect on total antioxidant capacity, malondialdehyde concentrations, glutathione levels and catalase activity.
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Le, Minh Tam, Vu Quoc Huy Nguyen, Quang Vinh Truong, Dinh Duong Le, Viet Nguyen Sa Le, and Ngoc Thanh Cao. "Metabolic Syndrome and Insulin Resistance Syndrome among Infertile Women with Polycystic Ovary Syndrome: A Cross-Sectional Study from Central Vietnam." Endocrinology and Metabolism 33, no. 4 (2018): 447. http://dx.doi.org/10.3803/enm.2018.33.4.447.
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Rudnicka, Ewa, Katarzyna Suchta, Monika Grymowicz, Anna Calik-Ksepka, Katarzyna Smolarczyk, Anna M. Duszewska, Roman Smolarczyk, and Blazej Meczekalski. "Chronic Low Grade Inflammation in Pathogenesis of PCOS." International Journal of Molecular Sciences 22, no. 7 (April 6, 2021): 3789. http://dx.doi.org/10.3390/ijms22073789.
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Polycystic ovary syndrome (PCOS) is a one of the most common endocrine disorders, with a prevalence rate of 5–10% in reproductive aged women. It’s characterized by (1) chronic anovulation, (2) biochemical and/or clinical hyperandrogenism, and (3) polycystic ovarian morphology. PCOS has significant clinical implications and can lead to health problems related to the accumulation of adipose tissue, such as obesity, insulin resistance, metabolic syndrome, and type 2 diabetes. There is also evidence that PCOS patients are at higher risk of cardiovascular diseases, atherosclerosis, and high blood pressure. Several studies have reported the association between polycystic ovary syndrome (PCOS) and low-grade chronic inflammation. According to known data, inflammatory markers or their gene markers are higher in PCOS patients. Correlations have been found between increased levels of C-reactive protein (CRP), interleukin 18 (IL-18), tumor necrosis factor (TNF-α), interleukin 6 (IL-6), white blood cell count (WBC), monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein-1α (MIP-1α) in the PCOS women compared with age- and BMI-matched controls. Women with PCOS present also elevated levels of AGEs and increased RAGE (receptor for advanced glycation end products) expression. This chronic inflammatory state is aggravating by obesity and hyperinsulinemia. There are studies describing mutual impact of hyperinsulinemia and obesity, hyperandrogenism, and inflammatory state. Endothelial cell dysfunction may be also triggered by inflammatory cytokines. Many factors involved in oxidative stress, inflammation, and thrombosis were proposed as cardiovascular risk markers showing the endothelial cell damage in PCOS. Those markers include asymmetric dimethylarginine (ADMA), C-reactive protein (CRP), homocysteine, plasminogen activator inhibitor-I (PAI-I), PAI-I activity, vascular endothelial growth factor (VEGF) etc. It was also proposed that the uterine hyperinflammatory state in polycystic ovary syndrome may be responsible for significant pregnancy complications ranging from miscarriage to placental insufficiency. In this review, we discuss the most importance evidence concerning the role of the process of chronic inflammation in pathogenesis of PCOS.
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Copp, T., D. M. Muscat, J. Hersch, K. J. McCaffery, J. Doust, B. W. Mol, A. Dokras, and J. Jansen. "Clinicians’ perspectives on diagnosing polycystic ovary syndrome in Australia: a qualitative study." Human Reproduction 35, no. 3 (February 26, 2020): 660–68. http://dx.doi.org/10.1093/humrep/deaa005.
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Abstract STUDY QUESTION What are clinicians’ views about the diagnosis of polycystic ovary syndrome (PCOS), and how do they handle any complexities and uncertainties in practice? SUMMARY ANSWER Clinicians have to navigate many areas of complexity and uncertainty regarding the diagnosis of PCOS, related to the diagnostic criteria, limitations in current evidence and misconceptions surrounding diagnosis, and expressed concern about the risk and consequences of both under- and overdiagnosis. WHAT IS KNOWN ALREADY PCOS is a complex, heterogeneous condition with many areas of uncertainty, raising concerns about both underdiagnosis and overdiagnosis. Quantitative studies with clinicians have found considerable variation in diagnostic criteria used and care provided, as well as a lack of awareness around the breadth of PCOS features and poor uptake of recommended screening for metabolic complications. Clinicians’ views about the uncertainties and complexities of diagnosing PCOS have not been explored. STUDY DESIGN, SIZE, DURATION Semi-structured telephone interviews were conducted with clinicians from September 2017 to July 2018 to explore their perceptions about the diagnosis of PCOS, including how they handle any complexities and uncertainties in practice. PARTICIPANTS/MATERIALS, SETTING, METHODS A group of 36 clinicians (15 general practitioners, 10 gynaecologists and 11 endocrinologists) currently practicing in Australia, were recruited through advertising via professional organisations, contacting a random sample of endocrine and gynaecology teams across Australia and snowballing. Transcribed audio-recordings were analysed thematically using Framework analysis. MAIN RESULTS AND THE ROLE OF CHANCE Clinicians expressed a range of uncertainties and complexities regarding the diagnosis of PCOS, which were organised into three areas: (i) establishing diagnosis (e.g. lack of standardisation regarding diagnostic cut-offs, risk of misdiagnosis), (ii) factors influencing the diagnostic process (e.g. awareness of limitations in evidence and consideration of the benefits and harms) and (iii) strategies for handling challenges and uncertainties (e.g. using caution and communication of uncertainties). Clinicians also varied in their concerns regarding under- and overdiagnosis. Overall, most felt the diagnosis was beneficial for women provided that it was the correct diagnosis and time was taken to assess patient expectations and dispel misconceptions, particularly concerning fertility. LIMITATIONS, REASONS FOR CAUTION There is possible selection bias, as clinicians who are more knowledgeable about PCOS may have been more likely to participate. Clinicians’ views may also differ in other countries. WIDER IMPLICATIONS OF THE FINDINGS These findings underscore the vital need to first consider PCOS a diagnosis of exclusion and use caution before giving a diagnosis in order to reduce misdiagnosis, as suggested by clinicians in our study. Until there is greater standardisation of diagnostic criteria, more transparent conversations with women may help them understand the uncertainties surrounding the criteria and limitations in the evidence. Additionally, clinicians emphasised the importance of education and reassurance to minimise the potential harmful impact of the diagnosis and improve patient-centred outcomes. STUDY FUNDING/COMPETING INTEREST(S) The study was funded by the University of Sydney Lifespan Research Network and an NHMRC Program Grant (APP1113532). T.C. is supported by an Australian Government Research Training Program (RTP) Scholarship and a Sydney Medical School Foundation Scholarship, from the The University of Sydney, Australia. B.W.M. reports consultancy for ObsEva, Merck, Merck KGaA and Guerbet. No further competing interests exist. TRIAL REGISTRATION NUMBER N/A
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Persson, S., E. Elenis, S. Turkmen, M. S. Kramer, E.-L. Yong, and I. Sundström-Poromaa. "Fecundity among women with polycystic ovary syndrome (PCOS)—a population-based study." Human Reproduction 34, no. 10 (September 2, 2019): 2052–60. http://dx.doi.org/10.1093/humrep/dez159.
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Abstract STUDY QUESTION Does the long-term fecundity of women with polycystic ovary syndrome (PCOS) differ from those without PCOS? SUMMARY ANSWER Cumulative probability of childbirth is similar between women with and without PCOS. WHAT IS KNOWN ALREADY PCOS is the main cause of anovulatory infertility in women after menarche. Previous studies indirectly suggest that fecundity in women with PCOS over the longer term may not be lower than in women without PCOS. STUDY DESIGN, SIZE, DURATION This is a population-based study using four linked Swedish national registries. A total of 45 395 women with PCOS and 217 049 non-PCOS women were included. Follow-up began at the age of 18 years and continued for a maximum of 26 years, from 1989 to the end of 2015. Childbirth was the main outcome, as identified from the Medical Birth Register. PARTICIPANTS/MATERIALS, SETTING, METHODS All women born between 1971 and 1997 who were identified with a PCOS diagnosis in the Swedish Patient Registry between 1 January 2001 and 31 December 2016 were included in the study population. Five controls per women with PCOS were randomly drawn from the Total Population Registry. The control women were born in the same year and living in the same municipality as the patient. The fecundity ratio (FR) was calculated by clustered Cox regression using a robust variance, adjusted for maternal birth period, country of birth and level of education. MAIN RESULTS AND THE ROLE OF CHANCE The cumulative probability of childbirth was 80.2% (95% CI, 79.5–80.9%) in women with PCOS and 78.2% (95% CI, 77.9–78.5%) in those without PCOS. Adjusted FR was 0.81 (95% CI, 0.80–0.82) for first childbirth and 0.58 (95% CI, 0.57–0.60) for first childbirth following a spontaneous pregnancy. The FR for second childbirth was 0.79 (95% CI, 0.77–0.80). Women with PCOS had more than one child less frequently than the comparison group. Within the PCOS group, early age at diagnosis, later birth year, Nordic country of origin and low educational level positively influenced the FR. LIMITATIONS, REASONS FOR CAUTION Results are not adjusted for BMI, and time from intention to conceive to first childbirth could not be captured. Data on pregnancies, miscarriages or abortions and fertility treatment are unknown for women who did not give birth during the study period. Women with PCOS who did not seek medical assistance might have been incorrectly classified as not having the disease. Such misclassification would lead to an underestimation of the true association between PCOS and outcomes. WIDER IMPLICATIONS OF THE FINDINGS While cumulative probability of childbirth is similar between groups, women with PCOS need longer time to achieve their first childbirth. Women with PCOS have a lower FR and give birth to fewer children per woman than women without PCOS. Early diagnosis of and information about PCOS may improve affected women’s reproductive potential. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the Swedish Society of Medicine. Inger Sundström Poromaa has, over the past 3 years, received compensation as a consultant and lecturer for Bayer Schering Pharma, MSD, Gedeon Richter, Peptonics and Lundbeck A/S. The other authors declare no competing interests.
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Diamanti-Kandarakis, Evanthia, Christina Piperi, Anastasios Kalofoutis, and George Creatsas. "Increased levels of serum advanced glycation end-products in women with polycystic ovary syndrome." Clinical Endocrinology 62, no. 1 (January 2005): 37–43. http://dx.doi.org/10.1111/j.1365-2265.2004.02170.x.
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Livzan, M. A., O. V. Gaus, N. A. Nikolaev, and T. S. Krolevetz. "NAFLD: comorbidity and associated diseases." Experimental and Clinical Gastroenterology 1, no. 10 (March 2, 2020): 57–65. http://dx.doi.org/10.31146/1682-8658-ecg-170-10-57-65.
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Non-alcoholic fatty liver disease (NAFLD) went beyond the competence of a gastroenterologist and acquired the character of a multidisciplinary problem. NAFLD requires the attention of many professionals. A characteristic feature of NAFLD is the variety of concomitant diseases and pathological conditions with common pathophysiological mechanisms. This review summarizes and presents the data available in the modern literature on the association of NAFLD with cardiovascular diseases, type 2 diabetes mellitus, hypothyroidism, polycystic ovary syndrome, chronic kidney disease, colorectal cancer, obstructive sleep apnea, osteoporosis, psoriasis.
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Bogomolov, P. O., A. O. Bueverov, E. A. Fedosina, V. E. Bakirova, and S. V. Koblov. "Clinical parallels and experience of antivira l therapy in chronic hepatitis with polycystic ovary syndrome." Experimental and Clinical Gastroenterology 174, no. 2 (May 2, 2020): 71–79. http://dx.doi.org/10.31146/1682-8658-ecg-174-2-71-79.
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Background. Despite the progress made in the treatment of chronic hepatitis C (CHC), there remain many unsolved problems in the treatment of patients infected with the 3rd virus genotype. This fact is mainly associated with the presence of hepatocyte steatosis due to the formation of local insulin resistance. Another important medical and social problem is polycystic ovary syndrome (PCOS), patogenetically associated with insulin resistance. Application of metformin in females to reduce insulin resistance can improve the results of antiviral therapy.Material and methods. Overall 81 females with CHC and PCOS were included in original study. The 1st group (35 patients) received metformin in dose of 20 mg/kg of body weight per day as preliminary and concomitant treatment in addition to antiviral therapy. In 14 patients of this group steatosis was revealed. In another subgroup (21 patients) steatosis was not revealed. The 2nd group (46 patients) received antiviral therapy only. Patients of this group were divided into two subgroups by presence (17 patients) or absence (29 patients) of hepatic steatosis. Interferon-α2b in a standard dose of 3 million IU3 times per week in combination to ribavirin 13 mg/kg/day for 24 wks was applied as antiviral therapy. The period of the subsequent follow-up was 24 wks.Results. Patients with hepatic steatosis had higher biochemical and histological scores of activities. In the groups of patients receiving metformin a higher incidence of a sustained virological response was observed. Additional application of metformin did not aff ect the safety profile of antiviral therapy.Conclusions. Women with CHC with the 3rd genotype and PCOS, who took metformin, had a significantly higher frequency of sustained virological response with an equal safety profile.
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Rutkowska, Aleksandra, and Evanthia Diamanti-Kandarakis. "Do Advanced Glycation End Products (AGEs) Contribute to the Comorbidities of Polycystic Ovary Syndrome (PCOS)?" Current Pharmaceutical Design 22, no. 36 (November 11, 2016): 5558–71. http://dx.doi.org/10.2174/1381612822666160714094404.
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Rouzi, A. A., and M. M. Ardawi. "Serum advanced glycation end-products in saudi women with polycystic ovary syndrome: a prospective study." Fertility and Sterility 88 (September 2007): S182. http://dx.doi.org/10.1016/j.fertnstert.2007.07.627.
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Pertynska-Marczewska, Magdalena, Evanthia Diamanti-Kandarakis, John Zhang, and Zaher Merhi. "Advanced glycation end products: A link between metabolic and endothelial dysfunction in polycystic ovary syndrome?" Metabolism 64, no. 11 (November 2015): 1564–73. http://dx.doi.org/10.1016/j.metabol.2015.08.010.
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Legro, R. S. "Surrogate end-points or primary outcomes in clinical trials in women with polycystic ovary syndrome?" Human Reproduction 19, no. 8 (June 3, 2004): 1697–704. http://dx.doi.org/10.1093/humrep/deh322.
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Vitek, Wendy, and Kathleen Hoeger. "Letrozole versus clomiphene in polycystic ovary syndrome—more than one way to crack an egg." Fertility and Sterility 111, no. 3 (March 2019): 469–70. http://dx.doi.org/10.1016/j.fertnstert.2018.12.020.
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Petrányi, Gyula, and Mária Zaoura-Petrányi. "Metformin treatment with or without life style changes in patients with polycystic ovary syndrome." Orvosi Hetilap 152, no. 16 (April 2011): 628–32. http://dx.doi.org/10.1556/oh.2011.29045.
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Treatment with metformin three times 500 mg daily had been advised since 2002, to patients suffering from the polycystic ovary syndrome diagnosed by the Rotterdam criteria and who did not want to take contraceptive pills. More recently, life style changes have also been introduced to treatment recommendation: increased physical activity, low glycaemic index diet; also with calorie restriction for the obese patients. Aim: To assess the efficacy of the two treatment forms on clinical symptoms of the disease. Method: The metformin only historical control group (metformin monotherapy) consisted of 27 patients between the ages from 18 to 39 years (mean 29 years); to which was the age-matched metformin and life style changes group (triple basal therapy) of 29 patients compared. The following parameters were registered at the beginning and the end of a six-month treatment period: global acne score, Ferriman-Gallwey hirsutism score, body mass index, waist-to-hip circumference ratio, and menstrual cycles. Results: By the end of the treatment period, both acne and hirsutism scores improved significantly in both treatment groups (P<0.001); the improvements did not differ between them: acne 8.6±5.7 vs. 9.2±5.9 (P = 0.70); hirsutism 2.5±2.0 vs. 2.6±1.6 (P = 0.83). Body mass index and waist-to-hip ratio remained practically unchanged in the metformin only group: 0.26±1.0 kg/m2 (P = 0.21) and 0.001±0.02 (P = 0.71). Body mass index decreased in the triple therapy group by 0.91±1.1 kg/m2 (P<0.001); and waist-to-hip ratio by 0.019±0.03 (P<0.001). The decrease of the body mass index was more remarkable in overweight patients: 1.10±1.26 kg/m2 (P = 0.002) vs. 0.64±0.88 kg/m2 (P = 0.03) in lean patients. Recommendation on life style changes with metformin did not show further improvement of hyperandrogenic symptoms in comparison to metformin alone but the combined therapy diminished body size indexes. Conclusion: Authors recommend the triple basal treatment consisting of metformin, physical exercise and low glycaemic index diet to their patients with polycystic ovary syndrome for assessment of its long-term efficacy. Orv. Hetil., 2011, 152, 628–632.
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Kim, Eunju, Hyun Ha Seok, Su-Yeon Lee, Dong Ryul Lee, Jisook Moon, Tae Ki Yoon, Woo Sik Lee, and Kyung-Ah Lee. "Correlation between Expression of Glucose Transporters in Granulosa Cells and Oocyte Quality in Women with Polycystic Ovary Syndrome." Endocrinology and Metabolism 29, no. 1 (2014): 40. http://dx.doi.org/10.3803/enm.2014.29.1.40.
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Zoltán, Kun Imre, Kun Ildikó, and Kolcsár Melinda. "Current aspects of polycystic ovary syndrome II: treatment of hyperandrogenism, insulin resistance and infertility." Bulletin of Medical Sciences 92, no. 2 (December 1, 2019): 89–104. http://dx.doi.org/10.2478/orvtudert-2019-0016.
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Abstract This work is a continuation of an earlier article published in this journal (no. 91/1: “Current aspects of polycystic ovary syndrome I: definition, pathophysiology, clinical manifestations, diagnosis and complications”). As the pathology of polycystic ovary syndrome is not fully known, the treatments used do not constitute a causal therapy, only pathogenetical interventions to break the vicious circles of pathological events. It does not currently have a universal therapeutic procedure or an approved specific drug. Treatment may be aimed at reducing hyperandrogenism, inducing ovulation and preventing complications. The patient’s complaints and desire for becoming pregnant should also be taken into account. In mild cases, an appropriate lifestyle (prevention/treatment of obesity) is sufficient, i.e. a 5-10% reduction in body weight can already result in significant improvement and also serves to prevent late complications (diabetes, hypertension, cardiovascular disease, hyperlipidemia). Oral contraceptives and antiandrogens are mainly used to treat hyperandrogenism (hirsutism, acne, and alopecia). A contraceptive whose progestogen component has antiandrogenic properties, or at least is androgen-neutral, is preferred, such as third-generation contraceptives. However, combined contraceptives (containing gestodene, desogestrel, drospirenone and cyproterone acetate) may increase the risk of venous thromboembolism and are therefore contraindicated in case of hypercoagulability. Antiandrogens (cyproterone acetate, spironolactone, finasteride, etc.) can also be used independently, but only with effective contraception (as these can cause feminization of the male fetus). Insulin resistance plays a crucial role in the development of this disease. Metformin is used as primary therapy, as it also has many other beneficial effects (e.g. cardiovascular and anti-cancer) described in recent years. These pleiotropic effects and their subtle mechanisms are discussed in detail. We highlight the possibilities of avoiding side effects and the current interpretation of rare contraindications (acidosis, hypoxic conditions, renal damage). Insulin resistance lowering agents include thiazolidinediones, acarbose, GLP-1 agonists, vitamin D, resveratrol, octreotide, but the beneficial effects of myoinositol and D-chiro-inositol are also mentioned. In the last part of the paper, the treatment options for infertility are discussed, highlighting the efficacy of clomiphene citrate, gonadotropins (“step-up”, “step- down” methods), IVF techniques, and ovarian drilling used for ovulation induction. We detail the importance and possibilities of the prevention of ovarian hyperstimulation syndrome and multiple pregnancies.
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Shivani, D., Pandala Sravanthi, and Naga Jyothi G. "Comparative study on efficacy of myo inositol over metformin in Polycystic ovary syndrome patients." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 5 (April 23, 2021): 1899. http://dx.doi.org/10.18203/2320-1770.ijrcog20211508.
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Background: Study aimed to determine the effectiveness of Myo-Inositol over Metform in women with established diagnosis of PCOS. Method: A total of 90 women diagnosed with PCOS with Vitamin D deficiency included in the study and divided into 3 groups of 30 each. Group A received Tab. Metformin 500mg thrice daily for a period of 24 wks. Group B women received Tab. Myoinositol 2 gm twice daily for a period of 24 wks. Group C women received Tab. Metformin 500mg twice daily with Tab. Myoinositol 2 gm twice daily. Results: After treatment, 26%, 50%, and 80% were showed regular menstrual cycles (p= 0.001). After 6 months of treatment, there was a reduction of polycystic ovaries in 50% in group A, 80% reduction in group B, and 93.33% reduction in group C respectively. There was a significant reduction in Acne, Hirusitism, BMI, serum LH, FSH, LH/FSH ratio, free testosterone, total testosterone, serum insulin levels, total cholesterol levels were seen at the end of 24 weeks in 3 groups, but higher significance seen in group C. Conclusion: It is thus evident that Myoinositol administration helps to improve insulin sensitivity and can be used in women with PCOS having insulin resistance. Myoinositol helps in reducing metabolic and endocrine abnormalities in PCOS patients. Myoinositol is safe, inexpensive and easily available, its addition to Metformin can contribute for normalization of the dysregulated metabolism in various tissues including ovaries, pancreas, muscle and enhance the action of Metformin in improving the clinical, biochemical features of PCOS.
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Gambineri, Alessandra, Laura Patton, Rosaria De Iasio, Barbara Cantelli, Graciela Estela Cognini, Marco Filicori, Antonina Barreca, Evanthia Diamanti-Kandarakis, Uberto Pagotto, and Renato Pasquali. "Efficacy of Octreotide-LAR in Dieting Women with Abdominal Obesity and Polycystic Ovary Syndrome." Journal of Clinical Endocrinology & Metabolism 90, no. 7 (July 1, 2005): 3854–62. http://dx.doi.org/10.1210/jc.2004-2490.
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Abstract Context: Somatostatin reduces LH, GH, and insulin, and somatostatin receptors are present at the ovarian level; somatostatin analogs are thus potential candidates for treatment of the polycystic ovary syndrome (PCOS). Objective: The purpose of this study was to evaluate the effect of octreotide-LAR, a long-acting somatostatin analog, in anovulatory abdominal obese women with PCOS. Design: A single-blind, placebo-controlled study was performed, lasting for 7 months. Setting: The patients were ambulatory throughout the study. Patients: Twenty PCOS subjects were enrolled. Eighteen completed the study. Interventions: A low-calorie diet was given during the first month, a low-calorie diet plus octreotide-LAR (10 mg; n = 10 subjects) or placebo (n = 10 subjects) was then given, with one im injection every 28 d (for 6 months). Main Outcome Measures: The main outcome measures were clinical features, computerized tomography measurement of fat distribution, androgens, GH, IGF-I, IGF-binding proteins (IGFBPs), fasting and glucose-stimulated insulin, and ovulation. Results: Octreotide had no additional effect in reducing body fat or improving fat distribution than placebo. Conversely, octreotide produced an additional decrease in fasting (P = 0.018) and glucose-stimulated (P = 0.038) insulin levels, an increase in IGFBP-2 (P = 0.042) and IGFBP-3 (P = 0.047), and an improvement in hirsutism (P = 0.004). Moreover, a trend toward greater reductions in testosterone (P = 0.061) and androstenedione (P = 0.069) was observed in women treated with octreotide-LAR compared with those given placebo. All women treated with octreotide ovulated at the end of the study compared with only one of those receiving placebo (P < 0.001). Conclusions: Octreotide-LAR may be usefully applied to hypocalorically dieting, abdominal obese PCOS women to improve hyperandrogenism and the insulin-IGF-I system. Restoration of ovulatory menstrual cycles appears to be another advantage of this treatment.
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Asadi, Negin, Mahin Izadi, Ali Aflatounian, Mansour Esmaeili-Dehaj, Mohammad Ebrahim Rezvani, and Zeinab Hafizi. "Chronic niacin administration ameliorates ovulation, histological changes in the ovary and adiponectin concentrations in a rat model of polycystic ovary syndrome." Reproduction, Fertility and Development 33, no. 7 (2021): 447. http://dx.doi.org/10.1071/rd20306.
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Polycystic ovary syndrome (PCOS) is one of the most common ovarian diseases among women of reproductive age. The reproductive and metabolic traits of PCOS are underpinned by adipocyte dysfunction, especially diminished adiponectin secretion. Based on evidence that niacin stimulates adiponectin secretion, this study evaluated the effects of niacin on adiponectin concentrations and reproductive traits in a rat model of PCOS. PCOS was induced by single injection of 4mg kg−1 oestradiol valerate (i.m.), and PCOS groups were administered orally with saline or niacin (10 or 25mg kg−1) daily for 30 days after PCOS induction. The control group received 0.2mL sesame oil (i.m.) only. At the end of the experimental period, serum samples and ovaries were collected for adiponectin, histological and molecular analyses. Niacin reduced the bodyweight gain and increased ovary weights in PCOS rats. Niacin also increased the number of normal antral follicles and corpora lutea while reducing the number of cystic follicles and the thickness of theca interna. Moreover, niacin significantly increased serum adiponectin concentration and the gene expression of adiponectin and its type 1 receptor. In conclusion, this study indicates that niacin reduces cystic follicles and improves ovulation in PCOS rats. Adiponectin signalling may have contributed, in part, to the beneficial effects.
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Berni, Thomas R., Christopher L. Morgan, and D. Aled Rees. "Women With Polycystic Ovary Syndrome Have an Increased Risk of Major Cardiovascular Events: a Population Study." Journal of Clinical Endocrinology & Metabolism 106, no. 9 (June 1, 2021): e3369-e3380. http://dx.doi.org/10.1210/clinem/dgab392.
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Abstract Context The effects of polycystic ovary syndrome (PCOS) on cardiovascular morbidity and mortality are unclear. Objective This work aims to establish the relative risk of myocardial infarction (MI), stroke, angina, revascularization, and cardiovascular mortality for women with PCOS. Methods Data were extracted from the Clinical Practice Research Datalink Aurum database. Patients with PCOS were matched to controls (1:1) by age, body mass index (BMI) category, and primary care practice. The primary outcome was the time to major adverse cardiovascular event (MACE); a composite end point incorporating MI, stroke, angina, revascularization and cardiovascular mortality. Secondary outcomes were the individual MACE end points. Results Of 219 034 individuals with a diagnosis of PCOS, 174 660 (79.7%) met the eligibility criteria and were matched. Crude rates of the composite end point, MI, stroke, angina, revascularization, and cardiovascular mortality were respectively 82.7, 22.7, 27.4, 32.8, 10.5, and 6.97 per 100 000 patient-years for cases, and 64.3, 15.9, 25.7, 19.8, 7.13, and 7.75 per 100 000 patient-years for controls. In adjusted Cox proportional hazard models (CPHMs), the hazard ratios (HRs) were 1.26 (95% CI, 1.13-1.41), 1.38 (95% CI, 1.11-1.72), 1.60 (95% CI, 1.32-1.94), and 1.50 (95% CI, 1.08-2.07) for the composite outcome, MI, angina, and revascularization, respectively. In a time-dependent CPHM, weight gain (HR 1.01; 1.00-1.01), prior type 2 diabetes mellitus (T2DM) (HR 2.40; 1.76-3.30), and social deprivation (HR 1.53; 1.11-2.11) increased risk of progression to the composite end point. Conclusion The risk of incident MI, angina, and revascularization is increased in young women with PCOS. Weight and T2DM are potentially modifiable risk factors amenable to intervention.
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Azeemuddin, Mohammed, Suryakanth D. Anturlikar, Mallappa Onkaramurthy, Mirza R. Baig, Basti K. Ashok, Raghavendra P. Rao, Mohamed Rafiq, and Paramesh Rangesh. "Effect of “DXB-2030,” a Polyherbal Formulation, on Experimental Polycystic Ovary Syndrome Associated with Hyperandrogenism." Advances in Pharmacological Sciences 2019 (February 3, 2019): 1–7. http://dx.doi.org/10.1155/2019/8272850.
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The objective of the present study was to evaluate “DXB-2030,” a polyherbal combination of Trigonella foenum-graecum, Aloe vera, Sphaeranthus indicus, Nardostachys jatamansi, and Symplocos racemosa extracts in an experimental model of testosterone propionate (TP), induced polycystic ovary syndrome (PCOS) in female rats. Thirty animals were divided into 3 groups of 10 each; group 1 served as normal control; group 2 was administered with TP and served as positive control; along with TP, group 3 was treated with “DXB-2030” at a dose of 100 mg/kg p.o., for 60 days. At the end of the study period, the animals were subjected for the estimation of serum testosterone levels, oral glucose tolerance test (OGTT), weight of the ovaries, estrous cycle, and histopathological evaluation. An in vitro assay on GLUT4 expression was carried out to understand the effect of “DXB-2030” on insulin resistance. Results showed that treatment with “DXB-2030” reversed the TP-induced changes by increasing the GLUT4 expression and decreasing the body weight, testosterone levels, AUC of glucose in OGTT, and the cystic follicles of the ovaries, thus indicating its beneficial effect in PCOS by ameliorating the metabolic dysfunction and reproductive impairment, which are the pathophysiological conditions associated with PCOS. From the results obtained, it can be concluded that “DXB-2030” was effective in the management of experimental PCOS and hence may be recommended in the treatment of PCOS.
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Sahu, Rakhi, Awanish Jaiswal, Anurag Pandey, and Ramanand Tiwari. "POLYCYSTIC OVARY SYNDROME (ARTAVA KSHAYA): GENETIC AND NONGENETIC ETIOPATHOLOGY AND DIAGNOSIS: AN AYURVEDIC NARRATIVE REVIEW." International Journal of Research in Ayurveda and Pharmacy 12, no. 4 (August 28, 2021): 161–65. http://dx.doi.org/10.7897/2277-4343.1204127.
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Polycystic ovary syndrome (PCOS) is a common heterogeneous endocrine disorder and about 6% to 20% of women are affected in their reproductive age. Clinical manifestations arise during the early pubertal years, and it’s characterized by irregular menstrual cycles, anovulation, acne, Oligomenorrhea/Amenorrhea, Hirsutism, and frequently infertility. Despite recent advancements in technologies in the scientific world pathophysiology of PCOS is still challenging and initially, most available clinical data communicated findings and outcomes is only in adult women. After that, the Rotterdam criteria are most accepted for adult women and adolescent girls. The diagnostic features for adolescent girls are based on classical tried e.g., menstrual irregularity, clinical hyperandrogenism, and/or hyperandrogenemia. Whereas findings of pelvic ultrasound are significant in adult women but least significant in adolescent girls. Mental health disorders including depression, anxiety, bipolar disorder also occur more frequently in both adolescent girls and women with PCOS. Ayurveda gives prime importance to maintain the healthiness of women and literature provides many references related to signs and symptoms of PCOS in the same way and hence PCOS correlated with Artava kshaya. This review aims to display comprehensive knowledge regarding the pathogenesis of PCOS and Artava Kshaya. The efforts made here will enable earlier identification of girls and adult women with a high propensity to develop PCOS. The timely implementation of individualized therapeutic interventions will improve the overall management of PCOS, prevent associated comorbidities, and improve quality of life. This review emphasizes the various etiological aspects and screening recommendations currently in use to prevent and manages PCOS.
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J. M. S. Al-Shahery, Nahla, and Roqaya A. Salih. "Proficiency of Broccoli (Brassice oleracea) Juice in Recovering of Testosterone Andriol-Induced Polycystic Ovary Syndrome Rats." Ibn AL- Haitham Journal For Pure and Applied Science 31, no. 2 (September 12, 2018): 1. http://dx.doi.org/10.30526/31.2.1957.
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The current study was designed to evaluate the efficiency of broccoli plant in therapy of PCOS that induced for the first time by testosterone andriol (T.A).
Forty-eight immature female rats (21 days old) were divided into 6 groups (8 rats each) as follows: G1, animals were injected with sesame oil for 39 cascade days (control). G2, animals were injected with 1mg/100g b.w of T.A for 39 cascade days. G3, animals were injected with 1mg/100g b.w of T.A gathered with gavaged broccoli juice (b.j) for 39 cascade days. G4, animals were injected with sesame oil for cascade 39 days at the end of last injection were gavaged with d.w for 30 cascade days. G5, animals were injected with 1 mg/100g b.w of T.A for 39 cascade days and at the end of last injection were gavaged with d.w for 30 cascade days. G6, animals were injected with 1mg/100g b.w of T.A for 39 days and at the end of the last injection were gavaged with b.j for 30 cascade days. T.A-induced PCOS rats (G2 and G5) in comparison with controls (G1 and G4) exhibited that had a significant (P≤0.01) increase in the b.w, ovarian, uterine and fat pads weights as well as the fat cells diameter. Additionally, these groups had acyclicity, high numbers of ovarian cysts, atretic and preantral follicles in the ovaries, lowering the number and the diameter of C.L., and uterine changes. The levels of T, E and LH, an insulin, glucose, LDL, cholesterol in the serum were increased whereas the levels of FSH, LDH were decreased.
Therefore, T.A PCOS model could be appropriated for studied all the features of syndrome i.e, ovarian, metabolic and endocrinologiccal disturbances. Whereas all these measurements of G3 and G6 were ameliorated and recovered into their normalcy. Our findings have shown the benefit of consuming broccoli in the protection (G3) and prevention (G6) of PCOS.
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Moran, Lisa J., Samantha K. Hutchison, Caroline Meyer, Sophia Zoungas, and Helena J. Teede. "A comprehensive assessment of endothelial function in overweight women with and without polycystic ovary syndrome." Clinical Science 116, no. 10 (April 15, 2009): 761–70. http://dx.doi.org/10.1042/cs20080218.
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PCOS (polycystic ovary syndrome) is associated with reproductive abnormalities, IR (insulin resistance) and elevated risk factors for CVD (cardiovascular disease) and Type 2 diabetes, including endothelial dysfunction. The present study aimed to assess a range of circulating markers of endothelial function in overweight women with and without PCOS. Overweight and obese age- and BMI (body mass index)-matched women with (n=80) and without (n=27) PCOS were assessed in a cross-sectional study. End-point measures were HOMA (homoeostasis model assessment)-IR, androgens, lipids, inflammatory markers [hsCRP (high-sensitivity C-reactive protein)] and endothelial function [FMD (flow-mediated dilation), ADMA (asymmetric dimethylarginine), PAI-1 (plasminogen activator inhibitor-1) and vWF (von Willebrand factor)]. Women with PCOS had elevated HOMA-IR (4.1±3.4 compared with 1.9±1.4), free androgen index (9.3±5.6 compared with 4.6±3.8), total cholesterol (5.2±1.0 compared with 4.7±0.9 mmol/l) and triacylglycerols (triglycerides; 1.4±0.7 compared with 0.9±0.3 mmol/l) (P<0.05 for all), but similar hsCRP compared with women without PCOS. With regard to endothelial function, women with PCOS had elevated ADMA (1.0±0.4 compared 0.3±0.1 μmol/l, P<0.001) and PAI-1 (5.6±1.8 compared with 4.6±1.1 units/ml, P=0.006), a trend towards worsened FMD (11.8±5.0 compared with 13.5±4.0%, P=0.075) and no difference in vWF compared with controls. For all subjects, ADMA (P=0.002) and PAI-1 (P<0.001) were increased with higher tertiles of HOMA-IR. Women with PCOS are hyperandrogenic, dyslipidaemic and have IR, and have risk factors for CVD and diabetes including increased circulating markers of endothelial function (ADMA and PAI-1) and a trend towards worse FMD as a global marker of endothelial function. In PCOS, deterioration in endothelial function is related to IR, hyperandrogenism and other factors.
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Fraser, Graeme L., Barbara Obermayer-Pietsch, Joop Laven, Georg Griesinger, Axelle Pintiaux, Dirk Timmerman, Bart C. J. M. Fauser, et al. "Randomized Controlled Trial of Neurokinin 3 Receptor Antagonist Fezolinetant for Treatment of Polycystic Ovary Syndrome." Journal of Clinical Endocrinology & Metabolism 106, no. 9 (May 17, 2021): e3519-e3532. http://dx.doi.org/10.1210/clinem/dgab320.
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Abstract Context Polycystic ovary syndrome (PCOS), a highly prevalent endocrine disorder characterized by hyperandrogenism, is the leading cause of anovulatory infertility. Objective This proof-of-concept study evaluated clinical efficacy and safety of the neurokinin 3 (NK3) receptor antagonist fezolinetant in PCOS. Methods This was a phase 2a, randomized, double-blind, placebo-controlled, multicenter study (EudraCT 2014-004409-34). The study was conducted at 5 European clinical centers. Women with PCOS participated in the study. Interventions included fezolinetant 60 or 180 mg/day or placebo for 12 weeks. The primary efficacy end point was change in total testosterone. Gonadotropins, ovarian hormones, safety and tolerability were also assessed. Results Seventy-three women were randomly assigned, and 64 participants completed the study. Adjusted mean (SE) changes in total testosterone from baseline to week 12 for fezolinetant 180 and 60 mg/day were −0.80 (0.13) and −0.39 (0.12) nmol/L vs −0.05 (0.10) nmol/L with placebo (P < .001 and P < .05, respectively). Adjusted mean (SE) changes from baseline in luteinizing hormone (LH) for fezolinetant 180 and 60 mg/d were −10.17 (1.28) and −8.21 (1.18) vs −3.16 (1.04) IU/L with placebo (P < .001 and P = .002); corresponding changes in follicle-stimulating hormone (FSH) were −1.46 (0.32) and −0.92 (0.30) vs −0.57 (0.26) IU/L (P = .03 and P = .38), underpinning a dose-dependent decrease in the LH-to-FSH ratio vs placebo (P < .001). Circulating levels of progesterone and estradiol did not change significantly vs placebo (P > .10). Fezolinetant was well tolerated. Conclusion Fezolinetant had a sustained effect to suppress hyperandrogenism and reduce the LH-to-FSH ratio in women with PCOS.
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Akamine, Eliana H., Anderson C. Marçal, João Paulo Camporez, Mara S. Hoshida, Luciana C. Caperuto, Estela Bevilacqua, and Carla R. O. Carvalho. "Obesity induced by high-fat diet promotes insulin resistance in the ovary." Journal of Endocrinology 206, no. 1 (May 7, 2010): 65–74. http://dx.doi.org/10.1677/joe-09-0461.
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Besides the effects on peripheral energy homeostasis, insulin also has an important role in ovarian function. Obesity has a negative effect on fertility, and may play a role in the development of the polycystic ovary syndrome in susceptible women. Since insulin resistance in the ovary could contribute to the impairment of reproductive function in obese women, we evaluated insulin signaling in the ovary of high-fat diet-induced obese rats. Female Wistar rats were submitted to a high-fat diet for 120 or 180 days, and the insulin signaling pathway in the ovary was evaluated by immunoprecipitation and immunoblotting. At the end of the diet period, we observed insulin resistance, hyperinsulinemia, an increase in progesterone serum levels, an extended estrus cycle, and altered ovarian morphology in obese female rats. Moreover, in female obese rats treated for 120 days with the high-fat diet, the increase in progesterone levels occurred together with enhancement of LH levels. The ovary from high-fat-fed female rats showed a reduction in the insulin receptor substrate/phosphatidylinositol 3-kinase/AKT intracellular pathway, associated with an increase in FOXO3a, IL1B, and TNFα protein expression. These changes in the insulin signaling pathway may have a role in the infertile state associated with obesity.
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Sellix, Michael T., Zachary C. Murphy, and Michael Menaker. "Excess Androgen During Puberty Disrupts Circadian Organization in Female Rats." Endocrinology 154, no. 4 (April 1, 2013): 1636–47. http://dx.doi.org/10.1210/en.2012-2066.
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Abstract Circadian clocks have been described in each tissue of the hypothalamo-pituitary-ovarian axis. Although a role for the clock in the timing of ovulation is indicated, the impact of diseases that disrupt fertility on clock function or the clocks' role in the etiology of these pathologies has yet to be fully appreciated. Polycystic ovary syndrome (PCOS) is a particularly devastating endocrinopathy, affecting approximately 10% of women at childbearing age. Common features of PCOS are a polycystic ovary, amenorrhea, and excess serum androgen. Approximately 40% of these women have metabolic syndrome, including hyperinsulinemia, dyslipidemia, and hyperleptinemia. It has been suggested that excess androgen is a critical factor in the etiology of PCOS. We have examined the effects of androgen excess during puberty on the phase of circadian clocks in tissues of the metabolic and hypothalamo-pituitary-ovarian axes. Female period1-luciferase (per1-luc) rats were exposed to androgen (5α-dihydrotestosterone [DHT]) or placebo for 4-6 weeks (short term) or 9-15 weeks (long term). As expected, DHT-treated animals gained more weight than controls and had disrupted estrous cycles. At the end of treatment, tissues, including the liver, lung, kidney, white adipose, cornea, pituitary, oviduct, and ovarian follicles, were cultured, and per1-luc expression in each was recorded. Analysis of per1-luc expression revealed that DHT exposure increased phase distribution of multiple oscillators, including ovarian follicles, liver, and adipose, and altered phase synchrony between animals. These data suggest that excess androgen during puberty, a common feature of PCOS, negatively affects internal circadian organization in both the reproductive and metabolic axes.
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Diamanti-Kandarakis, Evanthia, Krystallenia Alexandraki, Christina Piperi, Athanasios Aessopos, Thomas Paterakis, Ilias Katsikis, and Dimitrios Panidis. "Effect of metformin administration on plasma advanced glycation end product levels in women with polycystic ovary syndrome." Metabolism 56, no. 1 (January 2007): 129–34. http://dx.doi.org/10.1016/j.metabol.2006.09.006.
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Polyzos, Nikolaos P., Maria Tsappi, Davide Mauri, Vedat Atay, Ivan Cortinovis, and Giovanni Casazza. "Aromatase inhibitors for infertility in polycystic ovary syndrome. The beginning or the end of a new era?" Fertility and Sterility 89, no. 2 (February 2008): 278–80. http://dx.doi.org/10.1016/j.fertnstert.2007.10.016.
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Diamanti-Kandarakis, Evanthia, Athanasia Piouka, Sarantis Livadas, Christine Piperi, Ilias Katsikis, Athanasios G. Papavassiliou, and Demetrios Panidis. "Anti-mullerian hormone is associated with advanced glycosylated end products in lean women with polycystic ovary syndrome." European Journal of Endocrinology 160, no. 5 (May 2009): 847–53. http://dx.doi.org/10.1530/eje-08-0510.
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ObjectiveOocyte maturation process characterizes polycystic ovary syndrome (PCOS). The mechanisms of this abnormality leading to chronic anovulation are under investigation. Advanced glycosylated end products (AGEs), a marker of oxidative stress linked with oocyte maturation are localized in granulosa cells and are increased in sera, in women with PCOS. The aim of this study was to investigate the relationship, whether there is an association between the anti-mullerian hormone (AMH), a hormone produced by granulosa cells and AGEs in ovulatory and anovulatory PCOS (PCOS-Anov), as well as in non-PCOS anovulatory (Non-PCOS Anov) women.DesignCross-sectional study.MethodsData from sixty women with PCOS (37 anovulatory and 23 regularly ovulating) were compared with eleven Non-PCOS Anov women and 25 normal women. In each subject biochemical, hormonal, and ultrasonographic parameters were studied.ResultsAMH values were statistically significantly higher in PCOS-Anov (7.63±3.12) in comparison with ovulatory PCOS (PCOS-Ov; 4.92±2.50), Non-PCOS Anov (3.66±1.4), and controls (4.02±1.27 ng/ml). AGEs demonstrated a similar pattern: 8.70±1.65 in PCOS-Anov, 7.43±1.79, PCOS-Ov, 5.21±0.09, Non-PCOS Anov, and 5.85±0.89 U/ml in controls (P<0.005 for all comparison respectively). Follicle number was significantly higher in PCOS-Anov in comparison with other groups. A significant positive correlation between AMH and AGEs was observed (r: 0.326,P<0.01), and with the estimated AMH/AGEs ratio to follicle number (r: 0.42,P: 0.0001) and the presence of anovulation.ConclusionsThese data suggest that an oxidative marker, AGEs, and AMH, may interact in the anovulatory mechanisms in women with PCOS.
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Ramasamy, Vijayanand A., Rhonda M. Garad, and Jacqueline A. Boyle. "A Comprehensive PCOS Research and Guideline Translation Program to Improve Practice." Seminars in Reproductive Medicine 39, no. 03/04 (July 2021): 161–66. http://dx.doi.org/10.1055/s-0041-1733916.
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AbstractPolycystic ovary syndrome (PCOS) is a common and complex endocrinopathy affecting reproductive-age women with a reported prevalence of 8 to 13%. To address the knowledge, practice, consumer satisfaction, and research gaps, an international research collaboration was formed to develop the first “International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (2018).” This article describes an effective research translation program to disseminate the guideline internationally to women and health providers. To date, this had led to 75,197 views and almost 36,000 downloads of the PCOS guideline, and 43,000 views and 10,600 downloads of a suite of PCOS resources. AskPCOS app, the first freely accessible, evidence-based PCOS app, has 9,910 users (between 400 and 800 users per month), 23,447 sessions, and 87,801 screen viewings. Fifty-four percent of returning users are from across 137 countries, with the most users in Australia, the United States, the United Kingdom, the Netherlands, and India. Extensive global uptake of the PCOS guideline and compendium of resources was augmented by extensive formative consumer and health professional consultation, end-user engagement across the evidence-creation spectrum, co-design, and quality improvement.
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Jensterle, Mojca, Tomaz Kocjan, and Andrej Janez. "Phosphodiesterase 4 Inhibition as a Potential New Therapeutic Target in Obese Women With Polycystic Ovary Syndrome." Journal of Clinical Endocrinology & Metabolism 99, no. 8 (August 1, 2014): E1476—E1481. http://dx.doi.org/10.1210/jc.2014-1430.
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Context: Phosphodiesterase (PDE) enzymes, including members of PDE4, have been investigated in the regulation of endocrine and reproductive functions of ovaries. In addition, selective inhibition of PDE4 enzyme has recently been implicated in the regulation of metabolism with positive effects on glucose homeostasis and weight reduction. Objective: The aim of this study was to evaluate whether the PDE4 inhibitor roflumilast affects body weight and hormonal and metabolic status in obese women with polycystic ovary syndrome (PCOS). Design/Participants/Main Outcome Measures: A 12-week prospective randomized open-label study was conducted with 36 obese women with PCOS diagnosed by the National Eunice Kennedy Shriver Institute of Child Health and Human Development criteria that had been pretreated with metformin (MET). They were randomized to MET 1000 mg twice a day or combined treatment (COM) with MET 1000 mg twice a day and roflumilast 500 μg every day. The primary outcome was change in anthropometric measures of obesity. Results: Thirty-one patients (aged 33.8 ± 7.4 y, twice a day 36.4 ± 5.1 kg/m2, mean ± SD) completed the study: 16 on MET and 15 on COM. Subjects treated with COM lost on average 4.2 ± 2.8 kg compared with a 0.9 ± 2.5 kg weight gain in the MET group (P = .025). Body mass index decreased for 1.6 ± 1.1 kg/m2 in COM arm compared with increase for 0.9 ± 2.4 kg/m2 in the MET arm (P = .046). Visceral adipose tissue area as assessed by dual-energy x-ray absorptiometry decreased from 136.7 ± 37.8 to 121.2 ± 36.2 cm2 in the COM arm compared with an increase from 155.3 ± 61.9 to 166.7 ± 67.2 cm2 in the MET arm (P = .02). From baseline to study end, both treatment interventions resulted in a significant reduction of androstenedione (P = .013), free T (P = .002), and homeostasis model assessment for insulin resistance score (P = .027) and a significant increase in SHBG (P = .024), although the between-treatment differences of the changes have not been statistically significant yet. Conclusion: Roflumilast added to metformin reduced body weight in obese women with PCOS, primarily due to a loss of fat mass.
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Ortega-González, C., L. Cardoza, B. Coutiño, R. Hidalgo, G. Arteaga-Troncoso, and A. Parra. "Insulin sensitizing drugs increase the endogenous dopaminergic tone in obese insulin-resistant women with polycystic ovary syndrome." Journal of Endocrinology 184, no. 1 (January 2005): 233–39. http://dx.doi.org/10.1677/joe.1.05844.
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To investigate whether the long-term administration of metformin or pioglitazone to women with polycystic ovary syndrome (PCOS) could induce changes in their hypothalamic dopaminergic (DA) tone and to analyze whether these changes correlated with modifications in insulin resistance, we originally studied 57 obese hyperinsulinemic, non-diabetic, insulin resistant women with PCOS, but only 34 completed the study. They were randomly divided into two groups: group one (n=17) received pioglitazone (30 mg/day) and group 2 (n=17) received metformin (850 mg, three times a day) over 24 weeks. All women were identically studied before (basal) and 6 months after (T6) drug administration, including clinical evaluations, a 2 h oral glucose tolerance test (75 g) (OGTT) for glucose and insulin measurements, followed a week later by a 2 h intravenous metoclopramide test (10 mg bolus) for prolactin (PRL) determinations. The areas under the insulin (AUC-insulin) and PRL (AUC-PRL) curves were calculated, along with the index of insulin resistance (HOMA-IR) and the indexes of insulin sensitivity (QUICKI and fasting glucose–insulin ratio). At baseline, women in both groups were of similar age, body weight, body mass index (BMI) and Ferriman-Gallwey hirsutism score (F-G score). At completion of the study, body weight and BMI remained unchanged but the F-G score significantly decreased. Fasting serum insulin concentrations and the AUC-insulin significantly decreased by the end of the trial in a similar fashion in both groups, while the AUC-PRL significantly increased at the end of the trial in both groups. At no time were significant correlations between AUC-PRL and AUC-insulin or the indexes HOMA-IR, QUICKI or fasting glucose–insulin ratio observed. The present results suggests that either pioglitazone or metformin administration was associated with a clear improvement in the endogenous hypothalamic DA tone, simultaneously with an amelioration of the insulin resistance status in these obese women with PCOS.
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Zheng, Yan-Hua, Ying Xu, Hong-Xia Ma, Cheng-Jie Liang, and Tong Yang. "Effect of High-Fat Diet on the Intestinal Flora in Letrozole-Induced Polycystic Ovary Syndrome Rats." Evidence-Based Complementary and Alternative Medicine 2021 (June 25, 2021): 1–13. http://dx.doi.org/10.1155/2021/6674965.
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Aim. The aim of this study was to explore whether letrozole and high-fat diets (HFD) can induce obese insulin-resistant polycystic ovary syndrome (PCOS) with intestinal flora dysbiosis in a rat model. We compared the changes in the intestinal flora of letrozole-induced rats fed with HFD or normal chow, to explore the effects of HFD and letrozole independently and synergistically on the intestinal flora. Methods. Five-week-old female Sprague Dawley (SD) rats were divided into four groups: control (C) group fed with regular diet; L1 group administered with letrozole and fed with regular diet; L2 group received letrozole and fed with HFD; and HFD group fed with HFD. At the end of the experiment, ovarian morphology, hormones, metabolism, oxidative stress, and inflammatory status of all rats were studied. 16S rDNA high-throughput sequencing was used to profile microbial communities, and various multivariate analysis approaches were used to quantitate microbial composition, abundance, and diversity. Results. Compared to the C group, the increased plasma fasting insulin and glucose, HOMA-IR, triglyceride, testosterone, and malondialdehyde were significantly higher in the L2 group, while high-density lipoprotein cholesterol was significantly lower in the L1 group and L2 group. The indices of Chao1 and the Abundance-based Coverage Estimator (ACE) (α-diversity) in the L2 and HFD groups were significantly lower than that in the C group. Bray–Curtis dissimilarity based principal coordinate analysis (PCoA) plots and analysis of similarities (ANOSIM) test showed obvious separations between the L2 group and C group, between the HFD group and C group, and between the L2 and HFD groups. At the phylum level, Firmicutes and ratio of Firmicutes and Bacteroidetes (F/B ratio) were increased in the L2 group; Bacteroidetes was decreased in the L2 and HFD groups. No significant differences in bacterial abundance between the C group and L1 group were observed at the phylum level. Based on linear discriminant analysis (LDA) effect size (LEfSe) analysis, the bacterial genera (the relative abundance > 0.1%, LDA > 3, p < 0.05 ) were selected as candidate bacterial signatures. They showed that the abundance of Vibrio was significantly increased in the L1 group; Bacteroides and Phascolarctobacterium were enriched in the HFD group, and Bacteroides, Phascolarctobacterium, Blautia, Parabacteroides, Akkermansia [Ruminococcus]_torques_group, and Anaerotruncus were enriched in the L2 group. Conclusion. The effect of letrozole on intestinal flora was not significant as HFD. HFD could destroy the balance of intestinal flora and aggravate the intestinal flora dysbiosis in PCOS. Letrozole-induced rats fed with HFD have many characteristics like human PCOS, including some metabolic disorders and intestinal flora dysbiosis. The dysbiosis was characterized by an increased Firmicutes/Bacteroidetes ratio, an expansion of Firmicutes, a contraction of Bacteroidetes, and the decreased microbial richness. Beta-diversity also showed significant differences in intestinal microflora, compared with control rats.
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Comim, Fabio Vasconcellos, Lady Katerine Serrano Mujica, Fernanda Valente, Ligia G. Miyazato, Manuela W. Manta, Carolina D. Amaral, Melissa O. Premaor, et al. "Abnormalities in Microarchitecture and Reduced Mechanical Bone Strength in a Rat Model of Polycystic Ovary Syndrome." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A763. http://dx.doi.org/10.1210/jendso/bvab048.1552.
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Abstract Evidence from the literature is contentious about the impact of polycystic ovary syndrome (PCOS) on the skeleton, suggesting a possible negative role of this condition on non-obese women. We investigated this hypothesis employing a well-characterized testosterone propionate (TP) rodent model of PCOS to address the consequences of androgenization on bone microarchitecture, histology, and mechanical strength. For this study, Wistar rats (n= 38) were divided in 4 groups: 1) “Control OVX” (single dose of corn oil s.c. at day 5 of life and ovariectomy at day 100, n=9); 2) “Control SHAM” (n=9); 3) “Androgenized OVX”(single dose of TP 1.25 mg s.c. at day 5 of life and ovariectomy at day 100, n=10); and 4) “Androgenized SHAM” (n=10). Full characterization of estrous cycles and weight was performed during growth, and all animals were euthanized at day 180. Successful ovariectomy was confirmed by neglected levels of serum estradiol. Endpoints evaluated include bone micro CT (femur and spinal column), bone histology (number of osteoclasts and osteoblasts in the femur), and mechanical tests. The study was approved by the local Ethics Committee. At the end of the study (day 180), Androgenized OVX rats were heavier than the other three groups. MicroCT Analysis: Androgenized SHAM rats exhibited a significantly higher trabecular mass in the spine (BV/BT) (mean + SEM) 49.21 + 2.42 % versus Control SHAM 36.42 + 1.39 % (Student T-test p=0.001). Following ovariectomy, BV/BT in Androgenized OVX was 40.4 + 2.83 % against 20.34 + 1.85 % in Control OVX (Student T-test p=0.0003). Lumbar trabecular thickness(μm) was also higher in Androgenized OVX (p=0.0065) as well the Trabecular number (n/mm)(p=0.0003). A similar increase in trabecular mass was observed in the femur. Androgenized SHAM rats had a significant higher BV/BT (%), trabecular thickness(μm), and decreased trabecular separation (p < 0.001). However, a significant reduction in cortical bone (thickness) was noted (Student T-test p=0.001). A histological study of the distal femur of Androgenized SHAM rats also show a significantly increased number of osteoclasts and decreased number of osteoblasts than Control SHAM (0< 001). When submitted to the mechanical test, Androgenized Sham rats presented a decreased strength (p<0.01) in relation to its controls. After ovariectomy, there was a reduction in bone in all oophorectomized groups. However, differently than the vertebral bones, no differences regarding bone mechanical strength or stiffness as well microCT values, or bone histology parameters were noted in the femur of Control OVX or Androgenized OVX. Our results suggest that androgenization in a rodent model of PCOS leads, at the same time, to a generalized increase in trabecular (cancellous) bone mass (especially in the spine), associated with a reduced cortical bone mass and decreased strength of the femur.
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Diamanti-Kandarakis, Evanthia, Ilias Katsikis, Christina Piperi, Eleni Kandaraki, Athanasia Piouka, Athanasios G. Papavassiliou, and Dimitrios Panidis. "Increased serum advanced glycation end-products is a distinct finding in lean women with polycystic ovary syndrome (PCOS)." Clinical Endocrinology 69, no. 4 (October 2008): 634–41. http://dx.doi.org/10.1111/j.1365-2265.2008.03247.x.
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Komsa-Penkova, Regina S., Katya S. Kovacheva, Georgy M. Golemanov, Veselin P. Penkov, Zdravka V. Radionova, Galia B. Georgieva-Alexandrova, and Alim V. Izmajlov. "Fetuin-A – Alpha2-Heremans-Schmid Glycoprotein: From Structure to a Novel Marker of Chronic Diseases Part 2. Fetuin-A – A Marker of Insulin Resistance and Related Chronic Diseases." Journal of Biomedical and Clinical Research 11, no. 1 (July 1, 2018): 7–15. http://dx.doi.org/10.2478/jbcr-2018-0002.
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Summary Fetuin-A is a secretory liver glycoprotein with multiple physiological functions such as regulation of insulin resistance, tissue calcification, bone metabolism, cellular proteolytic activity, and self-proliferative signaling. Fetuin-A is a unique molecule which binds to the insulin receptor, modulating its sensitivity, and transducing “the physiological conditions” (serum levels of the metabolites like glucose, free fatty acids, inflammatory signals) from outside into inside the cells. Plasma fetuin-A levels correlate with reduced glucose tolerance and insulin resistance. Impaired insulin sensitivity leads to the development of metabolic syndrome, an increased risk for type 2 diabetes (T2DM), dyslipidaemias and cardiovascular diseases (CVDs). Furthermore, fetuin-A inversely correlates with inflammatory and activation biomarkers, e.g. in patients with T2DM. Thus, circulatory fetuin-A levels may have plausible predictive importance as a biomarker of risk of diabetes and negative acute phase protein. Dysregulated, it plays a crucial role in the pathogenesis of some metabolic disorders and clinical inflammatory conditions like metabolic syndrome, T2DM, CVDs, polycystic ovary syndrome (PCOS), etc.