Cigarette smoking,nicotine levels and increased risk for metabolic syndrome in women with polycystic ovary syndrome

Abstract

Women with polycystic ovary syndrome (PCOS) are at risk for metabolic syndrome, which may be exacerbated by smoking. We hypothesized that smoking worsens androgen levels and the metabolic profile in women with PCOS. PCOS smokers (n?=?47) and non-smokers (n?=?64) and control smokers (n?=?30) and non-smokers (n?=?28), aged 18–45 years, underwent anthropomorphic measurements, pelvic ultrasound and blood sampling. Smokers had higher cotinine (801?±?83 versus <11?nmol/L; smokers versus non-smokers, respectively; p?<?0.001) and nicotine levels (37?±?4 versus <12?µmol/L; p?<?0.001). Triglyceride levels were higher in women with PCOS who smoked compared to non-smokers (1.55?±?0.18 versus 0.95?±?0.08?mmol/L; p?<?0.001), even when adjusted for BMI. Metabolic syndrome was more common in smokers with PCOS compared to non-smokers with PCOS and smokers who were controls (28.6 versus 3.6%; p?=?0.02). There were no differences in reproductive parameters including androgen levels. Cotinine (r?=?0.3; p?<?0.001) and nicotine levels (r?=?0.2; p?=?0.005) correlated with triglycerides. Nicotine levels also correlated with pulse rate (r?=?0.2; p?=?0.02) and waist:hip ratio (WHR; r?=?0.2; p?=?0.02). Taken together, smoking may worsen the already high risk for metabolic syndrome in women with PCOS.     

Determinants of low bone mineral density in premenopausal polycystic ovary syndrome patients

Objective: The aim of this study was to evaluate the bone mineral density (BMD) values and to determine the associations between BMD and insulin sensitivity, hyperandrogenemia, body mass index (BMI), and sex hormones in premenopausal polycystic ovary syndrome (PCOS) patients.

Methods: A hundred and three women with PCOS and sixty age- and BMI-matched healthy control women were enrolled to this cross-sectional study. Serum androgen and estradiol (E2) levels were measured. Homeostasis model assessment of insulin resistance (HOMA-IR) and MATSUDA insulin sensitivity index (ISI) were calculated. BMD was measured with a dual X-ray absorptiometer.

Results: Lumbar BMD (LBMD) and femoral neck BMD (FnBMD) values were significantly lower in PCOS group than controls [(p?p?p?p?r?=?0.617; p?r?=??0.665; p?r?=?0.488; p?r?=?0.436; p?r?=?0.337; p?Conclusions: Despite the positive effects of hyperandrogenemia and hyperinsulinemia, PCOS patients have lower bone mineral density due to hypoestrogenism. Insulin resistance, BMI, estrogen, and androgen levels are the determinants of BMD in PCOS.     

High DHEAS/free testosterone ratio is related to better metabolic parameters in women with PCOS

Abstract

Aims: To demonstrate the effects of DHEAS/free testosterone (DHEAS/FT) ratio on metabolic parameters in women with and without polycystic ovary syndrome (PCOS).

Methods: The data of 91 women with PCOS and 66 women in the control group were collected retrospectively.

Results: DHEAS/FT of the control group was higher than that of PCOS group (684.93?±?300.54 to 517.2?±?300.8, p?<?0.001). DHEAS/FT correlated with BMI (r?=??0.352, p?=?0.001), WHR (r?=??0.371, p?=?0.0219), LDL (r?=??0.227, p?=?0.031), HOMA-IR (r?=??0.36, p?=?0.001) and FAI (r?=??0.639, p?=?0.001) negatively and with HDL (r?=?0.344, p?=?0.001) and SHBG (r?=?0.646, p?=?0.001) positively. In the control group, DHEAS/FT correlated with BMI (r?=??0.334, p?=?0.007), CRP (r?=??0.297, p?=?0.016) and FAI (r?=??0.399, p?=?0.01) negatively.

Conclusions: High DHEAS/FT ratios are related to a better metabolic phenotype in women with PCOS and low levels can be used to detect women with PCOS that have a higher risk of metabolic problems.     

Serum fibroblast growth factor 21 levels in polycystic ovary syndrome

Aim.?This study was designed to measure serum fibroblast growth factor 21 (FGF21) levels in patients with polycystic ovary syndrome (PCOS) and healthy subjects.

Methods.?A total of 37 women were evaluated. Serum levels FGF21, glucose, lipid profile, hormones (follicle-stimulating hormone, luteinising hormone, oestradiol, testosterone, thyroid stimulating hormone, prolactin and insulin) were determined in 24 PCOS (15 subjects of PCOS BMI?<?25?kg/m², 9 subjects of PCOS BMI?≥?25?kg/m²) and 13 control group (BMI?<?25?kg/m²).

Results.?Serum FGF21 levels were higher in the PCOS group [99.5 (173.7) pg/ml] than in the control group [52.0 (88.0) pg/ml]. LH and T are significantly higher in PCOS cases (respectively; p?<?0.05, p?<?0.01). A positive correlation was found between FGF21 and luteinising hormone and testosterone (respectively; r?=?0.43 p?=?0.007, r?=?0.38, p?=?0.02). Multivariate discriminant analysis showed that BMI, triglyceride, HOMA-IR, fasting glucose with rise of FGF21 were found significant in PCOS.

Conclusion.?Our study indicates that FGF21 in cases with PCOS exhibit an increase along with the increase of BMI and also has a positive correlation with LH and T. Further studies are required to clarify the aetiology and effects of FGF21 in women with PCOS.     

Galectin-3 is a potential biomarker to insulin resistance and obesity in women with polycystic ovary syndrome

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disorder that affects women in reproductive age. This study aimed to evaluate Gal-3 levels and its role on metabolic parameters in women with PCOS. Gal-3 was measured in 44 PCOS and 25 women recruited as control group for the case-control study. Gal-3 levels were similar between PCOS and control groups (p?>?0.05), but showed a positive correlation with glucose levels in the oral glucose tolerance test (OGTT) (r?=?0.403, p?=?0.037), body mass index (BMI) (r?=?0.469, p?=?0.027), insulin levels (r?=?0.453, p?=?0.030) and HOMA-IR (r?=?0.738, p?=?0.037) in PCOS group. The data suggest that Gal-3 plays a role in the pathophysiology of the insulin resistance and obesity in PCOS group.     

Dyslipidemia in women with polycystic ovary syndrome: incidence,pattern and predictors

One hundred forty-two women with polycystic ovary syndrome (PCOS) with an average body mass index (BMI) of 29.1 kg/m² and average age of 25.12 years were studied. By BMI, 30.2% were normal, 38.0% were overweight and 31.6% were obese. Thirty-one eumenorrheic women matched for BMI and age, with no evidence of hyperandrogenism, were recruited as controls. The incidence of dyslipidemia in the PCOS group was twice that of the Control group (76.1% versus 32.25%). The most frequent abnormalities were low high-density lipoprotein cholesterol (HDL-C; 57.6%) and high triglyceride (TG) (28.3%). HDL-C was significantly lower in all subgroups of women with PCOS when compared to the subgroups of normal women. No significant differences were seen in the total cholesterol (p?=?0.307), low-density lipoprotein cholesterol (LDL-C; p?=?0.283) and TGs (p?=?0.113) levels among the subgroups. An independent effect on HDL-C was detected for glucose (p?=?0.004) and fasting insulin (p?=?0.01); on TG for age (p?=?0.003) and homeostatic model assessment insulin resistance (p?=?0.03) and on total cholesterol and LDL-C for age (p?=?0.02 and p?=?0.033, respectively). In conclusion, dyslipidemia is common in women with PCOS, mainly due to low HDL-C levels. BMI has a significant impact on this abnormality.     

The relationship of urocortin-2 with insulin resistance patients having PCOS

In this study, we aimed to compare the serum urocortin-2 (UCN2) levels in women with polycystic ovary syndrome (PCOS) and healthy women. Thirty-eight patients with PCOS and 41 healthy women were included in the study whose age and BMI matched. The fasting serum glucose, insulin, free testosterone, hs-CRP and UCN2 levels of the all participants were examined. HOMA-IR formula was used in order to calculate the insulin resistance. Circulating UCN2 levels were significantly elevated in women with PCOS compared with controls (142.93?±?59.48 versus 98.56?±?65.01?pg/ml, p = 0.002). FBG, serum insulin, hs-CRP and HOMA-IR levels were found to be increased in women with PCOS. There was a positive correlation between UCN2 and free-testosterone in only PCOS group (r?=?0.235, p?=?0.027). Multivariate logistic regression analyses revealed that the odds ratio for PCOS was 2.31 for patients in the highest quartile of UCN2 compared with those in the lowest quartile (OR?=?2.31, 95% CI?=?1.88–2.83, p=0.021). Multiple linear regression analysis revealed that HOMA-IR, hs-CRP and free-testosterone independently predicted UCN2 levels (p?相似文献   

Independent predictors of cardiovascular risk in polycystic ovarian syndrome

We aimed to determine the independent predictors of cardiovascular risk in polycystic ovarian syndrome (PCOS). Ninety-one PCOS and 51 control patients were enrolled to our prospective cross sectional case–control study. In early follicular phase hormonal and lipid profile, fasting insulin and CRP (hs-CRP) levels and glucose levels on fasting and 2?h after the 75?g glucose intake were determined. Insulin resistance (IR) was evaluated with homeostasis model assessment and free testosterone was determined with free androgen index. PCOS was found to be associated with dyslipidemia, hyperandrogenism, IR and sub-clinical inflammation. The prevalence of overweight–obesity (41.8% vs. 25.5%, p?=?0.038), IR (42.9% vs. 23.5%, p?=?0.035) and glucose intolerance (15.38% vs. 1.96%, p?=?0.043) were significantly higher in PCOS compared to control group. Independent predictors of the risk of elevated hs-CRP level were PCOS status (OR?=?5, 95% CI: 1.55–16.14, p?=?0.007) and high BMI (OR?=?4.2, 95% CI: 1.2?14.2, p?=?0.022) and high BMI (OR?=?1.2, 95% CI: 1.05?1.4, p?=?0.007) and of TC/HDL ratio was high BMI (OR?=?1.21, 95% CI: 1.05–1.4, p?=?0.009) and increasing age (OR?=?1.11, 95% CI: 1.01–1.2, p?=?0.04). The presence of PCOS, independent from obesity and IR, is the strongest predictor of elevated hs-CRP level. Obesity and advanced age further increases the cardiovascular risk in PCOS.     

Women with polycystic ovary syndrome have greater muscle strength irrespective of body composition

Abstract

The aim of this study was to compare metabolic parameters, body composition (BC) and muscle strength of women with and without polycystic ovary syndrome (PCOS). This was a case–control study that evaluated 40 women with PCOS and 40 controls. Androgens and insulin resistance were measured. BC was based on dual-energy X-ray absorptiometry. Isometric handgrip and maximal dynamic muscle strength (1-RM) strength tests were performed. Median total testosterone (p?<?0.01), free androgen index (p?<?0.01), insulin (p?<?0.01) and homeostasis model assessment-insulin resistance (p?=?0.02) were higher and sex hormone binding globulin (SBHG) (p?=?0.04) was lower in the PCOS group. Normoweight women with PCOS had higher percentages of android body fat. However, the prevalence of android fat distribution was higher in the PCOS than in the control group (p?=?0.04). The strength 1-RM in bench press (p?<?0.01), muscle strength relative to lean muscle mass in the dominant lower limb (p?=?0.04) and isometric handgrip strength tests (p?=?0.03) was higher in the PCOS group. PCOS was a determinant of strength in the bench press exercise (p?=?0.04). The hyperandrogenism was a predictor of increased strength in biceps curl exercises (p?=?0.03) in the dominant lower limb (p?=?0.02) and isometric handgrip strength (p?=?0.03). In conclusion, women with PCOS have greater muscle strength and a higher prevalence of central obesity, but no difference in BC. Muscle strength may be related to high androgen levels in these women.     

Omentin and chemerin and their association with obesity in women with polycystic ovary syndrome

We aimed to investigate whether overweight/obesity is associated with omentin and chemerin. The study group consisted of 81 women with Polycystic ovarian syndrome (PCOS) (41 lean, BMI?2 and 40 overweight or obese, BMI?>?25?kg/m²) and 61 healthy subjects (31 lean, BMI?2 and 30 overweight or obese, BMI?>?25?kg/m²; control group). The clinical, endocrine, metabolic parameters, plasma omentin and chemerin levels were measured in patients and compared to control. In all subjects with PCOS (n?=?80), serum chemerin levels were higher compared with those of the controls (n?=?58) (7.71?±?1.78?ng/mL versus 6.94?±?0.82?ng/mL, p?=?0.003). However, serum omentin levels were not significantly different between the PCOS subjects and the controls (1.55?±?0.43?ng/mL versus 1.69?±?0.37?ng/mL, p?=?0.056). The mean chemerin concentrations were significantly elevated in the obese PCOS group compared with the obese control subjects (8.98?±?1.45?ng/mL versus 7.02?±?0.67?ng/mL, p?=?0.000) and the nonobese PCOS group compared with the obese control subjects (6.57?±?1.17?ng/mL versus 7.02?±?0.67?ng/mL, p?=?0.000). In conclusion, fat mass seems to be the main determinant factor of increased chemerin and decreased omentin in women with PCOS.     

A macrophage activation marker chitotriosidase in women with PCOS: does low-grade chronic inflammation in PCOS relate to PCOS itself or obesity?

Objective

Polycystic ovary syndrome (PCOS) is described as a low-grade chronic inflammatory state where the macrophage infiltration increased in visceral fat play the major role. The aim of this study was to assess chitotriosidase (ChT) activity (an activated macrophage marker) in women with PCOS and controls and to evaluate its correlation with anthropometric and biochemical parameters.

Study design

Seventy-nine women with PCOS and 60 healthy controls were included in the study. PCOS and controls were divided into two subgroups according to body mass indexes (BMIs) as normoweight (<25?kg/m²) and overweight (≥25?kg/m²). ChT activity, biochemical (free testosterone, luteinizing hormone, insulin resistance index, etc.) and clinical parameters [BMI, waist-to-hip ratio, modified Ferriman–Gallwey scores (mFG)] were analyzed according to groups.

Results

Serum ChT activity was significantly (p?r 0.598, p?r 0.525, p?r 0.402, p 0.001) and total testosterone (r 0.168, p 0.048) for the combined groups (PCOS?+?controls). In multivariant linear regression analysis participants’ PCOS status (presence or absence) and LH levels were the main predictors of ChT activity in the whole study population (p 0.002 and p 0.041, respectively).

Conclusion

ChT activity elevates in PCOS independent of obesity. Our findings support the concept of PCOS is a state of low-grade chronic inflammation where the macrophages could play the major role. Hyperandrogenism might also be related to this inflammatory state and can be a subject of further trials.     

Free fatty acid binding protein-4 and retinol binding protein-4 in polycystic ovary syndrome: response to simvastatin and metformin therapies

Abstract

Free fatty acid binding protein-4 (FABP4) and retinol binding protein-4 (RBP4) contribute to metabolic syndrome. We investigated serum FABP4 and RBP4 responses to insulin sensitizing and lipid lowering therapies in polycystic ovary syndrome (PCOS). Sixty-two healthy, untreated women with PCOS (age 25.1?±?3.6 years, BMI: 24.0?±?4.7?kg/m²) were randomized to metformin (n?=?24), simvastatin (n?=?20) or metformin plus simvastatin (n?=?18) for 3 months. Anthropometric measures, fasting blood tests and oral glucose tolerance tests (OGTT) were obtained at the baseline and the end. At the baseline serum FABP4 correlated with obesity (BMI: r?=?0.63, p?<?0.001), insulin resistance (fasting insulin: r?=?0.44, p?=?0.0002; QUICKI: r?=??0.30, p?=?0.02; OGTT-insulin sensitivity index: r?=??0.27, p?=?0.04), dyslipidemia (HDL: r?=??0.26, p?=?0.03) and hyperandrogenemia (free-testosterone: r?=?0.23, p?=?0.03; SHBG: r?=??0.28, p?=?0.03); while RBP4 correlated with total-cholesterol (r?=?0.33, p?=?0.009). Multiple regression analysis indicated that t best predictors of serum FABP4 and RBP4 were BMI (β?=?1.02, p?=?0.0003) and total cholesterol (β?=?2326, p?=?0.01), respectively. Simvastatin, alone or with metformin did not affect serum FABP4 or RBP4. Serum FABP4 related to the obesity, insulin resistance and inflammation while RBP4 related to lipids. Insulin sensitizing and lipid lowering therapies did not affect FABP4 or RBP4 levels in PCOS.     

Studying the correlation of renin-angiotensin-system (RAS) components and insulin resistance in polycystic ovary syndrome (PCOs)

Abstract

Objective: It is estimated that 5–7% of women of reproductive age have polycystic ovary syndrome (PCOS). Chronic anovulation, hyperandrogenism, and insulin resistance (IR) are the main characters of this complex syndrome. IR, diabetes and obesity are all strongly correlated with PCOS; moreover, the possibility of direct androgen mediated renin-angiotensin system (RAS) stimulation in women with PCOS is also reported. The aim of the present study was to investigate the correlation between RAS, IR and PCOS

Study design: Thirty one women with PCOS, diagnosed by the Rotterdam criteria, were compared with thirty six control subjects. Both case and control groups were evaluated regarding to their basal hormonal profile, fasting blood sugar, IR, angiotensin converting enzyme (ACE) activity, plasma renin activity (PRA) and angiotensin ?? (Ang??) levels.

Results: Compared to controls both ACE activity (p?=?0.04) and AngΙΙ levels (p?=?0.01) were significantly higher in case group. No significant differences between patients and controls were found in PRA. The results demonstrated that IR (p?=?0.02) and fasting insulin (p?=?0.004) were higher in case group, there was also a positive correlation between ACE activity and IR in case group (p?=?0.02, r?=?0.2).

Conclusion: These results may suggest that there is an important correlation between ACE activity and IR in patients with PCOS.     

Is there a role for kisspeptin in pathogenesis of polycystic ovary syndrome?

Aim: To investigate association of kisspeptin levels in infertile women with different ovarian reserve patterns.

Materials and methods: In this prospective cross-sectional study, 157 participants were recruited. The women were divided into three groups: (i) adequate ovarian reserve (AOR) (n?=?57), (ii) high ovarian reserve (PCOS) (n?=?60), (iii) diminished ovarian reserve (DOR) (n?=?40). Weight, height, waist circumference (WC), hip circumference (HC), body mass index (BMI), waist/hip ratio (WHR) were measured. The blood samples were analyzed for estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), 17-hydroxy progesterone (17OHP), dehydroepiandrosterone sulfate (DHEAS), antimullerian hormone (AMH), kisspeptin measurements.

Results: FSH concentration was higher and AMH concentration was lower in DOR group (p?p?p?=?.001, p?p?=?.003, respectively). The 17OHP level did not differ among the groups (p?=?.15). Women with PCOS possessed the highest kisspeptin level (p?=?.01). The kisspeptin level was negatively correlated with FSH level (r?=??0.18, p?=?.02) and positively correlated with TT and DHEAS levels (r?=?0.17, p?=?.02 and r?=?0.23, p?=?.003, respectively).

Conclusions: Women with PCOS had increased serum kisspeptin levels. Kisspeptin concentrations were negatively correlated with serum FSH and positively correlated with serum TT and DHEAS levels.     

Prostate specific antigen (PSA) in diagnosis of polycystic ovarian syndrome – a new insight

Introduction: Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder and cause of androgen excess in women. Prostate specific antigen (PSA) could be a new marker of hyperandrogenism in PCOS.

Objective: The aim of the study was to assess the concentration PSA (total PSA - TPSA and free PSA - fPSA) in 165 patients with PCOS and 40 healthy female controls, the relationship between PSA (TPSA and fPSA) and hormonal parameters and to determine the performance of PSA in diagnosis of PCOS.

Results: Total PSA was higher in PCOS group versus controls. The fPSA was below the lower detection levels among all patients. The median value of FAI was 4.31 in PCOS patients versus 1.79 in controls, p?r=?0.173, p?=?0.027) and TPSA and FAI (r?=?0.2603, p?=?0.001). AUC for FAI was 82.1%, threshold 2.56?nmol/l, for tT AUC 80.5%, threshold 0.54?ng/ml, for TPSA AUC 66.3%, threshold 0.005?ng/ml. The ROC analysis for A AUC 62.7%, threshold 3.95?ng/ml.

Conclusion: PCOS women have higher serum concentration of TPSA than controls. TPSA positively correlate with T and FAI, which is the best marker for hyperandrogenic states and has better accuracy for tT and total PSA serum levels in diagnostic of PCOS.     

Serum ghrelin level in women with polycystic ovary syndrome and its relationship with endocrine and metabolic parameters

Aims. To compare ghrelin levels in women with polycystic ovary syndrome (PCOS) and healthy subjects and to evaluate the relationships between circulating ghrelin and the heterogeneity of clinical and biochemical manifestations of PCOS women.

Methods. Forty-five women with PCOS and 20 controls were included in the study. Serum levels of ghrelin, leptin, testosterone, immune-reactive insulin (IRI), sex hormone-binding globulin, dehydroepiandrosterone sulfate, cortisol, luteinizing hormone and follicle-stimulating hormone were measured. Free androgen index and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. Body mass index (BMI) and waist-to-hip ratio (WHR) were calculated.

Results. Serum ghrelin levels in PCOS patients were lower than in the control group (mean±standard error of the mean: 21.78±2.12 vs. 34.67±3.57 ng/ml; p = 0.04). In women with PCOS, a strong negative correlation was observed between ghrelin values and the clinical (BMI, WHR, waist circumference) and hormonal indices of insulin resistance (IRI and HOMA-IR). The negative correlative relationship between ghrelin and HOMA-IR disappeared after partial correlation analysis when controlling for WHR and BMI. Negative correlation existed between ghrelin and testosterone (r = ?0.315; p<0.05) and between ghrelin and leptin levels (r = ?0.306; p<0.05). The latter correlation disappeared after partial correlation analysis controlling for BMI, WHR and HOMA-IR.

Conclusion. The ghrelin level in women with PCOS reflects the metabolic and hormonal changes which are characteristics of the syndrome. The inverse correlation between ghrelin and leptin in these women is mediated through metabolic factors.     

Relation between C-reactive protein and body mass index in patients with polycystic ovarian syndrome

Introduction.?Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women. These patients share common features like obesity with metabolic syndrome. C-reactive protein (CRP) is a low-grade chronic inflammation biomarker that independently predicts high-risk patients for cardiovascular diseases (CVD). Although many studies showed increased plasma CRP levels in patients with PCOS, there is still less evidence that can link obesity and CRP levels in patients with PCOS. The objective of this study was to investigate the relations between body mass index (BMI) and CRP plasma levels in patients with PCOS.

Method.?Forty patients with PCOS and 30 controls matched by age and BMI were included. Blood sample was obtained from all individuals in early follicular phase of menstrual cycle. CRP, fasting blood sugar (FBS), triglyceride (TG), and total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), blood pressure, waist circumference (WC) and BMI was measured for all subjects.

Result.?CRP and TG levels were higher in patients with PCOS (p?<?0.001 and p?=?0.011, respectively). CRP level increased significantly only in patients with PCOS with BMI?≥?25 kg/m² (p?=?0.001) but was not significant in patients with PCOS with BMI?<?25?kg/m² (p?=?0.067). In further analysis, BMI and WC affect CRP rising in patients with PCOS (p?=?0.001).

Conclusion.?In patients with PCOS, serum CRP levels were higher than age and BMI-matched controls. Furthermore, BMI was strongly related to CRP only in overweight patients with PCOS.     

Serum and follicular fluid levels of IGF-II,IGF-binding protein-4 and pregnancy-associated plasma protein-A in controlled ovarian hyperstimulation cycle between polycystic ovarian syndrome (PCOS) and non-PCOS women

Objective.?To investigate the difference of serum and follicular expression patterns for IGFα, IGFBP4 and PAPP-A in COH cycle between PCOS and non-PCOS women.

Methods.?COH was performed for total 30 sterile women (20 with PCOS and 10 with normal ovarian function). The serum and follicular fluid (FF)from dominant follicles levels of IGFα, IGFBP4 and PAPP-A before COH, day of hCG, and were measured using an ELISA.

Results.?The PCOS women had significantly higher day 3 serum PAPP-A, day of hCG serum IGFBP-4, and ff IGF-II levels compared to the normoovulatory subjects. Serum levels of IGF-II and IGFBP-4 in PCOS women had increased after gonadotropins stimulation, and yet PAPP-A was decreased. Within the PCOS women, day of hCG serum IGFBP-4 was strongly correlated with BMI (r?=?0.777; P?=?0.000), day of hCG IGF II (r?=??0.573, p?=?0.008), ff IGF II (r?=??0.573, p?=?0.008) and ff PAPP-A (r?=??0.461, p?=?0.041) was inversely related to diameter >16?mm follicle number and day 3 PAPP-A correlated to diameter?>16?mm follicle number (r?=?0.474; p?=?0.035).

Conclusions.?Ovarian IGF system on the gonadotropin response to differences in the PCOS and non-PCOS women in COH cycle, and may indicate a inordinate IGF system that might disturb folliculogenesis in PCOS women.     

Body fat composition and distribution in women with polycystic ovary syndrome

Objectives. The aims of the present study were to compare the distribution and accumulation of body fat in women with polycystic ovary syndrome (PCOS) and healthy controls matched for age and body mass index (BMI), and to investigate the association between androgen levels, insulin resistance and fat distribution.

Materials and methods. Thirty-one PCOS women and 29 age- and BMI-matched healthy control women were evaluated in terms of subcutaneous adipose tissue thickness determined with a skinfold caliper and body composition analyzed by bioelectrical impedance analysis. Blood samples were obtained for determination of follicle-stimulating hormone, luteinizing hormone, 17β-estradiol, 17-hydroxyprogesterone, basal prolactin, testosterone, dehydroepiandrosterone sulfate, sex hormone-binding globulin (SHBG), androstenedione, insulin and glucose levels. Insulin sensitivity was estimated by fasting glucose/insulin ratio and free androgen index (FAI) was calculated as 100 × testosterone/SHBG. Differences between means were analyzed by Student's t test or the Mann–Whitney U test according to distribution of the data. Correlation analysis was performed between the body fat distribution and parameters concerning insulin resistance and androgens.

Results. FAI was significantly higher in patients with PCOS compared with the control group (p = 0.001). Fasting insulin was significantly higher and fasting glucose/insulin ratio was significantly lower in the PCOS group vs. controls (p = 0.03 and 0.001, respectively). There was significantly less subcutaneous adipose tissue in the controls than the PCOS women at the triceps (p = 0.04) and subscapular region (p = 0.04). Waist-to-hip ratio of PCOS women was significantly higher than that of control subjects (p = 0.04).

Conclusion. Upper-half type body fat distribution is linked with PCOS, high free testosterone levels and insulin resistance.     

Polycystic ovary syndrome: a biopsychosocial understanding in young women to improve knowledge and treatment options

Aim.?To assess psychological features in young women with and without PCOS.

Methods.?Observational, cross-sectional pilot study in young women aged 18–25 with (n?=?24) or without (n?=?22) PCOS (age: 22.41?±?0.39 vs. 21.95?±?0.47 years, p?=?0.46; BMI: 29.17?±?1.54 vs. 22.05?±?0.83?kg/m², p?=?0.0003). The main outcome measures were quality of life, anxiety, depression, risk perception and fears on future health.

Results.?Women with PCOS demonstrated worsened quality of life (p?=?0.033) and greater anxiety (p?=?0.01) and depression (p?=?0.023) than women without PCOS related to BMI status. Women with PCOS were more likely to perceive themselves as at risk of obesity (p?=?0.012) and infertility (p?<?0.0001), and perceived greater importance in reducing future risk of prediabetes (p?=?0.027), gestational diabetes (p?=?0.039), type 2 diabetes (p?=?0.01), heart disease (p?=?0.005), obesity (p?=?0.0007) and infertility (p?=?0.023) than women without PCOS. Women with PCOS were more likely to have fears about future health related to weight gain (p?=?0.045), loss of femininity (p?=?0.035), loss of sexuality (p?=?0.003) and infertility (p?=?0.019) than women without PCOS.

Conclusions.?Worsened quality of life, anxiety and depression in young women with PCOS is related to BMI. Risk perception is appropriately high in PCOS, yet perceived risks of future metabolic complications are less common than those related to weight gain and infertility.