Body Mass Index and spontaneous miscarriage

Objective

We compared the incidence of spontaneous miscarriage in women categorised as obese, based on a Body Mass Index (BMI) >29.9 kg/m², with women in other BMI categories.

Study design

In a prospective observational study conducted in a university teaching hospital, women were enrolled at their convenience in the first trimester after a sonogram confirmed an ongoing singleton pregnancy with fetal heart activity present. Maternal height and weight were measured digitally and BMI calculated. Maternal body composition was measured by advanced bioelectrical impedance analysis.

Results

In 1200 women, the overall miscarriage rate was 2.8% (n = 33). The mean gestational age at enrolment was 9.9 weeks. In the obese category (n = 217), the miscarriage rate was 2.3% compared with 3.3% in the overweight category (n = 329), and 2.3% in the normal BMI group (n = 621). There was no difference in the mean body composition parameters, particularly fat mass parameters, between those women who miscarried and those who did not.

Conclusions

In women with sonographic evidence of fetal heart activity in the first trimester, the rate of spontaneous miscarriage is low and is not increased in women with BMI > 29.9 kg/m² compared to women in the normal BMI category.     

Abdominal surgical incisions and perioperative morbidity among morbidly obese women undergoing cesarean delivery

Objective

To test the hypothesis that there is no difference in perioperative morbidity and the type of uterine incisions between vertical skin incisions (VSI) and low transverse skin incisions (LTSI) at the time of cesarean delivery in morbidly obese women.

Study design

Retrospective cohort study of morbidly obese women (BMI > 35 kg/m²) who underwent cesarean delivery between June 2004 and December 2006.

Results

During the study, 424 morbidly obese women underwent cesarean section. Patients with VSI were older (31.0 ± 6.2 years vs. 26.7 ± 5.8 years), heavier (48.2 ± 9.1 kg/m² vs. 41.7 ± 6.7 kg/m²), and more likely to have a classical than a low transverse uterine incision (65.9% vs. 7.3%), p < 0.001. After controlling for confounders, women with VSI did not have an increase in perioperative morbidity, but underwent more vertical uterine incisions (adjusted odds ratio = 18.49, 95% CI: 6.44, 53.07).

Conclusion

VSI and LTSI are safe in morbidly obese patients undergoing cesarean section, but there is a tendency for increased vertical uterine incisions in those who underwent VSI.     

Induction of labor with vaginal misoprostol plus oxytocin versus oxytocin alone

Objective

To compare the effect of an oxytocin infusion alone or preceded by an intravaginal application of misoprostol for labor induction in women with term pregnancies and a low Bishop score.

Methods

This study randomized 100 multiparous women with singleton pregnancies over 38 weeks and a Bishop score less than 6 to receive either a single 50-µg dose of misoprostol intravaginally 3 hours before initiation of the oxytocin infusion or only an oxytocin infusion. The time from induction to delivery, the route of delivery, and maternal and fetal outcomes were analyzed.

Results

The mean time from induction to delivery was 9.36 ± 1.97 hours in the misoprostol plus oxytocin group and 11.08 ± 3.23 in the oxytocin alone group (P = 0.002). The rates of vaginal delivery, 1- and 5-minute Agpar scores, placental abruption, and postpartum hemorrhage were similar between the 2 groups, as were the rates of admission to the neonatal intensive care unit. There were no cases of perinatal asphyxia.

Conclusion

A 50-µg intravaginal application of misoprostol before starting the oxytocin infusion is a more effective method of labor induction than an oxytocin infusion alone for our study population.     

The influence of increasing BMI in nulliparous women on pregnancy outcome

Objective

The aim of the study was to demonstrate the influence of BMI in pregnancy on rates of adverse pregnancy outcome in overweight nulliparous women.

Study design

The study was a retrospective review of data from the local hospital database held at the Jessop Wing of the Royal Hallamshire Hospital in Sheffield. We reviewed all nulliparous women with recorded BMI at booking between January 2001 and November 2008 who delivered singleton babies. All the women were stratified into five groups (underweight, normal, overweight, obese, and morbidly obese). The different BMI range groups were compared with the group of women with a normal BMI (20-25). SPSS v15 was used for statistical analysis.

Results

The caesarean section rate rose from 18.2% in women of normal BMI to 40.6% in the morbidly obese women (RR 2.2 - CI 1.7-2.8). Morbidly obese women had three times that risk of macrosomia compared with normal BMI women (RR 3.1 - CI 2.1-4.8). The stillbirth rate was associated with increasing obesity with RR 16.7 (CI 4.9-56) for the morbidly obese women.

Conclusions

Increasing degrees of obesity are associated with increases in the incidence of caesarean section, fetal birth weight and adverse pregnancy outcomes. The increased risk shows an increment in a stepwise fashion among the different BMI groups.     

The risk of caesarean section in obese women analysed by parity

Objective

This study looked at the association between caesarean section (CS) and Body Mass Index (BMI) in primigravidas compared with multigravidas.

Study design

We enrolled women at their convenience, in the first trimester after an ultrasound examination confirmed an ongoing pregnancy. Weight and height were measured digitally and BMI calculated. After delivery, clinical details were again collected from the Hospital's computerised database.

Results

Of the 2000 women enrolled, there were 50.4% (n = 1008) primigravidas and 49.6% (n = 992) multigravidas. Of the 2000 8.5% were delivered by elective CS and 13.4% were delivered by emergency CS giving an overall rate of 21.9%. The overall CS rate was 30.1% in obese women compared with 19.2% in the normal BMI category (p < 0.001). In primigravidas the increase in CS rate in obese women was due to an increase in emergency CS (p < 0.005) and in multigravidas the increase was due to an increase in elective CS (p < 0.01). In obese primigravidas 20.6% had an emergency section for fetal distress. In obese multigravidas 17.2% had a repeat elective CS.

Conclusion

The influence of maternal obesity on the increase in CS rates is different in primigravidas compared with multigravidas.     

Morbidly obese women with and without endometrial cancer: are there differences in measured physical fitness, body composition, or hormones?

Objective

Exercise is potentially protective against cancer for obese women. The objectives were to examine differences in activity, body composition, and hormones in overweight/obese women with and without endometrial cancer.

Methods

Women ≥ 50 years old with a body mass index (BMI) ≥ 25 kg/m² scheduled for abdominal hysterectomy were enrolled. Demographics, physical activity, and quality of life (QOL) data were collected. Body composition/fitness was evaluated using Air Displacement Plethysmography (BodPod) and a standardized treadmill. Adiponectin, androstenedione, leptin, estradiol, estrone, progesterone, sex hormone binding globulin, insulin and glucose were measured.

Results

Thirty-eight women enrolled in this pilot study; 22 had endometrial cancer. Mean age was 58.3 years, mean BMI, fat weight and percent body fat were 41.3 kg/m², 55 kg and 51% respectively. Fitness levels were poor; 90% of women had peak oxygen uptakes below the 10th percentile of population normals yet 80% still rated their fitness level as equivalent to other women. Women with and without cancer did not differ in age, BMI, co-morbidities, energy expenditures, body composition, hormones or QOL although glucose levels were higher in women with cancer (119.5 vs. 90.7 mg/dl; p = 0.049). Cancer subjects scored worse on every fitness measurement, reaching statistical significance for VO_2peak (15.0 vs. 17.9 ml/kg/min; p = 0.033). Current exercisers had a lower BMI (p = 0.039), decreased fat weight (p = 0.024), decreased waist circumference (p = 0.05) and improved vitality compared to non-exercisers.

Conclusion

Physical fitness levels were abysmal in these morbidly obese subjects and worse for cancer patients. Exercise correlated with improved body composition and vitality.     

Beyond mere obesity: Effect of increasing obesity classifications on hysterectomy outcomes for uterine cancer/hyperplasia

Objective

To assess the impact of obesity severity on hysterectomy outcomes for uterine hyperplasia/cancer.

Methods

The data from women undergoing hysterectomies for endometrial hyperplasia/uterine cancer with a BMI ≥ 30 kg/m² were abstracted from records at the University of Virginia and Duke University following IRB approval. Univariate and multivariate statistical analyses were performed.

Results

Mean age of the 659 patients was 58.1 yrs; mean body mass index (BMI) was 43 kg/m². Women were grouped based on BMI: 39.6% (261) were obese (30-39 kg/m²), 41.7% (275) were morbidly obese (40-49 kg/m²) and 18.7% (123) were super obese (≥ 50 kg/m²). Minimally invasive surgical procedures (MIS) were attempted in 280 patients with a conversion rate of 16.1%; BMI was higher in the converted group (47.3 vs. 40.6 kg/m²; p < 0.001). As obesity group increased, there was a decreased frequency of lymphadenectomy (63.8% vs. 37.1% vs. 20.3%; p < 0.001), increased blood loss (242 vs. 281 vs. 378 mL; p < 0.001) and fewer nodes removed (p < 0.001). On multivariate analysis, type of surgery (open vs. MIS) and obesity classification were independently and significantly associated with wound complications (p < 0.001) and the presence of postoperative complications (p < 0.001, p = 0.003). Surgical staging with lymphadenectomy was significantly associated with obesity (p < 0.001) but not procedure type (p = 0.11). Blood transfusion (p < 0.001), hospital readmission (p = 0.025), and ileus (p < 0.001) were significantly associated with open procedures but not obesity. There were no significant differences in progression-free or disease-specific survival based on obesity group.

Conclusion

Women with BMI's exceeding 40 kg/m² have worse surgical outcomes than their less obese counterparts.     

Phenotypic expression, body mass index and insulin resistance in relation to LH levels in women with polycystic ovary syndrome

Objective

To evaluate LH levels in women with the classic (1990 criteria) and the newer (2003 criteria) PCOS phenotypes, and to examine the impact of BMI and insulin resistance indices on hormone levels.

Study design

In this controlled clinical study 936 women with PCOS, classified as classic (n = 729) and newer (n = 207), and 204 controls were included. All women were divided into normal-weight (BMI < 25 kg/m²) and overweight plus obese (BMI ≥ 25 kg/m²). Serum LH, FSH, anthropometrics, androgens, fasting insulin and glucose, HoMA-IR, number of follicles, and ovarian volume were assessed.

Results

Women with classic PCOS presented significantly higher LH and LH/FSH ratios, and lower glucose/insulin levels than those with the newer phenotype and controls. Overweight plus obese women of all groups had lower LH levels than normal-weight women. Independent positive correlations between LH and androgens and negative correlation between LH and BMI were found.

Conclusions

The higher LH concentrations of the classic phenotypes of PCOS could be attributed to the higher androgen levels, which desensitize the hypothalamus to the negative feedback regulation by progesterone. Moreover, the lower LH levels of overweight plus obese women of all groups could be attributed to the increased peripheral aromatization of androgens to estrogens in adipose tissue leading to suppression of LH secretion.

Condensation

Both normal-weight and overweight women with classic PCOS phenotypes present higher LH levels and LH-to-FSH ratios than women with similar BMI but the newer phenotypes.     

Prepregnancy body mass index, gestational weight gain, and pregnancy outcomes in China

Objective

To look for associations between pregnancy outcomes and prepregnancy body mass index and gestational weight gain among Han women from Shenyang province, China.

Method

A total of 2586 women were distributed across 4 prepregnancy categories according to the Chinese classification of body mass index, and to 4 end-of-pregnancy categories according to median weekly gestational weight gain.

Results

The risks for gestational hypertension, pre-eclampsia, gestational diabetes, and preterm premature rupture of membranes were higher for those who were overweight or obese before becoming pregnant (P < 0.05). Moreover, a gestational weight gain of 0.50 kg per week or greater was associated with a higher risk for gestational hypertension, preterm premature rupture of membranes, and fetal macrosomia (P < 0.05). Women in the highest quartile for weight gain (≥ 0.59 kg per week) were at higher risk for pre-eclampsia (P < 0.05).

Conclusion

A high prepregnancy body mass index and excessive gestational weight gain were associated with increased risks for adverse pregnancy outcomes.     

The influence of body mass index on in vitro fertilization outcome

Objective

To examine whether body mass index (BMI) influences the outcome of in vitro fertilization (IVF).

Methods

We studied 516 IVF cycles, 438 undergone by nonobese (BMI ≤ 30) and 78 by obese (BMI > 30) women who all had an a priori favorable prognosis (age < 40 years and first, second, or third IVF cycle).

Results

Pregnancy was achieved in 122 (27.9%) nonobese and 12 (15.4%) obese women. The obese women required significantly longer stimulation and more gonadotropin ampoules, and had lower peak estradiol levels and a significantly lower fertilization rate; obese poor responders had a significantly lower pregnancy rate than nonobese poor responders; and the prevalence of poor responders was significantly higher among obese than nonobese women (28.2% vs 16.9%, P < 0.04).

Conclusion

While the likelihood of poor responders was increased among obese women, reasonable conception rates were achieved in nonobese poor responders, and were comparable to the rates in nonobese and obese normal responders.     

A noninvasive evaluation of autonomic nervous system dysfunction in women with an overactive bladder

Objective

To verify the hypothesis that a connection exists between overactive bladder (OAB) syndrome and a bladder-specific dysfunction of the autonomic nervous system (ANS).

Method

An electrocardiogram recorded heartbeat cycles from the onset of urinary urgency to 5 minutes after voiding in 33 women with an overactive bladder and 176 controls. Power spectral density (PSD) analysis allowed to quantify heart rate variability (HRV), which is in relation to ANS function. Three-dimensional spectrograms and multiscale entropy graphs were used to display HRV values.

Results

The differences between patients and controls were all significant in the time and frequency domains of HRV (P < 0.05), which suggests disturbances in bladder-specific ANS activity in women with OAB.

Conclusion

By quantifying HRV data, PSD analysis provides a simple, noninvasive method of assessing disturbances in ANS activity and monitoring treatment in women with OAB. It can also be used to evaluate other neuronal conditions.     

Increasing adiposity in normal ovulatory women affects adipocytokine expression in subcutaneous and visceral abdominal fat

Objective

To determine which adipocytokines are differentially expressed as a function of body mass index (BMI), to compare expression of adipocytokines in abdominal subcutaneous and omental fat, and to correlate these findings with serum levels, BMI, and parameters of insulin resistance.

Methods

Serum and subcutaneous (sc) and omental (om) tissue were obtained from lean and obese ovulatory women undergoing gynecologic surgery. We determined adipocytokine expression in sc versus om abdominal fat and related this to increasing BMI.

Results

Serum leptin was higher and adiponectin lower in overweight subjects. Adipocytokines had higher expression in sc abdominal versus om adipose tissue with the most significant difference observed for leptin (P = 0.01). As BMI increased, sc leptin expression increased and adiponectin expression decreased. The leptin/adiponectin ratio correlated significantly with BMI (R = 0.84, P = 0.0001).

Conclusion

Increased adipocytokine expression correlates with BMI. Abdominal sc tissue has greater adipocytokine expression overall. The serum leptin/adiponectin ratio is highly correlated with BMI. These data may help in our understanding of how obesity affects women in a variety of ways.     

Comparison of four perioperative misoprostol regimens for surgical termination of first-trimester pregnancy

Objective

To compare the outcomes of 4 different perioperative misoprostol regimens for surgical termination of first-trimester pregnancy.

Methods

Retrospective analysis of the records of 4000 women (4 cohorts of 1000 each) who underwent surgical termination of pregnancy. The 4 cohorts received: no misoprostol; 200 μg of oral misoprostol 30 minutes preoperatively; 200 μg of sublingual misoprostol 30 minutes preoperatively; or 200 μg of oral misoprostol 3 hours preoperatively plus 200 μg of vaginal misoprostol postoperatively. Adverse effects of the last regimen were surveyed in 1000 women.

Results

In the cohorts that received misoprostol, the difficulty of cervical dilatation was reduced (P < 0.001) compared with the cohort of women that did not receive misoprostol. The frequency with which women made postoperative contacts with the clinic was also reduced in the cohorts that received misoprostol (P < 0.05). Adverse effects were minimal.

Conclusions

This retrospective study showed an association between perioperative administration of misoprostol, reduced difficulty for operators, and reduced demand for postoperative care. The regimen associated with the greatest reduction in difficult cervical dilatations and postoperative consultations was 200 μg of oral misoprostol 3 hours preoperatively plus 200 μg of misoprostol vaginally at the end of the surgical procedure.     

Polycystic ovary syndrome and abnormalities in glucose tolerance

Objectives

To compare the prevalence of abnormal glucose tolerance (AGT) among women with polycystic ovary syndrome (PCOS) and controls, and assess risk factors associated with PCOS.

Method

A fasting oral glucose tolerance test after ingestion of 75 g of glucose was administered to 264 women with and 116 without PCOS. Moreover, fasting glucose, insulin, and testosterone levels were measured in the women with PCOS. Body mass index (BMI), waist-to-hip ratio (WHR), and homeostasis model assessment-insulin resistance (HOMA-IR) were calculated for each woman with PCOS.

Results

The AGT prevalence was 14.4% in the PCOS group and 11.2% in the control group (P = 0.17). The women with both PCOS and AGT had significantly higher BMIs, WHRs, testosterone levels, and HOMA-IR values than those with normal glucose tolerance.

Conclusion

While AGT was not associated with PCOS, the women with both PCOS and AGT were significantly more obese, hyperandrogenic, and insulin resistant than those with PCOS and normal glucose tolerance.     

Pronóstico de pacientes con cáncer de mama tratadas con cirugía en un sistema privado extra de salud

Introduction

Many women enrolled in the Spanish National Health Service also take out private health insurance to improve gynecological follow-up and complementary examinations, such as annual mammograms. We analyzed the cure rate of these patients when diagnosed with breast cancer and treated with surgery with curative intent.

Material and methods

Both overall survival and prognosis were analyzed in patients with breast cancer without metastases referred to a private oncology facility and treated with definitive surgery in the context of multidisciplinary treatment.

Results

Between 1994 and 2009, 395 patients with breast cancer were analyzed. Thirty-eight had metastases at diagnosis and 357 could be treated with definitive surgery: conservative in 265 patients and mastectomy in the remaining 92. The median follow-up was 64 months and the 5-year survival rate was 91%: 97% for stage I, 94% for stage II and 77% for stage III. In women diagnosed by mammography, the 5-year survival rate was 96% versus 86% for women consulting a gynecologist after self palpation or for other symptoms (p = 0.0159). Treatment was conservative in 74%, with better survival than in the remaining 26% who were treated with mastectomy (p = 0.0024). Survival was greater in patients with positive hormone receptors than in those with negative hormone receptors (p = 0.0264). Hormone receptor status was the only independent prognostic factor in multivariate Cox analysis.

Conclusions

Patients with breast cancer treated with definitive surgery in a private health insurance system have high cure rate, possibly because they are diagnosed in an early stage.     

Maternal serum protein S forms in pregnancies complicated by intrauterine growth restriction

Objectives

The clinical relevance of protein S deficiency in pregnant women remains controversial. Major debate exists regarding which parameter (total protein S antigen, free protein S antigen or functional protein S) should be evaluated in order to define protein S deficiency. The present study aimed to identify which of these parameters correlate with intrauterine growth restriction (IUGR).

Study design

A retrospective case-control study of women with IUGR (n = 27) and healthy controls (n = 123) in the third trimester of pregnancy.

Results

The maternal serum of women in the IUGR group had significantly lower levels of functional and free protein S compared with the control group: 54.07 ± 24.72% vs 65.20 ± 17.95% (p < 0.005) and 42.88 ± 11.01% vs 56.64 ± 13.30% (p < 0.0001), respectively. No significant correlation was found between total protein S and IUGR.

Conclusions

Levels of functional and free protein S are correlated with IUGR.     

A cohort study evaluating robotic versus laparotomy surgical outcomes of obese women with endometrial carcinoma

Objective

Minimally invasive surgery offers advantages for management of obese patients, but technical difficulty often deters its utilization. Compared to laparotomy, robotic surgery should allow comparable staging and improved surgical outcomes. Therefore, we evaluated outcomes in robotic and laparotomy cohorts of obese women with endometrial cancer at our institution.

Methods

Retrospective robotic and laparotomy cohorts of obese women (BMI ≥ 30 kg/m²) undergoing surgical management of primary endometrial cancer from March 2006 to March 2009 were formulated utilizing a computerized database. Patient demographics, operative statistics, peri-operative complications, and pathologic details were collected in an intent to treat analysis. Chi-square or Fisher's exact test and t-test were used for statistical analysis.

Results

73 women underwent robotic surgical management, 11% converted to laparotomy. Mean BMI (39.8 vs. 41.9, p = 0.152), number of co-morbidities (2.49 vs. 2.62, p = 0.690), number of previous surgeries (0.97 vs. 0.94, p = 0.841), and lymphadenectomies performed (65.8% vs. 56.7%, p = 0.227) were similar between cohorts. Total lymph nodes obtained were not statistically different between cohorts (8.01 vs. 7.24, p = 0.505). Total operative time and room time was significantly longer for robotic surgery; however, estimated blood loss, the percentage of patients receiving transfusion, hospital length of stay, wound complications (4.1% vs. 20.2%, p = 0.002) and other complications (9.6% vs. 29.8%, p = 0.001) were improved for the robotic cohort.

Conclusions

Robotic management of obese women with endometrial cancer yields acceptable staging results and improved surgical outcomes. Although operating time is longer, hospital time is shorter. Robotic surgery may be an ideal approach for these patients.     

Postpartum evaluation of stress urinary incontinence among primiparas

Objective

To assess the prevalence of postpartum stress urinary incontinence (SUI); the relationship between postpartum SUI and mode of delivery; and the association between SUI and other obstetric factors.

Method

In this prospective study, 1000 primiparas with no history of UI were recruited and followed up for 4 months after delivery. The χ² and Fisher's Exact tests were used to calculate the effects of the nominal variables.

Result

The prevalence of postpartum SUI was 14.1%, and the mode of delivery was significantly associated with SUI. The prevalence rates were 15.9% after vaginal delivery, 10.7% after elective cesarean section (CS), and 25% after CS performed for obstructed labor. The prevalence of postpartum SUI was similar following spontaneous vaginal delivery and CS performed for obstructed labor (P = .21). Meanwhile, elective CS with no trial of labor was found to be associated with a significantly lower prevalence of postpartum SUI (P = .01; χ² = 12.42). A maternal body mass index greater than 30 before pregnancy and fetal weight higher than 3000 g appeared to be associated with an increased rate of SUI (P = .001; χ² = 17.6 and P = .000; χ² = 22.5, respectively).

Conclusion

Elective CS significantly reduced the rate of postpartum SUI.     

Brachial artery conductance during reactive hyperemia is increased in women with polycystic ovary syndrome

Objective

To examine changes in brachial artery conductance (BAC) during reactive hyperemia in women with polycystic ovary syndrome (PCOS) compared to controls.

Study design

This is a pilot case-control study performed at a single academic medical center. Changes in BAC during reactive hyperemia were evaluated in 31 women with PCOS and 11 healthy control women. Fasting glucose, insulin, lipids and androgen levels were also determined. A mixed-effects model was used to compare the PCOS curve to the control curve for change in BAC from baseline during reactive hyperemia.

Results

Body mass index (BMI) and testosterone levels were significantly increased in the PCOS group compared to controls (P < 0.05). In addition, the PCOS group had higher total and LDL cholesterol levels (P = 0.05 and 0.09, respectively). Change in BAC from baseline during reactive hyperemia was significantly increased in the PCOS group compared to controls even after adjusting for age, BMI and LDL cholesterol levels (P < 0.0001). There were no significant differences between the two groups in age, blood pressure, or fasting glucose or insulin levels.

Conclusions

Brachial artery conductance during reactive hyperemia is significantly increased in women with PCOS compared to controls and may be a novel early indicator of increased cardiovascular risk in women with PCOS.     

Circulating ghrelin levels and the polycystic ovary syndrome: correlation with the clinical, hormonal and metabolic features

Objectives

Dysregulation of ghrelin levels may lead to physiological problems including obesity and polycystic ovary syndrome (PCOS). The aim of the study was to compare ghrelin levels in women with and without PCOS.

Study design

Serum ghrelin levels (pre- and post-prandial) were compared between 30 Saudi women suffering from PCOS and 30 healthy controls. The relationship between circulating ghrelin levels and other hormones was investigated. Anthropometric measurements were made for all subjects. Biochemical and hormonal investigations included plasma glucose, insulin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), 17β-estradiol (E2), progesterone, testosterone and sex hormone binding globulin (SHGB), and serum ghrelin levels. The data were statistically analyzed using independent T-test and ANOVA. Correlation studies were performed between ghrelin levels and other variables.

Results

No differences were observed in the levels of ghrelin during fasting and the postprandial period in the PCOS (p = 0.487) and control groups (p = 0.378). A significant inverse correlation was observed in ghrelin levels (fasting and postprandial) levels and BMI (PCOS: r = −0.529; p = 0.009, controls: r = −0.670; p = 0.005); PCOS: r = −0.421; p = 0.007, controls: r = −0.491; p = 0.004 respectively). No correlations between ghrelin levels and other parameters were observed.

Conclusion

The findings of the study suggest that circulating plasma ghrelin levels were found to be normal and were inversely related to BMI in women with PCOS. No relationship between circulating ghrelin levels and the abnormal hormonal pattern of the PCOS were observed.