Association between anti-Mullerian hormone and insulin resistance in non-obese adolescent females with polycystic ovary syndrome

Objective: The present study was designed to evaluate the association between anti-Mullerian hormone (AMH) and insulin resistance (IR) in non-obese adolescent females with polycystic ovary syndrome (PCOS) with and without IR.

Methods: Seventy-seven consecutive non-obese patients were recruited and distributed into three groups according to diagnoses of PCOS and IR. Group I included 27 females diagnosed with PCOS and IR, group II included 18 females diagnosed with PCOS but without IR, and group III included 32 controls without PCOS.

Results: Group I had significantly higher AMH levels compared to group II and group III (p?p?p?=?0.004). There was a significant positive correlation between serum AMH and HOMA-IR levels in adolescent females with PCOS (p?=?0.003).

Conclusion: We found that serum AMH levels were higher in non-obese adolescent females with PCOS and IR than in PCOS patients without IR and the healthy controls. There was a significant positive correlation between AMH levels and IR in non-obese adolescent females with PCOS.     

HMGB1 is increased in adolescents with polycystic ovary syndrome (PCOS) and decreases after treatment with myo-inositol (MYO) in combination with alpha-lipoic acid (ALA)

Abstract

PCOS treatment should be based on pathophysiology. High-mobility-group-box-1 (HMGB1) was shown to increase in PCOS patients as a consequence of reduced cystic-fibrosis-transmembrane-conductance-regulator (CFTR) expression in the ovary, and was associated with insulin resistance and inflammation, both features of PCOS. Inositols and ALA derivatives could have positive effects on insulin sensitivity, reduce androgens, and improve ovulation rhythm. The aim of this study was to verify changes in HMGB1, in metabolic and endocrine parameters in adolescents with PCOS compared with controls and after treatment with a combination of MYO?+?ALA. Twenty-three PCOS adolescents and 21 controls matched for age and BMI were enrolled. In all subjects, metabolic and hormonal parameters were assayed. Homeostatic index (HOMA-IR) and the triglyceride/HDL-cholesterol ratio were calculated. Ovarian volumes were evaluated. Patients were treated with MYO?+?ALA for 6?months. HMGB1 was measured using a specific ELISA assay. HMGB1 was increased in PCOS compared with controls (19.76?±?5.99 versus 5.65?±?1.88?ng/ml; p?<?.05) and normalized after treatment (2.27?±?0.36?ng/ml, p?<?.05). Treatment significantly reduced insulin (24.0?±?4.11 versus 12.13?±?2.13 uU/ml), HOMA-IR (3.91?±?0.41 versus 2.42?±?0.45), and 17-hydroxyprogesterone (1.20?±?0.15 versus 0.78?±?0.11?ng/ml). Cholesterol, luteinizing hormone, 17-β-estradiol, delta 4-androstenedione, and testosterone were unchanged. Circulating HMGB1 was increased in PCOS adolescents, and treatment was effective in normalizing HMGB1.     

PCOS患者血清抗苗勒管激素(AMH)水平与胰岛素抵抗及雄激素的关系

目的:研究多囊卵巢综合征(PCOS)患者血清抗苗勒管激素(AMH)水平的变化及其与胰岛素抵抗(IR)和雄激素的关系。方法:回顾性分析85例PCOS患者及79例正常女性的体质量指数(BMI)、血清AMH、血糖、胰岛素、雄激素、稳态模型胰岛素抵抗指数(HOMA-IR)间的相互关系。血清AMH采用ELISA法测定,空腹血浆葡萄糖(FPG)采用葡萄糖氧化酶法测定,空腹胰岛素(FIns)采用化学发光法测定,睾酮(T)采用酶联免疫法测定。结果:PCOS组血清AMH水平明显高于对照组;Person相关分析表明,PCOS组血清AMH水平与HOMA-IR及BMI不相关,与雄激素、年龄相关。多元线性回归分析显示,PCOS组中血清雄激素水平是血清AMH的影响因素。结论:PCOS人群中血清AMH较正常女性升高,但其升高与IR无关,而与雄激素水平密切相关。     

Vascular endothelial growth factor in females of reproductive age

Abstract

This study explores the relationship between clinical cardiovascular risk factors and clinical androgen excess, with direct comparison to radial artery intima media thickness (rIMT). rIMT of 91 patients with polycystic ovary syndrome (PCOS) were compared with 72 healthy women. Patients were divided into three groups with regard to body mass index (BMI). Group1?=?56 women (31 controls and 25 PCOS) with low BMI(18–22.49?kg/m²), Group2?=?36 women (15 controls and 21 PCOS) with normal BMI (22.5–24.99?kg/m²) and Group3?=?71 women (26 controls and 45 PCOS) with high BMI (25–30?kg/m²). rIMT was significantly higher in patients with PCOS (p?=?0.007). rIMT was significantly higher group1 and group3 in patients with PCOS compared to controls (p?=?0.007 and p?=?0.042, respectively). There was a significant positive association between rIMT levels and fT in women with PCOS in group1 (r?=?0.24, p?=?0.04). rIMT levels correlated to fT levels in women with PCOS in group3 (r?=?0.32, p?=?0.03). Modified Ferriman–Gallwey (mFG) scores demonstrated a positive association with free testosterone, total testosterone, free androgen index, waist circumference (WC), LH levels, insulin levels, Homeostasis Model Assessment index(HOMA-IR), rIMT and a negative correlation with sex hormone binding globulin in group1 and group2. mFG scores demonstrated a positive association with free testosterone (r?=?0.33, p?=?0.029) in group3, but no association was found between mFG and WC, HOMA-IR in group3. Our findings indicate that clinical androgen excess may be associated with cardiovascular disease in patients with PCOS.     

Hormone profiling,including anti-Müllerian hormone (AMH), for the diagnosis of polycystic ovary syndrome (PCOS) and characterization of PCOS phenotypes

Objective was to evaluate serum anti-Müllerian hormone (AMH) levels in polycystic ovary syndrome (PCOS) and in its different phenotypes in relation to clinical, endocrine and metabolic parameters using a new automated VIDAS^® method and to compare it with the Gen II method. Study design was multi-center study including 319 PCOS women and 109 healthy controls. Serum AMH levels measured using VIDAS^® were significantly higher in PCOS women than controls (p?<?.001), and they correlated with those measured using the AMH Gen II method. An AMH cutoff value of 42.1?pmol/L distinguished PCOS women from controls with 67% sensitivity and 83% specificity. The PCOS women with three Rotterdam criteria or hyperandrogenism displayed significantly higher AMH levels compared with those with two Rotterdam criteria or normoandrogenism. In PCOS, AMH levels correlated positively with luteinizing hormone (LH), androgen and sex hormone-binding globulin (SHBG) levels and negatively with BMI, abdominal obesity, follicle-stimulating hormone (FSH), fasting glucose and insulin, and insulin resistance. In conclusion, AMH evaluated using the VIDAS^® method distinguished PCOS patients from healthy controls relatively well, especially in those with more severe phenotypes. Further studies are needed to establish whether AMH measurements can distinguish PCOS patients with different metabolic risk factors.     

Atherogenic metabolic profile in PCOS patients: role of obesity and hyperandrogenism

Objective. To investigate glyco-lipidic metabolism and androgenic profile in a cohort of women with polycystic ovary syndrome (PCOS) divided according to Rotterdam phenotypes and body mass index (BMI).

Design. A prospective case–control study.

Setting. Gynecology department in a teaching hospital.

Patients. A total of 223 PCOS women and 25 healthy control women were studied.

Methods. Patients and controls were subdivided into three groups according to their BMI: normal weight (18.5?≤?[BMI]?≤24.9?kg/m²), overweight (25.0?≤?BMI?≤29.9?kg/m²), or obese (BMI?≥30.0?kg/m²) and according to Rotterdam criteria of PCOS.

Main outcome measures. Pituitary-gonadal axis assessment including follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, PRL, testosterone, androstenedione, DHEA-S, 17-hydroxyprogesterone and inhibin B. Metabolic parameters included cholesterol (Chol), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG) and apolipoproteins (APO) AII and B as well as serum fasting insulin, glucose and HOMA-IR.

Results. Serum fasting insulin, glucose, HOMA-IR, TG and HDL were significantly higher in women with PCOS compared to controls. Additionally, serum levels of Chol, LDL and TG were significantly higher and HDL levels were significantly lower in obese PCOS women compared with overweight/normal PCOS irrespective of Rotterdam phenotypes. Free testosterone index but not androstenedione or total testosterone significantly correlated with TG, HDL and APO B. No significant correlations were detected between gonadotropins, inhibin B or estradiol with metabolic parameters studied.

Conclusions. Obesity but not overweight in PCOS is associated with dyslipidemia. Hyperandrogenic women showed the most atherogenic lipid profiles.     

Hyperinsulinemia does not influence androgens/estrogens ratio in patients with polycystic ovarian syndrome

OBJECTIVE: The ratio of androgens to estrogens in patients with polycystic ovarian syndrome (PCOS) and controls was evaluated in order to investigate whether hyperinsulinemia might induce hyperandrogenemia by decreasing androgen catabolism. STUDY DESIGN: Forty women were divided into four groups according to the presence of PCOS, insulin resistance, and normal or abnormal body mass index (BMI); each group consisted of 10 women. Group I comprised patients with PCOS, insulin resistance, and abnormal BMI. Group II consisted of patients with PCOS, without insulin resistance, and with normal BMI. Group III consisted of healthy women (controls) with abnormal BMI. Group IV consisted of healthy women with normal BMI. RESULTS: We found that: (1) the mean fasting insulin levels of groups II, III, and IV were significantly lower than those of group I (P < .001); (2) serum testosterone levels were significantly lower in groups III and IV than in group I and II; (3) there were no significant differences in serum estradiol and estrone levels between women of all groups; (4) women of groups III and IV had significantly lower ratios of testosterone to estradiol at time 0 compared to patients of groups I and II. CONCLUSION: Our results support the view that since hyperinsulinemia induces hyperandrogenism, the increase of androgens should not be attributed to the decrease of androgen catabolism.     

The impact of oral contraceptives and metformin on anti-Müllerian hormone serum levels in women with polycystic ovary syndrome and biochemical hyperandrogenemia

Objective.?To assess the impact of metformin and of two different oral contraceptives (OCs) containing cyproterone acetate and drospirenone, on serum anti-Müllerian hormone (AMH) levels, in a cohort of women with polycystic ovary syndrome (PCOS) with hyperandrogenism.

Design.?Prospective randomised study.

Setting. Division of Endocrinology and Human Reproduction, Aristotle University of Thessaloniki.

Patients.?Forty-five (45) women with PCOS diagnosed according to the criteria proposed in 1990 by the NIH.

Interventions.?Women with PCOS were randomised into three groups, all treated for 6 months: Group A received an OC containing 35?μg ethinylestradiol plus 2?mg cyproterone acetate, Group B received an OC containing 30?μg ethinylestradiol plus 3?mg drospirenone and Group C received metformin 850?mg?×?2.

Main outcome measure(s).?Anti-Müllerian hormone levels were measured by a specific ELISA.

Results.?AMH was significantly decreased under treatment with 35?μg ethinylestradiol plus 2?mg cyproterone acetate (p?=?0.002 at 3 months and p?<?0.001 at 6 months). Treatment with 30?μg ethinylestradiol plus 3?mg drospirenone, and treatment with metformin 850?mg?×?2 did not significantly affect serum AMH levels. AMH was significantly decreased under OCs treatment compared to metformin 850?mg?×?2 (p?=?0.005).

Conclusion(s).?AMH serum levels were significantly decreased under treatment with 35?μg ethinylestradiol plus 2?mg cyproterone acetate, due to decrease in androgens and suppression of gonadotropins.     

Assessment of oxytocin level,glucose metabolism components and cutoff values for oxytocin and anti-mullerian hormone in infertile PCOS women

Objective

Comparing oxytocin level and some other parameters between infertile women with or without polycystic Ovary Syndrome (PCOS), to evaluate the correlation between oxytocin with anti-mullerian hormone (AMH), Body Mass Index (BMI) and insulin resistance (IR).

Serum anti-Müllerian hormone and insulin resistance in the main phenotypes of non-obese polycystic ovarian syndrome women in China

Objectives: Objective was to evaluate anti-Müllerian-hormone (AMH) and parameters for insulin resistance (IR) in the main phenotypes of polycystic ovarian syndrome (PCOS), and to investigate their correlation for the first time in non-obese Chinese women.

Methods: Within this prospective study, 160 PCOS cases and 40 healthy women, matched by age and BMI, were included. In four groups (n?=?40) according to the four phenotypes of PCOS by definition of the National Institute of Health (2012), AMH, ovarian volume and number of follicles 2–9?mm were assessed as well as insulin resistance indexes (Homeostatic Model Assessment) (HOMA-IR) and Quantitative Insulin Sensitivity Check Index (QUICKI).

Results: AMH levels were higher in PCOS than in controls, with differences comparing the phenotypes, highest in the group with all three criteria for PCOS. However, for HOMA-IR and QUICKI and correlation to AMH no significant differences were found.

Conclusions: AMH is a useful parameter to assess in the different phenotypes the severity of PCOS, and to compare with healthy women, for the first time demonstrated in Chinese patients. In contrast, the parameters for IR and their relation to AMH did not show clear differences comparing the four phenotypes, and need further investigation.     

Are serum chemerin levels different between obese and non-obese polycystic ovary syndrome women?

The objective of this study is to measure serum chemerin levels in women with polycystic ovary syndrome (PCOS) and assess their relationship with clinical, metabolic, and hormonal parameters. One hundred eighteen PCOS women and 114 healthy women were recruited in this study. Their blood pressure, body mass index (BMI), waist circumference and waist-to-hip ratio (WHR), fasting insulin (FIN), fasting plasma glucose (FPG), blood serum sex hormone, and blood lipid were measured. Serum chemerin, leptin, and adiponectin were measured by ELISA. Serum chemerin was significantly higher in the obese PCOS group (47.62?±?11.27?ng/mL) compared with non-obese PCOS (37.10?±?9.55?ng/mL) and the obese (33.71?±?6.17?ng/mL) and non-obese (25.78?±?6.93?ng/mL) control groups (p?p?相似文献   

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.     

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   

Comparison of spironolactone and spironolactone plus metformin in the treatment of polycystic ovary syndrome

The aim of this study was to evaluate and compare the effects of spironolactone and spironolactone plus metformin treatments on body mass index (BMI), hirsutism score, hormone levels, and insulin resistance in women with polycystic ovary syndrome (PCOS). Thirty-seven patients with PCOS were randomly assigned to receive spironolactone 100?mg/d (spironolactone group, 18 patients) or spironolactone 100?mg/d plus metformin 2000?mg/d (combination group, 19 patients) for 12 months. BMI, modified Ferriman–Gallway score (FGS), serum levels of regarding hormones, and homeostasis model assessment of insulin resistance (HOMA-IR) index were assessed before and after the treatments. Six patients in the spironolactone group and four patients in the combination group reported inter-menstrual vaginal bleeding during treatments. In hirsutism scores, the spironolactone therapy resulted in 25.2% reduction, while combination therapy resulted in 28.3% reduction (p?>?0.05, between groups). When the groups were compared in terms of percent changes in BMI, FGS, HOMA-IR, and hormone values other than free testosterone, no significant difference was noted. In the present study, FGSs were significantly decreased in both groups; however, combination therapy was not more effective than spironolactone alone in terms of BMI, FGS, hormone levels, or insulin resistance.     

Serum resistin and adiponectin levels in women with polycystic ovary syndrome

Aim.?This study was performed to compare the serum levels of resistin and adiponectin in women with polycystic ovary syndrome (PCOS) and normal controls.

Materials and methods.?Seventy-six patients (36 obese, 40 non-obese) with PCOS and 42 healthy subjects were included in the study. Serum levels of resistin, adiponectin, follicle-stimulating hormone, luteinising hormone, dehydroepiandrosterone sulfate (DHEA-S), 17-hydroxy progesterone, free testosterone, androstenedione, glucose, insulin and lipid parameters were measured. Insulin resistance and carbohydrate metabolism were evaluated by using the homeostasis model (HOMA) and the area under the insulin curve (AUCI).

Results.?Plasma resistin levels, HOMA-IR and AUCI were significantly higher and adiponectin level was lower in women with PCOS than those in healthy women. Plasma resistin levels were similar among obese and non-obese women with PCOS. No correlation was observed between resistin, body mass index (BMI), HOMA-IR, AUCI, insulin, lipid parameters and serum androgen levels. In obese PCOS patients, adiponectin levels were lower than in the lean PCOS patients. A negative correlation was observed among adiponectin, HOMA-IR, AUCI, BMI, testosterone, DHEAS, total-cholesterol, LDL-cholesterol and lipoprotein (a) levels.

Conclusion.?These results suggest that the serum adiponectin level may be involved in the pathogenesis of PCOS. But resistin levels were independently associated with insulin resistance and BMI in PCOS patients. Nevertheless, wider-scale trials are required to be performed on this subject.     

Efficacy of myo-inositol in the treatment of cutaneous disorders in young women with polycystic ovary syndrome

Background.?Polycystic ovary syndrome (PCOS) is the most common endocrine cause of hirsutism, acne and pattern alopecia, often characterised by ovulation disorders (usually manifested as oligo- or amenorrhea). In addition, 30–40% of women with PCOS have impaired glucose tolerance, and a defect in the insulin signalling pathway seems to be implicated in the pathogenesis of insulin resistance. For this reason, insulin-lowering medications represent novel approach in women with PCOS. The aim of this study was to evaluate the effects of myo-inositol (MYO), an isoform of inositol, belonging to the vitamin B complex, in the treatment of cutaneous disorders like hirsutism and acne.

Methods.?Fifty patients with PCOS were enrolled in the study. BMI, LH, FSH, insulin, HOMA index, androstenedione, testosterone, free testosterone, hirsutism and acne were evaluated at the baseline and after receiving MYO therapy for 6 months.

Results.?After 3 months of MYO administration, plasma LH, testosterone, free testosterone, insulin and HOMA index resulted significantly reduced; no significant changes were observed in plasma FSH and androstenedione levels. Both hirsutism and acne decreased after 6 months of therapy.

Discussion.?MYO administration is a simple and safe treatment that ameliorates the metabolic profile of patients with PCOS, reducing hirsutism and acne.     

Effects of metformin on serum insulin and anti-mullerian hormone levels and on hyperandrogenism in patients with polycystic ovary syndrome

Objective: To evaluate the relationship between serum anti-mullerian hormone levels (AMH) and insulin resistance (IR) before and after meformin treatment and to compare AMH levels of polycystic ovary syndrome (PCOS) women in the early follicular phase. Methods: Twenty PCOS women with IR, taking metformin 1500?mg/day for 8 weeks, and 16 non-PCOS controls were enrolled in this longitudinal study. Serum levels of AMH, insulin, glucose, testosterone, and quantitative insulin check index (QUICKI), were assessed before and after treatment in PCOS group. Results: AMH levels were higher in untreated PCOS (p < 0.0001), as were luteinizing hormone (LH) (p = 0.0004), testosterone (p = 0.0017) as well as 17-hydroxyprogesterone (p = 0.03). PCOS women show positive correlation between AMH and testosterone (R = 0.83; p < 0.0001) only prior to treatment. Metformin treatment, lead to a significant decrease in serum insulin (p = 0.0132) and testosterone (p = 0.0017) levels. However, no alteration in AMH levels was observed after treatment. Conclusion: Despite the improvement of metabolic parameters and the reduction of androgen levels, AMH levels did not change after metformin treatment. Maybe, the dose, and possibly the time of use, of metformin are factors associated with the reduction of AMH levels.     

High plasma level of long Pentraxin 3 is associated with insulin resistance in women with polycystic ovary syndrome

Objectives: Polycystic ovary syndrome (PCOS) is characterized by insulin resistance. Chronic low-grade inflammation has been anticipated to play role in the pathogenesis of both insulin resistance and atherosclerosis. Pentraxin 3 (PTX3) is an inflammatory mediator synthesized in a variety of cells and tissues including heart, vascular endothelial cells, macrophages and adipocytes. In the present study, serum PTX3 level and its relationship with insulin resistance were investigated in patients with PCOS. Materials and Methods: Forty patients with PCOS and 40 age- and body mass index (BMI)-matched healthy controls were enrolled in the study. PTX3 and high-sensitivity C-reactive protein (hs-CRP) levels were determined by enzyme immunoassay (EIA). Insulin resistance was calculated by the homeostasis model assessment of insulin resistance (HOMA-IR) formula. Results: Plasma levels of PTX3, hs-CRP and HOMA-IR scores were all significantly higher (p?=?0.021, p?=?0.002 and p?=?0.0001, respectively) in women with PCOS compared with healthy controls. Blood PTX3 level correlated positively with hs-CRP, BMI, waist-to-hip ratio (WHR), HOMA-IR and negatively with high-density lipoprotein cholesterol level (p?<?0.05, for all). After adjustment for age and BMI, PTX3, total testosterone levels and BMI remained as independent predictors of HOMA-IR scores (p?<?0.05, for all). Conclusion: PTX3 level is increased in patients with PCOS in concordance with insulin resistance.     

Anti-Mullerian hormone and insulin resistance in classic phenotype lean PCOS

Purpose

This study is designed to explore the correlation between AMH levels and IR in normal weight PCOS women.

Materials and methods

This prospective study was conducted on 55 patients, who were admitted to obstetrics and gynecology department of a university clinic. Study group was consisted of 34 patients diagnosed as polycystic ovary syndrome (PCOS) according to the Rotterdam Criteria, whereas control group was consisted of 21 healthy volunteers without any features of clinical or biochemical hyperandrogenism, who had regular menstrual cycles. BMI ≥ 25 kg/m² were considered overweight and obese and excluded. Blood samples were obtained during days 2–3 after spontaneous menses or progesterone-induced withdrawal bleeding after overnight fasting for at least 12 h. The weight, height, hip and waist circumferences of the patients were measured. Fasting insulin and glucose (FPG) levels were used for calculating different insulin resistance indexes (Homeostatic Model Assessment (HOMA-IR), Quantitative Insulin Sensitivity Check Index (QUICKI)).

Results

No significant difference was found between PCOS and control groups regarding the mean age, BMI, waist to hip ratio (WHR), mean values of FPG, FPG/insulin ratio and HOMA B (p > 0.05). AMH values were significantly higher in PCOS cases when compared with controls (4.7 vs. 3.4 ng/mL) (p < 0.05).The mean values of HOMA-IR and QUICKI indexes were significantly higher among PCOS cases when compared with controls. E2 levels were significantly lower and Total-T were significantly higher in PCOS patients. When PCOS cases are categorized according to the existence of IR, no difference in Total-T and AMH levels between both groups. Although not statistically significant, a negative correlation of AMH with HOMA-IR and a positive correlation with QUICKI index were found. Among the hormone parameters, AMH was found to be positively correlated with Total-T (r = 0.332, p = 0.013).

Conclusion

Although the relation between AMH and androgen production is supported by current evidence, the mechanism underlying the relation between AMH and insulin resistance is not clear yet.     

Histopathologic and metabolic effect of ursodeoxycholic acid treatment on PCOS rat model

The aim of this study was to determine the effect of ursodeoxycholic acid (UDCA) treatment on a polycystic ovary syndrome (PCOS) rat model. Thirty-two female Wistar–Albino rats were randomly divided into four groups as follows – group 1: sham group (n: 8), group 2: letrozole-induced PCOS group (n: 8), group 3: letrozole-induced PCOS plus metformin-treated (500?mg/kg) group (n: 8) and group 4: letrozole-induced PCOS plus UDCA (150?mg/kg)-treated group (n: 8). Histopathologic examination of the ovaries, circulating estrone (E1), estradiol (E2), testosterone, androstenedione, glucose, insulin and lipid profiles were evaluated. Histopathologic examination results revealed that groups 3 and 4 had significantly lower cystic and atretic follicles compared to group 2. Besides, group 4 had significantly higher antral follicles than group 2 (8.5?±?2.9 versus 5.4?±?1.1; p: 0.001). Furthermore, total testosterone (4.9?±?2.8 versus 8.8?±?2.9; p=?0.004) and insulin levels were significantly lower in group 4 compared to group 2 (1.7?±?0.08 versus 2.1?±?0.5; p?=?0.02). However, lipid parameters, E1, E2, glucose and HOMA-IR were comparable between the groups. Our study results demonstrated that UDCA therapy improves ovarian morphology and decreases total testosterone and insulin levels.