多囊卵巢综合征患者非酒精性脂肪性肝病发病情况分析

目的 分析多囊卵巢综合征(PCOS)患者中非酒精性脂肪性肝病(NAFLD)的发病情况.方法 选择PCOS患者60例为PCOS组、非PCOS患者60例为对照组,比较两组患者NAFLD的发病情况.结果 PCOS组丙氨酸转氨酶(AIJT)水平、空腹胰岛素水平和稳态模型胰岛素抵抗指数(HOMA-IR)分别为(29±15)U/L、(19±12)mU/L和0.47±0.29,均显著高于对照组[分别为(15±13)U/L、(11±8)mU/L和0.31±0.21],差异均有统计学意义(P＜0.05).PCOS组胰岛素抵抗、NAFLD的发生率分别为63%(38/60)和42%(25/60),与对照组的35%(21/60)和20%(12/60)比较,差异有统计学意义(P＜0.05).PCOS组ALT异常的发生率为40%(24/60),对照组为3%(2/60),两者比较,差异有统计学意义(P＜0.01).PCOS组伴有NAFLD患者与不伴NAFLD患者比较,体重指数显著增高,差异有统计学意义(P＜0.01);腰围臀围比值、ALT、C反应蛋白、空腹胰岛素、口服葡萄糖耐量试验2 h后胰岛素水平和HOMA-IR也显著升高,差异也有统计学意义(P＜0.05).结论 PCOS患者中NAFLD患病率升高,提示了两种疾病在临床上的相关性及对PCOS患者进行肝脏相关检查的必要性.     

Prevalence of autoimmune thyroiditis in patients with polycystic ovary syndrome

Introduction  

Hypothyroidism is associated with pregnancy complications both for the mother and progeny and it should be considered in reproductive age. Thyroid autoimmunity is stated to be the main cause of hypothyroidism in iodine sufficient areas. Polycystic ovary syndrome (PCOS) is known as the most common endocrine disorder affecting women in reproductive age. Early diagnosis and treatment of hypothyroidism in PCOS may reduce the rate of infertility and pregnancy-related morbidity. In the present study we evaluated thyroid autoimmunity in PCOS patients.     

Increased risk of eating disorders in women with polycystic ovary syndrome: a case-control study

Abstract

Data on eating disorders in women with PCOS is insufficient. The objective of this case study was to examine the hypothesis that women with PCOS exhibit more impaired eating than healthy women. Women diagnosed with PCOS under the 2003 Rotterdam Diagnostic Criteria (n?=?40) were compared with a healthy control group (n?=?40). The groups also were divided into two as normal body weight and overweight/obese. The Eating Disorders Assessment Questionnaire (EDE-Q) and the Three Factor Eating Questionnaire (TFEQ-R21), were completed by all participants in order to evaluate eating behaviors in addition to eating disorders. Among the overweight/obese group, the average total and subscale scores of the EDE-Q as well as the total and sub-factor scores of the TFEQ-R21 were higher in women with PCOS compared to controls (p?<?.05). However, this statistically significant result was not shown among the women with normal weight (p?>?.05). In comparison to the controls, the PCOS women displayed higher values of the tool scores indicating abnormal restraint eating, body shape concern and weight concern subscale scores (p?<?.05). This result suggests that the evaluation of eating disorders should be added to routine screening and the monitoring of women with PCOS.     

Prevalence of symptoms associated with polycystic ovary syndrome.

OBJECTIVE: To establish the prevalence of symptoms associated with polycystic ovary syndrome (PCOS) in a population-based sample of women from Northern Sweden, and to relate symptoms of PCOS to features of metabolic syndrome. METHODS: A population-based survey of 147 women under 40 years of age sampled from 267 eligible women from the Northern Sweden component of the World Health Organization's MONICA study. The study involved questionnaires, physical examination, and assays of testosterone and sex hormone-binding globulin. RESULTS: The estimated prevalence of symptoms associated with PCOS was 4.8% in the study population. Features of metabolic syndrome were more common in women with signs of hyperandrogenism than in healthy controls. CONCLUSION: The estimated prevalence of PCOS in Northern Sweden corresponds with other prevalence studies. A simple questionnaire and analysis of the free androgen index are sufficient to detect the subgroup with the highest risk for metabolic syndrome.     

Atrial natriuretic peptide,copeptin and adrenomedullin levels in polycystic ovary syndrome: a case-control study

Background: Polycystic ovary syndrome (PCOS) defined by the Rotterdam criteria does not take into account the unhealthy metabolic profile of the syndrome with increased insulin resistance (IR) and overweight favoring development of type 2 diabetes, hypertension and cardiovascular disease (CVD). We assess three vasoactive peptides associated with CVD in women with PCOS.

Method: Plasma levels of mid-regional pro-atrial natriuretic peptide (MR-proANP), copeptin and mid-regional pro-adrenomedullin (MR-proADM) were measured in 98 PCOS patients and 46 age- and BMI-matched healthy women.

Results: We found no difference in levels of MR-proANP, copeptin and MR-proADM between the PCOS and control group. Multiple regression analyses on a combined group of PCOS and control subjects demonstrated an inverse correlation between MR-proANP and IR (measured by fasting C-peptide) and a positive correlations between copeptin and IR as well as MR-proADM and BMI. We found no association between peptide levels and different Rotterdam phenotypes.

Conclusion: Plasma concentrations of MR-proANP, copeptin and MR-proADM were not increased in PCOS compared to age- and BMI-matched controls. Thus, these peptides cannot be used to detect increased risk of CVD in a young PCOS cohort.     

The relationship between elevated serum xenin and insulin resistance in women with polycystic ovary syndrome: a case-control study

Abstract

This study aims to determine whether serum xenin-25 levels are altered in women with polycystic ovary syndrome (PCOS). The study included 31 women diagnosed with PCOS according to the 2003 Rotterdam criteria and 30 healthy controls. The primary outcome was serum xenin-25 levels. Other variables evaluated were menstrual history, physical findings, Ferriman-Gallwey hirsutism score, blood pressure, transvaginal ultrasonography, fasting blood glucose, insulin, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, C-reactive protein, follicle stimulating hormone, luteinizing hormone, estradiol, total testosterone, dehydroepiandrosterone sulfate, and day-21 progesterone. Median (min–max) values of xenin-25 were 45.50 pg/mL (7.10–656.40) and 9.85 pg/mL (7.00–564.40) for cases and controls, respectively, demonstrating a significant difference (Z = 2.803, p = .007). The ROC curve for xenin-25 predicting the PCOS risk had an area under the curve of 0.747. The optimal cutoff value of xenin-25 for detecting PCOS was calculated as ≥32.60 pg/mL with sensitivity, specificity values of 61.3% and 86.7%, respectively. A logistic regression model including xenin-25, FSH, Ferriman-Gallwey score, and Menstrual cycle frequency demonstrated the independent relationship of xenin-25 on PCOS (p < .05). This study demonstrated that xenin-25 may contribute to the diagnosis of PCOS. Further studies are needed to fully elucidate the effects of xenin-25 in the pathogenesis of PCOS.     

Prevalence of polycystic ovary syndrome in Thai University adolescents

Polycystic ovarian syndrome (PCOS) is a common and complex condition characterized by endocrine features and influenced by genetic and environmental factors. In Southeast Asia and Thailand, the prevalence of PCOS is unknown. The aim of this study was to estimate the prevalence of and determine factors associated with PCOS in Thai adolescents. We administered a validated questionnaire to 600 university female participants aged 17–19 years from Mahidol University in Bangkok. Of these, 548 (91.33%) responded and agreed to participate. Two-hundred and seventy-nine girls (50.91%) were identified as likely having PCOS and defined as ‘probable cases’. Of those 279 participants, 248 (88.88%) were evaluated further for PCOS using the Rotterdam criteria. A complete history was taken, and a physical examination including trans-abdominal ultrasound was performed. Blood chemistry tests were performed to exclude similar conditions and to investigate potential co-morbidities. The prevalence of PCOS in Thai adolescents was found to be 5.29%. After multivariate analyses, moderate acne was the strongest risk factor for PCOS. The odd ratios (95% confidence interval) for the presence of mild acne, moderate acne, and oligo- or amenorrhea in participants with PCOS were 2.83 (1.01–7.90; p?=?.47), 31.69 (10.07–99.67; p?p?相似文献   

多囊卵巢综合征患者的胰岛素抵抗

多囊卵巢综合征（peOS）是女性常见的生殖功能障碍性疾病,主要表现为卵巢的雄激素过多及无排卵,其发生率占生育年龄妇女的5％－10％卜］。此外,PCOS患者也存在糖代谢异常,主要表现为胰岛素抵抗（IR）及代偿性高胰岛素血症,其糖耐量低减的发生率也占生育年龄妇女的10％［'］。现就关于poOS的IR基础及临床方面研究进展作一综述。一、胰岛素作用及IR（一）胰岛素作用的细胞机理胰岛素是人体最重要的代谢激素,也是唯一降糖激素。胰岛素的生物学作用主要是调节糖代谢和脂代谢,还通过调控基因表达和蛋白质合成等进一步影响相应器官的…     

Circulating microRNAs in patients with polycystic ovary syndrome

Aim: To explore the pattern of expression of circulating miRNAs in patients with polycystic ovary syndrome (PCOS). Materials and methods: Microarray and qRT-PCR were used to investigate circulating miRNAs in PCOS during clinical diagnosis. The targets of dys-regulated miRNAs were predicted using bioinformatics, followed by function and pathway analysis using the databases of Gene Ontology and the KEGG pathway. Results: BMI, triglyceride, HOMA-IR, Testosterone and CRP levels were significantly higher, while estradiol was significantly lower in PCOS than in control groups. After SAM analysis, 5 circulating miRNAs were significantly up-regulated (let-7i-3pm, miR-5706, miR-4463, miR-3665, miR-638) and 4 (miR-124-3p, miR-128, miR-29a-3p, let-7c) were down-regulated in PCOS patients. Hierarchical clustering showed a general distinction between PCOS and control samples in a heat map. After joint prediction by different statistical methods, 34 and 41 genes targeted were up-and down-regulated miRNAs, in PCOS and controls, respectively. Further, GO and KEGG analyses revealed the involvement of the immune system, ATP binding, MAPK signaling, apoptosis, angiogenesis, response to reactive oxygen species and p53 signaling pathways in PCOS. Conclusions: We report a novel non-invasive miRNA profile which distinguishes PCOS patients from healthy controls. The miRNA-target database may provide a novel understanding of PCOS and potential therapeutic targets.     

Gonadotrophin treatment in patients with polycystic ovary syndrome

Gonadotrophin treatment in clomiphene citrate resistant polycystic ovarian syndrome (PCOS) patients, using either low-dose step-up or low-dose step-down protocols, is highly effective to achieve singleton live births. Concomitant use of gonadotrophin releasing hormone analogues (GnRHa), which will block the endogenous feedback for monofollicular development during the low-dose step-up protocol, should not be employed. It is more difficult to induce ovulation in patients with more 'severe' PCOS, characterized by obesity and insulin resistance. There is need for optimization of starting doses for both the low-dose step-up and step-down protocols. Such optimization will prevent hyperstimulation due to a starting dose far above the FSH threshold, as well as minimize the time-consuming low-dose increments by starting with a higher dose in women with augmented FSH threshold. External validation of reported models for prediction of FSH response is warranted for tailoring and optimizing treatment for everyday clinical practice. Although preliminary, the partial cessation of follicular development, along with regression leading to atresia, lends support to the LH ceiling theory, emphasizing the delicate balance and need for both FSH and LH in normal follicular development. Future well-designed randomized controlled trials will reveal whether IVF with or without in-vitro maturation of the oocytes will improve safety and efficacy compared with classical ovulation induction strategies.     

Prevalence of polycystic ovary syndrome (PCOS) in first-degree relatives of patients with PCOS

OBJECTIVE: To determine the rate of clinically evident polycystic ovary syndrome (PCOS) among first-degree female relatives within families with a proband affected by PCOS. DESIGN: Clinical and biochemical evaluation of the mothers and sisters of 93 patients with PCOS. The diagnosis of PCOS was established by: [1] a history of oligomenorrhea, [2] clinical evidence (i.e., hirsutism) or biochemical evidence (i.e., elevated total or free T) of hyperandrogenism, and [3] the exclusion of related disorders. SETTING: Tertiary care university. PATIENT(S): Patients with PCOS and their mothers and sisters. INTERVENTION(S): Interview, physical examination, and hormonal testing on blood samples were performed for all subjects. MAIN OUTCOME MEASURE(S): The presence of hirsutism and hyperandrogenemia was determined in the mothers and sisters of the patients with PCOS. RESULT(S): Of the 78 mothers and 50 sisters evaluated clinically, 19 (24%) and 16 (32%) were affected with PCOS, respectively. A higher rate of PCOS was observed when only premenopausal women not taking hormones (i.e., untreated) were considered (i.e., 35% of mothers and 40% of sisters), consistent with amelioration of symptoms with hormonal therapy or aging. These rates of PCOS are significantly higher than that observed in our general population (approximately 4%) and suggest the involvement of a major genetic component in the disorder. CONCLUSION(S): The rates of PCOS in mothers and sisters of patients with PCOS were 24% and 32%, respectively, although the risk was higher when considering untreated premenopausal women only.     

Prevalence of polycystic ovaries and polycystic ovary syndrome in lesbian women compared with heterosexual women

OBJECTIVE: To determine the prevalence of polycystic ovaries (PCO) and polycystic ovarian syndrome (PCOS) in lesbian women compared with heterosexual women undergoing fertility treatment. DESIGN: A prospective observational study. SETTING: The London Women's clinic and The Hallam Medical Center. Tertiary referral fertility setup. PATIENT(S): Six hundred eighteen women undergoing ovarian stimulation with or without IUI treatment between November 2001 and January 2003. Of these, 254 were self-identified as lesbians and 364 were heterosexual women. INTERVENTION(S): Baseline pelvic ultrasound examination and blood tests conducted to measure biochemical parameters such as FSH, LH, E(2), PRL, T, androstenedione (A), sex hormone-binding globulin (SHBG), and DHEAS were performed between day 2 and 3 of each woman's menstrual cycle. Tubal patency tests were performed by hysterosalpingography or laparoscopy. MAIN OUTCOME MEASURE(S): Biochemical parameters. RESULT(S): Eighty percent of lesbian women, compared with 32% of the heterosexual women, had PCO on pelvic ultrasound examination. Thirty-eight percent of lesbian women, compared with 14% of heterosexual women, had PCOS. There were no significant differences in the androgen concentrations between lesbian and heterosexual women with normal ovaries. However, lesbian women with PCO and PCOS had significantly higher androgen concentrations compared with heterosexual women with PCO and PCOS. Tubal disease was as common in lesbian women as in heterosexual women. CONCLUSION(S): There is a significantly higher prevalence of PCO and PCOS in lesbian compared with heterosexual women. Lesbian women with either PCO or PCOS had more pronounced hyperandrogenism than did heterosexual women with either PCO or PCOS.     

Higher circulating irisin levels in patients with polycystic ovary syndrome:a meta-analysis

Insulin resistance (IR) has been reported to be highly associated with the pathogenesis of polycystic ovary syndrome (PCOS). Although irisin, a newly identified myokine that may be closely associated with IR, has been implicated in the development of PCOS, the results are still ambiguous. We performed this meta-analysis to compare the circulating irisin levels between PCOS and healthy women and assess the association of irisin with IR. Published works were retrieved from PubMed and Embase databases using combinations of ‘irisin’ and (‘polycystic ovary syndrome’ or ‘PCOS’). Eight studies involving 1918 PCOS patients and 528 controls were included in the meta-analysis. Publication bias was observed using a funnel plot and Egger's regression asymmetry test. The pooled data indicated that the levels of irisin were at least 45.78?ng/ml [95% confidence interval (CI)] (12.45, 79.12, p?=?.007) higher in patients with PCOS than that in the healthy controls. Additionally, we did not observe a significant correlation between circulating irisin levels and IR in study populations, although the results may not be reliable for small sample sizes. The current meta-analysis suggested that irisin might contribute to the development of PCOS independent of IR.     

Prevalence of polycystic ovary syndrome in reproductive-aged women with type 2 diabetes

Background. Women with polycystic ovary syndrome (PCOS) are at higher risk of type 2 diabetes and cardiovascular disease. The present study was conducted to investigate the prevalence of PCOS in type 2 diabetic patients.

Methods. Type 2 diabetic women (n = 157) of reproductive age were selected by a convenience sampling method. PCOS was confirmed using the clinical diagnosis criteria proposed in 1990 by the National Institute of Child Health and Human Development Conference of PCOS. The diabetic patients were divided into two groups according to the presence of PCOS. Baseline demographic characteristics were obtained by questionnaire, and body weight, height, waist circumference, blood pressure and some biochemical indices were measured in both groups.

Results. The prevalence of PCOS was high (8.3%, 95% confidence interval 4.5–13.4%) in these type 2 diabetic women. The onset of diabetes occurred at a lower age in the PCOS group, who also displayed significantly greater waist circumference and body mass index (p<0.05). No difference in lipid profile, glycosylated hemoglobin or blood pressure was observed between the two groups.

Conclusions. PCOS is highly prevalent in type 2 diabetic patients. Hence, focusing the treatment on insulin sensitizers in these patients should improve both the metabolic and non-metabolic complications of PCOS.