Paraoxonase-1 is not affected in polycystic ovary syndrome without metabolic syndrome and insulin resistance,but oxidative stress is altered

Paraoxonase-1 (PON1) activity is decreased in polycystic ovary syndrome (PCOS) having metabolic syndrome (MetS) or insulin resistance (IR). We aimed to assess PON1 activity and oxidative stress in PCOS without MetS or IR. Metabolic and hormonal parameters, high-sensitive C-reactive protein (hs-CRP), oxidative stress parameters (total antioxidant status (TAS), total oxidative stress (TOS), oxidative stress index (OSI), lipid hydroperoxide (LOOH), total free sulfhydryl (?SH) groups), PON and arylesterase were analyzed in 30 normal weighed patients with PCOS without MetS or IR and 20 normal controls. Hs-CRP, PON, arylesterase, and TAS levels of PCOS and control groups were similar. LOOH, TOS, and OSI of PCOS group were higher than in the controls (p?<?0.05; p?<?0.001, and p?<?0.001, respectively). ?SH group levels showed a positive correlation with free testosterone (fT). TOS positively correlated with free androgen index (FAI), body mass index (BMI), waist-to-hip ratio (WHR), LOOH, and OSI. This study showed that oxidative stress is increased in PCOS even in the absence of MetS or IR. PON1 activity appears not to be affected in PCOS without MetS and IR. Several metabolic and antropometric risk factors may aggravate this altered oxidative state in PCOS.     

White blood cell differential counts in patients with polycystic ovary syndrome: a pilot study on Chinese women

Objective

A state of systemic chronic low grade inflammation has been observed in polycystic ovary syndrome (PCOS). It has been suggested that inflammation is a potential mechanism influencing the ovaries or endocrine system and might therefore contribute to the pathophysiology of PCOS. The aim of this study was to compare the total white blood cell (WBC), neutrophil granulocyte and lymphocyte differential counts between women with PCOS and controls. In addition, we estimated if the WBC differential counts had a relationship with body mass index (BMI), total testosterone levels, estradiol levels and luteinizing hormone levels of women with PCOS.

Study design

1016 subjects with PCOS and 1016 age-matched healthy women from a Han Chinese population were enrolled in this case–control study. Blood samples were taken from all the patients and controls to test total WBC counts, lymphocyte counts, neutrophil counts and related serum hormones.

Results

Total WBC counts and lymphocyte counts were elevated in PCOS subjects (t-test P < 0.01). Higher lymphocyte counts which contributed to higher total WBC counts in PCOS women were compared to age-matched controls. When the data were adjusted by BMI, the difference of WBC counts and lymphocyte counts between patients and controls remained significant.

Conclusions

The state of chronic low grade inflammation in patients with PCOS might be associated with immunological factors. Obesity and hyperandrogenism may be due to the underlying low grade inflammation.     

The lived experience of women diagnosed with polycystic ovary syndrome

OBJECTIVE: To uncover the meaning of living with polycystic ovary syndrome. DESIGN: Phenomenology. SETTING: A women's health care practice in northeast United States. PARTICIPANTS: A purposive sample consisting of 12 women, ages 21 to 48 years, who had been previously diagnosed with polycystic ovary syndrome. DATA COLLECTION: Semistructured interviews. RESULTS: Analysis of the participants' responses revealed the following themes: (a) identifying differences, (b) wanting to be normal, (c) searching for answers, (d) gaining control, (e) attempting to achieve femininity, (f) letting go of guilt, and (g) dealing with it. CONCLUSIONS: Polycystic ovary syndrome is a syndrome that impacts women both physically and psychosocially. Nurses can play a key role in assisting women afflicted with this hormonal disturbance through education and support.     

增生期血清泌乳素水平与多囊卵巢综合征不孕的关系探讨

研究多囊卵巢综合征不孕与增生期血清泌素的关系。方法采用放射免疫测定法测定血清泌乳素质量浓度。结果ＰＣＯＳ不孕组和非ＰＣＯＳ不孕组的增生期血清泌乳素水平无明显差异,但两组与生育组比较,血清乳素水平明显增高。     

The value of anti-Mullerian hormone in the management of polycystic ovary syndrome in adolescents

Abstract

A prospective study was carried out in 110 adolescents (13–19 years), 90 patients with polycystic ovary syndrome (PCOS) (study group) and 20 healthy adolescents (control group). The study group was divided into two: Group I – patients without insulin resistance (n?=?30) and Group II – patients with insulin resistance (n?=?60). Group I was treated with oral contraceptives (OCs), while Group II was divided into treatment subgroups of 20 patients each: Subgroup A received OCs; Subgroup B ? myo-inositol; subgroup C – OCs + myo-inositol. Data were analyzed at baseline, 3 and 6 months of treatment. Results showed average anti-Mullerian hormone (AMH) levels were significantly higher in PCOS patients (11.8?±?5.3?ng/ml) than in controls (2.98?±?4.5?ng/ml). After treatment, in Group I and Group II Subgroup A: AMH, luteinizing hormone (LH), free testosterone (FT), total testosterone (T), Ov/v, antral follicle count (AFC), and Ferriman–Gallwey modified scale (mFG) significantly decreased, homeostatic model assessment-insulin resistance (HOMA-IR), body mass index (BMI) did not change significantly. In Group II Subgroup B only HOMA-IR and BMI significantly decreased; in Subgroup C all the parameters decreased significantly. The correlation between AMH and hormonal, morphological characteristics of ovaries were established. The results indicate that AMH could possibly be a valuable marker for the diagnosis of PCOS in adolescents, and for the assessment of treatment efficacy as well.     

Endocrine and clinical effects of myo-inositol administration in polycystic ovary syndrome. A randomized study

Abstract

Objective: To evaluate the effects the administration of myo-inositol (MYO) on hormonal parameters in a group of polycystic ovary syndrome (PCOS) patients.

Design: Controlled clinical study.

Setting: PCOS patients in a clinical research environment.

Patients: 50 overweight PCOS patients were enrolled after informed consent.

Interventions: All patients underwent hormonal evaluations and an oral glucose tolerance test (OGTT) before and after 12 weeks of therapy (Group A (n¼10): MYO 2?g plus folic acid 200?mg every day; Group B (n¼10): folic acid 200?mg every day). Ultrasound examinations and Ferriman–Gallwey score were also performed.

Main outcome measures: Plasma LH, FSH, PRL, E2, 17OHP, A, T, glucose, insulin, C peptide concentrations, BMI, HOMA index and glucose-to-insulin ratio.

Results: After 12 weeks of MYO administration plasma LH, PRL, T, insulin levels and LH/FSH resulted significantly reduced. Insulin sensitivity, expressed as glucose-to-insulin ratio and HOMA index resulted significantly improved after 12 weeks of treatment. Menstrual cyclicity was restored in all amenorrheic and oligomenorrheic subjects. No changes occurred in the patients treated with folic acid.

Conclusions: MYO administration improves reproductive axis functioning in PCOS patients reducing the hyperinsulinemic state that affects LH secretion.     

ADIPOQ gene polymorphisms and susceptibility to polycystic ovary syndrome: a HuGE survey and meta-analysis

Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders. The aim of this study was to investigate possible associations between 45T/G and 276G/T variants of the ADIPOQ gene and susceptibility to PCOS. A meta-analysis of 11 published case-control studies on the 45T/G variant of the ADIPOQ gene (involving a total of 1176 patients with PCOS and 1759 controls) and eight published case-control studies on the 276G/T variant of the ADIPOQ gene (involving a total of 895 patients with PCOS and 1024 controls) was performed. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of associations. The comparison of G vs. T in ADIPOQ 45T/G showed significant differential susceptibility to PCOS (OR=1.397, 95% CI 1.156-1.689). A significant association was also found between PCOS susceptibility and the comparison of G vs. T in ADIPOQ 276G/T (OR 0.812, 95% CI 0.704-0.937). However, protective effects were found in both sites under the co-dominant model for Caucasians. Further studies are warranted to assess these associations in greater detail, especially in Asian populations.     

Efficacy of an oral contraceptive containing drospirenone in the treatment of women with polycystic ovary syndrome

Objective To investigate the efficacy of a combined oral contraceptive containing 30 µg ethinyloestradiol and 3 mg drospirenone in the treatment of hyperandrogenism affecting women with the polycystic ovary syndrome (PCOS).

Methods Prospective open study of 20 women for six cycles. At the beginning and at the end of the study the following values were determined: the Ferriman–Gallwey (F–G) score, body mass index, waist/hip ratio, serum levels of testosterone, SHBG, immune reactive insulin (IRI), glucose, the free androgenic index, and insulin resistance (HOMA-IR).

Results All 20 women completed six cycles of therapy. The medication was well tolerated. At the end of the study there was a significant improvement of hirsutism, expressed in the decrease of the F–G score, accompanied by a decrease of testosterone and an increase of SHBG values. The carbohydrate metabolism was not affected significantly.

Conclusion The combined oral contraceptive containing 30 µg ethinyloestradiol and 3 mg drospirenone is an effective drug in the treatment of hyperandrogenism in women with PCOS; it elicits few side effects and does not significantly influence insulin resistance.     

肥胖型多囊卵巢综合征并发妊娠期高血压/子痫前期风险因素的研究

目的探讨肥胖型多囊卵巢综合征(PCOS)患者并发妊娠期高血压/子痫前期(PIH/PE)的风险因素。方法对PCOS合并不孕患者通过促排卵成功单胎妊娠的妇女进行前瞻性队列研究,随访至产后12周。从孕前的临床体征评分、内分泌及代谢状态中筛选出PCOS并发PIH/PE的风险因素。结果本研究共纳入促排卵受孕的PCOS患者92例,其中肥胖型和非肥胖型分别为38例和54例,并发PIH/PE分别为11例和6例,发病率分别为28.9%和11.1%(P0.05)。Logistic回归多因素分析显示肥胖型PCOS患者并发PIH/PE的风险因素为血性激素结合球蛋白(SHBG)(OR=0.975,P0.05),是唯一的独立风险因子;受试者工作特征(ROC)曲线分析孕前SHBG和腰臀比(WHR)对肥胖型PCOS患PIH/PE的预测价值分别为0.883及0.775(P均0.05)。结论肥胖型比非肥胖型PCOS患者更易并发PIH/PE,肥胖型PCOS患者孕前的低SHBG、中心性肥胖都可能与孕期并发PIH/PE有关。     

The polycystic ovary syndrome and gynecological cancer risk

Abstract

This review updates the knowledge regarding the association between the polycystic ovary syndrome (PCOS) and the risk of gynecological cancer. We performed a literature review of clinical and epidemiological studies concerning PCOS and the risk of breast, endometrial and ovarian cancer after selecting information by quality of scientific methodology. It was found that evidence does not support a link between PCOS and breast cancer risk. There is an increased risk of endometrial cancer, while data concerning ovarian cancer are contradictory. Regarding PCOS and its association to cervical, fallopian tube, and vulvar cancer, the quality of evidence is heterogeneous. In conclusion, women with PCOS should be screened for endometrial cancer and more research is warranted to determine in this population the true risk of developing other gynecological cancers such as breast and ovarian.     

Evaluation of the correlation between insulin like factor 3, polycystic ovary syndrome,and ovarian maldescent

The aim of this study was to investigate a proposed correlation between the incidentally discovered undescended ovaries and their confirmed diagnosis as a polycystic ovary disease (PCOD) for all cases included, and to evaluate the role of estimated insulin like factor 3 (INSL3) circulating level in the pathogenesis of both abnormal findings. The study group (A) comprised 35 women whose ovaries had been incidentally found to be undescended during the routine laparoscopy for infertility causes, and all had been diagnosed as PCOD. The control category included two subgroups; subgroup (B) included 35 women group, diagnosed as PCOD but with normally allocated ovaries in the true pelvis, and subgroup (C) included 35 healthy women with regular menses and no signs of hyperandrogenism. Correlations between the level of INSL3 and other PCOD relevant biochemical tests: [e.g. BMI, waist-to-hip ratio (WHR), LH, FSH, androstendione (A), total and free testosterone (T &; Ft), DHEA-S, and SHBG] had been also investigated. INSL3 levels were significantly higher in PCOD groups (A) and (B) compared to the healthy fertile control subgroup (C) (80.5?±?29.4, 65.11?±?15.6, and 41.11?±?10.2?pg/mL, respectively), and was highest in group (A). Moreover, we identified a strong correlation between INSL3 and androstenedione (r?=?0.42, p?=?0.0012), and free (r?=?0.42, p?=?.0123) and total testosterone (r?=?0.41, p?=?.004) in the PCOD (A) and (B) subgroup compared to the levels in subgroup (C). LH was significantly higher in all PCOD women in groups (A&;B) (12. 3?±?3.4, and 11.2?±?1.4 mIU/L, respectively) compared to those in group (A) (5.7?±?2.5 mIU/L), with a fair correlation with INSL3. However, there was no statistically significant correlation between INSL3 and FSH, DHEA-S, glucose, basal insulin concentration or HOMA-IR in all PCOD women. The strong positive correlation between INSL3, and high ovarian androgens levels in all PCOD women, which appeared clearly in undescended polycystic ovaries could support the proposed syndrome hypothesis between those abnormal findings.     

多囊卵巢综合征源性人胚胎干细胞系的建立

目的:利用多囊卵巢综合征(PCOS)患者体外受精周期中废弃胚胎建立人胚胎干细胞(hESCs)系。方法:收集PCOS患者体外受精-胚胎移植周期中废弃的新鲜或冷冻胚胎,序贯培养至囊胚,机械分离内细胞团,接种于混合饲养层(小鼠胚胎成纤维细胞∶人包皮成纤维细胞为1∶1),传代培养。对稳定传代的hESCs进行形态学观察、碱性磷酸酶染色、阶段特异性胚胎抗原-4、转录因子OCT-4的表达、核型分析、体内、外分化潜能鉴定。结果:①收集到59枚新鲜废胚,培养后获得14枚囊胚,分离11个内细胞团,贴壁、传代后建立5株hESCs系,均具备hESC特性。②收集到解冻胚胎19枚,培养后获得6枚囊胚,分离5个内细胞团,形成5个原代克隆,目前传至3~4代。结论:建立了PCOS源性hESCs系,为研究PCOS发病机理、筛选候选基因、基因定位及基因治疗等提供良好的生物学模型;废弃的新鲜及冷冻胚胎均可作为hESC建系的材料来源。