Probiotic supplementation and the effects on weight loss,glycaemia and lipid profiles in women with polycystic ovary syndrome: a randomized,double-blind,placebo-controlled trial

The aim of the current study was to assess the effects of probiotic supplementation on weight loss, glycaemia and lipid profiles in women with polycystic ovary syndrome (PCOS). In a randomized, double-blind, placebo-controlled trial, 60 women with PCOS were randomized to receive probiotic capsule (n?=?30) or placebo (n?=?30) for 12 weeks. Consumption of probiotic supplements resulted in a significant reduction in weight (?0.5?±?0.4 vs.?+0.1?±?1.0?kg, p?=?0.004) and BMI (?0.2?±?0.2 vs.?+0.03?±?0.4?kg/m², p = 0.004) compared with the placebo. In addition, compared with the placebo, probiotic administration was associated with a significant decrease in fasting plasma glucose (?2.4?±?8.4 vs.?+2.1?±?7.0?mg/dL, p?=?0.02), serum insulin concentrations (?2.0?±?5.8 vs.?+1.6?±?5.0?μIU/mL, p?=?0.01), homoeostasis model of assessment-insulin resistance (?0.5?±?1.4 vs.?+0.3?±?1.1, p?=?0.01), homoeostatic model assessment-beta cell function (?7.5?±?22.3 vs.?+6.3?±?21.7, p?=?0.01), serum triglycerides (?13.3?±?51.3 vs.?+13.6?±?37.1?mg/dL, p=?0.02) and a significant increase in quantitative insulin sensitivity check index (QUICKI) (+0.006?±?0.01 vs. ?0.005?±?0.02, p = 0.01). When we adjusted the analysis for baseline values of biochemical parameters, age and baseline BMI, except for QUICKI (p?=?0.08), other findings did not alter. We found that probiotic supplementation among PCOS women for 12 weeks had favourable effects on weight loss, markers of insulin resistance, triglycerides and VLDL-cholesterol concentrations.     

Endometrial injury in the menstrual cycle prior to assisted reproduction techniques to improve reproductive outcomes

Abstract

Objective: Oral contraceptive pills (OCP) are widely used for treating women with polycystic ovary syndrome (PCOS). Metformin has beneficial effects on insulin resistance and endothelial functions. The aim of this study was to investigate the effects of treatment with drospirenone/ethinyl estradiol (EE) alone or in combination with metformin on the flow-mediated vasodilatation (FMD) and carotid intima media thickness (CIMT) in women with PCOS.

Methods: Fifty women with PCOS (mean age 23?±?5) were randomized to oral treatment of OCP alone (n?=?25) or an OCP combination with metformin (n?=?25) for 6 months. FMD from the brachial artery and CIMT were calculated. The hormonal profile, HOMA-IR score, basal insulin and glucose levels were studied in both groups. Before and after 6 months' treatment, echocardiographic measurements and laboratory tests were also obtained.

Results: After 6 months' treatment we observed a small decrease in FMD in the OCP group (14.9?±?9.4 versus 14.4?±?9.9, p?=?0.801) and a slight increase in the combination group (14.5?±?9.1 versus 15.0?±?8.0, p?=?0.715) but neither of them reached significance. CIMT increased in the OCP group (0.048?±?0.011 to 0.050?±?0.010?cm, p?=?0.433) and decreased slightly in the combination group (0.049?±?0.012, 0.048?±?0.011?cm, p?=?0.833).

Conclusion: We demonstrated that adding metformin to OCP treatment may have beneficial effect on FMD and CIMT that represent vascular function in patients with PCOS. These results suggest that adding metformin to OCP treatment for PCOS could preserve the cardiovascular system and improve it.     

Fibroblast growth factor 23 and 25(OH)D levels are related to abdominal obesity and cardiovascular risk in patients with polycystic ovarian syndrome

Abstract

Fibroblast growth factor 23 (FGF23) and Klotho are extensively studied in relation to bone metabolism and progression of chronic kidney disease. There is very limited information about their role in polycystic ovarian syndrome (PCOS). The aim of the present study was to investigate some bone markers in women with PCOS in relation to obesity and cardiovascular risk. In the study were included 80 patients, divided into three age-matched groups –Non-obese PCOS (n?=?40); Obese PCOS (n?=?20) and Obese control group (n?=?20). Bone marker levels were measured by an enzyme-linked immunosorbent assay. Obese PCOS patients had higher levels of FGF23 and sRANKL, lower levels of 25(OH)D and higher prevalence of vitamin D deficiency compared to non-obese subjects. Patients with abdominal obesity (waist circumference >80?cm) independently of PCOS status had significantly higher levels of FGF23 (112.5?±?86.5 vs. 73.4?±?37.9?pg/ml; p?=?.023) and lower of 25(OH)D (35.8?±?21.4 vs 47.8?±?26.5?nmol/l; p?=?.034). Patients with PCOS at risk of cardiovascular diseases according to AE-PCOS consensus also had increased levels of FGF23 (111.6?±?84.5 vs. 66.5?±?35.1?pg/ml; p?=?.031) and decreased levels of 25(OH)D (31.9?±?16.8 vs. 47.1 vs 28.4?nmol/l; p?=?.017) compared to those not at risk. There was no correlation between bone markers and blood glucose levels, insulin resistance or hormonal levels.     

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.     

Serum brain natriuretic peptide and C-reactive protein levels in adolescent with polycystic ovary syndrome

Objective: Our primary aim was to investigate whether N-terminal pro-brain natriuretic peptide (NT-proBNP) increases in adolescent with polycystic ovary syndrome (PCOS) compared with healthy controls and secondary aim was to determine whether metabolic and hormonal differences exist between groups. Methods: In this cross-sectional study, 25 adolescent patients with PCOS and 25 normal ovulatory control not suffering from PCOS were involved in the study. Fasting serum NT-proBNP, C-reactive protein (CRP), homocystein, insulin levels and biochemical and hormonal parameters were measured. Results: Serum NT-proBNP was not significantly different in PCOS subjects (0.62?±?0.80 vs 1.12?±?1.51?ng/mL, p?=?0.154). The mean serum fasting insulin levels (22.64?±?10.51 vs 13.32?±?3.97 mIU/mL, p?=?0.001) and Homeostasis Model Assessment Insulin–Resistance Index (HOMA-IR) levels (5.16?±?1.81 vs 2.97?±?0.89, p?=?0.001) were significantly high in the study group. The median serum CRP levels were not significantly different between groups (1 [1–12] vs 1 [1–19] g/dL, p?=?0.286). Conclusions: The present study demonstrated that the levels of BNP, CRP and homocystein were not different in PCOS subjects. Serum insulin levels and HOMA-IR were significantly higher in PCOS subjects. Possible serum markers for PCOS-related metabolic abnormalities and cardiovascular events, may not present in the adolescent years.     

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.     

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.     

Increased circulating urocortin-3 levels is associated with polycystic ovary syndrome

This study was aimed to compare serum urocortin-3 (UCN3) levels in women with polycystic ovary syndrome (PCOS) and healthy women, and establish what role UCN3 levels play in PCOS. Fifty-two patients with PCOS and 55 healthy women were included in the study, matched for age and body mass index. Fasting blood glucose (FBG), insulin, hs-CRP, UCN3 and free-testosterone levels of the all participants were measured. HOMA-IR was used to calculate the insulin resistance. Circulating UCN3 levels were significantly increased in women with PCOS than in control subjects (54.49?±?5.77 versus 51.28?±?5.86?pmol/l, p?=?0.005). Serum insulin, hs-CRP and HOMA-IR levels were higher in women with PCOS than in control group. UCN3 levels positively correlated with hs-CRP in PCOS group (r?=?0.391, p?=?0.004). Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curves were 0.732 (95% CI 0.634–0.830, p?相似文献   

A comparison between the effects of metformin and N-acetyl cysteine (NAC) on some metabolic and endocrine characteristics of women with polycystic ovary syndrome

Objective: To compare N-acetyl cysteine (NAC) and metformin on polycystic ovary syndrome (PCOS).

Method: Study was performed as a randomized double-blind clinical trial on women with diagnosis of PCOS without additional complications. In one group, oral NAC 600?mg, three times a day and in the other group, 500?mg oral metformin, three times a day were prescribed. Duration of treatment was 24 weeks, and after finishing this period of treatment, fasting blood glucose (FBS) and insulin, lipid profile and Homeostasis Model Assessment (HOMA) index were measured (all the blood samples were taken while fasting) and were compared in the two groups.

Results: Forty-six women in NAC group and 48 women in metformin group finished the study. The two groups did not show significant difference according to age, body mass index (BMI) of more than 30; mean BMI, AUB, FBS, fasting blood insulin, lipid profile and HOMA index before treatment. After 24 weeks of treatment; BMI >30 [17 (35.4%) versus 7 (15.2%), p?=?0.033], mean BMI [(28.36?±?2.27) versus (27.11?±?3.55), p?=?0.44], number of women with the complain of abnormal uterine bleeding (AUB) [24 (50%) versus 13 (28.3%), p?=?0.037], FBS [(90.02?±?6.24) versus (86.61?±?7.81), p?=?0.021], fasting insulin (10.40?±?2.64 versus 8.89?±?2.20, p?=?0.004), HOMA Index (2.09?±?0.69 versus 1.71?±?0.45, p?=?0.001), low density lipoprotein (LDL) (141.83?±?26.98 versus 127.89?±?28.70, p?=?0.017) were less in NAC group. Triglyceride (TG) and total cholesterol did not show significant difference between the two groups after treatment. High-density lipoprotein (HDL) was higher in NAC group.

Conclusion: NAC can improve lipid profile and fasting blood sugar (FBS) and fasting blood insulin better than metformin.     

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.     

Comparison of myo-inositol and metformin on mental health parameters and biomarkers of oxidative stress in women with polycystic ovary syndrome: a randomized,double-blind,placebo-controlled trial

Introduction: Data on comparison of myo-inositol and metformin on mental health parameters and biomarkers of oxidative stress in subjects with polycystic ovary syndrome (PCOS) are scarce. This purpose of this study was to compare of myo-inositol and metformin on mental health parameters and biomarkers of oxidative stress in subjects with PCOS.

Methods: This randomized controlled trial was conducted among 60 subjects diagnosed with PCOS according to the Rotterdam criteria. Subjects were randomly assigned into two groups to intake either myo-inositol (n?=?30) or metformin (n?=?30) for 12?weeks. Parameters of mental health were recorded at baseline and after the 12-week intervention. Fasting blood samples were obtained at baseline and the end of the study to determine biomarkers of biomarkers of oxidative stress.

Results: After the 12-week intervention, changes in beck depression inventory total score (?1.0?±?1.7 vs. ?0.3?±?0.7, p?=?0.03), general health questionnaire scores (?1.7?±?2.9 vs. ?0.5?±?1.2, p?=?0.02), depression anxiety and stress scale scores (?3.9?±?6.4 vs. ?0.9?±?1.9, p?=?0.01) and plasma total antioxidant capacity (TAC) concentrations (+106.1?±?69.6 vs. +2.1?±?132.4?mmol/L, p?<?0.001) in the myo-inositol group were significantly different from the changes in these indicators in the metformin group. Myo-inositol supplementation for 12?weeks among patients with PCOS did not affect plasma glutathione and malondialdehyde levels.

Conclusions: Overall, our data supported that myo-inositol supplementation for 12?weeks among patients with PCOS had favorable effects on parameters of mental health and plasma TAC levels.     

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.     

Endometrial flushing αVβ3 integrin,glycodelin and PGF2α levels for evaluating endometrial receptivity in women with polycystic ovary syndrome,myoma uteri and endometrioma

The aim of this cross-sectional study is to compare endometrial flushing fluid levels of α_Vβ₃ integrin, glycodelin and PGF2α during the midluteal phase of the menstrual cycle of women with polycystic ovary syndrome (PCOS, n?=?20), myoma uteri (n?=?20) and endometrioma (n?=?19) with the healthy controls (n?=?20). After collecting samples at the midluteal phase of ovulatory volunteers and storing them at ?80?°C, α_Vβ₃ integrin, glycodelin and PGF2α levels were analyzed using ELISA. The mean ages of the groups were 28.90?±?5.45, 37.25?±?2.73, 32.84?±?6.62 and 32.15?±?5.18 in PCOS, myoma uteri, endometrioma and control groups, respectively. The α_Vβ₃ integrin level (ng/ml) was statistically significantly higher in endometrioma group (9.70?±?1.72, p?0.05) as compared to myoma uteri and control groups. Similarly, glycodelin level (ng/ml) was significantly higher in endometrioma group (341.04?±?93.32) than PCOS (p?0.01), myoma uteri (p?0.001) and healthy subjects (p?0.001). Moreover, PGF2α level (350.04?±?464.50?ng/ml) was significantly higher in PCOS group relative to myoma uteri (p?0.001), endometrioma (p?0.05) and control (p?0.05) groups. In conclusion, α_Vβ₃ integrin level was significantly higher in endometrioma subjects than those with myoma uteri and control groups; glycodelin level was significantly higher in endometrioma group than other three groups, and lastly, PCOS patients had significantly higher PGF2α levels than those patients with myoma uteri, endometrioma and controls.     

Observation of phenotypic variation among Indian women with polycystic ovary syndrome (PCOS) from Delhi and Srinagar

Polycystic ovary syndrome (PCOS) is a heterogeneous disorder that demonstrates ethnic and regional differences. To assess the phenotypic variability among Indian PCOS women, we evaluated clinical, biochemical and hormonal parameters of these women being followed in two tertiary care institutions located in Delhi and Srinagar. A total of 299 (210 PCOS diagnosed by Rotterdam 2003 criteria and 89 healthy) women underwent estimation of T4, TSH, LH, FSH, total testosterone, prolactin, cortisol, 17OHP, and lipid profile, in addition to post OGTT, C-peptide, insulin, and glucose measurements. Among women with PCOS, mean age, age of menarche, height, systolic, diastolic blood pressure, and serum LH were comparable. PCOS women from Delhi had significantly higher BMI (26.99?±?5.38 versus 24.77?±?4.32?kg/m²; P?=?0.01), glucose intolerance (36 versus 10%), insulin resistance as measured by HOMA-IR (4.20?±?3.39 versus 3.01?±?2.6; P?=?0.006) and QUICKI (0.140?±?0.013 versus 0.147?±?0.015; P?=?0.03) while PCOS from Srinagar had higher FG score (12.12?±?3.91 versus 10.32?±?2.22; P?=?0.01) and serum total testosterone levels (0.65?±?0.69 versus 0.86?±?0.41?ng/ml; P?=?0.01. Two clear phenotypes, i.e. obese hyperinsulinaemic dysglycemic women from Delhi and lean hyperandrogenic women from Srinagar are emerging. This is the first report on North Indian women with PCOS showing phenotypic differences in clinical, biochemical and hormonal parameters despite being in the same region.     

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   

Oral carnitine supplementation influences mental health parameters and biomarkers of oxidative stress in women with polycystic ovary syndrome: a randomized,double-blind,placebo-controlled trial

Introduction: Limited data are available assessing the effects of oral carnitine supplementation on mental health parameters and biomarkers of oxidative stress of women with polycystic ovary syndrome (PCOS).This study was designed to determine the effects of oral carnitine supplementation on mental health parameters and biomarkers of oxidative stress in women with PCOS.

Methods: In the current randomized, double-blind, placebo-controlled trial, 60 patients diagnosed with PCOS were randomized to take either 250?mg carnitine supplements (n?=?30) or placebo (n?=?30) for 12 weeks.

Results: After 12 weeks’ intervention, compared with the placebo, carnitine supplementation resulted in a significant improvement in Beck Depression Inventory total score (?2.7?±?2.3 versus ?0.2?±?0.7, p?<?0.001), General Health Questionnaire scores (?6.9?±?4.9 versus ?0.9?±?1.5, p?<?0.001) and Depression Anxiety and Stress Scale scores (?8.7?±?5.9 versus ?1.2?±?2.9, p?=?0.001). In addition, changes in plasma total antioxidant capacity (TAC) (+84.1?±?151.8 versus +4.6?±?64.5?mmol/L, p?=?0.01), malondialdehyde (MDA) (?0.4?±?1.0 versus +0.5?±?1.5?μmol/L, p?=?0.01) and MDA/TAC ratio (?0.0005?±?0.0010 versus +0.0006?±?0.0019, p?=?0.003) in the supplemented group were significantly different from the changes in these indicators in the placebo group.

Conclusions: Overall, our study demonstrated that carnitine supplementation for 12 weeks among patients with PCOS had favorable effects on parameters of mental health and biomarkers of oxidative stress.     

Oral dehydroepiandrosterone restores ß-endorphin response to OGTT in early and late postmenopause

ß-endorphin is a neuropeptide involved in several brain functions: its plasma levels are higher in obese women and its release increases after oral glucose tolerance test (OGTT) in normal or obese women. The study included 46 healthy women and evaluated the effect of oral dehydroepiandrosterone [DHEA] (50?mg/day) in early postmenopausal women (50–55 years) both of normal weight (group A, n?=?12, BMI = 22.1?±?0.5) and overweight (group B, n?=?12, BMI = 28.2?±?0.5), and late postmenopausal women (60–65 years) both normal weight (group C, n?=?11, BMI = 22.5?±?0.6) and overweight (group D, n?=?11, BMI = 27.9?±?0.4) undergone OGTT, in order to investigate if DHEA could restore/modify the control of insulin and glucose secretion and ß-endorphin release in response to glucose load. The area under the curve (AUC) of OGTT evaluated plasma levels of different molecules. DHEA, DHEAS, and ß-endorphin plasma levels were lower in baseline conditions in older women than younger women. Considering the AUC of ß-endorphin response to OGTT, all groups showed a progressive significant increase after 3 and also after 6 months of treatment in comparison to baseline and 3 months of treatment.     

Polycystic ovary syndrome and combined oral contraceptive use: a comparison of clinical practice in the United States to treatment guidelines

Abstract

The October 2010 ESHRE/ASRM polycystic ovary syndrome (PCOS) workshop concluded: (1) all combined oral contraceptives (COC) appear to have equal efficacy for PCOS, (2) addition of antiandrogens (spironolactone) to COCs has little treatment benefit and (3) metformin does not improve the live-birth rate and should only be used with impaired glucose tolerance. We compared these guidelines to current practice in the United States IMS claims-database. Time-series analyses were conducted by calendar-year in women with PCOS to evaluate prescribing preferences for COCs, concomitant use of spironolactone, and utilization of metformin. Trends were analyzed with linear regression. Our cohort included 1.6 million women taking COCs, 46 780 with a PCOS claim. Drospirenone utilization increased by 1.52% (SE:0.48%, p?=?0.007) per-year more in women with PCOS (4.16%, SE:0.45%, p?<?0.001) than in women without PCOS (2.64%, SE:0.17%, p?<?0.001)). Concomitant use of drospirenone and spironolactone was common (14.26%) and increased by 0.75% (SE:0.15%, p?=?0.002) per-year. Although plasma glucose tests were unavailable, women with PCOS were more likely to take metformin than have a diabetes claim (45.8% versus 15.2%, p?<?0.001), indicating some women likely receive metformin solely for PCOS. Our data suggests further attention is needed to medication management of PCOS to bridge the gap between guidelines and practice.     

Magnesium sulphate can prolong pregnancy in patients with severe early-onset preeclampsia

Objective: To assess whether long-term use of magnesium sulphate prolongs pregnancy in patients with severe early-onset preeclampsia.

Methods: Retrospective cohort study included all singleton pregnancies with severe early-onset preeclampsia, expectantly managed in our institution between 2005 and 2013. Obstetric and perinatal outcomes were compared between patients managed using a current protocol that tolerates long-term (over 48 h) use of magnesium sulphate (long-term group, n?=?26) and a historical control group (control group, n?=?15) that underwent conventional treatment (up to 48 h use of magnesium sulphate).

Results: Long-term group showed significant prolongation of pregnancy compared with the control group (9.2?±?7.9 versus 16.6?±?9.3 d, log-rank test, p?=?0.021), which was also observed in patients with severe preeclampsia occurring before 28 weeks’ gestation (n?=?11, 4.5?±?5.2 versus 13.2?±?6.8 d, log-rank test, p?=?0.035). In contrast to a progressive decrease of platelet count in patients managed without magnesium sulphate, administration of magnesium sulphate for 7 d prevented the decrease of platelet count (p?=?0.001). Thirty two percent of patients (13/41) experienced a major complication irrespective of duration of magnesium sulphate use.

Conclusions: Long-term use of magnesium sulphate prolonged pregnancy in patients with severe early-onset preeclampsia and can help alleviate progression of preeclampsia.     

Is there association between vitamin D levels,apelin 36, and visfatin in PCOS?

Aim: We aimed to evaluate vitamin D, apelin-36, and visfatin levels in patients with polycystic ovary syndrome (PCOS).

Material and method: The study was completed in six months, including a total of 110 patients who were admitted to the obstetrics and gynecology polyclinic. Patients with a diagnosis of PCOS were divided into two subgroups according to their vitamin D levels. Thirty-four patients had?<10 ng/ml of vitamin D deficiency and 21 patients had 10–30 ng/ml of vitamin D insufficiency, with each being defined as a subgroup.

Results: Average apelin-36 and visfatin levels in PCOS patients were 2.52?±?0.68 nmol/L and 72.63?±?22:31 ng/ml, in the control group they were 0.92?±?0.33 nmol/L, 24.66?±?6 ng/ml, respectively. The difference found in PCOS patients was statistically significant (p?=?0.0001, p?=?0.0001).

Conclusion: In conclusion, the present study shows that in PCOS patients with low levels of vitamin D, insulin resistance is greater and apelin-36 serum levels were significantly higher. Although there are different opinions in the literature on this subject, we believe that when vitamin D levels are brought to an optimal level in PCOS patient, it can prevent the negative effects of adipokines in the pathogenesis of PCOS.