Serum visfatin,vascular endothelial growth factor and matrix metalloproteinase-9 in women with polycystic ovary syndrome

Aim: To evaluate serum concentrations of visfatin, vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) in women with polycystic ovary syndrome (PCOS) and to investigate their possible role as early endothelial markers in PCOS.

Methods: Forty-two women with PCOS and 42 controls, matched for age and weight, were included in the study. Serum concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, total testosterone (tT), Δ₄-androstenedione (Δ₄A), dehydroepinadrosterone sulphate (DHEA-S), 17-OH-progesterone, sex hormone-binding protein (SHBG), thyroid-stimulating hormone (TSH), free thyroxine (fT₄), visfatin, VEGF and MMP-9 were measured in all women; free androgen index (FAI) was calculated as well. Receiver-operating characteristic (ROC) analysis was performed to examine if visfatin, tT or FAI can predict the clinical status (PCOS or control).

Results: LH, Δ₄A, tT and FAI concentrations were higher in PCOS than in controls (p?=?0.002, 0.029, 0.0005 and 0.014, respectively). Visfatin, VEGF and MMP-9 concentrations were higher in women with PCOS than controls (p?=?0.019, 0.001 and 0.002, respectively). In ROC analysis, area under the curve (AUC) in the prediction of clinical status was 0.641 for visfatin (p?=?0.026), 0.731 for tT (p?=?0.001) and 0.666 for FAI (p?=?0.010), with no difference among them (p?=?0.117).

Conclusions: Visfatin may induce the expression of pro-angiogenic factors, such as VEGF and MMP-9, in women with PCOS, inplying gradually development of endothelial dysfunction. Further studies are required to clarify these findings.     

各项雄激素指标用于诊断多囊卵巢综合征的临床意义

目的:探讨各雄激素指标用于多囊卵巢综合征(PCOS)患者的诊断价值及临床意义。方法:分析294例PCOS患者及116例对照女性的临床表现和各生化雄激素指标,将PCOS组分为有高雄症状组和无高雄症状组,肥胖组和非肥胖组,检测总睾酮(TT)、性激素结合球蛋白(SHBG)、硫酸脱氢表雄酮(DHEA-S)、雄烯二酮(A4),并计算游离雄激素指数(FAI),绘制ROC曲线,计算曲线下面积,探讨各指标对于PCOS及其诊断价值。结果:PCOS患者BMI、m FG评分、痤疮评分、TT、DHEA-S、A4和FAI均较正常对照组高(P0.05),SHBG较正常对照组低(P0.05)。PCOS组及对照组各指标的曲线下面积(AUC)比较:DHEA-S(0.643)SHBG(0.746)TT(0.778)A4(0.849)FAI(0.915),DHEA-S、A4、FAI与TT相比有显著差异(P0.05),TT与SHBG无明显差异(P0.05)。有无高雄激素临床表现组间各指标AUC:DHEA-S(0.638)TT(0.685)A4(0.702)SHBG(0.847)FAI(0.938),FAI与TT比较差异有统计学意义(P0.05);肥胖组:DHEA-S(0.687)TT(0.711)A4(0.739)SHBG(0.768)FAI(0.860),SHBG、FAI与TT比较差异有统计学意义(P0.05)。结论:A4及FAI对于PCOS的诊断价值高于TT,且FAI在对高雄激素临床表现及肥胖的敏感性较高,更适合临床推广应用。     

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.     

Prostate specific antigen (PSA) in diagnosis of polycystic ovarian syndrome – a new insight

Introduction: Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder and cause of androgen excess in women. Prostate specific antigen (PSA) could be a new marker of hyperandrogenism in PCOS.

Objective: The aim of the study was to assess the concentration PSA (total PSA - TPSA and free PSA - fPSA) in 165 patients with PCOS and 40 healthy female controls, the relationship between PSA (TPSA and fPSA) and hormonal parameters and to determine the performance of PSA in diagnosis of PCOS.

Results: Total PSA was higher in PCOS group versus controls. The fPSA was below the lower detection levels among all patients. The median value of FAI was 4.31 in PCOS patients versus 1.79 in controls, p?r=?0.173, p?=?0.027) and TPSA and FAI (r?=?0.2603, p?=?0.001). AUC for FAI was 82.1%, threshold 2.56?nmol/l, for tT AUC 80.5%, threshold 0.54?ng/ml, for TPSA AUC 66.3%, threshold 0.005?ng/ml. The ROC analysis for A AUC 62.7%, threshold 3.95?ng/ml.

Conclusion: PCOS women have higher serum concentration of TPSA than controls. TPSA positively correlate with T and FAI, which is the best marker for hyperandrogenic states and has better accuracy for tT and total PSA serum levels in diagnostic of PCOS.     

Relationship between hyperandrogenism,obesity, inflammation and polycystic ovary syndrome

This prospective study aimed to determine the status of circulating levels of C-reactive protein (CRP), tumor necrosis factor α (TNF-α), IL-27, IL-35, IL-37, α-1 acid glycoprotein in patients with polycystic ovary syndrome (PCOS) compared with controls and to evaluate their relation with hyperandrogenism and obesity. Forty-eight patients with PCOS (29 obese, 19 lean) and 40 healthy controls (20 obese, 20 lean) were enrolled. CRP, TNF-α, IL-27, IL-35, IL-37, α-1 acid glycoprotein, sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEA-S) levels were measured. Levels of total testosterone, A4, DHEA-S were significantly higher in patients with PCOS than in controls both in the obese and lean groups, while levels of SHBG were significantly lower in all patients with PCOS than in all (p?p?p?p?p?相似文献   

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.     

Levels of lipoprotein and homocysteine in non-obese and obese patients with polycystic ovary syndrome

Aim.?This study was designed to examine the relationship between homocysteine (Hcy), lipoprotein levels and insulin resistance in obese and non-obese patients with polycystic ovary syndrome (PCOS).

Materials and methods.?Eighty-five patients (38 obese, 47 non-obese) with PCOS and 50 healthy subjects (25 obese, 25 non-obese) were included in the study. PCOS was defined according to the Homburg criterion. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), dehydroepiandrosterone sulfate (DHEA-S), insulin, 17-hydroxyprogesterone, free testosterone, androstenedione, vitamin B₁₂ and folate were measured. Also, serum concentrations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), lipoprotein (a) (Lp(a)), apoprotein B (Apo B) and apoprotein A (Apo A) were determined. Plasma Hcy levels were measured. Insulin resistance was evaluated by homeostasis model assessment (HOMA).

Results.?Plasma Hcy levels were significantly higher in women with PCOS than in healthy women. HOMA-R (insulin resistance) was significantly higher in women with PCOS compared with healthy women. Serum fasting TC, LDL-C, TG, Apo B, vitamin B₁₂ and folate levels were similar between PCOS and control groups. Lp(a) levels were higher in PCOS patients than in control subjects, whereas HDL-C and Apo A levels were lower. Compared with obese PCOS subjects, non-obese PCOS subjects had low HOMA-R, TC, LDL-C, TG, Apo B, Lp(a) and androgen levels. Plasma Hcy levels, serum HDL-C and Apo A levels were similar between obese and non-obese women with PCOS. Levels of HDL-C and Apo A were lower in both obese and non-obese PCOS patients than in obese and non-obese control subjects, whereas Lp(a) levels were higher. No correlation was observed between plasma Hcy, body mass index, HOMA-R, serum androgen levels, TC, LDL-C, HDL-C, Apo A, Apo B and Lp(a) levels.

Conclusion.?These results showed that elevated insulin resistance and plasma Hcy levels, and changes in serum lipid profile, which are possible risk factors for cardiovascular disorders, play important roles in the development of cardiovascular disease in both obese and non-obese patients with PCOS.     

Ultrasonographic assessment of skin thickness in patients with PCOS – a case-control study

Abstract

Objective: To measure skin thickness in patients with polycystic ovary syndrome (PCOS) in comparison to controls and to examine a possible association with sex steroids, body mass index, lipid profile and hyperinsulinemia.

Methods: Thirty patients with confirmed PCOS were compared to thirty-two women presenting for infertility workup. Skin thickness was measured using high-resolution ultrasound in a standardized area, blood samples were collected once at presentation.

Results: Patients with PCOS showed a statistically significant thicker skin than women in the control group (0.95?mm (±0.093?mm) versus 0.85?mm (±0.077?mm, p?<?0.0001)). LH, estradiol, testosterone, the free androgen index, triglycerides, cholesterol, LDL-cholesterol and body mass index were significantly increased in PCOS – patients. No correlation between hyperinsulinemia and skin thickness was seen.

Conclusions: PCOS – patients showed a greater skin thickness in comparison to women without PCOS. This might be due to proliferative effects of sex steroids such as estrogens and testosterone and metabolic derangements on skin thickness.     

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.     

Hyperandrogenemia influences the prevalence of the metabolic syndrome abnormalities in adolescents with the polycystic ovary syndrome

Objective.?The prevalence of the metabolic syndrome (MBS) abnormalities in Italian adolescents with polycystic ovary syndrome (PCOS) was evaluated.

Design.?Retrospective chart review.

Setting.?University outpatient clinic.

Participants.?Fifty-three adolescents with PCOS.

Interventions.?Subjects underwent a physical evaluation. Fasting blood samples were taken for the evaluation of metabolic parameters.

Main outcome measures.?The prevalence of MBS abnormalities according to de Ferranti criteria was assessed.

Results.?9.4% of adolescents with PCOS had the MBS (three abnormalities). Twelve girls (22.7%) had two abnormalities. Seventeen (32.1%) of PCOS girls have no MBS abnormalities. PCOS adolescents with the MBS were more obese, insulin resistant and they had significantly higher levels of total and free testosterone. The number of metabolic abnormalities correlated with free, total testosterone, free androgen index (FAI) and body mass index (BMI). Groups with two or three abnormalities were not differentiated by BMI, insulin, lipids, blood pressure, but they were differentiated by total and free testosterone and FAI. Adolescents with the MBS have higher total and free testosterone and FAI than girls with two MBS abnormalities.

Conclusions.?The MBS and its components are present in some adolescents with PCOS, placing them at increased risk for cardiovascular disease early in adulthood. Hyperandrogenemia is a risk factor for MBS independent of obesity.     

Prevalence of diminished ovarian reserve in Chinese women with polycystic ovary syndrome and sensitive diagnostic parameters

Objectives: To assess the prevalence of diminished ovarian reserve (DOR) in patients with polycystic ovary syndrome (PCOS) in China, and to search for sensitive diagnostic parameters.

Methods: Three hundred and thirty eight PCOS women aged 20–39 years were recruited. Basic characteristics, follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone and anti-Müllerian hormone (AMH) were measured. The best indices to diagnose PCOS with DOR were assessed.

Results: The prevalence of DOR in our Chinese PCOS patients was 16.9%. The level of E2 and FSH and the FSH/LH ratio had a positive correlation with PCOS and DOR (OR?>?1, p?p?r?=?0.016, p?r?=?0.209, p?r=–0.140, p?r=–0.229, p?r=–0.240, p?Conclusions: In our study, AMH was a sensitive parameter to diagnose PCOS with DOR, but to improve the accuracy it will still need further studies.     

Hirsutism and oligomenorrhea are appropriate screening criteria for polycystic ovary syndrome in adolescents

Abstract

We evaluated the association of hirsutism and oligomenorrhea (persistent menstrual cycles?>?45 days) as screening criteria for the detection of biochemical hyperandrogenism (BH) and polycystic ovaries (PCOM) during adolescence and determined which androgens, granulosa cell hormone, ultrasonographic parameters have the best association with polycystic ovary syndrome (PCOS). Hirsute girls with oligomenorrhea (N?=?26 Hirs/Oligo group) and non-hirsute girls with regular cycles (N?=?63, C group) were studied. Prevalence of BH and PCOM, diagnostic performance of androgens and ultrasound parameters for PCOS diagnosis were analyzed. BH and PCOM prevalence were higher in the Hirs/Oligo girls than in the C girls (76.9% versus 25.5%; 92.3% versus 33.3%, respectively; p?<?0.0001). A complete PCOS phenotype (Hirs/Oligo with BH and PCOM) was observed in 73.1% of the Hirs/Oligo group. The presence of both BH and PCOM was observed in 7.9% of the C group. The parameters with the best diagnostic performance were free androgen index ≥6.1, testosterone ≥2.4?nmol/L, follicle number ≥12 and ovarian volume ≥10?ml anti-Müllerian hormone (AMH) exhibited a low diagnostic accuracy. Hirsutism and persistent menstrual cycle over 45 days are highly associated with BH and PCOM suggesting that the presences of both criteria are necessary for the diagnosis of PCOS during adolescence.     

Can the source of hyperandrogenism in adolescents with polycystic ovary syndrome predict metabolic phenotype?

In this study, we demonstrated an association between adrenal hyperandrogenism, as determined by dehydroepiandrostenedione-to-free testosterone (DHEA-S/FT) ratio, and metabolic phenotype in obese and lean adolescents with polycystic ovary syndrome (PCOS). We compared 64 overweight/obese adolescents with PCOS (PCOS-O) with 18 lean (PCOS-L) adolescents. We analyzed the association between DHEA-S/FT ratios and metabolic parameters. Patients in the PCOS-O group were younger (median [interquartile range]) than those in the PCOS-L group (15 [15-17] vs. 16 [16–17] years; p?=?.04). The median DHEA-S/FT ratio and total testosterone concentrations did not differ. However, androstenedione concentrations were higher in the PCOS-L group (p?=?.02) and free testosterone levels lower in the PCOS-L group compared with the PCOS-O group (p?=?.02). Insulin resistance was present in 30 of 64 (46.9%) adolescents with PCOS-O compared with 1 of 18 (5.6%) with PCOS-L (p?=?.001). A significant negative correlation between DHEA-S/FT ratios and insulin concentrations in PCOS-O (p?=?.03) and PCOS-L (p?=?.04) groups was noted. In the PCOS-O group, the DHEA-S/FT ratio was negatively associated with serum triglyceride (p?=?.03) and total cholesterol concentrations (p?=?.02). We conclude that in adolescents with PCOS, a higher ratio of adrenal to ovarian androgens, signified by DHEA-S/FT, may be associated with a more favorable metabolic phenotype.     

Serum visfatin in Asian women with polycystic ovary syndrome

Objective.?To determine serum visfatin levels in Asian polycystic ovary syndrome (PCOS) women and its correlations with various parameters.

Study design.?Case–control study.

Setting.?University hospital.

Subjects.?Eighty women were enrolled in this study. Of these, 40 women were PCOS and 40 age-matched subjects with regular menstrual cycles were controls.

Intervention.?Seventy-five gram oral glucose tolerance tests were performed in all women. Fasting venous blood samples for serum visfatin, insulin and androgen levels were obtained both from the PCOS and the control women.

Main outcome measures.?Serum concentrations of visfatin, fasting insulin (FI), fasting glucose, 2-h post-load glucose (2hPG), homeostasis model assessment insulin resistance, homeostasis model assessment beta cell function, total testosterone, free testosterone, androstenedione and dehydroepiandrosterone sulfate were measured in both groups.

Results.?Women with PCOS had significantly higher serum visfatin levels than the healthy controls [100.39 ± 41.90 vs. 45.09 ± 28.24 mg/ml, p < 0.01]. PCOS women also had significantly higher concentrations of all androgens (p < 0.01). Insulin resistance seemed to be greater in the PCOS than the control groups, but did not reach a statistically significant level. In the PCOS group, serum visfatin levels were positively correlated with 2hPG, and systolic blood pressure and diastolic blood pressure. Serum visfatin levels were negatively associated with FI (r = ?0.80, p = 0.03) and positively associated with systolic and diastolic blood pressure (r = 0.77, p = 0.04, r = 0.79, p = 0.03, respectively) in the sub-group of PCOS women with abnormal glucose tolerance (AGT).

Conclusions.?Asian PCOS women had significantly higher serum visfatin levels than age-matched healthy controls. Their levels were significantly correlated with 2hPG and blood pressure in PCOS women, and with FI and blood pressure in PCOS women with AGT.     

Serum adiponectin is independently associated with the metabolic syndrome in Hong Kong,Chinese women with polycystic ovary syndrome

Objective: To evaluate the association of serum adiponectin level with the metabolic syndrome in Chinese women with polycystic ovary syndrome (PCOS).

Methods: This was a cross-sectional study carried out in Hong Kong Chinese women with PCOS at a university-affiliated tertiary hospital between January 2010 and January 2011. Clinical and biochemical parameters of the women were analysed. Prediction of the metabolic syndrome was determined by receiver–operator characteristic (ROC) curves, univariate and multivariate logistic regression analyses.

Results: A total of 116 women diagnosed to have PCOS were analysed. The area under the ROC curve of adiponectin for the prediction of metabolic syndrome was 0.820, 95% confidence interval (CI) 0.737–0.886. Univariate binary logistic regression showed that testosterone, sex hormone-binding globulin (SHBG), free androgen index (FAI), waist circumference, body mass index (BMI), quantitative insulin-sensitivity check index (QUICKI), homeostasis model assessment of insulin resistance (HOMA-IR) and adiponectin were significantly associated with the metabolic syndrome. On multivariate logistic regression analysis, adiponectin (p?= 0.020), HOMA-IR, age (p?= 0.011) and BMI (p?= 0.019) were independently associated with the metabolic syndrome, but not FAI (p?= 0.256).

Conclusions: Serum adiponectin is independently associated with the metabolic syndrome in Chinese women with PCOS. Further longitudinal follow-up studies are needed to determine whether serum adiponectin adds to the prediction of long-term cardiometabolic morbidity conferred by age, BMI and measures of insulin resistance.     

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.     

Effect of IGF-I and TNF-α on intensification of steroid pathways in women with PCOS phenotypes are not identical. Enhancement of progesterone pathway in women with PCOS increases the concentration of TNF-α

Objective: The aim of this study was to determine the correlations between the concentration of tumor necrosis factor (TNF-α) and insulin-like growth factor I (IGF-I) in each woman with polycystic ovary syndrome (PCOS) phenotypes based on the levels of androgen.

Methods: Two groups of women with PCOS differing in their levels of androgens. The test group composed of 39 women with PCOS according to the Rotterdam criteria in their reproductive age. The hormonal levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), thyroid stimulating hormone (TSH), prolactin (PRL), androstenedione, testosterone (T), estradiol (E₂) and sex hormone binding globulin (SHBG) were measured. Correlations analysis were performed calculating Spearman’s rank correlation coefficient of hormones with relation to TNF-α and IGF-I.

Results: There was a medium positive correlation of IGF-1 with LH levels (p?<?0.05) and negative medium correlation of TNF-α with of dehydroepiandrosterone (DHEA)-SO₄ levels (p?<?0.05) only in group of PCOS women with elevated androgens.

Conclusion: Analysis of TNF-α showed that women with high testosterone negative correlation between level of TNF-α and the concentration of DHEA-SO4. Inflammatory state involving TNF-α in women with PCOS and high concentration of androgens is caused by intensified Δ4 (progesterone) pathway and omitted or limited Δ5 (dehydroepiandrosterone) pathway of testosterone biosynthesis.     

The influence of other than prolactin hormones on bone mineral density in women with hyperprolactinaemia of various origins

Objective.?Hyperprolactinaemia may lead to bone loss, both due to hypogonadism and other hormonal disturbances. Aim of the case–control study was the analysis of influences of hormonal profiles associated with hyperprolactinaemia on the bone mineral density (BMD) in women with hyperprolactinaemia of various origin.

Material and methods.?The subjects were 32 patients with prolactinoma, 43 ones with functional hyperprolactinaemia and 29 healthy controls. All of them were studied for BMD (lumbar spine, proximal femur, forearm, total body) by dual-energy X-ray absorptiometry and their correlations with hormones levels (prolactin, oestradiol, luteinising hormone, follicle stimulating hormone, sex hormone binding globulin (SHBG), testosterone, dehydroepiandrosterone sulphate (DHEA-S), insulin-like growth factor-1 and intact parathyroid hormone) using Spearman correlation analysis and multiple regression analysis model.

Results.?Correlation analysis revealed the anabolic influence of PTH on lumbar spine in women with prolactinoma, and on ultradistal radius in functional hyperprolactinaemia. In multiple regression analysis, oestradiol had greatest influence on lumbar spine and total body BMD. Moreover, positive influence of testosterone, SHBG on spine BMD, and of oestradiol, testosterone, SHBG and DHEA-S on total body BMD were observed in patients with prolactinoma.

Conclusion.?Hormonal disturbances associated with hyperprolactinaemia influence BMD more in patients with prolactinoma than in ones with functional hyperprolactinaemia.     

Testosterone is associated with insulin resistance index independently of adiposity in women with polycystic ovary syndrome

Objective: To study the associations between androgens, glucose homeostasis, inflammation and statin treatment in women with polycystic ovary syndrome (PCOS).

Design and methods: Oral glucose tolerance tests, androgens, hs-CRP and interleukin-1 receptor antagonist (IL-1Ra) were analyzed at baseline and after 6?months of atorvastatin (20?mg/d) or placebo treatment in 27 women with PCOS.

Results: Testosterone associated with insulin resistance measured with ISI_Matsuda independently of BMI, age and SHBG concentrations and the full model, including IL-1Ra, hs-CRP and HDL-C, also showed independency of BMI and waist circumference (p?≤?.042). Free androgen index (FAI) associated with ISI_Matsuda independently of adiposity (p?≤?.025) but in the full model with waist circumference the association was insignificant. ISI_Matsuda decreased with testosterone >1.2?nmol/l compared with lower levels at baseline (p?=?.043) and at six months (p?=?.003). Accordingly, 30-minute insulin levels were increased with moderately elevated testosterone independently of adiposity (p?≤?.046). Increased fasting glucose and AUC insulin associated with statin treatment independently of adiposity and the associations attenuated after adjusting for testosterone.

Conclusions: Moderately elevated testosterone concentrations together with obesity-related inflammatory factors modify glucose homeostasis by increasing insulin resistance and early insulin secretion.     

Determinants of low bone mineral density in premenopausal polycystic ovary syndrome patients

Objective: The aim of this study was to evaluate the bone mineral density (BMD) values and to determine the associations between BMD and insulin sensitivity, hyperandrogenemia, body mass index (BMI), and sex hormones in premenopausal polycystic ovary syndrome (PCOS) patients.

Methods: A hundred and three women with PCOS and sixty age- and BMI-matched healthy control women were enrolled to this cross-sectional study. Serum androgen and estradiol (E2) levels were measured. Homeostasis model assessment of insulin resistance (HOMA-IR) and MATSUDA insulin sensitivity index (ISI) were calculated. BMD was measured with a dual X-ray absorptiometer.

Results: Lumbar BMD (LBMD) and femoral neck BMD (FnBMD) values were significantly lower in PCOS group than controls [(p?p?p?p?r?=?0.617; p?r?=??0.665; p?r?=?0.488; p?r?=?0.436; p?r?=?0.337; p?Conclusions: Despite the positive effects of hyperandrogenemia and hyperinsulinemia, PCOS patients have lower bone mineral density due to hypoestrogenism. Insulin resistance, BMI, estrogen, and androgen levels are the determinants of BMD in PCOS.