Failure of the homeostatic model assessment calculation score for detecting metabolic deterioration in young patients with polycystic ovary syndrome

2006 ◽  
Vol 86 (2) ◽  
pp. 398-404 ◽  
Author(s):  
Anna Maria Fulghesu ◽  
Stefano Angioni ◽  
Elaine Portoghese ◽  
Francesca Milano ◽  
Barbara Batetta ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Young Patients ◽  
Model Assessment ◽  
Ovary Syndrome ◽  
Homeostatic Model Assessment ◽  
Homeostatic Model

scholarly journals Evaluation of different biochemical markers in prediction of metabolic syndrome in polycystic ovary syndrome patients

2017 ◽  
Vol 6 (7) ◽  
pp. 2734
Author(s):  
Ahmed M. Radwan ◽  
Mohamed A. Youssry ◽  
Hossam M. El-saadany ◽  
Tabark Ahmed Patel
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Polycystic Ovary Syndrome ◽  
Biochemical Markers ◽  
Polycystic Ovary ◽  
Model Assessment ◽  
Biochemical Tests ◽  
Ovary Syndrome ◽  
Tissue Factors ◽  
Homeostatic Model Assessment

Background: Polycystic ovary syndrome (PCOS) is the commonest cause of chronic hyperandrogenic anovulation. Insulin resistance and compensatory hyperinsulinemia are keys of the pathogenesis of PCOS. It is also considered as a metabolic disorder. Since the components of metabolic syndrome (MBS) namely obesity, glucose intolerance, dyslipidemia, and hypertension are the common features of this syndrome. The association between MBS and PCOS can be explained by different theories as insulin resistance, obesity, and related adipose tissue factors (adipocytokines) independent of insulin resistance are the main pathogenic contributors to both disorders.Methods: A total of 143 women with PCOS were recruited as study subjects. All participants were subjected to anthropometric measurements, clinical assessment, and biochemical tests [fasting glucose, fasting insulin, and homeostatic model assessment-insulin resistance (HOMA-IR)]. Hormonal profile particularly leptin and homocysteine levels were also evaluated.Results: 25 patients (17.4%) out of 143 women with PCOS met the criteria for MBS. Patients with MBS had significantly higher body mass index, blood pressure, HOMA-IR, leptin, and homocysteine levels compared to PCOS only patients. When HOMA-IR cut off was ≥4.3 sensitivity and specificity were 90%, 88.6%, but when leptin level was ≥34.5 the corresponding statistics were 79.6%, 75.5%.Conclusions: Serum leptin, homocysteine, HOMA-IR as well as other biochemical markers are significantly higher in women with PCOS and MBS compared to PCOS only women. PCOS is associated with various factors like insulin resistance, obesity, and dyslipidemia. Consequently, adipocytokines and HOMA-IR play important role in the prediction of MBS in patients with PCOS.

scholarly journals Polycystic ovary syndrome: implications of metabolic dysfunction

2014 ◽  
Vol 41 (2) ◽  
pp. 106-110
Author(s):  
Márcio Augusto Pinto de Ávila ◽  
Ricardo Vasconcellos Bruno ◽  
Fábio Cuiabano Barbosa ◽  
Felipe Cupertino de Andrade ◽  
Adriana Cardoso de Oliveira e Silva ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
The State ◽  
Model Assessment ◽  
Metabolic Dysfunction ◽  
Ovary Syndrome ◽  
Cross Sectional ◽  
Homeostatic Model Assessment ◽  
Routine Inspection

OBJECTIVE: To determine the prevalence of metabolic syndrome (MS) and its clinical interrelations in polycystic ovary syndrome (PCOS).METHODS: This was a cross-sectional, prospective study with 100 patients with diagnosed PCOS based on the consensus of Rotterdam (2003). We investigated the interrelationships of MS, with intrinsic PCOS data. Dermatological profile was analyzed, in addition to acanthosis nigricans (AN) in the presence of hirsutism and acne. The use of HOMA-IR (homeostatic model assessment of insulin resistance) aimed at the correlation with MS in order to establish the metabolic dysfunction with the state of insulin resistance.RESULTS: The mean and standard deviations corresponding figures for age, body mass index and waist circumference were, respectively, 25.72 (± 4.87), 30.63 (± 9.31) and 92.09 (± 18.73). The prevalence of MS was 36% and significantly correlated with BMI, AN, and in 51% of patients the state of insulin resistance (HOMA-IR). Regarding skin profile, only AN significant correlation with MS.CONCLUSION: We propose the routine inspection of metabolic components related to severe PCOS. These parameters configure the cardiovascular risk and such conduct is of undoubted importance to public health.

Effects of an EE/CA compared with EE/CA-metformin on serum ADMA levels in women with polycystic ovary syndrome

Open Medicine ◽  
2009 ◽  
Vol 4 (4) ◽  
pp. 423-427 ◽  
Author(s):  
Levent Kebapcilar ◽  
Arif Yuksel ◽  
Giray Bozkaya ◽  
Cuneyt Taner ◽  
Ayse Kebapcilar ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Hdl Cholesterol ◽  
Model Assessment ◽  
Ovary Syndrome ◽  
Treatment Groups ◽  
Cholesterol Levels ◽  
Metformin Group ◽  
Homeostatic Model Assessment ◽  
Pre Treatment

AbstractTo determine the effects of EE/CA (Ethinylestradiol/ Cyproterone Acetate) and EE/CA-metformin treatments on the asymmetric dimethylarginine (ADMA) levels in women with PCOS (Polycystic Ovary Syndrome). Among 43 patients diagnosed with PCOS, one study arm (n=22) was administered (35 µg EE, 2mg CA) and the other (n=21) was administered (35 µg EE, 2mg CA plus 1700mg metformin). Serum ADMA, lipid profile, androgens, insulin, and HOMA-IR (Homeostatic Model Assessment of Insulin Resistance ) values were assessed prior to treatment and after 3 months of therapy. A significant reduction in ADMA levels relative to pre-treatment in the EE/CA+metformin group (1.2±0.4 vs 0.95±0.4, p=0.016) compared to the EE/CA group (1.0±0.5 vs 1.03±0.4, p >0.05). Andogens, insulin and HOMA-IR levels decreased in both treatment groups. All lipid profiles significantly improved in-group EE/CA+metformin while no significant decrease was observed in TG and HDL-cholesterol levels in EE/CA group. Post-treatment levels of HDL-C levels correlated significantly with the reducing ADMA levels in the EE/CA+metformin group (P=0.005, r= 0.602). Adding metformin to EE/CA therapy in PCOS may beneficial endothelium effects associated with reduction of ADMA levels.

scholarly journals Predicting Menstrual Recovery After Laparoscopic Sleeve Gastrectomy in Polycystic Ovary Syndrome Women With Obesity

2021 ◽  
Author(s):  
Meili Cai ◽  
Yuqin Zhang ◽  
Jingyang Gao ◽  
Diliqingna Dilimulati ◽  
Ziwei Lin ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Polycystic Ovary Syndrome ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Polycystic Ovary ◽  
Preoperative Evaluation ◽  
Total Testosterone ◽  
Model Assessment ◽  
Ovary Syndrome ◽  
Homeostatic Model Assessment

Abstract Objectives: To investigate the recovery of menses in polycystic ovary syndrome (PCOS) women with obesity after laparoscopic sleeve gastrectomy (LSG), and to explore the predictors for menstrual recovery. Methods: A total of 88 PCOS patients with obesity and 76 control patients with obesity aged 18-45 years were enrolled between May 2013 and December 2020. Preoperative clinical characteristics, metabolic parameters and sex hormones were collected. Postoperative menstrual status, body weight and use of oral contraceptives were obtained through telephone follow-up. Results: Patients with PCOS were followed up for at least six months after surgery, and the mean follow-up time was 3.23 years. About 24.66% of patients with PCOS started their first menstruation after LSG within 7 days, and 79.52% patients had regular menstruation at six months after LSG. In logistic regression analyses, duration of PCOS ≤4.5 years (P=0.007), number of preoperative menstruation per year >4.0 times/year (P=0.045), homeostatic model assessment of insulin resistance (HOMA-IR) ≤7.3 (P=0.020) and total testosterone (TT) ≤1.5 nmol/L (P=0.029) at baseline were significantly associated with menstrual resumption in PCOS patients within 6 months after LSG. After adjusting confounders, combination of four clinical indices at baseline could effectively predict menstrual recovery in PCOS patients within 6 months after LSG (AUC=0.837, [95%CI: 0.735-0.939], P<0.001). Conclusion: Overall, the combination of PCOS duration, menstruations per year, HOMA-IR and TT at baseline could be used as an effective tool for the prediction of menstrual recovery in PCOS patients within 6 months after LSG, which can be applied in preoperative evaluation.

scholarly journals Effects of probiotic and synbiotic supplementation on insulin resistance in women with polycystic ovary syndrome: a meta-analysis

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110317
Author(s):  
Chenyun Miao ◽  
Qingge Guo ◽  
Xiaojie Fang ◽  
Yun Chen ◽  
Ying Zhao ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Confidence Interval ◽  
Polycystic Ovary ◽  
Serum Insulin ◽  
Meta Analysis ◽  
Mean Difference ◽  
Model Assessment ◽  
Ovary Syndrome ◽  
Synbiotic Supplementation

Objective This meta-analysis evaluated the effect of probiotics and synbiotics on insulin resistance in patients with polycystic ovary syndrome (PCOS). Methods A systematic search was performed to identify all relevant publications listed on the electronic databases (PubMed®, Web of Science, Embase® and China National Knowledge Infrastructure) between inception and 30 October 2020. All statistical analyses were performed on randomized controlled trials (RCTs) using RevMan version 5.3 software provided by the Cochrane Collaboration. Results A total of 486 patients from seven RCTs were included in the meta-analysis. Probiotic and synbiotic supplementation appeared to improve levels of homeostatic model assessment of insulin resistance (mean difference = –0.37; 95% confidence interval –0.69, –0.05) and serum insulin (standardized mean difference = –0.66; 95% confidence interval –1.19, –0.12). The results failed to show any influence of probiotic and synbiotic supplementation on body mass index, waist circumference, hip circumference and fasting blood sugar. Conclusions Probiotics and synbiotics appear to have a partially beneficial effect on indices of insulin resistance in patients with PCOS.

scholarly journals Comparison of various adiposity indexes in women with polycystic ovary syndrome and normo-ovulatory non-hirsute women: a population-based study

2014 ◽  
Vol 171 (2) ◽  
pp. 199-207 ◽  
Author(s):  
Fahimeh Ramezani Tehrani ◽  
Sonia Minooee ◽  
Fereidoun Azizi
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Normal Control ◽  
Polycystic Ovary ◽  
Population Based ◽  
Visceral Adiposity Index ◽  
Model Assessment ◽  
Ovary Syndrome ◽  
Assessment Index ◽  
Control Subjects ◽  
Index Sensitivity

ObjectiveInsulin resistance (IR) and metabolic disorders are common in polycystic ovary syndrome (PCOS). However, it is still not clear which adiposity marker could precisely predict metabolic syndrome (MetS) in women with PCOS and whether these indexes are different in normo-ovulatory non-hirsute women.DesignA case–control study was conducted on a total of 175 Iranian subjects with PCOS and 525 normal control subjects, aged 18–45 years.MethodsWaist circumference (WC), BMI, waist-to-hip ratio, lipid accumulation product (LAP) index, and visceral adiposity index (VAI) were examined and the homeostasis model assessment index was calculated. MetS was defined according to the joint interim statement. The receiver operating characteristic curves were used to evaluate the extent to which measures of adiposity can predict IR and MetS risk.ResultsLAP index and VAI are two indicators (sensitivity and PPV of 70% (LAP index) and 60% (VAI), and 80% (LAP index) and 83% (VAI) respectively) that best predict IR in women with PCOS. Among healthy women, the LAP index and WC were better markers (sensitivity and PPV of 78% (LAP index) and 75% (VAI), and 82% (LAP index) and 81% (VAI) respectively). The two most reliable indicators for prediction of MetS among PCOS and normal women were the WC and VAI (sensitivity and PPV of 83% (WC) and 81% (VAI), and 97% (WC) and 95% (VAI) respectively) and the VAI and LAP index (sensitivity and PPV of 88% (VAI) and 83% (LAP index), and 98% (VAI) and 98% (LAP index) respectively) respectively.ConclusionsWhile the appropriate adiposity indicators and their optimum cutoff values vary in women with PCOS, compared with the normal control subjects, the LAP index is an easily obtainable index that might be useful for screening of cardiometabolic complications among both groups.

scholarly journals Serum Testosterone to Androstenedione Ratio Predicts Metabolic Health in Normal-Weight Polycystic Ovary Syndrome Women

2021 ◽  
Author(s):  
Daniel A Dumesic ◽  
Ayli Tulberg ◽  
Megan McNamara ◽  
Tristan R Grogan ◽  
David H Abbott ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Elevated Serum ◽  
Normal Weight ◽  
Model Assessment ◽  
Metabolic Function ◽  
Ovary Syndrome ◽  
Intravenous Glucose

Abstract Context Increased aldo-keto reductase 1C3 (AKR1C3)-mediated conversion of androstenedione (A4) to testosterone (T) promotes lipid storage in subcutaneous (SC) abdominal adipose in overweight/obese polycystic ovary syndrome (PCOS) women. Objective To examine whether an elevated serum T/A4 ratio, as a marker of enhanced AKR1C3 activity in SC abdominal adipose, predicts metabolic function in normal-weight PCOS women. Design Prospective cohort study. Setting Academic center. Patients Nineteen normal-weight PCOS women; 21 age- and body mass index-matched controls. Intervention(s) Circulating hormone/metabolic determinations, intravenous glucose tolerance testing, total body dual-energy x-ray absorptiometry, SC abdominal fat biopsy. Main Outcome Measure(s) Serum T/A4 ratios, hormone/metabolic measures and AKR1C3 expression of adipocytes matured in vitro were compared between female types; serum T/A4 ratios were correlated with serum lipids, adipose insulin resistance (adipose-IR), homeostatic model assessment of insulin resistance (HOMA-IR) and insulin sensitivity (Si). Results Increased serum T/A4 ratios (P=0.040) and log adipose-IR values (P=0.002) in PCOS women versus controls were accompanied by AKR1C3 mRNA overexpression of PCOS adipocytes matured in vitro (P=0.016). Serum T/A4 ratios in PCOS women, but not controls, negatively correlated with log triglycerides (TG: R=-0.65, P=0.002) and the TG index (R=-0.57, P=0.011). Adjusting for serum free T, serum T/A4 ratios in PCOS women remained negatively correlated with log TG (R=-0.57, P=0.013) and TG index (R=-0.50, P=0.036), respectively, without significant relationships with other metabolic measures. Conclusion An elevated serum T/A4 ratio, as a marker of enhanced AKR1C3 activity in SC abdominal adipose, predicts healthy metabolic function in normal-weight PCOS women.

scholarly journals Berberine Phospholipid Is an Effective Insulin Sensitizer and Improves Metabolic and Hormonal Disorders in Women with Polycystic Ovary Syndrome: A One-Group Pretest–Post-Test Explanatory Study

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3665
Author(s):  
Mariangela Rondanelli ◽  
Antonella Riva ◽  
Giovanna Petrangolini ◽  
Pietro Allegrini ◽  
Attilio Giacosa ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Sex Hormone ◽  
Model Assessment ◽  
Ovary Syndrome ◽  
Insulin Sensitizer ◽  
Tnf Α ◽  
Post Test ◽  
Liver And Kidney ◽  
Kidney Functions

Polycystic Ovary Syndrome (PCOS) is the most frequent endocrine disease in females of reproductive age and is characterized by multifactorial unhealthy conditions related to hormonal unbalance and also to dysmetabolism and inflammation. Recently, increasing evidence has shown that natural plant-based products may play a role in PCOS management. The aim of this one-group pretest–post-test explanatory study was to evaluate, in normal–overweight PCOS women with normal menses, the effectiveness of berberine on: Insulin resistance (IR) by Homeostasis Model Assessment (HOMA); Inflammation by C-Reactive Protein (CRP), Tumor Necrosis Factor α (TNF-α); Lipid metabolism; Sex hormone profile and symptoms correlated to hyperandrogenism, such as acne, by Global Acne Grading System (GAGS) and Cardiff Acne Disability Index (CADI); Body composition by DXA. Finally, adverse effects were assessed by liver and kidney functions and creatine phosphokinase (CPK). All these parameters were collected at baseline and 60 days after supplementation with a new bioavailable and safe berberine formulation. Twelve females (aged 26.6 ± 4.9, BMI 25.3 ± 3.6) were supplied for 60 days with two tablets/day (550 mg/table) of the bioavailable berberine. Results showed a statistically significant decrease in HOMA, CRP, TNF-α, Triglycerides, testosterone, Body Mass Index (BMI), Visceral Adipose Tissue (VAT), fat mass, GAGS and CADI scores, and a statistically significant increase in sex hormone-binding globulin (SHBG). Liver and kidney functions and CPK are not statistically significantly different. Therefore, berberine can represent a safe novel dietary supplement, helpful in treatment strategy for PCOS.

scholarly journals Endotrophin as a novel marker in PCOS and its relation with other adipokines and metabolic parameters: a pilot study

2021 ◽  
Vol 12 ◽  
pp. 204201882110496
Author(s):  
Gurhan Guney ◽  
Mine Islimye Taskin ◽  
Ozgur Baykan ◽  
Ertan Adali ◽  
Selin Gul Tezcan ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Density Lipoprotein ◽  
Resistance Index ◽  
Total Testosterone ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Ovary Syndrome ◽  
Significant Difference

Background: Polycystic ovary syndrome is known to be the most common hormonal disorder in women of reproductive age. Current evidence shows that regulatory proteins secreted from the adipose tissue called adipokines may have a role in polycystic ovary syndrome. We planned to investigate the role of endotrophin that has never been researched in polycystic ovary syndrome before and its correlation with other metabolic parameters and adipokines such as adiponectin and ghrelin in patients with polycystic ovary syndrome. Methods: Forty-three women ( n: 43) with polycystic ovary syndrome and 43 ( n: 43) women as a control group were enrolled in this cross-sectional study. Serum levels of endotrophin, adiponectin, and ghrelin levels were measured with the enzyme-linked immunosorbent assay method. High-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol levels, luteinizing hormone/follicle-stimulating hormone ratio, total testosterone, and triglyceride levels were measured. Homeostasis model assessment for insulin resistance index, body mass index, Ferriman Gallwey Score, and waist-to-hip ratio were also evaluated. Results: Total testosterone, homeostasis model assessment for insulin resistance, C-reactive protein, luteinizing hormone/follicle-stimulating hormone ratio, and triglyceride levels were higher in patients with polycystic ovary syndrome ( p < 0.01). No difference was detected between the groups in terms of body mass index, Ferriman Gallwey Score, waist-to-hip ratio, total cholesterol, low-density lipoprotein, and high-density lipoprotein levels ( p > 0.05). We did not observe any significant difference in adiponectin and ghrelin levels between the groups ( p > 0.05). Patients with polycystic ovary syndrome had significantly higher endotrophin levels ( p < 0.01). According to our regression analyses [area under the curve: 0.973 (0.935–1.000), 95% confidence interval, 95.2% sensitivity, and 100% specificity], it was shown that endotrophin greater than 92 ng/ml and homeostasis model assessment for insulin resistance greater than 2.5 might be good predictors for polycystic ovary syndrome diagnosis. Conclusion: We demonstrated that endotrophin level is higher in patients with polycystic ovary syndrome and may have predicted polycystic ovary syndrome with increased homeostasis model assessment for insulin resistance index. There was no significant difference in adiponectin and ghrelin levels in the polycystic ovary syndrome group. Endotrophin may have a role in polycystic ovary syndrome etiology rather than other adipokines.

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