scholarly journals Ultrasonographic and biochemical assessments as early prediction of polycystic ovarian syndrome in obese women

2020 ◽  
Vol 20 (2) ◽  
pp. 676-681
Author(s):  
Alaa A Ahmed ◽  
Said S Moselhy ◽  
Taha A Kumosani ◽  
Etimad A Huwait ◽  
Maryam A AL-Ghamdi ◽  
...  
Keyword(s):  
Biochemical Markers ◽  
Polycystic Ovary ◽  
Glycosylated Hemoglobin ◽  
Clinical Signs ◽  
Free Testosterone ◽  
Early Prediction ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Ovarian Morphology ◽  
Ovarian Syndrome

Backgroud: Polycystic ovary syndrome (PCOS) is considered as a common cause of hormonal disturbance and obesity. The diagnosis of PCOS was done by different methods including clinical signs as anovulation, hyperandrogenism, biochem- ical markers and ultrasounographic investigation. This study investigated comparative outcomes of ultrasonographic and biochemical markers for early prediction of PCOS in obese women. Subjects and methods: Seventy-five patients were clinically diagnosed with obese, PCOS and obese with PCOS and twen- ty-five normal age matched subjects were enrolled as control. Abdominal and transvaginal ultrasonographic for assessment of ovarian properties. In addition, BMI, serum free testosterone, dehydroepiandrosterone (DHEA), insulin, glycosylated hemoglobin (HbA1c) and LDL-c levels were evaluated. Results: In obese patients with PCOs (20%) ovaries revealed normal appearance in morphology while the rest (80%) showed PCOs in the form of cysts of 2–8 mm in diameter peripherally arranged around stroma. A significant elevation of free testosterone, DHEA and insulin in obese with or without PCOS compared with obese group (p<0.001). A positive correlation with hormonal abnormalities of increased HA1c, LDL-c, free testosterone, DHEA and insulin compared with obese only. Conclusion: According to our study findings, ovarian morphology combined with biochemical markers is more reliable for early prediction and diagnosis of PCOS for interpretation and management. Keywords: PCOS; ultrasound; diagnosis; hormones.

scholarly journals Hyperandrogenism in polycystic ovarian syndrome and role of CYP gene variants: a review

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Sairish Ashraf ◽  
Mudasar Nabi ◽  
Shayaq ul Abeer Rasool ◽  
Fouzia Rashid ◽  
Shajrul Amin
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovary ◽  
Follicular Development ◽  
Pulse Frequency ◽  
Ovary Syndrome ◽  
Ovarian Morphology ◽  
Genetic And Environmental Factors ◽  
Hallmark Feature ◽  
Ovarian Syndrome

Abstract Background Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder characterized by anovulation, hyperandrogenism, and polycystic ovarian morphology. The pathophysiology of PCOS is not clear; however, disturbance in hypothalamic-pituitary-ovarian axis and abnormal steroidogenesis along with genetic and environmental factors act as main contributors to this disorder. Main text Hyperandrogenism, the hallmark feature of PCOS, is clinically manifested as hirsutism, acne, and alopecia. Excessive androgen production by ovaries as well as from adrenals contributes to hyperandrogenism. Abnormalities in the neuroendocrine system like increased pulse frequency of gonadotropin-releasing hormone, stimulating the pituitary for excessive production of luteinizing hormone than that of follicle-stimulating hormone is seen in PCOS women. Excess LH stimulates ovarian androgen production, whereas a relative deficit in FSH impairs follicular development. The imbalance in LH: FSH causes proliferation of ovarian theca cells leading to increased steroidogenesis, and ultimately leading to hyperandrogenism in PCOS women. Various genetic factors have been shown to be associated with abnormal steroidogenesis. CYP genes involved in steroidogenesis play an important role in androgen production and are considered as key players in hyperandrogenism in PCOS. Conclusion Polymorphisms in CYP genes can aggravate the hyperandrogenic phenotype in women with PCOS by either upregulating or downregulating their expression, thus increasing androgens further. However, this hypothesis needs to be validated by further studies.

scholarly journals Metastatin as a Marker for Hyperandrogenemia in Iraqi Women with Polycystic Ovary Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Manal Madany Abdalqader ◽  
Shatha Sami Hussein
Keyword(s):  
Roc Analysis ◽  
Polycystic Ovarian Syndrome ◽  
Case Control Study ◽  
Polycystic Ovary ◽  
Free Testosterone ◽  
Ovary Syndrome ◽  
Significant Difference ◽  
Iraqi Women ◽  
Ovarian Syndrome ◽  
Control Study

Objective. Kisspeptin 1 might reflect increased androgen level in polycystic ovarian syndrome instead of other markers. Study Design. A case control study was performed in Al-Yarmouk Teaching Hospital from 1st of July 2016 to 1st of July 2017; it involved 87 women divided into two groups: 44 women diagnosed as PCOS, 22 women with BMI ≥ 25 kg/m2 and 22 women with BMI < 25 kg/m2, and another 43 women without PCOS, 22 women with BMI ≥ 25 kg/m2 and 21 women with BMI < 25 kg/m2. Hormonal, metabolic profiles, and hirsutism scores, as well as serum kisspeptin level, were assessed by using Human Kisspeptin 1(KISS-1) ELISA Kit. The blood samples between days 2 and 5 of menstrual cycle were drawn by an disposable sterile syringe and collected in EDTA containing tubes (as anticoagulant), and the hormonal profile was measured using a biotech ELISA reader. Result. Serum level of kisspeptin was significantly higher in PCOS compared to control (322.4 vs. 235.3 ng/L, respectively). There was no significant difference in age, BMI, and parity between control and PCOS; the frequency of hirsutism, acne, elevated LH, and increased free testosterone (fTT) were significantly higher in PCOS compared to control. Kisspeptin shows a direct significant correlation with hirsutism and fTT (r = 0.648, 0.238, respectively). In ROC analysis, kisspeptin had AUC (95% CI) = 0.874 (0.785–0.935) for predicting PCOS. Conclusion. Kisspeptin levels might be used as a marker for hyperandrogenemia in polycystic ovarian syndrome.

Variation in Ovarian Morphology and Biochemical Markers of Hyperandrogenism in Adolescents with Polycystic Ovary Syndrome

2009 ◽  
Vol 22 (2) ◽  
pp. e19
Author(s):  
Beth W. Rackow ◽  
Amanda N. Carlson ◽  
Elvira J. Duran ◽  
Rachel Goldberg-Gell ◽  
Tania S. Burgert
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Biochemical Markers ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Ovarian Morphology

Molecular diagnosis of polycystic ovary syndrome in obese and non-obese women by targeted plasma miRNA profiling

2021 ◽  
Vol 185 (5) ◽  
pp. 637-652
Author(s):  
Antonio Romero-Ruiz ◽  
Beatriz Pineda ◽  
David Ovelleiro ◽  
Cecilia Perdices-Lopez ◽  
Encarnación Torres ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Decision Tree ◽  
Molecular Diagnosis ◽  
Polycystic Ovary ◽  
Geometric Mean ◽  
Clinical Signs ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Mirna Profiling ◽  
Plasma Mirna

Objective Polycystic ovary syndrome (PCOS) is diagnosed based on the clinical signs, but its presentation is heterogeneous and potentially confounded by concurrent conditions, such as obesity and insulin resistance. miRNA have recently emerged as putative pathophysiological and diagnostic factors in PCOS. However, no reliable miRNA-based method for molecular diagnosis of PCOS has been reported. The aim of this study was to develop a tool for accurate diagnosis of PCOS by targeted miRNA profiling of plasma samples, defined on the basis of unbiased biomarker-finding analyses and biostatistical tools. Methods A case–control PCOS cohort was cross-sectionally studied, including 170 women classified into four groups: non-PCOS/lean, non-PCOS/obese, PCOS/lean, and PCOS/obese women. High-throughput miRNA analyses were performed in plasma, using NanoString technology and a 800 human miRNA panel, followed by targeted quantitative real-timePCR validation. Statistics were applied to define optimal normalization methods, identify deregulated biomarker miRNAs, and build classification algorithms, considering PCOS and obesity as major categories. Results The geometric mean of circulating hsa-miR-103a-3p, hsa-miR-125a-5p, and hsa-miR-1976, selected among 125 unchanged miRNAs, was defined as optimal reference for internal normalization (named mR3-method). Ten miRNAs were identified and validated after mR3-normalization as differentially expressed across the groups. Multinomial least absolute shrinkage and selection operator regression and decision-tree models were built to reliably discriminate PCOS vs non-PCOS, either in obese or non-obese women, using subsets of these miRNAs as performers. Conclusions We define herein a robust method for molecular classification of PCOS based on unbiased identification of miRNA biomarkers and decision-tree protocols. This method allows not only reliable diagnosis of non-obese women with PCOS but also discrimination between PCOS and obesity. Capsule We define a novel protocol, based on plasma miRNA profiling, for molecular diagnosis of PCOS. This tool not only allows proper discrimination of the condition in non-obese women but also permits distinction between PCOS and obesity, which often display overlapping clinical presentations.

scholarly journals A comparative study of combination of Myo-inositol and D-chiro-inositol versus Metformin in the management of polycystic ovary syndrome in obese women with infertility

2019 ◽  
Vol 8 (3) ◽  
pp. 825
Author(s):  
Sujana Thalamati
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Comparative Study ◽  
Polycystic Ovary ◽  
Free Testosterone ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Serum Lh ◽  
Symptom Complex ◽  
Group B

Background: Polycystic ovary syndrome (PCOS) is a symptom complex associated with increased amounts of circulating androgens in females, increased insulin resistance and obesity. The drugs, Myo-inositol, D-chiro-inositol and Metformin, which are insulin sensitizers, are very helpful in taking care of one of the key components of PCOS that is insulin resistance. This study was done to compare the effects of combination of Myo-inositol and D-chiro-inositol with the use of metformin on clinical and biochemical profile in PCOS.Methods: A prospective, randomized, comparative study was conducted on 200 patients. The patients were randomly assigned into the two groups of 100 each. Group A receiving Tab. Myoinositol 550mg twice daily and Tab. D-chiro-inositol 13.8mg twice daily and Group B receiving Tab. Metformin 500mg thrice daily. The patients were assessed by menstrual cycle regulation, hirsutism score (Ferriman Gallwey), fasting and post prandial glucose and insulin levels, serum DHEA levels, serum free testosterone levels and fasting day 3 serum LH and FSH ratio.Results: In both the groups there was significant improvement in all the above mentioned parameters, however the group with Combination of Myo-inositol and D-chiro-inositol had statistically significant improvement over the Metformin group.Conclusions: Combination of Myo-inositol and D-chiro-inositol and use of metformin, significantly improved insulin sensitivity in PCOS women. But combination of Myo-inositol and D-chiro-inositol was effective in controlling the hormonal profiles (LH/FSH ration and free testosterone) when compared to Metformin.

scholarly journals Lower insulin sensitivity differentiates hirsute from non-hirsute Sicilian women with polycystic ovary syndrome

2006 ◽  
Vol 155 (6) ◽  
pp. 859-865 ◽  
Author(s):  
Marco C Amato ◽  
Aldo Galluzzo ◽  
Simona Merlino ◽  
Antonina Mattina ◽  
Pierina Richiusa ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Insulin Sensitivity ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Free Testosterone ◽  
Total Testosterone ◽  
Obese Women ◽  
Ovary Syndrome ◽  
The Metabolic Syndrome ◽  
Matsuda Index

Objective: It is well known that hyperandrogenism and insulin-resistance with or without compensatory hyperinsulinism are closely associated, but the Rotterdam Consensus has concluded that principally obese women with polycystic ovary syndrome (PCOS) should be evaluated for the metabolic syndrome. Our aim was to study insulin sensitivity in PCOS women with hirsutism regardless of obesity. Methods: Clinical characteristics, sex hormones and fasting- and after OGTT-glycemia and insulinemia, homeostatic model of insulin resistance (HOMA IR), and Matsuda index of insulin sensitivity were analyzed in 130 women with PCOS. Hirsutism has been evaluated through the Ferriman–Gallwey (FG) map scoring system. Results: PCOS women with hirsutism (57.7% of participants) showed significant higher values of total testosterone levels (P = 0.016), free testosterone (P = 0.027), DHEA sulfate (P = 0.017), and Δ4androstenedione (P = 0.018). They had similar body mass index (BMI) (P = 0.073) and were significantly less insulin sensitive (P = 0.002) than those without hirsutism (42.3% of participants). In women with PCOS and hirsutism, there was a significant correlation between FG score and insulin-sensitivity indexes (HOMA IR, ρ = 0.33, P = 0.005; Matsuda index, ρ = −0.34, P = 0.003) but not with the androgen levels. Moreover, women with hirsutism showed a significantly greater insulin (P = 0.019), C-peptide (P = 0.002), and glucose (P = 0.024) areas under the curve (auc2h). Conclusions: Our study suggests that the increased responsiveness of the pilo-sebaceous unit to androgens seems to be influenced by insulin sensitivity and that insulin resistance should be assessed in all hirsute women with PCOS regardless of their BMI, as insulin resistance was found in hirsute women irrespective of whether they were overweight or obese.

scholarly journals Ovarian aromatase activity in polycystic ovarian syndrome

2014 ◽  
Vol 63 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Igor Pavlovich Nikolayenkov ◽  
Vladimir Vsevolodovich Potin ◽  
Marina Anatolyevna Tarasova ◽  
Natalya Nikolayevna Tkachenko ◽  
Maria Igorevna Yarmolinskaya ◽  
...  
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovary ◽  
Free Testosterone ◽  
Antral Follicle ◽  
Reproductive Age ◽  
Blood Levels ◽  
Aromatase Activity ◽  
Ovary Syndrome ◽  
Antral Follicles ◽  
Ovarian Syndrome

41 women with polycystic ovary syndrome (PCOS) and 15 healthy women of reproductive age were examined to evaluate ovarian aromatase activity. Aromatase activity was determined by the decrease of estradiol level after peroral intake of aromatase inhibitor letrosol. To examine aromatase activity of antral follicle (∆E2) was divided on the blood level of antimullerian hormone (AMH), which is corresponded to the number of antral follicles. Significant variations of aromatase activity of antral follicles in patients with PCOS were determined: in 34.1 % of women it was within physiological ranges, in 48.8 % of women it was decreased and in 17.1 % of women it was increased. Aromatase activity of antral follicles in patients with PCOS correlated with blood levels of estradiol (r = 0.67), estron (r = 0.27), free testosterone(r = 0.43), androstendion (r = 0.34) and body mass index (r = 0.30). Aromatase activity had reverse correlation with number of antral follicles. Athors suggest that the sensitivity of the ovaries to gonadotropinic stimulation is decreased in patients with PCOS and low aromatase activity.

scholarly journals Influence of spironolactone treatment on endothelial function in non-obese women with polycystic ovary syndrome

2011 ◽  
Vol 164 (3) ◽  
pp. 389-395 ◽  
Author(s):  
Katica Bajuk Studen ◽  
Miran Šebeštjen ◽  
Marija Pfeifer ◽  
Janez Preželj
Keyword(s):  
Endothelial Dysfunction ◽  
Polycystic Ovary Syndrome ◽  
Endothelial Function ◽  
Polycystic Ovary ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Free Testosterone ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Increased Risk

ObjectiveAccumulating evidence connects polycystic ovary syndrome (PCOS) with increased risk of cardiovascular disease. Endothelial dysfunction is present in PCOS and represents an early, reversible marker of cardiovascular damage. As androgens and renin–angiotensin–aldosterone system are implicated in the atherogenesis process of PCOS, we tested the hypothesis that treatment with spironolactone, an androgen and mineralocorticoid receptor blocking drug, might reverse endothelial dysfunction in PCOS.PatientsA total of 30 non-obese PCOS patients, compared with 20 body mass index matched control subjects, were evaluated. PCOS patients were given spironolactone 100 mg daily in 21-day long intervals followed by a 7-day pause, for 6 months.MeasurementsFlow-mediated dilatation (FMD), glyceryl trinitrate-induced dilatation, free testosterone, androstenedione, DHEA-sulfate, total, low-density lipoprotein (LDL)-, high-density lipoprotein-cholesterol, and triglycerides were determined at baseline and after 6 months.ResultsResults are expressed as median (25–75th percentile). At baseline, FMD was significantly lower in PCOS patients than in controls: 6.0 (0.0–11.7) vs 10.2 (6.8–15.9) %, P=0.018. This difference disappeared after 6 months of spironolactone treatment, as FMD in PCOS patients significantly increased to 8.3 (5.7–10.3) %, P=0.034, and was no longer different from controls. In PCOS patients, serum androgen levels did not change during treatment, while total and LDL-cholesterol decreased significantly from 4.8 (4.1–5.1) mmol/l to 4.4 (3.9–4.8) mmol/l and from 2.5 (2.1–3.1) to 2.2. (2.1–2.5) mmol/l, P<0.05 and P<0.05 respectively.ConclusionTreatment with spironolactone normalized endothelial function and improved cholesterol levels in non-obese PCOS patients.

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