The relationship between sex hormones, metabolic markers, and cognitive linguistic functions in women with PCOS.

Background/Objectives: Increased dehydroepiandrosterone sulfate (DHEAS) is used as a diagnostic marker of hyperandrogenism in women with polycystic ovary syndrome (PCOS). The mechanisms of adrenal hyperandrogenism in PCOS include hyperinsulinism as a potential stimulator, but results of studies associating insulinemia with DHEAS in PCOS are conflicting. The objective of this study was to evaluate the factors associated with DHEAS levels in PCOS, focusing on insulinemia. Methods: We performed a cross-sectional retrospective study in a total of 257 patients with PCOS (Rotterdam criteria) evaluated in our tertiary center of endocrinology. Clinical and biochemical parameters included body mass index (BMI), serum DHEAS, total testosterone and sex hormone-binding globulin (SHBG), insulin and glycaemia at fasting and 2 h during the oral glucose tolerance test (OGTT), and homeostasis model assessment for insulin resistance (HOMA-IR) was calculated. Results: The comparative analysis of PCOS divided into DHEAS tertiles revealed that patients in the upper tertile were younger (p < 0.05) and had higher 2 h insulin in the OGTT (p < 0.05) than the lower tertile, while fasting insulin and HOMA-IR were not different. DHEAS correlated negatively with age (r = -0.146, p < 0.05) and positively with 2 h insulinemia (r = 0.246, p < 0.001), while fasting insulin and HOMA-IR did not correlate with DHEAS in all PCOS. In stepwise linear regression models, 2 h insulin remained a positive independent predictor for DHEAS only in non-obese PCOS (p < 0.0001). Conclusions: Our data indicate a positive association between stimulated insulin and DHEAS in PCOS. Two-hour insulin in OGTT was an independent predictor of DHEAS in non-obese PCOS, suggesting that DHEAS might be a reliable marker for the stimulatory insulin effect on adrenal steroidogenesis in non-obese PCOS patients.

Objective To investigate the effect of sex hormone binding globulin (SHBG) and total testosterone (TT) on predicting insulin resistance (IR), reproductive endocrine hormones, carbohydrate and lipid changes in polycystic ovary syndrome (PCOS) patients. Methods Three hundred forty–four cases of PCOS and 100 cases of normal women cellected from June 2004 to May 2006 in the Obstetrics and Gynecology Hospital of Fudan University were included in the study, the mean age was (23±5) years, the levels of SHBG and TT in serum were compared between PCOS and normal control, the correlation between SHBG/TT and basal body index, waist to hip ratio, endocrine hormone, lipids and glucose profile were analyzed by Spearman correlation. The impact of age, ovarian volume, leuteinizing hormone(LH), follicle stimulating hormone(FSH), LH/FSH ratio, TT, SHBG, dehydroepiandrosterone–sulphate, prolactin and cortisol on IR were analyzed by Logistic regression. A receiver operating characteristic(ROC) curve between SHBG and IR were taken and acquired a cut–off point, difference between groups with higher/lower SHBG were compared. Results SHBG was lower in PCOS group than in normal control ((114±88) vs (201±106) mmol/L, t=–5.60, P<0.01) and TT was higher in PCOS than in normal control ((2.8±1.0) vs (1.7±0.6) nmol/L, t=7.73, P<0.01), the difference had significantly statistic mean. SHBG had an inverse correlation with fasting plasma insulin, insulin area under curve, glucose area under curve, homeostasis model assessment insulin resistance, triglycerides and waist–hipo ratio(r=–0.30, –0.26, –0.29, –0.19, –0.20, –0.29, –0.22, respectively, all P<0.01). Total testosterone had a positive correlation with fasting plasma insulin (r=0.14, P<0.01), all the point of insulin releasing test (1, 2, 3 h r=0.15, 0.12, 0.11, respectively, all P<0.05), the corresponding insulin area under curve(r=0.15, P<0.05)and homeostasis model assessment insulin resistance(r=0.11, P<0.05). Logistic regression demonstrated that SHBG was an independent predictor of IR(OR=3.741). A SHBG level of 88 mmol/L(95%CI: 0.668 to 0.774) was used as the cut–off point for predicting IR according to the ROC curve.Fasting plasma insulin, insulin area under curve, homeostasis model assessment insulin resistance, fasting plasma glucose, glucose area under curve were higher in patients with SHBG<88 mmol/L than those SHBG≥88 mmol/L(t=–6.45, –5.08, –6.19, –3.16, –3.66, respectively, all P<0.01), the same trend as triglycerides(t=–2.06, P<0.05). Conclusions TT in serum is higher in PCOS women while SHBG on the control. TT has a positive correlation and SHBG has a negative correlation with IR in PCOS. SHBG is perhaps the only independent risk factor to predict IR in PCOS women. Key words: Polycystic ovary syndrome; Sex hormone binding globulin; Insulin resistance; Total testosterone; Correlation

Dehydroepiandrosterone sulfate and insulin resistance in patients with polycystic ovary syndrome

Variation in metabolic and cardiovascular risk in women with different polycystic ovary syndrome phenotypes

Objective To investigate the differences in the metabolic indicators and sex hormones between obese and non-obese patients with polycystic ovary syndrome (PCOS), and their impacts on endometrial receptivity (ER). Methods We selected 255 individuals with PCOS, and categorized them into the obese groups, including the OP group (obese patients with PCOS) and the ON group (obese patients without PCOS), and selected 64 individuals who were categorized in the non-obese groups, namely, the control groups, which comprise the NP group (non-obese patients with PCOS) and the NN group(non-obese patients without PCOS). The one-way analysis of variance (ANOVA) and Mann-Whitney U tests were used to compare the metabolic indicators, and sex hormone-associated and ER-associated indicators between the groups. The correlation between the aforementioned clinical markers and ER was analyzed using the Pearson’s correlation coefficient. Results (1) In comparison with the NP group, the OP group exhibited higher levels (p < .01) of free androgen index (FAI), anti-müllerian hormone (AMH), fasting insulin (FINS), insulin level within 60 min, 120 min, and 180 min—60minINS, 120minINS, and 180minINS, respectively, fasting blood glucose (FBG), blood glucose level within two hours (2hGlu), homeostatic model assessment for insulin resistance (HOMA-IR), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), waist-to-hip ratio (WHR), waist circumference, hip circumference, the ratio of the maximum blood flow velocity of the uterine artery during systole to the blood flow velocity of the uterine artery at the end of diastole (uterine artery S/D), and blood flow resistance index (RI) of the uterine artery. In comparison with the NP group, the OP group exhibited lower levels (p < .01) of sex hormone binding globulin (SHBG), dehydroepiandrosterone (DHEA), high molecular weight adiponectin (HMWA), and high-density lipoprotein cholesterol (HDL-C). (2) In the PCOS group, RI was significantly positively correlated with FAI, FINS, 120minINS, HOMA-IR, and WHR (p < .01), and significantly negatively correlated with SHBG, HDL-C, and HMWA (p < .01); uterine artery S/D was significantly positively correlated with FAI, FINS, 2hGlu, HOMA-IR, LDL-C, and WHR (p < .01), significantly positively correlated with 120minINS and FBG (p < .05), and significantly negatively correlated with SHBG and HMWA (p < .01). Conclusion (1) The OP group exhibited obvious metabolic disorders and poor ER, which was manifested as low levels of SHBG and HMWA, and high levels of FAI, HOMA-IR, WHR, uterine artery S/D, and RI. (2) In patients with PCOS, there was a substantial correlation between ER-associated indicators RI and uterine artery S/D and FAI, FINS, 120minINS, HOMA-IR, WHR, SHBG, and HMWA.

BackgroundFeatures of metabolic syndrome such as abdominal obesity, insulin resistance, hypertension and dyslipidemia are commonly encountered in polycystic ovary syndrome (PCOS). Recent evidence has suggested an association between high serum uric acid/creatinine (UA/Cr) ratio and metabolic syndrome however, no studies have investigated this association in PCOS. The current study was conducted to investigate the relationship between UA/Cr ratio and PCOS and to identify whether UA/Cr ratio and free androgen index (FAI) have an additive interaction for detection of PCOS risk in obese women.MethodsThis study enrolled 40 obese women with PCOS and 40 control women with regular menstrual cycles matched for age and body mass index (BMI). Anthropometric measurements, fasting glucose, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), lipids profile, luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, dehydroepiandrosterone sulfate (DHEAS), sex hormone binding globulin (SHBG), total testosterone, free androgen index (FAI), UA/Cr ratio were assessed.ResultsSerum UA/Cr ratio was significantly higher in obese women with PCOS than in non-PCOS women. UA/Cr ratio was correlated with BMI, waist and neck circumferences, blood pressure, fasting insulin, HOMA-IR, lipids, LH/FSH, estradiol, DHEAS, total testosterone, FAI and SHBG. UA/Cr ratio and FAI were independent risk factors for PCOS in obese women however, the addictive interaction between UA/Cr ratio and FAI had a higher fold risk (OR: 4.3, 95% CI, 3.4–7.58) and a more significance (P = 0.002) for determination of PCOS.ConclusionSerum UA/Cr ratio combined with FAI can exert an additive or synergistic impact on prediction of PCOS in obese women.

Objective To evaluate the insulin resistance of patients with polycystic ovary syndrome (PCOS) by hyperinsulin-euglycemic clamp test, and to explore the characteristics of glycolipid metabolism and sex hormone levels in PCOS patients with insulin resistance. Methods Seventy-three patients with PCOS and 27 healthy women with body mass index and age matched with PCOS patients who were admitted to the Department of Endocrinology of Affiliated Hospital of Zunyi Medical University from July 2017 to February 2019 were underwent hyperinsulin-euglycemic clamp test. All subjects were grouped according to glucose metabolic rate, body mass index, and homeostasis model assessment for insulin resistance (HOMA-IR), the changes and differences of glucose and lipid metabolism and sex hormone indexes in PCOS patients were analyzed. Results In the PCOS group, impaired glucose regulation accounted for 3.23% (1/31), and abnormal lipid metabolism for 9.68% (3/31). In the PCOS with insulin resistance group, impaired glucose regulation accounted for 7.14% (3/42). Abnormal blood lipid metabolism reached 47.62% (20/42), and 5 patients were diagnosed with metabolic syndrome, accounting for 11.90%. Correlation analysis showed glucose metabolic rate and body mass index, waist-to-hip ratio, systolic blood pressure, fasting plasma glucose, fasting insulin, HOMA-IR, cortisol, triglyceride, total cholesterol, low density lipoprotein-cholesterol (LDL-C), free androgen index (FAI), and glutamyl transpeptidase (GGT) were negatively correlated(all P<0.05), while positively correlated with high density lipoprotein-cholesterol (HDL-C; P=0.028). HOMA-IR was positively correlated with body mass index, waist-to-hip ratio, systolic blood pressure, fasting plasma glucose, fasting insulin, HbA1C, LDL-C (P<0.05), and negatively correlated with glucose metabolic rate and HDL-C (P<0.05). Body mass index and waist-to-hip ratio, systolic blood pressure, fasting plasma glucose, fasting insulin, HOMA-IR, triglyceride, and LDL-C (P<0.05) were positively correlated, and negatively correlated with glucose metabolic rate, HDL-C, and sex hormone binding globulin (SHBG; P<0.01). Multivariate linear stepwise regression analysis showed that body mass index, total cholesterol, triglyceride, and cortisol were principal factors affecting glucose metabolic rate. Fasting plasma glucose, fasting insulin, and systolic blood pressure were important factors influencing HOMA-IR. Glucose metabolic rate, HOMA-IR, HDL-C, while SHBG were still vital to body mass index. Conclusion FAI, SHBG, and cortisol may be involved in the insulin resistance development of PCOS patients, and PCOS patients with insulin resistance were more susceptible to metabolic disorders. Key words: Polycysic ovarian syndrome; Insulin resistance; Hyperinsulin-euglycemic clamp; Glycolipid metabolism; Sex hormone

Objective: To investigate the correlation between body composition parameters, adiponectin, leptin and the adiponectin/leptin ratio and the LH/FSH ratio in women with polycystic ovary syndrome (PCOS).&#x0D; Methods: A cross-sectional study was conducted at Reproductive Cluster Yasmin, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia, with sixty women with PCOS and sixty healthy women as controls (matched for age and BMI). Body composition parameters, including body weight, body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), percent body fat (PBF), visceral fat area (VFA), percent subcutaneous fat (PSF) and skeletal muscle mass (SMM), were measured; levels of fasting glucose, fasting insulin, testosterone, and sex hormone binding globulin (SHBG) were measured; and homeostatic model assessment for insulin resistance (HOMA-IR) values, anti-Mullerian hormone (AMH), free androgen index (FAI), Ferriman-Gallwey (FG) score, adiponectin levels, leptin levels, adiponectin/leptin ratio, LH, FSH and LH/FSH ratio were measured.&#x0D; Results: Body composition parameters (body weight, BMI, WC, WHR, PBF, VFA, PSF, SMM) were not significantly different between women with PCOS and controls. Fasting insulin (P&lt;0.05), HOMA-IR (P&lt;0.05), AMH (P&lt;0.01), FAI (P&lt;0.01), FG score (P&lt;0.01) and LH/FSH ratio (P&lt;0.05) were higher in PCOS women. Adiponectin (P&lt;0.01) was lower in PCOS women, while leptin and the adiponectin/leptin ratio were not significantly different between groups. Most of body composition parameters, adiponectin, leptin and adiponectin/leptin ratio were correlated with HOMA-IR in both groups.&#x0D; SMM was positively correlated with the LH/FSH ratio, while body weight, BMI, WC, PBF, VFA, and PSF were inversely correlated with the LH/FSH ratio in PCOS patients but not in controls. WHR was not correlated in either group. Leptin (r=-0.278; P&lt;0.05) was negatively correlated with the LH/FSH ratio only in the PCOS group. Adiponectin (r=0.394; P&lt;0.01) and the adiponectin/leptin ratio (r=0.413; P&lt;0.01) were also positively correlated with the LH/FSH ratio only in the PCOS group. AMH was correlated with the LH/FSH ratio, whereas testosterone level, FAI, FG score, fasting insulin level and HOMA-IR value were not correlated with the LH/FSH ratio in PCOS women.&#x0D; Conclusion: Most of the body composition parameters, leptin, adiponectin and the adiponectin/leptin ratio were significantly correlated with HOMA-IR in both groups. However, correlations of those parameters with LH/FSH ratio were found only in PCOS but not in women without PCOS. Adiponectin and leptin may play a significant role in the mechanism of neuroendocrine disorders in PCOS, which is characterized by an increased LH/FSH ratio.&#x0D; Keywords: adiponectin, adiponectin/leptin ratio, body composition, HOMA-IR, leptin, LH/FSH ratio, PCOS

This study was designed to investigate the correlationship between plasma metastin and pathogenesis of adolescent women with polycystic ovary syndrome (PCOS). From Jan. 2006 to Jun. 2006, 42 PCOS patients including 19 adolescent women and 23 adults with syndrome were treated in Second Affiliated Hospital of Sun Yat-Sen University. According to the range of age, those patients were divided into 19 cases in adolescent group (</= 19 years) and 23 cases in adult group (> 19 years). Meanwhile, 20 adolescent women were matched as controls. Blood samples were collected between day 1 and day 5 of a spontaneous bleeding episode in the PCOS groups and a menstrual cycle of the controls. The levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), free T (FT), dehydroepiandrosterone sulfate (DHEAS), sex hormone-binding globulin (SHBG), insulin, glucose, and metastin were detected from day 1 to day 5 of spontaneous bleeding or withdrawal bleeding by progesterone. On the next day, oral glucose tolerance test (75 g) and insulin release test were performed on those above patients and controls. The area under curve (AUC), the ratio of fasting blood glucose to insulin (GIR) and homeostasis model assessment insulin resistance index (HOMA-IR) were calculated. (1) The level of hormone: the level of LH was in (12 +/- 7) U/L in adult group and (12 +/- 8) U/L in adolescent PCOS group, which were significantly higher than (6 +/- 4) U/L in controls (P < 0.05). The level of FT was (2.3 +/- 1.2) pmol/L in adult group, which was significantly higher than (1.3 +/- 0.8) pmol/L in adolescent group and (1.1 +/- 0.5) pmol/L in control group (P < 0.05). It was observed that the level of (3.1 +/- 2.7)micromol/L in adolescent group was significantly lower than (6.3 +/- 2.7) micromol/L in control group (P < 0.05). Meanwhile, the level of FAI of 5.6 +/- 4.1 in adult group was significantly higher than 3.0 +/- 1.3 in control group (P < 0.05). No significant difference in FSH, T and SHBG levels among three groups were observed (P > 0.05). (2) Metastin and metabolism: Both the levels of fasting blood insulin, 2-hour insulin and AUC of insulin were (13 +/- 7) mU/L, (88 +/- 59) mU/L and (133 +/- 80) mUxL(-1)xmin(-1) in adolescent group, which were significantly higher than (7 +/- 3) mU/L, (57 +/- 29) mU/L and (82 +/- 34) mUxL(-1)xmin(-1) in control group. The fasting blood insulin of (13 +/- 7) mU/L in adolescent group was significantly higher than (9 +/- 5) mU/L in adult group. The level of fasting blood glucose and 2-hour glucose were (5.01 +/- 0.44) mmol/L and (6.48 +/- 1.16) mmol/L in adult group, which were significantly higher than (4.68 +/- 0.29) mmol/L and (5.44 +/- 0.83) mmol/L in control group and (4.67 +/- 0.30) mmol/L and (5.93 +/- 1.44) mmol/L in adolescent group. The glucose AUC of (9.99 +/- 1.85) mmolxL(-1)xmin(-1) in adult group was significantly higher than (8.42 +/- 1.53) mmolxL(-1)xmin(-1) in control group (P < 0.05). HOMA-IR of 2.6 +/- 2.0 in adolescent group was significantly higher than 1.4 +/- 0.7 in control group. GIR of 10 +/- 8 in adolescent group was significantly lower than 16 +/- 10 in control group (P < 0.05). The metastin level of (0.25 +/- 0.19) pmol/L in adolescent group and (0.29 +/- 0.29) pmol/L in adult group were all significantly higher than (0.18 +/- 0.23) pmol/L in control group (PPh glucose were observed (r = 0.256, 0.286 and 0.267. P = 0.044, 0.025 and 0.043). The expression of metastin in adolescent PCOS women was significantly higher that of normal adolescent women. The increased level of metastin might be associated with pathogenesis of adolescent women with PCOS.

Lower serum apelin levels in women with polycystic ovary syndrome

To investigate and analyze the clinical presentation, hormonal profile, and metabolic abnormalities of obese women with polycystic ovary syndrome (PCOS). The data of the anthropometric measurements, clinical manifestations of hyperandrogenism, serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E(2)), testosterone (T), prolactin (PRL), dehydro-epiandrosterone sulfate (DHEAS), sex-hormone-binding globulin (SGBG), and 17-oxyhydroprogesterone (17-OHP), fasting plasma glucose (FPG) and fasting insulin (FINS) detected after oral glucose tolerance test (OGTT), serum lipid levels, including total cholesterol (Chol), triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL), homeostasis model assessment (HOMA) and area under curve (AUC) so as to assess the insulin resistance (IR), free androgen index (FAI) to estimate the extent of hyperandrogenism, HOMA IS and DeltaI(30)/DeltaG(30) used to assess the function of islet beta cells, were collected from 192 women with PCOS, aged 24 +/- 6, that were divided into 2 groups according to the body mass index (BMI): Group A (n = 70) with the BMI > or = 25 kg.m(-2) and Group B (n = 122) with the BMI < 2 5 kg.m(-2), and 65 age-matched bilateral tubal block factor infertile women served as controls that were divided into 2 groups as well: Group C (n = 25) with the BMI > or = 25 kg.m(-2); and Group D (n = 79) with the BMI < 25 kg.m(-2), and underwent a cross-sectional study. (1) Clinical phenotype: The presence of obesity was 36.46% (70/192) of which 80.00% (56/70) was central obesity. The incidence of acanthosis nigricans was 17.18% (33/192), 35.71% in Group A and 6.56% in Group B. (P < 0.01). Groups A and C showed increased frequency of acanthosis nigricans compared with Group B. The value of FAI of Group A was 3.40 +/- 1.84, significantly higher than those of Group B (1.75 +/- 1.20) and Group C (1.65 +/- 0.90), (both P < 0.01). The LH/FSH ratio of Group B was 2.41 +/- 1.13, significantly higher than those of Groups A, C, and D (all P < 0.01). (2) Hormonal profile: The IR rate was 43.23% in the 192 patients, 82.86% in Group A and 20.49% in Group B. The LH and LH/FSH ratio were significantly higher in Group B than in Groups A, C, and D (all P < 0.01); T level was higher in Groups A and B than in Group C and D (all P < 0.05). SHBG was lower in Group A (108.70 +/- 81.35 nmol.L(-1)) and Group C (150.34 +/- 106.23 nmol.L(-1)) compared with Group B (192.49 +/- 98.30 nmol.L(-1)) and Group D (231.84 +/- 90.09 nmol.L(-1)) (P < 0.01 and P < 0.05). FAI level was 3.40 +/- 1.84 in Group A, significantly higher than those of Groups B (1.75 +/- 1.20), C (1.65 +/- 0.90), and D (0.84 +/- 0.45) (all P < 0.01). The FINS, TG, and HOMA IR of Groups A and C were all significantly higher than those of Groups B and D (all P < 0.01). The OGTT GAUC was significantly higher than those of Groups B, C, and D (P = 0.006, 0.028, and 0.031 respectively). (3) Metabolic profile: The prevalence of IR was 43.23% (83/192) with a higher prevalence rate in Group A (82.76%, 58/70) compared with Group B (20.49%, 25/122). The values of FINS, HOMA IR, GAUC, IAUC, and TG were all higher in Group A than in Group B (all P < 0.01). BMI and WHR were positively correlated with FAI and HOMA-IR (all P < 0.01), whereas negatively correlated with LH/FSH ratio (r = -0.345, -0.260, P < 0.01). There were no significant differences in HOMA-IS and DeltaI(30)/DeltaG(30) among these groups (all P > 0.05). Obese PCOS women have more severe hyperandrogenism, IR and hyperinsulinism than normal-weight PCOS women, which may have some health implications later in life.

Objectives To compare serum leptin levels in women with polycystic ovary syndrome (PCOS) and healthy subjects, and to evaluate the relationship between leptin concentration and insulin resistance.Methods Forty-five women with PCOS and 20 controls were included in the study. Serum levels of leptin, testosterone, immune-reactive insulin (IRI), sex hormone-binding globulin, dehydroepiandrosterone sulfate, cortisol, LH and FSH were measured. Free androgen index (FAI) and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. Body mass index (BMI) and waist-to-hip ratio (WHR) were assessed.Results Serum leptin levels in PCOS patients were higher than in the control group independently of BMI, WHR and waist circumference. In PCOS patients there was a strong positive correlation between leptin and IRI (r = 0.592, p < 0.01) on the one hand, and leptin and HOMA-IR, on the other (r = 0.637, p < 0.01). In PCOS patients with more pronounced insulin resistance (IR) the correlation between leptin levels and HOMA-IR is independent of BMI, WHR and waist circumference. We did not find any correlation between leptin and other hormonal indices in PCOS patients.Conclusions Our study confirms the existence of a significant positive correlation between serum leptin levels and clinical and hormonal indices of IR. The hyperleptinaemia is probably due to leptin resistance and may be characteristic of the syndrome. The lack of correlation with other hormonal parameters is probably due to the heterogeneity of the PCOS group.

ObjectiveWe intended to establish the threshold for anti-Mullerian hormone (AMH) in the diagnosis of polycystic ovary syndrome (PCOS) in China.MethodsA total of 771 women (653 with PCOS and 118 healthy controls) were enrolled. The serum AMH, follicle-stimulating hormone (FSH), luteinizing hormone (LH), FSH/LH, prolactin, estradiol, testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), sex hormone-binding globulin (SHBG), 17α-OH progesterone (17α-OHP), fasting insulin (INS), fasting glucose, free androgen index (FAI%) and homeostasis model assessment for insulin resistance (HOMA-IR) index were analyzed, and the diagnostic utility of AMH, LH/FSH, T and INS was established using receiver operator characteristic (ROC) curves. With AMH, LH/FSH, T and INS as independent variables, a logistic regression model was established, and the ROC curve for combined detection was fitted with the probability value of the model.ResultsThe serum level of FSH, LH, LH/FSH, AMH, FAI%, 17α-OHP, fasting INS, T, SHBG, DHEA-S and HOMA-IR were altered in the PCOS patients. The best compromise between sensitivity and specificity was found at an AMH cut-off level of 8.16 ng/ml and 5.89 ng/ml for the age groups 20–29 and 30–39 years, with the corresponding area under the curve being 0.846 and 0.865 respectively. The area under the ROC curve for combined detection was 0.951, which was significantly greater than that of each index. Finally, the concentration of AMH was associated with FSH, LH, LH/FSH, T, and ovarian volume in PCOS patients.ConclusionThe optimal AMH diagnostic threshold for PCOS was 8.16 ng/ml (20–29 years) and 5.89 ng/ml (30–39 years) in the Chinese population of this study. Moreover, serum AMH, LH/FSH, T and INS could be used in combination to improve the diagnostic specificity and sensitivity for the detection of PCOS.

Objectives: The aim of this study was to compare the white blood cells (WBC) count in patients with polycystic ovary syndrome (PCOS) with the controls and to assess its relationship between metabolic markers and hormonal measures. Materials and Methods: The study was conducted retrospectively. One hundred-thirty women with PCOS and 71 healthy women with regular menses were included in the study. General characteristics and anthropometric measures were analyzed. Hormonal, metabolic and inflammatory parameters were studied in all subjects at the follicular phase of the menstrual cycle. Results: The average age and body mass index (BMI) of PCOS and the control groups were similar ( P =0.071 and P =0.063, respectively). Inflammatory markers, WBC [6.00 (4.51-7.17) vs. 7.20 (5.91-8.41);( P <0.001)] and c-reactive protein (CRP) [3.45 (3.30-3.61) vs. 3.48 (3.45-4.98); ( P =0.031)] were significantly higher in the PCOS group. In multiple regression analysis in a model when WBC is the dependent variable and total testosterone (TT), sex hormone binding globuline (SHBG), and homeostatic model assessment of insulin resistance (HOMA-IR) were the predictors, WBC was positively associated with TT levels and BMI even after adjustment for confounders ( P =0.006; P =0.039, respectively). Conclusion: WBC is an independent predictor of cardiovascular disease, is elevated in women with PCOS and is explained by both obesity and hyperandrogenemia.

The purpose of this study was to assess the rate of insulin resistance (IR) and the relationship between IR and high-molecular weight adiponectin (HMWA) in patients with polycystic ovary syndrome (PCOS). A cross sectional study involving 43 women with PCOS and 39 normal women was carried out over a period of nine months. Fasting glucose and insulin levels, lipid parameters and androgen levels were measured in all serum samples. HMWA was determined by enzyme-linked immunosorbent assay and IR was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR) index. The IR was more prevalent in the PCOS group than in the controls (p=0.002). Dehydroepiandrosterone sulfate, sex hormone binding globulin, free androgen index, total testosterone, insulin, and HOMA-IR levels were significantly higher in the PCOS group as compared to the control group (all p<0.05). Moreover, HMWA was significantly lower and negatively correlated with the clinical and biochemical hyperandrogenism in the PCOS group. HMWA and HOMA-IR were also associated with triglyceride, body mass index, and fat mass in this group. ROC curve analyses demonstrated that the AUC, indicative of the HMWA value for discriminating PCOS with IR, was 0.725, with a confidence interval of 0.615-0.835 (p=0.001). The serum HMWA levels are lower in patients with PCOS, which suggest that HMWA might be involved in the pathogenesis of PCOS. We also conclude that HMWA might be a strong determinant of IR in PCOS patients.