Polycystic Ovary Syndrome Cases Research Articles

Evaluation of Hormonal Profile and Ovarian Morphology among Adolescent Girls with Menstrual Irregularities in a Tertiary Care Centre at Central India.

Menstrual disturbances are common among adolescents with a prevalence rate of 11.3–26.7%. The most frequent menstrual irregularities are oligomenorrhea, menorrhagia, polymenorrhoea, and hypomenorrhea. PCOS (polycystic ovarian syndrome) is now recognized as the most prevalent endocrine disorder among the women of reproductive age. The current study was planned to evaluate socio-demographic factors, endocrine profiles, and ovarian morphology among adolescent girls with menstrual irregularities and compare these parameters in different phenotypes of adolescent PCOS cases. It is a hospital-based cross-sectional study among 248 adolescent girls (10–19 years) with menstrual irregularities. After obtaining informed consent, history and clinical examination findings were recorded on preform proforma. All girls were assessed on day 2/3 of the menstrual cycle for hormonal profile (serum TSH, FSH, LH, prolactin, and serum testosterone) and ovarian morphology (by transabdominal ultrasonography). All participating girls were divided into three groups (groups 1, 2, and 3) corresponding to phenotypes A, B, & D as per the Rotterdam criteria. In the study, oligomenorrhea was the most common menstrual disorder (70.97%). Biochemical hyperandrogenism and thyroid dysfunction were reported in 14.91% and 8.46% of girls, respectively. Our study noted that phenotype D ,i.e., group 3 (MI + PCOM-HA; 49.43%) was the most common phenotype in the study. In a comparative analysis of different groups, significant differences (p < 0.05) in hormonal and metabolic parameters showed highest in group 2, which represents phenotype B of PCOS (hyperandrogenic anovulation). This analysis revealed that adolescent hyperandrogenism (phenotypes A and B) is associated with a more deranged hormonal and metabolic profile than nonandrogenic PCOS (phenotype D). To prevent long-term sequelae, lifestyle changes, early treatment, and close follow-up are recommended in this subset of girls.

The Association of Mitochondrial Translocator Protein and Voltage-Dependent Anion Channel-1 in Granulosa Cells with Estradiol Levels and Presence of Immature Follicles in Polycystic Ovary Syndrome.

Granulosa cells (GCs) play key roles in oocyte maturation by providing required estradiol (E2). Since the presence of immature oocytes has been reported in cases with polycystic ovary syndrome (PCOS), in this study, the levels of mitochondrial membrane transporter proteins involved in E2 synthesis were determined. E2 concentration and parameters of oxidative status were also measured in follicular fluids of PCOS women. Forty-three women with PCOS and 43 healthy women who were candidates for IVF procedure due to their husbands' infertility were enrolled in this case-control study. The gene expression and protein levels of mitochondrial translocator protein (TSPO) and voltage-dependent anion channel 1 (VDAC1) were determined in GCs using RT-qPCR and immunocytochemistry assay, respectively. E2 level was measured with electrochemiluminescence, whereas total cholesterol, total antioxidant capacity (TAC), total oxidant status (TOS), and malondialdehyde (MDA) were determined using colorimetric methods in follicular fluids. Data were analyzed using unpaired t-test or Mann-Whitney U test, and Spearman's correlation coefficient. VDAC1 and TSPO were significantly lower in mRNA (p<0.05) and protein levels (p<0.001) of PCOS patients. PCOS patients had lower cholesterol, estradiol, and TAC levels, and higher TOS and MDA contents. E2 level had direct correlation with VDAC1, TSPO, and TAC while it was negatively correlated with TOS, oxidative stress index (OSI), and MDA (p<0.001). Higher E2 levels were associated with higher numbers of high-quality oocytes and conceived embryos (p<0.001). Decreased E2 levels and increased oxidative stress in the follicular fluid may be the cause of immature oocytes in PCOS cases.

A meta-analysis of the association of ApaI, BsmI, FokI, and TaqI polymorphisms in the vitamin D receptor gene with the risk of polycystic ovary syndrome in the Eastern Mediterranean Regional Office population.

BackgroundThe results of case-control studies on the association between vitamin D receptor gene (VDR) polymorphisms and polycystic ovary syndrome (PCOS) are inconclusive.ObjectiveWe aimed to more precisely evaluate the correlation between the ApaI, BsmI, FokI, and TaqI VDR gene polymorphisms and PCOS susceptibility.Materials and MethodsPubMed, Scopus, Science Citation Index, and Google Scholar databases were searched to retrieve related reports released up to the end of 2020. To evaluate the association strength of the VDR gene polymorphisms with PCOS risk, pooled odds ratios (OR) with a 95% confidence interval were determined.ResultsIn total, 1,119 subjects (560 PCOS cases and 559 controls) from 7 studies were included which met the inclusion criteria. A statistically significant association between the TaqI polymorphism and PCOS susceptibility was found in the Eastern Mediterranean Regional Office population (T vs. t: OR = 0.715; TT vs. tt: OR = 0.435, p 0.001; TT vs. Tt+tt: OR = 0.696, p = 0.01; tt vs. TT+Tt: OR = 1.791, p 0.001). It was found that the ApaI variant was a risk factor in the dominant inheritance model (AA vs. Aa+aa: OR = 1.466, p = 0.01) and the FokI polymorphism was a protective factor in the recessive inheritance model (ff vs. FF+Ff: OR = 0.669, p = 0.04). The VDR BsmI polymorphism did not show association with PCOS susceptibility.ConclusionOur meta-analysis revealed that the VDR ApaI in the dominant model, VDR FokI in the recessive model, and VDR TaqI polymorphisms in all genetic models are associated with vulnerability to PCOS. However, further studies with a larger sample size are required.

ADIPOQ gene polymorphisms and haplotypes linked to altered susceptibility to PCOS: a case–control study

Research questionWhat role do ADIPOQ variants play in controlling adiponectin concentrations and altered risk of polycystic ovary syndrome (PCOS)? DesignStudy subjects comprised 583 women with PCOS and 713 age-matched controls. Genotyping of rs182052, rs822393, rs822396, rs7649121, rs3774271, rs266729, rs3774261 and rs6773957 ADIPOQ polymorphisms was done by real-time polymerase chain reaction (PCR). ResultsOf the 16 ADIPOQ variants, the minor allele frequencies of rs182052, rs822393, rs822396, rs7649121, rs3774261 and rs6773957 were significantly different between PCOS cases and controls. Significant differences in rs266729 (P = 0.02), rs822396 (P = 0.02), rs3774261 (P < 0.001) and rs6773957 (P < 0.001) genotypes were also noted between PCOS cases and controls. Reduced PCOS risk was found with heterozygous rs266729, while increased risk was linked to heterozygous rs822396 and homozygous minor allele rs3774361, and in heterozygous and homozygous minor allele rs6773957 genotype carriers. Haplotype analysis identified two blocks based on linkage disequilibrium pattern; alleles coded as ‘1’ (major) and ‘2’ (minor). Within Block 1 (rs4632532, rs16861194, rs266729, rs182052, rs16861209, rs822393, rs822395, rs822396, rs7649121), haplotypes 111111111 and 212211221 were positively, while haplotypes 212212112 and 212211211 were negatively associated with PCOS. Within Block 2 (rs2241766, rs1501299, rs2241767, rs3774261, rs6773957, rs1063539) haplotypes 111221 and 112221 were positively, while haplotype 111111 was negatively associated with PCOS. ConclusionsThis is the first study to confirm the association of rs182052, rs822393, rs7649121 and rs6773957 ADIPOQ variants with altered risk of PCOS. The varied association of ADIPOQ variants with PCOS in relation to earlier reports indicate there is an ethnic contribution to ADIPOQ association with PCOS.

Correlation of Serum Visfatin Level in Non-obese Women with Polycystic Ovary Syndrome and Matched Control.

Polycystic ovary syndrome (PCOS) is a heterogeneous endocrinopathy affecting reproductive-age women. Visfatin, an adipocytokine, and insulin resistance (IR) marker in diabetes since PCOS and diabetes share insulin resistance as an etiological factor, this study aimed to investigate visfatin as a predictive marker for IR and hyperandrogenemia in non-obese PCOS women and test its correlation to other parameters. A cross-sectional study conducted at the University Hospital recruited 140 women, divided into two groups. Group I (70/140, study group) was PCOS patients' diagnosis based on 2003 Rotterdam criteria and Group II (70/140, healthy controls). Both were aged, and body mass index (BMI) matched. After a detailed history and general examination, the clinical, demographic, biochemical, hormonal, and metabolic parameters were taken for comparison's sake. PCOS patients were subdivided according to the clinical or hormonal evidence of hyperandrogenemia into two groups: those with hyperandrogenemia and those without. Higher serum visfatin was estimated in the PCOS group (4.4 ± 1.7) versus healthy controls (3.1 ± 0.7) ng/mL, P &lt; 0.0001. Significantly higher visfatin was confirmed in hyperandrogenic PCOS versus non-hyperandrogenic PCOS women (5.69 ± 1.1 vs. 2.76 ± 0.51ng/mL). A strong correlation was found between visfatin versus hemoglobin A1c and free androgen index (FAI); r = 0.784 and 0.624, respectively. BMI and free testosterone scored a modest correlation. BMI centiles' correlation with serum visfatin revealed no significant effect on serum visfatin, P = 0.62. The ROC calculated visfatin cut-off value; 4.34ng/mL with 51.4% sensitivity and 100% specificity, and a P-value &lt; 0.001 in discriminating PCOS cases. In conclusion, a strong positive correlation of visfatin with insulin resistance, followed by FAI in PCOS cases irrespective of BMI, suggests the intimate relation of visfatin in PCOS pathophysiology among non-obese women. Further research is warranted to explore this association's therapeutic and prognostic value.

The study of the role of insulin resistance as etiological factor in polycystic ovarian syndrome: a case control study.

The relationship between insulin resistance (IR) and polycystic ovary syndrome (PCOS) has been consistently shown by several studies but what is the cause and what is the effect remained an unsolved issue. In recent years, IR has been suggested to be a key etiological factor which contributes to the severity of metabolic and reproductive features in PCOS. The aim of the present study is to determine the etiological role of IR in PCOS. This is an analytical case control study where 30 newly diagnosed normoglycemic cases of PCOS (according to Rotterdam revised criteria 2003) between the age group of 15 and 35 years were enrolled. A total of 30 age matched, apparently healthy women were selected from volunteers as controls. Fasting glucose was analysed by spectrophotometry and fasting insulin by chemiluminescence immunoassay. HOMA-IR, Log HOMA-IR, QUICKI, G/I ratio and FIRI were calculated using standard formulae. The anthropometric parameters and markers of IR were high and QUICKI & G/I ratio were low in cases as compared to controls (p<0.05). Cases with BMI≥25 showed significantly higher IR markers and lower QUICKI & G/I ratio than BMI<25 cases and BMI matched controls. No significant difference was present in IR markers between high and low central obesity cases. The findings of our study suggest that in normoglycemic PCOS women, raised IR markers in obese patients cannot be attributed to obesity or central obesity alone. Presence of IR in newly diagnosed cases at such an early stage i.e.,even before development of hyperglycemia and hyperinsulinemia suggest IR to be a causative factor in development of PCOS.

Monocyte high density lipoprotein ratio and neutrophil lymphocyte ratio a novel marker in polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is the most common endocrinological problem and is the cause of irregular menstruation in the women of reproductive age. The present study was undertaken to find out novel inflammatory markers in polycystic ovary syndrome (PCOS). Study population was divided into two groups controls (n=100) and cases (n=100) diagnosed with PCOS were recruited for the study. The anthropometric data such as Height, Weight, BMI and, hormonal profile LH, FSH, LH/FSH ratio, Thyroid profile, Testosterone, HOMA-IR, Lipid profile, Monocytes, Neutrophils were noted for all the participants. Taking BMI 25 kg/m as the boundary, the control group was divided into Group A and Group B. Group A includes 53 subjects which is normal BMI group and Group B includes 47 subjects in the High-BMI group and among the cases Group C and Group D. Group C consists of 67 cases (normal BMI group) and 33 cases in the Group D (high BMI group). It is observed that monocyte HDL ratio (M/HDL ratio) and Neutrophil lymphocyte ratio (N/L ratio) in PCOS case group increased significantly (P&amp;#60;0.05) when compared to control group. Through the analysis of differences between the subgroups along with LH, LH/FSH, Total Testosterone, M/HDL ratio, and N/L ratio can be considered as specific indicators of PCOS disease. Through correlation analysis, M/HDL ratio and N/L ratio showed association with hormone levels of LH and Total Testosterone respectively. Through ROC curve, it is found that M/HDL ratio is &amp;#62;10.139 or N/L ratio is &amp;#62;1.7 had diagnostic value for PCOS, and the combined diagnostic value of the two was higher. From the observation of this study, it can be concluded that M/HDL ratio and N/L ratio are not chronic inflammatory indicators caused by obesity but caused by the PCOS disease itself. Therefore, M/HDL ratio and N/L ratio can be used as diagnostic markers for PCOS.

Is there a correlation between heart rate recovery and androgen parameters in polycystic ovary syndrome? Heart rate recovery in polycystic ovary syndrome

Objectives: In our preliminary study, we assessed heart rate recovery (HRR) in patients with polycystic ovary syndrome (PCOS) and controls by subjecting them to moderate exercise and estimating androgen levels, and examined the correlation between HRR and androgen levels. Methods: 30 newly diagnosed cases of PCOS and 30 controls with comparable anthropometric measurements performed isotonic moderate exercise. Serum testosterone and DHEAS levels were measured. The HRR was calculated as the difference between the maximum heart rate and the 1st, 5th and 10th minute after the end of the exercise. Results: Heart rate recovery at 1 minute (p=0.001) and 5 minutes, (p=0.002) was significantly impaired in PCOS patients. Testosterone (p=0.100) and DHEAS (p=0.061) were elevated in PCOS patients compared to normal controls, although this was not statistically significant. A positive correlation was observed between HRR and androgen levels (testosterone: r=0.318; p=0.08, DHEAS: r=0.064; p=0.07). Conclusion: Decreased cardiovascular fitness and increased androgen levels have been observed in PCOS patients. Impaired HRR, reflecting sympathetic overactivity, has also been observed in newly diagnosed cases of PCOS. We therefore suggest that HRR is an accurate and sensitive marker to detect early signs of cardiovascular impairment and enables timely measures to avoid further morbidity.

Evaluation of CAG repeat length in the androgen receptor gene and polycystic ovary syndrome risk in Iranian women: A case-control study.

BackgroundPolycystic ovary syndrome (PCOS) is a heterogeneous disorder, which affects about 15-20% of women of reproductive age. The most important etiopathogenesis factor in its incidence is hyperandrogenism; over 70 candidate genes are known to be associated with this syndrome, such as the androgen receptor (AR) gene which encodes a steroid receptor and is located on the Xq11-12 chromosome. The N-terminus of exon 1 of AR contains a polymorphic trinucleotide repeat (CAG)n region that encodes glutamine tract. There are some studies showing that shorter AR CAG repeats are significantly related to enhanced AR sensitivity.ObjectiveThis study investigated the frequency of the polymorphic expansion of the trinucleotide CAG repeats of AR in PCOS.Materials and Methods160 Iranian women aged 17-40 yr participated in this case-control study: 80 women as PCOS patients and 80 women as healthy controls according to the Rotterdam criteria. Other similar phenotype factors such as hyperandrogenism were not considered as PCOS. The frequency of polymorphic expansion of CAG trinucleotide repeats in PCOS patients was compared with the frequency in non-PCOS controls in using two primer sets for nested polymerase chain reaction. The polymerase chain reaction products were visualized on polyacrylamide gel and then were confirmed by a sequencing process.ResultsThe results did not show a significant correlation between the frequency of CAG repeats in AR and PCOS incidence.ConclusionIn contrast to some previous reports, the present data showed that the CAG length in PCOS cases did not significantly differ from that of controls. So, the AR (CAG)n does not appear to be a major factor for PCOS in Iranian women.

Effect of pioglitazone treatment on serum chemerin and vaspin levels in polycystic ovary syndrome.

Abdominal fat synthesizes a variety of adipokines, including vaspin and chemerin, that affect the resistance to insulin. This research was conducted to demonstrate the effect of pioglitazone, one insulin sensitizer used to decrease insulin resistance, on these adipokines in&#x0D; &#x0D; obese patients with polycystic ovary (PCOS). Twenty-five obese women with PCOS were treated with pioglitazone 15mg/bid for 12 weeks. Modifications in fasting blood glucose (FBG), serum fasting insulin (FSI), chemerin and vaspin serum levels, follicle stimulation hormone (FSH), luteinizing hormone (LH), testosterone (T), and in baseline and post-therapy were assessed. Body mass index decreased without any substantial variance after 12 weeks of pioglitazone therapy (P&gt; 0.05). T, FSI, HOMA-IR, LH, and FBG levels have decreased considerably (P≤0.01, P≤0.05) after the therapy. No substantial variations were found in FSH (P&gt;0.05). Serum chemerin and vaspin levels were observed no significant difference than before treatment (P&gt;0.05) in obese women with polycystic ovarian syndrome cases.

Quantitative Changes in White Blood Cells: Correlation with the Hallmarks of Polycystic Ovary Syndrome.

Background and Objectives: In women of reproductive age, leukocytosis is a risk factor that bridges low-grade chronic inflammation (metabolic inflammation), metabolic changes, and polycystic ovary syndrome (PCOS) and is a potential early predictor of PCOS. This study aims to explore the predictive role of quantitative changes in white blood cells (WBCs) and neutrophils in PCOS-associated metabolic changes. Materials and Methods: A total number of 176 blood samples were obtained from age-matched women of the reproductive period, comprising 88 PCOS cases and 88 healthy controls. Hematological, metabolic, and anthropometric indices and ultrasonic assessment were recorded. Results: Elevated levels of luteinizing hormone, testosterone, and lipid parameters except HDL-C levels, and the prevalence of metabolic syndrome in PCOS were statistically significant (p < 0.001). The neutrophil count and neutrophil–lymphocyte ratio (NLR) in PCOS patients were significantly higher (p < 0.001) than their counterparts. The predictive ability of the neutrophil count and neutrophil–lymphocyte ratio (NLR) for PCOS, and possibly its associating subclinical inflammation at optimum cut-off values for the neutrophil count and NLR of >46.62% (sensitivity 94.32% and specificity 74.42%) and >1.23 (sensitivity 71.59% and specificity 100%), respectively. With regard to the areas under the curve (AUC) and Youden indices, they constituted 0.922 and 0.697 for neutrophil count and 0.926 and 0.716 for NLR, respectively. The comparative ROC z-statistic value was 2.222 and a p = 0.026. The multiple linear regression analysis revealed no significant influence for hormonal and metabolic independent variables on the neutrophil count in PCOS cases, but, as can be expected, revealed a significant negative relationship with the other components of WBCs. Conclusion: In conclusion, relative neutrophilia and elevated NLR are potential cost-effective, sensitive, and specific predictors of PCOS that may also shed light on the mechanism of chronic low-grade inflammation that is characteristic of the disease.

Homoeopathy and PCOS: A case study

PCOS (polycystic ovarian syndrome) is one of the most attended female complaints in clinics of the reproductive age group. Homoeopathy can be used as an option for treatment and management of patients suffering from PCOS, as it can be seen from the case report presented of a 32 years female who was suffering from PCOS and treated within 2 years with Homoeopathic similimum which was selected on the basis of individualisation. Normal USG report and regular menstrual cycle with mental calmness of patient shows effectiveness of homoeopathic medicines. After normal USG, the case was observed for further 4 months and there was no recurrence of symptoms, USG again shows a normal study suggesting the good prognosis for PCOS cases.

A Comprehensive Review on Tailoring an Herbal Approach for Treatment of Poly Cystic Ovarian Syndrome

The review gives a brief about poly cystic ovarian syndrome (PCOS) and the symptoms related to the disease. Around 2.2 to 26% of cases of PCOS are present globally. The disorder generally occurs in the reproductive age group of women. The review has a mention of few herbs which can be used to correct the diseased condition. The various herbs have a positive effect on the diseased condition and can be used to cure symptoms like hypothyroidism, hyperplasia, obesity, diabetes, Menorrhagia, sleep disturbances, cardiovascular problems, hyperlipidemia, hirsutism, infertility, irregular menstrual cycle, etc. The herbs included in the review include Bauhinia variegata useful in hormone imbalance, Phyllanthus emblica, Terminalia bellirica, Terminalia chebula, and Commiphora wightii are used to regulate the hormones, Cinnamon cassia acts as an anti-oxidant, Tribulus terrestris improves reproductive dysfunction, Hypericum perforatum regulates depression, Commiphora myrrha prevents menorrhagia, Nigella sativa controls cholesterol, Saraca asoca has estrogenic action, Asparagus racemosus promotes folliculogenesis, Tinospora cordifolia regulates menstrual flow, Ocimum sanctum as an anti-oxidant. The plants taken had a positive effect on women with PCOS without causing any side effects. The natural herbs used for the treatment of PCOS did not have any side effects and treated the diseased condition naturally. This review aims to understand the natural plants available for the treatment of the disease naturally. The herbs can be used individually or can be used in combination. Keywords: Poly cystic ovarian syndrome, Herbal medicine, Herbs, Natural plants

Association of High Levels of Testosterone and Ferritin with Overweight in Women with PCOS

Background &amp; Objective: The present study was conducted to determine testosterone and ferritin levels in women with polycystic ovary syndrome (PCOS) and investigate its relationship with body mass index (BMI) Materials &amp; Methods: In this case-control study, 104 PCOS cases and 99 controls were included. The concentration of testosterone, ferritin, lipid profile, insulin, glucose, and androgen was measured in fasting blood samples. Results: Testosterone level was equal to 1.08 ± 0.50 and 0.85 ± 0.42 in the case and control groups, respectively (P&lt; 0.001). Values of ferritin (123.45 ± 18.21ng/dl vs. 92.14 ± 17.74 ng/dl in control group, p&lt; 0.001), insulin (11.41 ± 3.84 µU/ml vs. 7.02 ± 3.29 µU/ml in control group, p&lt; 0.001), and insulin resistance (11.41 ± 3.84 vs.7.02 ± 3.29 in control group, p&lt; 0.001) were also measured. There was a significant relationship between serum concentration of testosterone and ferritin with BMI) p&lt;0.001). The role of ferritin to predict PCOS was significant (ß:-1.1, P&lt; 0.001). Conclusion: According to the findings of the present study, the levels of testosterone and ferritin were increased in patients with PCOS. Although elevated testosterone levels are effective in PCOS, ferritin concentration is an important factor in predicting and exacerbating the disease.

Bifidobacterium Is Enriched in Gut Microbiome of Kashmiri Women with Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is a very common endocrine condition in women in India. Gut microbiome alterations were shown to be involved in PCOS, yet it is remarkably understudied in Indian women who have a higher incidence of PCOS as compared to other ethnic populations. During the regional PCOS screening program among young women, we recruited 19 drug naive women with PCOS and 20 control women at the Sher-i-Kashmir Institute of Medical Sciences, Kashmir, North India. We profiled the gut microbiome in faecal samples by 16S rRNA sequencing and included 40/58 operational taxonomic units (OTUs) detected in at least 1/3 of the subjects with relative abundance (RA) ≥ 0.1%. We compared the RAs at a family/genus level in PCOS/non-PCOS groups and their correlation with 33 metabolic and hormonal factors, and corrected for multiple testing, while taking the variation in day of menstrual cycle at sample collection, age and BMI into account. Five genera were significantly enriched in PCOS cases: Sarcina, Megasphaera, and previously reported for PCOS Bifidobacterium, Collinsella and Paraprevotella confirmed by different statistical models. At the family level, the relative abundance of Bifidobacteriaceae was enriched, whereas Peptococcaceae was decreased among cases. We observed increased relative abundance of Collinsella and Paraprevotella with higher fasting blood glucose levels, and Paraprevotella and Alkalibacterium with larger hip, waist circumference, weight, and Peptococcaceae with lower prolactin levels. We also detected a novel association between Eubacterium and follicle-stimulating hormone levels and between Bifidobacterium and alkaline phosphatase, independently of the BMI of the participants. Our report supports that there is a relationship between gut microbiome composition and PCOS with links to specific reproductive health metabolic and hormonal predictors in Indian women.

Assessment of Serum Elements Concentration and Polycystic Ovary Syndrome (PCOS): Systematic Review and Meta-analysis.

Change in the levels of trace elements has been linked with PCOS pathogenesis by various studies, whereas some had reported no such association. Therefore, in order to evaluate association of eleven trace element (Cu, Zn, Cr, Cd, Se, Mn, Fe, Mg, Co, Ni and Pb) serum concentration with PCOS pathogenesis, current systematic review and meta-analysis has been carried out. Literature search was conducted using PubMed, Central Cochrane Library, Google Scholar and Science Direct databases with appropriate keywords. Studies published upto 3rd of September were evaluated for eligibility with suitable inclusion and exclusion criteria. Only case-control studies examining the association of serum trace element concentrations between PCOS cases and controls were selected. Present meta-analysis identified 32 articles with 2317 PCOS and 1898 controls. The serum Cu (MD = 15.40; 95% CI = 4.32 to 26.48; p = 0.006), Co (MD = 0.01; 95% CI = 0.01 to 0.02; p = 0.000), Cr (MD = 0.04; 95% CI = 0.00 to 0.07; p = 0.03) and Fe (MD = 12.98; 95% CI = 5.87-20.09; p = 0.0003) concentration is significantly higher, while lower concentration has been observed for Se (MD = - 0.99; 95% CI = - 1.31 to - 0.67; p = 0.000) and Mg (MD = - 223.41; 95% CI = - 391.60 to - 55.23; p = 0.009) among women with PCOS in comparison with the healthy group. Concentration of other elements which were analysed is not significantly related to PCOS. In short, PCOS women has higher serum concentrations of Cu, Co, Cr and Fe and lower concentrations of Se and Mg. Studies with sub-population of obese, non-obese and with and without insulin resistance are important to understand the pathomechanism of these elements in the syndrome.

A case-control study of polychlorinated biphenyl association with metabolic and hormonal outcomes in polycystic ovary syndrome

Polychlorinated biphenyls (PCBs) are a class of environmental pollutants with a long half-life that sequester in fat. Women with polycystic ovarian syndrome (PCOS) may represent a sensitive subgroup to endogenous exposure to PCBs because of associated weight gain. Seven PCB congeners were compared in age, ethnicity, and BMI matched women with (n = 29) and without (n = 30) PCOS and related to metabolic outcomes, and steroid and thyroid hormone levels. PCB118, PCB138, PCB153, and PCB180 were detected in all serum samples but geometric mean did not differ between cases and controls. PCBs correlated with increasing concentrations of each other (p < .01), increasing age (p < .01) and decreasing lneGFR (p < .05). lnPCB118 correlated with increasing Free-T4 (p = .028). lnPCB158, lnPCB180, and ln∑PCB correlated with increasing lnSHBG (p = .044). In regression modeling, although not significant, PCB118 positively associated with lnSHBG in controls (p = .0504) but not in cases; estradiol inversely associated with PCB138 in controls (p = .055) and ∑PCB in cases (p = .051). No significant associations were observed between metabolic endpoints, and steroid and thyroid hormone levels. The results presented do not suggest the PCOS cases in this cohort are at adverse risk compared to age, ethnicity, and BMI matched controls.

Dihydrotestosterone- A Potential Biomarker of Hyperandrogenaemia in Polycystic Ovary Syndrome: A Case-control Study from North India

Introduction: Polycystic Ovary Syndrome (PCOS) is a complex reproductive disorder characterised by hyperandrogenism, ovulatory dysfunction and polycystic/enlarged ovary. Although clinical and/or biochemical hyperandrogenism is one of the major features of PCOS, biochemical hyperandrogenism in the form of high testosterone and/or Free Androgen Index (FAI) is rarely observed in the Asian Indians. Aim: To assess various androgens to determine best available biomarker of androgens in PCOS from North India. Materials and Methods: This case-control study was conducted at Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India, between January 2016 to December 2019. During this period 137 female with PCOS and 49 female as control were included. Serum total testosterone (T), FAI, Dehydroepiandrosterone Sulphate (DHEAS), androstenedione and Dihydrotestosterone (DHT) were measured besides assessment of hirsutism using the FerrimanGallwey (FG) scale. Statistical differences were derived using Mann-Whitney U test, Receiver Operating Characteristic (ROC) curve analysis and Spearman’s correlation test. Results: There were 87 PCOS cases with phenotype A, 25 PCOS cases with phenotype B, 10 PCOS cases with phenotype C and 15 PCOS cases with phenotype D. The mean age was 23.7 years in the PCOS group and 26.2 years in the control group. The mean body mass index in the PCOS group was 25.23 kg/m2 and in the control was 22.6 kg/m2 . FG score of ≥9 was observed in 75.9% PCOS cases. High (mean+2SD) levels of T (≥0.51 ng/ mL), FAI (≥2.55), DHEAS (≥309 ug/dL), androstenedione (≥2.2 ng/mL) and DHT (≥462 pg/mL) were observed in 35.29%, 56.25%, 14.18%, 18.62% and 61.38%, cases, respectively. Mean DHT value was 584.27 pg/mL in study group whereas in control was 257.16 pg/mL (p-value &lt;0.0001) and area under ROC curve was 0.895. Similarly, area under ROC curve was 0.86, 0.817, 0.721 and 0.63 for FAI, testosterone, DHEAS and androstenedione, respectively. Spearman’s correlation test of androgens with body mass index, age and FG Score did not find any associations with DHT. Conclusion: Dihydrotestosterone (DHT) is best available biomarker and can be considered as diagnostic biomarker of hyperandrogenemia in PCOS women from north India.

Can Red cell distribution width screen for metabolic abnormality in women with Polycystic Ovarian Syndrome?

Polycystic ovarian syndrome (PCOS) is a prevalent endocrinopathy in reproductive-age females, accredited to a chronic low-grade inflammatory reaction. Red distribution width (RDW), a parameter of complete blood count, was tested as an inflammatory marker ; higher RDW was linked to metabolic syndrome. We aimed to examine RDW in distinguishing PCOS-related metabolic and hormonal abnormalities. Methods : A case-control study recruited 128 women, divided into PCOS cases (64 / 128) and controls (64 / 128) according to Rotterdam criteria. Body mass index (BMI), estimated complete blood count parameters, hormonal markers (serum follicle-stimulating hormone (FSH), luteinizing hormone, and serum testosterone), and metabolic markers (HOMA-IR, serum high and low-density lipoprotein) were measured. Results showed that RDW was significantly higher in PCOS. HOMA-IR, LDL, testosterone, and LH / FSH were higher in PCOS and strongly correlated with RDW with positive correlations. HDL was elevated and correlated negatively with RDW in PCOS. ROC calculated (13.55) as RDW cut-off value for insulin-resistant with an AUC of 0.95, P < 0.001. In conclusion, a strong and remarkable correlation of RDW with metabolic abnormalities in PCOS cases with 100% sensitivity and specificity, in addition to being quick and inexpensive, makes it a reliable marker for screening for insulin resistance. J. Med. Invest. 69 : 191-195, August, 2022.

A Case of PCOS (Polycystic Ovarian Syndrome) Treated Successfully by the Application of Yoga Prana Vidya Healing System Through Sustained Selfpractice, Self-healing and Self-belief

Introduction: Polycystic ovary syndrome (PCOS) is a disorder involving infrequent, irregular or prolonged menstrual periods, caused often by excess male hormone (androgen) levels. The ovaries develop numerous small collections of fluid — called follicles — and may fail to regularly release eggs. PCOS is a complex disorder of uncertain etiology, having strong evidence that it is a genetic disease. This paper presents a case of PCOS treated successfully by Yoga Prana Vidya healing protocols. Method: This report uses case study method of investigating the case of a 22-year-old female diagnosed with having PCOS (polycystic ovarian syndrome) during 2015. First symptoms were heavy menstrual flow accompanied by weakness. A Gynaecologist advised Ultrasound, full body test that revealed multiple cysts. The doctor prescribed steroids for treatment of this condition without any improvement, and instead deterioration was taking place. Her medical history before PCOS showed that she had sinusitis, low Iron count in blood and irregular periods. Results: The patient joined YPV from January 2017. She started taking healings from a senior YPV trainer from March, 2017, when she stopped taking medications. The senior YPV trainer helped the patient greatly through healings and constant nurturing. Slowly and gradually through healings, meditations, physical exercises, rhythmic breathing, forgiveness and learning lessons over the course of three years, the patient began to recover from march 2017 onwards. Conclusion: PCOS is one of the most important endocrine female disorders affecting in the reproductive age and may lead to serious complications, if not given due care and attention. Scientific studies are needed to determine the exact etiology of PCOS, and methods of proper management. Further research using YPV with appropriate number of samples of cases similar to this case is recommended to throw more light on treatment and normalization of this condition to give renewed life to patients in the society at large.