Endocrine Abnormalities Research Articles

Dysregulation of IL-6 and Iron Biomarkers as Potential Diagnostic Markers for Polycystic Ovary Syndrome

Polycystic Ovary Syndrome is one of the most common endocrinopathies in women of reproductive age group. A Case-control study is carried out in Kirkuk city from 10th of November 2022 to 10th of March 2023 for determination the relationship of ferritin, serum iron and interleukin-6 among PCOS women. The number of PCOS women under study were 60 women whose ages were between 15-45 years old. These patients admitted to obstetrics and gynecology unit at Gynecological and Pediatric Hospital in Kirkuk city. In addition, the control group consisted of 30 healthy volunteer females with regular menstrual cycles aged between 15 to 45 years. All PCOS patients and healthy control underwent full physical examination and anthropometric measurements including weight, height, and were asked to complete a general questionnaire. Body Mass Index (BMI) was calculated by using the formula: weight (Kg)/height (meters2). Blood samples collected from each women for measurement of interleukin-6 by Enzyme linked immunosorbent assay (ELISA), and serum ferritin, by immunofluorescence and serum iron by manual biochemistry procedures. The average IL-6 level in PCOS women was (279.8±77.8 pg/ml), whereas the control group had a level of( 92.5±11.54 pg/ml). Based on the study findings, women with PCOS had significantly higher average serum iron levels compared to the control group (223.5±57.3 and 129.144.9 g/dl), serum ferritin levels were significantly elevated in women with PCOS (279.9±44.9 and 189.5 57.3 ng/ml), The Mean of IL-6 in PCOS women with BMI>25 (kg/m2) was (293.1± 81.8pg/ml) which is significantly higher than in PCOS women with normal BMI (231.9±18.9 pg/ml). The study showed that the serum iron and ferritin were elevated significantly in obese PCOS women (151.72±44.85 g/dl and 247.4±147.4 ng/ml) respectively as compared with non-obese PCOS women (140.61±35.08 g/dl and 228.7±38.2 ng/ml). High levels of iron, ferritin and IL-6 were observed in PCOS women as compared with healthy women specialty obese women with PCOS which highlight the importance of inflammation in PCOS and suggest that IL-6 levels could potentially serve as a biomarker for the condition. Additionally, exploring the relationship between IL-6 and other factors, such as hormonal imbalances and metabolic abnormalities, can provide a more comprehensive understanding of the pathophysiology of PCOS.

Ziziphus mauritiana Leaves Normalize Hormonal Profile and Total Cholesterol in Polycystic Ovarian Syndrome Rats.

In the present study, the beneficial effect of leaves of Ziziphus mauritiana on testosterone, estradiol, progesterone, LH hormones, blood glucose, and total cholesterol levels in the experimentally induced polycystic ovaries of female Sprague Dawley rats were evaluated. Letrozole was used to induce PCOS in rats, and clomiphene citrate was used as a standard control. This study was carried out in vivo on 30 female rats where group I received normal saline and group II to V were treated with letrozole (1 mg/kg/day), which was dissolved in normal saline orally for 21 days to induce PCOS. After PCOS induction, test groups III and IV were orally treated with ZMME at a dose of 100 mg/kg and 200 mg/kg for 14 days, respectively, and group V was treated with clomiphene citrate (2 mg/kg) orally for 14 days. At the end of the experimental period, the animals were sacrificed by cervical dislocation, and blood samples were collected by cardiac puncture. After blood collection, the ovaries were removed and weighed. The results showed that Ziziphus mauritiana normalized all hormones and total cholesterol levels. The HPTLC profile showed the presence of gallic acid, rutin, quercetin, and ursolic acid. Many studies have reported that quercetin is effective against PCOS and its complications; it suppresses insulin resistance and reduces testosterone and LH levels. The present study showed an improvement in the inflammatory microenvironment of the ovarian tissue in the PCOS rat model. This research concluded that the leaves of Ziziphus mauritiana have potential efficacy in the treatment of PCOS by normalizing abnormal hormones and total cholesterol levels, which could be due to the presence of quercetin in the leaves.

Erectile dysfunction prevalence and associated factors in men living with HIV from Western Turkey: A cross-sectional study.

The majority of people living with HIV in our country are younger men. However, limited data exist for the sexual health of these patients. Knowledge of the epidemiology in this population may improve health outcomes across the continuum of HIV care. The aim of this study was to determine the prevalence of erectile dysfunction (ED) and its association with some clinical and laboratory factors. A cross-sectional study was conducted using random sampling in men living with HIV (MLWH) at a tertiary hospital in Turkey. Patients were asked to fill out the five-item International Index of Erectile Function (IIEF-5), and blood was collected for HIV viral load, CD4+ T lymphocyte count, lipids and hormone levels to assess biological aspects at the same clinical visit. A total of 107 MLWH were recruited. Mean age was 40.4 ± 12.4 years. ED was found in 73.8% (n = 79) of the participants. Severe ED was found in 6.3%, moderate in 5.1%, mild-moderate 35.4%, mild 53.2% of the participants, respectively. The mean age of men with erectile dysfunction was 42.5 ± 12.5 years, while those without erectile dysfunction were 34.5 ± 10years (p:0.00). ED was detected more frequently in cases with high Low Density Lipoprotein (LDL) levels (p:0.003). There was no statistically significant difference between ED presence and having hormone abnormality. There was a moderate, negative correlation between age and ED score (r: -0.440, p < 0.001). A negative and low correlation was found between triglyceride level and ED score (r: -0.233, p:0.02). The only predictive variable was age in the multivariate analysis [B: -0.155 (95% CI -0.232 to -0.078), p: <0.001]. Our study revealed a high prevalence of ED in the MLWH cohort. Age was found to be the only factor associated with ED. HIV clinicians should consider routine ED screening with validated measures as a part of the follow-up scheme to improve integrated wellbeing in MLWH.

Management and Outcomes of Pediatric Craniopharyngioma: A 15-Year Experience in Singapore

Craniopharyngiomas arise from the Rathke pouch and account for 1.2%-18.4% of pediatric primary brain tumors. Despite relatively good survival outcomes, patients face long-term morbidity from recurrences, visual impairment, and endocrinopathies, which reduce quality of life. We examined the management of pediatric craniopharyngiomas, their recurrences, and subsequent neuroendocrine sequelae in a tertiary center in South-East Asia. A retrospective cohort of 12 paediatric patients (aged ≤18 years) with histologically confirmed diagnosis of craniopharyngioma treated from January 2002 to June 2017 was conducted. Data collected included demographics, clinical presentation, imaging data, treatment details, postoperative sequelae, and outcomes on mortality and recurrence. Survival analysis was conducted using Cox-proportional hazards model. The median follow-up time was 6.60 years (1.9-11.5 years). The mean age was 7.6 years (standard deviation 4.8) and 7 patients (58.3%) were male. The most common presenting symptoms were raised intracranial pressure (7, 58.3%), visual deficits (6, 50.0%), and preoperative endocrine abnormalities (2, 16.7%). Five patients underwent gross total resection (41.7%), and 7 underwent subtotal resection (58.3%). Overall survival was 75.0% (9 patients), and recurrence was 58.0% (7 patients). Median time-to-recurrence was 5.87 months (0.23-33.7, interquartile range 15.8), and median progression-free survival was 4.16 years (0.18-10.1, interquartile range 5.29). Long-term management of pediatric craniopharyngioma remains difficult, with multiple recurrences and long-term neuroendocrine sequelae impairing quality of life for patients. Further research into management of recurrences and neuroendocrine sequelae, as well as novel therapies to improve outcomes in these patients, may be warranted.

The Role of Circadian Rhythms in Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS), as a most common metabolic disrupted disease, has several main symptoms, including ovarian insufficiency, hyperandrogenism, insulin resistance, etc., which may lead to female infertility. Many studies on the processes of PCOS have been done throughout the years, but unfortunately, the pathophysiology of PCOS is still not fully figured out. The circadian rhythm is the metronomic adjustment of the organisms to the external environment at all levels, from the molecular to the individual. It is revealed in multiple studies that there is a clear association between the progression of PCOS and the disturbance of circadian rhythms. Numerous studies have demonstrated that circadian rhythms can influence the development of PCOS by altering the Wnt/β-catenin, GPCR/cAMP/PKA, PI3K/AKT, and MAPK signaling pathways of the hypothalamic-pituitary-ovarian/hypothalamic-pituitary-adrenal axis, which result in abnormal hormone expression, receptor resistance, and metabolic disorders. The circadian rhythm misalignment may contribute to the formation and development of PCOS through the expression of certain genes that control the canonical signaling pathway. It is foreseeable that more preventive and targeted treatment for PCOS is the hot zone of clinical research in the future. This article aimed to review the state regarding the link between circadian rhythm disorder and PCOS, focus on the pathophysiology of PCOS, explore the pathways of circadian rhythm in the process of PCOS, and seek to offer a clear direction and practical approach for the prevention and treatment of PCOS.

Endocrinology for the hepatologist.

Endocrinology for the hepatologist.

Potential role of latent toxoplasmosis in inducing thyroid disorders with relevance to autoimmune thyroid disease and interleukin-33 level during pregnancy

Background and Aim: Latent toxoplasmosis is the most frequently occurring parasitic infection worldwide, which causes hormonal and behavioral changes that seriously affect pregnant women. It has also been linked to several autoimmune diseases, including autoimmune thyroid disease (AITD). This study aimed to investigate the association between Toxoplasma gondii seropositivity and thyroid dysfunction, considering the impact of latent toxoplasmosis on the prevalence of maternal AITD and interleukin-33 (IL-33) levels in infected and non-infected pregnant women. Materials and Methods: We conducted a cross-sectional study on 400 pregnant women aged 15–50 in the 8th–36th gestational week. Toxoplasma status was confirmed by detecting anti-Toxoplasma immunoglobulin (Ig)G antibodies. Recent and past chronic toxoplasmosis status was differentiated using the Toxoplasma IgG avidity test. Free triiodothyronine (FT3), free thyroxine, and thyroid-stimulating hormone (TSH) levels were determined to evaluate thyroid disorders. Antibodies against thyroid peroxidase, thyroglobulin, and TSH receptor were assessed to distinguish patients with autoimmune thyroid disorders from those with other thyroid diseases. We divided the subjects into four groups (Toxo+ and abnormal hormone level, Toxo– and normal hormone level, Toxo+ and normal hormone level, and Toxo– and abnormal hormone level) and evaluated their IL-33 levels to investigate its role during the infection. All the tests were performed using the enzyme-linked immunosorbent assay. Results: The results showed that (205/400, 51.2%) samples were seropositive for anti-Toxoplasma IgG antibodies. Of these, (25/205, 12.2%) and (180/195, 87.8%) had recent and past chronic infections, respectively. High infection rates were reported among rural dwellers (150/400, 37.5%) and those in their 3rd trimester (110/400, 27.5%). Of the 205 seropositive patients, (131/205, 63.9%) had thyroid disorders, among which (69/205, 33.7%) and (119/205, 58.0%) had abnormal FT3 and TSH hormone levels, respectively. In contrast, out of 195 Toxoplasma seronegative samples, (99/195, 50.8%) had thyroid disorders; (48/195, 24.6%) and (90/195, 46.2%) had abnormal FT3 and TSH hormone levels, respectively. Groups with abnormal FT3 and TSH levels had significantly higher seropositive anti-toxoplasma IgG antibodies (p = 0.01). Women with seropositive anti-Toxoplasma IgG antibodies had a high hypothyroidism rate (115/205, 56.1%) compared with those with seronegative anti-Toxoplasma IgG antibodies (86/195, 44.1%). We found an association between toxoplasmosis and thyroid status (p &lt; 0.05). Out of 400 samples, 85 (85/400, 21.25%) had AITD. Further, (58/205, 28.3%) of women with seropositive anti-toxoplasma IgG antibodies had AITD compared to (27/195, 13.85%) in the seronegative ones. We found a significant association between toxoplasmosis and AITD (p &lt; 0.05). The IL-33 level was highest in the Toxo+ and abnormal hormone level group (210.86 ± 44.39 pg/mL) and lowest in the Toxo-and normal hormone level group (22.27 ± 8.41 pg/mL). Conclusion: Our results suggest that latent toxoplasmosis was significantly associated with thyroid hormone secretion, which might stimulate the immune system, leading to the development of AITD among pregnant women. Furthermore, the T. gondii seroprevalence was positively correlated with pregnant patients who were rural dwellers and in their 3rd trimester. Keywords: autoimmune thyroiditis disease, interleukin-33, pregnancy, thyroid hormones, toxoplasmosis.

Prevalence Of Thyroid Hormones Test Abnormality In Females At Reproductive Age Attending Al-batool Maternity Teaching Hospital

Background: Although there is little information about the prevalence of thyroid disorders in young women, but they are common in Iraq.&#x0D; Objective: To prevalence of thyroid hormones test abnormality in females at reproductive age attending al-batool maternity teaching hospital&#x0D; Patients and Methods: This study involved 1570 of reproductive female ages patients at the Al-batool Maternity Hospital in Diyala Province, Iraq. Serum levels of T3, T4, and TSH were measured in this study. According to the conventional definitions of T3, T4, and TSH levels of overt hyper- and hypothyroidism patients were grouped according to their thyroid status at the time of testing.&#x0D; Results: A total of 1570 subjects were screened of whom 152 subjects (18.6%) had abnormal TSH. The overall prevalence of hyperthyroidism with elevated TSH was 17.4%, of which 1.2% had hypothyroidism with elevated TSH. A low TSH was seen in 1.3% of the study population (P= 0.001). Generally, thyroxin hormone (T4) abnormalities were totaled at 12.02%, of which 10.22% were hypothyroidism and 1.8% was hyperthyroidism. Furthermore, the triiodothyroxin hormone T4 abnormality percentage was 14.84%, compared to hypothyroidism of 3.12% and hyperthyroidism of 11.72%.&#x0D; Conclusion: Thyroid dysfunction was common in young women. Therefore, females more susceptible to thyroid disorders.

Prevalence Of Thyroid Hormones Test Abnormality In Females At Reproductive Age Attending Al-batool Maternity Teaching Hospital

Background: Although there is little information about the prevalence of thyroid disorders in young women, but they are common in Iraq. Objective: To prevalence of thyroid hormones test abnormality in females at reproductive age attending al-batool maternity teaching hospital Patients and Methods: This study involved 1570 of reproductive female ages patients at the Al-batool Maternity Hospital in Diyala Province, Iraq. Serum levels of T3, T4, and TSH were measured in this study. According to the conventional definitions of T3, T4, and TSH levels of overt hyper- and hypothyroidism patients were grouped according to their thyroid status at the time of testing. Results: A total of 1570 subjects were screened of whom 152 subjects (18.6%) had abnormal TSH. The overall prevalence of hyperthyroidism with elevated TSH was 17.4%, of which 1.2% had hypothyroidism with elevated TSH. A low TSH was seen in 1.3% of the study population (P= 0.001). Generally, thyroxin hormone (T4) abnormalities were totaled at 12.02%, of which 10.22% were hypothyroidism and 1.8% was hyperthyroidism. Furthermore, the triiodothyroxin hormone T4 abnormality percentage was 14.84%, compared to hypothyroidism of 3.12% and hyperthyroidism of 11.72%. Conclusion: Thyroid dysfunction was common in young women. Therefore, females more susceptible to thyroid disorders. Keywords: prevalence, thyroid‑stimulating hormone, hyperthyroidism, hypothyroidism, Iraq, women

Association between normal, abnormal thyroid hormones and diabetes mellites retinopathy in patients with type 1, 2 and 3 diabetes in the Anbar city

Diabetes is a type of disease that affects the rest of the body's functions. The study was conducted at Al-Ramadi Teaching Hospital for Women and Children for the period from 2021-2022. Our study aimed to investigate the relationship between the three types of diabetes (T2DM, gestational diabetes and T1DM). The study found that age affects disease severity levels in addition to weight, where the effect was less in type 2 and gestational diabetes. For fats, there was no strong effect in increasing diabetes. With regard to low-density lipids, it has been shown that it directly affects the development of the disease, because triglyceride levels have a strong and direct influence on the development of diabetes, especially type 1 and type 2. Cumulative glucose testing: Sugar and insulin have been linked to disease. In this study, when performing Pearson's correlation analysis of the relationship between TSH and some biochemical tests, there was a strong correlation between TSH, age, weight, T3, RBS, HbA1c and insulin, while there was no correlation for TSH with lipids, T4 and other tests. These results indicate the importance of thyroid screening for diabetic patients.

Possible cognition changes in women with polycystic ovary syndrome: a narrative review.

Nowadays, polycystic ovary syndrome (PCOS) and cognitive dysfunction are major health problems among female. This narrative review aimed to investigate cognitive dysfunction in female with PCOS. English and Persian articles published in PubMed, Scopus, Web of Science, Google Scholar, PsycINFO, Scientific Information Database, and Cochrane Database of Systematic Reviews until May 2022 were searched. Sixteen studies involving 850 female with PCOS and 974 controls were assessed. In these studies, the association between biochemical factors and symptoms of PCOS and memory, attention, executive functioning, information processing speed, and visuospatial skills was evaluated. The literature review revealed the possible cognitive changes in female with PCOS. This study summarized the different aspects of cognitive function in female with PCOS due to medication, psychological problems (mood disorders caused by disease symptoms and complications), and biochemical markers, such as metabolic and sex hormone abnormalities. Considering the existing scientific gap regarding the possibility of cognitive complications in female with PCOS, further biological studies should be conducted to evaluate the potential mechanisms involved.

Pituitary abscess: a case report and systematic review of 488 cases

BackgroundPituitary abscess (PA) is a rare condition and not well understood. We aimed to describe a case and perform a comprehensive systematic review to explore presenting symptoms, radiological findings, endocrine abnormalities and mortality.AimTo identify presenting symptoms, radiological findings, endocrinological abnormalities and predictors of mortality for PA.MethodsWe systematically reviewed the literature to identify all case reports of PA. Data regarding presentation, mortality, radiological findings, endocrinological abnormalities and treatment was extracted.ResultsWe identified 488 patients from 218 articles meeting the inclusion criteria. Mortality was 5.1%, with days to presentation (OR 1.0005, 95% CI 1.0001–1.0008, p < 0.01) being the only identified independent predictor of mortality. Mortality rates have decreased over time, with cases published prior to 2000 having higher mortality rates (OR 6.92, 95% CI 2.80–17.90, p < 0.001). The most common symptom was headache (76.2%), followed by visual field defects (47.3%). Classical signs of infection were only present in 43%. The most common imaging feature on magnetic resonance imaging (MRI) was high T2 and low T1 signal of the pituitary gland with peripheral contrast enhancement. Over half (54.8%) were culture negative, with the most common bacterial organism being staphylococcus aureus (7.8%) and fungal organism being aspergillus (8.8%). The most common endocrine abnormality was hypopituitarism (41.1%), followed by diabetes insipidus (24.8%). Whilst symptoms resolved in most patients, persistent endocrine abnormalities were present in over half of patients (61.0%).ConclusionPA is associated with significant mortality, with delayed presentation increasing risk of mortality. Ongoing endocrinological abnormalities are common. Given the non-specific clinical presentation, the appearance of high T2, low T1 and peripheral contrast enhancement of the pituitary on MRI should prompt consideration of this rare disease.

Red Meat Consumption and its Relationship With Cardiovascular Health: A Review of Pathophysiology and Literature.

Red meat is the muscle meat of mammals like beef, lamb, and pork that is red due to the abundance of myoglobin pigment and becomes even darker when cooked. The global average per capita consumption of meat and the total amount of meat consumed is rising, and there has been a particularly marked increase in the global consumption of chicken and pork. The consumption of red meat has always been a contentious issue, with data suggesting benefits in terms of nutritional value and at the same time linking its consumption to major health disorders such as endocrine abnormalities, gastrointestinal issues, cancers, and cardiovascular diseases (CVDs). Despite being normalized by major food franchises, red meat consumption may lead to adverse cardiovascular outcomes such as atherosclerosis, ischemic heart disease, stroke, and cardiac failure. Given the evidence that indicates the consumption of red and processed meat as a risk factor for cardiovascular diseases and all-cause mortality, it is important to review the effects of red meat on the risk of cardiovascular diseases.

P-522 Embryo transfer procedural parameters do not predict IVF cycle outcome

Abstract Study question Do embryo transfer (ET) procedural parameters affect the clinical outcome, in terms of positive human chorionic gonadotropin (hCG), clinical pregnancy and live-birth? Summary answer Observation of ET procedural parameters, either as single parameters or combined in a model, does not seem to have a predictive value on cycle outcome. What is known already It has been reported that several ET procedural parameters of technical nature may influence IVF outcome. Observational studies on variables during and post ET from mucus presence to catheter reload, have been published and data hitherto is conflicting leaving practitioners confounded. It is essential to evaluate the effect of the reported ET performance parameters, clarifying the degree of effect on a singular or combinatorial level. This will assist practitioners in recording and analysing strictly factors that hold high-significance predictive value, instead of redundantly recording moot parameters that may be unfit to serve as key performance indicators post ET. Study design, size, duration A prospective observational study was performed between 3/2018 and 9/2022 in a single IVF center. ET procedures for a total of 1417 women were assessed. The performance parameters studied and associated with clinical outcomes were the following: time of ET, presence of cervical mucus in the catheter, presence of blood, catheter reload, employment of tenaculum and stylet, resistance during transfer, ease of transfer according to the practitioner and discomfort as experienced by the patient. Participants/materials, setting, methods Only women of normal endometrial and uterine anatomy and function were included. Genetic and endocrine abnormalities, azoospermia and PGT cycles were excluded. Embryo grading was performed according to Veeck’s and Gardner’s system depending on developmental stage. All ETs were performed employing the same type of soft catheter. The clinical outcomes evaluated were positive hCG, clinical pregnancy, and live-birth. Associations were evaluated on a singular or combinatorial level between the ET performance parameters and clinical outcomes. Main results and the role of chance A univariate logistic regression was employed to evaluate the possible effect of each of the ET procedural parameters. None of the ET parameters presented with statistical significance. The employment of ultrasound, the number, and the quality of transferred embryos, maternal age as well as the physician and embryologist performing the transfer were evaluated as covariates in a univariate regression model. Number (p = 0.01) and quality of transferred embryos (p = 0.003), as well as maternal age (p = 0.004) presented with statistical significance. The multivariate approach yielded similar results. To evaluate the possibility that interactions between the ET procedural parameters could affect cycle outcome a model was created evaluating all possible interactions and combination of the ET parameters. To adjust for possible multiple comparison bias, the Bonferroni correction was employed. Only the presence of mucus along with significant resistance seemed to present with statistical significance (p &amp;lt; 0.0001). However, when adjusting for the covariates the combination of cervical mucus and significant resistance did not provide a statistically significant effect on clinical outcomes and thus cannot be considered as an independent predictor. When subgrouping only for women below the age of 35 with at least one top quality embryo, no statistically significant association was observed. Limitations, reasons for caution The sample size could be a reason for caution when interpreting the results of the present study as a larger number of women presenting with each combination may be required to reach the threshold of statistical significance. The single-center nature of the study may present as another limitation. Wider implications of the findings Data indicates that ET procedural parameters hold no predictive value singularly or combinatorially. The only robust predictive factors are embryo quality, number, and maternal age. While further studies are required to cement this finding, it may be the case that the time-consuming recording and analysis of such parameters is redundant. Trial registration number Not applicable

O-095 Different phenotypes of PCOS: Implications to clinical practice

Abstract Polycystic ovary syndrome (PCOS) is a very common, heterogeneous syndrome which presents with a spectrum of clinical and biochemical features. It is associated with both reproductive and metabolic dysfunction and has a negative impact on long term health, including mental health. Although there appears to be a common genetic background to PCOS, regardless of presentation, environmental factors, including diet, play an important part in determining the phenotype. The most commonly used diagnostic criteria, the Rotterdam criteria, takes account of the heterogenous nature of the syndrome but the spectrum of presentation can be categorised as four clinical and biochemical subtypes which comprise (A) ovulatory dysfunction, hyperandrogenism, polycystic ovaries (PCO), (B) ovulatory dysfunction, hyperandrogenism but without PCO, (C) hyperandrogenism without ovulatory dysfunction but with PCO and (D) ovulatory dysfunction with PCO but without hyperandrogenism. These are not rigid categories since some women may go from one to another, for example weight gain may lead to anovulation in a woman who previously had hirsutism but regular cycles. Nevertheless, the diagnostic sub-category has a significance influence on clinical management. Women who have both hyperandrogenism and ovulatory dysfunction (A&amp;B) are at higher risk of metabolic dysfunction which is exacerbated by obesity (and carries a high long-term risk of diabetes and cardiovascular disease) and so merit thorough investigation which includes assessment of glucose tolerance and lipids. Those who have predominantly ovulatory problems may require fertility treatment or regulation of menses but some who simply have irregular menses may need no specific treatment. Symptoms of hyperandrogenism (hirsutism, acne, alopecia) can be particularly distressing and may be best managed in collaboration with a dermatologist. The negative impact of PCOS on mental health is a very common problem, the high prevalence of which has only recently been appreciated. Not surprisingly, it is particularly relevant in those women who have moderate to severe symptoms of hyperandrogenism. In summary, PCOS is a syndrome characterised by a variety of symptoms and endocrine abnormalities and it is important to tailor treatment individually, according to the need for symptom relief and with regard to concerns about long-term health.

P-641 Clinical significance of differential expression of miRNA642-a/miRNA5739/miRNA3648 in the follicular microenvironment in patients with polycystic ovary syndrome

Abstract Study question What is the relationship between differential expression of miRNA in the follicular microenvironment,follicular fluid hormone and oocyte quality in polycystic ovary syndrome (PCOS) patients. Summary answer In PCOS patients, differential expression of miRNA in the follicular microenvironment is associated with abnormal hormone levels in the follicular fluid and oocyte quality. What is known already PCOS has abnormalities in local ovarian morphology and function, and studies have shown that the expression of local miRNA in the ovaries will be accompanied by dynamic changes in follicular recruitment, oocyte growth, follicular microenvironment changes, etc., which may affect the quality of oocytes. Study design, size, duration 19 patients with PCOS (PCOS group) and 17 patients with infertility due to male factors alone (control group) aged 22-35 years was included in the study. The main results included differential expression of miRNA642-a/miRNA5739/miRNA3648, MII egg rate, high-quality embryo rate, testosterone and insulin levels in follicular fluid. Participants/materials, setting, methods From April 2017 to January 2019, 19 PCOS patients (PCOS group) and 17 patients (control group) who underwent Intracytoplasmic sperm injection-embryo transfer at the Reproductive Center of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine were collected. RT-PCR was used to detect the differential expression levels of miRNA642-a/miRNA5739/miRNA3648 in follicular fluid and granule cells in PCOS group and control group, and Chemiluminescence was used to detect follicular fluid T and insulin levels. Main results and the role of chance The levels of testosterone and insulin in follicular fluid in PCOS group were significantly higher than those in the control group, and the difference was statistically significant (P &amp;lt; 0.05). The MII egg rate and optimal embryo rate in the PCOS group were both lower than those in the control group, and the difference was significant (P &amp;lt; 0.05). The expression level of miR-642a-3p in follicular fluid and granule cells was consistent, and the PCOS group was lower than that in the control group. The difference was statistically significant (P &amp;lt; 0.05). The expression levels of miRNA-5739 and miRNA-3648 in follicular fluid were higher than those in the control group, but the expression levels in granule cells were lower than those in the control group, and the difference was significant (P &amp;lt; 0.05). Correlation analysis showed that the expression levels of miRNA-3648 and miRNA-5739 in follicular fluid were closely related to the normal fertilization rate of PCOS patients, and the expression levels of miRNA-5739 were closely related to the optimal embryo rate of PCOS patients. The expression levels of miRNA-642a-3p, miRNA-5739 and miRNA-3648 in granule cells were closely related to the MII egg rate and 2PN cleavage rate of PCOS patients. Limitations, reasons for caution MiRNAs participate in follicle development and maturation and hormone secretion through multiple signaling pathways. We only examined miRNA-642a-3p, miRNA-5739, miRNA-3648 in follicular fluid and granule cells, and did not detect the exosomal miRNAs. Dynamic changes in miRNA in the follicular microenvironment are not fully revealed. Wider implications of the findings Our results further demonstrate that the abnormal expression of miRNA in follicular fluid and granule cells in women with polycystic ovary syndrome (PCOS) is closely related to the local abnormal hormone secretion and follicle development of PCOS ovaries. Trial registration number not applicable

DISCORDANT CALCIUM AND PARATHYROID HORMONE WITH PRESUMED EPILEPTIC SEIZURES

Epileptic seizures are a neurological condition characterized by abnormal electrical activity in the brain, leading to involuntary and unpredictable movements, changes in consciousness, and other symptoms. The study's main objective is to find the discordant calcium and parathyroid hormone with presumed epileptic seizures. This study aims to investigate the association between discordant calcium and parathyroid hormone (PTH) levels and presumed epileptic seizures in a cohort of 200 patients. The study was conducted between June 2022 and December 2022. The study was conducted in collaboration with the neurology department. Patients admitted to the hospital with presumed epileptic seizures were included in the study. This study found that out % of the 200 patients who met the inclusion criteria, 65% had discordant calcium and PTH levels. Among these patients, 80% had low calcium and high PTH levels, while 20% had high calcium and low PTH levels. The logistic regression analysis showed a significant association between discordant calcium and PTH levels and presumed epileptic seizures (p&lt;0.05). In conclusion, the results of this study suggest that abnormalities in calcium and parathyroid hormone (PTH) levels are not a major contributor to the development of epileptic seizures in most patients. While patients with hypocalcemia appeared to have a higher risk of seizures than those with normal calcium levels, most patients with hypocalcemia did not experience seizures.

X-linked hypophosphatemic rickets: from diagnosis to management.

X-linked hypophosphatemia (XLH), the most common cause of hypophosphatemic rickets, affects one in every 20,000 people. Although conventional therapy for XLH was introduced approximately 4 decades ago, the temporary replacement of oral phosphate salts and activated vitamin D cannot completely control chronic hypophosphatemia, leaving patients with incomplete healing and residual skeletal deformity as well as at risk of endocrine abnormalities and adverse drug reactions. However, understanding the pathophysiology has led to the development of a targeted therapy, burosumab, a fibroblast growth factor-23 inhibitor that was recently approved in Korea for the treatment of XLH. This review provides insight into the diagnosis, evaluation, treatment, and recommended follow-up for a typical case of XLH and reviews its pathophysiology.

Effects of early life overnutrition and hyperandrogenism on spatial learning and memory in a rat model of polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a complex disorder characterized by endocrine and metabolic abnormalities such as obesity and insulin resistance. PCOS is also associated with psychiatric disorders and cognitive impairment. The animal model of PCOS was induced by treating rats with 5α-dihydrotestosterone (5α-DHT) and additionally modified to induce adiposity by litter size reduction (LSR). Spatial learning and memory were assessed using the Barnes Maze test, and striatal markers of synaptic plasticity were analyzed. Striatal insulin signaling was estimated by the levels of insulin receptor substrate 1 (IRS1), its inhibitory phosphorylation at Ser307, and glycogen synthase kinase-3α/β (GSK3α/β) activity. Both LSR and DHT treatment significantly decreased striatal protein levels of IRS1, followed by increased GSK3α/β activity in small litters. Results of the behavioral study showed that LSR had a negative effect on learning rate and memory retention, whereas DHT treatment did not induce impairment in memory formation. While protein levels of synaptophysin, GAP43, and postsynaptic density protein 95 (PSD-95) were not altered by the treatments, DHT treatment induced an increase in phosphorylation of PSD-95 at Ser295 in both normal and small litters. This study revealed that LSR and DHT treatment suppressed insulin signaling by downregulating IRS1 in the striatum. However, DHT treatment did not have an adverse effect on learning and memory, probably due to compensatory elevation in pPSD-95-Ser295, which had a positive effect on synaptic strength. This implies that hyperandrogenemia in this setting does not represent a threat to spatial learning and memory, opposite to the effect of overnutrition-related adiposity.

Oxytocin's Regulation of Thermogenesis May Be the Link to Prader-Willi Syndrome.

Prader-Willi Syndrome (PWS) is a genetic neurodevelopmental disorder that is caused by either the deletion of the paternal allele of 15q11-q13, maternal uniparental disomy of chromosome 15 or defects in the chromosome 15 imprinting centre and is characterized by cognitive impairment, hyperphagia and low metabolic rate with significant risk of obesity, as well as a variety of other maladaptive behaviours and autistic spectrum disorder (ASD). Many of the features seen in PWS are thought to be due to hypothalamic dysfunction resulting in hormonal abnormalities and impaired social functioning. The preponderance of evidence indicates that the Oxytocin system is dysregulated in PWS individuals and that this neuropeptide pathways may provide promising targets for therapeutic intervention although the process by which this dysregulation occurs in PWS awaits mechanistic investigation. PWS individuals present abnormalities in thermoregulation an impaired detection for temperature change and altered perception of pain indicating an altered autonomic nervous system. Recent studies indicate that Oxytocin is involved in thermoregulation and pain perception. This review will describe the update on PWS and the recent discoveries on Oxytocin regulation of thermogenesis together with the potential link between Oxytocin regulation of thermogenesis and PWS to create a new groundwork for the treatment of this condition.