Follicle-stimulating Hormone Ratio Research Articles

The predictive value of preoperative luteinizing hormone to follicle stimulating hormone ratio for ovulation abnormalities recovery after laparoscopic sleeve gastrectomy: A prospective cohort study.

Obesity-related ovulation abnormalities (OA) affect fertility. LSG is the most frequent bariatric operation. However, no research has identified a reliable indicator for predicting OA recovery after LSG. The purpose of this research was to examine the prognostic usefulness of preoperative the luteinizing hormone (LH) to follicle-stimulating hormone (FSH) ratio (LFR). Our department conducted a prospective study from 2016 to 2021. Venous blood was typically tested 3 days before surgery to get the preoperative LFR. Descriptive data, preoperative and postoperative variables were also collected. Binary logistic regression related preoperative LFR with OA recovery. The receiver operating characteristic (ROC) curve evulated preoperative LFR's predictive capability. A total of 157 women with a complete follow-up of one year were included. LFR was the only factor linked with OA (P < 0.001). AUC (area under the ROC curve) = 0.915, cutoff = 1.782, sensitivity = 0.93, and specificity = 0.82. Overall, LSG has a favorable surgical result, with a %TWL of 66.082 ± 12.012 at 12 months postoperatively. Preoperative sexual hormone levels, as expressed by LFR, has the potential to predict the fate of OA following LSG at one year post-operatively.

Прогнозування перебігу гіпоандрогенії в хлопців-підлітків

The most pathological conditions that adversely affect the reproductive function in men of mature age is formed precisely in adolescence as a result from hypoandrogenism (HA), - a decrease in the production of male sex hormones (androgens) below the age norm. Therefore, the ability to predict the course of HA in adolescent boys allows to prevent serious health problems in the future. Purpose - to determine significant prognostic criteria for adverse course of HA in adolescent boys with delayed sexual development. Materials and methods. Were examined 157 boys 14-17 years old with signs of androgen deficiency, the degree of which was based on the assessment of total testosterone (TT). The levels of gonadotropic hormones, estradiol, their ratios were studied by enzyme-linked immunosorbent assay, and the content of thyroid-stimulating hormone and free thyroxine, their ratio was determined. The lipid spectrum of blood was studied. On the basis of X-rays of the non-dominant hand and wrist determined bone age and ossification deficiency. Сonditionally unfavorable course of HA was formed in adolescent boys with severe androgen deficiency (HA 3 degree) at the level of total testosterone &lt;4 nmol/l. Favorable course of HA was considered to be the presence of clinical signs of hypoandrogenism in adolescents with normal TT, levels more than 12 nmol/l (HA 0 degree). Results. Based on the study was identified the most informative features and calculated their prognostic coefficient. It is proved that significant informative signs of HA in adolescent boys are such as body mass index abnormalities, bone age deficit, levels and ratios of gonadotropic hormones, estradiol values and testosterone / estradiol, testosterone / luteinizing hormone ratios, thyroid stimulating hormone / free thyroxine, changes in lipid profile. To the most prognostically significant negative prognostic criteria for adverse HA in adolescent boys are excess body weight by body mass index level, significant deficit of bone age (more than 3 years), decreased luteinizing hormone levels, decreased luteinizing hormone / follicle stimulating hormone ratio, hyperestrogenism, pronounced androgenic-estrogenic disbalance, the presence of minimal thyroid dysfunction, disorders of the lipid profile. Conclusions. The developed prognostic criteria for adolescent boys with HA will make it possible to predict the further course of the disease (in the early stages of its formation pathology), what will carry out timely treatment and rehabilitation measures in adolescent boys, and this will help to improve their health. Teens with HA, who show prognostically unfavorable signs, need more careful dispensary observation of an endocrinologist. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Efficacy of a Proprietary Fenugreek Seed Extract (Trigonella foenum-graecum, Furocyst®) in Women with Polycystic Ovary Syndrome (PCOS): a Randomized, Double-Blind, Placebo-Controlled Study

Introduction Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenemia, a quite common heterogenous endocrine/hormonal disorder, and accompanied by elevated androgen level, menstrual irregularity, and hirsutism. The consequences include infertility or miscarriage. It is a challenging problem to the physicians. In a one-arm, non-randomized preliminary investigation in fifty premenopausal women, we demonstrated the efficacy of Furocyst®, a patented, standardized Trigonella foenum-graecum extract, in ameliorating the symptoms of PCOS over a period of 90 consecutive days. Objective In the present study, a double-blind, two-arm, single-center, randomized, comparative study was conducted to assess the efficacy of Furocyst® (2 capsules of 500 mg/day) in 208 pre-menopausal women diagnosed with PCOS. Methods Ethical committee approval was obtained. A total of 208 subjects (placebo = 95; Furocyst® = 113; age:18-45 years, BMI < 42 kg/m2) completed the investigation. The comparative efficacy of placebo and Furocyst® was assessed on the number of cysts, ovarian volume, hirsutism, LH:FSH ratio, titer of TSH, SHBG, prolactin and free testosterone. Key clinical parameters such as fasting blood glucose levels, HOMA Index, cholesterol, LDL, and triglyceride levels, as well as total blood chemistry were also investigated Results Furocyst® supplementation significantly reduced the number of cysts, ovarian volume, and hirsutism levels, as well as normalized the menstrual cycle in Furocyst®-treated subjects as compared to placebo group. Furocyst® significantly reduced luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels, and thyroid stimulating hormone (TSH) levels, and reduced the prolactin and SHBG levels. Furocyst® significantly reduced the fasting blood glucose levels, HOMA Index, cholesterol, LDL, and triglyceride levels as compared to the placebo group, while the free testosterone levels were significantly decreased in the Furocyst® group. Conclusion The studies collectively demonstrated the efficacy of Furocyst® as a safe, natural phytochemical-based formulation to alleviate the symptoms of PCOS. No significant adverse events were observed.

Polycystic Ovary Syndrome Phenotype D Versus Functional Hypothalamic Amenorrhea With Polycystic Ovarian Morphology: A Retrospective Study About a Frequent Differential Diagnosis

The two most frequent causes of secondary amenorrhea are polycystic ovary syndrome (PCOS) and functional hypothalamic amenorrhea (FHA). Despite several studies showing differences in hormonal profile between these groups, the differential diagnosis remains challenging, in particular between FHA women with polycystic ovarian morphology (FHA-PCOM) and PCOS patients without hyperandrogenism (phenotype D, PCOS-D). In a retrospective case-control study, 58 clearly defined patients with FHA-PCOM were compared to 58 PCOS-D patients, matched 1:1 for age and BMI. Significantly higher levels of LH, estradiol, testosterone, and a higher luteinizing hormone (LH): follicle stimulating hormone (FSH) ratio as well as lower sexual hormone binding globulin (SHBG) levels were found in PCOS-D patients (p< 0.05). Optimized cut-off values for the prediction of FHA-PCOM were calculated by the Youden index. The highest sensitivity was found for an estradiol serum level <37.5 pg/mL (84.5%, 95% confidence interval, CI: 72.6-92.6), whereas a LH : FSH ratio <0.96 had the highest specificity (94.8, 95% CI: 85.6-98.9). A linear discriminant analysis including testosterone, SHBG and LH was able to correctly classify 87.9% of FHA-PCOM patients (bootstrap 95% CI: 80.2 - 94.0%). In conclusion, this model including serological parameters could be an easy and reliable tool to distinguish between FHA-PCOM and PCOS-D patients, especially in situations where the clinical profile is not obvious.

Testosterone level correlates significantly with luteinizing hormone to follicle-stimulating hormone ratio among women with polycystic ovary syndrome: A cross sectional study

Background: Polycystic ovary syndrome (PCOS), an endocrinological problem among women in the reproductive age, is characterized by chronic ovulatory dysfunction, hyperandrogenism, and elevated luteinizing hormone: follicle stimulating hormone (LH-FSH) ratio. The goal of this study was to examine if the blood LH-FSH ratio and total testosterone (TT) levels in Sudanese women with PCOS were linked. Methods: This cross-sectional study included 300 women with confirmed PCOS based on Rotterdam criteria. PCOS women mean (standard deviation): age 29.1(5.8) years; body mass index (BMI) 27.9±4.6 kg/m2. Each participant underwent a clinical history, physical examination, and ovaries ultrasonogram. ASYS Expert Plus Microplate was used to quantify serum LH, FSH, and TT levels in fasting blood specimen drawn during the follicular phase of the menstrual cycle of women with PCOS. Results: More than two-thirds of the participants (71.0%) had an aberrant LH-FSH ratio (cut-off&gt;1.0), and 58.3% had hyperandrogenemia (TT&gt;109.5 ng/dL). Hyperandrogenemic women had significantly increased LH-FSH ratio (P= 0.000). The LH-FSH ratio and serum TT were significantly positive correlated (r= 0.329, P= 0.000). Overall, 52.0% of women with PCOS exhibited menstrual cycle irregularity, and 59.0 % had a positive family history of PCOS. On logistic regression analysis, the LH-FSH ratio (odds ratio (OR) (95% confidence interval (CI)): 2.308 (1.698- 3.139, P= 0.000) was found to be positively related to hyperandrogenemia independently. Furthermore, when the LH-FSH ratio is greater than one, hyperandrogenemia can be distinguished from normoandrogenemia, area under the curve (AUC) = 0.726, P= 0.000, 95% CI: (0.668-0.785) with a serum TT threshold of 109.5 ng/dL (sensitivity 70.0%, specificity 77.1%). Conclusions: In Sudanese women with PCOS, the serum LH-FSH ratio and TT have a strong relationship. Furthermore, LH-FSH ratio of greater than one can be used to distinguish between hyperandrogenic and non-hyperandrogenic PCOS women.

Management of polycystic ovary syndrome among Indian women using myo-inositol and D-chiro-inositol.

Myo-Inositol and D-chiro-inositol (MI-DCI) are used in the treatment of polycystic Ovary syndrome (PCOS) due to their insulin-sensitizing actions. Therefore, it is of interest to evaluate the treatment patterns, clinical effectiveness and safety of MI-DCI combination in anagement of PCOS in Indian women. Data from 50 healthcare centers across India was collected between September 2019 and February 2020 and was used in the study. Women aged 12-45 years diagnosed with PCOS, who had received MI-DCI (550-150 mg) were included. The outcome parameters were change in weight, luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio, hirsutism, blood glucose and insulin levels, HOMA-IR, and lipid profile. A total of 283 women were included (mean age: 27.74 years; body mass index: 26.89 kg/m2); of which 197 (69.61%) reported reduction in weight after treatment with MI-DCI. The hirsutism scores considerably improved after treatment and the proportion of patients with, no hirsutism increased from 31.07% to 50.51% and moderate hirsutism reduced from 32.52% to 6.12% while, there were no patients with severe hirsutism after the treatment. There was a significant reduction in LH:FSH ratio (mean difference: 0.25 mg/dL; p=0.021), free testosterone (mean difference: 1.49; p<0.001) and dehydroepiandrosterone (mean difference: 21.49; P<0.001) levels after regular use of MI-DCI tablets. Treatment with MI-DCI resulted in significant improvement in insulin levels, HOMA-IR score, Fasting plasma glucose (FPG), post-prandial plasma glucose (PPG) and lipid profile. The therapy restored menstruation and spontaneous ovulation and significantly attenuated the LH/FSH ratio. Thus, MI-DCI (550-150 mg) has shown multidimensional benefits in improving the hormonal, glycemic, and lipid profile of women with PCOS with considerable efficacy and tolerability.

Phytotherapy of polycystic ovary syndrome: A review.

BackgroundPolycystic ovary syndrome (PCOS) is a complex heterogeneous disease with various symptoms, which can affect females of reproductive age. Endocrine and metabolic abnormalities such as infertility, being overweight or obese, type 2 diabetes, hyperandrogenism and increased luteinizing hormone (LH) are common in women with PCOS.ObjectiveThis review aimed to assess the efficacy of non-chemical and herbal substances for PCOS recovery.Materials and MethodsThe keywords “non-chemical treatment”, “herbal treatment”, “polycystic ovary syndrome” and “PCOS” were used to search for articles in the electronic databases PubMed/MEDLINE, Web of Science, Scopus, and Reaxys, published from January 2009 to December 2019.Results34 relevant studies were found and were briefly described in this review. The most effective herbal treatments in animal models of PCOS were used to restore abnormality in serum sex steroid profile, LH: follicle stimulating hormone ratio, steroidogenic enzymes, cardiovascular parameters, lipid profile, and glucose and estrous cycles. In PCOS patients, positive effects on PCOS due to reductions in testosterone, estrogen, LH, LH: follicle stimulating hormone ratio, and insulin levels were observed.ConclusionThe results of this reviewrevealed the variability and efficacy of phytotherapy and non-chemical treatments associated with PCOS disease. These findings may help future studies on the etiology and treatment of this syndrome.

Testosterone level correlates significantly with luteinizing hormone to follicle-stimulating hormone ratio among women with polycystic ovary syndrome: A cross sectional study

Background: Polycystic ovary syndrome (PCOS), an endocrinological problem among women in the reproductive age, is characterized by chronic ovulatory dysfunction, hyperandrogenism, and elevated luteinizing hormone: follicle stimulating hormone (LH-FSH) ratio. The goal of this study was to examine if the blood LH-FSH ratio and total testosterone (TT) levels in Sudanese women with PCOS were linked. Methods: This cross-sectional study included 300 women with confirmed PCOS based on Rotterdam criteria. PCOS women mean (standard deviation): age 29.1(5.8) years; body mass index (BMI) 27.9±4.6 kg/m2. Each participant underwent a clinical history, physical examination, and ovaries ultrasonogram. ASYS Expert Plus Microplate was used to quantify serum LH, FSH, and TT levels in fasting blood specimen drawn during the follicular phase of the menstrual cycle of women with PCOS. Results: More than two-thirds of the participants (71.0%) had an aberrant LH-FSH ratio (cut-off&gt;1.0), and 58.3% had hyperandrogenemia (TT&gt;109.5 ng/dL). Hyperandrogenemic women had significantly increased LH-FSH ratio (P= 0.000). The LH-FSH ratio and serum TT were significantly positive correlated (r= 0.329, P= 0.000). Overall, 52.0% of women with PCOS exhibited menstrual cycle irregularity, and 59.0 % had a positive family history of PCOS. On logistic regression analysis, the LH-FSH ratio (odds ratio (OR) (95% confidence interval (CI)): 2.308 (1.698- 3.139, P= 0.000) was found to be positively related to hyperandrogenemia independently. Furthermore, when the LH-FSH ratio is greater than one, hyperandrogenemia can be distinguished from normoandrogenemia, area under the curve (AUC) = 0.726, P= 0.000, 95% CI: (0.668-0.785) with a serum TT threshold of 109.5 ng/dL (sensitivity 70.0%, specificity 77.1%). Conclusions: In women with PCOS, the serum LH-FSH ratio and TT have a strong relationship. Furthermore, LH-FSH ratio of greater than one can be used to distinguish between hyperandrogenic and non-hyperandrogenic PCOS women.

Correlation assessment of gender and thyroid hormones in patients with primary oligomenorhea in anamnesis

Objective. To determine the concentration of pituitary, ovarian and thyroid hormones in the blood and the correlation between them in women with a history of primary oligomenorrhea.&#x0D; Material and methods. The study involved 56 women of reproductive age with primary oligomenorrhea. Control 50 women of fertile age with an undisturbed rhythm of menstruation. An ultrasound of the uterus, ovaries and thyroid gland was performed. Concentrations of luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin, estradiol, testosterone dehydroepiandrosterone sulfate (DHEA-S), triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH) were determined by ELISA.&#x0D; Results. The average age of women in the main and control groups was 30.0 1.34 and 30.52 5.92 years (p 0.05), respectively. The average age of menarche in women of the main group was 13.27 0.80 years; duration of menstruation 3.4 0.40 days and 5.2 0.82 days (p = 0.051), respectively; duration of the menstrual cycle was 33.90 0.70 days (p = 0.001). Length and width of the uterus 3.99 0.19 cm (p = 0.055) and 4.51 0.11 cm, respectively; endometrial thickness 9.78 1.20 mm. The sizes of thyroid lobes did not differ between the groups. The LH level and the LH / FSH ratio were higher than the control values by 50.79 % (p = 0.052) and 52.66 % (p = 0.045), respectively. Testosterone and TSH concentrations were 38.33 and 34.36 % higher, respectively. The estradiol level was reduced by 56.67 % (p = 0.113). A weak correlation was revealed between sex and thyroid hormones.&#x0D; Conclusions. In women with a history of primary oligomenorrhea, the concentration of luteini-zing hormone and the LH / FSH ratio in the blood serum are significantly higher (p 0.05). In women with primary oligomenorrhea, there was a weak correlation between sex and thyroid hormones. The results will provide insight into the relationship between the thyroid function and the menstrual cycle.

Investigating the potential of clinical and biochemical markers to differentiate between functional hypothalamic amenorrhoea and polycystic ovarian syndrome: A retrospective observational study.

Functional hypothalamic amenorrhoea (FHA) is a common cause of amenorrhoea, but diagnosis can be challenging. The aim of this study was to investigate the clinical and biochemical features of FHA, compared to that of polycystic ovarian syndrome (PCOS) and assess the diagnostic performance of the different parameters for differentiating the two conditions. This was a retrospective observational study. We analysed clinical and biochemical parameters of women diagnosed with FHA and PCOS following specialist assessment at the reproductive endocrine gynaecology clinic, St Mary's Hospital. Compared with PCOS, women with FHA had significantly lower body mass index (BMI; 20.1 ± 2.9 vs. 31.1 ± 7.8 kg/m2 ; p< .0001) and a thinner endometrium (3.75 ± 2.23 vs. 6.82 ± 3.32 mm; p< .0001). Women with FHA had significantly lower luteinising hormone (LH; 3.46 ± 7.31 vs. 8.79 ± 4.98 IU/L; p< .0001), and lower LH to follicle-stimulating hormone (FSH) ratio, estradiol, thyroid-stimulating hormone, free thyroxine and prolactin levels; there was no significant difference in FSH levels. BMI had the greatest predictive performance for FHA (area under the curve [AUC]: 0.93; p< .001), followed by estradiol (AUC: 0.89;p< .001), LH (AUC: 0.88; p< .001) and LH:FSH ratio (AUC: 0.86; p< .001). Our data provides quantification for diagnostic accuracy of clinical parameters to differentiate FHA from PCOS, namely low BMI, estradiol, LH and LH:FSH ratio. These data could help clinicians more reliably diagnose FHA in women with secondary amenorrhoea.

Correlation of Homeostatic Model Assessment-Insulin Resistance, Anti-Mullerian Hormone, and BMI in the Characterization of Polycystic Ovary Syndrome.

Objective: To evaluate the correlation of homeostatic model assessment-insulin resistance (HOMA-IR), anti-Mullerian hormone (AMH), and BMI and to compare their values across the different phenotypes in polycystic ovary syndrome (PCOS) women of the reproductive age group.Study design: A total of 307 PCOS-diagnosed women were included in the study and further classified in different phenotypes. BMI, HOMA-IR, and serum AMH values were noted and their association with different phenotypes was seen. The correlation of these variables was also noted.Results: Phenotype D was the most common phenotype followed by type A, type B, and type C. A total of 265 women had an AMH value of ≥4 mg/ml with the highest value in phenotype A followed by D, C, and B. HOMA-IR and BMI values did not vary significantly among different phenotypes. HOMA-IR and BMI had a statistically significant positive correlation and serum AMH was negatively correlated with HOMA-IR, but no significant correlation was seen between serum AMH and BMI. The biochemical parameters like luteinizing hormone (LH), follicle-stimulating hormone (FSH), LH: FSH ratio, and serum testosterone showed no correlation with phenotypes or any other clinical parameter.Conclusion: HOMA-IR and BMI showed a statistically significant positive correlation indicating the need for lifestyle modification and weight reduction in PCOS women, which can further help in decreasing insulin resistance. A strong correlation of serum AMH levels and phenotypes shows the importance of serum AMH levels for classifying different PCOS phenotypes.

Sexual Function in Chinese Women with Polycystic Ovary Syndrome and Correlation with Clinical and Biochemical Characteristics

To investigate sexual function in Chinese women with polycystic ovary syndrome (PCOS) and to explore the correlation with clinical and biochemical characteristics. A cross-sectional study was designed in 1000 PCOS women, aged 18–45 years, via the Chinese version of Female Sexual Function Index (FSFI) evaluating sexual function, with additional questions possibly related to sexual life. Clinical and biochemical characteristics likely to affect sexual function were determined, including anthropometric indicators, serum levels of hormones, luteinizing hormone to follicle-stimulating hormone ratio (LH/FSH ratio), prolactin (PRL), total testosterone (TT), free androgen index (FAI), sex-hormone-binding globulin (SHBG), glucose, and lipid metabolism indicators. Nine hundred ten PCOS women participated in the study, 685 patients were included after screening, and 211 were suitable to detect correlations of clinical and biochemical characteristics with sex function parameters. The mean total FSFI score was 24.19 ± 2.8; 79.56% of the women were at risk of female sexual dysfunction (FSD). Women doing regular aerobic exercise and use of contraception had higher FSFI scores, while those with a desire to conceive and clinical signs of hyperandrogenism had lower FSFI scores. There were negative associations of FSFI scores with age and body fat distribution. No significant associations between FSFI scores and hormonal factors (surprisingly including SHBG) were found, except for total testosterone and satisfaction (OR = 0.976, p = 0.002). HOMA-IR was significantly related to reduced desire score (OR = 0.914, p = 0.004) and lubrication score (OR = 0.964, p = 0.044). PCOS was associated with a high risk of FSD (defined according to FSFI) in about 80% of the women in our study, and clinical characteristics play a more important role.

Clinical and epidemiological characteristics and hormonal profile of adult females with acne vulgaris: a cross-sectional study from a tertiary care hospital

&lt;p class="abstract"&gt;&lt;strong&gt;Background: &lt;/strong&gt;To study clinical and epidemiological characteristics and hormonal profile of adult females with acne&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Adult female patients of &amp;gt;25 years of age with acne were enrolled. Demographic profile, habits, location of acne lesions, associated disease and acne flare association with menstrual cycle were noted. Prevalence of abnormalities in testosterone, dihydroepiandrosterone-sulfate (DHEAS), prolactin, luteinizing hormone (LH), follicle stimulating hormone (FSH), LH:FSH ratio, anti-mullerian hormone (AMH), and serum insulin were noted. Ultrasound (abdomen and pelvis) was performed for screening the presence of any abnormality.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Fifty one patients [mean (SD) age 30.96 (4.93) years] were included in the study. Thirty six (70.59%) patients had persistent type of acne. Grade 2 acne was present in 40 (78.43%) patients. Oily skin was seen in 27 (52.94%) patients. Hirsuitism and menstrual irregularity was present in 24 (47.06%) and 13 (25.49%) patients respectively. Pigmentation and scarring was present in 27 (52.94%) and 35 (68.63%) patients respectively. Acne lesions were seen on cheeks in 36 (70.59%) patients. Eight (15.69%) patients had elevated testosterone. DHEAS and prolactin levels were normal in all patients. Elevation of LH and decreased FSH levels were seen in five (9.80%) and three (5.88%) patients respectively. Five (9.80%) patients had elevated LH:FSH level. Raised insulin level was seen in 8 (15.69%) patients.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Derangement of hormonal profile is not very common among adult female patients with acne. However, in some patients laboratory markers of hyperandrogenism are seen. &lt;/p&gt;

Effect of Sodium Benzoate on Cognitive Function Among Patients With Behavioral and Psychological Symptoms of Dementia

Female gender is a major risk factor for dementia; however, gender has not yet been adequately addressed by clinical trials. A recent study demonstrated that sodium benzoate, a D-amino acid oxidase inhibitor, improved cognitive function in early-phase Alzheimer disease. To examine the potential gender difference in the effects of benzoate treatment on the behavioral and psychological symptoms of dementia (BPSD). This post hoc secondary analysis used data from a randomized, double-masked, placebo-controlled trial conducted in 3 major medical centers in Taiwan and enrolled 97 patients with BPSD. Data were analyzed between February 2014 and November 2017. Six weeks of treatment of 250 to 1500 mg/d of sodium benzoate or placebo. The primary outcome measures were Alzheimer disease assessment scale-cognitive subscale (ADAS-cog) and Behavioral Pathology in Alzheimer Disease Rating Scale (BEHAVE-AD) scores. Among 97 total participants (62 [64%] women; mean [SD] age, 75.4 [7.7] years), 49 patients (30 women and 19 men) were randomized to sodium benzoate, and 48 (32 women and 16 men) were randomized to placebo. Among 62 women, 6-week benzoate treatment significantly surpassed placebo in the effects on ADAS-cog performance (mean [SD] difference in score between baseline and end point, -3.1 [6.4] points vs 0 [4.5] points; Cohen d = 0.56; P = .04) but not BEHAVE-AD performance. In contrast, among 35 men, the 2 treatment groups did not differ significantly in both ADAS-cog and BEHAVE-AD scores. Compared with placebo, benzoate treatment also increased estradiol to follicle-stimulating hormone ratios among women (mean [SD] difference between baseline and end point, 0 [0.2] vs -0.1 [0.3]; P = .03). These findings suggest that benzoate treatment may improve cognitive function in women with later-phase dementia. In the future, longer dose-finding trials are warranted to further clarify the efficacy of benzoate for later-phase dementia and investigate the role of sex hormones and other factors in the pathogenesis of dementia. ClinicalTrials.gov Identifier: NCT02103673.

Luteinizing Hormone to Follicle-Stimulating Hormone Ratio Significantly Correlates With Androgen Level and Manifestations Are More Frequent With Hyperandrogenemia in Women With Polycystic Ovary Syndrome

Background: Altered luteinizing hormone to follicle-stimulating hormone (LH-FSH) ratio and hyperandrogenism are two important pathophysiological characteristics of polycystic ovary syndrome (PCOS). The aim of this study was to evaluate the relationship of LH-FSH ratio with androgen in women with PCOS. Methods: This cross-sectional study included 550 newly detected reproductive aged women with PCOS (mean ± standard deviation (SD): age 23.14 ± 4.80 years; body mass index (BMI) 27.64 ± 5.34 kg/m 2 ) according to revised Rotterdam criteria. Relevant clinical history, physical examination and ultrasonogram of ovaries were done for each participant. Fasting serum LH, FSH and total testosterone (TT) were measured by chemiluminescent microparticle immunoassay from blood collected during follicular phase of menstrual cycle. Results: More than two-thirds (n = 389, about 71%) had altered LH-FSH ratio (cut-off > 1.0) and about 43% (n = 234) had hyperandrogenemia (TT > 46 ng/dL). Frequency of none of the clinical variables or ovarian morphology differed statistically between the groups with or without altered LH-FSH ratio (NS for all). Serum TT and LH-FSH ratio were positively correlated (r = 0.139, P = 0.001). However, menstrual irregularity (P = 0.002), polycystic ovaries (P = 0.045), diabetes mellitus (P = 0.017), obesity (P = 0.009) and hirsutism (P < 0.001) were higher in frequency in the hyperandrogenic group. Serum TT had predictive association with altered LH-FSH ratio (odds ratio (OR) (95% confidence interval (CI)): 1.09 (1.02 - 1.16), P = 0.02) and LH-FSH had predictive association with hyperandrogenemia (OR (95% CI): 1.15 (1.03 - 1.28), P = 0.02) in women with PCOS. Conclusions: Serum LH-FSH ratio and androgenemia significantly correlate in women with PCOS. However, manifestations are more frequent with hyperandrogenemia rather than altered LH-FSH ratio. J Endocrinol Metab. 2021;11(1):14-21 doi: https://doi.org/10.14740/jem716

Luteinizing Hormone to Follicle-Stimulating Hormone Ratio Significantly Correlates With Androgen Level and Manifestations Are More Frequent With Hyperandrogenemia in Women With Polycystic Ovary Syndrome

Background: Altered luteinizing hormone to follicle-stimulating hormone (LH-FSH) ratio and hyperandrogenism are two important pathophysiological characteristics of polycystic ovary syndrome (PCOS). The aim of this study was to evaluate the relationship of LH-FSH ratio with androgen in women with PCOS. Methods: This cross-sectional study included 550 newly detected reproductive aged women with PCOS (mean ± standard deviation (SD): age 23.14 ± 4.80 years; body mass index (BMI) 27.64 ± 5.34 kg/m 2 ) according to revised Rotterdam criteria. Relevant clinical history, physical examination and ultrasonogram of ovaries were done for each participant. Fasting serum LH, FSH and total testosterone (TT) were measured by chemiluminescent microparticle immunoassay from blood collected during follicular phase of menstrual cycle. Results: More than two-thirds (n = 389, about 71%) had altered LH-FSH ratio (cut-off &gt; 1.0) and about 43% (n = 234) had hyperandrogenemia (TT &gt; 46 ng/dL). Frequency of none of the clinical variables or ovarian morphology differed statistically between the groups with or without altered LH-FSH ratio (NS for all). Serum TT and LH-FSH ratio were positively correlated (r = 0.139, P = 0.001). However, menstrual irregularity (P = 0.002), polycystic ovaries (P = 0.045), diabetes mellitus (P = 0.017), obesity (P = 0.009) and hirsutism (P &lt; 0.001) were higher in frequency in the hyperandrogenic group. Serum TT had predictive association with altered LH-FSH ratio (odds ratio (OR) (95% confidence interval (CI)): 1.09 (1.02 - 1.16), P = 0.02) and LH-FSH had predictive association with hyperandrogenemia (OR (95% CI): 1.15 (1.03 - 1.28), P = 0.02) in women with PCOS. Conclusions: Serum LH-FSH ratio and androgenemia significantly correlate in women with PCOS. However, manifestations are more frequent with hyperandrogenemia rather than altered LH-FSH ratio. J Endocrinol Metab. 2021;11(1):14-21 doi: https://doi.org/10.14740/jem716

Effect of Jiajian Guishen Formula on the senescence-associated heterochromatic foci in mouse ovaria after induction of premature ovarian aging by the endocrine-disrupting agent 4-vinylcyclohexene diepoxide

Ethnopharmacological relevanceJiajian Guishen Formula (JJGSF), which is a prescription of Traditional Chinese Medicine (TCM), has been reported to be useful in the treatment of premature ovarian insufficiency (POI). Aim of the studyTo investigate the therapeutic effects of JJGSF on the treatment of POI induced by 4-vinylcyclohexene diep-oxide (VCD), an endocrine-disrupting chemical (EDC), and to elucidate the potential mechanism. Materials and methodsFemale 8-week-old ICR mice (N = 72) were randomized into six groups, containing the Model group, Control group, three JJGSF groups, and Progynova group which was served as a positive control. After model establishment by VCD, the Progynova group were given a daily intragastric administration of Progynova, and the three JJGSF groups (high dose group, medium dose group and low dose group) received a daily intragastric administration of JJGSF at doses of 9, 4.5 and 2.25 g/kg for four weeks. The general growth of the mice was observed and the estrous cycles were examined. The serum hormone concentrations were measured by enzyme-linked immunosorbent assay (ELISA). To explore the potential mechanism of effect, the protein expressions of H3K9me3, HP1, and HMGA1/HMGA2 related to senescence-associated heterochromatic foci (SAHF), were determined by Immunofluorescence and Western blot analysis, respectively. ResultsAfter treating with JJGSF, the estrous cycles were improved significantly. The level of estrogen (E2) and anti-müllerian hormone (AMH) was increased and the ratio of follicle-stimulating hormone (FSH) to luteinizing hormone (LH) in serum was decreased significantly. Furthermore, a significant down-regulation of HMGA1/HMGA2 on protein level, a reduction distribution of HP1 and H3K9me3 in ovarian, and a lower fraction of SAHF-positive cells were observed after the administration with JJGSF, additionally effects showed a positive correlation with dosages. ConclusionsJJGSF could treat POI by the mechanism of inhibiting SAHF.

Features of the hormonal profile in obese reproductive-age women

Aim. To assess the hormonal profile features in obese reproductive-age women. Materials and Methods. We consecutively enrolled 163 women of reproductive age (140 women with body mass index ≥ 30 kg/m2 and 23 women with normal body mass index) who have been admitted to Podgorbunskiy Regional Emergency Medicine Hospital. All patients of both groups underwent general and gynecological examination. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, estradiol, estrone, testosterone, dehydroepiandrosterone sulfate, thyroid-stimulating hormone, free triiodothyronine, total and free thyroxine, cortisol, leptin, immunoreactive insulin, and progesterone were assessed on days 5-6 and 21-22 of the menstrual cycle. Results. Obese women of reproductive age were characterised by higher values of LH, LH/ FSH ratio, testosterone, estradiol, estrone, leptin, IRI and by lower levels of FSH and progesterone compared with normal weight women. A direct correlation was found between the level of leptin and estrone (r = 0.21, p = 0.014), insulin resistance (r = 0.18, p = 0.039), triglycerides (r = 0.20, p = 0.030), and low-density lipoprotein cholesterol (r = 0.22, p = 0.016). There was a statistically significant inverse correlation between the level of leptin and high-density lipoprotein cholesterol (r = -0.18, p = 0.043). A direct correlation was established between insulin and LH (r = 0.24, p = 0.030), testosterone (r = 0.32, p = 0.037), dehydroepiandrosterone sulfate (r = 0.56, p = 0.003), insulin resistance (r = 0.95, p &lt; 0.001), cholesterol (r = 0.20, p = 0.024), triglycerides (r = 0.29, p &lt; 0.001). Conclusion. Obese women of reproductive age have certain hormonal features that underlie menstrual and reproductive disorders in these patients.

Effectiveness of tonifying-kidney and regulating-liver therapy on diminished ovarian reserve: a systematic review and Meta-analysis of randomized controlled trials.

To evaluate the effectiveness of the Traditional Chinese Medicine tonifying-kidney and regulating-liver therapy on diminished ovarian reserve (DOR). The literature was comprehensively searched up to August 2019 using four Chinese and three English electronic databases to extract randomized clinical trials (RCTs) comparing Traditional Chinese Medicine tonifying-kidney and regulating-liver prescriptions (combined with hormone therapy or not) with Western Medicine. Data quality evaluation was conducted using the Cochrane risk of bias tool. Meta-analysis was conducted using Revman 5.3 software with effect estimates presented as mean difference (MD), risk ratio (RR), and 95% confidence interval (CI). A total of nine RCTs with 512 participants were extracted and eligible for Meta-analysis. There were no significant differences between Chinese medicine and Western Medicine on basal serum follicle-stimulating hormone (FSH) level (MD 0.11, 95% CI －0.52 to 0.74, 392 participants, seven trials), anti-Müllerian hormone level (MD 0.48, 95% CI －0.62 to 1.58, 95 participants, two trials), and the FSH and luteinizing hormone ratio (MD 0.01, 95% CI －0.95 to 0.96, 115 participants, two trials). Chinese medicine was more effective at improving Traditional Chinese Medicine symptom scores (TCMSS) (MD －2.39, 95% CI －3.83 to －0.94, 160 participants, three trials), effective rate of TCMSS (RR 1.18, 95% CI 1.02 to 1.36, 160 participants, three trials), antral follicle count (AFC) (MD 0.55, 95% CI 0.05 to 1.04, 155 participants, three trials), and FSH levels at 3 months post-treatment (MD -4.77, 95% CI －6.09 to －3.45, 137 participants, two trials). Compared with Western Medicine, tonifying-kidney and regulating-liver therapy is more effective at relieving symptoms and improving AFC and FSH at 3 months post-treatment.

Correlation of Cutaneous Manifestations with Body Mass Index, Blood Glucose, and Hormonal Levels in Patients with Polycystic Ovarian Disease.

Background:Polycystic ovarian disease (PCOD) is characterized by oligo/anovulation, ultrasonographic evidence of polycystic ovaries and cutaneous features such as hirsutism, acne, acanthosis nigricans, androgentic alopecia, and signs of virilization.Aim:Correlation of dermatological manifestations with body mass index (BMI), blood glucose, and levels of free testosterone, dehydroepiandrosterone sulfate (DHEAS), follicle stimulating hormone (FSH), and luteinizing hormone (LH) in patients of PCOD hailing from Pimpri, Pune.Subjects and Methods:This observational study was carried out from November 2015–April 2017 on 102 patients (aged 12–45 years, non-pregnant) of PCOD, attending dermatology/gynecology outpatient departments. After recording socio-demographic/menstrual and medical history, BMI was calculated and examination of cutaneous manifestations were done. Participants were then subjected to pelvic ultrasonography and blood sugar/hormonal estimation.Statistical Analysis:By using statistical package for the Social Sciences 17.0 software, Chi-square test, and Fisher's exact test.Results:Age: 59.80% belonged to the third decade (range,12–40; mean, 26.27 ± 5.05 years); ultrasonography revealed polycystic ovaries in 79.41%. Cutaneous manifestations recorded were – acne (74.50%); acanthosis nigricans (50%); striae (49.02%); hirsutism (40.19%); acrochordons (36.27%); seborrheic dermatitis (32.35%), and androgenetic alopecia (30.39%). Free testosterone (35;34.31%), DHEAS (9;8.82%), LH and FSH (2;1.96% each), and LH: FSH ratio (51;50%) were raised. Statistical association of acanthosis nigricans emerged with free testosterone (P = 0.034), DHEAS (P = 0.016), fasting blood sugar (P = 0.01), and raised BMI (P = 0.002) and of hirsutism with raised DHEAS (P = 0.016), free testosterone (P = 0.012), and BMI (P = 0.022).Conclusion:Significant correlations demonstrated were acanthosis nigricans with free testosterone, DHEAS, FBS, and BMI and hirsutism with DHEAS, free testosterone, and BMI.