Hyperandrogenism In Young Women Research Articles

The influence of ESR1 polymorphisms on selected hormonal, metabolic and mineral balance markers in women with hyperandrogenism

Hyperandrogenism is the most common endocrine disorder in women, characterized by an imbalance in normal estrogen and androgen levels in the blood. Androgens influence bone mineral density, body mass composition, muscle mass, mental state, and the regulation of sexual function.. The aim of the study was to assess the effect of estrogen receptor α gene (ESR1) polymorphisms on selected markers of bone metabolism and hormonal parameters in women with hyperandrogenism. The study group included 80 young women with hyperandrogenism who underwent measurements of bone mineral density (BMD), and determination of hormonal and metabolic parameters. Enzyme immunoassays were used to measure leptin, sRANKL (soluble receptor activator of nuclear factor-kB ligand), osteoprotegerin and 25-OH vitamin D total levels. An analysis of ESR1 gene polymorphisms was performed using the real-time PCR method. A relationship was demonstrated between the concentration of free estradiol (FEI) and the concentration of 17-OH-progesterone, and the ESR1 gene polymorphisms: rs3020314 (p = 0.031, p = 0.026 respectively) and rs1884051 (p = 0.033, p = 0.026 respectively). In conclusion, the ESR gene polymorphisms may be associated with hormonal disturbances in the concentration of estrogens and androgens, in hyperandrogenism in young women which may indirectly affect bone mineral density. However, no statistically significant relationships between the studied polymorphisms and the selected parameters of mineral metabolism have been demonstrated..

Frequency of Hyperandrogenism in Young Women with Polycystic Ovarian Syndrome

Polycystic ovary syndrome (PCOS) is the communal disorder of endocrinology in females of reproductive age. Objective: The purpose of the study was to govern the incidence of hyperandrogenism in young females with polycystic ovarian syndrome. Methods: Total 93 women of age 20 to 35 years with any parity and diagnosed patients of PCOS were included. All patients were assessed biochemically. Serum of testosterone and sex hormone binding globulin analysis was done randomly at any phase of menstrual cycle. Participants were followed in OPD. Free androgen index was calculated. Score more than 5 labeled as Hyperandrogenemia. Data were analyzed using SPSS version 21.0. Results: The mean age was 27.22±4.58 years, with range of 15(20–35) years. Age of 46(49.5%) patients was ≤27 years and age of 47(50.5%) patients was >27 years. 41 patients were married and 52 patients were unmarried. The mean parity was 1.41±0.94 with range of 4(0–4). Results of free androgen index score (FAI) showed that overall mean FAI was 7.80±5.82 with range of 32.60(0.80–33.40). Total 60 patients were found with hyperandrogenism. Among these patients the mean age was 26.93±4.68 years. Ages of 32(53.3%) patients were ≤27 years. participants it was observed that 18 patients were nulliparous, 3 patients had 1-2 parity, and 2 patients had parity more than 2. Chi square results for association of hyperandrogenism showed no significant association with age, marital status, and parity with p>0.05. Conclusion: Hyperandrogenism is an important feature of PCOS. It mainly comes from the ovaries of women diagnosed with PCOS. The best indicator of hyperandrogenism is Serum testosterone levels.

996-P: Prevalence of Functional Hyperandrogenism in Young Women with Type 1 Diabetes: A Preliminary Analysis from a Cross-Sectional Study of a Spanish Cohort

Introduction: Increased prevalence of functional hyperandrogenism/polycystic ovary syndrome (PCOS) has been previously described in type 1 diabetes (T1DM) patients. However, the reported prevalence rates vary depending on different diagnostic criteria. Our study aim was to determine the prevalence of PCOS and hyperandrogenic traits in premeopausal women with T1DM. Methods: A cross-sectional study was conducted at a diabetes outpatient clinic in a tertiary Hospital from Madrid, Spain. We recruited consecutive premenopausal woman with T1DM, and menarche at least 2 years before the study. For this preliminary report, we included 40 patients. History data collection, physical exam, a complete hormonal analysis in follicular phase (including d4-androstenedione, DHEA-S, total testosterone, SHBG, 17-OH-progesterone, FSH, LH, prolactin, and TSH), and ovarian ultrasound were performed. Results: Mean age of patients was of 28 ± 8 yr; mean duration of T1DM was of 13 ± 8 yr-old. Twenty-seven patients were on multiple daily insulin therapy, while 13 of them were on continuous subcutaneous insulin infusion. Mean BMI was of 23.8 ± 3.7 Kg/m2. Mean daily insulin dose was 0.64 ± 0.2 U/kg and mean A1C was 7.5 ± 1.8%. PCOS was diagnosed in 7 patients resulting in a 18% (95% CI: 8; 32) prevalence of PCOS according to NIH-Rotterdam, and in 6 patients resulting in a 15% (95% CI: 7; 29) prevalence of PCOS according to AES-PCOS criteria. Three patients [7% (95% CI: 3; 20)] had isolated polycystic ovarian morphology (PCOM), and 7 patients [18% (95% CI: 8; 32)] presented with oligo-amenorrhea (ovulatory dysfunction-WHO class 2). Conclusion: Our preliminary data show a significant increase in prevalence of PCOS in premenopausal women with T1DM with respect to the general population. Disclosure A. Bayona: None. L. Nattero-chávez: None. E. Fernández durán: None. B. Dorado avendaño: None. H. F. Escobar-morreale: Consultant; Self; InsudPharma. M. Luque-ramírez: None.

Polycystic ovary syndrome and (pre)osteoarthritis: assessing the link between hyperandrogenism in young women and cartilage oligomeric matrix protein as a marker of cartilage breakdown.

OBJECTIVES: Our aim was to analyze the link between hyperandrogenism and early clinical manifestations of osteoarthritis (OA), knee cartilage thickness, and serum cartilage oligomeric matrix protein (sCOMP) levels in patients with polycystic ovary syndrome (PCOS) and to compare them with healthy volunteers. Fifty-four PCOS patients who met the Rotterdam criteria with phenotypes A, B, and C were included. They were compared with 26 age- and body mass index (BMI)-matched controls. Detailed anthropometric measurements and clinical evaluation for hyperandrogenism were performed for all participants who also filled in the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Furthermore, laboratory tests including sCOMP and hormone quantification were performed in a fasting stage. Finally, an ultrasound assessment was carried out in randomly selected 56 study participants. PCOS women reported more prominent knee-related symptoms (p = 0.035) and more impaired activities of daily living (ADL) (p = 0.001) than controls. Cartilage thickness of the left and right medial condyle and left lateral condyle was significantly greater in PCOS group (n = 41) than in control group (n = 15) (p = 0.05, p = 0.006, and p = 0.036, respectively). COMP correlated significantly and negatively with testosterone levels (p = 0.029, r = - 0.297) in women with PCOS and the correlation remained significant after controlling for BMI. Women with PCOS may experience knee-related symptoms and impaired ADL. They had greater knee femoral cartilage thickness. Although sCOMP levels did not significantly differ between the groups, lower levels of sCOMP may be inherent to PCOS patients with higher testosterone levels. Key Points • Although PCOS patients may experience more prominent knee related symptoms, their femoral cartilage of the knee joint is found thicker than controls. • PCOS patients did not have significantly elevated levels of sCOMP. • Lower sCOMP levels were related to higher testosterone levels.

Anti-müllerian hormone in the pathophysiology and diagnosis of polycystic ovarian syndrome.

Polycystic ovarian syndrome (PCOS) is the most common cause of chronic anovulation and hyperandrogenism in young women and represents a true public health concern and an economic burden. The pathophysiology of PCOS is still not fully understood, but progresses have been made and the relationships between anti mullerian hormone (AMH), follicle stimulating hormone, luteinizing hormone, E2 and androgens have been explored. The follicle excess plays a central role in the syndrome and AMH is definitively a major component of this phenomena. The aim of this chapter is to present the recent work studying the role of AMH in the pathophysiology of PCOS and to discuss the improvement that serum AMH assay brings in the diagnosis of PCOS.

Role of Anti-Müllerian Hormone in pathophysiology, diagnosis and treatment of Polycystic Ovary Syndrome: a review.

Polycystic ovary syndrome (PCOS) is the most common cause of chronic anovulation and hyperandrogenism in young women. Excessive ovarian production of Anti-Müllerian Hormone, secreted by growing follicles in excess, is now considered as an important feature of PCOS. The aim of this review is first to update the current knowledge about the role of AMH in the pathophysiology of PCOS. Then, this review will discuss the improvement that serum AMH assay brings in the diagnosis of PCOS. Last, this review will explain the utility of serum AMH assay in the management of infertility in women with PCOS and its utility as a marker of treatment efficiency on PCOS symptoms. It must be emphasized however that the lack of an international standard for the serum AMH assay, mainly because of technical issues, makes it difficult to define consensual thresholds, and thus impairs the widespread use of this new ovarian marker. Hopefully, this should soon improve.

Effects of the Insulin Sensitizer Pioglitazone on Menstrual Irregularity, Insulin Resistance and Hyperandrogenism in Young Women with Polycystic Ovary Syndrome

BackgroundPolycystic ovary syndrome (PCOS) is the most common endocrine cause of menstrual irregularities, hirsutism and acne. Women with PCOS present elevated plasma insulin levels, both fasting and after a glucose load, as an indirect evidence of insulin resistance. PCOS women may also present hypertension, low levels of HDL cholesterol, hypertriglyceridemia, visceral obesity and a higher level of CRP and fibrinogen that can predict an atherosclerotic risk. MethodsThis study was carried out on 15 young women with PCOS selected according to the 2003 diagnostic criteria of The Rotterdam Consensus Statement and 15 Control women. PCOS women were treated with pioglitazone 30 mg/day and at the beginning and after 6 months of treatment were evaluated: menstrual cycle trend, hirsutism and acne, total cholesterolemia and HDL, triglyceridemia, fibrinogenemia, C-reactive protein, oral glucose tolerance test, glycated hemoglobin, FSH, LH, 17OH-progesterone, 17β-estradiol, free and total testosterone, SHBG, DHEA-S, Δ4-androstenedione and adiponectin. Results and DiscussionTreatment with pioglitazone improves the irregularities of menses and hirsutism. Six months of treatment modify other parameters linked with a higher risk of type 2 diabetes mellitus and cardiovascular diseases: adiponectin increased with reduction of insulin resistance while fibrinogen and CRP levels decreased.

The consequences of hyperandrogenism in young women.

The consequences of hyperandrogenism in young women.