Prediction Of Polycystic Ovary Syndrome Research Articles

Serum uric acid/creatinine ratio and free androgen index are synergistically associated with increased risk of polycystic ovary syndrome in obese women

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

Efficacy of serum anti-mullerian hormone (AMH) levels for prediction of polycystic ovary syndrome (PCOS) and its association with clinical, biochemical and hormonal parameters.

The online version contains supplementary material available at 10.1007/s12291-022-01058-4.

Prediction of PCOS and Mental Health Using Fuzzy Inference and SVM.

Polycystic ovarian syndrome (PCOS) is a hormonal disorder found in women of reproductive age. There are different methods used for the detection of PCOS, but these methods limitedly support the integration of PCOS and mental health issues. To address these issues, in this paper we present an automated early detection and prediction model which can accurately estimate the likelihood of having PCOS and associated mental health issues. In real-life applications, we often see that people are prompted to answer in linguistic terminologies to express their well-being in response to questions asked by the clinician. To model the inherent linguistic nature of the mapping between symptoms and diagnosis of PCOS a fuzzy approach is used. Therefore, in the present study, the Fuzzy Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method is evaluated for its performance. Using the local yet specific dataset collected on a spectrum of women, the Fuzzy TOPSIS is compared with the widely used support vector machines (SVM) algorithm. Both the methods are evaluated on the same dataset. An accuracy of 98.20% using the Fuzzy TOPSIS method and 94.01% using SVM was obtained. Along with the improvement in the performance and methodological contribution, the early detection and treatment of PCOS and mental health issues can together aid in taking preventive measures in advance. The psychological well-being of the women was also objectively evaluated and can be brought into the PCOS treatment protocol.

O-105 High prevalence of obesity and polycystic ovary syndrome in an online community seeking assistance with fertility

Abstract Study question What are the characteristics of a large online community of women trying to conceive and what are the factors that predict infertility in this group? Summary answer The cohort was not characterized by increased age, though age, obesity and PCOS strongly correlated with fertility. PCOS may be under-recognized within some ethnic groups. What is known already Obesity, polycystic ovary syndrome (PCOS), and age are among the primary predictors of infertility in women. However, most studies assessing reproductive health employ populations who have sought medical assistance for infertility or associated disorders, potentially leading to populations more likely to exhibit disorders such as PCOS or to be of increased age. Characterization of factors affecting fertility in a general population may highlight epidemiological influences that should be better addressed to aid women trying to conceive. Study design, size, duration This study employed users of the mobile application, FertilityAnswers, for people searching for answers to fertility problems. Users answered a short survey describing themselves, their fertility history and goals. Recruitment for this study began in March 2017 and ended in January 2021. 61814 participants downloaded the application during this period, and 56878 at least provided their age. The primary inclusion criteria were that study participants be US females over eighteen years of age. Participants/materials, setting, methods Regression models estimated beta coefficients and corresponding confidence intervals. Multivariable models determined independence of variables. To model PCOS, the available data in January 2020 was split randomly into discovery and validation subsets. Missing value imputation using random forests was performed in the discovery dataset. Minimal feature selection used a linear regression model penalized with a lasso and elastic net. The model was then validated on samples collected after the model was trained and tested. Main results and the role of chance Age was a significant predictor of fertility in this study (p < 1x10-10). However, the distribution of age in the cohort was very similar to that of women at first birth in the United States, therefore we did not observe the majority of study participants to be of an age where in a typical clinical setting age-related concerns would be addressed (i.e., approaching 35 years). Using National Center for Health Statistics data, the mean age of 1,433,604 women at first birth in 2018 in the US was younger than the study population (restricted to those without children) by only one month. Obesity was of increased prevalence in this cohort, with 55% being obese, compared to 37% in an age-matched US population. Participants reported a variety of fertility-related disorders, with polycystic ovary syndrome (PCOS) being most prevalent (19.0%), followed by endometriosis (6.0%). Prediction of PCOS, performed by modeling on training and test sets (10476 and 5312 participants) and then validating with an additional 21097 participants collected after the model creation, found that African-Americans and Latino members of this cohort had a lower self-reported rate of the disorder than was anticipated by the model, in contrast to those of Asian or European descent. Limitations, reasons for caution All health data was self-reported. Additionally, as this is the initial survey of this population, no a priori hypotheses were made as to the expected relationships to be observed. Instead, all associations were examined, and measurements of false discovery rate were estimated. Wider implications of the findings We found that women were seeking answers about infertility at ages coincident with that of their peers achieving first pregnancies. ART is often not a first-line treatment for women of this age, but there may be a disconnect between traditional clinical response to this group and their desire for assistance. Trial registration number not applicable

Ultrasonographic and biochemical assessments as early prediction of polycystic ovarian syndrome in obese women.

Polycystic ovary syndrome (PCOS) is considered as a common cause of hormonal disturbance and obesity. The diagnosis of PCOS was done by different methods including clinical signs as anovulation, hyperandrogenism, biochemical markers and ultrasounographic investigation. This study investigated comparative outcomes of ultrasonographic and biochemical markers for early prediction of PCOS in obese women. Seventy-five patients were clinically diagnosed with obese, PCOS and obese with PCOS and twenty-five normal age matched subjects were enrolled as control. Abdominal and transvaginal ultrasonographic for assessment of ovarian properties. In addition, BMI, serum free testosterone, dehydroepiandrosterone (DHEA), insulin, glycosylated hemoglobin (HbA1c) and LDL-c levels were evaluated. In obese patients with PCOs (20%) ovaries revealed normal appearance in morphology while the rest (80%) showed PCOs in the form of cysts of 2-8 mm in diameter peripherally arranged around stroma. A significant elevation of free testosterone, DHEA and insulin in obese with or without PCOS compared with obese group (p<0.001). A positive correlation with hormonal abnormalities of increased HA1c, LDL-c, free testosterone, DHEA and insulin compared with obese only. According to our study findings, ovarian morphology combined with biochemical markers is more reliable for early prediction and diagnosis of PCOS for interpretation and management.

Anti-Mullerian Hormone as A new Marker for Diagnosis of Poly Cystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) is a complex disease characterized by various endocrine disorders that are the potential cause of anovulation and hyperandrogenism. This heterogeneous syndrome affects about 5– 10% of reproductive-age female population and it can be considered the most common endocrine disorder affecting women during reproductive life. PCOS is a multifactorial polygenic disease. Genes that regulate steroidogenesis and folliculogenesis are interested. Hence, AMH measurement has been found to offer a relatively high specificity and sensitivity as a diagnostic marker. Objectives: The study aimed to assess the accuracy of AMH in the prediction of PCOS in patients admitted to Elsayed Galal and El Hussein University Hospital. Subjects and methods: This was a retrospective study that was done on 130 women, divided into two groups, group I include 100 PCOS patients and group II, 30 control subject. Results: The results of this study showed that there was no significant difference between the two groups regarding age, while there was a significant increase in BMI in patients more than in control. The level of LH showed a significant increase in patients more than in the control. The level of FSH showed a significant decrease in patients less than in the control. The Testosterone showed a significant increase in patients more than in the control. The androstenedione showed a significant increase in patients more than in the control group. The AMH showed a highly significant increase in patients more than in the control and in turn the number of follicles in group II (patients) was significantly higher than in the control. The sensitivity of AMH in diagnosis PCOS was 98.0, specificity was 80.0% and the total accuracy was 93.0 at the cutoff of point 0.911. Conclusion: Additional advantages of AMH as diagnostic tool are that it is biological, objective, quantitative marker not affected by day of menses or OCP intake. So in future, more studies should be undertaken to validate its role as diagnostic tool for PCOS.

Comparison of uterine and ovarian stromal blood flow in patients with polycystic ovarian syndrome.

Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders. The aim of this study was to find the correlation between color Doppler ultrasound and serum tests as auxiliary diagnostic criteria in areas where there is no possibility of some tests. A total of 108 patients were enrolled. They were divided into three groups including patients with PCOS, patients with PCOA ultrasound, patients with ovaries and normal hormone tests. Transvaginal sonography was performed from three groups and the results were evaluated in gray scale. The volume of the ovary, the number of follicles and the placement of follicles were recorded using using Doppler spectrum of uterine artery and ovarian stroma. Their arterial resistance index was also calculated. In the next step, serum samples were evaluated to determine the level of LH, FSH, free testosterone, DHEAS and 17-OHP hormones in the early follicular phase. Gray scale ultrasonographic findings (volume and number of ovarian follicles) as well as LH values were higher in patients with PCOS than those in the other two groups. These results proved the reliability of using these factors in the prediction of PCOS. In this study, Doppler indexes did not correlate with the size of the ovaries, the number of ovarian follicles and the measured hormone levels. The findings of transvaginal ultrasound and investigating the relationship with clinical and laboratory outcomes, a more suitable pattern could be chosen for more accurate patient selection and, leading to timely treatment and reducing the complications of the disease.

Sex hormone binding globulin - an important biomarker for predicting PCOS risk: A systematic review and meta-analysis

ABSTRACTSex hormone-binding globulin (SHBG) is a glycoprotein which regulates bioavailability of sex steroid hormones. Interest in SHBG has escalated in recent years because of its inverse association with polycystic ovary syndrome (PCOS), obesity, insulin resistance, metabolic syndrome, and diabetes type II. This meta-analysis was performed to examine the associations of SHBG with PCOS and to correlate serum SHBG levels with various PCOS associated endocrine and metabolic dysregulation as well as to determine the effects of various therapeutic agents on serum SHBG levels in PCOS patients in order to assess the true accuracy of SHBG in the prediction of PCOS. A literature search was performed using Pub-Med, Science direct, google scholar, EMBASE, and Cochrane library. A total of 675 relevant records were identified, of which 62 articles were included. Meta-analysis using a random-effects model was performed using STATA version 13 to calculate standardized mean difference (SMD) with 95% confidence intervals (95 % CIs). SHBG levels in controls were significantly higher than that of PCOS patients (SMD= -0.83, 95%CI = -1.01, –0.64), with significant heterogeneity across studies (I2= 93.9% and p=0.000). Our results suggest that the lower serum SHBG levels are associated with the risk of PCOS. SHBG may also play an important role in various metabolic disturbances in PCOS patients. Therapeutic interventions improved SHBG levels in PCOS women which further reduced PCOS associated complications. Therefore, SHBG levels may prove to be a useful biomarker for the diagnosis and treatment of PCOS.Systematic review registration: PROSPERO CRD42017057972Abbreviations: PCOS: polycystic ovary syndrome; SHBG: sex hormone-binding globulin

Age-stratified thresholds of anti-Müllerian hormone improve prediction of polycystic ovary syndrome over a population-based threshold.

Clinical EndocrinologyVolume 87, Issue 6 p. 649-650 COMMENTARY Age-stratified thresholds of anti-Müllerian hormone improve prediction of polycystic ovary syndrome over a population-based threshold Didier Dewailly, Corresponding Author Didier Dewailly didier.dewailly@chru-lille.fr Service de Gynécologie-Endocrinienne et Médecine de la Reproduction, CHU Lille, Hôpital Jeanne de Flandre, Lille, France Correspondence Didier Dewailly, CHU Lille, Service de Gynécologie-Endocrinienne et Médecine de la Reproduction, Hôpital Jeanne de Flandre, Lille, France. Email: didier.dewailly@chru-lille.frSearch for more papers by this author Didier Dewailly, Corresponding Author Didier Dewailly didier.dewailly@chru-lille.fr Service de Gynécologie-Endocrinienne et Médecine de la Reproduction, CHU Lille, Hôpital Jeanne de Flandre, Lille, France Correspondence Didier Dewailly, CHU Lille, Service de Gynécologie-Endocrinienne et Médecine de la Reproduction, Hôpital Jeanne de Flandre, Lille, France. Email: didier.dewailly@chru-lille.frSearch for more papers by this author First published: 26 September 2017 https://doi.org/10.1111/cen.13479Citations: 2 Please see related paper on pages [733–740] of this issue. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume87, Issue6December 2017Pages 649-650 RelatedInformation

Age‐stratified thresholds of anti‐Müllerian hormone improve prediction of polycystic ovary syndrome over a population‐based threshold

Due to its consistent elevation in polycystic ovary syndrome (PCOS) and correlation with polycystic ovarian morphology (PCOM), anti-Mullerian hormone (AMH) has been proposed as a marker of the syndrome. However, prior studies reporting thresholds of AMH for a PCOS diagnosis have been limited by small sample size, inappropriate controls, and heterogeneous AMH assays. We sought to evaluate the suitability of a standardized AMH assay as a biomarker of PCOS. Cross-sectional study at academic medical centres across the United States. Women with PCOS were diagnosed by Rotterdam criteria and included 282 subjects from the multisite PPCOS II trial and 109 patients from a tertiary academic centre's multidisciplinary PCOS clinic. Controls included 245 participants in the ovarian ageing (OVA) study, a community-based cohort of ovulatory women not seeking treatment for fertility. Determination of AMH by a central laboratory. Receiver-operating characteristic (ROC) analyses were used to investigate the accuracy of AMH thresholds for prediction of PCOS diagnosis with stratification by age. The optimal threshold of AMH to distinguish PCOS from controls was 55.36pmol/L (sensitivity: 0.82, specificity: 0.78, J: 0.60). When examining the population by age groups, the optimal AMH threshold decreased with increasing age. AMH is an effective biomarker of PCOS. Age-stratified thresholds more accurately predicted PCOS than an overall population-based threshold.

Risk factors in adolescence for the development of polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is the most common gynaecological endocrinopathy in women of fertile age and represents a major health issue among women affecting not only reproductive function, but also emergence of the most frequent causes of morbidity and mortality in women of postmenopausal age – type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVDs). The current epidemic of obesity suggests that the prevalence of PCOS and its adverse health effects may rise even further in the future. The ability to predict development of PCOS early in life would be essential to decrease and prevent late morbidity linked to PCOS, although, on the other hand, over-diagnosis should be avoided as it can lead to unnecessary labelling and can impact on an adolescent’s quality of life. Systematic search in the Medline literature database through PubMed using the search terms “Polycystic ovary syndrome”, “PCOS”, “Adolescents”, “Polycystic ovary morphology”, “PCOM”, “Menstrual disorders in adolescence”, “Hirsutism”, “Hyperandrogenaemia”, “Anti-Mullerian hormone”, “Obesity and adolescents” and “Prediction of PCOS”. Follow-up and re-evaluation are warranted in all adolescents with features suggestive of PCOS, such as menstrual irregularities two or more years after menarche, or a menstrual interval >90 days, moderate to severe hirsutism and moderate to severe inflammatory acne vulgaris unresponsive to topical medication. Because of the strong association between obesity, weight gain through life, hyperandrogenism and development of PCOS, screening for PCOS and overweight/obesity as early as in adolescence is important in order to tailor treatment and intervention protocols and reduce future risks of infertility, CVDs and T2DM.

Testosterone, free testosterone, and free androgen index in women: Reference intervals, biological variation, and diagnostic value in polycystic ovary syndrome

ObjectiveThe objective of our study was to determine reference intervals and biologic variation for testosterone (T), free testosterone (fT), and free androgen index (FAI) in women with accurate methods and to test the discriminative value of these parameters in a polycystic ovary syndrome (PCOS)-population. MethodsSerum was obtained daily during a normal menstrual cycle from 25 healthy women (677 data-points). A single serum sample was obtained from 44 PCOS-patients. T was measured by LC–MS/MS and by Architect® 2nd generation T Immunoassay. Sex hormone-binding globulin was measured to calculate fT and FAI. ResultsReference intervals which were established in healthy women with an ovulatory menstrual cycle were T=0.3–1.6nmol/L and 0.5–2.0nmol/L, fT=5.2–26pmol/L and 7.2–33pmol/L, and FAI=0.4–2.9 and 0.6–4.4, by LC–MS/MS and immunoassay, respectively. T, fT and FAI were higher in PCOS patients than in controls (p<0.0001). The areas under the curve of receiver operator characteristic (ROC) plots were not different for T, fT, or FAI when T was measured by LC–MS/MS versus immunoassay based on prediction of PCOS. FAI and fT were the strongest predictors of PCOS. ConclusionsWhen based upon the appropriate reference intervals and ROC analysis, LC–MS/MS and second generation immunoassay have equivalent clinical utility for the diagnosis of PCOS.

Serum Copeptin, Pentraxin 3, Anti-Mullerian Hormone Levels With Echocardiography and Carotid Artery Intima-Media Thickness in Adolescents With Polycystic Ovary Syndrome.

BackgroundThe aim of the study was to investigate the presence of possible markers in the prediction of polycystic ovary syndrome (PCOS)-related metabolic alterations and cardiovascular events in adolescent PCOS cases and also to investigate the applicability of anti-Mullerian hormone (AMH) levels for the diagnosis of PCOS.MethodsIn this cross-sectional study, a total of 75 non-obese women (adolescent PCOS group, n = 25; adult PCOS group, n = 25; control group, n = 25) were included. Measurements of copeptin, pentraxin 3 (PTX3), and AMH serum levels were performed.ResultsSerum copeptin, PTX3 and echocardiographic indices were not significantly different in PCOS subjects and they did not have higher common carotid artery intima-media thickness (CIMT) measurement. AMH levels were significantly higher in PCOS patients. There was a positive correlation between AMH and mean ovarian volume (r = 0.58, P < 0.001) and between AMH and total testosterone level (r = 0.63, P < 0.001). In order to predict a threshold value for the diagnosis of PCOS by using AMH, the receiver operating characteristic (ROC) method was used. Area under the curve was 0.820 and cut-off point was 6.66 ng/mL for AMH with a sensitivity of 62% and specificity of 76%.ConclusionsPossible markers for PCOS-related metabolic alterations may not present in the adolescent years. Serum AMH may be useful as a diagnostic test for adolescents.

Prediction of polycystic ovarian syndrome based on ultrasound findings and clinical parameters.

To determine the accuracy of sonographic-diagnosed polycystic ovaries and clinical parameters in predicting polycystic ovarian syndrome. Medical records and ultrasounds of 151 women with sonographically diagnosed polycystic ovaries were reviewed. Sonographic criteria for polycystic ovaries were based on 2003 Rotterdam European Society of Human Reproduction and Embryology/American Society for Reproductive Medicine guidelines: at least one ovary with 12 or more follicles measuring 2-9 mm and/or increased ovarian volume >10 cm(3) . Clinical variables of age, gravidity, ethnicity, body mass index, and sonographic indication were collected. One hundred thirty-five patients had final outcomes (presence/absence of polycystic ovarian syndrome). Polycystic ovarian syndrome was diagnosed if a patient had at least one other of the following two criteria: oligo/chronic anovulation and/or clinical/biochemical hyperandrogenism. A logistic regression model was constructed using stepwise selection to identify variables significantly associated with polycystic ovarian syndrome (p < .05). The validity of the model was assessed using receiver operating characteristics and Hosmer-Lemeshow χ(2) analyses. One hundred twenty-eight patients met official sonographic criteria for polycystic ovaries and 115 (89.8%) had polycystic ovarian syndrome (p = .009). Lower gravidity, abnormal bleeding, and body mass index >33 were significant in predicting polycystic ovarian syndrome (receiver operating characteristics curve, c = 0.86). Pain decreased the likelihood of polycystic ovarian syndrome. Polycystic ovaries on ultrasound were sensitive in predicting polycystic ovarian syndrome. Ultrasound, combined with clinical parameters, can be used to generate a predictive index for polycystic ovarian syndrome.

Can Anti-Müllerian Hormone Predict the Diagnosis of Polycystic Ovary Syndrome? A Systematic Review and Meta-Analysis of Extracted Data

Existing biochemical tests for polycystic ovary syndrome (PCOS) have poor sensitivity and specificity. Many women with PCOS have high anti-Müllerian hormone (AMH) concentrations; thus, this may be a useful addition to the diagnostic criteria. A systematic literature review was performed to assess the true accuracy of AMH in the prediction of PCOS and to determine the optimal diagnostic threshold. Published and gray literature were searched for all years until January 2013. Observational studies defining PCOS according to the Rotterdam criteria and assessing the value of AMH in diagnosing PCOS were selected. Ten studies of the initial 314 hits reporting AMH values in the diagnosis of PCOS were included in the meta-analysis and the construction of the summary receiver-operating characteristic curve. Four studies that plotted individual AMH serum levels of women with PCOS and controls on graphs were selected for individual data extraction. Two researchers independently assessed the abstracts resulted from the initial search against the inclusion criteria, graded the papers for selection and verification biases, and selected the papers that assessed the value of AMH in diagnosing PCOS. Data were extracted from 4 studies with the plotted individual data on graphs with the help of computer software. The meta-analysis of the extracted data demonstrated the specificity and sensitivity in diagnosing PCOS in the symptomatic women of 79.4% and 82.8%, respectively, for a cutoff value of AMH of 4.7 ng/mL. The area under the curve was 0.87 (95% confidence interval 0.83-0.92), identical with the area under the curve of 0.87 for the summary receiver-operating characteristic curve involving 10 separate studies. AMH may be a useful initial diagnostic test for PCOS subject to validation in prospective population cohorts.