Signs Of Polycystic Ovary Syndrome Research Articles

FETAL METABOLIC PROGRAMMING IN THE ETIOLOGY OF POLYCYSTIC OVARIAN SYNDROME

Polycystic ovary syndrome (PCOS) is an endocrine dysfunction, which can be characterized by hyperandrogenism and chronic anovulation. The main signs of PCOS are amenorrhea and polycystic forms in the ovaries, being the most common disorder in women in menacme and very commonly associated with other metabolic syndromes. Studies suggest that one of the etiological factors of the syndrome is related to fetal metabolic programming, maternal, nutritional, genetic and environmental influences are determinant in the emergence of diseases, including PCOS. The objective of this work is to relate the fetal metabolic programming with the development of PCOS. The study methodology consists in a literature review, through research in PubMed and Scielo databases. It is concluded that factors such as placental pathologies and maternal metabolism, fetal hypoxia, intrauterine growth restriction, low birth weight, maternal hyperandrogenism state and pathologies that corroborate this, hyperinsulinemia, and insulin resistance (IR), in addition to maternal exposure to plastic components, such as bisphenol A, are factors associated with the etiology of PCOS. Thus, during pregnancy, care must be taken to minimize the chances of future adolescents developing the syndrome and the various comorbidities that are associated with it.

Association of classic and 11-oxygenated androgens with polycystic ovaries and menstrual cycle prolongation in infertile women with PCOS

Background and aimsThe etiology of polycystic ovary syndrome (PCOS) is unclear. This study aimed to evaluate the role of classic and 11-oxygenated (11oxyC19) androgens in two typical signs of PCOS, polycystic ovary morphology (PCOM) and menstrual cycle prolongation. Materials and methodsA total of 462 infertile women with diagnosed PCOS and/or commonly accompanied metabolic disorders were recruited. Classic and 11oxyC19 androgens were determined with a sensitive high-performance liquid chromatography-differential mobility spectrometry tandem mass spectrometry apparatus. Least absolute shrinkage and selection operator logistic regression with fivefold cross-validation was applied to construct prediction models. ResultsFor PCOM, the most significant contributing androgen was testosterone (T), with the weight of 51.6%. The AUC of the prediction model was 0.824 in validation set. For menstrual cycle prolongation, androstenedione (A4) was the most significant contributing androgen with weights of 77.5%. The AUC the prediction model was less than 0.75. When including other variables, the most significant variable turned to be AMH both in PCOM and in menstrual cycle prolongation. ConclusionAndrogens had more contribution in PCOM than in menstrual cycle prolongation. The classic androgen T or A4 contributed more than 11oxyC19 androgens. However, their contributions were diminished when other factors were considered, especially AMH.

Polycystic ovary syndrome (PCOS) – role of chronic inflammation in the expression of dysmetabolic phenotype

Polycystic ovary syndrome (PCOS) is a complex disorder that affects both reproductive and metabolic functions. In­su­lin resistance (IR) and compensatory hyperinsulinemia (HI) are considered major factors in the pathophysiology of PCOS and are involved in the development of hyper­an­dro­ge­nism and reproductive dysfunction. Excess androgens are a distinctive sign of PCOS, which determines many of the phenotypic features. Chronic low-grade inflammation is associated with PCOS characteristics, including insulin re­sis­tance and cardiovascular risk factors. Adipose tissue can be considered a proinflammatory organ, involved in the PCOS pathogenesis. Mediators released from immune cells and adipocytes have been identified as being involved in the development of IR. In conclusion, PCOS is a complex dis­order with multiple contributing factors, including in­su­lin resistance, hyperinsulinism, hyperandrogenism, and chro­nic inflammation. Understanding these mechanisms is es­sen­tial for the development of more effective diagnostic and therapeutic approaches to this multifactorial con­di­tion.

Effects of probiotic supplementation on hormonal and clinical outcomes of women diagnosed with polycystic ovary syndrome: A double-blind, randomized, placebo-controlled clinical trial

• Recent studies have suggested a bidirectional association between intestinal microflora and pathological components of PCOS. • Probiotics and prebiotics are among the most studied functional foods used widely due to their beneficial role in reducing oxidative stress, inflammation, and insulin resistance. • The present study revealed that synbiotic supplementation in PCOS women for 12 weeks had a beneficial effect on SHBG but did not affect other clinical and hormonal parameters. Previous reports examined the efficacy of probiotic supplementation in women with polycystic ovary syndrome (PCOS); however, the main focus of these studies has been on metabolic and inflammatory parameters rather than hormonal indicators. Therefore, the current pilot study was carried out to examine the effects of probiotic supplementation on hormonal and clinical parameters of women diagnosed with PCOS. This study was conducted to investigate the effects of probiotic supplementation in women diagnosed with PCOS according to the 2003 Rotterdam criteria. Participants were randomized to either a probiotic (n = 50) or placebo (n = 49) group to receive allocated intervention for 12 weeks. Women’s hormonal profiles, including serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), total testosterone (TT), and free androgen index (FAI) and clinical signs of PCOS including acne and hirsutism were examined at baseline and after 12 weeks of intervention. Analysis of covariance (ANCOVA) was done to assess between-group comparison in terms of probiotic efficacy. Following 12 weeks of intervention, compared with the placebo, probiotic supplementation significantly increased serum levels of sex hormone-binding globulin (SHBG) (+3.95; 95% CI: −6.20, 14.12 vs. −6.49; 95% CI: −12.71, −0.27; P = 0.030). However, no other significant improvement was observed in terms of hormonal and clinical outcomes. The present study revealed that probiotic supplementation in PCOS women for 12 weeks had a beneficial effect on SHBG but did not affect other clinical and hormonal parameters. Further RCTs with longer duration, other probiotic strains, other prebiotics, and higher dosages, respectively, may improve our knowledge regarding the role of gut microbiota in PCOS.

AMPK Activation Is Important for the Preservation of Insulin Sensitivity in Visceral, but Not in Subcutaneous Adipose Tissue of Postnatally Overfed Rat Model of Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is a well-known reproductive syndrome usually associated with obesity, insulin resistance, and hyperinsulinemia. Although the first signs of PCOS begin early in adolescence, it is underexplored whether peripubertal obesity predisposes women to PCOS metabolic disturbances. To highlight that, we examined the impact of postnatal overfeeding-induced obesity, achieved by litter size reduction during the suckling period, on metabolic disturbances associated with visceral and subcutaneous adipose tissue (VAT and SAT) function in the 5α-dihydrotestosterone (5α-DHT)-induced animal model of PCOS. We analyzed markers of insulin signaling, lipid metabolism, and energy sensing in the VAT and SAT. Our results showed that postnatally overfed DHT-treated Wistar rats had increased VAT mass with hypertrophic adipocytes, together with hyperinsulinemia and increased HOMA index. In the VAT of these animals, insulin signaling remained unchanged while lipogenic markers decreased, which was accompanied by increased AMPK activation. In the SAT of the same animals, markers of lipogenesis and lipolysis increased, while the activity of AMPK decreased. Taken together, obtained results showed that postnatal overfeeding predisposes development of PCOS systemic insulin resistance, most likely as a result of worsened metabolic function of SAT, while VAT preserved its tissue insulin sensitivity through increased activity of AMPK.

Influence of hormonal stimulation and intermittent cold exposure on the mechanisms of formation of polycystic ovarian syndrome

Introduction. Polycystic ovary syndrome (PCOS) is one of the most pressing problems in gynecological endocrinology. The aim of the study was to elucidate the morphological changes in the ovaries of rats under various types of hormonal exposure in experimental modeling of PCOS. Materials and methods. To study three working experimental models were developed, associated with the introduction of various hormonal drugs into the body of an animal. Model I-st consisted of subcutaneous administration of an estrogen-containing drug at a dose of 3 mg for 25 days. Model II-d involved the development of PCOS by daily subcutaneous administration of 3 mg of dehydroandrostenediol sulfate. The III model - the formation of PCOS in 5 immature rats using dopamine phytoanalogues at a dose of 3 mg subcutaneously for 25 days. The animals were divided into 3 groups: group 1 - rats that were induced with experimental PCOS and kept in a vivarium at a temperature of +23°C (n=8), group 2 - animals that, against the background of experimental PCOS, were exposed to cold exposure (CE) for 4 hours in a chamber with a constant light regime and a temperature of + 4 °C for 25 days (n = 8); group 3 - intact control (n = 8) - healthy rats without PCOS, which were kept in a vivarium at a temperature of + 23°C. Results. Histological examination of the ovaries of group 1 rats revealed morphological changes in the ovaries characteristic of PCOS. The morphological structure of the ovaries corresponded to type II PCOS. In rats of group 3, macroscopically, the ovaries were slightly reduced in size compared to the control group. The levels of adiponectin and leptin as markers of the functional ovarian tissue of PCOS model experiments.When studying the effect of CE on the body of experimental animals, their effect on the formation of tissue cell hyperplasia as a characteristic sign of PCOS was determined. Conclusions. Studies have shown that the formation of PCOS, as well as structural changes in the ovaries, significantly depend on hormonal regulation disorders.

Effect of statins combined or not combined with metformin on polycystic ovary syndrome: A systematic review and meta-analysis.

This meta-analysis was conducted to evaluate the effect of statins combined or not combined with metformin on polycystic ovary syndrome (PCOS). Databases were systematically searched from inception to February 2022. Meta-analysis was conducted by using STATA 12.0 software. In the study, standard mean difference (SMD) and 95% confidence intervals (CI) were computed as the effect size. A random effect model was used. Meta-analysis showed significant decline of total testosterone, free testosterone, dehydroepiandrosterone sulphate, androstenedione, luteinizing hormone (LH), LH to follicle-stimulating hormone (FSH) ratio, and prolactin in statin group. Our study also demonstrated significant decline of total cholesterol, low-density lipoprotein cholesterol, and triglycerides in statin group. Moreover, we found significant decline of fasting glucose, insulin sensitivity index, and high-sensitivity C-reactive protein. The meta-analysis showed that statin therapy was good for women with PCOS, and could improve clinical signs of PCOS.

Modern approaches to the diagnosis and treatment of polycystic ovary syndrome in adolescence

Тhe diagnosis of polycystic ovary syndrome (PCOS) in adolescence still raises many questions. The problem is that the characteristics of normal puberty often coincide with the symptoms of PCOS. The article presents the criteria of a normal menstrual cycle, clinical and laboratory hyperandrogenism. In the diagnosis of the latter, the most informative indicators are the determination of the index of free testosterone and androstenedione, and the assessment of free and total testosterone are relatively low sensitivity. Clinical hyperandrogenism in adolescents includes only severe acne and hirsutism. The level of antimullerian hormone has no independent significance. Irregular menstrual cycles during the first year after menarche represent a normal period of puberty. At the second and third year after menarche , menstrual cycles of less than 21 days and more than 45 days are considered irregular, and from the fourth year – less than 21 days and more than 35 days. From the second year after menarche, menstrual irregularities are considered to be more than 90 days for any cycle. Primary amenorrhea is indicated by the absence of menarche at 15 years, or 3 years after telarche. Ultrasound is not used as a criterion for PCOS in the first 8 years after menarche due to the high frequency of ovarian multifollicularity in adolescence. Therefore, adolescent girls in the presence of menstrual disorders and hyperandrogenism may be diagnosed with «PCOS. Phenotype B» (ultrasound signs are not taken into account). Adolescents who have signs of PCOS but do not meet the diagnostic criteria are at risk for PCOS. The most important stage of PCOS therapy is lifestyle modification, normalization of body weight and metabolic processes. Combined oral contraceptives in adolescents are more often prescribed not for direct purposes (contraception), but as off-label therapy not only at diagnosis, but also in the «risk group», which involves the treatment of irregular menstrual cycles and / or clinical hyperandrogenism. In the absence of the effect of lifestyle changes, proper nutrition to correct metabolic disorders in addition to combined oral contraceptives may be prescribed metformin, inositol and etc.

Clinical manifestations of polycystic ovary syndrome: a modern view

INTRODUCTION: Polycystic ovary syndrome (PCOS) is one of the urgent problems of gynecological endocrinology. The main signs of PCOS include a violation of menstrual and/or ovulatory function and clinical and/or biochemical hyperandrogenism, as well as polycystic ovarian morphology according to the ultrasound results. PCOS leads to infertility, obesity, and cardiovascular system diseases. PCOS is an important symptom complex in the diagnosis, which directly affects the reproductive function of females, hence the percentage of fertility. This study aimed to analyze the features of clinical, laboratory, and instrumental parameters in females with a previously established PCOS diagnosis referred for surgical treatment. The obtained results were studied from the point of view of the clinical guidelines of the American Society for Reproductive Medicine and the European Society of Human Reproduction and Embryology (2003), International PCOS Network (2018), and the Ministry of Health of the Russian Federation (2021).
 MATERIALS AND METHODS: The study included 121 females who were admitted to hospitals in Moscow for surgical treatment. Among the gynecological surgical hospitals, the following medical institutions were allocated: the city clinical hospital, the research center, and the commercial clinic we conditionally divided into three levels.
 The city clinical hospital had 54 females (1st group) aged 2137 years, the research center with 48 females (2nd group) aged 2242 years, and the commercial clinic with 19 females (3rd group) aged 2541. Before the ovarian surgery for PCOS, all patients underwent an additional examination, including the collection of anamnesis, particularly, features of menstrual and generative function, anthropometric indicators, body weight, and height study. Based on these parameters, the body mass index (BMI) was calculated, the clinical signs of hyperandrogenism (acne, excessive hair growth on the body and face, and the degree of hirsutism) were assessed, and the hormonal profile was determined to detect biochemical hyperandrogenism (free testosterone). Additionally, the level of glucose and insulin in the blood plasma was determined in all patients, and a pelvic ultrasound examination (ultrasound) was performed.
 RESULTS: Menstrual irregularities were revealed, of which complaints were presented by a total of 49.5% of patients. The results of the preliminary selection of patients with PCOS for surgical treatment revealed that 108 (89.2%) had primary and secondary infertility, of whom 64 (52.9%) had BMI within the normative values, 29 (23.9%) were overweight, and 25 (20.6%) were obese. Clinical manifestations of hyperandrogenism were present in 61 (50.4%) patients included in the study. The level of free testosterone above the normative values (2.85 pg/ml) was diagnosed only in 9 (7.4%) patients out of 121 who are included in the study. Additionally, this parameter was within the upper limit of the norm (average value of 2.780.36 pg/ml) in 112 females but was combined with clinical manifestations of hyperandrogenism. Black acanthosis was noted in 6 (5.0%) patients with free testosterone levels in 3.013.64 pg/ml. Increased blood glucose levels were combined with obesity in 3 (5.5%) patients of 1st group and 1 (2.1%) in 2nd group. Insulin levels significantly exceeded the upper limit of the norm in 6 (5.0%) patients. The ultrasound result in all patients (n=121) revealed the presence of echographic signs of PCOS in PCOS was confirmed by ultrasound in 54 females in 1st group, 48 females in 2nd group, and 19 females in 3rd group.
 CONCLUSION: Our results suggest an unreasonably broad interpretation of PCOS diagnosis. Therefore, PCOS diagnosis should be primarily remembered as a diagnosis-exception. Only repeated, extended, thorough, and comprehensive examination of patients with a presumed PCOS diagnosis will allow you to better navigate the individual characteristics of patients and offer adequate methods for correcting the symptom complex to improve the overall health, fertility, and quality of life.

Prevalence, phenotypic distribution, and clinical characteristics of polycystic ovary syndrome in Egyptian women with type 1 diabetes mellitus

BackgroundType 1 diabetes mellitus (T1DM) has shown a steady increase in prevalence in most parts of the world. Polycystic ovary syndrome (PCOS) frequently occurs in 15–20% of women in their reproductive age. It is associated with subfertility, ovulatory dysfunction, dysregulated androgen biosynthesis, and increased risk of insulin resistance. This study aims to assess the prevalence, phenotypic distribution, and clinical characteristics of PCOS in a sample of Egyptian women with T1DM.Patients and methodsA total of 100 Egyptian women in their reproductive age (18–42 years old) previously diagnosed as having T1DM were recruited in the study. They were screened for symptoms and signs of PCOS by clinical, laboratory, and radiological investigations.ResultsOverall, 28% of our women with T1DM had PCOS and 61% had metabolic syndrome. Frank PCOS was the most common PCOS phenotype (47%). When women with T1DM with and without PCOS were compared, BMI, waist circumference, systolic blood pressure, and fasting blood sugar were statistically higher in the PCOS group, whereas high-density lipoprotein cholesterol was statistically lower (P < 0.05). Follicular-stimulating hormone (FSH) and sex hormone-binding globulin were also statistically lower and luteinizing hormone (LH), LH/FSH ratio, and total testosterone (TT) were statistically higher (P < 0.01) in the PCOS than in the non-PCOS group. In women with T1DM, LH, LH/FSH ratio, and TT were positively correlated with BMI and waist circumference, whereas LH/FSH ratio and TT were negatively correlated with high-density lipoprotein cholesterol.ConclusionThe prevalence of PCOS among women with T1DM in our sample of Egyptian patients revealed that PCOS and its associated traits are common findings. Thus, current T1DM management guidelines should include screening tests for PCOS and androgen excess as these patients have a high incidence of metabolic syndrome.

Синдром полікістозних яєчників у щоденній практиці

Синдром полікістозних яєчників (СПКЯ) — системна патологія, при якій порушуються всі ланки ендокринної системи, а не лише функція яєчників. СПКЯ трапляється у жінок будь-якого віку, розпочинаючи від пубертатного періоду і до менопаузи, із залученням у процес майже всіх органів і систем організму. СПКЯ виявляють у 6–19 % жінок репродуктивного віку. На СПКЯ припадає більш ніж половина всіх випадків ендокринного безпліддя (50–75 %) і близько 20–22 % причин безплідного шлюбу взагалі. Основними клінічними ознаками СПКЯ є гіперандрогенія, менструальна й/або овуляторна дисфункція та полікістозна морфологія яєчників. У жінок, яким виставлений цей діагноз, значно вищий ризик розвитку серцево-судинних захворювань, цукрового діабету, злоякісних новоутворень малого тазу, мастопатії та раку молочної залози. У патогенезі синдрому велике значення мають гландулярна й екстрагландулярна гіперандрогенія, інсулінорезистентність, гіпофізарна дисфункція, генетичні порушення та порушення продукції гормонів жирової тканини. Основна мета діагностики СПКЯ — визначення ступеня тяжкості клінічних проявів, джерела та патогенезу гіперпродукції андрогенів, впливу на репродуктивну функцію, оцінка метаболічних і кардіоваскулярних ризиків. Диференційна діагностика скерована на виключення захворювань щитоподібної залози, гіперпролактинемії та некласичної вродженої дисфункції кори надниркових залоз. На сьогодні все більше уваги приділяється комплексному підходу до лікування порушень, що виникають у пацієнток з СПКЯ, з урахуванням їх віку, репродуктивних планів і стану гормонального фону. Важливим є не тільки відновлення фертильності та досягнення косметичних ефектів, але й профілактика пізніх метаболічних порушень.

Adult female acne: Clinical characteristics and factors significantly associated with polycystic ovary syndrome.

Adult female acne (AFA) may be different from adolescent acne, and may be a sign of polycystic ovary syndrome (PCOS). The objective of the study was to investigate the clinical characteristics of AFA, and the factors significantly associated with PCOS in AFA. AFA patients aged 25 years or older were enrolled. History taking and dermatologic examinations were performed by dermatologists. PCOS was diagnosed by gynaecologists. Perimenopausal acne (aged 45 years or older) and the Dermatology Life Quality Index (DLQI) were also evaluated. Among 208 patients, mean age was 31.8 ± 7.1 years and 47.1%, 26.9%, and 26% had persistent, late-onset, and recurrent acne, respectively. The common aggravating factors included pre-menstruation (72.6%) and stress (53.8%). Recurrent acne was significantly aggravated by cosmetic products. Higher body mass index (BMI) was positively correlated with acne severity. Acne lesions were predominately located on both cheeks (87.0%) and at the perioral area (81.7%). PCOS was identified in 48.1%. Younger age (≥25 to <33 years), premenstrual flare, and irregular menstruation, but not hirsutism or androgenetic alopecia, were associated with PCOS in univariate and multivariate analysis. Perimenopausal acne was identified in 6.7%. The total mean DLQI score was 8.0 ± 5.4 (range from 0 to 23). Persistent acne with moderate severity was common in AFA patients and higher BMI was associated with acne severity. PCOS should be screened in AFA patients with younger age, premenstrual flare, and irregular menstruation.

Clinical and biochemical signs of polycystic ovary syndrome in young women born preterm.

ObjectiveIt has been suggested that adverse early life exposures increase the risk of developing polycystic ovary syndrome (PCOS) in later life. We hypothesized that women born preterm would have more biochemical and clinical signs of PCOS than women born at term.DesignThe ESTER Preterm Birth Study participants were born in Northern Finland and identified from the Northern Finland Birth Cohort and the Finnish Medical Birth Register. Altogether, 74 women born very or moderately preterm (<34 gestational weeks, VMPT), 127 born late preterm (at 34–36 weeks, LPT), and 184 born full term (≥37 weeks, controls) were included in the analysis (mean age: 23.2 years).MethodsWe measured serum total testosterone and sex hormone-binding globulin (SHBG) and calculated the free androgen index (FAI). PCOS according to the clinical and biochemical signs was defined either as hirsutism and oligoamenorrhea (via questionnaire) or as oligoamenorrhea and elevated testosterone levels (>2.4 nmol/L).ResultsWomen born VMPT/LPT exhibited 33.0% (8.7, 62.8)/16.4% (−2.0, 38.1) higher testosterone, 28.5% (5.3, 45.9)/24.1% (5.6, 38.9) lower SHBG levels, and 64.6% (19.4, 127.1)/42.5% (11.1, 82.9) higher FAI than controls after adjusting for age and recruitment cohort, maternal BMI, smoking, and pregnancy disorders, parental education, history of hypertension, diabetes, myocardial infarction or stroke, and subject’s birth weight s.d. Odds ratios for having PCOS were 1.67 (0.44, 6.23)/3.11 (1.26, 7.70).ConclusionsWomen born preterm have a more hyperandrogenic hormonal profile, and those born LPT are approximately three times more likely at risk to have PCOS compared to women born at term.

Abstract P022: Self-reported Polycystic Ovary Syndrome Is Associated With Higher Odds Of Metabolic Syndrome In Women Aged 18-76 Years From The Hispanic Community Health Study/Study Of Latinos

Introduction: Polycystic Ovary Syndrome (PCOS) is associated with increased Metabolic Syndrome (MetS), however, these findings have not been characterized in Hispanic/Latina women who are disproportionately burdened by obesity and cardiovascular disease risk compared to non-Hispanic whites. It is also unclear if this association is moderated by elevated high-sensitivity C-Reactive Protein (hs-CRP) levels, a marker for inflammation and a predictor of cardiovascular disease. Hypothesis: In Hispanic/Latina women, we hypothesized that 1) PCOS (self-reported diagnosis and signs) is associated with a higher prevalence of MetS compared to those not reporting PCOS 2) elevated hs-CRP is associated with MetS, and 3) the PCOS-MetS association is moderated by elevated hs-CRP. Methods: We used information from reproductive and economic questionnaires and venous blood measurements collected in Hispanic Community Health Study/Study of Latinos (2008-2017), a U.S. community-based cohort study of Hispanic/Latino adults. PCOS was operationalized as either 1) signs of PCOS (e.g., menstrual cycles &gt;35 days, irregular cycles (at age 20 to 40 years old when not using birth control pills or other hormone medications and not pregnant or breastfeeding) or 2) having answered “yes” to a self-reported question on PCOS. MetS was operationalized as ≥3 elevated subcomponents of MetS (i.e., waist circumference, hypertension, insulin resistance, lipid profile, and triglycerides). A hs-CRP value ≥3.0 mg/L was considered elevated. We adjusted for the complex survey study design, age, study center, Hispanic/Latina background, and age at immigration in all models. Results: The overall (unweighted N=9582) age ranged from 18 to 76 years (mean=41.74, SD=14.18). The prevalence of PCOS (self-reported diagnosis and signs) was 12% (1008/7366), prevalence of MetS was 40% (2380/3495), prevalence of elevated-hsCRP was 44% (3704/4667). PCOS was associated with a significantly higher odds of MetS before (OR 1.35, 95% CI: 1.06-1.71) and after adjusting for elevated-hsCRP (OR 1.29, 95%CI: 1.02-1.65). Elevated hs-CRP is significantly associated with MetS (OR 2.31, 95%CI: 1.95-2.76). There was no significant interaction effect of hs-CRP in the PCOS-MetS association. Conclusions: Prevalence of PCOS (self-reported and signs) was 12% in our sample of Hispanic/Latina women, which is consistent with the previous findings in non-Hispanic whites. Both PCOS (self-reported diagnosis and signs) and elevated hs-CRP were significantly associated with higher prevalence of MetS and could indicate women at metabolic disease risk.

The role of cholecalciferol in the pathogenesis of polycystic ovary syndrome

Objective to evaluate and compare clinical, anamnestic and laboratory data of patients with polycystic ovary syndrome (PCOS) and without syndrome, including the level of vitamin 25(OH) D3.&#x0D; Material and methods. In this work, 81 patients were examined, who, at the 1st stage of the study, were divided into two groups depending on the presence or absence of signs of PCOS. The main group included 51 patients with signs of PCOS. The control group included 30 healthy women without signs of PCOS, matched by sex and age with the main group. The main and control groups were compared by clinical and anamnestic data, including birth weight, by the presence of complications of pregnancy and childbirth in their mothers during their gestation, by the level of vitamin D. PCOS was verified on the basis of diagnostic criteria Rotterdam (2003) and International guidelines on PCOS (2018). Vitamin 25(OH)D3 was determined by mass spectrometry (ng/ml).&#x0D; At the 2nd stage of the study, the main group with PCOS was divided into 2 subgroups depending on the waist circumference (WT). Subsequently, the subgroups were compared with each other in the same parameters as at stage 1, as well as in the level of insulin, low-density lipoprotein (LDL), triglycerides (TG), anti-Mllerian hormone (AMH), follicle-stimulating hormone (FSH) and luteinizing hormone (LH). To reflect the statistical results, the parametric parameters of the Students t-test were applied for two independent samples with equal or different variance. For nominal data Pearsons Chi-test, when the means are not calculated and a test is carried out for the presence of a relationship between nominal variables.&#x0D; Results. There was no statistically significant difference in vitamin 25(OH)D3 levels in patients with and without PCOS. Statistically significant differences in vitamin 25(OH)D3 levels were found in women with PCOS, depending on the waist circumference (WT). In these subgroups, differences were also found in the level of insulin, LDL, TG.&#x0D; Conclusion. The values of the level of vitamin 25(OH)D3 do not differ in the groups of patients with PCOS and without PCOS, but significantly correlate with the metabolic profile of patients.

EFFECT OF POLY-CYSTIC OVARIAN SYNDROME ON SELF-ESTEEM AND BODYIMAGE AMONG ADOLESCENT GIRLS ATTENDING ADOLESCENT CLINIC IN A TERTIARY CARE CENTRE

Background: Polycystic ovary syndrome (PCOS) have serious health issues, affecting female health, causing body disfigurement, lowers self- esteem decreases the quality of life and, lifelong health consequences related to metabolic disorders. Objective: The objective of the study was to evaluate, 'the impact of various clinical features of PCOS namely obesity, hirsutism, acne, menstrual irregularities on psychological well-being in adolescent girls'. Material and methods: A cross-sectional study conducted in the adolescent clinic, BHU. Tools used for data collection were a self-structured questionnaire which includes socio-demographic status, menstrual history, and anthropometric assessment. Hirsutism was assessed by the Ferriman-Gallwey scoring system, acne by the Global acne grading system, self-esteem by Rosenberg self-esteem scale, and body image by Body Image Concern Inventory scale. Statistical analysis was done by SPSS version '22'. Results: Findings of multiple regression analysis suggests that adolescent girls with hirsutism experienced poorer self-esteem (β= -2.621, p=0.01) and greater body dissatisfaction (β= 0.258, p= 0.02) than adolescents girls without hirsutism. Furthermore, obese adolescents had a lower level of self-esteem (β= -0.056, p=0.01) and negative body image (β= 0.748, p=0.01) compared with non- obese PCOS adolescents. Adolescent girls with menstrual irregularities had higher body dissatisfaction (β=0.143, p=0.05) than patients with a regular cycle. Conclusion: PCOS in adolescents having obesity, menstrual irregularities, and features of hyper-androgenism have a profound effect on psychological well being. So, the recognition of the early signs of PCOS during adolescence and early treatment can improve the quality of life.

The role of cholecalciferol deficiency in the pathogenesis of polycystic ovary syndrome.

Objectives:to evaluate and compare clinical presentations, medical history, and laboratory data of patients with polycystic ovary syndrome, including vitamin 25(OH)D3 level.Methods:In total, 81 patients were examined. The patient group included 51 patients with signs of polycystic ovary syndrome. The control group included 30 healthy women without signs of polycystic ovary syndrome, comparable according to gender and age to the patient group. Polycystic ovary syndrome was verified based on the diagnostic Rotterdam and international polycystic ovary syndrome guidelines’ criteria. The levels of cholecalciferol were determined by mass spectrometry (ng/mL). At the second stage of the study, the patient group with polycystic ovary syndrome was divided into two subgroups depending on the waist circumference and compared with each other by the level of insulin, low-density lipoproteins, triglycerides, anti-Mullerian hormone, follicle-stimulating hormone, and luteinizing hormone. Statistical analysis was carried out using the parametric t-test for two-independent samples with equal or different variance. For nominal data—Pearson’s chi-test, when the means are not calculated and a test is carried out for the presence of a relationship between the nominal variables.Results:Patients with polycystic ovary syndrome and without polycystic ovary syndrome did not have a statistically significant difference in 25(OH)D3 level. Statistically significant differences in the level of 25(OH)D3 were found in women with polycystic ovary syndrome with the waist circumference ⩾80 cm. In these subgroups, differences in insulin, low-density lipoprotein, and triglycerides levels were also revealed.Conclusion:The correlation of the 25(OH)D3 level does not differ in the groups of patients with polycystic ovary syndrome and without polycystic ovary syndrome, but significantly correlates with the metabolic profile of patients.

Clinical and hormonal characteristics in heterozygote carriers of congenital adrenal hyperplasia

Non-classical congenital adrenal hyperplasia (NC-CAH) includes a group of genetic disorders due to a broad class of CYP21A2 variants identifying a disease-causing ‘C’ genotype.The heterozygous carriers of CYP21 mutations are at increased risk of developing clinically evident hyperandrogenism, even though clinical and laboratory characteristics are still underestimated. With the aim of obtaining a more accurate delineation of the phenotype of heterozygous carrier of CAH, we analyzed clinical, biochemical and molecular characteristics in a cohort of Sicilian subjects. Fifty-seven females with biallelic and monoallelic CYP21A2 variants classifying NC-CAH (24) and heterozygous carriers of CAH (33), respectively were selected. Forty-four females age-matched healthy controls were also enrolled and genotyped for CYP21A2. Clinical, hormonal and genetic data were collected.CYP21A2 monoallelic mutations, defining the heterozygous carriers state, were identified in subjects with clinical features including hirsutism, oligomenorrhoea, overweight and a PCO-like phenotype, particularly occurring in the age of adolescence. Consistently, levels of 17OHP and cortisol were found to be significantly different from NC-CAH. Overall, some clinical and laboratory findings including oligomenorrhea and 17OHP/cortisol ratio were observed as independent markers associated with carriers of CAH. Here we report a high prevalence of late-onset signs of polycystic ovary syndrome (PCOS) and hyperandrogenism in heterozygous carriers. The 17OHP/cortisol ratio may be a predictive tool to identify the carriers of CAH, even though specific cut-off values have not yet been identified.

A case of massive ovarian edema: ovarian wedge resection by laparoendoscopic single-site surgery (LESS) resulted in complete remission of hyperandrogenic symptoms

Massive ovarian edema is a rare entity and easily mistaken as a malignant neoplasm of ovary. This pseudo-tumor occurs predominantly in young women and its presentation varies from being asymptomatic and to being a cause of acute abdomen, such as ovarian torsion. Polycystic ovary syndrome (PCOS) is characterized by elevated androgen and its pathogenesis is associated with endocrine dysfunction. Here the authors present a young woman who showed typical symptoms and signs of PCOS that was finally diagnosed to have massive ovarian edema by laparoendoscopic single-site surgery (LESS) and disappearance of the symptoms of PCOS after resection of edematous pseudo-tumor. This correlation is thought to be the removal of ovarian edema including large proportion of theca tissue which is responsible for overproduction of androgen in ovarian follicles. A 23-year-old woman, a registered nurse at this facility, visited the gynecologic department complaining of six-month amenorrhea and male pattern pubic hair growth. Initial transvaginal ultrasonography showed polycystic morphology in the left ovary and a large right adnexal solid mass with positive Doppler flows. Magnetic resonance imaging was performed and it revealed enlargement of right ovary measuring 9.3 centimeters in largest diameter, with peripheral displacement of follicles and massive ovarian edema was assumed to be a diagnosis. Operation for confirming diagnosis was decided after discussion with patient, as she was anxious for the uncertainty of the nature of the mass. Frozen section pathology report of right ovarian biopsy suggested cystic follicles with edematous stroma. Operation was ended after resection of the two-thirds of the right ovary that showed marked edematous change, while preserving one-third for future fertility. Final pathology confirmed the frozen biopsy. Her symptoms of PCOS that included irregular menstruation and male pattern pubic hair growth were completely improved after the surgery at six-month follow-up.

Zespół policystycznych jajników jako problem w ginekologii i medycynie rodzinnej, z uwzględnieniem pacjentek w wieku rozwojowym

Symptoms of female developmental changes associated with puberty appear at the age of 9 to 14 years. These include the formation of secondary sexual characteristics that begin with breast development followed by rapid growth and, finally, the first menstruation (menarche), after which fertility is achieved. There is no fixed age limit for puberty in girls. It may start early or late. It may be also disturbed by endocrinopathies. Polycystic ovary syndrome (PCOS), which develops at a late stage of puberty, is one of them. The syndrome is associated with hyperandrogenism and overweight. At the same time, it is one of the most common causes of hyperandrogenism in women. Polycystic ovary syndrome is manifested by the lack of menstruation, hirsutism, obesity and significantly enlarged cystic ovaries. Girls with clinical signs of polycystic ovary syndrome show a different pattern of GnRH secretion during early adolescence, which may lead to abnormal stimulation of the maturing ovary. Therefore, polycystic ovary syndrome is not only a problem in adult gynaecology, but also in adolescent gynaecology.