Young Polycystic Ovary Syndrome Women Research Articles

A study on the factors affecting polycystic ovary syndrome in young women

Aims: The aim of this study was to define the incidence of polycystic ovary syndrome (PCOS) in young women and the affecting characteristics. In this study, environmental factors and demographic characteristics of women with PCOS were compared with the control group, which included healthy young women. Methods: This is a retrospective study with control in young women aged 18-25, suffering from PCOS and healthy women, referred to our clinic between September 2018- August 2020. Women's socio-demographic characteristics such as age, weight, height, economic status, employment status, education status, smoking and alcohol abuse, chronic disease, exercise status, family history of cancer, and menstrual irregularity of participants were compared. Results: Results did not show a statistically significant association between case and control regarding age, economic status, education status, family history of cancer, smoking and alcohol abuse (p>0.05). There was a statistically significant difference between groups regarding menstrual irregularity, chronic disease, body mass index (BMI), exercise and working status (p<0.05). Healthy women exercise more, and a higher percentage of them are employed. Chronic diseases were more common in women with PCOS. Women with PCOS were fatter and had more menstrual irregularities problems. Conclusion: BMI, working status, exercise status, menstrual irregularity, and chronic disease status helped diagnose PCOS in young women.

Assessment of the effect of endocrine abnormalities on biomacromolecules and lipids by FT-IR and biochemical assays as biomarker of metabolites in early Polycystic ovary syndrome women

Polycystic ovary syndrome (PCOS) is a common endocrinopathy associated with metabolic disturbances. Both in the development and improvement of the disease, the structure of phospholipids and proteins in the blood serum plays important role in the treatment of these disease. Herein, to investigate the metabolic process and the variations of biomacromolecules and lipids between young PCOS women and healthy subjects, biochemistry and Fourier Transform InfraRed spectroscopy (FTIR) methods, were used. Moreover, partial least squares regression (PLS) and Principal component analysis (PCA) to research differentiation of biomacromolecules, were performed. We obtained blood serum of of 100 individuals including 57 with PCOS and 43 healthy controls. The biochemical blood profile of PCOS women was presented by spectroscopic measurements, which is an analytical technique, as well as by laboratory indexes and oxidative stress status measurements. There was a significant structural differentiation between studied groups in the number of functional groups and biomolecules differentiation depending on the protein expression and oxidative stress status. Hence, FTIR spectroscopy and oxidative load can be effectively utilized as tools for classifying quantitative and qualitative changes of biomolecules in PCOS samples. PCOS samples did not correlate with luteinizing hormone (LH) level and proteins but had a negative correlation between carbohydrates and fatty acids, compared with control group.

Effect of aging on clinical features and metabolic complications of women with polycystic ovary syndrome

PurposeTo assess the distribution of clinical features and metabolic abnormalities of polycystic ovary syndrome (PCOS) women according to their age.MethodsRetrospective study on 602 women (mean age 23.9 ± 6.2 years), diagnosed according to International PCOS Network Guidelines criteria as having PCOS in a University-based Hospital. Anthropometric features, hormonal and metabolic parameters were measured and compared between the different age groups (group A ≤ 20 years; group B 21–30 years; group C > 30 years).ResultsPatients in group A were more often hyperandrogenic, while in group C hypertension, dyslipidemia, obesity, impaired fasting glucose, and insulin resistance (IR) were more prevalent. After adjusting for BMI, age correlated positively with sex hormone-binding globulin (SHBG), IR, total- and LDL-cholesterol, and negatively with DHEAS, insulin, and free androgen index (FAI). SHBG was significantly associated with IR and atherogenic dyslipidemia, while FAI levels were linked to hypertension, independently of other factors considered. Furthermore, the regression analysis showed a stronger relationship between BMI and metabolic outcomes, regardless of age.ConclusionPolycystic ovarian syndrome (PCOS) phenotype changes with age. Clinical and biochemical hyperandrogenism are a major concern in young PCOS women, while metabolic burden tends to increase with aging. Some of the cardiovascular risk factors are dependent on FAI and SHBG levels, whereas BMI confirms its key role in the genesis of most of the metabolic sequelae in PCOS, independently of age.

English

BACKGROUND Polycystic ovary syndrome (PCOS) is one of the main causes for infertility. Many studies show that PCOS is associated with production of some inflammatory factors like CRP and IL - 18, which has a prognostic significance in analysing the risk of future cardiovascular diseases (CVD). American heart association (AHA) has put forward C - reactive protein (CRP) as a clinically useful marker for risk of cardiovascular diseases. Previous studies show an increased incidence of high levels of CRP in PCOS patients as compared to controls. If such an association is proved in our population, CRP can be used as an ideal marker to screen apparently normal young PCOS women for CVD. So we wanted to assess the CRP levels in PCOS through this study. METHODS This was a cross sectional study conducted in the outpatient departments of Infertility and Gynaecology in a tertiary care hospital of South India, from 2018 to 2019. It was conducted among women of age 25 - 35 years who were diagnosed to have PCOS according to Rotterdam’s criteria, satisfying inclusion criteria. Women of age 25 - 35 years without PCOS were taken as comparison group. The study was conducted in 50 PCOS women and 50 women without PCOS were taken as comparison group. Data was obtained with the help of appropriate questionnaire and laboratory investigations. CRP level was assessed by Immunoturbidimetric method. RESULTS CRP was found to be significantly elevated (P < 0.01) in PCOS (1.87 ± 2.16) when compared to women without PCOS (0.16 ± 0.4). CONCLUSIONS CRP levels were significantly higher in PCOS women as compared to women without PCOS. Thus CRP can be used as tool to assess inflammatory state in PCOS. KEYWORDS Polycystic Ovary Syndrome, C Reactive Protein, Inflammation

Serum pregnancy-associated placental protein-a (PAPP-A) levels are increased in polycystic ovary syndrome (PCOS) in women with oligo-anovulation

Background/Aim: Pregnancy associated placental protein-A (PAPP-A) is a zinc-binding metalloproteinase with a key role in insulin like growth factor (IGF) pathway, and potential atherogenic effects. There is little information in the literature regarding PAPP-A levels in Polycystic ovary syndrome (PCOS). We aimed to investigate the serum PAPP-A levels among non-obese women with PCOS as a cardiovascular risk marker. Methods: Non-obese women of reproductive age (18-35 years of age) diagnosed with PCOS according to Rotterdam Consensus Conference criteria were included in this case-control study. Serum PAPP-A levels were compared with independent samples t-test between two main groups (PCOS and control) and investigated in PCOS subgroups as PCOS patients were further classified according to main phenotypes (hyperandrogenism and oligo-anovulation). Results: A total of 41 women with PCOS and 40 age- and body mass index- matched controls were included in the analysis. The serum PAPP-A levels of the control and PCOS groups, and of PCOS patients with hyperandrogenism were similar (P=0.128, P=0.261, respectively). However, the serum PAPP-A levels of those with oligo-anovulation was higher than those without (P=0.006), and that of women without oligo-anovulation was comparable to that of the control group (P=0.613). Conclusion: Lean and young PCOS women with oligo-anovulation had increased serum levels of PAPP-A when compared to women without. Prospective studies are needed to uncover the long-term cardiovascular risk of elevated PAPP-A levels in PCOS women with oligo-anovulation.

Changes in Metabolic Profile in the Women with a History of PCOS-A Long-Term Follow-Up Study.

Data concerning metabolic consequences in women with polycystic ovary syndrome (PCOS) are delivered mainly by cross-sectional studies. In this research, we re-examined 31 Caucasian PCOS women after a median period of 120.9 months to evaluate the changes in metabolic syndrome components. Clinical examination, oral glucose tolerance test with estimations of glucose and insulin, lipids, sex hormone-binding globulin (SHBG) and sex hormones assessments were performed on two occasions. Additionally, the euglycaemic hyperinsulinaemic clamp technique was used at the baseline to assess insulin sensitivity (M-clamp value). In the end, the median age of participants was 35. We observed an increase in glucose concentrations, a decrease in insulin concentrations and no changes in insulin resistance markers. Final mean glucose, mean insulin, Matsuda index and body mass index (BMI) were correlated with baseline M-clamp value and SHBG (p < 0.01). During the follow-up, no one in the sample developed diabetes. The annualised incidence rate for conversion from normoglycaemia to prediabetes totalled 4.5%. Baseline BMI, free androgen index, fasting glucose and M-clamp value were identified as prediabetes predictors in young PCOS women (respectively, OR = 1.17, OR = 1.42, OR = 1.2, OR = 0.73, p < 0.05). Prediabetes appeared in 76.47% of the women with a final BMI of ≥ 25 kg/m2 and in 7.14% of the normal-weight women (p = 0.0001). In conclusion, we report a high rate of adverse change in glucose metabolism in overweight and obese participants, a deterioration in β-cell function and strong correlations between metabolic parameters assessed in the third and the fourth decade in PCOS women, emphasising the role of early intervention to prevent cardiometabolic diseases.

49. Non-alcoholic Fatty Liver Disease in Young Polycystic Ovary Syndrome Women

49. Non-alcoholic Fatty Liver Disease in Young Polycystic Ovary Syndrome Women

Complementary effect of Vitamin D supplementation and lifestyle modification on anthropometric and metabolic parameters in young polycystic ovary syndrome women with Vitamin D deficiency: a 3-month prospective interventional study

Complementary effect of Vitamin D supplementation and lifestyle modification on anthropometric and metabolic parameters in young polycystic ovary syndrome women with Vitamin D deficiency: a 3-month prospective interventional study

High-normal thyroid stimulating hormone is a predictor of metabolic syndrome among young polycystic ovary syndrome women

Background and objectives High-normal thyroid stimulating hormone (TSH) (2.6–4.5 μIU/ml) is associated with metabolic syndrome (MetS) in population studies. We hypothesized that euthyriod polycystic ovary syndrome (PCOS) with TSH of higher than 2.5 had altered anthropometric, metabolic, and endocrine parameters as well as higher percentage of MetS compared with those with lower TSH levels. Patients and methods The present study included 60 young euthyroid PCOS women without any thyroid risk factors and 60 age-matched and BMI-matched healthy, fertile women. Anthropometric measurements were obtained, biochemical and hormonal assay were evaluated, and the homeostatic model assessment-insulin resistance was calculated. PCOS women were divided into high-normal TSH (group 1) and low-normal TSH (group 2) groups. MetS was defined according to National Cholesterol Education Program/Adult Treatment Panel III. Results Group 1 had significantly higher waist circumference, systolic blood pressure and diastolic blood pressure, total cholesterol, triglycerides, low-density lipoprotein cholesterol, fasting glucose, fasting insulin, homeostatic model assessment-insulin resistance, and free androgenic index and significantly lower high-density lipoprotein cholesterol, free thyroxin, and sex hormone binding globulin compared with both group 2 and healthy controls. In addition, group 1 (compared with group 2) had significantly higher percentage and higher risk of MetS [46.7 vs. 16.7%, P=0.01; odds ratio (OR)=4.4] and some of its components such as fasting glucose of at least 100 mg/dl (26.7 vs. 6.7%, P=0.03; OR=4.3), high-density lipoprotein cholesterol of less than 50 mg/dl (50 vs. 23.3%, P=0.03; OR=3.3), TG of at least 150 mg/dl (50 vs. 20%, P=0.01; OR=4), and near-significant higher percentage of both waist circumference of 88 cm or more and systolic blood pressure of at least 130 (P=0.06 for both, OR=3.25, 5, respectively). TSH level of 2.85 was the best threshold to indicate MetS risk (sensitivity=68%, specificity=88%, Youden index=0.56, area under the curve=0.81). Conclusion High-normal TSH PCOS women had increased risk of MetS. The optimal cut-off point for diagnosis of MetS was 2.85 µIU/ml.

Association of Calpain (CAPN) 10 (UCSNP-43, rs3792267) gene polymorphism with elevated serum androgens in young women with the most severe phenotype of polycystic ovary syndrome (PCOS)

Objectives: To highlight a possible association of Calpain (CAPN 10) gene UCSNP-43 polymorphism with hormonal and metabolic traits of young women with different phenotypes of polycystic ovary syndrome (PCOS).Design: PCOS women were genotyped for the CAPN 10 gene UCSNP-43 polymorphism. A comparison of clinical and biochemical features of women with PCOS stratified on the basis of the CAPN 10 gene UCSNP-43 variants was assessed.Methods: Anthropometric, hormonal and biochemical measurements were carried out in 668 PCOS women and 200 healthy controls. Subjects were also genotyped for the CAPN 10 gene UCSNP-43 polymorphism. The genotype frequency distributions between groups and controls were compared using the chi-square test. The association of the polymorphism with the clinical and biochemical features of the study cohort was estimated as well.Results: No association of the frequency of CAPN 10 gene UCSNP-43 polymorphism with PCOS was detected. No association of the polymorphism with the anthropometric, biochemical and hormonal features was detected both in PCOS and control women. The polymorphism was associated with serum Δ4 androstenedione (p = 0.018), as well as with 17-OH progesterone (17-hydroxyprogesterone) among women with PCOS phenotype A (p = 0.012).Conclusions: CAPN 10 gene polymorphism UCSNP-43 is deprived of a metabolic contribution to cardiovascular disease (CVD). However, due to its association with androgen excess in phenotype A, CAPN 10 gene polymorphism UCSNP-43 could be used as a genetic marker for CVD in young PCOS women.

Polycystic ovary syndrome: Metabolic consequences and long-term management

Young women with polycystic ovary syndrome (PCOS) present an increased risk for type II diabetes and cardiovascular diseases. The prevalence of altered glucose tolerance ranges between 20 and 35 % in patients while the prevalence of type II diabetes ranges between 2 and 8 % and seems related to body weight and ethnic group. Moving from the young fertile age to the 40s and the menopause the prevalence of type II diabetes continues to increase compared to the general female population and may reach 10–16 % of PCOS women. However, prevalence of altered glucose tolerance does not increase. Also cardiovascular risk is increased in a large part of young PCOS women but this risk tends to be normalized with age because of the reduction of ovarian androgen secretion and occurrence of ovulatory cycles in at least one third of PCOS women approaching menopause. It may explain the discrepancy between cardiovascular (CV) risk during young age and observed number of CV events. Long-term management should be directed to aggressively treat obesity and altered glucose tolerance. In non-obese patients with normal glucose tolerance it may be wise to wait until the age of 40 before deciding a long-term management of CV risk.

Clinical efficacy and metabolic impact of two different dosages of ethinyl-estradiol in association with drospirenone in normal-weight women with polycystic ovary syndrome: A randomized study

The estrogenic component of estro- progestin (EP) is responsible for a negative impact on the metabolic and lipid assessment in women with polycystic ovary syndrome (PCOS). To evaluate the risk/benefit ratio of two EP combinations, containing the same progestin (3 mg drospirenone) and a different dose of ethinyl-estradiol (EE) (20 vs 30 μg) and to compare their effects on the clinical and endocrine-metabolic parameters in normal-weight PCOS women. In this randomized pilot study, we enrolled 30 young normal-weight PCOS women. Fifteen subjects were allocated to group A (20 μg EE) and 15 PCOS subjects to group B (30 μg EE). Hirsutism score, hormonal assays, oral glucose tolerance test, euglycemic hyperinsulinemic clamp and lipid profile were performed at baseline, and after 6 and 12 months of therapy. Main outcome measures were signs of hyperandrogenism, glucose and insulin metabolism, lipid profile. Both treatment regimens induced a significant improvement in hirsutism score, testosterone, DHEAS, and SHBG levels. Androstenedione significantly dropped only in patients of Group A, while 17(OH)P only in those from Group B. Both the formulations did not significantly modify gluco-insulinemic metabolism. Total cholesterol, LDL cholesterol, and HDL cholesterol levels significantly increased in both groups. Triglycerides levels, which increased as well, resulted more markedly influenced by the formulation with 30 μg EE. In association with drospirenone, 20 μg EE results as effective as 30 μg in improving clinical and hormonal features of normal-weight PCOS women, while exhibiting a milder influence on lipidic parameters.

Polycystic Ovary Syndrome and Hepatic Steatosis: Could Low-Grade Chronic Inflammation Be Mediated by the Spleen?

Polycystic Ovary Syndrome (PCOS) is characterized by an extreme variety of phenotypes and controversial metabolic implications. Hepatic Steatosis (HS) and low-grade chronic inflammation (LGCI) might be common findings in PCOS. We conducted a cross-sectional study to evaluate the LGCI and HS in young women with PCOS according to their Body Mass index (BMI), Insulin Resistance (IR), and PCOS phenotypes. Sixty young premenopausal PCOS women and 20 age-matched controls participated. Primary outcome measures were the presence/severity of HS; LGCI index evaluated as spleen longitudinal diameter (SLD) by UltraSound, C-Reactive Protein (CRP) and Interleukin (IL)-6 levels; BMI and the Homeostasis Model Assessment (HoMA) of IR. The second outcome measures were testosterone, Sex Hormone-Binding Globulin (SHBG) levels, and Free Androgen Index (FAI). The presence of HS and LGCI was not significantly different between NW and O/O patients, while there were significant differences particularly when the PCOS-women were grouped according to IR or to PCOS phenotypes. At multiple regression adjusted for BMI, HoMA-IR and the spleen size were the major determinants of the severity of HS (β= 0.36, p=0.007, and β= 0.28, p=0.034, respectively). At multiple regression SLD represented the unique predictor of FAI (β=0.32; p=0.018). In young women with PCOS, HS was detected independently from obesity and was well predicted not only by IR but also by spleen size, with variable expression of the liver-spleen axis across the different PCOS subtypes. A possible role of the spleen in determining LGCI also in women with PCOS is emphasized.

Hyperinsulinemia Amplifies GnRH Agonist Stimulated Ovarian Steroid Secretion in Women with Polycystic Ovary Syndrome

In vitro data show that insulin may enhance basal and LH-stimulated ovarian androgen secretion, particularly in theca cells from women with polycystic ovary syndrome (PCOS). However, in vivo studies gave inconsistent results. The objective of the study was to assess whether hyperinsulinemia affects in vivo ovarian steroid secretion and steroid metabolism. This was a controlled cross-sectional study, conducted in a tertiary care academic center. Nine young PCOS women participated in the study. Participants were submitted, in two separate days, to a GnRH agonist stimulation (buserelin 100 μg, s.c.), during a 17-h hyperinsulinemic (80 mU/m(2) · min) euglycemic clamp and, as a control, during saline infusion. Adrenal steroid secretion was suppressed by dexamethasone. During both protocols, before and after GnRH agonist stimulation, serum insulin, gonadotropins, cortisol, progesterone, 17-hydroxyprogesterone, androstenedione, testosterone, estradiol, and urinary androgen metabolites were measured. Insulin increased from 25.1 ± 13.3 to 341.5 ± 102.6 mU/liter during the clamp, whereas it did not significantly change during saline infusion. Baseline steroids and gonadotropins were similar in the two protocols. During hyperinsulinemia, GnRH agonist-stimulated serum progesterone and androstenedione were significantly higher than during saline infusion, and 17-hydroxyprogesterone was of borderline significance. Moreover, 24 h after GnRH agonist stimulation, testosterone was higher after hyperinsulinemia. Serum gonadotropins and estradiol response did not differ between the protocols. Urinary androgen metabolites excretion significantly increased after GnRH agonist stimulation, but the increase was similar during insulin and saline infusions. These in vivo data show that sustained hyperinsulinemia potentiates gonadotropin-stimulated ovarian androgen steroidogenesis. Insulin-induced increase in ovarian hormone secretion is not accompanied by an increased steroid metabolism.

Metabolomics Reveals Reduction of Metabolic Oxidation in Women with Polycystic Ovary Syndrome after Pioglitazone-Flutamide-Metformin Polytherapy

Polycystic ovary syndrome (PCOS) is a variable disorder characterized by a broad spectrum of anomalies, including hyperandrogenemia, insulin resistance, dyslipidemia, body adiposity, low-grade inflammation and increased cardiovascular disease risks. Recently, a new polytherapy consisting of low-dose flutamide, metformin and pioglitazone in combination with an estro-progestagen resulted in the regulation of endocrine clinical markers in young and non-obese PCOS women. However, the metabolic processes involved in this phenotypic amelioration remain unidentified. In this work, we used NMR and MS-based untargeted metabolomics to study serum samples of young non-obese PCOS women prior to and at the end of a 30 months polytherapy receiving low-dose flutamide, metformin and pioglitazone in combination with an estro-progestagen. Our results reveal that the treatment decreased the levels of oxidized LDL particles in serum, as well as downstream metabolic oxidation products of LDL particles such as 9- and 13-HODE, azelaic acid and glutaric acid. In contrast, the radiuses of small dense LDL and large HDL particles were substantially increased after the treatment. Clinical and endocrine-metabolic markers were also monitored, showing that the level of HDL cholesterol was increased after the treatment, whereas the level of androgens and the carotid intima-media thickness were reduced. Significantly, the abundance of azelaic acid and the carotid intima-media thickness resulted in a high degree of correlation. Altogether, our results reveal that this new polytherapy markedly reverts the oxidant status of untreated PCOS women, and potentially improves the pro-atherosclerosis condition in these patients.

Abnormal serum alanine aminotransferase levels are associated with impaired insulin sensitivity in young women with polycystic ovary syndrome

Non-alcoholic fatty liver disease (NAFLD) and polycystic ovary syndrome (PCOS) are both associated with insulin resistance.We assessed whether NAFLD is associated with impaired insulin sensitivity in PCOS women independently of age and total adiposity. We enrolled 14 young PCOS women with NAFLD, 14 women with PCOS alone and 14 healthy controls, who were matched for age, body mass index, and total body fat (by bio-impedance analyzer). NAFLD was diagnosed by the surrogate measure of abnormal serum alanine aminotransferase (ALT) concentrations (defined as ALT>19 U/l) after excluding other secondary causes of liver disease (alcohol, virus, and medications). Insulin sensitivity was measured by euglycemic hyperinsulinemic clamp. Insulin sensitivity was markedly decreased (p<0.001) in PCOS women with abnormal ALT levels, whereas it was similar between PCOS women with normal ALT levels andmatched healthy controls (8.3+/-2.5 vs 12.1+/-1.7 vs 13.2+/-1.8 mg/min x kg of fat-free mass, respectively). PCOS women with abnormal ALT levels also had higher plasma triglycerides and lower HDLcholesterol concentrations than those with PCOS alone. There was a strong inverse association between serum ALT levels and insulin sensitivity in the whole group of PCOS women (r=-0.59, p=0.0013). Abnormal serum ALT levels, as surrogate measure of NAFLD, are closely associated with impaired insulin sensitivity in young PCOS women in a manner that is independent from the contribution of age and total adiposity. Early recognition of NAFLD by radiological imaging tests in this group of young patients is warranted.

Abnormal arterial blood pressure in overweight and obese young polycystic ovary syndrome women

Abnormal arterial blood pressure in overweight and obese young polycystic ovary syndrome women

Correlation between serum lipid profile and carotid intima-media thickness in Polycystic Ovarian Syndrome

Abnormal lipid profile is often found in women with Polycystic Ovary Syndrome. To assess the impact of abnormal lipid profile on atherosclerosis in young Polycystic Ovary Syndrome women, carotid intima-media thickness as judged by B-mode ultrasonography were done in 30 young (18-35 yrs) Polycystic Ovary Syndrome women and in similarly age-matched 30 apparently healthy controls. Compared to controls, young Polycystic Ovary Syndrome women had significantly elevated serum total cholesterol, triglyceride and LDL-C levels and carotid intima-media thickness. HDL-C level did not differ significantly between two groups of women. In Polycystic Ovary Syndrome women carotid intima-media thickness was positively correlated with serum total cholesterol, triglyceride and LDL-C and negatively correlated with serum HDL-C. Our study suggests that even young Polycystic Ovary Syndrome women are prone to atherosclerosis from early age.

Association of CYP3A7*1C and Serum Dehydroepiandrosterone Sulfate Levels in Women with Polycystic Ovary Syndrome

Adrenal androgen excess is common in polycystic ovary syndrome (PCOS) and appears to be heritable. CYP3A7 metabolizes dehydroepiandrosterone and its sulfate (DHEAS). A promoter variant, CYP3A7*1C, which results in persistent expression in adults, was associated with reduced DHEAS levels in a previous study, which led us to consider CYP3A7*1C as a modulator of adrenal androgen excess in patients with PCOS. The objective was to replicate the association between CYP3A7*1C and reduced DHEAS levels in PCOS patients and assess its possible role in modulating testosterone levels. Women with and without PCOS were genotyped for CYP3A7*1C, and this variant was tested for association with DHEAS and total and free testosterone. Subjects were recruited from the reproductive endocrinology clinic at the University of Alabama at Birmingham; controls were recruited from the surrounding community. Genotyping took place at Cedars-Sinai Medical Center (Los Angeles, CA). A total of 287 white women with PCOS and 187 controls were studied. CYP3A7*1C genotype, PCOS risk, and androgen levels were measured. PCOS subjects who carried the CYP3A7*1C variant had lower levels of serum DHEAS and total testosterone (P = 0.0006 and 0.046, respectively). The variant was not associated with PCOS risk. This study replicated prior work of the association of CYP3A7*1C and decreased DHEAS in a different population of young PCOS women, providing further genetic evidence that CYP3A7 plays a potential role in modulation of DHEAS levels. Adult expression of CYP3A7 may modify the PCOS phenotype by ameliorating adrenal androgen excess.

Metabolic and cardiopulmonary effects of detraining after a structured exercise training programme in young PCOS women

The aim of the present study was to determine if the favourable cardiopulmonary and metabolic benefits induced by exercise training (ET) programme are maintained after its cessation. Thirty-two young overweight polycystic ovary syndrome (PCOS) women matched for age and body mass index (BMI) with other 32 PCOS patients was enrolled. The first group [PCOS-T (trained)] underwent 24-week ET programme, whereas the second [PCOS-DT (detrained)] underwent 12-week ET programme followed by 12-week detraining period. At baseline, after 12- and 24-week follow-up, all PCOS women were studied for their hormonal (ovarian and adrenal androgens), metabolic (glucose and insulin) and lipid profile, and underwent cardiopulmonary exercise test. After the initial 12-week ET programme, both PCOS-T and PCOS-DT groups, without differences between groups, showed a similar significant (P < 0.05) improvement in BMI, fasting insulin, areas under curve insulin (AUC(INS)), glucose and insulin AUC (AUC(GLU/INS)), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C) and maximal oxygen consumption at cardiopulmonary exercise test (VO2max). At 24-week follow-up, PCOS-T group showed a significant (P < 0.05) improvement in BMI, fasting insulin, AUC(INS), AUC(GLU/INS), LDL-C, HDL-C and VO2max, in comparison to baseline and 12-week follow-up. At same follow-up visit, the all parameters resulted significantly (P < 0.05) worsened in PCOS-DT group in comparison to 12-week follow-up and PCOS-T group. In PCOS-DT group, no parameter assessed at 24-week follow-up was significantly different in comparison with baseline. In young PCOS women, 12-week detraining resulted in a complete loss of the favourable adaptations obtained after ET.