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Chen X, Hong L, Mo M, Xiao S, Yin T, Liu S. Contributing factors for pregnancy outcomes in women with PCOS after their first FET treatment: a retrospective cohort study. Gynecol Endocrinol 2024; 40:2314607. [PMID: 38349325 DOI: 10.1080/09513590.2024.2314607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/30/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE We aim to explore the contributing factors of clinical pregnancy outcomes in PCOS patients undergoing their first FET treatment. METHODS A retrospective analysis was conducted on 574 PCOS patients undergoing their first FET treatment at a private fertility center from January 2018 to December 2021. RESULTS During the first FET cycle of PCOS patients, progesterone levels (aOR 0.109, 95% CI 0.018-0.670) and endometrial thickness (EMT) (aOR 1.126, 95% CI 1.043-1.419) on the hCG trigger day were associated with the clinical pregnancy rate. Similarly, progesterone levels (aOR 0.055, 95% CI 0.007-0.420) and EMT (aOR 1.179, 95% CI 1.011-1.376) on the hCG trigger day were associated with the live birth rate. In addition, AFC (aOR 1.179, 95% CI 1.011-1.376) was found to be a risk factor for preterm delivery. CONCLUSIONS In women with PCOS undergoing their first FET, lower progesterone levels and higher EMT on hCG trigger day were associated with clinical pregnancy and live birth, and AFC was a risk factor for preterm delivery. During FET treatment, paying attention to the patient's endocrine indicators and follicle status may have a positive effect on predicting and improving the pregnancy outcome of PCOS patients.
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Affiliation(s)
- Xi Chen
- Reproductive Medical Centre, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ling Hong
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Meilan Mo
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Shan Xiao
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Tailang Yin
- Reproductive Medical Centre, Renmin Hospital of Wuhan University, Wuhan, China
| | - Su Liu
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
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Kaur M, Singh S, Kaur A. Structural changes in amide I and amide II regions of PCOS women analyzed by ATR-FTIR spectroscopy. Heliyon 2024; 10:e33494. [PMID: 39040335 PMCID: PMC11261041 DOI: 10.1016/j.heliyon.2024.e33494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 07/24/2024] Open
Abstract
The etiology of PCOS is complex and frequently mis or undiagnosed, which may enhance morbidity and reduce the quality of life. Attenuated total reflection- Fourier transform infrared (ATR-FTIR) spectroscopy examines the structural fingerprints of the biochemical compounds and can provide distinct FTIR spectra of the PCOS cases and controls. The present study recruited 61 PCOS cases and 38 control women. The student's t-test was used to compare BMI, WHR, and lipid profile. The FTIR spectral region was compared among both groups using the Mann-Whitney U test and multivariate analysis involved principal component analysis (PCA) and hierarchical cluster analysis (HCA). FTIR spectra of different phenotypes of PCOS were also analyzed using multivariate analysis. In univariate analysis, PCOS women had significantly higher WHR (p = 0.007), BMI (p = 0.04), triglycerides (p = 0.04), and VLDL (p = 0.02) than the controls. The spectral regions of amide I (1700-1600 cm-1) and amide II (1580-1480 cm-1), were significantly greater in the PCOS group than in the controls (p < 0.01 and p < 0.001, respectively). The PCA and HCA revealed a distinct molecular fingerprint for phenotype A (PCOM + OA + HA) and phenotype B (HA + OA). Our study postulated that the spectral regions of amide I and amide II can distinguish between PCOS cases and control women and it may be used for the diagnosis of cases.
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Affiliation(s)
- Mandeep Kaur
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, 143005, India
| | - Sukhjashanpreet Singh
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, 143005, India
| | - Anupam Kaur
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, 143005, India
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Suturina L, Lizneva D, Lazareva L, Danusevich I, Nadeliaeva I, Belenkaya L, Atalyan A, Belskikh A, Bairova T, Sholokhov L, Rashidova M, Krusko O, Darzhaev Z, Rinchindorzhieva M, Malanova A, Alekseeva L, Sharifulin E, Kuzmin M, Igumnov I, Babaeva N, Tyumentseva D, Grebenkina L, Kurashova N, Darenskaya M, Belyaeva E, Belkova N, Egorova I, Salimova M, Damdinova L, Sambyalova A, Radnaeva E, Dyachenko O, Antsupova K, Trofimova T, Khomyakova A, Ievleva K, Stanczyk FZ, Legro RS, Yildiz BO, Azziz R. Ethnicity and the Prevalence of Polycystic Ovary Syndrome: The Eastern Siberia PCOS Epidemiology and Phenotype Study. J Clin Endocrinol Metab 2024:dgae424. [PMID: 38888252 DOI: 10.1210/clinem/dgae424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 06/12/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024]
Abstract
CONTEXT Previous studies have shown that the prevalence of polycystic ovary syndrome (PCOS) may vary according to race/ethnicity, although few studies have assessed women of different ethnicities who live in similar geographic and socio-economic conditions. OBJECTIVE To determine the prevalence of PCOS in an unselected multiethnic population of premenopausal women. DESIGN A multicenter prospective cross-sectional study. SETTINGS The main regional employers of Irkutsk Region and the Buryat Republic, Russia. PARTICIPANTS During 2016-19, 1398 premenopausal women underwent a history and physical exam, pelvic ultrasound, and testing during a mandatory annual employment-related health assessment. MAIN OUTCOME MEASURES PCOS prevalence, overall and by ethnicity in a large medically unbiased population, including Caucasian (White), Mongolic or Asian (Buryat), and mixed ethnicity individuals, living in similar geographic and socio-economic conditions for centuries. RESULTS PCOS was diagnosed in 165/1134 (14.5%) women who had a complete evaluation for PCOS. Based on the probabilities for PCOS by clinical presentation observed in the cohort of women who had a complete evaluation we also estimated the weight-adjusted prevalence of PCOS in 264 women with an incomplete evaluation: 46.2 or 17.5%. Consequently, the total prevalence of PCOS in the population was 15.1%, higher among Caucasians and women of Mixed ethnicity compared to Asians (16.0% and 21.8% vs. 10.8%, pz <0.05). CONCLUSIONS We observed a 15.1% prevalence of PCOS in our medically unbiased population of premenopausal women. In this population of Siberian premenopausal women of Caucasian, Asian and Mixed ethnicity living in similar geographic and socio-economic conditions, the prevalence was higher in Caucasian or Mixed than Asian women. These data highlight the need to assess carefully ethnic-dependent differences in the frequency and clinical manifestation of PCOS.
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Affiliation(s)
- Larisa Suturina
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Daria Lizneva
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ludmila Lazareva
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Irina Danusevich
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Iana Nadeliaeva
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Lilia Belenkaya
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Alina Atalyan
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Alexey Belskikh
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Tatyana Bairova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Leonid Sholokhov
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Maria Rashidova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Olga Krusko
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Zorikto Darzhaev
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Marina Rinchindorzhieva
- Republican Perinatal Center of the Ministry of Health of Republic of Buryatia, Ulan-Ude, Republic of Buryatia, Russian Federation
| | - Ayuna Malanova
- Republican Perinatal Center of the Ministry of Health of Republic of Buryatia, Ulan-Ude, Republic of Buryatia, Russian Federation
| | - Lilia Alekseeva
- Banzarov Buryat State University, Institute of Medicine, Ulan-Ude, Republic of Buryatia, Russian Federation
| | - Eldar Sharifulin
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Mikhail Kuzmin
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Ilia Igumnov
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Natalia Babaeva
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Daria Tyumentseva
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Ludmila Grebenkina
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Nadezhda Kurashova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Marina Darenskaya
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Elena Belyaeva
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Natalia Belkova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Irina Egorova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Madinabonu Salimova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Ludmila Damdinova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Alexandra Sambyalova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Elena Radnaeva
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Olesya Dyachenko
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Karina Antsupova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Tatyana Trofimova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Anastasia Khomyakova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Kseniia Ievleva
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Frank Z Stanczyk
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Richard S Legro
- Penn State College of Medicine, Penn State University, Hershey, PA, USA
| | - Bulent O Yildiz
- Hacettepe University School of Medicine, Hacettepe, Ankara, Turkey
| | - Ricardo Azziz
- Heersink School of Medicine and School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
- School of Public Health, University at Albany, SUNY, Rensselaer, NY, USA
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Rashid R, Tripathi R, Singh A, Sarkar S, Kawale A, Bader GN, Gupta S, Gupta RK, Jha RK. Naringenin improves ovarian health by reducing the serum androgen and eliminating follicular cysts in letrozole-induced polycystic ovary syndrome in the Sprague Dawley rats. Phytother Res 2023; 37:4018-4041. [PMID: 37165686 DOI: 10.1002/ptr.7860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 04/03/2023] [Accepted: 04/17/2023] [Indexed: 05/12/2023]
Abstract
Polycystic ovary syndrome (PCOS) is most common in women of reproductive age, giving rise to androgen excess and anovulation, leading to infertility and non-reproductive complications. We explored the ameliorating effect of naringenin in PCOS using the Sprague Dawley (SD) rat model and human granulosa cells. Letrozole-induced PCOS rats were given either naringenin (50 mg/kg/day) alone or in combination with metformin (300 mg/kg/day), followed by the estrous cycle, hormonal analysis, and glucose sensitivity test. To evaluate the effect of naringenin on granulosa cell (hGC) steroidogenesis, we treated cells with naringenin (2.5 μM) alone or in combination with metformin (1 mM) in the presence of forskolin (10 μM). To determine the steroidogenesis of CYP-17A1, -19A1, and 3βHSD2, the protein expression levels were examined. Treatment with naringenin in the PCOS animal groups increased ovulation potential and decreased cystic follicles and levels of androgens. The expression levels of CYP-17A1, -19A1, and 3βHSD2, were seen restored in the ovary of PCOS SD rats' model and in the human ovarian cells in response to the naringenin. We found an increased expression level of phosphorylated-AKT in the ovary and hGCs by naringenin. Naringenin improves ovulation and suppress androgens and cystic follicles, involving AKT activation.
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Affiliation(s)
- Rumaisa Rashid
- Endocrinology Division, CSIR-Central Drug Research Institute, Lucknow, India
- Department of Pharmaceutical Sciences, University of Kashmir, Jammu and Kashmir, India
| | - Rupal Tripathi
- Endocrinology Division, CSIR-Central Drug Research Institute, Lucknow, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Akanksha Singh
- Endocrinology Division, CSIR-Central Drug Research Institute, Lucknow, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Sudarsan Sarkar
- Endocrinology Division, CSIR-Central Drug Research Institute, Lucknow, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Ajaykumar Kawale
- Endocrinology Division, CSIR-Central Drug Research Institute, Lucknow, India
| | - G N Bader
- Department of Pharmaceutical Sciences, University of Kashmir, Jammu and Kashmir, India
| | - Satish Gupta
- Endocrinology Division, CSIR-Central Drug Research Institute, Lucknow, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Rakesh Kumar Gupta
- Endocrinology Division, CSIR-Central Drug Research Institute, Lucknow, India
| | - Rajesh Kumar Jha
- Endocrinology Division, CSIR-Central Drug Research Institute, Lucknow, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
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Bahawi YO, Radwan EM, Khouj MA, Alotaibi RK, Bajuwaiber NA, Baghlaf LF, AlFaraj WF, Oraif AM. Pregnancy Rates in Women With Polycystic Ovary Syndrome (PCOS) Using Letrozole Versus Clomiphene Citrate: A Retrospective Record Review. Cureus 2023; 15:e42257. [PMID: 37605693 PMCID: PMC10440068 DOI: 10.7759/cureus.42257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2023] [Indexed: 08/23/2023] Open
Abstract
Background and objectives Polycystic ovary syndrome (PCOS) is a prominent cause of anovulation. Thus, this study aimed to compare the pregnancy rates of women with PCOS treated with letrozole (LE) or clomiphene citrate (CC) at King Abdulaziz University Hospital. Patients and methods A retrospective record review was conducted from April 2021 to August 2022 to review 1370 records of women with PCOS from January 2015 to December 2021. Sixty-one patients were included in this analysis. Chi-square tests and independent sample t-tests were used to analyze various associations. Statistical significance was set at P < 0.05. Results Letrozole was associated with a higher pregnancy rate (41.7%) than CC (32.0%). However, this relationship was not statistically significant (P = .619). Furthermore, patients treated with letrozole required fewer cycles to achieve pregnancy (two cycles compared to three cycles). The different age groups and body mass indexes did not affect the pregnancy rate in either group. Conclusion No significant difference was found between CC and LE in ovulation induction and outcome among PCOS patients. Studies with larger sample sizes and multiple centers should be conducted in Saudi Arabia to obtain more conclusive results, which will eventually lead to changes in guidelines for anovulation treatment in women with PCOS.
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Affiliation(s)
- Yara O Bahawi
- Department of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Ebtesam M Radwan
- Department of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Maryam A Khouj
- Department of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Rahaf K Alotaibi
- Department of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Nada A Bajuwaiber
- Department of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Lama F Baghlaf
- Department of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Wala F AlFaraj
- Department of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Ayman M Oraif
- Department of Obstetrics and Gynecology, King Abdulaziz University, Jeddah, SAU
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Kaundal A, Renjhen P, Kumari R. Awareness of Lifestyle Modifications in the Management of Polycystic Ovarian Syndrome: A Hospital-Based Descriptive Cross-Sectional Study. Cureus 2023; 15:e36889. [PMID: 37139281 PMCID: PMC10151105 DOI: 10.7759/cureus.36889] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2023] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE Polycystic ovarian syndrome (PCOS) is a prevalent endocrinological disorder in reproductive-age women. Due to varied presentations, it's often difficult to diagnose and manage women with PCOS. Management usually focuses on treating the symptoms and preventing long-term sequelae of the disease. This study was planned to assess the knowledge among reproductive-age women (15-44 years) regarding the risk factors, symptoms, complications, and management of PCOS. MATERIAL AND METHODS This is a hospital-based descriptive cross-sectional study. A pre-validated well-structured questionnaire which included basic demographic data, menstrual history, knowledge about PCOS symptoms, risk factors, complications, prevention, and treatment, was administered. Completed questionnaires were analyzed to calculate the knowledge score of the participants and its association with their education level and occupation was seen. RESULTS A total of 350 women participated but only 334 completed questionnaires were included for final evaluation. The mean age of the study population was 28.70±6.29 years. Around 9.3% of the participants were already diagnosed with PCOS. Most of the women (43.4%) had heard about PCOS. The source of information was doctors (26.6%), the internet (6.28%), teachers (5.6%), and friends (4.7%). Obesity (33.5%), unhealthy dietary habits (35%), and genetic predisposition (40.7%) were thought as risk factors for PCOS. Most of the participants were aware that subfertility (40.1%), abortions (34.4%), diabetes (28.7%), hypertension (31.7%), cardiovascular disease (33.5%), endometrial carcinoma (35.9%), and psychological disturbances (37.1%) are among the known PCOS related complications. Eating a healthy diet (37.1%) and weight reduction (41%) can help in the management of PCOS. Around 60.5% of women showed poor knowledge, 14.7% fair knowledge, and 24.9% good knowledge regarding PCOS. Education level and occupation status were found to be significantly related to the knowledge score (P≤0.001). CONCLUSION PCOS is a prevalent condition with varied presentations which significantly affects one's quality of life. Since there is no definitive treatment for PCOS the management generally aims at managing symptoms and reducing the risk of long-term complications. To reduce the burden of PCOS-related long-term complications behavioral changes in terms of regular exercise and healthy dietary habits need to be incorporated from childhood.
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Zhao H, Zhou D, Liu C, Zhang L. The Relationship Between Insulin Resistance and Obesity and Serum Anti-Mullerian Hormone Level in Chinese Women with Polycystic Ovary Syndrome: A Retrospective, Single-Center Cohort Study. Int J Womens Health 2023; 15:151-166. [PMID: 36778752 PMCID: PMC9911904 DOI: 10.2147/ijwh.s393594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 01/18/2023] [Indexed: 02/06/2023] Open
Abstract
Background Anti-Mullerian hormone (AMH) is vital in the pathophysiological process of polycystic ovary syndrome (PCOS). The exact relationship between obesity and insulin resistance (IR) with AMH levels remains unclear. Methods A retrospective, single-center cohort study of 220 women with PCOS who underwent physical, endocrine, and metabolic assessments were performed. Patients were grouped by age, body mass indices (BMI), Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and different phenotypes. Pearson correlation analysis assessed the correlation between AMH and HOMA-IR, BMI, and other PCOS indicators, and multiple linear regression analysis was performed to determine factors influencing AMH. Results In 220 patients with PCOS, serum AMH levels decreased with age and were significantly higher in the IR group than in the non-IR group (P < 0.01). AMH increased significantly in anovulatory patients with hyperandrogenemia and/or polycystic ovary, with no significant difference between obese and non-obese individuals. AMH levels correlated positively with luteinizing hormone (LH), LH/follicular stimulating hormone (FSH), testosterone, fasting insulin (FINS), and HOMA-IR levels; negatively with age and BMI levels (P < 0.05) and weakly with fasting plasma glucose in the classical PCOS phenotype (r=0.148, P < 0.05). Regression analysis showed that age, testosterone, FINS, LH, LH/FSH, and BMI influenced AMH levels (P < 0.05). Conclusion Chinese women with PCOS-IR showed associations with greater AMH levels. AMH levels correlated positively with HOMA-IR levels and negatively with BMI. AMH combined with BMI and HOMA-IR levels may help determine PCOS severity.
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Affiliation(s)
- Han Zhao
- Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, People’s Republic of China
| | - Dexin Zhou
- Department of Endocrinology, Dalian Third People´s Hospital, Dalian, Liaoning, People’s Republic of China
| | - Cong Liu
- Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, People’s Republic of China,Correspondence: Cong Liu; Le Zhang, Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, People’s Republic of China, Email ;
| | - Le Zhang
- Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, People’s Republic of China
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Hong Y, Zhou ZH, Dong Z, Yang DZ. Prevalence of polycystic ovary syndrome under NIH criteria among the tenth-grade Chinese schoolgirls in Guangzhou area: a cross-sectional epidemiological survey. BMC Womens Health 2023; 23:31. [PMID: 36681820 PMCID: PMC9863194 DOI: 10.1186/s12905-023-02173-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 01/12/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is currently considered to have a peri-adolescence onset and continuously influence the reproductive and metabolic health of the patients, while the diagnostic criteria among adolescent population haven't been universally unified till now. This survey seeks to preliminarily evaluate the prevalence of PCOS in the tenth grade schoolgirls in Guangzhou area under NIH criteria and analyze the clinical features of adolescents with PCOS. METHODS The cross-sectional epidemiological survey was carried out among the tenth grade schoolgirls in Guangzhou area by the method of cluster sampling. The contents of this survey included the questionnaire, physical exams and serum measurements. Until now, totally 1294 girls underwent this survey and 1095 serum samples were restored. 235 non-hirsute (mFG < 6), postmenarcheally 2-year girls were randomly selected as the control group, among which the cut-off value of biochemical hyperandrogenemia was set accordingly. The prevalence of PCOS among this population was preliminarily evaluated according to the NIH criteria. RESULTS Along with the increase of gynecological age, the menstruations of girls was becoming more regular and the incidence of oligomenorrhea or amenorrhea was declining. Even among those who were less than 2 years after menarche, those whose menstrual cycle were longer than 90 days accounted for lower than 5%. The 95th percentile of mFG score was 6 among the girls who were < 2 years after menarche, and 5 among the girls who were > 2 years after menarche. Among the 235 healthy girls, the 95th percentile values of Testosterone (T), Free androgen index (FAI) and Androstenedione (A2) were 2.28 nmol/mL, 4.37, and 5.20 nmol/mL respectively. Based on the NIH criteria, the prevalence of PCOS in this survey was 3.86%. The prevalence of adolescent PCOS tend to slightly increase with age and gynecological age, but the difference was not statistically significant. The prevalence of PCOS among obese girls was markedly higher than that in lean girls. CONCLUSION Based on the NIH criteria, the prevalence of PCOS among the tenth grade schoolgirls in Guangzhou area was 3.86%. The diagnosis of hyperandrogenism among adolescents should also be based on both clinical and biochemical parameters.
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Affiliation(s)
- Yu Hong
- Department of Obstetrics and Gynecology, Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China.
- Department of Obstetrics and Gynecology, Kiangwu Hospital, Kiangwu Road #33, Macau Special Administrative Region, People's Republic of China.
| | - Ze-Hong Zhou
- Department of Obstetrics and Gynecology, Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China
| | - Zhe Dong
- Department of Obstetrics and Gynecology, Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China
| | - Dong-Zi Yang
- Department of Obstetrics and Gynecology, Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China
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Muacevic A, Adler JR, Goswami J, Singal K, Rajendran V. Prevalence of Polycystic Ovarian Syndrome in India: A Systematic Review and Meta-Analysis. Cureus 2022; 14:e32351. [PMID: 36628015 PMCID: PMC9826643 DOI: 10.7759/cureus.32351] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2022] [Indexed: 12/13/2022] Open
Abstract
Stein-Leventhal syndrome, often known as polycystic ovarian syndrome (PCOS), is a syndrome that affects women's reproductive health. PCOS is one of the most common endocrine and metabolic disorders in women of reproductive age. The etiology of PCOS remains unknown mainly, and the estimation of PCOS burden in a specific geographical location will impact disease control strategies. Hence, this study estimated the pooled prevalence of PCOS in Indian women. Databases such as PubMed, CINHAL, Scopus, and Google Scholar were thoroughly searched. Only those published Indian studies that reported the prevalence of PCOS from 2010 to 2021 and had at least one of the following diagnostic PCOS criteria were included in the systematic review: the National Institutes of Health (NIH), Rotterdam's criteria, or/and Androgen Excess Society (AES). MetaXL version 5.3 software was used for data analysis. The risk of bias was assessed using modified Joanna Briggs Institute criteria for cross-sectional studies. Out of 17132 articles, 11 articles were selected for systematic review and meta-analysis. The pooled prevalence of PCOS was 11.33(7.69-15.59) using the random effect. The proportion of Hirsute using the Ferriman-Gallwey score was highly variable, ranging from 1.6% to 37.9% (n=6). The prevalence rate of PCOS is high among Indian women. The pooled prevalence of PCOS was close to 10% using Rotterdam's criteria and AES criteria, while it was 5.8% using NIH criteria. The study's overall finding emphasizes the need for more acceptable and uniform diagnostic criteria for screening PCOS. At the same time, policy-makers should consider giving more importance to PCOS in their effort to control non-communicable diseases.
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10
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Park B, Lee H, Park S, Lee ES, Lee JJ, Lee Y, Seo JH. Trend changes and factor analysis of endometrial hyperplasia in patients with polycystic ovarian syndrome based on the Korean National Health Insurance Database. BMC Womens Health 2022; 22:439. [DOI: 10.1186/s12905-022-02015-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 10/16/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract
Background
Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with an increased risk of other gynecological disorders, such as endometrial hyperplasia (EH). However, substantial factors in the comorbidity of EH and PCOS remain to be investigated. We analyzed trend changes in PCOS and factors related to the comorbidity of PCOS and EH using data from the Korea National Health Insurance (KNHI) claims database.
Methods
The data for this population-based study of people diagnosed with PCOS or EH in Korea from 2009 to 2016 were collected from the KNHI claims database between 2007 and 2017. We conducted a trend analysis of the prevalence and incidence of PCOS and EH. In addition, we performed a logistic regression analysis to identify risk factors associated with EH incidence in people with PCOS using the matched case-control methodology.
Results
The average annual growth rate of the incidence of PCOS was 14.1% from 2009 to 2016, whereas the EH rate increased by only 3.4% annually. Comorbidities, type 2 diabetes, obesity, hypertension, hyperlipidemia, and infertility, increased the risk of EH in PCOS patients. Additionally, the cumulative duration of oral contraceptive & progestin treatment for PCOS correlated highly with the comorbidity of EH and PCOS.
Conclusions
We confirmed the relationship between PCOS and EH using big data suitable for time series analyses of the diagnosis and treatment of diseases. Endometrial evaluation should be done with more caution if oral contraceptives & progestins have been used for a long time.
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11
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Li R, Mai T, Zheng S, Zhang Y. Effect of metformin and exenatide on pregnancy rate and pregnancy outcomes in overweight or obese infertility PCOS women: long-term follow-up of an RCT. Arch Gynecol Obstet 2022; 306:1711-1721. [PMID: 35829765 DOI: 10.1007/s00404-022-06700-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 07/03/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE The majority of Polycystic ovary syndrome (PCOS) are overweight or obese with increased infertility and high risk of pregnancy complications. We aim to compare efficacy of metformin and exenatide on spontaneous pregnancy rate, overall pregnancy rate after assisted reproductive technology treatment (ART) and pregnancy outcomes in overweight or obese infertility PCOS. METHODS In this long-term follow-up study, 160 overweight or obese infertility Chinese PCOS were randomized to exenatide or metformin treatment for 12 weeks. Afterward, all were treated with metformin alone until pregnancy confirmed and followed until delivery. If patients failed spontaneous pregnancy during the second 12 weeks, ART could be offered until end of 64 weeks. The primary outcome was spontaneous pregnancy rate. RESULTS At week 24, 29.2% of women in exenatide group conceived spontaneously while 14.7% in metformin group (p = 0.03). At week 64, total pregnancy rates were 79.2% in exenatide group and 76% in metformin group without significant difference (p = 0.65). Between two groups, there was no significant difference of pregnancy outcomes (p > 0.05). A stepwise logistic regression showed that spontaneous pregnancy was positively associated with body weight reduction and HOMA-IR improvement in either group. CONCLUSION In overweight or obese infertility Chinese PCOS, 12 weeks pregestational exenatide treatment resulted in more spontaneous pregnancy likely due to greater weight reduction and improvement of insulin resistance compared with metformin treatment without obvious benefit on overall pregnancy rate after ART or pregnancy outcomes of successful conceived women. TRIAL REGISTRATION This clinical trial was registered at Chinese Clinical Trials Registry (ChiCTR-IIR-16008084) on 13/3/2016.
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Affiliation(s)
- Renyuan Li
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China.,Key Laboratory for Major Obstetric Diseases of Guangdong Higher Education Institutes, Guangzhou, Guangdong, People's Republic of China
| | - Tingting Mai
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China.,Key Laboratory for Major Obstetric Diseases of Guangdong Higher Education Institutes, Guangzhou, Guangdong, People's Republic of China
| | - Siyuan Zheng
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China.,Key Laboratory for Major Obstetric Diseases of Guangdong Higher Education Institutes, Guangzhou, Guangdong, People's Republic of China
| | - Ying Zhang
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China. .,Key Laboratory for Major Obstetric Diseases of Guangdong Higher Education Institutes, Guangzhou, Guangdong, People's Republic of China.
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12
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Motlagh Asghari K, Nejadghaderi SA, Alizadeh M, Sanaie S, Sullman MJM, Kolahi AA, Avery J, Safiri S. Burden of polycystic ovary syndrome in the Middle East and North Africa region, 1990-2019. Sci Rep 2022; 12:7039. [PMID: 35488014 PMCID: PMC9052181 DOI: 10.1038/s41598-022-11006-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/11/2022] [Indexed: 01/15/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is one of the most important contributing factors to infertility. In this study, we report the burden of PCOS by age and sociodemographic index (SDI) for the 21 countries in the Middle East and North Africa (MENA) region. Publicly available data on the point prevalence, incidence and years lived with disability (YLDs), from 1990 to 2019, were retrieved from the Global Burden of Disease (GBD) 2019 study for the 21 countries in MENA. The results are presented with age-standardised numbers and rates per 100,000 population, along with their corresponding 95% uncertainty intervals (UIs). In 2019, the age-standardised point prevalence and incidence rate for PCOS in the MENA region were 2079.7 (95% UI: 1392.0 to 2812.3) and 77.2 (95% UI: 51.6 to 105.4) per 100,000, respectively, which represents a 37.9% (95% UI: 31.7 to 45.0) and a 33.7% (95% UI: 27.7 to 40.3) increase since 1990, respectively. Also in 2019, the age-standardised YLD rate of PCOS in this region was 18.7 (95% UI: 7.8 to 37.9) per 100,000 women, which has increased by 36.1% (95% UI: 29.4 to 43.4) since 1990. Kuwait [25.4 (10.7, 51.2)] had the highest age-standardised YLD rate, while Afghanistan [10.8 (10.1, 49.2)] had the lowest. Moreover, the largest increase in the YLD rate, from 1990 to 2019, was seen in Sudan [90.3% (64.1, 120.9)], whereas no country decreased during the measurement period. The total prevalent number and point prevalence of PCOS (per 100,000) were both highest in the 20-24 age group. The prevalence of PCOS was highest among women of reproductive age, but decreased rapidly after 45 years of age. Moreover, at the country level there was a positive association between SDI and the age-standardised YLD rates of PCOS. The growing prevalence and burden of PCOS in the MENA region highlights the need to implement cost-effective preventive programs, especially for women in their third decade of life, and in MENA countries with higher SDI levels.
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Affiliation(s)
- Kimia Motlagh Asghari
- Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Aria Nejadghaderi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mahasti Alizadeh
- Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sarvin Sanaie
- Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mark J M Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Jodie Avery
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Saeid Safiri
- Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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13
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Sharma M, Khapre M, Saxena V, Kaushal P. Polycystic ovary syndrome among Indian adolescent girls - A systematic review and metanalysis. Nepal J Epidemiol 2021; 11:1063-1075. [PMID: 34733568 PMCID: PMC8560138 DOI: 10.3126/nje.v11i3.38460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 09/23/2021] [Accepted: 09/26/2021] [Indexed: 11/18/2022] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is a common endocrine disorder in the progenitive age group and the leading cause of infertility. The worldwide prevalence of PCOS in women varies between 2.2% to 26%. Due to limited literature on burden of PCOS among adolescent girls, its significance is still unfathomed as a research is few and far between in the present time. We conducted Systematic review and metanalysis to estimate the pooled prevalence of PCOS among Indian adolescent girls (14-19 years). Methods With the help of a search strategy, two authors searched Scopus, Embase and Pubmed independently. We screened studies considering eligibility criteria and extracted data. Selected studies were assessed for quality and risk biases using the NIH tool. R software was used for analysis. Results Twelve studies were included in the meta-analysis. The total number of participants in the study was 4473. All studies scored average and above as per the NIH quality assessment tool. The prevalence of PCOS among adolescents based on the Rotterdam criteria was 17.74 per 100 (CI = 11.77-23.71) with I2 =97 %. Hospital-based studies had a comparatively higher prevalence of PCOS as compared to community-based. Conclusion Pooled prevalence of PCOS among Indian adolescents’ girls was high, approximately one in five.
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Affiliation(s)
- Megha Sharma
- MPH PG School of Public Health AIIMS Rishikesh, Uttarakhand, India
| | - Meenakshi Khapre
- Deptartment of Community and Family Medicine, AIIMS Rishikesh, Uttarakhand, India
| | - Vartika Saxena
- Deptartment of Community and Family Medicine, AIIMS Rishikesh, Uttarakhand, India
| | - Pawna Kaushal
- MPH PG School of Public Health AIIMS Rishikesh, Uttarakhand, India
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14
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Crespi B. Variation among human populations in endometriosis and PCOS A test of the inverse comorbidity model. EVOLUTION MEDICINE AND PUBLIC HEALTH 2021; 9:295-310. [PMID: 34659773 PMCID: PMC8514856 DOI: 10.1093/emph/eoab029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/14/2021] [Indexed: 12/19/2022]
Abstract
Evidence linking endometriosis to low prenatal testosterone, and evidence that risk of polycystic ovary syndrome (PCOS) is associated with high prenatal testosterone, have motivated the hypothesis that endometriosis and PCOS exhibit inverse comorbidity. The inverse comorbidity hypothesis predicts that populations exhibiting higher prevalence of one disorder should show lower prevalence of the other. To test this prediction, data were compiled from the literature on the prevalence of endometriosis and PCOS, levels of serum testosterone in women during pregnancy and digit ratios as indicators of prenatal testosterone, in relation to variation in inferred or observed population ancestries. Published studies indicate that rates of endometriosis are highest in women from Asian populations, intermediate in women from European populations and lowest in women from African populations (i.e. with inferred or observed African ancestry); by contrast, rates of PCOS show evidence of being lowest in Asian women, intermediate in Europeans and highest in individuals from African populations. Women from African populations also show higher serum testosterone during pregnancy (which may increase PCOS risk, and decrease endometriosis risk, in daughters), and higher prenatal testosterone (as indicated by digit ratios), than European women. These results are subject to caveats involving ascertainment biases, socioeconomic, cultural and historical effects on diagnoses, data quality, uncertainties regarding the genetic and environmental bases of population differences and population variation in the causes and symptoms of PCOS and endometriosis. Despite such reservations, the findings provide convergent, preliminary support for the inverse comorbidity model, and they should motivate further tests of its predictions. Lay Summary: Given that endometriosis risk and risk of polycystic ovary syndrome show evidence of having genetically, developmentally, and physiologically opposite causes, they should also show opposite patterns of prevalence within populations: where one is more common, the other should be more rare. This hypothesis is supported by data from studies of variation among populations in rates of endometriosis and PCOS and studies of variation among populations in levels of prenatal testosterone, which mediaterisks of both conditions.
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Affiliation(s)
- Bernard Crespi
- Department of Biological Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
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15
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Chin HB, Marsh EE, Hall JE, Baird DD. Prevalence of Hirsutism Among Reproductive-Aged African American Women. J Womens Health (Larchmt) 2021; 30:1580-1587. [PMID: 34520248 DOI: 10.1089/jwh.2021.0125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Hirsutism is the most common clinical symptom of hyperandrogenism, but racial and ethnic-specific thresholds have not been established. Our objective was to characterize hirsutism using self-report of hair growth in a large sample of African American women. Materials and Methods: The Study of Environment, Lifestyle, and Fibroids is a prospective community-based cohort study of African American women (23-34 at recruitment). A total of 1568 participants received the modified Ferriman-Gallwey (mFG) pictorial assessment and were asked if they were ever bothered by excess hair. We estimated the prevalence of hirsutism (mFG score ≥8) and associations of acne, polycystic ovary syndrome (PCOS), and menstrual cycle characteristics with hirsutism. We also explored hirsutism defined by the 95th percentile of scores in our cohort (mFG = 11) and a newly recommended criterion, mFG = 4. Results: We could determine hirsutism status in 1556 women. Thirty-seven percent reported being bothered by excess hair, and 10% met the mFG criterion for hirsutism. History of severe facial acne was positively associated with hirsutism (prevalence ratio: 1.90; 95% confidence interval [CI]: 1.30-2.76), as was physician-diagnosed PCOS (2.22, 95% CI: 1.30-3.81). Women with irregular menstrual cycles were also more likely to report hirsutism (1.78, 95% CI: 1.00-3.18). Results were similar using mFG ≥11 and attenuated using mFG ≥4. Conclusions: Hirsutism prevalence was 10% in this community sample of African American women and was associated with PCOS, severe acne, and irregular menstrual cycles suggesting this represented hirsutism caused by hyperandrogenism. Ethnically diverse, population-based studies assessing the association between mFG score and androgen levels are needed to better understand the hirsutism threshold as a clinical marker of hyperandrogenism.
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Affiliation(s)
- Helen B Chin
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA.,Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA
| | - Erica E Marsh
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Janet E Hall
- Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA
| | - Donna D Baird
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA
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16
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Alur-Gupta S, Lee I, Chemerinski A, Liu C, Lipson J, Allison K, Gallop R, Dokras A. Racial differences in anxiety, depression, and quality of life in women with polycystic ovary syndrome. F S Rep 2021; 2:230-237. [PMID: 34278359 PMCID: PMC8267396 DOI: 10.1016/j.xfre.2021.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/09/2021] [Accepted: 03/09/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To evaluate racial differences in the anxiety and depression prevalence and scores in women with polycystic ovary syndrome (PCOS). DESIGN Cross-sectional. SETTING Academic institution. PATIENTS Reproductive-aged women with PCOS (n = 272) and controls (n = 295). INTERVENTIONS Hospital anxiety and depression scale and modified PCOS quality-of-life survey (MPCOS-Q). MAIN OUTCOME MEASURES Differences in depression and anxiety scores and quality-of-life score measured using the hospital anxiety and depression scale and MPCOS-Q were determined between White and Black women with PCOS. Multivariable correlation regressions assessed the association of the Ferriman-Gallwey score, total testosterone, body mass index (BMI), and homeostatic model assessment of insulin resistance with anxiety, depression, and quality-of-life scores. RESULTS Multivariable regression controlling for age, BMI, and socioeconomic status showed that White women with PCOS had a significantly higher prevalence of anxiety than Black women with PCOS (75.9% vs. 61.3%) and significantly higher anxiety scores (mean ± SD, 10.3 ± 4.1 vs. 8.7 ± 4.6). The prevalence of depression (24.4% vs. 29%) and depression scores (4.8 ± 3.6 vs. 5.1 ± 4.0) was not significantly different. In multivariable correlation regressions, the interaction between BMI and race in its association with anxiety scores was significant. The association of race with Ferriman-Gallwey score, total testosterone, or homeostatic model assessment of insulin resistance was not significant. In multivariable models, although the total MPCOS-Q scores were similar, the infertility domain was significantly lower in Black women with PCOS (mean ± SD, 12.6 ± 7.8 vs. 17.5 ± 6.8) indicating a lower quality of life related to infertility. CONCLUSION Racial differences identified in the prevalence of anxiety and MPCOS-Q domains suggest the importance of routine screening and provide an opportunity for targeted interventions based on race.
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Affiliation(s)
- Snigdha Alur-Gupta
- Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Iris Lee
- Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anat Chemerinski
- Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Chang Liu
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jenna Lipson
- Pennsylvania Hospital, Philadelphia, Pennsylvania
| | - Kelly Allison
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Robert Gallop
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anuja Dokras
- Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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17
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Chung YK, Kim JJ, Hong MA, Hwang KR, Chae SJ, Yoon SH, Choi YM. Association Between Polycystic Ovary Syndrome and the Polymorphisms of Aryl Hydrocarbon Receptor Repressor, Glutathione-S-transferase T1, and Glutathione-S-transferase M1 Genes. Gynecol Endocrinol 2021; 37:558-561. [PMID: 33124502 DOI: 10.1080/09513590.2020.1832066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To investigate the association between the aryl hydrocarbon receptor repressor (AhRR) C/G polymorphisms and glutathione-S-transferase M1 (GSTM1) and GSTT1 null mutation and the risk of polycystic ovary syndrome (PCOS) in Korean women. METHODS This was a case-control study of 478 women with PCOS and 376 aged-matched healthy controls. Genotyping of the AhRR C/G polymorphism and GSTM1 and GSTT1 were performed using real-time PCR analysis and multiplex PCR, respectively. RESULTS The genotype distribution of the AhRR C/G polymorphisms and GSTM1/GSTT1 null mutations did not differ between women with PCOS and controls. Using the wild-type combined AhRR CC and GSTT1 present genotype as a reference, the odds that a woman had PCOS were 1.54 (95% CIs 1.04-2.29) times higher if she had a combined AhRR CG or GG and GSTT1 null genotype. The odds that a woman had PCOS was 1.48 (95% CIs 1.08-2.04) times higher if she had a combined GSTM1/GSTT1 null genotype compared with the wild-type combined GSTM1/GSTT1 present genotype. However, there were no significant associations between the risk of PCOS and any combined AhRR and GSTM1. CONCLUSIONS Our data suggest that a combined AhRR CG or GG and GSTT1 null genotype or a combined GSTT1/GSTM1 null genotype might be associated with an increased risk of PCOS.
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Affiliation(s)
- Youn Kyung Chung
- Department of Obstetrics and Gynecology, National Cancer Center, Goyang, Korea
| | - Jin Ju Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
- Department of Obstetrics and Gynecology, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
- The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Min A Hong
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Kyu Ri Hwang
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
- Department of Obstetrics and Gynecology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Soo Jin Chae
- Department of Obstetrics and Gynecology, IORA Fertility Clinic, Suwon, Korea
| | - Sang Ho Yoon
- Department of Obstetrics and Gynecology, IORA Fertility Clinic, Suwon, Korea
| | - Young Min Choi
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
- The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
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18
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Douglas CC, Jones R, Green R, Brown K, Yount G, Williams R. University Students with PCOS Demonstrate Limited Nutrition Knowledge. AMERICAN JOURNAL OF HEALTH EDUCATION 2021. [DOI: 10.1080/19325037.2021.1877218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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19
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Deswal R, Narwal V, Dang A, Pundir CS. The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. J Hum Reprod Sci 2020; 13:261-271. [PMID: 33627974 PMCID: PMC7879843 DOI: 10.4103/jhrs.jhrs_95_18] [Citation(s) in RCA: 185] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/27/2019] [Accepted: 06/18/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Polycystic ovary syndrome (PCOS), the major endocrinopathy among reproductive-aged women, is not yet perceived as an important health problem in the world. It affects 4%–20% of women of reproductive age worldwide. The prevalence, diagnosis, etiology, management, clinical practices, psychological issues, and prevention are some of the most confusing aspects associated with PCOS. Aim: The exact prevalence figures regarding PCOS are limited and unclear. The aim of this review is to summarize comprehensively the current knowledge on the prevalence of PCOS. Materials and Methods: Literature search was performed through PubMed, ScienceDirect, Cochrane Library, and Google Scholar (up to December 2019). All relevant articles published in English language were identified following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Our analysis yielded 27 surveys with a pooled mean prevalence of 21.27% using different diagnostic criteria. The proportion of women with PCOS also increased in the last decade. Conclusion: The current review summarizes and interprets the results of all published prevalence studies and highlights the burden of the syndrome, thereby supporting early identification and prevention of PCOS in order to reverse the persistent upward trend of prevalence.
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Affiliation(s)
- Ritu Deswal
- Center for Medical Biotechnology, MD University, Rohtak, Haryana, India
| | - Vinay Narwal
- Department of Biochemistry, MD University, Rohtak, Haryana, India
| | - Amita Dang
- Center for Medical Biotechnology, MD University, Rohtak, Haryana, India
| | - Chandra S Pundir
- Department of Biochemistry, MD University, Rohtak, Haryana, India
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20
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Noroozzadeh M, Raoufy MR, Bidhendi Yarandi R, Faraji Shahrivar F, Moghimi N, Ramezani Tehrani F. Cardiac function and tolerance to ischemia/reperfusion injury in a rat model of polycystic ovary syndrome during the postmenopausal period. Life Sci 2020; 262:118394. [PMID: 32910953 DOI: 10.1016/j.lfs.2020.118394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/28/2020] [Accepted: 09/02/2020] [Indexed: 12/21/2022]
Abstract
AIMS There is much controversy regarding whether cardiovascular events increase in women with polycystic ovary syndrome (PCOS) with aging. Considering the lack of possibility of certain investigations in humans, animal models of PCOS may be suitable resources to obtain the useful data needed. In this study; we aimed to investigate whether cardiac function and tolerance to ischemia/reperfusion (I/R) injury worsen in postmenopausal rats, who had PCOS at younger ages, compared to controls. MAIN METHODS The hearts of aged rats with a history of PCOS and their controls were isolated and perfused in a Langendorff apparatus. Values of hemodynamic parameters, including left ventricular systolic pressure (LVSP), left ventricular developed pressure (LVDP), rate pressure product (RPP) and peak rates of positive and negative changes in left ventricular pressure (±dp/dt) were recorded using a power lab system. Blood serum levels of total testosterone (TT) and estradiol (E2) were determined by ELISA kits. Generalized Estimating Equation Model and t-student unpaired test results were used to compare the findings documented between two groups. KEY FINDINGS No statistically significant differences were observed in hemodynamic parameters of the heart including, LVSP, LVDP, RPP and ±dp/dt, between the rats of two groups of study, at baseline or before ischemia and after I/R. Nor were any significant differences observed in the levels of two hormones between the two groups (p > 0.05). SIGNIFICANCE History of PCOS during reproductive ages should not be considered an important risk factor for reduction in cardiac contractile function or less tolerance to I/R injury during the postmenopausal period.
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Affiliation(s)
- Mahsa Noroozzadeh
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Raoufy
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Razieh Bidhendi Yarandi
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Faraji Shahrivar
- Department of Medical laboratory Sciences, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Naghmeh Moghimi
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Azziz R, Kintziger K, Li R, Laven J, Morin-Papunen L, Merkin SS, Teede H, Yildiz BO. Recommendations for epidemiologic and phenotypic research in polycystic ovary syndrome: an androgen excess and PCOS society resource. Hum Reprod 2020; 34:2254-2265. [PMID: 31751476 DOI: 10.1093/humrep/dez185] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 06/08/2019] [Indexed: 01/01/2023] Open
Abstract
STUDY QUESTION What are the best practices for undertaking epidemiologic and phenotypic studies in polycystic ovary syndrome (PCOS)? SUMMARY ANSWER Best practices for the undertaking of epidemiologic and phenotypic studies in PCOS are outlined. WHAT IS KNOWN ALREADY Currently methodologies used for studies of PCOS epidemiology and phenotypes vary widely, and the comparability of studies is low, reducing the ability to harmonize studies. STUDY DESIGN, SIZE, DURATION The Androgen Excess and PCOS (AE-PCOS) Society established a Task Force to draft a research resource for epidemiologic and phenotypic studies in PCOS, with the aim of providing guidelines on study design and execution, insights into the limitations and alternatives and protocols to be used, taking into consideration a global perspective. PARTICIPANTS/MATERIALS, SETTING, METHODS A targeted review of the literature was carried out as necessary. MAIN RESULTS AND THE ROLE OF CHANCE High level recommendations include the following: (i) Before initiating the study, a number of critical factors should be addressed including selecting the population and diagnostic criteria (which should ideally align with the recommendations of the International Guidelines), the type of observational study to be undertaken and the primary and secondary endpoint(s) of the study.(ii) To assess the 'natural' or true phenotype and epidemiology of PCOS, the least medically biased, broadest and most generalizable population, and the broadest definition of PCOS, should be used.(iii) Four PCOS phenotypes (Phenotypes A through D), based on the presence or absence of three general features (oligo-anovulation, hyperandrogenism and polycystic ovarian morphology), should be ascertained.(iv) In epidemiologic and phenotypic studies, the detection of PCOS rests on the accuracy and sensitivity of the methods used for assessing the individual features of the disorder, and how 'normal' is defined.(v) Although an assessment algorithm that minimizes the use of certain measures (e.g. androgen levels and/or ovarian ultrasonography) can be devised, when possible it is preferable to uniformly assess all subjects for all parameters of interest. (vi) The inclusion of subjects in epidemiologic studies who do not appear to have PCOS (i.e. 'non-PCOS') will provide the necessary cohort to establish population-specific normative ranges for the various features of PCOS. (vii) Epidemiologic studies of PCOS in unselected populations will yield relatively limited numbers of PCOS subjects available for genetic study; alternatively, large population-based epidemiologic studies of PCOS will potentially generate large numbers of unaffected individuals that may serve as genetic controls. (viii) Epidemiologic studies of PCOS will benefit from a clear governance structure and should begin by informing, educating and engaging both the formal and informal leaders of the populations targeted for study. (ix) In designing their study investigators should, in advance, establish statistical power and recognize, manage and account for inherent biases. (x) Subjects suspected of having PCOS but who do not/cannot complete their evaluation (i.e. have 'possible PCOS') can be included by imputation, assigning them a 'diagnostic weight' based on those subjects of similar clinical phenotype that have completed the study. (xi) In obtaining, storing and retrieving subject data, subjects should be assessed consecutively using a uniform data collection form; providing as complete and in depth data as possible. (xii) Maintenance of both paper and electronic medical records should focus on ensuring data quality, accuracy and institutional ethical compliance, and familiarity with country-dependent laws, including biobanking-specific laws, tissue laws and research laws. (xiii) In obtaining and biobanking study samples, these should be ideally collected at the time of the first assessment. (xiv) Access to stored data sets should ideally be granted to other bona fide researchers conducting research in the public interest. (xv) SOPs detailing the exact method of each of the activities for handling the data and the samples are necessary to ensure that all methods are performed uniformly. (xvi) Epidemiologic studies of PCOS must be resourced adequately. LIMITATIONS, REASONS FOR CAUTION As with all reports involving expert interpretation of experiential and published data, inherent individual biases are possible. This risk is minimized in the present study by including experts from varying fields of study, aligning with recent international evidence-based guidelines and obtaining consensus approval of the recommendations from the Task Force and the board of the AE-PCOS. WIDER IMPLICATIONS OF THE FINDINGS These guidelines should encourage investigators worldwide to undertake much needed epidemiologic studies of PCOS, increasing the validity, integrity and comparability of the data. STUDY FUNDING/COMPETING INTEREST(S) The study received no funding. R.A. serves as consultant for Medtronic, Spruce Biosciences and Ansh Labs; has received research funding from Ferring Pharmaceuticals; and is on the advisory board of Martin Imaging; R.L. has received research funding from MSD Pharmaceuticals; J.L. has received fees and/or grant support from the Dutch Heart Association, The Netherlands Organisation for Health Research and Development (ZonMw), Ferring Pharmaceuticals, Danone, Euroscreen/Ogeda and Titus Health Care; H.T. receives grant funding from the National Health and Medical Research Council; K.K., L.M.-P., S.S.M. and B.O.Y. have no potential conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Ricardo Azziz
- Dept. of Health Policy, Management & Behavior School of Public Health, University at Albany, SUNY, Albany, NY, USA.,Dept. of Obstetrics and Gynecology, Albany Medical College, Albany, NY, USA.,Dept. of Obstetrics and Gynecology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Kristina Kintziger
- Department of Public Health, College of Education, Health, and Human Sciences, The University of Tennessee, Knoxville, TN, USA
| | - Rong Li
- Department of Obstetrics and Gynecology, Reproductive Medical Center, Peking University Third Hospital, Beijing, China
| | - Joop Laven
- Division of Reproductive Endocrinology and Infertility, Department of OBGYN, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Laure Morin-Papunen
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Sharon Stein Merkin
- Division of Geriatrics, Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Bulent O Yildiz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hacettepe University School of Medicine, Hacettepe, Ankara, Turkey
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Yang Y, Ouyang N, Ye Y, Hu Q, Du T, Di N, Xu W, Azziz R, Yang D, Zhao X. The predictive value of total testosterone alone for clinical hyperandrogenism in polycystic ovary syndrome. Reprod Biomed Online 2020; 41:734-742. [PMID: 32912651 DOI: 10.1016/j.rbmo.2020.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 07/14/2020] [Accepted: 07/16/2020] [Indexed: 11/17/2022]
Abstract
RESEARCH QUESTION Is the sole measurement of total testosterone sufficient to assess the presence of hyperandrogenism in women with polycystic ovary syndrome (PCOS)? DESIGN Serum samples from 294 patients with PCOS who met the Rotterdam criteria were used for the analysis of total testosterone by liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) and chemiluminescent immunoassay (CLIA). The free androgen index (FAI) was calculated as total testosterone (TT)/sex hormone-binding globulin (SHBG) × 100%, and the presence/degree of hirsutism were assessed using the modified and simplified Ferriman-Gallwey (mFG and sFG, respectively) scoring systems. RESULTS The hirsute subjects presented higher LC-MS/MS-based total testosterone and FAI values than the non-hirsute subjects (all P < 0.001), including those defined based on mFG ≥5 or sFG ≥3. Total testosterone and FAI were both positively correlated with the mFG (rank correlation coefficient [RCC] 0.598 and 0.443, P < 0.001) or sFG (RCC 0.747 and 0.568, P < 0.001) score, and a receiver operating characteristic curve analysis indicated that both parameters could significantly predict the presence of hirsutism determined by the mFG (area under the curve [AUC] 0.797 and 0.725, P < 0.001) or sFG (AUC 0.894 and 0.817, P < 0.001) score. However, similar results were not obtained with the CLIA platform. CONCLUSIONS In this East Asian population, total testosterone was found to be a strong predictor of the presence and degree of hyperandrogenism (i.e. assessed by the presence and degree of hirsutism), but this finding was obtained only if the total testosterone level was measured by LC-MS/MS and not by CLIA. These findings might have important implications for global epidemiologic, phenotypic and clinical studies of PCOS.
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Affiliation(s)
- Yabo Yang
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou Guangdong 510120, China
| | - Nengyong Ouyang
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou Guangdong 510120, China
| | - Yang Ye
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou Guangdong 510120, China
| | - Qin Hu
- Kobilka Institute of Innovative Drug Discovery, Chinese University of Hong Kong (Shenzhen), Shenzhen 518172, China
| | - Tao Du
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou Guangdong 510120, China
| | - Na Di
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou Guangdong 510120, China
| | - Wenming Xu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu 610041, China
| | - Ricardo Azziz
- Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany, SUNY, Rensselaer NY 12144, USA
| | - Dongzi Yang
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou Guangdong 510120, China.
| | - Xiaomiao Zhao
- Department of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou Guangdong 510120, China.
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Inthu DM, Paul DSFD, Palanippan DN, Dr. Kumarasamy. Mitochondrial DNA Mutations and ND1 Gene Copy Number in Patients with Polycystic Ovary Syndrome (PCOS). CYTOL GENET+ 2020. [DOI: 10.3103/s0095452720030056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cross-sectional Study on the Knowledge and Prevalence of PCOS at a Multiethnic University. PROGRESS IN PREVENTIVE MEDICINE 2020. [DOI: 10.1097/pp9.0000000000000028] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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Willis SK, Mathew HM, Wise LA, Hatch EE, Wesselink AK, Rothman KJ, Mahalingaiah S. Menstrual patterns and self-reported hirsutism as assessed via the modified Ferriman-Gallwey scale: A cross-sectional study. Eur J Obstet Gynecol Reprod Biol 2020; 248:137-143. [PMID: 32203825 DOI: 10.1016/j.ejogrb.2020.03.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/26/2020] [Accepted: 03/05/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Hirsutism, the presence of excess terminal hair in a male pattern, is a clinical marker of androgen excess in women. We used cross-sectional data from a North American preconception cohort study to evaluate the association between menstrual cycle characteristics and hirsutism. STUDY DESIGN Women aged 21-45 years were recruited to a North American cohort of pregnancy planners. On the baseline questionnaire, participants self-reported menstrual characteristics, which included menstrual regularity, cycle length, bleed length, and bleed heaviness. Participants provided a self-rating of hirsutism in nine distinct body areas using pictograms representing the modified Ferriman-Gallwey (mFG) score. Using their ratings, we calculated total mFG scores and defined hirsutism as mFG scores ≥8. We used log-binomial regression models to estimate prevalence ratios (PRs) for the association between menstrual characteristics and hirsutism assessed at baseline. RESULTS We included 5,542 women in the analytic cohort. Mean mFG score was 4.7, with 21.7 % reporting mFG scores ≥8. Compared with women with regular menstrual cycles, irregular cycles were positively associated with mFG ≥8 (PR 1.73, 95 % CI 1.56-1.91). Bleed lengths of ≥7 days compared with <3 days also showed a positive association with mFG score ≥8 (PR 1.59, 95 % CI 1.16-2.19), as did heavy bleeds (PR 1.42, 95 % CI 1.21-1.67) compared with moderate bleeds. Findings remained consistent when restricted to women without a prior diagnosis of polycystic ovary syndrome. CONCLUSIONS In a population-based cohort of North American women, menstrual irregularity, increased cycle and bleeds lengths, and heavier menstrual bleeds were associated with self-reported hirsutism.
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Affiliation(s)
- Sydney K Willis
- Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA.
| | - Hannah M Mathew
- Department of Endocrinology, Diabetes, Weight Management and Nutrition, Boston Medical Center, 720 Harrison Avenue, Boston, MA 02118, USA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Elizabeth E Hatch
- Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Amelia K Wesselink
- Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Kenneth J Rothman
- Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA; RTI Health Solutions Research Triangle Park, NC, USA
| | - Shruthi Mahalingaiah
- Department of Obstetrics and Gynecology, Boston University School of Medicine, 85 East Concord Street, Boston MA 02118, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, 200 Longwood Avenue, Boston, MA 02115, USA
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Belenkaia LV, Lazareva LM, Walker W, Lizneva DV, Suturina LV. Criteria, phenotypes and prevalence of polycystic ovary syndrome. ACTA ACUST UNITED AC 2020; 71:211-223. [PMID: 31089072 DOI: 10.23736/s0026-4784.19.04404-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Polycystic ovarian syndrome (PCOS) is known as one of the most frequent endocrine diseases in women worldwide. However, this term does not completely capture the diversity of clinical signs associated with this syndrome e.g., menstrual irregularity and clinical features of androgen excess, which are though commonplace in women with PCOS, they are not included under the definition of PCOS, limited to polycystic ovarian morphology (PCOM). Utilizing the most globally accepted criterion used today in the diagnosis of PCOS, the authors of this article review and discuss the historical and current context of evidence as well as their limitations. This review addresses the phenotypic approach and age-dependent aspects of PCOS in adolescents, adult and peri/postmenopausal women, as presented in the NIH (1990, 2012), Rotterdam (2003), AE-PCOS Society (2006) consensuses and in the latest evidence-based international guideline (2018). Global data on the epidemiology of PCOS, including prevalence and distribution of polycystic ovarian syndrome phenotypes, is also analyzed in the article. Lastly, the authors discuss the importance and current need to perform more epidemiological studies focused on PCOS.
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Affiliation(s)
- Liliia V Belenkaia
- Department of Reproductive Health Protection, Scientific Center for Family Health and Human Reproduction, Irkutsk, Russia
| | - Lyudmila M Lazareva
- Department of Reproductive Health Protection, Scientific Center for Family Health and Human Reproduction, Irkutsk, Russia
| | - Walidah Walker
- Research Administration Office, Augusta University, Augusta, GA, USA
| | - Daria V Lizneva
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Larisa V Suturina
- Department of Reproductive Health Protection, Scientific Center for Family Health and Human Reproduction, Irkutsk, Russia -
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Oxidative stress markers and lipid profiles of patients with polycystic ovary syndrome in a Nigerian tertiary hospital. Obstet Gynecol Sci 2019; 62:335-343. [PMID: 31538077 PMCID: PMC6737061 DOI: 10.5468/ogs.2019.62.5.335] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/26/2019] [Accepted: 03/18/2019] [Indexed: 11/25/2022] Open
Abstract
Objective To determine the activities of oxidative stress markers and lipid profiles of patients with polycystic ovary syndrome (PCOS) in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria. Methods This was a nested case-control study consisting of 50 PCOS patients and 50 healthy women of the same age range without any evidence of PCOS. The study measured the levels of malondialdehyde (MDA), activity of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), total antioxidant capacity (TAC); concentrations of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C), as well as high-density lipoprotein cholesterol (HDL-C) using standard spectrophotometric methods. Anthropometric indices were also assessed. P-values of <0.05 were taken to be statistically significant. Results There were significantly higher levels of MDA (P=0.002), lower activity of SOD (P<0.001), and lower TAC (P=0.001) in PCOS patients when compared with the controls. There were higher concentrations of TC (P=0.017) and LDL-C P=0.012) in PCOS patients than in controls. Significant differences were not observed between the 2 groups in terms of the activity of GSH-Px, as well as the concentrations of HDL-C and TG. The body mass index, waist circumference, and waist-hip ratio were all significantly higher in PCOS patients. Conclusion This study revealed higher levels of MDA, as well as lower activity of SOD and TAC, among PCOS patients. Furthermore, there were higher levels of TC and LDL-C among the PCOS patients. Hence, monitoring these parameters may improve the clinical management of PCOS.
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Deswal R, Nanda S, Ghalaut VS, Roy PS, Dang AS. Cross‐sectional study of the prevalence of polycystic ovary syndrome in rural and urban populations. Int J Gynaecol Obstet 2019; 146:370-379. [DOI: 10.1002/ijgo.12893] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 04/12/2019] [Accepted: 06/18/2019] [Indexed: 01/09/2023]
Affiliation(s)
- Ritu Deswal
- Centre for Medical BiotechnologyMaharshi Dayanand University Rohtak India
| | - Smiti Nanda
- Department of Obstetrics and GynecologyPost Graduate Institute of Medical Sciences Rohtak India
| | - Veena S. Ghalaut
- Department of BiochemistryPost Graduate Institute of Medical Sciences Rohtak India
| | - Prasanta S. Roy
- Department of BiochemistryPost Graduate Institute of Medical Sciences Rohtak India
| | - Amita S. Dang
- Centre for Medical BiotechnologyMaharshi Dayanand University Rohtak India
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Sun Z, Chang HM, Wang A, Song J, Zhang X, Guo J, Leung PCK, Lian F. Identification of potential metabolic biomarkers of polycystic ovary syndrome in follicular fluid by SWATH mass spectrometry. Reprod Biol Endocrinol 2019; 17:45. [PMID: 31186025 PMCID: PMC6560878 DOI: 10.1186/s12958-019-0490-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 06/04/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a complex disorder associated with multiple metabolic disturbance, including defective glucose metabolism and insulin resistance. The altered metabolites caused by the related metabolic disturbance may affect ovarian follicles, which can be reflected in follicular fluid composition. The aim of this study is to investigate follicular fluid metabolic profiles in women with PCOS using an advanced sequential window acquisition of all theoretical fragment-ion spectra (SWATH) mass spectrometry. MATERIALS AND METHODS Nineteen women with PCOS and twenty-one healthy controls undergoing IVF/ET were recruited, and their follicular fluid samples were collected for metabolomic study. Follicular fluid metabolic profiles, including steroid hormones, free fatty acids, bioactive lipids, and amino acids were analyzed using the principal component analysis (PCA) and partial least squares to latent structure-discriminant analysis (PLS-DA) model. RESULTS Levels of free fatty acids, 3-hydroxynonanoyl carnitine and eicosapentaenoic acid were significantly increased (P < 0.05), whereas those of bioactive lipids, lysophosphatidylcholines (LysoPC) (16:0), phytosphingosine, LysoPC (14:0) and LysoPC (18:0) were significantly decreased in women with PCOS (P < 0.05). Additionally, levels of steroid hormone deoxycorticosterone and two amino acids, phenylalanine and leucine were higher in the PCOS patients (P < 0.05). CONCLUSION Women with PCOS display unique metabolic profiles in their follicular fluid, and this data may provide us with important biochemical information and metabolic signatures that enable a better understanding of the pathogenesis of PCOS.
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Affiliation(s)
- Zhengao Sun
- grid.479672.9Integrative Medicine Research Centre of Reproduction and Heredity, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No 42 Wen Hua Xi Road, Jinan, 250011 China
- 0000 0001 2288 9830grid.17091.3eDepartment of Obstetrics and Gynaecology, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, British Columbia V6H 3V5 Canada
| | - Hsun-Ming Chang
- grid.479672.9Integrative Medicine Research Centre of Reproduction and Heredity, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No 42 Wen Hua Xi Road, Jinan, 250011 China
- 0000 0001 2288 9830grid.17091.3eDepartment of Obstetrics and Gynaecology, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, British Columbia V6H 3V5 Canada
| | - Aijuan Wang
- grid.479672.9Integrative Medicine Research Centre of Reproduction and Heredity, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No 42 Wen Hua Xi Road, Jinan, 250011 China
| | - Jingyan Song
- grid.479672.9Integrative Medicine Research Centre of Reproduction and Heredity, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No 42 Wen Hua Xi Road, Jinan, 250011 China
| | - Xingxing Zhang
- grid.479672.9Integrative Medicine Research Centre of Reproduction and Heredity, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No 42 Wen Hua Xi Road, Jinan, 250011 China
| | - Jiayin Guo
- 0000 0000 8877 7471grid.284723.8Guandong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, 510515 China
| | - Peter C. K. Leung
- grid.479672.9Integrative Medicine Research Centre of Reproduction and Heredity, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No 42 Wen Hua Xi Road, Jinan, 250011 China
- 0000 0001 2288 9830grid.17091.3eDepartment of Obstetrics and Gynaecology, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, British Columbia V6H 3V5 Canada
- 0000 0001 2288 9830grid.17091.3eDepartment of Obstetrics and Gynaecology, BC Children’s Hospital Research Institute, University of British Columbia, Room 317, 950 West 28th Avenue, Vancouver, British Columbia V5Z 4H4 Canada
| | - Fang Lian
- grid.479672.9Integrative Medicine Research Centre of Reproduction and Heredity, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No 42 Wen Hua Xi Road, Jinan, 250011 China
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Geographical Prevalence of Polycystic Ovary Syndrome as Determined by Region and Race/Ethnicity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112589. [PMID: 30463276 PMCID: PMC6266413 DOI: 10.3390/ijerph15112589] [Citation(s) in RCA: 183] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/12/2018] [Accepted: 11/14/2018] [Indexed: 01/16/2023]
Abstract
Polycystic ovarian syndrome (PCOS) is thought to be the most common endocrine disorder found in women. Common symptoms include irregular menstrual cycle, polycystic ovaries, and hirsutism, as well as an increased risk for a multitude of conditions, including insulin resistance, dyslipidemia and infertility. The prevalence of polycystic ovarian syndrome is generally thought to be between 3% and 10% but it is widely unknown for specific subpopulations based on geographical location and race/ethnicity. Based on the high degree of variability and inconsistencies between the different diagnostic criteria, there is a unique challenge that exists when determining the prevalence of this syndrome. There are a large percentage of individuals that remain undiagnosed even after visiting multiple health care providers. Most studies conducted across the world are limited by small sample size, selection bias, and lack of comparability across studies. There have been very few studies that have examined the prevalence of polycystic ovary syndrome across the United States. Based on the National Institutes of Health (NIH)’s diagnostic criteria, there is a similar prevalence of PCOS documented across the United States, the United Kingdom, Spain, Greece, Australia, and Mexico. Other studies have shown some differences between geographical location and race. The existing data is not conclusive enough to determine whether or not there is any significant differences in the prevalence of PCOS across geographical location, racial or ethnic groups. This review will seek to determine the prevalence of polycystic ovarian syndrome based on geographical location and race/ethnicity.
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Goldrat O, Delbaere A. PCOS: update and diagnostic approach. Clin Biochem 2018; 62:24-31. [PMID: 30195483 DOI: 10.1016/j.clinbiochem.2018.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/26/2018] [Accepted: 09/04/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Oranite Goldrat
- Fertility Clinic, Department of Obstetrics and Gynecology, CUB-Hôpital Erasme, Université Libre de Bruxelles (ULB), Route de Lennik, 808, Brussels, Belgium.
| | - Anne Delbaere
- Fertility Clinic, Department of Obstetrics and Gynecology, CUB-Hôpital Erasme, Université Libre de Bruxelles (ULB), Route de Lennik, 808, Brussels, Belgium.
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Artani M, Iftikhar MF, Khan S. Effects of Metformin on Symptoms of Polycystic Ovarian Syndrome Among Women of Reproductive Age. Cureus 2018; 10:e3203. [PMID: 30410828 PMCID: PMC6207166 DOI: 10.7759/cureus.3203] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 08/24/2018] [Indexed: 12/22/2022] Open
Abstract
Background Metformin is a highly preferred drug that is used to treat the symptoms of polycystic ovarian syndrome among women. Pakistan is facing a continuous rise in the prevalence of polycystic ovarian syndrome. Therefore, the determination of the effectiveness of the drug in this condition is considered ideal as per the presenting situation. Objective The aim of the study was to determine the effects of metformin in patients with polycystic ovarian syndrome. Methods This cross-sectional study has investigated the influence of metformin on the ability to conceive, body weight, mood swings, energy levels, menstrual irregularities, and acne and hirsutism. As per the inclusion criteria, 100 women were evaluated from the outpatient clinics of Jinnah Postgraduate Medical Centre and Civil Centre, Karachi, from November 2016 to January 2017. A structured, pre-tested questionnaire was used for data collection. Results The study group had a mean age of 27.2 ± 4.75 years. Outcomes reported by study participants suggested a significant influence of metformin on menstrual irregularities (p 0.046), acne and hirsutism (p<0.001), mood swings (p<0.001), and daily energy levels (p<0.001). Findings further proposed that metformin does not produce a significant impact on the ability to conceive (p 0.096) and in the change in body weight (p 0.073) of the patients. Conclusion Metformin has been realized to have a significant role in dealing with the symptoms of polycystic ovarian syndrome. It is recommended to conduct more in-depth and longitudinal research on the long-term effects of the drug and compliance among these women.
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Affiliation(s)
- Moiz Artani
- Department of Community Health Sciences, Jinnah Medical and Dental College, Karachi, PAK
| | | | - Shehroz Khan
- Department of Community Health Sciences, Jinnah Medical and Dental College, Karachi, PAK
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Skiba MA, Islam RM, Bell RJ, Davis SR. Understanding variation in prevalence estimates of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update 2018; 24:694-709. [DOI: 10.1093/humupd/dmy022] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/24/2018] [Indexed: 12/19/2022] Open
Affiliation(s)
- Marina A Skiba
- Women’s Health Research Program, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, Australia
| | - Rakibul M Islam
- Women’s Health Research Program, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, Australia
| | - Robin J Bell
- Women’s Health Research Program, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, Australia
| | - Susan R Davis
- Women’s Health Research Program, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, Australia
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Kaewnin J, Vallibhakara O, Arj-Ong Vallibhakara S, Wattanakrai P, Butsripoom B, Somsook E, Hongsanguansri S, Sophonsritsuk A. Prevalence of polycystic ovary syndrome in Thai University adolescents. Gynecol Endocrinol 2018; 34:476-480. [PMID: 29202617 DOI: 10.1080/09513590.2017.1409716] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Polycystic ovarian syndrome (PCOS) is a common and complex condition characterized by endocrine features and influenced by genetic and environmental factors. In Southeast Asia and Thailand, the prevalence of PCOS is unknown. The aim of this study was to estimate the prevalence of and determine factors associated with PCOS in Thai adolescents. We administered a validated questionnaire to 600 university female participants aged 17-19 years from Mahidol University in Bangkok. Of these, 548 (91.33%) responded and agreed to participate. Two-hundred and seventy-nine girls (50.91%) were identified as likely having PCOS and defined as 'probable cases'. Of those 279 participants, 248 (88.88%) were evaluated further for PCOS using the Rotterdam criteria. A complete history was taken, and a physical examination including trans-abdominal ultrasound was performed. Blood chemistry tests were performed to exclude similar conditions and to investigate potential co-morbidities. The prevalence of PCOS in Thai adolescents was found to be 5.29%. After multivariate analyses, moderate acne was the strongest risk factor for PCOS. The odd ratios (95% confidence interval) for the presence of mild acne, moderate acne, and oligo- or amenorrhea in participants with PCOS were 2.83 (1.01-7.90; p = .47), 31.69 (10.07-99.67; p < .001), and 5.89 (2.42-14.37; p < .001), respectively.
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Affiliation(s)
- Jetsadaporn Kaewnin
- a Department of Obstetrics & Gynecology, Faculty of Medicine , Ramathibodi Hospital, Mahidol University , Bangkok , Thailand
| | - Orawin Vallibhakara
- b Department of Obstetrics & Gynecology, Reproductive Endocrinology and Infertility Unit, Faculty of Medicine , Ramathibodi Hospital, Mahidol University , Bangkok , Thailand
| | - Sakda Arj-Ong Vallibhakara
- c Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine , Ramathibodi Hospital, Mahidol University , Bangkok , Thailand
| | - Penpun Wattanakrai
- d Department of Medicine, Faculty of Medicine, Division of Dermatology , Ramathibodi Hospital, Mahidol University , Bangkok , Thailand
| | | | - Ekasith Somsook
- f Department of Chemistry, Faculty of Science , Mahidol University , Bangkok , Thailand
| | - Sirichai Hongsanguansri
- g Department of Psychiatry, Faculty of Medicine , Ramathibodi Hospital, Mahidol University , Bangkok , Thailand
| | - Areepan Sophonsritsuk
- b Department of Obstetrics & Gynecology, Reproductive Endocrinology and Infertility Unit, Faculty of Medicine , Ramathibodi Hospital, Mahidol University , Bangkok , Thailand
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Ratnakumari ME, Manavalan N, Sathyanath D, Ayda YR, Reka K. Study to Evaluate the Changes in Polycystic Ovarian Morphology after Naturopathic and Yogic Interventions. Int J Yoga 2018; 11:139-147. [PMID: 29755223 PMCID: PMC5934949 DOI: 10.4103/ijoy.ijoy_62_16] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background Polycystic ovarian syndrome (PCOS) is one of the commonest endocrine disorders in women, with a prevalence ranging from 2.2% to 26% in India. Patients with PCOS face challenges including irregular menstrual cycles, hirsutism, acne, acanthosis nigricans, obesity and infertility. 9.13% of South Indian adolescent girls are estimated to suffer from PCOS. The efficacy of Yoga & Naturopathy (Y&N) in the management of polycystic ovarian syndrome requires to be investigated. Aims: The aim of the present study is to observe the morphological changes in polycystic ovaries of patients following 12 weeks of Y&N intervention. Settings and Design The study was conducted at the Government Yoga and Naturopathy Medical College and Hospital, Chennai, India. The study was a single blinded prospective, pre-post clinical trial. Methods and Material Fifty PCOS patients of age between 18 and 35 years who satisfied the Rotterdam criteria were recruited for the study. According to their immediate participation in the study they were either allocated to the intervention group (n=25) or in the wait listed control group (n=25). The intervention group underwent Y&N therapy for 12 weeks. Change in polycystic ovarian morphology, anthropometric measurements and frequency of menstrual cycle were studied before and after the intervention. Results: Significant improvement was observed in the ovarian morphology (P<0.001) and the anthropometric measurements (P<0.001) between the two groups. Conclusions The findings of the study indicate that Y&N interventions are efficient in bringing about beneficial changes in polycystic ovarian morphology. We speculate that a longer intervention might be required to regulate the frequency of menstrual cycle.
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Affiliation(s)
- M Ezhil Ratnakumari
- Department of Naturopathy, Government Yoga and Naturopathy Medical College, Arumbakkam, Chennai, India
| | - N Manavalan
- Department of Naturopathy, Government Yoga and Naturopathy Medical College, Arumbakkam, Chennai, India
| | - D Sathyanath
- Department of Naturopathy, Government Yoga and Naturopathy Medical College, Arumbakkam, Chennai, India
| | - Y Rosy Ayda
- Department of Naturopathy, Government Yoga and Naturopathy Medical College, Arumbakkam, Chennai, India
| | - K Reka
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
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Jové M, Pradas I, Naudí A, Rovira-Llopis S, Bañuls C, Rocha M, Portero-Otin M, Hernández-Mijares A, Victor VM, Pamplona R. Lipidomics reveals altered biosynthetic pathways of glycerophospholipids and cell signaling as biomarkers of the polycystic ovary syndrome. Oncotarget 2017; 9:4522-4536. [PMID: 29435121 PMCID: PMC5796992 DOI: 10.18632/oncotarget.23393] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 12/04/2017] [Indexed: 01/12/2023] Open
Abstract
Purpose In this work, a non-targeted approach was used to unravel changes in the plasma lipidome of PCOS patients. The aim is to offer new insights in PCOS patients strictly selected in order to avoid confounding factors such as dyslipemia, obesity, altered glucose/insulin metabolism, cardiovascular disease, or cancer. Results Multivariate statistics revealed a specific lipidomic signature for PCOS patients without associated pathologies. This signature implies changes, mainly by down-regulation, in glycerolipid, glycerophospholipid and sphingolipid metabolism suggesting an altered biosynthetic pathway of glycerophospholipids and cell signaling as second messengers in women with PCOS. Conclusions Our study confirms that a lipidomic approach discriminates a specific phenotype from PCOS women without associated pathologies from healthy controls. Methods In a cross-sectional pilot study, data were obtained from 34 subjects, allocated to one of two groups: a) lean, healthy controls (n = 20), b) PCOS patients (n = 14) with diagnosis based on hyperandrogenaemia, oligo-anovulation and abnormal ovaries with small follicular cysts. A detailed biochemical characterization was made and lipidomic profiling was performed via an untargeted approach using LC-ESI-QTOF MS/MS.
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Affiliation(s)
- Mariona Jové
- Department of Experimental Medicine, Lleida University-Institute for Research in Biomedicine of Lleida (UdL-IRBLleida), 25198 Lleida, Spain
| | - Irene Pradas
- Department of Experimental Medicine, Lleida University-Institute for Research in Biomedicine of Lleida (UdL-IRBLleida), 25198 Lleida, Spain
| | - Alba Naudí
- Department of Experimental Medicine, Lleida University-Institute for Research in Biomedicine of Lleida (UdL-IRBLleida), 25198 Lleida, Spain
| | - Susana Rovira-Llopis
- Foundation for the Promotion of Healthcare and Biomedical Research in the Valencian Community (FISABIO), Service of Endocrinology, University Hospital Dr. Peset, 46017 Valencia, Spain
| | - Celia Bañuls
- Foundation for the Promotion of Healthcare and Biomedical Research in the Valencian Community (FISABIO), Service of Endocrinology, University Hospital Dr. Peset, 46017 Valencia, Spain
| | - Milagros Rocha
- Foundation for the Promotion of Healthcare and Biomedical Research in the Valencian Community (FISABIO), Service of Endocrinology, University Hospital Dr. Peset, 46017 Valencia, Spain
| | - Manuel Portero-Otin
- Department of Experimental Medicine, Lleida University-Institute for Research in Biomedicine of Lleida (UdL-IRBLleida), 25198 Lleida, Spain
| | - Antonio Hernández-Mijares
- Foundation for the Promotion of Healthcare and Biomedical Research in the Valencian Community (FISABIO), Service of Endocrinology, University Hospital Dr. Peset, 46017 Valencia, Spain.,Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia University, 46010 Valencia, Spain.,Department of Medicine, Valencia University, 46010 Valencia, Spain
| | - Victor M Victor
- Foundation for the Promotion of Healthcare and Biomedical Research in the Valencian Community (FISABIO), Service of Endocrinology, University Hospital Dr. Peset, 46017 Valencia, Spain.,Department of Physiology, Valencia University, 46010 Valencia, Spain
| | - Reinald Pamplona
- Department of Experimental Medicine, Lleida University-Institute for Research in Biomedicine of Lleida (UdL-IRBLleida), 25198 Lleida, Spain
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Hormone-induced rat model of polycystic ovary syndrome: A systematic review. Life Sci 2017; 191:259-272. [DOI: 10.1016/j.lfs.2017.10.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 10/04/2017] [Accepted: 10/17/2017] [Indexed: 12/16/2022]
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Dabbaghmanesh MH, Naderi T, Akbarzadeh M, Tabatabaee H. Metabolic syndrome in Iranian adolescents with polycystic ovary syndrome. Int J Adolesc Med Health 2017; 31:ijamh-2017-0029. [PMID: 28779567 DOI: 10.1515/ijamh-2017-0029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 05/10/2017] [Indexed: 01/29/2023]
Abstract
Background Metabolic syndrome (MS) in adolescents is a risk factor for type 2 diabetes and cardiovascular diseases. Objective The present study aimed to determine the prevalence of MS in 14-18-year-old girls. Methods This analytical case-control study was conducted on 3200 high school students with polycystic ovarian syndrome (PCOS). PCOS was confirmed by an endocrinologist after detection of clinical hyperandrogenism (acne, hirsutism and alopecia) and oligomenorrhea, rejection of hypothyroidism and hyperprolactinemia and performance of abdominal sonography. In the second stage, the prevalence of MS was compared between 70 girls with PCOS and 45 healthy girls using the ATPIII, Cooki and Ferranti scales. The study data were collected using a demographic questionnaire, body mass index (BMI) graph, the WC graph and standard blood pressure graph in adolescents. Then, the data were analyzed using the t-test and the χ2-test. Results Based on the Ferranti scale, the prevalence of MS was 10.4% and 0% in the case and control groups, respectively. The highest prevalence was related to hyperandrogenism and polycystic ovaries phenotype (11.6% vs. 0%, p = 0.05). Based on the Cooki and ATPIII scales, the prevalence of this disorder was 4.1% in the case group and 0.67% in the control group, with the highest rate being related to hyperandrogenism, oligomenorrhea and polycystic ovaries phenotype (7.5% vs. 0%, p = 0.28). Conclusion In comparison to the control group, the prevalence of MS in the patients with PCOS was 10-fold higher according to the Ferranti scale and nearly 3.5-fold higher based on the Cooki and ATPIII scales. Thus, long-term follow-up is suggested in these patients.
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Affiliation(s)
- Mohammad H Dabbaghmanesh
- Department of Internal Medicine, Endocrine and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Naderi
- Department of Midwifery, student research center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Akbarzadeh
- Maternal-fetal medicine Research Center, Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Nemazee Square, P.O. Box: 71345-1359, Shiraz, Iran, Phone: +98 711 36474250, Fax: +98 711 3647425
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Overweight and Obesity Prevalence in Referral Population of Infertile Women with Polycystic Ovary Syndrome. ACTA ACUST UNITED AC 2017. [DOI: 10.15406/aowmc.2017.07.00188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Endocrine Abnormalities in Adolescents with Menstrual Disorders. J Obstet Gynaecol India 2017; 68:58-64. [PMID: 29391677 DOI: 10.1007/s13224-017-1035-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 07/03/2017] [Indexed: 10/19/2022] Open
Abstract
Purpose To look for endocrine abnormalities like thyroid disorders, hyperprolactinemia, hyperandrogenism and PCOS among adolescents with menstrual disorders and to compare the above endocrine status with those without menstrual disorders. Methods This was a case-control study carried out in adolescent girls aged 10-19 years in gynecology outpatient department of a tertiary care hospital. Sample of venous blood (5 ml) was taken for hormonal studies as clinically indicated-thyroid function test, serum prolactin, total testosterone, which were analyzed by chemiluminescence system. Results Oligomenorrhea was the most common menstrual abnormality in our study, the prevalence being 61.0% in cases followed by primary amenorrhea (16.4%). Thyroid dysfunction was found in 13.6% girls with menstrual disorders compared to 3.5% in those without menstrual disorders, and this was statistically significant (p = 0.006). Biochemical hyperandrogenism was seen in 9.04% cases compared to 0.7% controls (p = 0.001). The overall prevalence of hyperprolactinemia was 0.94%, and there was no statistically significant difference in girls with and without menstrual disorders. The prevalence of PCOS was 12.4% in the study population and 22.6% cases. Oligomenorrhea and PCOS were the most prevalent phenotypes in 52.5% of PCOS girls. No endocrine abnormality was detected in cases of polymenorrhea, hypomenorrhea and intermenstrual bleeding. Conclusions Although immaturity of hypothalamic pituitary ovarian axis is considered to be the most common cause of menstrual irregularities in adolescent girls, endocrine abnormalities, namely thyroid dysfunction and hyperandrogenism, may be responsible in some cases, thus warranting further evaluation.
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Noroozzadeh M, Tehrani FR, Mobarakabadi SS, Farahmand M, Dovom MR. Sexual function and hormonal profiles in women with and without polycystic ovary syndrome: a population-based study. Int J Impot Res 2016; 29:1-6. [PMID: 27654035 DOI: 10.1038/ijir.2016.35] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/30/2016] [Accepted: 06/18/2016] [Indexed: 01/23/2023]
Abstract
There is no consensus regarding the impact of polycystic ovary syndrome (PCOS) and its hormonal profile on sexual function of affected women; majority of data documented are not population based and there is a lack of studies investigating the association between hormonal profiles with sexual function in women with PCOS. We aimed to compare the sexual function of PCOS women with controls in a population-based study based on their hormonal profiles. In this cross-sectional study, sexual function (using the Female Sexual Function Index (FSFI) questionnaire) and hormonal profiles were determined in 63 PCOS subjects and 216 healthy women (controls); aged 18-45 years. A comparison of PCOS women and controls showed no statistically significant difference in total FSFI and each of its specific domain scores. There were significant positive correlations between dehydroepiandrosterone sulfate and total FSFI, orgasm and satisfaction domains in controls (r=0.156, r=0.206, r=0.275, respectively). No significant correlations between hormonal profiles and FSFI scores were found in the PCOS group, except for prolactin and orgasm (r=-0.250). In conclusion, sexual function did not differ between PCOS women and controls. High levels of androgens in women with PCOS were not associated with an improvement in sexual function.
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Affiliation(s)
- M Noroozzadeh
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - F Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S Sedigh Mobarakabadi
- Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Farahmand
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Rostami Dovom
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod 2016; 31:2841-2855. [PMID: 27664216 DOI: 10.1093/humrep/dew218] [Citation(s) in RCA: 734] [Impact Index Per Article: 91.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 07/27/2016] [Accepted: 08/08/2016] [Indexed: 12/22/2022] Open
Abstract
STUDY QUESTION What is the reported overall prevalence of polycystic ovary syndrome (PCOS) according to the criteria of the National Institutes of Health (NIH), Rotterdam or the Androgen Excess and PCOS Society (AE-PCOS Society)? SUMMARY ANSWER The reported overall prevalence of PCOS (95% CI) according to diagnostic criteria of the NIH, Rotterdam and the AE-PCOS Society is 6% (5-8%, n = 18 trials), 10% (8-13%, n = 15 trials) and 10% (7-13%, n = 10 trials), respectively. WHAT IS ALREADY KNOWN PCOS is the most common endocrine disorder among women of reproductive age. Although many studies have investigated the prevalence of PCOS, there are discrepancies in their results, in part due to the use of various definitions of the syndrome and its subphenotypes, differences between study cohorts, ethnicities, and types of recruitment and sampling. STUDY DESIGN, SIZE, DURATION A systematic review and meta-analysis were performed on all published studies that have reported the prevalence of PCOS according to at least one subset of diagnostic criteria. PARTICIPANTS/MATERIALS, SETTING, METHODS To identify relevant studies based on the PRISMA statement, PubMed and Ovid databases were searched up to September 2015 by two blind investigators using the terms 'PCOS', 'polycystic ovarian disease', 'Stein Leventhal syndrome', 'Androgen Excess Society', 'National Institute of Health', 'Rotterdam', 'ESHRE/ASRM', 'criteria' and 'prevalence'. Articles that represented the prevalence of PCOS according to at least one subset of diagnostic criteria were included. Exclusion criteria were a focus on adolescent subjects, an absence of data on prevalence, inappropriate design or non-English reporting. An appraisal tool to evaluate the methodological quality of the available studies was generated by the authors. MAIN RESULTS AND THE ROLE OF CHANCE A total of 55 reports remained following screening of the abstracts and text for the subject of the study. Of these, 24 articles were eligible and evaluated for qualitative and quantitative synthesis. Since heterogeneity was observed among studies, a random-effects model was used to estimate the prevalence and its 95% CI. The proportions of PCOS prevalence (95% CI) according to the diagnostic criteria of NIH, Rotterdam and AE-PCOS Society were 6% (5-8%, n = 18 trials), 10% (8-13%, n = 15 trials) and 10% (7-13%, n = 10 trials), respectively. When only unselected population studies were included, the given rates were 6% (5-8%, n = 3 trials), 9% (7-12%, n = 6 trials) and 10% (7-14%, n = 3 trials). The respective proportions for hirsutism, hyperandrogenaemia, polycystic ovaries (PCO) and oligo-anovulation were 13% (8-20%, n = 14 trials), 11% (8-15%, n = 9 trials), 28% (22-35%, n = 12 trials) and 15% (12-18%, n = 19 trials), respectively. LIMITATIONS, REASONS FOR CAUTION The effects of ethnic differences, particularly, on the presence or severity of hirsutism cannot be ruled out in any way. In addition, there was a lack of standardization in defining phenotypes of the syndrome and selection bias was evident in most of the studies regarding recruitment of the cohorts. WIDER IMPLICATIONS OF THE FINDINGS Geographical differences in frequencies of the components of the syndrome, such as oligo-anovulation and clinical/biochemical androgen excess, must be taken into account in the development and implementation of regional diagnostic and precision treatment strategies. Further efforts and resources are required to increase standardization of the methods and comparability of the study results on prevalence and phenotypic characterization of PCOS around the globe. STUDY FUNDING/COMPETING INTERESTS No funding to declare. The authors have no conflicts of interest to declare. REGISTRATION NUMBER None.
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Affiliation(s)
- Gurkan Bozdag
- Department of Obstetrics and Gynecology, School of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey
| | - Sezcan Mumusoglu
- Department of Obstetrics and Gynecology, School of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey
| | - Dila Zengin
- Department of Obstetrics and Gynecology, School of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey
| | - Erdem Karabulut
- Department of Biostatistics, School of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey
| | - Bulent Okan Yildiz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey
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Merkin SS, Phy JL, Sites CK, Yang D. Environmental determinants of polycystic ovary syndrome. Fertil Steril 2016; 106:16-24. [DOI: 10.1016/j.fertnstert.2016.05.011] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 05/03/2016] [Accepted: 05/16/2016] [Indexed: 12/17/2022]
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Ganie MA, Marwaha RK, Dhingra A, Nisar S, Mani K, Masoodi S, Chakraborty S, Rashid A. Observation of phenotypic variation among Indian women with polycystic ovary syndrome (PCOS) from Delhi and Srinagar. Gynecol Endocrinol 2016; 32:566-70. [PMID: 26878496 DOI: 10.3109/09513590.2016.1141879] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a heterogeneous disorder that demonstrates ethnic and regional differences. To assess the phenotypic variability among Indian PCOS women, we evaluated clinical, biochemical and hormonal parameters of these women being followed in two tertiary care institutions located in Delhi and Srinagar. A total of 299 (210 PCOS diagnosed by Rotterdam 2003 criteria and 89 healthy) women underwent estimation of T4, TSH, LH, FSH, total testosterone, prolactin, cortisol, 17OHP, and lipid profile, in addition to post OGTT, C-peptide, insulin, and glucose measurements. Among women with PCOS, mean age, age of menarche, height, systolic, diastolic blood pressure, and serum LH were comparable. PCOS women from Delhi had significantly higher BMI (26.99 ± 5.38 versus 24.77 ± 4.32 kg/m(2); P = 0.01), glucose intolerance (36 versus 10%), insulin resistance as measured by HOMA-IR (4.20 ± 3.39 versus 3.01 ± 2.6; P = 0.006) and QUICKI (0.140 ± 0.013 versus 0.147 ± 0.015; P = 0.03) while PCOS from Srinagar had higher FG score (12.12 ± 3.91 versus 10.32 ± 2.22; P = 0.01) and serum total testosterone levels (0.65 ± 0.69 versus 0.86 ± 0.41 ng/ml; P = 0.01. Two clear phenotypes, i.e. obese hyperinsulinaemic dysglycemic women from Delhi and lean hyperandrogenic women from Srinagar are emerging. This is the first report on North Indian women with PCOS showing phenotypic differences in clinical, biochemical and hormonal parameters despite being in the same region.
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Affiliation(s)
| | | | | | | | - Kaliavani Mani
- c Department of Biostatistics , Endocrinology and Metabolism, All India Institute of Medical Sciences , New Delhi , India , and
| | - Shariq Masoodi
- d Department of Endocrinology , Sheri-Kashmir Institute of Medical Sciences , Srinagar, J&K , India
| | | | - Aafia Rashid
- d Department of Endocrinology , Sheri-Kashmir Institute of Medical Sciences , Srinagar, J&K , India
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Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertil Steril 2016; 106:6-15. [PMID: 27233760 DOI: 10.1016/j.fertnstert.2016.05.003] [Citation(s) in RCA: 612] [Impact Index Per Article: 76.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 05/05/2016] [Accepted: 05/06/2016] [Indexed: 12/28/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a highly prevalent disorder effecting reproductive-aged women worldwide. This article addresses the evolution of the criteria used to diagnosis PCOS; reviews recent advances in the phenotypic approach, specifically in the context of the extended Rotterdam criteria; discusses limitations of the current criteria used to diagnosis, particularly when studying adolescents and women in the peri- and postmenopause; and describes significant strides made in understanding the epidemiology of PCOS. This review recognizes that although there is a high prevalence of PCOS, there is increased variability when using Rotterdam 2003 criteria, owing to limitations in population sampling and approaches used to define PCOS phenotypes. Last, we discuss the distribution of PCOS phenotypes, their morbidity, and the role that referral bias plays in the epidemiology of this syndrome.
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Lin CY, Ou HT, Wu MH, Chen PC. Validation of Chinese Version of Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (Chi-PCOSQ). PLoS One 2016; 11:e0154343. [PMID: 27124836 PMCID: PMC4849642 DOI: 10.1371/journal.pone.0154343] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 04/11/2016] [Indexed: 11/24/2022] Open
Abstract
Objectives To evaluate the responsiveness, longitudinal validity, and measurement invariance of the Chinese version of the Polycystic Ovary Syndrome Health-related Quality of Life Questionnaire (Chi-PCOSQ). Research Design and Method This prospective study was conducted in a medical center in southern Taiwan. 102 women aged 18–45 years and diagnosed with PCOS were enrolled. Objective indicators for clinical changes of PCOS included assessing the 2-hour glucose and insulin levels before and after treatment. The responsiveness of Chi-PCOSQ and WHOQOL-BREF was analyzed using paired t-tests and the standard response mean. Confirmatory factor analysis was performed to assess the measurement invariance of Chi-PCOSQ. Results With improved 2-hour glucose and insulin levels, we also found significantly increased Chi-PCOSQ total and individual domain scores (total score: t (49) = 5.20; p < 0.001, domain scores: t (49) = 2.72 to 3.87; p < 0.01), except for hair growth. Half of the domains scores (3 of 6) and the total score of Chi-PCOSQ had a medium responsiveness, but WHOQOL-BREF was not sufficiently responsive to clinical changes of PCOS. Improved PCOS-specific health-related quality of life (HRQoL), as indicated by Chi-PCOSQ scores, was significantly associated with improved 2-hour glucose and insulin levels. All indices of the data-model fit of the Chi-PCOSQ structure were satisfactory, except for the slightly high standardized root mean square residual values (0.087 to 0.088). The measurement invariance of Chi-PCOSQ was supported across time. Conclusion Chi-PCOSQ is sufficiently sensitive in detecting clinical changes and its measurement structure is suitable for Chinese women with PCOS. It is thus a promising tool for assessing the HRQoL of ethnic Chinese women with PCOS.
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Affiliation(s)
- Chung-Ying Lin
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Huang-tz Ou
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, National Cheng Kung University College of Medicine, Tainan, Taiwan
- * E-mail:
| | - Meng-Hsing Wu
- Department of Obstetrics and Gynecology, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan
| | - Pei-Chi Chen
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, National Cheng Kung University College of Medicine, Tainan, Taiwan
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Ou HT, Wu MH, Lin CY, Chen PC. Development of Chinese Version of Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (Chi-PCOSQ). PLoS One 2015; 10:e0137772. [PMID: 26452153 PMCID: PMC4599828 DOI: 10.1371/journal.pone.0137772] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 08/20/2015] [Indexed: 11/28/2022] Open
Abstract
Objectives To develop the Chinese version of the Polycystic Ovary Syndrome Health-related Quality of Life Questionnaire (Chi-PCOSQ). Research Design and Method This cross-sectional study was conducted in a medical center in Taiwan. Eighty women who met the criteria were enrolled: female, age range of 18–45 years, competent in the Chinese language, had been diagnosed with polycystic ovary syndrome (PCOS), and were regularly followed at outpatient clinics (defined as at least two outpatient visits before enrollment). The PCOSQ was translated and culturally adapted according to standard procedures. A semi-structured interview was applied to assess face validity. Exploratory factor analysis (EFA) was applied to determine scale constructs. Measurements of internal consistency via Cronbach’s α, test-retest reliability via intraclass correlation coefficient (ICC), construct validity, and discriminative validity were performed. Results Five additional items, representing the issues of acne, hair loss, and fear of getting diabetes, were incorporated into the original scale. A six-factor structure emerged as a result of the EFA, explaining 71.9% of the variance observed. The reliability analyses demonstrated satisfactory results for Cronbach’s α ranging from 0.78–0.96, and for ICC ranging from 0.73–0.86. Construct validity was confirmed by significant correlation between the domains of the Chi-PCOSQ and generic health-related quality of life (HRQoL) measures (WHOQOL-BREF, EQ-5D) and clinical parameters (body mass index, waist-hip ratio, blood pressure). The known-group analysis indicated that the Chi-PCOSQ is a discriminative tool that differentiates patients according to their HRQoL. Conclusion The Chi-PCOSQ seems internally consistent, culturally acceptable, and our preliminary evidence suggests that it may be reliable and valid. The Chi-PCOSQ is a promising assessment tool to address the HRQoL of women affected by PCOS in Chinese-speaking countries and to further identify ethnic/cultural differences in the HRQoL of women with PCOS.
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Affiliation(s)
- Huang-tz Ou
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, National Cheng Kung University College of Medicine, Tainan, Taiwan
- * E-mail:
| | - Meng-Hsing Wu
- Department of Obstetrics and Gynecology, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan
| | - Chung-Ying Lin
- Department of Public Health, National Cheng Kung University College of Medicine, Tainan, Taiwan
| | - Pei-Chi Chen
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, National Cheng Kung University College of Medicine, Tainan, Taiwan
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The correlation of plasma omentin-1 with insulin resistance in non-obese polycystic ovary syndrome. ANNALES D'ENDOCRINOLOGIE 2015; 76:620-7. [DOI: 10.1016/j.ando.2015.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 08/03/2015] [Accepted: 08/04/2015] [Indexed: 01/24/2023]
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Schmidt TH, Shinkai K. Evidence-based approach to cutaneous hyperandrogenism in women. J Am Acad Dermatol 2015; 73:672-90. [PMID: 26138647 DOI: 10.1016/j.jaad.2015.05.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 05/15/2015] [Accepted: 05/16/2015] [Indexed: 10/23/2022]
Abstract
Hirsutism, acne, and androgenetic alopecia are classically considered signs of cutaneous hyperandrogenism (CHA). These common skin findings have significant impacts on the quality of patients' lives and pose the diagnostic challenge of excluding underlying disorders. Many with CHA have normal serum androgen levels. Hirsutism is more strongly associated with hyperandrogenism than are acne or androgenetic alopecia. Variable association of CHA with hyperandrogenemia results from the complexity of the underlying pathophysiology, including factors local to the pilosebaceous unit. CHA often occurs in the setting of polycystic ovary syndrome, the most common disorder of hyperandrogenism, but can also present in uncommon conditions, including nonclassic adrenal hyperplasia and androgen-producing tumors. A thorough history and full skin examination are important to guide appropriate diagnostic evaluation. Oral contraceptive pills with or without antiandrogens can provide therapeutic benefit for hirsutism and acne. Medical options for androgenetic alopecia remain limited. Multidisciplinary approaches may be needed given endocrine, metabolic, reproductive, and psychiatric disorders associated with CHA. More high-quality studies into the mechanisms of CHA and the benefits of antiandrogenic therapies are needed. We provide an evidence-based review of key diagnostic and therapeutic considerations in the treatment of women with CHA.
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Affiliation(s)
- Timothy H Schmidt
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Kanade Shinkai
- Department of Dermatology, University of California San Francisco, San Francisco, California.
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Yang Q, Zhao Y, Qiu X, Zhang C, Li R, Qiao J. Association of serum levels of typical organic pollutants with polycystic ovary syndrome (PCOS): a case-control study. Hum Reprod 2015; 30:1964-73. [PMID: 26040477 DOI: 10.1093/humrep/dev123] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 05/05/2015] [Indexed: 01/01/2023] Open
Abstract
STUDY QUESTION Is polycystic ovary syndrome (PCOS) associated with increased serum levels of typical organic pollutants? SUMMARY ANSWER PCOS in Han females from Northern China was significantly associated with elevated serum levels of pollutants, including polychlorinated biphenyls (PCBs), organochlorine pesticides and polycyclic aromatic hydrocarbons (PAHs). WHAT IS KNOWN ALREADY PCOS is arguably the most common endocrinopathy in females of reproductive age. The etiology of PCOS is thought to be multifactorial. STUDY DESIGN, SIZE, DURATION This was a preliminary case-control study undertaken at the Division of Reproductive Center, Peking University Third Hospital. Fifty participants affected by PCOS and 30 normal controls were recruited between August and October 2012 from Northern China. All participants were Han women. PARTICIPANTS/MATERIALS, SETTING, METHODS PCOS participants were diagnosed according to the 2003 Rotterdam criteria. The control participants were non-pregnant females unable to conceive solely due to male azoospermia. Serum levels of a wide range of organic pollutants, including PCBs, organochlorine pesticides, PAHs and more than 20 phenolic pollutants, were analyzed using gas chromatographic mass spectrometry. MAIN RESULTS AND THE ROLE OF CHANCE Serum levels of PCBs, pesticides and PAHs were significantly higher in the PCOS group than the control group. Concentrations of PCBs, p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) and PAHs in serum above median levels were associated with PCOS with odds ratios of 3.81 [95% confidence interval (CI), 1.45-10.0], 4.89 (95% CI, 1.81-13.2) and 2.39 (95% CI, 0.94-6.05), respectively. Partial least-squares-discriminant analysis (PLS-DA) confirmed that serum levels of organic pollutants were associated with PCOS, especially for p,p'-DDE and PCBs. LIMITATIONS, REASONS FOR CAUTION Some other possible covariates (e.g. dietary and income) were missed in this study, although education and occupation have been considered as an indicator of personal income. The PLS-DA model allowed a quasi-exposome analysis with over 60 kinds of typical organic pollutants; however, the possibility of other pollutants involved in the PCOS still could not be excluded. WIDER IMPLICATIONS OF THE FINDINGS Our study identified that bodily retention of environmental organic pollutants-including PCBs, pesticides (especially p,p'-DDE) and PAHs-was associated with PCOS. STUDY FUNDING/COMPETING INTERESTS This research was supported by the Ministry of Science and Technology of China Grants (973 program; 2014CB943203 and 2015CB553401), National Natural Science Foundation of China (21322705, 21190051, 41121004 and 81170538), National Key Technology R&D Program in the Twelve Five-Year Plan (2012BAI32B01) and the Collaborative Innovation Center for Regional Environmental Quality. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER None. This is not a clinical trial.
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Affiliation(s)
- Qiaoyun Yang
- College of Environmental Sciences and Engineering, Third Hospital, Peking University, Beijing 100871, P.R. China State Key Joint Laboratory for Environmental Simulation and Pollution Control, Beijing 100871, P.R. China
| | - Yue Zhao
- College of Environmental Sciences and Engineering, Third Hospital, Peking University, Beijing 100871, P.R. China Key Laboratory of Assisted Reproduction, Ministry of Education and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, P.R. China
| | - Xinghua Qiu
- College of Environmental Sciences and Engineering, Third Hospital, Peking University, Beijing 100871, P.R. China State Key Joint Laboratory for Environmental Simulation and Pollution Control, Beijing 100871, P.R. China
| | - Chunmei Zhang
- College of Environmental Sciences and Engineering, Third Hospital, Peking University, Beijing 100871, P.R. China Key Laboratory of Assisted Reproduction, Ministry of Education and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, P.R. China
| | - Rong Li
- College of Environmental Sciences and Engineering, Third Hospital, Peking University, Beijing 100871, P.R. China Key Laboratory of Assisted Reproduction, Ministry of Education and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, P.R. China
| | - Jie Qiao
- College of Environmental Sciences and Engineering, Third Hospital, Peking University, Beijing 100871, P.R. China Key Laboratory of Assisted Reproduction, Ministry of Education and Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, P.R. China
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