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Zaki M, Hassan N, El-Bassyouni HT, Kamal S, Basha W, Azmy O, Amr K. Association of the Pro12Ala Polymorphism with the Metabolic Parameters in Women with Polycystic Ovary Syndrome. Open Access Maced J Med Sci 2017; 5:275-280. [PMID: 28698741 PMCID: PMC5503721 DOI: 10.3889/oamjms.2017.088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 04/21/2017] [Accepted: 04/22/2017] [Indexed: 11/17/2022] Open
Abstract
AIM: To investigate the association of peroxisome proliferator-activated receptor gamma (PPARG) Pro12Ala polymorphism with polycystic ovary syndrome (PCOS) and its effect on the metabolic parameters in PCOS women. METHODS: The study used PCR to identify the presence of the PPARG Pro12Ala polymorphism in 100 PCOS women and 120 age-matched healthy women. All participants were subjected to anthropometry, biochemical and metabolic evaluation. RESULTS: Significant difference in the genotypes distributions of PPARG Pro12Ala polymorphism was observed among PCOS women and controls (p = 0.03). The frequency of the polymorphic allele Ala was significantly higher in PCOS cases than that in the controls (OR = 2.01, p = 0.01). The carries of the variant allele Ala in PCOS women showed significant higher values in body mass index (BMI), systolic and diastolic blood pressure, waist circumference, waist to hip ratio, sum of skin folds, fasting blood glucose, fasting blood insulin, HOMA-IR, fasting triglycerides, total cholesterol and low-density lipoprotein than non-carriers. CONCLUSION: The PPARG Pro12Ala polymorphism might contribute to the risk of PCOS and abnormal metabolic parameters and could be considered as a biomarker for early diagnosis and clinic prediction of metabolic complications.
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Affiliation(s)
- Moushira Zaki
- Biological Anthropology Department, National Research Centre, Cairo, Egypt
| | - Naglaa Hassan
- Biological Anthropology Department, National Research Centre, Cairo, Egypt
| | | | - Sanaa Kamal
- Biological Anthropology Department, National Research Centre, Cairo, Egypt
| | - Walaa Basha
- Biological Anthropology Department, National Research Centre, Cairo, Egypt
| | - Osama Azmy
- Reproductive Health Research Department, National Research Centre, Cairo, Egypt
| | - Khalda Amr
- Molecular Genetics Department, National Research Centre, Cairo, Egypt
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Dursun F, Güven A, Yıldız M. Assessment of Anti-Müllerian Hormone Level in Management of Adolescents with Polycystic Ovary Syndrome. J Clin Res Pediatr Endocrinol 2016; 8:55-60. [PMID: 26761944 PMCID: PMC4805049 DOI: 10.4274/jcrpe.2338] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 11/03/2015] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE This study was oriented to investigate the benefit of anti-Müllerian hormone (AMH) level in the management of polycystic ovary syndrome (PCOS). To assess the impact of metformin and oral contraceptives (OC) on serum AMH levels in a cohort of adolescents with PCOS. METHODS Forty-nine adolescents with PCOS were recruited to the study. Twenty-nine patients without insulin resistance were treated with OC (group 1), and 20 patients with insulin resistance were treated with metformin and OC (group 2). AMH and androgen levels were measured prior to and 6 months after the initiation of treatment. RESULTS AMH levels were significantly decreased with treatment in both group 1 (p=0.006) and group 2 (p=0.0048). There was a significant correlation between pre- and post-treatment AMH and left ovarian volume (pretreatment: rho=0.336, p=0.018; post-treatment: rho=0.310, p=0.034). CONCLUSION This study investigated two different treatment regimens in adolescents with PCOS and revealed that AMH levels decreased with treatment. AMH levels were correlated with ovarian volume.
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Affiliation(s)
- Fatma Dursun
- Ümraniye Education and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey, Phone: +90 505 267 14 03 E-mail:
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Kamangar F, Okhovat JP, Schmidt T, Beshay A, Pasch L, Cedars MI, Huddleston H, Shinkai K. Polycystic Ovary Syndrome: Special Diagnostic and Therapeutic Considerations for Children. Pediatr Dermatol 2015; 32:571-8. [PMID: 25787290 DOI: 10.1111/pde.12566] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Polycystic ovary syndrome (PCOS) is an endocrine syndrome with variable phenotypic expression and important systemic associations and sequelae, including obesity, insulin resistance, infertility, risk of endometrial cancer, and possible risk of cardiovascular events. PCOS is recognized as a condition influenced by genetic and environmental factors and distinct manifestations in all stages of life, including the prenatal period, childhood, adolescence, and adulthood. Identification of this disorder in childhood and adolescence has received growing attention, in part because of emerging evidence of the benefit of early intervention, but the diagnosis and management of PCOS in children and adolescents can be challenging. Diagnostic and therapeutic considerations of PCOS in children are reviewed to enhance identification and evaluation of patients suspected of having this disorder. When a diagnosis of PCOS is suspected in a child but cannot be confirmed, a provisional diagnosis is strongly recommended so as to prompt ongoing monitoring with an emphasis on important early interventions such as obesity reduction.
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Affiliation(s)
- Faranak Kamangar
- Department of Dermatology, University of California at Davis, Davis, California
| | - Jean-Phillip Okhovat
- David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Timothy Schmidt
- School of Medicine, University of California at San Francisco, San Francisco, California
| | - Abram Beshay
- Eastern Virginia Medical School, Norfolk, Virginia
| | - Lauri Pasch
- Department of Psychiatry, University of California at San Francisco, San Francisco, California.,Department of Reproductive Endocrinology, University of California at San Francisco, San Francisco, California
| | - Marcelle I Cedars
- Department of Reproductive Endocrinology, University of California at San Francisco, San Francisco, California
| | - Heather Huddleston
- Department of Reproductive Endocrinology, University of California at San Francisco, San Francisco, California
| | - Kanade Shinkai
- Department of Dermatology, University of California at San Francisco, San Francisco, California
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Ahmed S, Pahwa S, Das CJ, Mir FA, Nisar S, Jehangir M, Parveen S, Rashid A, Ganie MA. Comparative evaluation of sonographic ovarian morphology of Indian women with polycystic ovary syndrome versus those of normal women. Indian J Endocrinol Metab 2014; 18:180-4. [PMID: 24741513 PMCID: PMC3987267 DOI: 10.4103/2230-8210.129108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To study ovarian morphology by ultrasound in women with or without polycystic ovary syndrome (PCOS) and to establish cut-off values of these parameters in Indian women with PCOS. MATERIALS AND METHODS A total of 119 consecutive women diagnosed PCOS and 77 apparently healthy women were enrolled. Transabdominal ultrasound examination was carried out to assess ovarian volume, stromal echogenecity, follicle number and size. Cut-off values of the above ovarian parameters with sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were calculated. RESULTS Sensitivity of 79.49% and specificity of 90.67% was achieved with a cut-off of 8 mL as ovarian volume. A cut-off value of 9 follicles to distinguish between PCOS and control women yielded a sensitivity of 82.35% and specificity of 92.0% while as a follicular size of 5 mm yielded sensitivity and specificity of 74.67% and 78.15% respectively. With all the three parameters sensitivity was 87.39% and specificity 87.84% with 92.04% PPV and 81.25% NPV. CONCLUSION Using two or three sonographic criteria in combination improves sensitivity and helps diagnose additional patients with PCOS. Our results are at variance with the established cut-off values highlighting the fact that American Society for Reproductive Medicine consensus cut-off values are not reproducible in Indian context.
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Affiliation(s)
- Sanjeed Ahmed
- Department of Radiodiagnosis, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Shivani Pahwa
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Chandan Jyoti Das
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Farooq A Mir
- Department of Radiodiagnosis, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Sobia Nisar
- Department of Geriatric Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Majid Jehangir
- Department of Radiodiagnosis, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Shameem Parveen
- Department of Obstetrics and Gynecolgy, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Aafia Rashid
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Mohd Ashraf Ganie
- Department of Endocrinology, Metabolism and Diabetes, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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da Cunha MG, Fonseca FLA, Machado CDAS. Androgenic hormone profile of adult women with acne. Dermatology 2013; 226:167-71. [PMID: 23689531 DOI: 10.1159/000347196] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 01/16/2013] [Indexed: 11/19/2022] Open
Abstract
Acne in adult women is a hard-to-manage frequent disease with many relapse cases. It mostly interferes with quality of life and causes major social and metabolic losses for patients. This is a transversal retrospective study and the aim was to standardize the research on circulating androgenic hormone levels and to detect hyperandrogenic states early, showing the frequency and the pattern of the altered hormones, useful resources to correctly evaluate each patient. In this study 835 women above 15 years of age, with acne or aggravation cases, were analyzed. The aim was to verify the percentage of androgen examinations with levels above normal. The levels of the hormones dehydroepiandrosterone sulfate, dehydroepiandrosterone (DHEA), dehydrotestosterone, androstenedione and total testosterone were measured in all patients. The evaluation of the hormone profile showed that 54.56% of the patients had hyperandrogenism, and the levels of DHEA were most frequently elevated. Therefore, in the face of the importance of hyperandrogenism in the pathogenesis of acne, standardizing the research of the hormone profile is paramount for the treatment and control of relapses in case of a surge of acne breakouts during a woman's adult life.
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Ságodi L, Barkai L. [Diagnostic difficulties of polycystic ovarian syndrome in adolescent girls]. Orv Hetil 2013; 154:136-42. [PMID: 23335723 DOI: 10.1556/oh.2013.29527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Polycystic ovary syndrome is a heterogeneous disorder characterized by chronic ovulatory dysfunction and hyperandrogenism. It occurs in 6-8% of the female population in the reproductive age. The syndrome may be associated with various metabolic disorders which may impair the quality of life and life expectancy of patients. The diagnosis in adults is usually established by the presence of three criteria. Polycystic ovary syndrome can be also identified in adolescent girls. Although the clinical, hormonal and metabolic features are similar to those found in adult women, it may be difficult to distinguish normal adolescents from those with polycystic ovary syndrome. Irregular menstruation, anovulatory cycles, and acne are not uncommon in adolescents, and polycystic ovary syndrome may mimic physiological anovulation in adolescents. There is a high probability of polycystic ovary syndrome if anovulatory cycles persist for more than 2 years. The diagnosis of polycystic ovary syndrome in adolescents may require a unique set of criteria, however, there are no generally accepted recommendations for the diagnostic work-up. The authors propose that hyperandrogenemia is often the most reliable finding in this age group, and it may be prudent to define adolescent polycystic ovary syndrome according to the Rotterdam consensus criteria. Obesity in adolescent girls may increase the severity of symptoms of polycystic ovary syndrome and this underlines the importance of early diagnosis and treatment.
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Affiliation(s)
- László Ságodi
- Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház Csecsemő- és Gyermekosztály Miskolc Pf. 188 3501 Miskolci Egyetem, Egészségügyi Kar Preventív Egészségtudományi Tanszék Miskolc.
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Coste O, Paris F, Galtier F, Letois F, Maïmoun L, Sultan C. Polycystic ovary–like syndrome in adolescent competitive swimmers. Fertil Steril 2011; 96:1037-42. [DOI: 10.1016/j.fertnstert.2011.07.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Revised: 06/27/2011] [Accepted: 07/05/2011] [Indexed: 11/29/2022]
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de Zegher F, Ibáñez L. Early Origins of polycystic ovary syndrome: hypotheses may change without notice. J Clin Endocrinol Metab 2009; 94:3682-5. [PMID: 19808859 DOI: 10.1210/jc.2009-1608] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Sun L, Fu Q. Three-dimensional transrectal ultrasonography in adolescent patients with polycystic ovarian syndrome. Int J Gynaecol Obstet 2007; 98:34-8. [PMID: 17459387 DOI: 10.1016/j.ijgo.2007.02.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2006] [Revised: 02/15/2007] [Accepted: 02/18/2007] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To evaluate the diagnostic value of 3-dimensional transrectal ultrasonography (3D-TRS) in adolescent patients with polycystic ovarian syndrome (PCOS). METHODS Ovarian follicle number, ovarian volume, ovarian stromal area, total ovarian area, and stromal area to total area ratio (S/A) were evaluated using 3D-TRS in 75 amenorrheic, oligomenorrheic, or asymptomatic virgin patients and 25 healthy controls. Serum biochemical markers of PCOS were assayed during the early follicular phase of the menstrual cycle in menstruating patients and controls, and on a randomly selected day in amenorrheic patients. RESULTS When assessing the delicate structure of the ovary in virgin patients, 3D-TRS was convenient, accurate, specific, sensitive, and more reliable overall than transabdominal ultrasonography. Ovarian stromal area and S/A ratio were significantly greater in patients with PCOS than in controls, and also in the patients who had ultrasonically diagnosed polycystic ovaries without clinical or biochemical evidence of PCOS. The S/A ratio was the studied variable most significantly correlated with androgen levels. CONCLUSIONS These findings indicated that, in adolescent patients, 3D-TRS combined with transabdominal ultrasonography can improve the precision of the diagnosis of PCOS. The S/A ratio may become the ultrasonographic diagnostic marker for PCOS.
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Affiliation(s)
- Li Sun
- Department of Obstetrics and Gynecology, Shandong University Qilu Hospital, Jinan, Shandong, China
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