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de Medeiros SF, Winck Yamamoto de Medeiros AL, Souto de Medeiros MA, da Silva Carvalho AB, Yamamoto MW, M Soares J, Baracat EC. Anthropometric, Metabolic, and Endocrine Parameters as Predictors of Estimated Average Glucose and Other Biomarkers of Dysglycemia in Women with Different Phenotypes of Polycystic Ovary Syndrome. Horm Metab Res 2024; 56:445-454. [PMID: 37940116 DOI: 10.1055/a-2207-0739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
The aim of the study was to evaluate the efficacy of anthropometric, metabolic, and endocrine abnormalities as predictors of estimated average glucose and other biomarkers of dysglycemia in women with different phenotypes of polycystic ovary syndrome (PCOS). This cross-sectional study included 648 women with PCOS and 330 controls. A single protocol of investigation was applied for all subjects. PCOS women were divided by phenotypes according to the Rotterdam criteria. Biomarkers of dysglycemia were considered dependent variables and anthropometric, lipid, and hormone alterations as independent variables using univariate and multivariate logistic regressions. Univariate logistic regression analysis, controlled for age and BMI, showed that many biomarkers of dysglycemia could be predicted by anthropometric, lipid, and endocrine variables. Multivariate logistic models showed that in non-PCOS women estimated average glucose (eAG) was predicted by lower TSH levels (OR=0.39; p=0.045); fasting glucose was predicted by increased T (OR=2.3). For PCOS, phenotype A, eAG was predicted by decreased HDL-C (OR=0.17, p=0.023) and high levels of free estradiol (OR=7.1, p<0.001). Otherwise, in PCOS, phenotype D, eAG was predicted by higher levels of HDL-C. The current study demonstrated that eAG was poorly predicted by anthropometric, lipid, and hormone parameters. Nevertheless, without adding significant benefits, it was comparable with other established markers of dysglycemia in women with different PCOS phenotypes.
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Affiliation(s)
- Sebastião Freitas de Medeiros
- First Department of Gynecology and Obstetrics, Medical School - Brazil, Federal University of Mato Grosso - Brazil, Cuiabá, Brazil
| | | | | | | | | | - José M Soares
- Department of Obstetrics and Gynecology, Medical School, University of São Paulo, São Paulo, Brazil
| | - Edmund C Baracat
- Department of Obstetrics and Gynecology, Medical School, University of São Paulo, São Paulo, Brazil
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Wright PJ, Tavakoli AS, Dawson RM. Exploratory factor and confirmatory analyses of the polycystic ovary syndrome health-related quality of life questionnaire (PCOSQ-50). Health Qual Life Outcomes 2024; 22:15. [PMID: 38310238 PMCID: PMC10837866 DOI: 10.1186/s12955-024-02228-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 01/02/2024] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND A condition-specific instrument is necessary to measure the health-related quality of life among those with polycystic ovary syndrome (PCOS), the most common chronic endocrinopathy among women. The first instrument was developed in 1988, followed by several revisions. However, further recommendations from all versions include additional application and measurement among different cultural populations of women with PCOS and psychometric testing based on use among larger samples of women with PCOS. Thus, the purpose of this study was to explore the factor structure of the Polycystic Ovary Syndrome Questionnaire (PCOSQ-50) using an international cross-sectional survey data from women with PCOS aged 18-42 years. METHODS Using data from the largest known international cross-sectional study of women with PCOS aged 18-42 years (n = 935) to date, exploratory factor and confirmatory analyses were conducted for the PCOSQ-50, followed by factor labeling using a thematic analysis approach. RESULTS Respondents were 31.0 ± 5.8 years of age, mostly White (72%), well-educated (56% had a college degree), married (69%), and employed full-time (65%). Three-quarters (74%) of the sample had one or more chronic conditions in addition to PCOS. Approximately 20% of the respondents originated from countries such as the United Kingdom, Australia, South Africa, etc. The PCOSQ-50 demonstrated good reliability but may be best described using a 7-factor model. The 7-factor model revealed goodness-of-fit. Thematic analysis suggested the following labels of those seven factors: hirsutism, fertility, isolation/trepidation, sexual function, self-esteem, emotional, and obesity. CONCLUSION More research is needed to adapt the current PCOSQ-50, as well as to create an age-appropriate PCOS-specific HRQoL instrument for peri-postmenopausal women with PCOS.
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Affiliation(s)
- Pamela J Wright
- College of Nursing, University of South Carolina, Columbia, SC, USA.
- Advancing Chronic Care Outcomes through Research and iNnovation (ACORN) Center, College of Nursing, University of South Carolina, Columbia, SC, USA.
| | - Abbas S Tavakoli
- College of Nursing, University of South Carolina, Columbia, SC, USA
| | - Robin M Dawson
- College of Nursing, University of South Carolina, Columbia, SC, USA
- Advancing Chronic Care Outcomes through Research and iNnovation (ACORN) Center, College of Nursing, University of South Carolina, Columbia, SC, USA
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Ryu KJ, Park H, Kim MS, Jeong HG, Kim T. Risk of cardiocerebrovascular diseases is increased in Korean women with polycystic ovary syndrome: a nationwide cohort study. Sci Rep 2024; 14:1055. [PMID: 38212642 PMCID: PMC10784481 DOI: 10.1038/s41598-023-50650-y] [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: 06/11/2023] [Accepted: 12/22/2023] [Indexed: 01/13/2024] Open
Abstract
To investigate the relationship between polycystic ovary syndrome (PCOS) and risk of cardiocerebrovascular disease in Korean women. This longitudinal cohort study using data from the Korean National Health Insurance Service included the women aged 15-44 years diagnosed with PCOS between 2002 and 2019, and the controls were matched 1:3 by age group, income, and region of residence. The endpoint outcomes of this study were the occurrence of ischemic heart disease, cerebrovascular diseases, and combined cardiocerebrovascular diseases in the PCOS and control groups. A stratified Cox proportional hazards regression analysis for matched data was performed to evaluate the relative hazard of events in the PCOS group compared to that in the control group. Among a total of 549,400 participants in the cohort, 137,416 women had a diagnosis of PCOS and 412,118 women did not have it. During a median follow-up of 54 months (interquartile range, 30-78 months), the incidence rates of all cardiovascular, ischemic heart, and cerebrovascular diseases were 6.6, 4.0, and 2.9, respectively, per 1000 person-years for women with PCOS, and 4.8, 2.8, and 2.3, respectively, per 1000 person-years for healthy control women. Women with PCOS had a higher hazard ratio of 1.224 (95% confidence interval, 1.18-1.27) of the composite cardiocerebrovascular diseases than those in the controls after propensity score matching for confounding variables, including body mass index, diabetes mellitus, hypertension, dyslipidemia, physical exercise level, alcohol consumption, current smoking, systolic and diastolic blood pressures, total cholesterol, and triglyceride levels. Hazard ratio for ischemic heart and cerebrovascular diseases was higher in women with PCOS than in the control group (hazard ratio, 1.254; 95% confidence interval, 1.20-1.31 and hazard ratio, 1.201; 95% confidence interval, 1.14-1.27, respectively). PCOS is associated with an increased risk of cardiocerebrovascular diseases in Korean women irrespective of their obesity. Counselling on the management of long-term risk of cardiovascular diseases should be offered to women with PCOS in East Asian countries where PCOS is characterized by a relatively low BMI.
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Affiliation(s)
- Ki-Jin Ryu
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Goryeodae-Ro, Seongbuk-Gu, Seoul, 02841, Republic of Korea
| | - Hyuntae Park
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Goryeodae-Ro, Seongbuk-Gu, Seoul, 02841, Republic of Korea.
| | - Min Sun Kim
- Department of Biostatistics, Korea University College of Medicine, 73 Goryeodae-Ro, Seongbuk-Gu, Seoul, 02841, Republic of Korea
| | - Hye Gyeong Jeong
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Goryeodae-Ro, Seongbuk-Gu, Seoul, 02841, Republic of Korea
| | - Tak Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Goryeodae-Ro, Seongbuk-Gu, Seoul, 02841, Republic of Korea
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Chen KJ, Huang JY, Wei JCC. Letter to the Editor: 'Maternal Polycystic Ovary Syndrome and the Risk of Early Childhood Obesity in Female Offspring: A Nationwide Population-Based Study'. J Korean Med Sci 2023; 38:e365. [PMID: 37846793 PMCID: PMC10578988 DOI: 10.3346/jkms.2023.38.e365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/27/2023] [Indexed: 10/18/2023] Open
Affiliation(s)
- Kuan-Jung Chen
- Division of Pediatric Genetics and Metabolism, Changhua Christian Children's Hospital, Changhua, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Jing-Yang Huang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
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Yang SW, Yoon SH, Kim M, Seo YS, Yuk JS. Risk of Gestational Diabetes and Pregnancy-Induced Hypertension with a History of Polycystic Ovary Syndrome: A Nationwide Population-Based Cohort Study. J Clin Med 2023; 12:jcm12051738. [PMID: 36902525 PMCID: PMC10003301 DOI: 10.3390/jcm12051738] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/20/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE To evaluate the risks of developing gestational diabetes (GDM) and pregnancy-induced hypertension (PIH) in women with polycystic ovary syndrome (PCOS) using data from Korea's National Health Insurance Service. METHOD The PCOS group comprised women aged 20 to 49 years diagnosed with PCOS between 1 January 2012, and 31 December 2020. The control group comprised women aged 20 to 49 years who visited medical institutions for health checkups during the same period. Women with any cancer within 180 days of the inclusion day were excluded from both the PCOS and control groups, as were women without a delivery record within 180 days after the inclusion day, as well as women who visited a medical institution more than once before the inclusion day due to hypertension, diabetes mellitus (DM), hyperlipidemia, DM in pregnancy, or PIH. GDM and PIH were defined as cases with at least three visits to a medical institution with a GDM diagnostic code and a PIH diagnostic code, respectively. RESULTS Overall, 27,687 and 45,594 women with and without a history of PCOS experienced childbirth during the study period. GDM and PIH cases were significantly higher in the PCOS group than in the control group. When adjusted for age, SES, region, CCI, parity, multiple pregnancies, adnexal surgery, uterine leiomyoma, endometriosis, PIH, and GDM, an increased risk of GDM (OR = 1.719, 95% CI = 1.616-1.828) was observed among women with a history of PCOS. There was no increase in the risk of PIH among women with a history of PCOS (OR = 1.243, 95% CI = 0.940-1.644). CONCLUSION A history of PCOS itself might increase the risk of GDM, but its relationship with PIH remains unclear. These findings would be helpful in the prenatal counseling and management of patients with PCOS-related pregnancy outcomes.
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Affiliation(s)
| | | | | | | | - Jin-Sung Yuk
- Correspondence: ; Tel.: +82-10-2928-1273; Fax: +82-504-274-1273
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Ryu KJ, Park H, Han YI, Lee HJ, Nam S, Jeong HG, Kim T. Effects of time-restricted feeding on letrozole-induced mouse model of polycystic ovary syndrome. Sci Rep 2023; 13:1943. [PMID: 36732546 PMCID: PMC9894941 DOI: 10.1038/s41598-023-28260-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 01/16/2023] [Indexed: 02/04/2023] Open
Abstract
The present study aimed to investigate whether time-restricted feeding (TRF) ameliorates metabolic and reproductive phenotypes in a letrozole-induced mouse model of polycystic ovary syndrome (PCOS). Sixty female C57BL/6 N mice were randomly divided into two groups according to the type of food received: either a chow or a 60% high-fat diet. Those mice were subcutaneously implanted with letrozole or placebo pellets at four weeks of age. Then, letrozole-treated mice were randomly assigned to different feeding regimens: (1) TRF for 4 h (ZT12-ZT16) or (2) ad libitum diet. After 4 weeks of dietary intervention, estrous cycles were determined with daily vaginal smear examination, and serial tail-tip blood sampling was performed at 5-min intervals for 2 h to measure the luteinizing hormone (LH) pulse frequency, amplitude, and mean LH levels in the diestrus cycle stage. Letrozole-treated mice in the ad libitum group demonstrated multiple PCOS-like phenotypes including ovulatory dysfunction, polycystic ovaries, and increased body weight, parametrial fat weight, adipocyte size and inflammation, and higher expression of Cyp17, Cyp19, and Fshr in the ovary, and Kiss1r and Gnrh in the hypothalamus, elevated serum testosterone levels, and more rapid and elevated LH pulsatility, with increased pulse frequency, amplitude, and mean levels in the diestrus stage, compared with the controls. After TRF for 4 weeks, those phenotypes reverted to normal levels in letrozole-treated mice, except the percentage of diestrus cycles indicating the arrest of estrous cycling which did not differ between the TRF and ad libitum groups. Our results demonstrate that TRF has therapeutic effects on the reproductive and metabolic phenotypes of a letrozole-induced mouse model of PCOS.
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Affiliation(s)
- Ki-Jin Ryu
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Goryeodae-Ro, Seongbuk-Gu, Seoul, 02841, Republic of Korea
| | - Hyuntae Park
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Goryeodae-Ro, Seongbuk-Gu, Seoul, 02841, Republic of Korea.
| | - Young In Han
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Goryeodae-Ro, Seongbuk-Gu, Seoul, 02841, Republic of Korea
| | - Hee Jung Lee
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Goryeodae-Ro, Seongbuk-Gu, Seoul, 02841, Republic of Korea
| | - Seunghyun Nam
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Goryeodae-Ro, Seongbuk-Gu, Seoul, 02841, Republic of Korea
| | - Hye Gyeong Jeong
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Goryeodae-Ro, Seongbuk-Gu, Seoul, 02841, Republic of Korea
| | - Tak Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Goryeodae-Ro, Seongbuk-Gu, Seoul, 02841, Republic of Korea
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Topaloglu O, Evren B, Uzun M, Yologlu S, Guldogan E, Sahin I. Is there a Relationship between Serum IGF-1 and Thyroid Nodule, Thyroid or Ovarian Volume in Polycystic Ovarian Syndrome? ACTA ENDOCRINOLOGICA-BUCHAREST 2021; 17:138-146. [PMID: 34539923 DOI: 10.4183/aeb.2021.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Context Studies investigating the association between serum IGF-1, and thyroid nodule, ovarian or thyroid volume in polycystic ovarian syndrome (PCOS) are limited. Objective We aimed to analyze the association between serum IGF-1 level, and ovarian or thyroid volume, or thyroid nodule in PCOS. Design The study was performed between June 2017 and August 2019 as prospective design. Subjects and Methods Adult females with new-onset PCOS were included. The patients having comorbid illness, or using medication were excluded. Basic tests, thyroid and ovarian sonography were performed. The patients were grouped according to thyroid nodule(absent/present) and ovarian volume (<10mL/≥10mL). We planned to find a positive association between IGF-1, and thyroid nodule, thyroid or ovarian volume in PCOS. Results Of total 118 patients, 11(9%) had thyroid nodule. The patients with thyroid nodule had a higher ovarian volume (p=0.006). No correlation was found between GH or IGF-1, and thyroid or ovarian volume. IGF-1 was not a predictor for thyroid nodule or higher ovarian volume. Thyroid nodule was a significant predictor for higher ovarian volume. Conclusion Our study is the first to analyze the association between IGF-1 and thyroid nodule in PCOS. We found that thyroid nodule was associated with thyroid and ovarian volume, but IGF-1 was not associated with thyroid nodule, thyroid or ovarian volume.
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Affiliation(s)
- O Topaloglu
- Kocaeli Derince Training and Research Hospital - Endocrinology, Kocaeli, Inonu University School of Medicine
| | | | - M Uzun
- University of Health Sciences, Izmir Suat Seren Chest Diseases and Surgery Training and Research Hospital - Intensive Care Unit, Izmir, Turkey
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Zaeemzadeh N, Sadatmahalleh SJ, Ziaei S, Kazemnejad A, Mottaghi A, Mohamadzadeh N, Movahedinejad M. Prevalence of metabolic syndrome in four phenotypes of PCOS and its relationship with androgenic components among Iranian women: A cross-sectional study. Int J Reprod Biomed 2020; 18:253-264. [PMID: 32494764 PMCID: PMC7218672 DOI: 10.18502/ijrm.v13i4.6888] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 10/15/2019] [Accepted: 10/21/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) increases the risk of metabolic syndrome (MetS). Insulin resistance (IR) plays a major role in the pathophysiology of both PCOS and MetS. OBJECTIVE This study was designed to compare the prevalence of MetS among different phenotypes of PCOS and its relationship with androgenic components. MATERIALS AND METHODS 182 participants eligible for this five-group comparative study were selected by convenience sampling method. They were classified according to the Rotterdam criteria: clinical and/or biochemical hyperandrogenism (H) + PCOS on ultrasound (P) + ovulation disorders (O) (n = 41), clinical and/or biochemical H + PCOS on P (n = 33), PCOS on P + O (n = 40), clinical and/or biochemical H + O (n = 37), and control (without PCOS) (n = 31). MetS was measured based on the National Cholesterol Education Program Adult Treatment Panel III criteria. Androgenic components included free-androgen-index (FAI), total-testosterone (TT) level and sex-hormone-binding-globulin (SHBG). RESULTS A significant difference was observed between the study groups in terms of MetS prevalence (p = 0.01). In phenotype H+P+O, there was a statistically significant positive association between TG and TT, and a significant negative association between SBP and DBP with SHBG. In phenotype O+P, WC was inversely associated with SHBG. In phenotype H+O, FBS and TG were positively associated with FAI but HDL was inversely associated with FAI. Moreover, WC and DBP were positively associated with TT in phenotype H+O. No associations were detected between MetS parameters and androgenic components in other PCOS subjects (phenotype H+P) and in the control group. TT was significantly higher in the PCOS group suffering from MetS (p = 0.04). CONCLUSION According to the research results, hyperandrogenic components are potent predictors of metabolic disorders. Thus, we suggest that MetS screening is required for the prevention of MetS and its related complications in PCOS women.
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Affiliation(s)
- Narges Zaeemzadeh
- Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | | | - Saeideh Ziaei
- Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Anoshirvan Kazemnejad
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Azadeh Mottaghi
- Research Center for Prevention of Cardiovascular Diseases, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
| | - Neda Mohamadzadeh
- Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Maryam Movahedinejad
- Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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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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Cao NT, Le MT, Nguyen VQH, Pilgrim J, Le VNS, Le DD, Pham CK, Aharon D, Hill MJ. Defining polycystic ovary syndrome phenotype in Vietnamese women. J Obstet Gynaecol Res 2019; 45:2209-2219. [PMID: 31435998 DOI: 10.1111/jog.14097] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 08/04/2019] [Indexed: 12/20/2022]
Abstract
AIM This study aimed to evaluate the unique phenotype of the Vietnamese polycystic ovarian syndrome (PCOS) population. METHODS In this multicenter cross-sectional descriptive study, a total of 901 reproductive-age women were recruited at three medical centers in Vietnam from June 2016 to May 2018. Group I included 479 patients with PCOS (Rotterdam 2003 consensus) and Group II included 422 non-PCOS women, consisted of women with regular menstrual cycle, collected at the same time of PCOS recruitment, without ovarian disease or ovarian failure. Main outcome measures were anthropomorphic, serum hormone, ultrasound and physical characteristics of PCOS. RESULTS The Vietnamese PCOS population was lean, but with a higher weight and body mass index compared to controls. About 34.4% of PCOS subjects had hirsutism, primarily confined to the leg, arm and pubis. The PCOS population had higher serum luteinizing hormone (LH), LH : follicle stimulating hormone ratio, anti-Mullerian hormone and testosterone. The PCOS population had double the ovarian volume compared to controls. PCOS subjects had no increase in metabolic disease history and had on average optimal serum markers for low metabolic disease risk. Group D (O + polycystic ovary morphology [PCOM]) was the most prevalent phenotype noted in our Vietnamese PCOS cohort (67.6%). Modified Ferriman-Gallwey, levels of LH, testosterone and anti-Mullerian hormone were highest in Group A (O + H + PCOM) and lowest in Group D (O + PCOM). CONCLUSION The Vietnamese PCOS population is characterized by a lean body type, nonfacial hirsutism, anovulatory, enlarged ovaries and typical PCOS serum hormone markers, low risk factors for metabolic syndrome. Nonclassical phenotypes for PCOS were more frequent than the classic phenotype.
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Affiliation(s)
- Ngoc Thanh Cao
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Minh Tam Le
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Vu Quoc Huy Nguyen
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Justin Pilgrim
- Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Viet Nguyen Sa Le
- Department of Obstetrics and Gynecology, Hue Central Hospital, Hue, Vietnam
| | - Dinh Duong Le
- Department of Public Health, Hue University of Medicine and Pharmacy, Hue, Vietnam
| | - Chi Kong Pham
- Department of Obstetrics and Gynecology, Danang Women and Children hospital, Danang, Vietnam
| | - Devora Aharon
- Department of OBGYN, Icahn School of Medicine, Mount Sinai, New York, USA
| | - Micah J Hill
- Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
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Sachdeva G, Gainder S, Suri V, Sachdeva N, Chopra S. Comparison of the Different PCOS Phenotypes Based on Clinical Metabolic, and Hormonal Profile, and their Response to Clomiphene. Indian J Endocrinol Metab 2019; 23:326-331. [PMID: 31641635 PMCID: PMC6683693 DOI: 10.4103/ijem.ijem_30_19] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To compare the different polycystic ovarian syndrome (PCOS) phenotypes based on their clinical, metabolic, hormonal profile, and their differential response to clomiphene. DESIGN Prospective observational study. SETTING Infertility clinic, a government hospital. SAMPLE SIZE 164 women with PCOS-related infertility. MATERIALS AND METHODS Sample population was divided into four phenotypes based on the NIH (National Institute of Health) consensus panel criteria. The incremental dose of clomiphene from 50 to 150 mg/day over three cycles was given. OUTCOME MEASURES Clinical history, metabolic, hormonal profile, and ultrasound features of each phenotype. Also, the response to clomiphene citrate was studied as presence or absence of ovulation. RESULTS The prevalence of phenotypes A, B, C, and D were 67.7%, 11%, 17.7%, and 3.6%, respectively. Phenotype A had significantly higher weight, body mass index, clinical, and biochemical hyperandrogenism, menstrual irregularities, ovarian reserve parameters, fasting insulin, HOMA-IR, and more deranged lipid profile (P < 0.05). Clomiphene resistance was significantly more common in phenotype A (P < 0.05). No significant differences were noted in the waist circumference, waist-hip ratio, blood pressure and blood sugar values (fasting, 1-hour postprandial, 2-hour postprandial). Also, the Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), LH-FSH ratio, 17-hydroxyprogesterone, and vitamin D levels were not significantly different among various PCOS phenotypes. CONCLUSION Full-blown PCOS (phenotype A) is at a higher risk of adverse metabolic and cardiovascular outcomes as compared with the others, and phenotype D is the least severe phenotype. Thus, the phenotypic division of patients with PCOS-related infertility can help in prognosticating the patients about the severity of the disease and the fertility outcome.
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Affiliation(s)
- Garima Sachdeva
- Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shalini Gainder
- Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vanita Suri
- Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Naresh Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Seema Chopra
- Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Purwanto B, Rtamagustini NNT, Dharmayanti HE. Waist Circumference as a Predictor for Menstrual Cycle Disturbance Among College Student. JURNAL NERS 2019. [DOI: 10.20473/jn.v13i2.8335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: Menstrual cycle disturbance is the sign of a reproductive health problem, yet the cause tends to be multifactorial. This study aimed to analyze the risk factors of menstrual cycle disturbance which related to nutrition status among college students.Methods: This was an observational analytical study with a cross-sectional approach. There were 59 participants taken as samples according to inclusion criteria using proportionate stratified random sampling. Data were analyzed with chi-square and multiple logistic regression test.Results: Results found that 35.6% of participants experienced menstrual cycle disturbance. Bivariate analysis showed significant correlation between body fat percentage (p= 0.038, OR: 2.417) and waist circumference (p= 0.003, OR: 2.956) with menstrual cycle disturbance, otherwise no correlation found between Body Mass Index (BMI) (p= 0.052, OR: 2.145), subcutaneous fat thickness (p= 1, OR: 1.279), and total cholesterol levels (p= 1, OR: 1.063) with menstrual cycle disturbance. Multiple logistic regression analysis showed that waist circumference became determinant factor among other variables predicting menstrual cycle disturbance in this study (p= 0.002, OR: 7.260).Conclusion: Waist circumference and body fat percentage were both risk factors of menstrual cycle disturbance, yet waist circumference was found being a determinant predictor to predict menstrual cycle disturbance among college student. Female students may pay particular attention to their waist circumference for detection of reproductive health problem earlier, especially regarding menstruation cycle disturbance.
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Sachdeva G, Gainder S, Suri V, Sachdeva N, Chopra S. Obese and Non-obese Polycystic Ovarian Syndrome: Comparison of Clinical, Metabolic, Hormonal Parameters, and their Differential Response to Clomiphene. Indian J Endocrinol Metab 2019; 23:257-262. [PMID: 31161114 PMCID: PMC6540884 DOI: 10.4103/ijem.ijem_637_18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To study the clinical, metabolic, hormonal parameters, and differential response to clomiphene among the obese and non-obese PCOS (polycystic ovarian syndrome). DESIGN Prospective observational study. SETTING Infertility OPD, a government hospital. SAMPLE SIZE About 164 women with PCOS-related infertility. STUDY GROUPS Obese PCOS group [body mass index (BMI) ≥23 kg/m2) and non-obese PCOS group (BMI <23 kg/m2). RESULTS Of the total 164 PCOS women, 124 (75.61%) were in the obese group with BMI ≥23 kg/m2 and 40 (24.39%) were in the non-obese PCOS group. The prevalence of menstrual irregularity, hypertension, insulin resistance (IR), metabolic syndrome, endometrial hyperplasia, and clomiphene resistance in the PCOS women were 82.34%, 3.66%, 59.76%, 24.39%, 7.93%, and 53.7%, respectively. The Ferriman-Gallwey score, menstrual irregularity, IR [fasting insulin and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)], metabolic syndrome, deranged lipid profile, and clomiphene resistance were statistically more common in the obese PCOS group (P < 0.05). Hypertension, deranged blood sugar profile, testosterone, androstenedione levels, and endometrial hyperplasia were more common in obese PCOS group but the results were not statistically significant. No significant differences were found in the luteinizing hormone (LH), follicle-stimulating hormone (FSH), LH-FSH ratio, and 17-hydroxyprogesterone (17-OHP) levels between the two groups. CONCLUSION Obese PCOS have a higher risk of adverse outcomes like hypertension, IR, metabolic syndrome, and endometrial hyperplasia. So, targeting obesity in PCOS women will not only help to prevent adverse outcomes but also improve responsiveness to clomiphene citrate.
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Affiliation(s)
- Garima Sachdeva
- Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shalini Gainder
- Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vanita Suri
- Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Naresh Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Seema Chopra
- Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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14
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Yanes Cardozo LL, Romero DG, Reckelhoff JF. Cardiometabolic Features of Polycystic Ovary Syndrome: Role of Androgens. Physiology (Bethesda) 2018; 32:357-366. [PMID: 28814496 DOI: 10.1152/physiol.00030.2016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 05/08/2017] [Accepted: 05/08/2017] [Indexed: 01/09/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder that affects reproductive-age women. Hyperandrogenemia is present in a significant fraction (~80%) of women with PCOS. Increased prevalence of cardiometabolic risk factors is frequently observed in PCOS women. The present review aims to highlight the key role of androgens in mediating the negative cardiometabolic profile observed in PCOS women.
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Affiliation(s)
- Licy L Yanes Cardozo
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi; .,Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi.,Women's Health Research Center, University of Mississippi Medical Center, Jackson, Mississippi; and.,Cardio Renal Research Center, University of Mississippi Medical Center, Jackson, Mississippi
| | - Damian G Romero
- Department of Biochemistry, University of Mississippi Medical Center, Jackson, Mississippi; .,Department of Biochemistry, University of Mississippi Medical Center, Jackson, Mississippi.,Cardio Renal Research Center, University of Mississippi Medical Center, Jackson, Mississippi
| | - Jane F Reckelhoff
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi.,Department of Biochemistry, University of Mississippi Medical Center, Jackson, Mississippi.,Department of Biochemistry, University of Mississippi Medical Center, Jackson, Mississippi.,Cardio Renal Research Center, University of Mississippi Medical Center, Jackson, Mississippi
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15
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Hallajzadeh J, Khoramdad M, Karamzad N, Almasi-Hashiani A, Janati A, Ayubi E, Pakzad R, Sullman MJM, Safiri S. Metabolic syndrome and its components among women with polycystic ovary syndrome: a systematic review and meta-analysis. J Cardiovasc Thorac Res 2018; 10:56-69. [PMID: 30116503 PMCID: PMC6088762 DOI: 10.15171/jcvtr.2018.10] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 04/27/2018] [Indexed: 01/24/2023] Open
Abstract
Introduction: The objectives of this study were to provide an estimate of the prevalence of metabolic syndrome (MetS ) and its components among women with PCOS; and calculate the odds ratio (OR) for MetS (using different definitions of MetS) in women with PCOS, compared to healthy controls.
Methods: All of the relevant databases were used to search for appropriate articles that were published during the period 2003-2016. We included observational studies (cross-sectional, comparative cross-sectional) among women who met the inclusion criteria. The random-effect models were used to pool the prevalence of MetS and its components among PCOS women. This model was also applied to the pooled OR assessing the association between MetS and PCOS.
Results: The pooled prevalence of MetS among PCOS women was found to be 26.30% (95% CI: 23.68–28.93), but varied from 7.10% (95% CI: 1.64-12.56) to 37.50% (95% CI: 28.84-46.16), depending upon the diagnostic criteria used. Low high-density lipoprotein cholesterol (HDL) - 61.87% (95% CI: 53.31–70.43) and high waist circumference (WC)- 52.23% (95% CI: 43.84–60.61) were the most common components of MetS in PCOS women. Compared to healthy controls, the overall pooled (OR) of MetS in PCOS patients was 2.09 (95% CI: 1.67-2.60), but this ranged from 0.31 (95% CI: 0.13-0.74) to 4.69 (95% CI: 2.09-10.52), depending upon the diagnostic criteria used.
Conclusion: Women with PCOS had a much higher prevalence of MetS than was found among the healthy controls. Furthermore, as low HDL and high WC were the most common components of MetS in PCOS women, these two components specifically need to be addressed in prevention strategies.
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Affiliation(s)
- Jamal Hallajzadeh
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Maliheh Khoramdad
- Department of Epidemiology and Biostatistics, Faculty of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nahid Karamzad
- Nutrition Research Center, Department of Biochemistry and Diet Therapy, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Almasi-Hashiani
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Ali Janati
- Iranian Center of Excellence in Health Management, Department of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Erfan Ayubi
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Pakzad
- Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Mark J M Sullman
- Middle East Technical University, Northern Cyprus Campus, Güzelyurt/Morphou, Northern Cyprus
| | - Saeid Safiri
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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16
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Abbasi-Ranjbar Z, Sharami SH, Kazemi S, Sayyad-Abdi D, Dalil Heirati SF. The Relation Between Free Testosterone and Components of Metabolic Syndrome in Women With Polycystic Ovary Syndrome. J Family Reprod Health 2018; 12:1-7. [PMID: 30647752 PMCID: PMC6329990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective: To assess the relationship between free testosterone level and components of MS in women with PCOS. Materials and methods: This is a cross-sectional study which was conducted on 215 women with PCOS. PCOS was diagnosed based on the Rotterdam criteria. Patients were divided into two subgroups of patients with and without MS based on ATP III criteria. In each subgroup, the association between individual components of MS with free testosterone was measured. Data were analyzed using SPSS software. Results: The prevalence of MS was 28.8% (n = 62). The mean level of free testosterone in patients with blood pressure ≥ 130/85 was significantly higher than those with blood pressure < 130/85 mm/hg. (p = 0.029) Also, in patients with diastolic blood pressure ≥ 85, the level of free testosterone was significantly higher than patients with diastolic blood pressure < 85. (p = 0.026). Results showed significant positive correlation between the level of free testosterone and cholesterol (p = 0.024). But no significant correlation was noted between levels of free testosterone and other variables. Conclusion: Regarding the relationship between blood pressure and high levels of free testosterone, it seems that regular blood pressure screening has a higher priority of concern comparing other complications for preventing cardiovascular adverse effects in women with PCOS and hyperandrogenism.
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Affiliation(s)
- Zahra Abbasi-Ranjbar
- Department of Endocrinology and Metabolism, Reproductive Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Seyedeh Hajar Sharami
- Reproductive Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Soudabeh Kazemi
- Reproductive Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Deswal R, Yadav A, Dang AS. Sex hormone binding globulin - an important biomarker for predicting PCOS risk: A systematic review and meta-analysis. Syst Biol Reprod Med 2017; 64:12-24. [PMID: 29227165 DOI: 10.1080/19396368.2017.1410591] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Sex hormone-binding globulin (SHBG) is a glycoprotein which regulates bioavailability of sex steroid hormones. Interest in SHBG has escalated in recent years because of its inverse association with polycystic ovary syndrome (PCOS), obesity, insulin resistance, metabolic syndrome, and diabetes type II. This meta-analysis was performed to examine the associations of SHBG with PCOS and to correlate serum SHBG levels with various PCOS associated endocrine and metabolic dysregulation as well as to determine the effects of various therapeutic agents on serum SHBG levels in PCOS patients in order to assess the true accuracy of SHBG in the prediction of PCOS. A literature search was performed using Pub-Med, Science direct, google scholar, EMBASE, and Cochrane library. A total of 675 relevant records were identified, of which 62 articles were included. Meta-analysis using a random-effects model was performed using STATA version 13 to calculate standardized mean difference (SMD) with 95% confidence intervals (95 % CIs). SHBG levels in controls were significantly higher than that of PCOS patients (SMD= -0.83, 95%CI = -1.01, -0.64), with significant heterogeneity across studies (I2= 93.9% and p=0.000). Our results suggest that the lower serum SHBG levels are associated with the risk of PCOS. SHBG may also play an important role in various metabolic disturbances in PCOS patients. Therapeutic interventions improved SHBG levels in PCOS women which further reduced PCOS associated complications. Therefore, SHBG levels may prove to be a useful biomarker for the diagnosis and treatment of PCOS. Systematic review registration: PROSPERO CRD42017057972 Abbreviations: PCOS: polycystic ovary syndrome; SHBG: sex hormone-binding globulin.
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Affiliation(s)
- Ritu Deswal
- a Centre for Medical Biotechnology, Maharshi Dayanad University , Haryana , India
| | - Arun Yadav
- b All India Institute of Medical Sciences , New Delhi , India
| | - Amita Suneja Dang
- a Centre for Medical Biotechnology, Maharshi Dayanad University , Haryana , India
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18
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Ko KM, Han K, Chung YJ, Yoon KH, Park YG, Lee SH. Association between Body Weight Changes and Menstrual Irregularity: The Korea National Health and Nutrition Examination Survey 2010 to 2012. Endocrinol Metab (Seoul) 2017; 32:248-256. [PMID: 28685514 PMCID: PMC5503870 DOI: 10.3803/enm.2017.32.2.248] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 03/16/2017] [Accepted: 03/28/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Menstrual irregularity is an indicator of endocrine disorders and reproductive health status. It is associated with various diseases and medical conditions, including obesity and underweight. We aimed to assess the association between body weight changes and menstrual irregularity in Korean women. METHODS A total of 4,621 women 19 to 54 years of age who participated in the 2010 to 2012 Korea National Health and Nutrition Examination Survey were included in this study. Self-reported questionnaires were used to collect medical information assessing menstrual health status and body weight changes. Odds ratios (ORs) and 95% confidence interval (CI) were calculated to evaluate the association between body weight changes and menstrual irregularity. RESULTS Significantly higher ORs (95% CI) were observed in the association between menstrual irregularity and both weight loss (OR, 1.74; 95% CI, 1.22 to 2.48) and weight gain (OR, 1.45; 95% CI, 1.13 to 1.86) after adjusting for age, body mass index, current smoking, heavy alcohol drinking, regular exercise, calorie intake, education, income, metabolic syndrome, age of menarche, parity, and stress perception. Of note, significant associations were only observed in subjects with obesity and abdominal obesity, but not in non-obese or non-abdominally obese subjects. U-shaped patterns were demonstrated in both obese and abdominally obese subjects, indicating that greater changes in body weight are associated with higher odds of menstrual irregularity. CONCLUSION We found a U-shaped pattern of association between body weight changes and menstrual irregularity among obese women in the general Korean population. This result indicates that not only proper weight management but also changes in body weight may influence the regulation of the menstrual cycle.
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Affiliation(s)
- Kyung Min Ko
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyungdo Han
- Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Youn Jee Chung
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kun Ho Yoon
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong Gyu Park
- Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| | - Seung Hwan Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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19
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Yang R, Yang S, Li R, Liu P, Qiao J, Zhang Y. Effects of hyperandrogenism on metabolic abnormalities in patients with polycystic ovary syndrome: a meta-analysis. Reprod Biol Endocrinol 2016; 14:67. [PMID: 27756332 PMCID: PMC5069996 DOI: 10.1186/s12958-016-0203-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 10/12/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The study evaluated the effect of hyperandrogenism (HA) in polycystic ovary syndrome (PCOS) on metabolic parameters. METHODS We searched PubMed, EMBASE, Cochrane, Web of Science, Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), WanFang data and VIP for clinical observational studies. The study evaluated PCOS patients with or without HA on metabolic parameters was included. Prevalence of metabolic syndrome, indexes of insulin resistance (IR) including homeostasis model assessment IR index (HOMA-IR), incidence of IR, biomarkers of serum lipid metabolism such as total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), and low density lipoprotein (LDL). RESULTS Of 4457 identified trials, 32 observational studies were included for the final analysis comprising 9556 female with PCOS. 6482 cases were having HA, and the others were negative. There were significant differences in the incidence of metabolic syndrome, HOMA-IR, rate of IR, TC level and HDL level between PCOS patients with or without HA, except for LDL level. No significant publication bias was found as P value of Egger's test was 0.82. CONCLUSIONS HA play an important role in metabolic disorders in PCOS patients. The incidence of metabolic syndrome, IR indexes, and most biomarkers of serum lipid metabolism were significantly different between patients with and without HA.
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Affiliation(s)
- Rui Yang
- Reproductive Medical Center, Peking University Third Hospital, No 49, North Huayuan Road, Haidian District, Beijing, 100191, China
| | - Shuo Yang
- Reproductive Medical Center, Peking University Third Hospital, No 49, North Huayuan Road, Haidian District, Beijing, 100191, China
| | - Rong Li
- Reproductive Medical Center, Peking University Third Hospital, No 49, North Huayuan Road, Haidian District, Beijing, 100191, China.
| | - Ping Liu
- Reproductive Medical Center, Peking University Third Hospital, No 49, North Huayuan Road, Haidian District, Beijing, 100191, China
| | - Jie Qiao
- Reproductive Medical Center, Peking University Third Hospital, No 49, North Huayuan Road, Haidian District, Beijing, 100191, China
| | - Yanwu Zhang
- Institute of Medical Information (IMI) & Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
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20
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Yuan C, Liu X, Mao Y, Diao F, Cui Y, Liu J. Polycystic ovary syndrome patients with high BMI tend to have functional disorders of androgen excess: a prospective study. J Biomed Res 2016; 30:197-202. [PMID: 27526961 PMCID: PMC4885167 DOI: 10.7555/jbr.30.20140111] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 09/03/2014] [Accepted: 02/12/2016] [Indexed: 12/29/2022] Open
Abstract
Biochemical or clinical changes of hyperandrogenism are important elements of polycystic ovary syndrome (PCOS). There is currently no consensus on the definition and diagnostic criteria of hyperandrogenism in PCOS. The aim of this study was to investigate the complex symptoms of hyperandrogenic disorders and the correlations between metabolism and hyperandrogenism in patients with PCOS from an outpatient reproductive medicine clinic in China. We conducted a case control study of 125 PCOS patients and 130 controls to evaluate differences in body mass index (BMI), total testosterone (TT), modified Ferriman-Gallwey hirsutism score, sex hormone binding globulin (SHBG), homeostasis model assessment-estimated insulin resistance (HOMA-IR) and free androgen index (FAI) between PCOS patients and controls and subgroups of PCOS. The prevalence of acne and hirsutism did not differ significantly between the hyperandrogenic and non-hyperandrogenic subgroup. Patients with signs of hyperandrogenism had significantly higher BMI (P < 0.05), but differences in TT, SHBG, FAI and waist/hip ratio were insignificant. The odds ratio of overweight was calculated for all PCOS patients. Our results suggest that PCOS patients with high BMI tend to have functional disorders of androgen excess; therefore, BMI may be a strong predictor of hyperandrogenism in PCOS.
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Affiliation(s)
- Chun Yuan
- The State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210036, China
| | - Xiaoqiang Liu
- The State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210036, China
| | - Yundong Mao
- The State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210036, China
| | - Feiyang Diao
- The State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210036, China
| | - Yugui Cui
- The State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210036, China
| | - Jiayin Liu
- The State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210036, China.
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Salehpour S, Nazari L, Hoseini S, Saharkhiz N, Ghazi F, Sohrabi MR. A Potential Therapeutic Role of Myoinositol in the Metabolic and Cardiovascular Profile of PCOS Iranian Women Aged between 30 and 40 Years. Int J Endocrinol 2016; 2016:7493147. [PMID: 27648072 PMCID: PMC5014950 DOI: 10.1155/2016/7493147] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 08/03/2016] [Indexed: 01/11/2023] Open
Abstract
Introduction. Polycystic ovary syndrome (PCOS) is a common disorder in reproductive age. This pilot study investigated the effects of myoinositol (MI) treatment on metabolic and cardiovascular profile in PCOS women over 30 years of age. Methods. Between 2015 and 2016, 50 women with diagnosis of PCOS by the Rotterdam Criteria were included in the study. All women received MI 2 g plus 200 μg of folic acid (Inofolic, Health Parsian, Iran; twice daily) for 3 months. Baseline and 3-month serum samples were taken after an overnight fast to evaluate the insulin resistance index (HOMA-IR), fasting glucose, and the levels of triglyceride, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), homocysteine, systolic blood pressure, and diastolic blood pressure. Participants' weight was measured before and after treatment and body mass index (BMI) was calculated. Results. The data showed a significant improvement in the serum level of insulin sensitivity and a reduction of cholesterol, LDL, and homocysteine after three months of treatment. Furthermore, blood pressure was significantly reduced in the treated patients. Three participants became pregnant during treatment. Conclusion. Results showed that supplementation with MI and folic acid in PCOS patients over 30 years of age could decrease the risk of cardiovascular problems by normalizing the metabolic profile.
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Affiliation(s)
- Saghar Salehpour
- Department of Obstetrics and Gynecology, Preventive Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Nazari
- Department of Obstetrics and Gynecology, Preventive Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- *Leila Nazari:
| | - Sedighe Hoseini
- Department of Obstetrics and Gynecology, Preventive Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Saharkhiz
- Department of Obstetrics and Gynecology, Preventive Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Ghazi
- Department of Obstetrics and Gynecology, Preventive Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Sohrabi
- Department of Obstetrics and Gynecology, Preventive Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Glueck CJ, Woo JG, Khoury PR, Morrison JA, Daniels SR, Wang P. Adolescent oligomenorrhea (age 14-19) tracks into the third decade of life (age 20-28) and predicts increased cardiovascular risk factors and metabolic syndrome. Metabolism 2015; 64:539-53. [PMID: 25633270 DOI: 10.1016/j.metabol.2015.01.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 12/22/2014] [Accepted: 01/06/2015] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Assess whether adolescent oligomenorrhea (age 14-19) tracks into young adulthood (age 20-28) and predicts increased cardiometabolic risk factors, metabolic syndrome (MetS), and impaired fasting glucose-type II diabetes mellitus (IFG+T2DM). MATERIALS AND METHODS Prospective study of menstrual cyclicity and its metabolic effects in 865 black and white schoolgirls from age 9 to 19, and 605 of these 865 girls from age 20 to 28. MAIN FINDINGS Patterns of menstrual delays (oligomenorrhea) during ages 14-19 and ages 20-28 were closely related (p<.0001). Adolescent menses delay (ages 14-19, p<.0001), mean insulin (ages 20-28, p=.0003), and self-identified polycystic ovary syndrome (PCOS, p=.049) predicted ages 20-28 menses delay. Menses delays during ages 14-19 and 20-28, and, their interaction product were correlated with IFG+T2DM and MetS at ages 20-28. Waist circumference (ages 20-28, p<.0001), mean triglyceride (ages 20-28, p=.005), and the number of average menstrual cycles≥42 days (ages 20-28, p=.04) predicted IFG+T2DM (ages 20-28). MetS (ages 9-19, p<.0001), mean insulin (ages 20-28, p=.0002), the number of ≥42 day gaps between menstrual periods (ages 20-28, p=.02), and cigarette smoking at age 18-19 (p=.04) were significant explanatory variables for MetS at ages 27-28. As MetS status category changed from age 14-19 to 27-28 from best to worst: (no → no), (yes → no), (yes → yes), (no → yes), the number of women with ≥2 menses delays during ages 20-28 rose from 3% to 4% to 15% to 17%, p=.0001. MetS status change from age 9-19 to 27-28 was positively associated with mean insulin (age 20-28, p<.0001), cigarette smoking (age 24-25, p=.01) and the number of menses delays during ages 20-28 (p=.04). PRINCIPAL CONCLUSIONS Menstrual patterns track from adolescence to young adulthood, and oligomenorrhea predicts MetS and IFG+T2DM. Patterns of menses delays in adolescence should be considered as a significant risk factor for future development of young adult IFG+T2DM, MetS, oligomenorrhea, and polycystic ovary syndrome.
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Affiliation(s)
- Charles J Glueck
- Cholesterol Metabolism Thrombosis Center Jewish Hospital of Cincinnati, Cincinnati, OH.
| | - Jessica G Woo
- Heart Institute the Division of Biostatistics Epidemiology Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Philip R Khoury
- Heart Institute the Division of Biostatistics Epidemiology Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - John A Morrison
- Heart Institute the Division of Biostatistics Epidemiology Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | | | - Ping Wang
- Cholesterol Metabolism Thrombosis Center Jewish Hospital of Cincinnati, Cincinnati, OH
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