HMGB1 is increased in adolescents with polycystic ovary syndrome (PCOS) and decreases after treatment with myo-inositol (MYO) in combination with alpha-lipoic acid (ALA)

PCOS treatment should be based on pathophysiology. High-mobility-group-box-1 (HMGB1) was shown to increase in PCOS patients as a consequence of reduced cystic-fibrosis-transmembrane-conductance-regulator (CFTR) expression in the ovary, and was associated with insulin resistance and inflammation, both features of PCOS. Inositols and ALA derivatives could have positive effects on insulin sensitivity, reduce androgens, and improve ovulation rhythm. The aim of this study was to verify changes in HMGB1, in metabolic and endocrine parameters in adolescents with PCOS compared with controls and after treatment with a combination of MYO + ALA. Twenty-three PCOS adolescents and 21 controls matched for age and BMI were enrolled. In all subjects, metabolic and hormonal parameters were assayed. Homeostatic index (HOMA-IR) and the triglyceride/HDL-cholesterol ratio were calculated. Ovarian volumes were evaluated. Patients were treated with MYO + ALA for 6 months. HMGB1 was measured using a specific ELISA assay. HMGB1 was increased in PCOS compared with controls (19.76 ± 5.99 versus 5.65 ± 1.88 ng/ml; p < .05) and normalized after treatment (2.27 ± 0.36 ng/ml, p < .05). Treatment significantly reduced insulin (24.0 ± 4.11 versus 12.13 ± 2.13 uU/ml), HOMA-IR (3.91 ± 0.41 versus 2.42 ± 0.45), and 17-hydroxyprogesterone (1.20 ± 0.15 versus 0.78 ± 0.11 ng/ml). Cholesterol, luteinizing hormone, 17-β-estradiol, delta 4-androstenedione, and testosterone were unchanged. Circulating HMGB1 was increased in PCOS adolescents, and treatment was effective in normalizing HMGB1.

Current Knowledge on Endocrine Disrupting Chemicals (EDCs) from Animal Biology to Humans, from Pregnancy to Adulthood: Highlights from a National Italian Meeting

Wildlife has often presented and suggested the effects of endocrine disrupting chemicals (EDCs). Animal studies have given us an important opportunity to understand the mechanisms of action of many chemicals on the endocrine system and on neurodevelopment and behaviour, and to evaluate the effects of doses, time and duration of exposure. Although results are sometimes conflicting because of confounding factors, epidemiological studies in humans suggest effects of EDCs on prenatal growth, thyroid function, glucose metabolism and obesity, puberty, fertility, and on carcinogenesis mainly through epigenetic mechanisms. This manuscript reviews the reports of a multidisciplinary national meeting on this topic.

Glucose tolerance and insulin release in adolescent female

The increase in insulin requirement at the onset of adolescence is compensated by an increase of insulin secretion. This metabolic pattern persists during adolescence but is no longer present in adults. It is supposed to depend on a decrease of insulin sensitivity of uncertain origin. We compared the metabolic pattern of late adolescent girls (13-16 year old) with young women (21-30 year old) with similar body mass indexes, testing subjects with iv glucose tolerance test (IVGTT) (glucose 0.33 g/kg) and arginine test (ATT) (arginine 30 g in 30 min). In late adolescent vs adult women we observed: i) IVTT: similar k of glucose tolerance and higher insulin and C-peptide responses; ii) ATT: unmodified plasma glucose, insulin and glucagon values, higher GH plasma levels; iii) in adolescent girls GH and CPR incremental areas significantly correlated (r = 0.755, p less than 0.05). These data show that: i) the adolescent pattern of glucose metabolism persists after completion of sexual development and, ii) there is a positive correlation between GH response to arginine and beta-cell response to glucose. So GH should play a role in the impairment of glucose metabolism during adolescence.

Human reproduction and a D.D.D. (determination, differentiation, development) pathogenetical classification of genital anomalies in phenotypic females

Analysing 90 cases of different genital anomalies in phenotypic females a new pathogenetical classification is presented. The different anomalies are classified in 5 groups of disorders in the steps of genital development: gonadal determination, differentiation and development, genital ducts differentiation and development. Symptoms in reproductive age, diagnostic approach and therapeutic possibilities with particular attention to assisted reproduction are presented.

[Effects of body weight changes on menarche and menstrual cycles in a group of adolescents]

In Italian girls (7-17 years-old) the effects of body weight on the onset of menarche and on menstruation were studied on the basis of measurements performed in 86 normally developed healthy girls (group 1), in 5 girls affected by precocious puberty (group 2), and in 9 girls with delayed puberty (group 3). Height and weight were evaluated at menarche in all groups, as well as 2 years later in groups 2 and 3. The results were transferred on the graphs proposed by Frisch for the American girls: at menarche 20% of group 1 girls were out of range; in group 2 all girls were in range; 33% of group 3 were below the 10th percentile. Two years later, all groups 2 and 3 girls but one were in range. These data do not confirm the role of body fat in determining the onset of the puberal process, while they support it in the maintenance of menses.

Uterus didelphys with an obstructed hemivagina and ipsilateral renal agenesis in teenagers: report of three cases

Gynecologic and urinary congenital malformations are often associated and mostly diagnosed in teenagers. To update a 116-case international case registry, three cases of uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis, detected in young girls, are reported. Diagnostic procedures and surgical treatment are discussed.