Differential Effects of Various Androgens on Polycystic Ovary Syndrome

Author(s):  
Sebastião Freitas de Medeiros ◽  
Bruna Barcelo Barbosa ◽  
Ana Karine Lin Winck Yamamoto de Medeiros ◽  
Matheus Antônio Souto de Medeiros ◽  
Márcia Marly Winck Yamamoto

AbstractThe hyperandrogenism in polycystic ovary syndrome (PCOS) is associated with the risk for the future development of the cardiovascular disease. The objective of the study is to verify whether different androgens have the same harmful effect. This cross-sectional study enrolled 823 women with PCOS: 627 (76.2%) with biochemical hyperandrogenism and 196 (23.8%) with normal androgen levels. The role of individual androgen was evaluated using univariate and multivariate logistic regression. In normoandrogenemic PCOS (NA-PCOS), free androgen index (FAI) predicted significant abnormality in visceral adipose index (VAI, OR=9.2, p=0.002) and dehydroepiandrosterone (DHEA) predicted against alteration in β-cell function (OR=0.5, p=0.007). In hyperandrogenemic PCOS (HA-PCOS), FAI predicted derangements in waist triglyceride index (WTI), VAI, and lipid accumulation product (LAP) (OR ranging from 1.6 to 5.8, p<0.05). DHEA weakly predicted against VAI (OR 0.7, p=0.018), dehydroepiandrosterone sulfate (DHEAS) tended to predict against the conicity index (OR=0.7, p=0.037). After multiple regression, FAI retained significant strength to predict various anthropometric and metabolic abnormalities (OR ranging from 1.1 to 3.0, p<0.01), DHEA was kept as a protector factor against WTI, LAP, and VAI (OR ranging from 0.6 to 0.9; p<0.01) and DHEAS against the conicity index (OR=0.5, p<0.001). In conclusion, the free androgen index was the most powerful predictor of anthropometric and metabolic abnormalities of polycystic ovary syndrome. Conversely, DHEA and DHEAS demonstrated protective effects against disorders in some markers of obesity and abnormal metabolism.

2014 ◽  
Vol 171 (3) ◽  
pp. 301-309 ◽  
Author(s):  
Sarantis Livadas ◽  
Anastasios Kollias ◽  
Dimitrios Panidis ◽  
Evanthia Diamanti-Kandarakis

BackgroundPolycystic ovary syndrome (PCOS) represents a moving spectrum of hormonal to metabolic abnormalities, as women with the syndrome are aging. Hormonal abnormalities, anovulation, and hyperandrogenic signs were predominant during the early years of PCOS and fade away with the years. Metabolic abnormalities and insulin resistance (IR) remain throughout the PCOS life cycle; however, it is unclear as to how they change, as women with the syndrome are aging.ObjectiveTo evaluate the changes in IR and its associations with clinical, biochemical, hormonal, and ultrasound findings in a large cohort of women with PCOS and controls, as they are aging.DesignA cross-sectional study was carried out to evaluate the diverse impacts of aging on IR.SettingAn outpatient clinic was chosen for the study.ParticipantsA total of 1345 women with PCOS (Rotterdam criteria) and 302 controls of Caucasian origin and Greek ethnicity comprised the study group.Main outcome and measuresThe impact of age on IR, as calculated using homeostasis model assessment of IR (HOMA-IR) index, and several PCOS characteristics were evaluated.ResultsIn PCOS, age (−0.045±0.008) was negatively, and BMI positively (0.18±0.007) associated with HOMA-IR (R2=0.36). When data were stratified with regard to the BMI status, a negative association of age with HOMA-IR was found in lean, normal, and overweight patients (r: −0.266, −0.233, −0.192, P<0.001), which was neutralized in obese patients (r: −0.009, P: NS). Free androgen index and BMI were positively associated with HOMA-IR in all age quartiles. When mean HOMA-IR values were plotted according to BMI subgroups at different age quartiles, a significant gradual decrease in HOMA-IR was observed in normal (P<0.001) and overweight (P: 0.004), but not obese, women (P: 0.202) across age quartiles.ConclusionsAging increases IR in obese but not in lean and overweight women with PCOS. As BMI and androgens are positively associated with HOMA-IR and androgens decline through time, it appears that if women with PCOS do not become obese they may exhibit a better metabolic profile during their reproductive years.


2021 ◽  
Vol 12 ◽  
Author(s):  
Mohammed Altigani Abdalla ◽  
Harshal Deshmukh ◽  
Irfaan Mohammed ◽  
Stephen Atkin ◽  
Marie Reid ◽  
...  

Purpose: Free androgen index (FAI) and anti-Mullerian hormone (AMH) are independently associated with polycystic ovary syndrome (PCOS). This study aimed to describe the relationship between these two markers and health-related quality of life (HR-QoL) in women with PCOS.Methods: This cross-sectional study consisted of 81 women in the Hull PCOS biobank, who fulfilled the Rotterdam consensus criteria for the diagnosis of PCOS. The primary outcome was to measure the various domains of the QoL in the modified polycystic ovary syndrome questionnaire (MPCOSQ).Results: Mean age of the study participants was 28 ± 6.0 years, mean body mass index (BMI) 33.5 ± 7.8 kg/m2, mean FAI (6 ± 5.5), free testosterone (2.99 ± 0.75) and mean AMH (3.5 ± 0.8 units). In linear regression analysis, the FAI was associated with overall mean MPCOSQ score (Beta = 0.53, P-value = 0.0002), and with depression (Beta = 0.45, P-value = 0.01), hirsutism (Beta = 0.99, P-value = 0.0002) and menstrual irregularity (Beta = 0.31, P-value = 0.04). However, with adjustment for age and BMI, FAI was only associated with the hirsutism domain (Beta = 0.94, P-value = 0.001) of the MPCOSQ. FAI was also associated with the weight domain (Beta = 0.63 P-value = 0.005) of MPCOSQ. However, AMH was not associated with the overall mean MPCOSQ score or with any of its domains.Conclusion: FAI but not AMH was associated with QoL in women with PCOS, and this effect was mediated by BMI.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Deng Yan ◽  
Wang Yan-Fang ◽  
Zhu Shi-Yang ◽  
Ma Rui-Lin ◽  
Ding Xue-Song ◽  
...  

Abstract Background To describe the diagnostic criteria used and their application accuracy in the practice of polycystic ovary syndrome (PCOS) caring among obstetricians and gynaecologists across China. Methods This was an Online cross-sectional survey of Obstetricians and gynecologists involved in PCOS caring conducted via the largest continuing education platform of obstetrics and gynecology across China from September 2019 to November 2019. Results A total of 2,328 respondents were eligible for the final analysis. Of these, 94.5 % were general obstetricians and gynaecologists (Ge-ObGyn), and 5.5 % were reproductive endocrinologists (Re-ObGyn). Overall, the most frequently used criteria were the Androgen Excess and Polycystic Ovary Syndrome Society (AE-PCOS) criteria (48.2 %), followed by the Rotterdam criteria (35.7 %) and NIH criteria (12.1 %). Of the respondents, 31.3 % used their diagnostic criteria in their clinical practice. More respondents who chose the Rotterdam criteria could accurately apply the diagnostic criteria than those who chose the AE-PCOS criteria (41.2 % vs. 32.1 %, P < 0.001). Compared with Ge-ObGyn, Re-ObGyn were less likely to use the AE-PCOS criteria (adjusted odds ratio, 0.513; 95 % CI, 0.328–0.802; P < 0.05) and 1.492 times more likely to accurately use their criteria (95 % CI, 1.014–2.196; P < 0.05). Conclusions Less than one-third of obstetricians and gynaecologists across China could accurately use the diagnostic criteria they choose to diagnose PCOS. There is an urgent need to train obstetricians and gynaecologists on PCOS diagnosis in an effort to improve the medical care quality of patients with PCOS.


Author(s):  
Dimitrios Panidis ◽  
Djuro Macut ◽  
Dimitrios Farmakiotis ◽  
David Rousso ◽  
Anargyros Kourtis ◽  
...  

2020 ◽  
Vol 27 (09) ◽  
pp. 1804-1808
Author(s):  
Anam Rehman ◽  
Shireen Jawed ◽  
Amna Rashid Tariq

Objectives: Polycystic ovary syndrome (PCOS) is a rampant endocrine disorder distressing women of child bearing age worldwide. Many current researches have detected the presence of some organ specific and non-specific autoantibodies in females with PCOS. Study Design: Cross Sectional study. Setting:  Aziz Fatimah Hospital, Faisalabad, Pakistan. Period: April to September 2017. Material & Methods: This study comprised of 88 female subjects of 17-35 years old. Participants were divided into four group’s i.e PCOS obese females, PCOS non-obese, obese females without PCOS and age matched controls. Thyroid function was evaluated by the measurement of serum TSH, FT3 and FT4 levels. Thyroid peroxidase antibody was detected as an indicator of thyroid autoimmunity. All parameters were measured by chemiluminescence immunoassay technique (CLIA). SPSS version 22 was used for the statistical analysis of the data. Results: Out of total 88 female participants, 38.6% were hypothyroid and 61.4% were euthyroid females. While on comparing the percentages of hypothyroidism among the study groups PCOS, non-PCOS patients and obese we found higher percentages of hypothyroidism among non-obese PCOS. Thyroid peroxidase antibody levels were higher in PCOS obese subjects. PCOS patients have 15 times more risk for hypothyroidism as compared to non-PCOS patients. Conclusion: Hypothyroidism was commonly found in PCOS patients with high levels of TPO-Antibody indicating that PCOS is an independent risk factor for hypothyroidism which suggests that evaluation of thyroid function and autoimmunity must be deliberated in PCOS patients.


Author(s):  
Somnath Singh Raghuvanshi ◽  
Anirban Sinha ◽  
Animesh Maiti ◽  
Partha Pratim Chakraborty ◽  
Asish Kumar Basu ◽  
...  

Background: Ovarian steroidogenesis requires gonadotropin stimulation, Luteinizing Hormone (LH) is a key factor in the hyperandrogenaemia of the polycystic ovary syndrome. Progesterone is the primary regulator of Gonadotropin-Releasing Hormone (GnRH) pulse frequency; however, in the polycystic ovary syndrome, the GnRH pulse generator is relatively resistant to the negative feedback effects of progesterone.  Study aims to evaluate the association of Anti-mullerian hormone with serum androgen and gonadotropin level in adolescents and young women of Polycystic Ovary Syndrome (PCOS).Methods: This was a single centre observational Cross-sectional study carried out in the department of Endocrinology and metabolism, Medical College, Kolkata from March 2017 to January 2019. Total number of study subjects were 207 out of which 138 were cases.Results: The AMH had strong positive correlation with serum testosterone in both case and control groups (r 0.542, p<0.001 and r 0.57, p<0.001) respectively .After the adjustment of age and BMI , the AMH moderately positive  but extremely significant correlation with serum testosterone as compare to control.Conclusions: Hyperandrogenaemia and higher ratio of LH and FSH associated with higher serum AMH level is associated with the higher serum AMH in polycystic ovarian syndrome.


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