scholarly journals Increased 5α-Reductase Activity and Adrenocortical Drive in Women with Polycystic Ovary Syndrome

2009 ◽  
Vol 30 (5) ◽  
pp. 536-536
Author(s):  
Dimitra A. Vassiliadi ◽  
Thomas M. Barber ◽  
Beverly A. Hughes ◽  
Mark I. McCarthy ◽  
John A. H. Wass ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Reductase Activity ◽  
Tertiary Care ◽  
Hydroxysteroid Dehydrogenase ◽  
Cross Sectional Study ◽  
Ovary Syndrome ◽  
Cross Sectional ◽  
Cortisol Metabolism ◽  
The Metabolic Syndrome

ABSTRACT Context Polycystic Ovary Syndrome (PCOS) is characterized by hyperandrogenism, anovulation and susceptibility to the metabolic syndrome. Altered peripheral cortisol metabolism has been reported in PCOS but also in simple obesity. Objective To describe cortisol metabolism and metabolic characteristics of a large PCOS cohort and to delineate the effect of obesity by comparison to BMI-matched controls. Design Observational, cross-sectional study. Setting Outpatient clinics of two secondary/tertiary care centres Patients or Other Participants 178 PCOS patients fulfilling Rotterdam criteria and 100 BMI-matched controls. Intervention 24-h urine collection for steroid metabolite excretion, fasting blood samples followed by an OGTT. Main Outcome Measures Urinary steroid metabolites including glucocorticoids and androgens and the ratios reflecting enzymatic activities involved in peripheral cortisol and androgen metabolism, 5α-reductase and 11β-hydroxysteroid dehydrogenase type 1 and 2. Circulating levels of glucose, insulin, DHEA, DHEAS and testosterone, calculation of HOMA. Results Total androgen metabolites were higher in PCOS compared to BMI-matched controls (4105 ± 2047 vs. 2532 ± 1610 μg/24h for the non-obese, 5547 ± 2911 vs. 2468 ± 1794 μg/24hr for the obese, both p < 0.001). Total glucocorticoid metabolites were higher in obese PCOS vs. controls (10786 ± 3852 vs. 8834 ± 4487 μg/24hr, p = 0.001). 5α-reductase activity correlated with BMI, insulin levels and HOMA. Both obese and non-obese PCOS patients had higher 5α-reductase activity than controls (all p < 0.05). 11β-hydroxysteroid dehydrogenase activities did not differ between PCOS and controls. Conclusions PCOS is associated with enhanced androgen and cortisol metabolite excretion and increased 5α-reductase activity that cannot be explained by obesity alone. Increased adrenal corticosteroid production represents an important pathogenic pathway in PCOS.

scholarly journals Correlation of anti-Müllerian hormone levels with metabolic syndrome events in polycystic ovary syndrome: A cross-sectional study

2020 ◽  
Author(s):  
Budi Wiweko ◽  
Lieke Koes Handayani ◽  
Achmad Kemal Harzif ◽  
Gita Pratama ◽  
Raden Muharam ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Ovary Syndrome ◽  
Cross Sectional ◽  
The Metabolic Syndrome ◽  
Independent Variable

Background: Various endocrine disorders have been reported in women of reproductive age, 10% of which is affected by polycystic ovary syndrome (PCOS). Objective: This study aimed to evaluate the correlation of anti-Müllerian hormone (AMH) levels with the metabolic syndrome in patients with PCOS. Materials and Methods: This cross-sectional study employed a consecutive sampling method using medical records from January 2013 to December 2017 at Dr. Cipto Mangunkusumo General Hospital polyclinic and Yasmin in vitro fertilization Clinic (Kencana), Jakarta, Indonesia. The primary outcome of the study was the AMH levels as independent variable correlated with metabolic syndrome. The secondary outcome was also the AMH levels correlated with each PCOS phenotype. The tertiary outcome was each PCOS phenotype as independent variable correlated with metabolic syndrome. Results: Women with phenotype 1 of PCOS had a median AMH level of 13.92 (range: 3.88-34.06) ng/ml. 21% patients had metabolic syndrome, with a median AMH level 7.65 (3.77-20.20) ng/ml, higher than the women without metabolic syndrome (p = 0.38). The most frequent phenotype in women with PCOS was phenotype 4, oligo- or anovulation and polycystic ovary morphology (OA/PCOM) in 41.3%. The most frequent phenotype in women with metabolic syndrome was phenotype 1, OA + PCOM + hyperandrogenism in 56.5%. Conclusion: All PCOS phenotypes exhibited significant correlations with the AMH level. Phenotype 1 (OA + PCOM + hyperandrogenism) was associated with the highest AMH level and was significantly associated with metabolic syndrome. Key words: Anti-Müllerian hormone, Metabolic syndrome, Polycystic ovary syndrome.

scholarly journals Tissue-specific dysregulation of 11β-hydroxysteroid dehydrogenase type 1 in overweight/obese women with polycystic ovary syndrome compared with weight-matched controls

2014 ◽  
Vol 171 (1) ◽  
pp. 47-57 ◽  
Author(s):  
Alessandra Gambineri ◽  
Flaminia Fanelli ◽  
Federica Tomassoni ◽  
Alessandra Munarini ◽  
Uberto Pagotto ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Hydroxysteroid Dehydrogenase ◽  
Whole Body ◽  
Mrna Levels ◽  
Ovary Syndrome ◽  
Tissue Specific ◽  
Cortisol Metabolism ◽  
Cortisol Metabolites

ContextAbnormal cortisol metabolism in polycystic ovary syndrome (PCOS) has been invoked as a cause of secondary activation of the hypothalamic–pituitary–adrenal axis and hence androgen excess. However, this is based on urinary excretion of cortisol metabolites, which cannot detect tissue-specific changes in metabolism and may be confounded by obesity.ObjectiveTo assess cortisol clearance and whole-body and tissue-specific activities of 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1 (HSD11B1)) in PCOS.DesignCase–control study.SettingMedical center.PatientsA total of 20 overweight–obese unmedicated Caucasian women with PCOS, aged 18–45 years, and 20 Caucasian controls matched for age, BMI, body fat distribution, andHSD11B1genotypes (rs846910 and rs12086634).Main outcome measuresCortisol metabolites were measured in 24 h urine. During steady-state 9,11,12,12-[2H]4-cortisol infusion, cortisol clearance was calculated and whole-body HSD11B1 activity was assessed as the rate of appearance of 9,12,12-2H3-cortisol (d3-cortisol). Hepatic HSD11B1 activity was quantified as the generation of plasma cortisol following an oral dose of cortisone. Subcutaneous adipose HSD11B1 activity andHSD11B1mRNA were measured,ex vivo, in biopsies.ResultsUrinary cortisol metabolite excretion, deuterated cortisol clearance, and the rate of appearance of d3-cortisol did not differ between patients with PCOS and controls. However, hepatic HSD11B1 conversion of oral cortisone to cortisol was impaired (P<0.05), whereas subcutaneous abdominal adipose tissueHSD11B1mRNA levels and activity were increased (P<0.05) in women with PCOS when compared with controls.ConclusionsTissue-specific dysregulation of HSD11B1 is a feature of PCOS, over and above obesity, whereas increased clearance of cortisol may result from obesity rather than PCOS.

scholarly journals Prevalence of Self-reported Polycystic Ovary Syndrome and Profiles of Health Among Women of Different Generations: A Cross Sectional Study

2019 ◽  
Vol 01 (03) ◽  
pp. 141-147
Author(s):  
Jodie C. Avery ◽  
Lisa J. Moran ◽  
Vivienne Moore ◽  
Renae C. Fernandez ◽  
Melissa Whitrow ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Age Groups ◽  
South Australia ◽  
Cross Sectional Study ◽  
Age Group ◽  
Ovary Syndrome ◽  
Cross Sectional ◽  
Younger Women

Objective: Although polycystic ovary syndrome (PCOS) is considered a lifelong disorder, very little is understood about the diagnosis and impact of this condition in women outside of the peak reproductive years. We examined the frequency of diagnosed PCOS and concurrent health conditions in women across the lifespan. Methods: Data were analysed from 1509 women aged 15–95 years participating in a cross-sectional, face-to-face population survey in South Australia, 2015. We assessed the prevalence of PCOS in 10-year age groups and the frequency of comorbidities in women with and without PCOS subgrouped by age (< 45, [Formula: see text] 45 years). The main outcome measures were Diagnosed PCOS and other chronic conditions; lifestyle factors. Logistic regression analyses determined the risk of comorbidities in women with PCOS adjusting for age and BMI. Results: Overall prevalence of PCOS was 5.6% (95% confidence interval (CI) 4.6–6.9%), peaking in the 35–44 year age group (9.1%), and lowest in those aged 15–24 (4.1%) or [Formula: see text] 65 (3.7%) years. Women with PCOS and aged <45 years were more likely to report diabetes (16.7% vs. 3.8%), cardiovascular disease (15.5% vs. 7.2%) and arthritis (15.5% vs. 7.2%) than their peers; these differences were diminished in the [Formula: see text] 45 year age group. The odds of diabetes and cardiovascular disease were more than doubled among women with PCOS (adjOR 2.23, 95% CI 1.49–4.31; adjOR 3.18, 95% CI 1.31–7.68). Conclusion: PCOS is underdiagnosed in young and post-menopausal women. Diabetes and cardiovascular disease are key comorbidities requiring greater attention in younger women with PCOS.

scholarly journals The effects of obesity and polycystic ovary syndrome on serum lipocalin-2 levels: a cross-sectional study

2010 ◽  
Vol 8 (1) ◽  
pp. 151 ◽  
Author(s):  
Dimitrios Panidis ◽  
Konstantinos Tziomalos ◽  
Ekaterini Koiou ◽  
Eleni A Kandaraki ◽  
Elena Tsourdi ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Cross Sectional Study ◽  
Lipocalin 2 ◽  
Sectional Study ◽  
Ovary Syndrome ◽  
Cross Sectional

scholarly journals Changes in clinical and biochemical characteristics of polycystic ovary syndrome with advancing age

2020 ◽  
Vol 9 (2) ◽  
pp. 74-89 ◽  
Author(s):  
Sebastião Freitas de Medeiros ◽  
Márcia Marly Winck Yamamoto ◽  
Matheus Antônio Souto de Medeiros ◽  
Bruna Barcelo Barbosa ◽  
José Maria Soares ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Total Cholesterol ◽  
Polycystic Ovary ◽  
Cross Sectional Study ◽  
Reproductive Period ◽  
University Hospital ◽  
Ovary Syndrome ◽  
Cross Sectional ◽  
Biochemical Characteristics ◽  
Age Stratification

Objective To verify whether aging can modify the clinical and biochemical characteristics of women with polycystic ovary syndrome (PCOS). Material and methods This observational cross-sectional study was conducted at the reproductive endocrinology clinics of Julio Muller University Hospital and Tropical Institute of Reproductive Medicine in Cuiabá, MT, Brazil, between 2003 and 2017. Both, 796 PCOS and 444 non-PCOS normal cycling women underwent the same examination. PCOS was diagnosed using the Rotterdam criteria as recommended for adolescent and adult subjects. Anthropometric, metabolic, and endocrinological modifications with aging were initially examined in the two groups: control and PCOS. Further analyses were performed after a 5-year age stratification of data throughout the reproductive period. All participants signed a consent form approved by the local ethical committee. Results Biomarkers of adiposity were more remarkable in African descendant PCOS women. Body weight, waist/hip ratio, fat mass, and BMI were higher in PCOS women and tended to increase at all 5 age-strata, between ≤19 and 35 years of age. Serum androgen levels decreased with aging, markedly in PCOS subjects (P < 0.01 for all age-strata comparisons), but remained elevated when compared with the levels found in controls. Carbohydrate markers, triglycerides, and total cholesterol tended to increase over time in PCOS (P < 0.01 for all age-strata comparisons). Total cholesterol also tended to increase with age in non-PCOS women (P = 0.041). Conclusion The present study has shown that the advancing age influences many features of PCOS women. Biochemical hyperandrogenism, the core criterion recommended in the current systems to define the syndrome, showed statistically significant tendencies to decrease with aging progression but did not normalize. The use of age-adjusted features for the diagnosis of PCOS are recommended.

scholarly journals Maternal and neonatal outcomes among pregnant women with different polycystic ovary syndrome phenotypes: A cross-sectional study

2020 ◽  
Author(s):  
Akramsadat Dehghani Firoozabadi ◽  
Razieh Dehghani Firouzabadi ◽  
Maryam Eftekhar ◽  
Afsar Sadat Tabatabaei Bafghi ◽  
Farimah Shamsi
Keyword(s):  
Gestational Diabetes ◽  
Polycystic Ovary Syndrome ◽  
Pregnant Women ◽  
Polycystic Ovary ◽  
Cross Sectional Study ◽  
Neonatal Outcomes ◽  
Pregnancy Induced Hypertension ◽  
Ovary Syndrome ◽  
Cross Sectional ◽  
Induced Hypertension

Background: Pregnancy is a process associated with various metabolic and hormonal changes, and polycystic ovary syndrome (PCOS) can affect this process. Objective: This study aimed to evaluate and compare the maternal and neonatal outcomes among pregnant women with different polycystic ovary syndrome phenotypes. Materials and Methods: In this cross-sectional study, 200 pregnant women with PCOS according to the 2003 ESHRE/ASRM criteria were categorized into four phenotype groups (A-D). The maternal outcomes include gestational diabetes mellitus, pregnancy-induced hypertension, premature rupture of membranes, preterm labor, small-for-gestational age birth, intrauterine growth restriction, intrauterine mortality, preeclampsia, abortion, amniotic fluid disorders, delivery method, and cause of cesarean section were studied between groups. Additionally, neonatal outcomes such as neonatal weight, neonatal recovery, 5-min Apgar score, neonatal icter, the need for NICU admission, the cause of hospitalization, and infant mortality rate were investigated and compared among the groups. Results: According to the results, phenotype D (37%) was the most common phenotype among the participants. The risk of gestational diabetes was more common in phenotype A than in the other phenotypes, whereas pregnancy-induced hypertension was most common in phenotype B. No significant differences were observed in the neonatal complications among the PCOS phenotypes. Conclusion: Considering the higher risk of gestational diabetes mellitus and pregnancy-induced hypertension in PCOS phenotypes A and B, women with these phenotypes need more precise prenatal care. Key words: Pregnancy outcome, Polycystic ovary syndrome, Phenotype, Pregnancy.

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