scholarly journals Genotypes at 11β-Hydroxysteroid Dehydrogenase Type 11B1 and Hexose-6-Phosphate Dehydrogenase Loci Are Not Risk Factors for Apparent Cortisone Reductase Deficiency in a Large Population-Based Sample

2005 ◽  
Vol 90 (10) ◽  
pp. 5880-5883 ◽  
Author(s):  
Perrin C. White
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Outcome Measure ◽  
Large Population ◽  
Hydroxysteroid Dehydrogenase ◽  
Population Based ◽  
Main Outcome Measure ◽  
Reductase Deficiency ◽  
Free Cortisol ◽  
Minor Alleles ◽  
Ovarian Syndrome

Context: Apparent cortisone reductase deficiency (ACRD) is a rarely ascertained condition characterized by signs of androgen excess in women or children and decreased urinary excretion of cortisol metabolites compared with cortisone metabolites. These findings suggest a deficiency of 11β-hydroxysteroid dehydrogenase type 1 (11-HSD1; encoded by the HSD11B1 gene), which normally converts cortisone to cortisol. Common polymorphisms in both HSD11B1 and the hexose-6-phosphate dehydrogenase (H6PD) gene encoding hexose-6-phosphate dehydrogenase have been found together in ACRD patients, who carry three of a possible four minor alleles at the two loci. Objective: The objective of this study was to confirm the postulated digenic inheritance mechanism for ACRD. Design: This was a population-based association study (Dallas Heart Study). Subjects were genotyped for the 1971T>G polymorphism in intron 3 of HSD11B1 and the R453Q polymorphism in H6PD. Subjects: The study comprised 3551 individuals in a population-based sample (50% black, 35% white, and 15% Hispanic). Main Outcome Measure: The main outcome measure was association between genotypes and risk for polycystic ovarian syndrome. Results: Both polymorphisms occurred more frequently than previously reported. Thus, ACRD genotypes (at least three of four minor alleles) occurred in 7.0% of subjects. There were no associations between genotype and body mass index; waist/hip ratio; visceral adiposity; measures of insulin sensitivity; levels of testosterone, FSH, or LH (in females); or risk of polycystic ovarian syndrome. There was no genotype effect on urinary free cortisol/cortisone or corticosteroid metabolite ratios, which were measured in 10 subjects, each carrying zero, three, or four minor alleles. Conclusions: Previously reported associations of ACRD with HSD11B1 and H6PD alleles represent ascertainment bias. However, rare severe mutations in these genes cannot be ruled out.

scholarly journals Is Surrogate LH Surge Essential in All Induced Cycles?

2013 ◽  
Vol 26 (2) ◽  
pp. 72-76
Author(s):  
Mosammat Rashida Begum ◽  
Mariya Ehsan ◽  
Mosammat Shahina Begum ◽  
Farzana Khan ◽  
Maruf Siddiqi ◽  
...  
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Outcome Measure ◽  
Follicular Development ◽  
Target Population ◽  
Treated Group ◽  
Hormone Production ◽  
Main Outcome Measure ◽  
Group A ◽  
Group B ◽  
Ovarian Syndrome

Objective: Aim of this study was to identify the necessity of use of exogenous or surrogate  LH for triggering of ovulation in induced cycles. Materials and methods: This study was conducted in Infertility Care and Research Center (ICRC) Dhaka, Bangladesh. Three hundred anovulatory patients with polycystic ovarian syndrome (PCOS) were the target population for this study. The patients were treated by  different ovulation inducing agents to produce mature follicles. When follicle got the size of 18 mm or more LH was given to 150 patients (Group A) and 150 patients did not receive LH (Group B). Follicular rupture was monitored by USG. Main outcome measure was rupture of the follicle.Result: In group A 33.33% and in group B 34.67% patients responded by letrozole only, whereas 66.66% in group A and 65.34% in group B needed additional drugs like metformin glucocorticoids and gonadotropins. In both the groups response was similar in terms of number of follicular recruitment, follicular maturity, endometrial development and hormone production. Follicular rupture rate was similar in both hCG and non-hCG treated group. LUFS was detected only in 2.67% in group A and 2% cases in group B.Conclusion: If follicular development is adequate exogenous LH is not necessary for triggering of ovulation in all stimulated cycles. DOI: http://dx.doi.org/10.3329/bjog.v26i2.13783 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(2) : 72-76  

Association between depression risk and polycystic ovarian syndrome in young women: a retrospective nationwide population-based cohort study (1998–2013)

2019 ◽  
Vol 34 (9) ◽  
pp. 1830-1837 ◽  
Author(s):  
Tomor Harnod ◽  
Weishan Chen ◽  
Jen-Hung Wang ◽  
Shinn-Zong Lin ◽  
Dah-Ching Ding
Keyword(s):  
Clinical Trial ◽  
Cohort Study ◽  
Polycystic Ovarian Syndrome ◽  
Population Based ◽  
Aged Patients ◽  
Depression Risk ◽  
Increased Risk ◽  
History Of ◽  
Competing Interest ◽  
Ovarian Syndrome

Abstract STUDY QUESTION Is polycystic ovarian syndrome (PCOS) in women associated with the increasing incidence of depression in an East Asian population? SUMMARY ANSWER Younger PCOS patients (aged 15–29 years), but not middle-aged patients, have an increased risk of depression in Taiwan. WHAT IS KNOWN ALREADY During reproductive age, 6–10% of women have PCOS. Among them, ~40% experience depression, mostly at young ages. STUDY DESIGN, SIZE, DURATION This is a retrospective population-based cohort study analysing depression risk in Taiwanese women using data from a nationwide database containing 1998–2013 data of nearly 1 million people. PARTICIPANTS/MATERIALS, SETTING, METHODS We included 15- to 50-year-old women newly diagnosed with PCOS during 1998–2013 from the Taiwan National Health Insurance Research Database as the PCOS cohort (n = 7684) and then randomly matched them 4 : 1 by sex, age and index year with women without PCOS as the comparison cohort (n = 30 736). We used multivariable Cox proportional hazard regression analysis to determine the association between PCOS and depression risk [hazard ratio (HR) with 95% confidence interval (CI)]. MAIN RESULTS AND THE ROLE OF CHANCE The incidence of depression was higher in the PCOS group than in the comparison group (6.67 vs. 4.82 per 1000 person-years; adjusted HR = 1.28, 95% CI = 1.12–1.46). PCOS patients aged 15–29 years had a significantly higher depression risk (adjusted HR = 1.39, 95% CI = 1.18–1.65); no such significant association was noted among patients aged 30–39 years and 40–50 years. LIMITATIONS, REASONS FOR CAUTION A history of malignancy, which may increase depression, could not be obtained for our study patients. Moreover, we could not obtain a family history of depression, a relevant risk factor for depression. Finally, the database has no records of body mass index, which may influence depression outcome. WIDER IMPLICATIONS OF THE FINDINGS In Taiwan, younger PCOS patients (15–29 years), but not the middle-aged patients, have an increased risk of depression. Our findings provide vital information to patients, clinicians, the Taiwan Government and other developing Asian countries to improve the PCOS treatment strategies in the future. Routine screening for depression in PCOS patients may be implemented into the health practice. STUDY FUNDING/COMPETING INTEREST(S) This study was supported in part by the Taiwan Ministry of Health and Welfare Clinical Trial Center (MOHW108-TDU-B-212-133 004), China Medical University Hospital, Academia Sinica Stroke Biosignature Project (BM10701010021), MOST Clinical Trial Consortium for Stroke (MOST 107-2321-B-039 -004-), Tseng-Lien Lin Foundation, Taichung, Taiwan and Katsuzo and Kiyo Aoshima Memorial Funds, Japan. No competing interest existed. TRIAL REGISTRATION NUMBER N/A.

scholarly journals Obstetric and non-obstetric surgery during pregnancy: A 20-year Danish population-based prevalence study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e028136 ◽  
Author(s):  
Anne Staub Rasmussen ◽  
Christian Fynbo Christiansen ◽  
Niels Uldbjerg ◽  
Mette Nørgaard
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Procedures ◽  
Outcome Measure ◽  
Smoking Status ◽  
Population Based ◽  
Main Outcome Measure ◽  
Medical Databases ◽  
Laparoscopic Procedures ◽  
High Prevalence ◽  
Obstetric Surgery

ObjectivesPopulation-based studies on use of non-obstetric and obstetric surgical procedures during pregnancy are sparse. Therefore, our objective was to estimate the prevalence of surgery during pregnancy, including potential time trends, overall and by trimester and describe the characteristics of pregnant women undergoing surgery.DesignThis study is a large nationwide cohort study.SettingFrom administrative and medical databases, we obtained information about all pregnancies ending in a live birth, a stillbirth or an abortion (spontaneous and induced) in Denmark during 1996–2015. Procedures (excluding caesarean sections) conducted during pregnancy were categorised as a non-obstetric or obstetric surgery and further divided into laparoscopic or non-laparoscopic procedures.Main outcome measureMain outcome measure is prevalence of surgery during pregnancy.ResultsWe included 1 687 176 pregnancies of which 108 502 (6.4%) received 117 424 surgical procedures. The prevalence of non-obstetric surgery was almost stable (1.5% in 1996–1999 to 1.6% in 2012–2015), whereas non-obstetric abdominal or gynaecological laparoscopic procedures increased from 0.5% to 0.8%. For appendectomies, the proportion of laparoscopic surgery increased from 4.2% to 79.2% during the study period. In 49 pregnancies, surgery for internal herniation was conducted in 2012–2015 versus none in 1996–1999. The prevalence of obstetric surgery, excluding invasive diagnostic tests, increased from 0.2% to 0.8%. High multiplicity, smoking, increasing age, body mass index (BMI) and parity were factors associated with a high prevalence of surgery during pregnancy.ConclusionsThe increase in the prevalence of laparoscopic surgery during pregnancy may reflect a decreased restraint concerning conductance of these surgical procedures during pregnancy. The increasing proportion of laparoscopic procedures complies with clinical recommendations, and the prevalence of surgery during pregnancy varied by multiplicity, smoking status, parity, age and BMI.

scholarly journals Pubertal Progression and Reproductive Hormones in Healthy Girls With Transient Thelarche

2016 ◽  
Vol 102 (3) ◽  
pp. 1001-1008 ◽  
Author(s):  
Marie Lindhardt Johansen ◽  
Casper P. Hagen ◽  
Mikkel G. Mieritz ◽  
Ole D. Wolthers ◽  
Carsten Heuck ◽  
...  
Keyword(s):  
Outcome Measure ◽  
Population Based ◽  
Pubic Hair ◽  
Reproductive Hormones ◽  
Cross Sectional ◽  
Population Based Study ◽  
Main Outcome Measure ◽  
Detailed Evaluation ◽  
Cross Sectional Studies ◽  
Prospective Longitudinal

Abstract Context: Detailed evaluation of pubertal progression in girls from longitudinal studies is sparse, and the phenomenon of transient thelarche (TT), defined as the appearance, regression, and subsequent reappearance of breast buds, in healthy girls remains undescribed. Objective: To describe TT in terms of pubertal progression, growth, genotypes, and reproductive hormones and to apply new puberty nomograms for breast stages, pubic hair, and menarche. Design: A prospective, longitudinal population-based study. Patients or Other Participants: Ninety-eight healthy Danish schoolchildren (Caucasian girls) followed longitudinally as part of the COPENHAGEN Puberty Study were included in the evaluation of TT. A total of 1466 girls from 2 cross-sectional studies were included in the creation of the puberty nomograms. Intervention(s): None. Main Outcome Measure(s): Pubertal progression, specifically thelarche, reproductive hormones, genotype, and growth. Results: Twelve of 98 (12%) girls experienced TT. A larger proportion of girls with TT entered puberty by the pubarche pathway (50%) compared with girls with normal progression (15.4%), P = 0.014. Girls with TT progressed through puberty normally when evaluated using puberty nomograms. Reproductive hormones and growth velocity were lower at the first (transient) thelarche than the second (permanent) thelarche. Conclusion: TT is a frequent phenomenon that appears to be a peripheral occurrence independent of central puberty. It does not appear to affect subsequent pubertal progression as evaluated by our new puberty nomograms.

scholarly journals Chemerin, a Novel Regulator of Follicular Steroidogenesis and Its Potential Involvement in Polycystic Ovarian Syndrome

Endocrinology ◽  
2012 ◽  
Vol 153 (11) ◽  
pp. 5600-5611 ◽  
Author(s):  
Qi Wang ◽  
Ji Young Kim ◽  
Kai Xue ◽  
Jia-yin Liu ◽  
Arthur Leader ◽  
...  
Keyword(s):  
Granulosa Cells ◽  
Polycystic Ovarian Syndrome ◽  
Regulatory Protein ◽  
Hydroxysteroid Dehydrogenase ◽  
Negative Regulator ◽  
Estradiol Secretion ◽  
Chain Cleavage ◽  
Steroidogenic Acute Regulatory ◽  
Ovarian Syndrome

Abstract Polycystic ovarian syndrome (PCOS) is a heterogeneous syndrome associated with follicle growth arrest, minimal granulosa cell proliferation, dysregulated sex hormone profile, hyperthecosis, and insulin resistance. Using a 5α-dihydrotestosterone (DHT)-induced rat model that recapitulates the reproductive and metabolic phenotypes of human PCOS, we have examined the steroidogenic capability of granulosa cells from DHT-treated rats. Gene expression of several key steroidogenic enzymes including p450 side-chain cleavage enzyme (p450scc), aromatase, steroidogenic acute regulatory protein, hydroxysteroid dehydrogenase-17β, and hydroxysteroid dehydrogenase-3β were markedly lower in DHT-treated rats than the controls, although the responsiveness of their granulosa cells to FSH was higher. Expression of the adipokine chemerin and its receptor, chemokine receptor-like 1, was evident in control and DHT-treated rats, with significantly higher ovarian mRNA abundances and protein contents of chemerin and its receptor. Recombinant chemerin decreases basal estradiol secretion in granulosa cells from DHT-treated rats. When the inhibitory role of chemerin on steroidogenesis was further examined in vitro, chemerin suppressed FSH-induced progesterone and estradiol secretion in cultured preantral follicles and granulosa cells. Chemerin also inhibits FSH-induced aromatase and p450scc expression in granulosa cells. Overexpression of nuclear receptors NR5a1 and NR5a2 promotes p450scc and aromatase expression, respectively, which is suppressed by chemerin. These findings suggest that chemerin is a novel negative regulator of FSH-induced follicular steroidogenesis and may contribute to the pathogenesis of PCOS.

scholarly journals Polycystic ovarian syndrome (PCOS), related symptoms/sequelae, and breast cancer risk in a population-based case–control study

2016 ◽  
Vol 27 (3) ◽  
pp. 403-414 ◽  
Author(s):  
Jayeon Kim ◽  
Jennifer E. Mersereau ◽  
Nikhil Khankari ◽  
Patrick T. Bradshaw ◽  
Lauren E. McCullough ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Polycystic Ovarian Syndrome ◽  
Case Control Study ◽  
Population Based ◽  
Case Control ◽  
Ovarian Syndrome ◽  
Control Study

scholarly journals The Risk of Subsequent Miscarriage in Pregnant Women with Prior Polycystic Ovarian Syndrome: A Nationwide Population-Based Study

2021 ◽  
Vol 18 (16) ◽  
pp. 8253
Author(s):  
Mei-Lien Pan ◽  
Li-Ru Chen ◽  
Kuo-Hu Chen
Keyword(s):  
Pregnant Women ◽  
Polycystic Ovarian Syndrome ◽  
Significant Risk ◽  
Population Based ◽  
Control Group ◽  
Case Group ◽  
Chromosomal Anomalies ◽  
Research Database ◽  
Metformin Treatment ◽  
Ovarian Syndrome

Objective: To assess the risk of subsequent miscarriage in pregnant women with a prior diagnosis of polycystic ovarian syndrome (PCOS). Methods: Using a nationwide, population-based database (Taiwan National Health Insurance Research Database) during 1998–2012, the study retrieved 1,000,000 randomly-sampled insured citizens as research subjects. The women with a diagnosis of pre-pregnancy PCOS (n = 13,562) who had chromosomal anomalies, artificial abortion, inconsistent diagnoses, and who were initially diagnosed with PCOS at >45 or <15 year-old were excluded, respectively. The records of gynecologic ultrasonography and/or blood tests were checked to verify the accuracy of the diagnoses of both PCOS and miscarriage (ICD-9 CM codes). After pregnancy, every woman with prior PCOS was age-matched to four women without prior PCOS. Results: Pregnant women with prior PCOS (the case group; n = 1926) and those without prior PCOS (the control group; n = 7704) were compared. The incidence of subsequent miscarriage was much higher in the case group compared with the control group (33.80% vs. 4.09%, p < 0.0001). Logistic regression analysis revealed that the risk of subsequent miscarriage was significantly higher in the case group than the control group (odds ratio [OR] 11.98; 95% CI 10.34–13.87, p < 0.0001), and the result remained similar while adjusted with covariates (adjusted OR 11.97; 95% CI 10.27–13.95, p < 0.0001). In the case group, the patient who used metformin had a lower risk of subsequent miscarriage (adjusted OR 9.53; 95% CI 6.69–13.57) when compared with those who did not receive metformin treatment (adjusted OR 12.13; 95% CI 10.38–14.18). Conclusion: For pregnant women, a pre-pregnancy diagnosis of PCOS is an independent and significant risk factor for subsequent miscarriage. The risk of subsequent miscarriage is reduced by about 1/4 for the PCOS patients who undergo metformin treatment compared with those who do not.

scholarly journals Treatment of Pituitary-Dependent Cushing’s Disease with the Multireceptor Ligand Somatostatin Analog Pasireotide (SOM230): A Multicenter, Phase II Trial

2009 ◽  
Vol 94 (1) ◽  
pp. 115-122 ◽  
Author(s):  
M. Boscaro ◽  
W. H. Ludlam ◽  
B. Atkinson ◽  
J. E. Glusman ◽  
S. Petersenn ◽  
...  
Keyword(s):  
Medical Therapy ◽  
Phase Ii ◽  
Cushing’S Disease ◽  
Outcome Measure ◽  
De Novo ◽  
Plasma Concentrations ◽  
Somatostatin Analog ◽  
Cushing's Disease ◽  
Main Outcome Measure ◽  
Free Cortisol

Abstract Context: There is currently no medical therapy for Cushing’s disease that targets the pituitary adenoma. Availability of such a medical therapy would be a valuable therapeutic option for the management of this disorder. Objective: Our objective was to evaluate the short-term efficacy of the novel multireceptor ligand somatostatin analog pasireotide in patients with de novo, persistent, or recurrent Cushing’s disease. Design: We conducted a phase II, proof-of-concept, open-label, single-arm, 15-d multicenter study. Patients: Thirty-nine patients with either de novo Cushing’s disease who were candidates for pituitary surgery or with persistent or recurrent Cushing’s disease after surgery without having received prior pituitary irradiation. Intervention: Patients self-administered sc pasireotide 600 μg twice daily for 15 d. Main Outcome Measure: Normalization of urinary free cortisol (UFC) levels after 15 d treatment was the main outcome measure. Results: Of the 29 patients in the primary efficacy analysis, 22 (76%) showed a reduction in UFC levels, of whom five (17%) had normal UFC levels (responders), after 15 d of treatment with pasireotide. Serum cortisol levels and plasma ACTH levels were also reduced. Steady-state plasma concentrations of pasireotide were achieved within 5 d of treatment. Responders appeared to have higher pasireotide exposure than nonresponders. Conclusions: Pasireotide produced a decrease in UFC levels in 76% of patients with Cushing’s disease during the treatment period of 15 d, with direct effects on ACTH release. These results suggest that pasireotide holds promise as an effective medical treatment for this disorder.

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