scholarly journals The influence of combined oral contraceptives containing drospirenone on hypothalamic-pituitary-adrenocortical axis activity and glucocorticoid receptor expression and function in women with polycystic ovary syndrome

HORMONES ◽  
2014 ◽  
Author(s):  
Djuro Macut ◽  
Ivana Bozic Antic ◽  
Jelena Nestorov ◽  
Vladanka Topalović ◽  
Jelica Bjekić Macut ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Glucocorticoid Receptor ◽  
Oral Contraceptives ◽  
Polycystic Ovary ◽  
Receptor Expression ◽  
Ovary Syndrome ◽  
Combined Oral Contraceptives ◽  
And Function

Hypothalamic-Pituitary-Adrenocortical Axis Hypersensitivity and Glucocorticoid Receptor Expression and Function in Women with Polycystic Ovary Syndrome

2011 ◽  
Vol 119 (10) ◽  
pp. 636-643 ◽  
Author(s):  
D.Vojnović Milutinović ◽  
D. Macut ◽  
I. Božić ◽  
J. Nestorov ◽  
S. Damjanović ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Glucocorticoid Receptor ◽  
Hpa Axis ◽  
Protein Concentration ◽  
Polycystic Ovary ◽  
Normal Weight ◽  
Receptor Expression ◽  
Obese Women ◽  
Ovary Syndrome ◽  
And Function

AbstractMolecular mechanisms underlying pathophysiology of polycystic ovary syndrome (PCOS), especially those related to cortisol signaling, are poorly understood. We hypothesized that modulation of glucocorticoid receptor (GR) expression and function, may underlie possible PCOS-related impairment of feedback inhibition of hypothalamic-pituitary-adrenocortical (HPA) axis activity and thus contribute to increased adrenal androgen production in women with PCOS.24 normal-weight and 31 obese women with PCOS were compared to 25 normal-weight controls. Fasting blood samples were collected for measurements of serum concentrations of dehydroepiandrosterone sulfate, testosterone, sex hormone-binding globulin, insulin, basal cortisol and cortisol after oral administration of 0.5 mg dexamethasone. Concentrations of GR mRNA, GR protein, mineralocorticoid receptor (MR) protein and heat shock proteins (Hsps), as well as the number of GR per cell (Bmax) and its equilibrium dissociation constant (KD) were measured in isolated peripheral blood mononuclear cells.An increase in HPA axis sensitivity to dexamethasone, an elevation of the GR protein concentration, and unaltered receptor functional status were found in both normal-weight and obese women with PCOS vs. healthy controls. Lymphocyte MR, Hsp90 and Hsp70 concentrations, and MR/GR ratio were similar in all groups. Correlation between Bmax and KD was weaker in the group of obese women with PCOS than in the other 2 groups.The results did not confirm the initial hypothesis, but imply that PCOS is associated with increased GR protein concentration and HPA axis sensitivity to dexamethasone.

scholarly journals Polycystic Ovary Syndrome, Combined Oral Contraceptives, and the Risk of Dysglycemia: A Population-Based Cohort Study With a Nested Pharmacoepidemiological Case-Control Study

2021 ◽  
Author(s):  
Balachandran Kumarendran ◽  
Michael W O'Reilly ◽  
Anuradhaa Subramanian ◽  
Dana Šumilo ◽  
Konstantinos Toulis ◽  
...  
Keyword(s):  
Cohort Study ◽  
Polycystic Ovary Syndrome ◽  
Oral Contraceptives ◽  
Case Control Study ◽  
Polycystic Ovary ◽  
Population Based ◽  
Case Control ◽  
Ovary Syndrome ◽  
Combined Oral Contraceptives ◽  
Control Study

<b>Objectives: </b>Irregular menstrual cycles are associated with increased cardiovascular mortality. Polycystic ovary syndrome (PCOS) is characterized by androgen excess and irregular menses; androgens are drivers of increased metabolic risk in women with PCOS. Combined oral contraceptives (COCPs) are used in PCOS both for cycle regulation and to reduce the biologically active androgen fraction. We examined COCP use and risk of dysglycemia (pre-diabetes and type 2 diabetes) in women with PCOS. <p><b>Research Design and Methods: </b>Utilizing a large UK primary care database (The Health Improvement Network, THIN; 3.7 million patients from 787 practices), we carried out a retrospective population-based cohort study to determine dysglycemia risk (64,051 women with PCOS, 123,545 matched controls), as well as a nested pharmaco-epidemiological case-control study to investigate COCP use in relation to dysglycemia risk (2407 women with PCOS with [=cases] and without [=controls] a diagnosis of dysglycemia during follow-up).<b> </b>Cox models were used to estimate the unadjusted and adjusted hazard ratio and conditional logistic regression was used to obtain adjusted odds ratios (aORs). </p> <p><b>Results: </b>The adjusted hazard ratio for dysglycemia in women with PCOS was 1.87 (95% CI 1.78-1.97, p<0.001; adjustment for age, social deprivation, BMI, ethnicity, and smoking), with increased rates of dysglycemia in all BMI subgroups. Women with PCOS and COCP use had a reduced dysglycemia risk (aOR 0.72, 95% CI 0.59 to 0.87).</p> <p><b>Conclusions: </b>In this study limited by its retrospective nature and the use of routinely collected electronic general practice record data, which does not allow to exclude the impact of prescription-by-indication bias, women<b> </b>with PCOS exposed to COCPs had a reduced risk of dysglycemia across all BMI subgroups. Future prospective studies should be considered to further understand these observations and potential causality. </p>

Effects of two forms of combined oral contraceptives on carbohydrate metabolism in adolescents with polycystic ovary syndrome

2006 ◽  
Vol 85 (2) ◽  
pp. 420-427 ◽  
Author(s):  
George Mastorakos ◽  
Carolina Koliopoulos ◽  
Efthymios Deligeoroglou ◽  
Evanthia Diamanti-Kandarakis ◽  
George Creatsas
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Carbohydrate Metabolism ◽  
Oral Contraceptives ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Combined Oral Contraceptives

scholarly journals Polycystic Ovary Syndrome, Combined Oral Contraceptives, and the Risk of Dysglycemia: A Population-Based Cohort Study With a Nested Pharmacoepidemiological Case-Control Study

2021 ◽  
Author(s):  
Balachandran Kumarendran ◽  
Michael W O'Reilly ◽  
Anuradhaa Subramanian ◽  
Dana Šumilo ◽  
Konstantinos Toulis ◽  
...  
Keyword(s):  
Cohort Study ◽  
Polycystic Ovary Syndrome ◽  
Oral Contraceptives ◽  
Case Control Study ◽  
Polycystic Ovary ◽  
Population Based ◽  
Case Control ◽  
Ovary Syndrome ◽  
Combined Oral Contraceptives ◽  
Control Study

<b>Objectives: </b>Irregular menstrual cycles are associated with increased cardiovascular mortality. Polycystic ovary syndrome (PCOS) is characterized by androgen excess and irregular menses; androgens are drivers of increased metabolic risk in women with PCOS. Combined oral contraceptives (COCPs) are used in PCOS both for cycle regulation and to reduce the biologically active androgen fraction. We examined COCP use and risk of dysglycemia (pre-diabetes and type 2 diabetes) in women with PCOS. <p><b>Research Design and Methods: </b>Utilizing a large UK primary care database (The Health Improvement Network, THIN; 3.7 million patients from 787 practices), we carried out a retrospective population-based cohort study to determine dysglycemia risk (64,051 women with PCOS, 123,545 matched controls), as well as a nested pharmaco-epidemiological case-control study to investigate COCP use in relation to dysglycemia risk (2407 women with PCOS with [=cases] and without [=controls] a diagnosis of dysglycemia during follow-up).<b> </b>Cox models were used to estimate the unadjusted and adjusted hazard ratio and conditional logistic regression was used to obtain adjusted odds ratios (aORs). </p> <p><b>Results: </b>The adjusted hazard ratio for dysglycemia in women with PCOS was 1.87 (95% CI 1.78-1.97, p<0.001; adjustment for age, social deprivation, BMI, ethnicity, and smoking), with increased rates of dysglycemia in all BMI subgroups. Women with PCOS and COCP use had a reduced dysglycemia risk (aOR 0.72, 95% CI 0.59 to 0.87).</p> <p><b>Conclusions: </b>In this study limited by its retrospective nature and the use of routinely collected electronic general practice record data, which does not allow to exclude the impact of prescription-by-indication bias, women<b> </b>with PCOS exposed to COCPs had a reduced risk of dysglycemia across all BMI subgroups. Future prospective studies should be considered to further understand these observations and potential causality. </p>

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