scholarly journals Hyperandrogenemia and high prolactin in congenital utero–vaginal aplasia patients

Reproduction ◽  
2017 ◽  
Vol 153 (5) ◽  
pp. 555-563 ◽  
Author(s):  
Patricia G Oppelt ◽  
Andreas Müller ◽  
Liana Stephan ◽  
Ralf Dittrich ◽  
Johannes Lermann ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Polycystic Ovary ◽  
Dehydroepiandrosterone Sulfate ◽  
Biologically Active ◽  
Sex Hormone Binding Globulin ◽  
Normal Female ◽  
Normal Range ◽  
Ovary Syndrome ◽  
Free Androgen Index ◽  
Vaginal Aplasia

Patients with the Mayer–Rokitansky–Küster–Hauser syndrome (MRKH) have a congenital utero–vaginal cervical aplasia, but normal or hypoplastic adnexa and develop with normal female phenotype. Some reports mostly demonstrated regular steroid hormone levels in small MRKH cohorts including single MRKH patients with hyperandrogenemia and a clinical presentationof hirsutism and acne has also been shown. Genetically a correlation of WNT4 mutations with singular MRKH patients and hyperandrogenemia was noted. This study analyzed the hormone status of 215 MRKH patients by determining the levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, 17-OH progesterone, testosterone, dehydroepiandrosterone sulfate (DHEAS), sex hormone–binding globulin (SHBG) and prolactin to determine the incidence of hyperandrogenemia and hyperprolactinemia in MRKH patients. Additional calculations and a ratio of free androgen index and biologically active testosterone revealed a hyperandrogenemia rate of 48.3%, hyperprolactinemia of 9.8% and combined hyperandrogenemia and hyperprolactinemia of 4.2% in MRKH patients. The rates of hirsutism, acne and especially polycystic ovary syndrome (PCOS) were in the normal range of the population and showed no correlation with hyperandrogenemia. A weekly hormone assessment over 30 days comparing 5 controls and 7 MRKH patients revealed high androgen and prolactin, but lower LH/FSH and SHBG levels with MRKH patients. The sequencing of WNT4, WNT5A, WNT7A and WNT9B demonstrated no significant mutations correlating with hyperandrogenemia. Taken together, this study shows that over 52% of MRKH patients have hyperandrogenemia without clinical presentation and 14% hyperprolactinemia, which appeals for general hormone assessment and adjustments of MRKH patients.

scholarly journals The Correlation of Serum Total Testosterone, Sex Hormone Binding Globulin and Free Androgen Index with Athens Insomnia Scale Score in Polycystic Ovary Syndrome

2018 ◽  
Vol 10 (1) ◽  
pp. 46
Author(s):  
Hartanto Bayuaji ◽  
Heda Melinda Nazaruddin Nataprawira ◽  
Herri Suhari Sastramihardja
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Sleep Disturbance ◽  
Testosterone Level ◽  
Polycystic Ovary ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Hormone Binding ◽  
Ovary Syndrome ◽  
Free Androgen Index ◽  
Athens Insomnia Scale

BACKGROUND: Polycystic ovary syndrome (PCOS), a common reproductive endocrinologic disorder in woman, was considered to be related to sleep disturbance. This study is aimed to analyze the correlation between excess androgen markers and Athens Insomnia Scale (AIS) in PCOS.METHODS: This observational, cross-sectional study of PCOS was conducted to 31 subjects to evaluate the correlation between serum total testosterone, sex hormone binding globulin (SHBG) and free androgen index with the incidence of sleep disturbance using AIS. Sleep disturbance was present if the score ≥6. The correlation between excess androgen markers and sleep disturbance was analyzed using Pearson’s coefficient of correlation or Spearman’s rho test. Correlation coefficient more than 0.5 with p<0.05 was considered significant.RESULTS: Out of 31 PCOS subjects aged 20-40 years, 39% subjects had AIS score ≥6. Mean serum testosterone in AIS score >6 group was higher than AIS score <6 group but not statistically significant (46.68 vs. 28.49 ng/mL, p>0.05). No significant correlation was found between serum total testosterone, SHBG and free androgen index with AIS score. After adjusting for AIS score, there was the moderate positive correlation between serum total testosterone level although not statistically significant (r=0.54, p=0.07).CONCLUSION: The serum total testosterone level might influence the occurrence of sleep disturbance in PCOS.KEYWORDS: PCOS, androgen excess, testosterone, sleep disturbance, Athens Insomnia Scale

Saturated Fat Intake Is Related to Heart Rate Variability in Women with Polycystic Ovary Syndrome

2017 ◽  
Vol 71 (3-4) ◽  
pp. 224-233 ◽  
Author(s):  
Scheila K. Graff ◽  
Fernanda M. Mario ◽  
Jose A. Magalhães ◽  
Ruy S. Moraes ◽  
Poli Mara Spritzer
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Polycystic Ovary Syndrome ◽  
Dietary Intake ◽  
Fruits And Vegetables ◽  
Polycystic Ovary ◽  
Dehydroepiandrosterone Sulfate ◽  
Sex Hormone Binding Globulin ◽  
Calorie Intake ◽  
Ovary Syndrome

Background/Aims: There is a heightened risk for cardiovascular diseases in women with polycystic ovary syndrome (PCOS). Alterations in heart rate variability (HRV) may reflect subclinical cardiovascular disease, with a putative association between HRV and dietary fat. This study evaluated HRV in PCOS and control women based on the dietary intake of saturated fatty acid (SFA). Methods: Biochemical/hormonal profile, resting metabolic rate, physical activity, HRV in response to the Stroop test, and dietary intake were assessed in 84 PCOS and 54 control women stratified by median SFA intake in the PCOS group (8.5% of daily energy intake). Results: Body mass index (p = 0.041), blood pressure (p < 0.01), and HOMA-IR (p = 0.003) were higher in PCOS vs. controls. PCOS women had higher testosterone (p = 0.001), dehydroepiandrosterone sulfate (p = 0.012), and free androgen index (p = 0.001), and lower sex hormone-binding globulin levels than controls (p = 0.001). In both groups, the clinical profile and calorie intake were similar between SFA categories. In PCOS, testosterone was lower when SFA intake <8.5%. PCOS women with SFA <8.5% consumed more beans, fruits, and vegetables and had better frequency and time domain HRV indices. No differences in HRV were detected between SFA categories in controls. In PCOS, age and SFA intake were independent predictors of HRV. Conclusions: Lower SFA intake is related to improved cardiovascular autonomic function in PCOS.

scholarly journals Effect of aging on clinical features and metabolic complications of women with polycystic ovary syndrome

2021 ◽  
Author(s):  
P. Falcetta ◽  
E. Benelli ◽  
A. Molinaro ◽  
C. Di Cosmo ◽  
B. Bagattini ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Clinical Features ◽  
Polycystic Ovary ◽  
Age Groups ◽  
Sex Hormone Binding Globulin ◽  
Atherogenic Dyslipidemia ◽  
Ovary Syndrome ◽  
Metabolic Complications ◽  
Free Androgen Index ◽  
Group A

Abstract Purpose To assess the distribution of clinical features and metabolic abnormalities of polycystic ovary syndrome (PCOS) women according to their age. Methods Retrospective study on 602 women (mean age 23.9 ± 6.2 years), diagnosed according to International PCOS Network Guidelines criteria as having PCOS in a University-based Hospital. Anthropometric features, hormonal and metabolic parameters were measured and compared between the different age groups (group A ≤ 20 years; group B 21–30 years; group C > 30 years). Results Patients in group A were more often hyperandrogenic, while in group C hypertension, dyslipidemia, obesity, impaired fasting glucose, and insulin resistance (IR) were more prevalent. After adjusting for BMI, age correlated positively with sex hormone-binding globulin (SHBG), IR, total- and LDL-cholesterol, and negatively with DHEAS, insulin, and free androgen index (FAI). SHBG was significantly associated with IR and atherogenic dyslipidemia, while FAI levels were linked to hypertension, independently of other factors considered. Furthermore, the regression analysis showed a stronger relationship between BMI and metabolic outcomes, regardless of age. Conclusion Polycystic ovarian syndrome (PCOS) phenotype changes with age. Clinical and biochemical hyperandrogenism are a major concern in young PCOS women, while metabolic burden tends to increase with aging. Some of the cardiovascular risk factors are dependent on FAI and SHBG levels, whereas BMI confirms its key role in the genesis of most of the metabolic sequelae in PCOS, independently of age.

scholarly journals Reproductive Hormones and Anthropometry: A Follow-Up of PCOS and Controls From Perimenopause to Older Than 80 Years

2020 ◽  
Author(s):  
Maria Forslund ◽  
Johanna Schmidt ◽  
Mats Brännström ◽  
Kerstin Landin-Wilhelmsen ◽  
Eva Dahlgren
Keyword(s):  
Polycystic Ovary ◽  
Reproductive Hormones ◽  
University Hospital ◽  
Sex Hormone Binding Globulin ◽  
Control Cohort ◽  
Ovary Syndrome ◽  
Original Cohort ◽  
Free Androgen Index ◽  
Age Range

Abstract Context There is a lack of knowledge about hormonal and anthropometric changes in women with polycystic ovary syndrome (PCOS) after the menopause. Objective This work aimed to study reproductive hormones and anthropometry in women with PCOS older than 80 years. Design and Setting This prospective cohort study was conducted at a university hospital. Patients A well-defined cohort of women with PCOS, previously examined in 1987 and 2008 (21 years) was reexamined in 2019 (11 years). Of the original cohort (n = 37), 22 women were still alive and 21 (age range, 72-91 years) participated. Comparisons were made with age-matched controls (n = 55) from the original control cohort (body mass index [BMI] similar to PCOS women). The results were compared with results from 1987 and 2008. Interventions Hormonal measurements and a physical examination were performed. Main Outcome Measures Follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, sex hormone–binding globulin (SHBG), free androgen index (FAI), hirsutism score, BMI, and waist to hip ratio (WHR) were measured. Results At mean age 81 years, FSH levels were lower in women with PCOS (50 vs 70 IU/L) who were still more hirsute than controls (33% vs 4%). No differences were found in FAI, testosterone, SHBG or LH levels, BMI, or WHR. From perimenopausal age until the present age, levels of testosterone and FAI continued to decline in women with PCOS. SHBG levels continued to increase with age. FSH had not changed over time during the last 11 years. Conclusions Women with PCOS at age 72 to 91 had lower FSH levels, remained clinically hyperandrogenic, and had similar FAI and body composition as controls.

scholarly journals Reproductive Hormone Levels and Anthropometry in Postmenopausal Women with Polycystic Ovary Syndrome (PCOS): A 21-Year Follow-Up Study of Women Diagnosed with PCOS around 50 Years Ago and Their Age-Matched Controls

2011 ◽  
Vol 96 (7) ◽  
pp. 2178-2185 ◽  
Author(s):  
Johanna Schmidt ◽  
Mats Brännström ◽  
Kerstin Landin-Wilhelmsen ◽  
Eva Dahlgren
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Dehydroepiandrosterone Sulfate ◽  
Reproductive Hormones ◽  
Total Testosterone ◽  
Thyroid Peroxidase ◽  
Climacteric Symptoms ◽  
Ovary Syndrome ◽  
Waist To Hip Ratio ◽  
Free Androgen Index

Abstract Context: The hormonal and anthropometric profile of premenopausal women with polycystic ovary syndrome (PCOS) is well described, but there is a lack of data concerning changes in these variables into the postmenopausal period. Objective: Our objective was to examine whether PCOS women differ from normal women regarding levels of reproductive hormones, anthropometry, and presence of hirsutism/climacteric symptoms also after menopause. Design and Setting: In this prospective study, women with PCOS (61–79 yr) and age-matched controls, examined in 1987, were reinvestigated at a university hospital. Participants: Twenty-five PCOS patients (Rotterdam criteria) and 68 controls (randomly allocated from the Gothenburg WHO MONICA study) participated. Interventions: Reexamination and hormonal measurements were done 21 yr after previous visit. Main Outcome Measures: FSH, LH, TSH, thyroid peroxidase antibodies, prolactin, estrone, estradiol, SHBG, androstenedione, total testosterone, dehydroepiandrosterone sulfate, free androgen index, and anthropometry were determined. Presence of climacteric symptoms, hirsutism, and menopausal age were recorded. Results: PCOS women had higher free androgen index (P = 0.001) but lower FSH (P &lt; 0.001) and SHBG (P &lt; 0.01) than controls. Menopausal age, body weight, body mass index, waist to hip ratio, LH, prolactin, androstenedione, dehydroepiandrosterone sulfate, total testosterone, estradiol, and estrone were similar in PCOS and controls. Women with PCOS reported hirsutism more frequently (P &lt; 0.001) but had fewer climacteric symptoms (P &lt; 0.05) and hypothyroidism than controls (P &lt; 0.05). Conclusions: PCOS women differ from controls with regard to levels of certain reproductive hormones also after menopause, but the established premenopausal increase in waist to hip ratio in PCOS patients disappeared after menopause, mainly due to weight gain among controls. A novel finding was the lower prevalence of hypothyroidism in PCOS women.

scholarly journals Matrix metalloproteinases 2 and 9 and MMP9/NGAL complex activity in women with PCOS

Reproduction ◽  
2016 ◽  
Vol 151 (4) ◽  
pp. 305-311 ◽  
Author(s):  
Javad Ranjbaran ◽  
Marzieh Farimani ◽  
Heidar Tavilani ◽  
Marzieh Ghorbani ◽  
Jamshid Karimi ◽  
...  
Keyword(s):  
Matrix Metalloproteinases ◽  
Marked Decrease ◽  
Polycystic Ovary ◽  
Follicular Development ◽  
Serum Levels ◽  
Sex Hormone Binding Globulin ◽  
Complex Activity ◽  
Ovary Syndrome ◽  
Gelatinase Activity ◽  
Free Androgen Index

It is believed that matrix metalloproteinases (MMPs) play important roles in follicular development and pathogenesis of polycystic ovary syndrome (PCOS). However, conflicting results are available about the alteration of MMP2 and MMP9 concentrations or activities in PCOS. In fact, there is no study entirely investigating both concentration and activity of these MMPs and serum levels of their tissue inhibitors TIMP2 and TIMP1, as well as lipocalin-bound form of MMP9 (MMP9/NGAL). Therefore, the thoroughness of previous studies is questionable. This study was conducted to determine circulatory concentration of MMP2, MMP9, MMP9/NGAL complex, TIMP1 and TIMP2 as well as gelatinase activities of MMP2, MMP9 and MMP9/NGAL complex in women with PCOS and controls. Mean age and BMI as well as serum levels of total cholesterol, triacylglycerol, HDL-C, LDL-C, fasting blood sugar (FBS), insulin, estradiol and sex hormone-binding globulin did not differ between groups, whereas a marked decrease in FSH and significant increases in LH, LH/FSH ratio, testosterone and free androgen index were observed. Women with PCOS and controls showed closed concentrations of MMP2, MMP9, MMP9/NGAL, TIMP1 and TIMP2. Gelatinase activity of MMP9 was found significantly higher in PCOS than in controls (64.53±15.32 vs 44.61±18.95 respectively) while patients and healthy subjects showed similar activities of MMP2 and MMP9/NGAL complex. Additionally, PCOS patients showed a higher MMP9/TIMP1 ratio compared with control women. Direct correlations were also observed between circulatory MMP9 level and the concentration and activity of MMP9/NGAL complex. In conclusion, based on the results of present study, we believe that MMP9 may be involved in the pathogenesis of PCOS.

scholarly journals Clinical and Biochemical Signs of Polycystic Ovary Syndrome in Young Women Born Preterm

2021 ◽  
Author(s):  
Marika Paalanne ◽  
Marja Vääräsmäki ◽  
Sanna Mustaniemi ◽  
Marjaana Tikanmäki ◽  
Karoliina Wehkalampi ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Parental Education ◽  
Polycystic Ovary ◽  
Clinical Signs ◽  
Later Life ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Ovary Syndrome ◽  
Free Androgen Index ◽  
Medical Birth Register

Objective: It has been suggested that adverse early life exposures increase the risk of developing polycystic ovary syndrome (PCOS) in later life. We hypothesized that women born preterm would have more biochemical and clinical signs of PCOS than women born at term. Design: The ESTER Preterm Birth Study participants were born in Northern Finland, and identified from the Northern Finland Birth Cohort and the Finnish Medical Birth Register. Altogether, 74 women born very or moderately preterm (<34 gestational weeks, VMPT), 127 born late preterm (at 34–36 weeks, LPT), and 184 born full term (≥37 weeks, controls) were included in the analysis (mean age 23.2y). Methods: We measured serum total testosterone and sex hormone binding globulin (SHBG) and calculated free androgen index (FAI). PCOS according to the clinical and biochemical signs was defined either as hirsutism and oligoamenorrhea (via questionnaire), or as oligoamenorrhea and elevated testosterone levels (>2.4 nmol/l). Results: Women born VMPT/LPT exhibited 33.0% (8.7, 62.8)/16.4% (-2.0, 38.1) higher testosterone, 28.5% (5.3, 45.9)/24.1% (5.6, 38.9) lower SHBG levels, and 64.6% (19.4, 127.1)/ 42.5% (11.1, 82.9) higher FAI than controls after adjusting for age and recruitment cohort, maternal BMI, smoking, and pregnancy disorders, parental education, history of hypertension, diabetes, myocardial infarction or stroke, and subject’s birth weight SD. Odds ratios for having PCOS were 1.67 (0.44, 6.23)/3.11 (1.26, 7.70). Conclusions: Women born preterm have a more hyperandrogenic hormonal profile, and those born LPT are approximately three times more likely at risk to have PCOS compared to women born at term.

scholarly journals Loss of anti-Müllerian hormone (AMH) immunoactivity due to a homozygous AMH gene variant rs10417628 in a woman with classical polycystic ovary syndrome (PCOS)

2020 ◽  
Vol 35 (10) ◽  
pp. 2294-2302 ◽  
Author(s):  
Luis R Hoyos ◽  
Jenny A Visser ◽  
Anke McLuskey ◽  
Gregorio D Chazenbalk ◽  
Tristan R Grogan ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Phenotypic Expression ◽  
Antral Follicle ◽  
Dehydroepiandrosterone Sulfate ◽  
Normal Weight ◽  
Sex Hormone Binding Globulin ◽  
Transvaginal Sonography ◽  
Ovary Syndrome

ABSTRACT Anti-Müllerian hormone (AMH) is produced by granulosa cells of pre-antral and small antral ovarian follicles. In polycystic ovary syndrome (PCOS), higher levels of serum AMH are usually encountered due to the ample presence of small antral follicles and a high AMH production per follicular unit which have led to the proposal of AMH as a serum diagnostic marker for PCOS or as a surrogate for polycystic ovarian morphology (PCOM). However, heterozygous coding mutations of the AMH gene with decreased in vitro bioactivity have been described in some women with PCOS. Such mutation carriers have a trend toward reduced serum AMH levels compared to noncarriers, although both types of women with PCOS have similar circulating gonadotropin and testosterone (T) levels. This report describes a normal-weight woman with PCOS by NIH criteria with severely reduced AMH levels (index woman with PCOS). Our objective was to examine the molecular basis for her reduced serum AMH levels and to compare her endocrine characteristics to similar-weight women with PCOS and detectable AMH levels. Twenty normoandrogenic ovulatory (control) and 13 age- and BMI-matched women with PCOS (19–35 years; 19–25 kg/m2) underwent transvaginal sonography and serum hormone measures including gonadotropins, sex hormone-binding globulin, total and free T, androstenedione, dehydroepiandrosterone sulfate, estrone, estradiol and AMH. The latter was measured by ELISA (Pico-AMH: Ansh Labs, Webster, TX, USA). Women with PCOS and detectable AMH had higher serum AMH (10.82 (6.74–13.40) ng/ml, median (interquartile range)), total and free T (total T: 55.5 (49.5–62.5) ng/dl; free T: 5.65 (4.75–6.6) pg/ml) levels and greater total antral follicle count (AFC) (46 (39–59) follicles) than controls (AMH: 4.03 (2.47–6.11) ng/ml; total T: 30 (24.5–34.5) ng/dl; free T: 2.2 (1.8–2.45) pg/ml; AFC 16 (14.5–21.5) follicles, P &lt; 0.05, all values), along with a trend toward LH hypersecretion (P = 0.06). The index woman with PCOS had severely reduced serum AMH levels (∼0.1 ng/ml), although she also had a typical NIH-defined PCOS phenotype resembling that of the other women with PCOS and elevated AMH levels. All women with PCOS, including the index woman with PCOS, exhibited LH hypersecretion, hyperandrogenism, reduced serum estrogen/androgen ratios and PCOM. A homozygous Ala515Val variant (rs10417628) in the mature region of AMH was identified in the index woman with PCOS. Recombinant hAMH-515Val displayed normal processing and bioactivity, yet had severely reduced immunoactivity when measured by the commercial pico-AMH ELISA assay by Ansh Labs. In conclusion, homozygous AMH variant rs10417628 may severely impair serum AMH immunoactivity without affecting its bioactivity or PCOS phenotypic expression. Variants in AMH can interfere with serum AMH immunoactivity without affecting the phenotype in PCOS. This observation can be accompanied by discordance between AMH immunoactivity and bioactivity.

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