scholarly journals Efficiency of modern correction methods of ovarian hyperandrogenism in puberty

2018 ◽  
Vol 99 (6) ◽  
pp. 931-935
Author(s):  
E M Alieva ◽  
N E Akhundova
Keyword(s):  
Comparison Group ◽  
Polycystic Ovary ◽  
Follicular Phase ◽  
Sex Hormone Binding Globulin ◽  
Hormonal Status ◽  
Ovary Syndrome ◽  
Early Follicular Phase ◽  
Pathogenetic Therapy ◽  
Ovarian Hyperandrogenism

Aim. To evaluate the effectiveness of correction of the ovarian hyperandrogenism (OHA) in girls in puberty. Methods. 38 girls with OHA syndrome were examined. The average age of the girls was 14.39 ± 0.27 years. Ferriman-Gallwey hirsutism score was 19.7 ± 0.47, the hormonal score 18.14 ± 2.43, the indifferent score 2.34 ± 0.13. The comparison group included 20 girls matched by age (14.74 ± 0.15 years) with physiological course of puberty. The study included the evaluation of hirsutism severity by Ferriman-Gallway score, determination of the hormones of hypothalamus-pituitary-adrenal-ovarian system in early follicular phase on day 5-7 of menstrual cycle. Results. The causes of OHA syndrome in the pubertal period were found to be polycystic ovary syndrome in 68.42 % and tumor-like formations (follicular cysts) in 31.58 % of girls. Compared to healthy girls, the girls with OHA syndrome had statistically significantly higher values of luteinizing hormone (LH) - 9.19 ± 0.96 mME/ml, LH/FSH ratio - 1.8 ± 0.15, total testosteron (Ttotal) - 1.3 ± 0.11 ng/ml, estrone (E1) - 109.5 ± 4.88 ng/ml, androstenedione (An) - 4.01 ± 0.12 ng/ml as well as low values of estradiol (E2) - 49.1 ± 2.6 pg/ml and sex hormone-binding globulin (SHBG) - 45.7 ± 2.14 nmol/l. The study demonstrated that correction of ovarian hyperandrogenism, promotes an increase in the level of E2, SHBG and decrease of the level of LH, LH/FSH ratio, Ttotal, An. Conclusion. Complex pathogenetic therapy of OHA syndrome in girls in puberty leads to significant improvement of hormonal status in this group of patients.

scholarly journals Therapeutic effects of metformin on insulin resistance and hyperandrogenism in polycystic ovary syndrome

1998 ◽  
pp. 269-274 ◽  
Author(s):  
E Diamanti-Kandarakis ◽  
C Kouli ◽  
T Tsianateli ◽  
A Bergiele
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Free Testosterone ◽  
Sex Hormone Binding Globulin ◽  
Therapeutic Effects ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Before And After ◽  
Ovarian Hyperandrogenism

Evidence suggests that insulin resistance and hyperinsulinaemia are associated with ovarian hyperandrogenism and menstrual irregularities in polycystic ovary syndrome (PCOS). Sixteen obese women with PCOS on a weight-maintaining diet were studied before and after 6 months of therapy with the insulin-sensitizing antidiabetic agent metformin at a dose of 1700 mg per day. Compared with baseline values, glucose utilization was markedly enhanced at 6 months using the two-step euglycaemic-hyperinsulinaemic clamp to measure changes in insulin sensitivity (2.56 +/- 0.32 vs 4.68 +/- 0.49 mg/kg per min, P = 0.0001, when 40 mU insulin/m2 per min was infused, and 6.48 +/- 0.58 vs 9.84 +/- 0.72 mg/kg per min, P = 0.0002, when 400 mU insulin insulin/m2 per min was infused). The improvement in insulin action was accompanied by significant increases in the levels of sex hormone-binding globulin (24.5 +/- 7.2 vs 39.8 +/- 16.2 nmol/l, P = 0.003) and decreases in free testosterone (12.8 +/- 5.8 vs 9.0 +/- 3.0 pmol/l, P = 0.03) and androstenedione (12.9 +/- 5.6 vs 7.3 +/- 1.7 nmol/l, P = 0.003). No significant changes were recorded in body weight. Seven subjects resumed normal menstruation and two cases of spontaneous pregnancy occurred during treatment. Metformin was well tolerated except for one case of flatulence. These results confirm that metformin treatment can lead to improvements in insulin resistance and ovarian hyperandrogenism.

Uterine Volume and Endometrial Thickness in the Early Follicular Phase in Patients with Polycystic Ovary Syndrome

2014 ◽  
Vol 20 (6) ◽  
pp. 540-547 ◽  
Author(s):  
Dimitrios Panidis ◽  
Konstantinos Tziomalos ◽  
Efstathios Papadakis ◽  
Christos Vosnakis ◽  
Georgios Betsas ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Follicular Phase ◽  
Ovary Syndrome ◽  
Early Follicular Phase ◽  
Uterine Volume

scholarly journals The Relevant Hormonal Levels and Diagnostic Features of Polycystic Ovary Syndrome in Adolescents

2020 ◽  
Vol 9 (6) ◽  
pp. 1831
Author(s):  
Elena Khashchenko ◽  
Elena Uvarova ◽  
Mikhail Vysokikh ◽  
Tatyana Ivanets ◽  
Lyubov Krechetova ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Polycystic Ovary Syndrome ◽  
Diagnostic Accuracy ◽  
Polycystic Ovary ◽  
Regression Function ◽  
High Sensitivity ◽  
Sex Hormone Binding Globulin ◽  
Control Group ◽  
Ovary Syndrome ◽  
Diagnostic Features

Relevance: The clinical picture of polycystic ovary syndrome (PCOS) is extremely polymorphic, especially in adolescence. At the same time, the diagnostic criteria of PCOS in adolescence are still under discussion, and the hormonal parameters, including anti-Mullerian hormone range and hyperandrogenism, are not determined. The aim of the present study was to characterize the pivotal clinical and hormonal features of PCOS in adolescents and to establish the age-specific thresholds of the most essential hormonal parameters. Design: A case-control study. Methods: The study included 130 girls with PCOS according to the complete Rotterdam criteria, aged 15 to 17 years. The control group consisted of 30 healthy girls with a regular menstrual cycle of the same age. A complete clinical and laboratory examination, hormonal assays, and ultrasound of the pelvic organs were performed. The serums anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH, prolactin, estradiol, 17α-OH progesterone (17α-OHP), androstenedione, testosterone (T), dehydroepiandrosterone sulfate (DHEAS), sex hormone-binding globulin (SHBG), leptin, and free androgen index (FAI) were analyzed. The diagnostic accuracy of AMH, FAI, LH/FSH, T, and androstenedione levels in predicting PCOS in adolescents was established using a logistic regression model and calculating area under the receiver operator characteristic (ROC) curve (AUC). Results: The serum levels of LH (9.0 (5.4–13.8) vs. 3.7 (2.5–4.7) IU/L; p < 0.0001), LH/FSH (1.6 (1.0–2.3) vs. 0.7 (0.5–1.1); p < 0.0001), 17α–OHP (4.1 (3.2–5.1) vs. 3.4 (2.7–3.8) nmol/L; p = 0.0071), cortisol (464.0 ± 147.6 vs. 284.0 ± 129.7 nmol/L; p < 0.0001), prolactin (266.0 (175.0–405.0) vs. 189.0 (142.0–269.0) mIU/L; p = 0.0141), T (1.9 (1.2–2.5) vs. 0.8 (0.7–1.1) nmol/L; p < 0.0001), androstenedione (15.8 (11.6–23.2) vs. 8.3 (6.5–10.8) ng/mL; p < 0.0001), AMH (9.5 (7.5–14.9) vs. 5.8 (3.8–6.9) ng/mL; p < 0.0001), FAI (5.5 (2.8–7.0) vs. 1.6 (1.1–2.3); p < 0.0001), SHBG (37.0 (24.7–55.5) vs. 52.9 (39.0–67.6) nmol/L; p = 0.0136), DHEAS (6.8 ± 3.2 vs. 5.1 ± 1.5 μmol/L; p = 0.0039), and leptin (38.7 ± 27.1 vs. 23.7 ± 14.0 ng/mL; p = 0.0178) were significantly altered in the PCOS patients compared to the controls. Multivariate analysis of all studied hormonal and instrumental parameters of PCOS in adolescents revealed as the most essential: AMH level > 7.20 ng/mL, FAI > 2.75, androstenedione > 11.45 ng/mL, total T > 1.15 nmol/L, LH/FSH ratio > 1.23, and the volume of each ovary > 10.70 cm3 (for each criterion sensitivity ≥ 75.0–93.0%, specificity ≥ 83.0–93.0%). The diagnostic accuracy of PCOS determination was 90.2–91.6% with the combined use of either four detected indexes, which was significantly higher than the use of each index separately. The accuracy of PCOS diagnostics reached 92% using AMH and leptin concentrations when the value of the logistic regression function [85.73 − (1.73 × AMH) − (0.12 × Leptin)] was less than 70.72. Conclusions: The results of the study estimate the threshold for AMH, FAI, androstenedione, testosterone, LH/FSH, and ovarian volume, which could be suggested for use in the PCOS diagnostics in adolescents with a high sensitivity and specificity. Moreover, the combination of either four determined indexes improved the diagnostic accuracy for the PCOS detection in adolescents.

The frequency of late-onset 21-hydroxylase and 11 beta-hydroxylase deficiency in women with polycystic ovary syndrome

1997 ◽  
pp. 670-674 ◽  
Author(s):  
Y Sahin ◽  
F Kelestimur
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Late Onset ◽  
Polycystic Ovary ◽  
Serum Testosterone ◽  
Free Testosterone ◽  
Sex Hormone Binding Globulin ◽  
Acth Stimulation ◽  
Hydroxylase Deficiency ◽  
Ovary Syndrome ◽  
Biochemical Features

OBJECTIVE: To determine the frequency of late-onset adrenal hyperplasia (LOCAH) due to 21-hydroxylase (21-OH) and 11 beta-hydroxylase (11 beta-OH) deficiency in women with clinical and biochemical features of polycystic ovary syndrome (PCOS). DESIGN: Eighty-three consecutively selected women with PCOS and eighteen normal women were included in the study. METHODS: Ultrasound, clinical and hormonal parameters were used to define PCOS. Basal FSH, LH, testosterone, free testosterone, androstenedione, dehydroepiandrosterone sulfate (DHEA-S), sex hormone-binding globulin (SHBG) and cortisol levels were measured. Serum 17-hydroxyprogesterone (17-OHP) and 11-deoxycortisol (11-DOC) levels were also measured before, 30 and 60 min after a single bolus injection of 0.25 mg ACTH (1-24) at 0900 h during the mid-follicular phase of the cycle. ACTH-stimulated 17-OHP levels > 30 nmol/l were considered as the criteria of 21-OH deficiency. The diagnosis 11 beta-OH deficiency was made if the adrenal 11-DOC response to ACTH stimulation exceeded threefold the 95th percentile of controls. RESULTS: Basal serum testosterone, free testosterone, androstenedione, DHEA-S, cortisol and 11-DOC levels were significantly higher in PCOS than in control subjects. ACTH-stimulated 17-OHP (P < 0.05) and 11-DOC (P < 0.0005) levels were found to be significantly higher in patients with PCOS than in controls. Seven (8.4%) patients had an 11-DOC response to ACTH higher than threefold the 95th percentile of controls, while no patients showed evidence of 21-OH deficiency. CONCLUSIONS: We have found that 8.4% of the women with clinical and biochemical features of PCOS could be presumed to have 11 beta-OH deficiency. No patients among the women with PCOS showed evidence of 21-OH deficiency. 11 beta-OH deficiency is unexpectedly more common than 21-OH deficiency in women with PCOS.

Effects of caloric intake timing on insulin resistance and hyperandrogenism in lean women with polycystic ovary syndrome

2013 ◽  
Vol 125 (9) ◽  
pp. 423-432 ◽  
Author(s):  
Daniela Jakubowicz ◽  
Maayan Barnea ◽  
Julio Wainstein ◽  
Oren Froy
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Therapeutic Option ◽  
Caloric Intake ◽  
Area Under The Curve ◽  
Ovulation Rate ◽  
Sex Hormone Binding Globulin ◽  
Ovary Syndrome ◽  
Meal Timing

In women with PCOS (polycystic ovary syndrome), hyperinsulinaemia stimulates ovarian cytochrome P450c17α activity that, in turn, stimulates ovarian androgen production. Our objective was to compare whether timed caloric intake differentially influences insulin resistance and hyperandrogenism in lean PCOS women. A total of 60 lean PCOS women [BMI (body mass index), 23.7±0.2 kg/m2] were randomized into two isocaloric (~1800 kcal; where 1 kcal≈4.184 J) maintenance diets with different meal timing distribution: a BF (breakfast diet) (980 kcal breakfast, 640 kcal lunch and 190 kcal dinner) or a D (dinner diet) group (190 kcal breakfast, 640 kcal lunch and 980 kcal dinner) for 90 days. In the BF group, a significant decrease was observed in both AUCglucose (glucose area under the curve) and AUCinsulin (insulin area under the curve) by 7 and 54% respectively. In the BF group, free testosterone decreased by 50% and SHBG (sex hormone-binding globulin) increased by 105%. GnRH (gonadotropin-releasing hormone)-stimulated peak serum 17OHP (17α-hydroxyprogesterone) decreased by 39%. No change in these parameters was observed in the D group. In addition, women in the BF group had an increased ovulation rate. In lean PCOS women, a high caloric intake at breakfast with reduced intake at dinner results in improved insulin sensitivity indices and reduced cytochrome P450c17α activity, which ameliorates hyperandrogenism and improves ovulation rate. Meal timing and distribution should be considered as a therapeutic option for women with PCOS.

scholarly journals Decreased Sex Hormone-Binding Globulin Indicated Worse Biometric, Lipid, Liver, and Renal Function Parameters in Women with Polycystic Ovary Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Xi Luo ◽  
Xin-Ming Yang ◽  
Wang-Yu Cai ◽  
Hui Chang ◽  
Hong-Li Ma ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Renal Function ◽  
Polycystic Ovary ◽  
Density Lipoprotein ◽  
Metabolic Parameters ◽  
Sex Hormone Binding Globulin ◽  
Hormone Binding ◽  
Ovary Syndrome ◽  
Renal Functions

Objective. To investigate the relationships between sex hormone-binding globulin (SHBG) and comprehensive metabolic parameters including biometric, glycemic, lipid, liver, and renal functions of women with polycystic ovary syndrome (PCOS). Study Design and Methods. A total of 1000 women diagnosed as PCOS by modified Rotterdam criteria were enrolled in a randomized controlled trial. SHBG and comprehensive metabolic parameters were measured at the baseline visit. Metabolic parameters included biometric parameters, glucose and lipid panels, and liver and renal function parameters. An independent t-test and linear regression were performed to investigate the associations between SHBG and metabolic parameters. Logistic regression was used to detect the relationship between SHBG and the presence of metabolic syndrome. Results. In comparative analyses, PCOS women with lower SHBG levels had higher body mass index, waist circumference, insulin, homeostatic model assessment-insulin resistance (HOMA-IR) index, systolic and diastolic blood pressure, triglycerides, apolipoprotein B (APOB), low-density lipoprotein (LDL), aspartate transferase (AST), alanine transferase (ALT), and blood urea nitrogen (BUN), but lower high-density lipoprotein (HDL) and apolipoprotein A1 (APOA1). In linear regression, SHBG was inversely associated with waist circumference, systolic blood pressure, triglyceride, LDL, APOB, ALT, AST, and BUN but positively associated with HDL and APOA1 after adjusting the BMI. In logistic regression, SHBG is a protective predictor for metabolic syndrome (odds ratio = 0.96; 95% confidence interval: 0.95–0.97). The area under the receiver-operator characteristic curve is 0.732 with a 95% confidence interval of 0.695–0.770. SHBG <26.75 mmol/L is the cutoff point with the best Youden index, which has a sensitivity of 0.656 and specificity of 0.698. Conclusions. Lower SHBG was associated with worsening biometric, lipid, liver, and renal functions but not glycemic parameters among women with PCOS. SHBG can be used as a tool to screen metabolic syndrome. This trial is registered with NCT01573858 and ChiCTR-TRC-12002081.

scholarly journals 206 Attainment and maintenance of pubertal cyclicity may predict high A4 cows with reduced fertility

2019 ◽  
Vol 97 (Supplement_2) ◽  
pp. 118-119 ◽  
Author(s):  
Andrea S Cupp ◽  
Sarah Nafziger ◽  
Mohamed Abedal-Majed ◽  
Sarah Tenley ◽  
Mariah Hart ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Reproductive Tract ◽  
Culture Media ◽  
Polycystic Ovary ◽  
Sex Hormone Binding Globulin ◽  
Hormone Binding ◽  
Early Puberty ◽  
Ovary Syndrome ◽  
Ovarian Cortex ◽  
Calving Season

Abstract The UNL physiology herd has a population of cows that secrete excess androstenedione (A4) in follicular fluid. These High A4 cows are less fertile, have irregular cycles, are often anovulatory, and have similar characteristics to women with Polycystic Ovary Syndrome (PCOS). Ovarian cortex cultures of High A4 cows secrete more A4 than controls. High A4 cows reached puberty 45 d earlier than control cows. Thus, we hypothesized that heifers reaching puberty earlier were predisposed to become High A4 cows. To test this hypothesis, we collected blood plasma from weaning to breeding (2012–2017) in 611 heifers. A custom SAS program was developed using progesterone >1ng/ml to identify four distinct puberty groups: 1) Early Puberty- 317.0 ± 3.6 days of age (doa) with continued cyclicity (n = 143); 2) Typical Puberty- 378.4 ± 2.1 doa with continued cyclicity (n = 279); 3) Start-Stop Puberty- 265.3 ± 4.1 doa with discontinued cyclicity (n = 91); and 4) Non-Cycling- no P4≥1ng/ml (n = 98). The pattern of Sex Hormone Binding Globulin (SHBG) was increased prior to puberty in Early and Typical and reduced in Start-Stop and Non-Cycling heifers. Early heifers (4.9) had greater prebreeding reproductive tract scores, followed by Typical (4.7), Start-Stop (4.5), and Non-Cycling (4.0) heifers. At breeding, all heifers that showed estrus in response to PGF2a were artificially inseminated. Typical (78.9%), Early (79.5%) and Start-Stop heifers (50.3%) had a greater response compared to Non-Cycling heifers (12.6%). All heifers were exposed to bulls, and overall pregnancy rate was not different. However, a greater percentage of Typical (57.9%), Early (51.0%), and Start-Stop (45.2%) heifers calved in the first 21 d of the calving season compared to Non-Cycling (20.9%). Start-Stop (3.0ng/ml) and Non-Cycling (4.2ng/ml) heifers had increased A4 in ovarian cortex culture media compared to Typical (0.062ng/ml) or Early (0.091ng/ml) puberty heifers. Greater A4 produced by ovarian cortex of Start-Stop and Non-Cycling heifers, irregular cycles and reduced calves in the first 21 d indicates these females may be predisposed to becoming High A4 cows with decreased fertility.

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