多囊卵巢综合征患者血清中血管生成素相关生长因子水平的评价

目的探讨多囊卵巢综合征(PCOS)患者血清中血管生成素相关生长因子(angiopoientin-related growth factor,AGF)水平变化,及AGF与PCOS患者胰岛素抵抗的关系。方法 2010年3月至2011年3月在沧州市中心医院选择67例未合并糖尿病的PCOS患者作为研究组,同期选择112例健康女性作为对照组,测定所有研究对象血清AGF质量浓度及与胰岛素抵抗相关的内分泌代谢指标。结果研究组血清AGF水平显著高于对照组(345.3±38.6)vs.(288.7±33.4)μg/L,P<0.05;PCOS胰岛素抵抗组血清AGF水平显著高于PCOS非胰岛素抵抗组(350.9±29.6)vs.(338.4±31.6)μg/L,P<0.05。AGF与BMI(r=0.23,P<0.05)、胰岛素抵抗(IR)指数(HOMA-IR)(r=0.19,P<0.05)呈正相关,与年龄、低密度脂蛋白(LDL-C)、腰臀比(WHR)、空腹血糖(FBG)、2h糖耐量试验(OGTT)、空腹胰岛素(FINS)无关。结论升高的AGF可能在PCOS患者糖脂代谢紊乱的发生发展过程中发挥作用。     

多囊卵巢综合征患者血循环中瘦素水平及其相关因素的临床研究

目的 :探讨多囊卵巢综合征 (PCOS)患者血循环中瘦素水平与其它内分泌、代谢指标之间的关系 ,进一步研究瘦素的作用规律。方法 :PCOS患者 82例 ,行葡萄糖耐量试验 (OGTT)、胰岛素释放试验 ,测定 5个时点的血糖、胰岛素以及C 肽 (C P)浓度 ;测定空腹血瘦素、性激素及促性腺激素浓度 ;同时测定患者的体重指数 (BMI)、腰臀比例(WHR) ,观察胰岛素增敏剂治疗对瘦素的影响。瘦素和胰岛素用放免法测定 ,C 肽和性激素用发光免疫法测定。结果 :肥胖组瘦素水平显著高于消瘦组 (P =0 .0 0 0 1 ) ,瘦素水平与体重指数呈高度正相关 (P =0 .0 0 0 1 ) ;与腰臀比例、空腹、60min、1 2 0min胰岛素浓度呈显著正相关 (P分别为 0 .0 1 96、0 .0 3 0 8、0 .0 0 0 6、0 .0 0 1 4) ;与OGTT各时点的血糖、C 肽浓度以及血糖、胰岛素、C 肽曲线下面积之间无显著相关性 (P >0 .0 5 )。二甲双胍、文迪雅对瘦素水平无显著影响。结论 :PCOS患者的瘦素浓度与体内脂肪含量及分布密切相关。PCOS患者可能同时存在瘦素抵抗和胰岛素抵抗。用改善胰岛素敏感性药物治疗对瘦素水平无显著影响。     

多囊卵巢综合征患者甲状腺激素水平及其临床意义

目的 探讨多囊卵巢综合征（PCOS）患者甲状腺素水平及其临床意义。方法 选取45例PCOS患者作为研究组;另选取同期45例健康检查者为健康组。比较两组受试者甲状腺激素指标[三碘甲状腺原氨酸（T3）、甲状腺素（T4）、游离三碘原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）];根据研究组血清TSH水平不同分为A组（26例,TSH<2.5 mIU/L）、B组（14例,2.5 mIU/L4 mIU/L）,比较A组、B组、C组性激素水平[睾酮（T）、促黄体生成素（LH）、卵泡刺激素（FSH）、雌二醇（E2）、LH/FSH]、糖脂代谢指标[总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、空腹血糖（FPG）、空腹胰岛素（FINS）]、胰岛素抵抗指标[胰岛素抵抗指数（HOMA-IR）、胰岛素敏感指数（ISI）、血糖曲线下面积（GAUC）、胰岛素曲线下面积（AUCI）]水平。结果 研究组TSH(3.07±0.99)mIU/L水平显著高于健康组（2.57±0.88）mIU/L,T3...     

多囊卵巢综合征及其相关疾病超声评价

多囊卵巢综合征（PCOS）需要迅速准确的诊断方法和适当的处理。近年PCOS的诊断标准成为广泛争议的话题。卵巢超声波检查在临床的广泛应用为PCOS的诊断提供了标准，并超过卵巢腹腔镜下组织学检查或活体组织检查。经阴道超声检查和多普勒卵巢血流动力学检查，都已从观察卵巢的形态改变，转向研究子宫及卵巢间质的血流动力学改变，并对病情程度及进展进行评价，监测及评价PCOS的治疗，选择受孕时机。     

多囊卵巢综合征患者糖耐量异常及相关因素分析

目的:探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者糖耐量受损(IGT)和2型糖尿病(NIDDM)的发生率及其高危因素。方法:回顾分析101例PCOS患者口服葡萄糖耐量(OGTT)实验后的临床资料,多因素logistic回归分析探讨PCOS患者糖耐量异常的危险因素。结果:(1)根据葡萄糖耐量实验结果分成糖耐量正常组(NGT)77例与糖耐量异常组(AGT)24例(IGT22例、NIDDM2例),IGT发生率21.8%,NIDDM发生率1.98%;(2)AGT组的年龄、腰臀比(WHR)、体重指数(BMI)、睾酮(T)、空腹血糖(FPG)、2h血糖增高,与NGT组的差异有统计学意义(P<0.05),空腹胰岛素(FINS)、2h胰岛素、稳态模式胰岛素抵抗指数(HOMA-IR)升高,差异有统计学意义(P<0.01)。初潮年龄、黄体生成素/卵泡刺激素(LH/FSH)两组差异无统计学意义(P>0.05);(3)AGT组糖尿病家族史发生率高于NGT组,差异有统计学意义(P<0.01);(4)多因素logistic回归分析显示,年龄、BMI、2型糖尿病家族史、空腹胰岛素升高为PCOS糖耐量异常的高危因素。结论:多囊卵巢综合征发生糖耐量受损、糖尿病的危险性增加,葡萄糖耐量2h血糖水平是监测PCOS糖耐量异常的较好指标。年龄、BMI、2型糖尿病家族史、空腹胰岛素升高是PCOS糖耐量异常发生的危险因素。     

多囊卵巢综合征患者血清瘦素水平的测定及意义

目的　探讨多囊卵巢综合征 (PCOS)患者血清瘦素水平变化及其临床意义。方法　采用放射免疫法测定 5 3例PCOS患者血清瘦素、胰岛素水平并与 2 0例月经周期正常妇女作对照。结果　PCOS组空腹血清瘦素水平 (19 72± 18 11) μg/L ,对照组 (8 0 6± 3 2 8) μg/L ,两组比较差异有显著性 (t =4 498,P <0 0 5 ) ;PCOS组空腹胰岛素水平 (11 78± 8 0 3)mIU/L ,明显高于对照组 [(7 95± 2 2 4)mIU/L],差异有显著性 (t=3 16 3,P <0 0 5 ) ,PCOS组血清瘦素水平与胰岛素呈正相关。结论　瘦素和胰岛素可能共同参与PCOS的病理过程 ,检测血中瘦素水平 ,对于PCOS促排卵治疗的效果判断可能具有一定的意义     

多囊卵巢综合征

多囊卵巢综合征(PCOS)是高雄激素性不排卵性不孕的最常见原因，在育龄女性中的发生率约为6％，是一种发病多因性，临床表现为多态性的综合征，随医学研究的进展，对PCOS的认识无论在临床特征还是发病机制方面均有长足进展，在治疗方面也有重大变革。从发病机制、临床特征、治疗进展及预后等方面进行综合阐述。     

探讨多囊卵巢综合征患者甲状腺素水平及其临床意义

目的 探究多囊卵巢综合征(PCOS)患者甲状腺素水平及其临床意义。方法 选取40例PCOS患者作为观察组,依据血清促甲状腺激素(TSH)水平将患者分为低水平组(16例,TSH为<2.5 mIU/L)、中水平组(14例,TSH为2.5～4 mIU/L)、高水平组(10例,TSH为>4mIU/L)。另选取本院同期健康体检者40例作为对照组。比较甲状腺素、糖脂代谢水平。结果 观察组三碘甲状腺原氨酸(T₃)、甲状腺素(T₄)、游离三碘原氨酸(FT₃)水平较对照组低,TSH、空腹胰岛素(FINS)水平较对照组高(P<0.05)。三组促黄体生成素(LH)、卵泡刺激素(FSH)、FINS水平两两比较差异均有统计学意义(P<0.05)。结论 PCOS患者甲状腺素水平会发生明显改变,且TSH水平越高,患者性激素分泌、糖脂代谢异常程度越高,临床需予以重视,尽早监测。     

多囊卵巢综合征及其相关疾病超声评价

多囊卵巢综合征(PCOS)需要迅速准确的诊断方法和适当的处理.近年PCOS的诊断标准成为广泛争议的话题.卵巢超声波检查在临床的广泛应用为PCOS的诊断提供了标准,并超过卵巢腹腔镜下组织学检查或活体组织检查.经阴道超声检查和多普勒卵巢血流动力学检查,都已从观察卵巢的形态改变,转向研究子宫及卵巢间质的血流动力学改变,并对病情程度及进展进行评价,监测及评价PCOS的治疗,选择受孕时机.     

多囊卵巢综合征相关研究和治疗

多囊卵巢综合征(PCOS)是女性最常见的内分泌性疾病，也是妇科研究和治疗最有争议的领域之一，它是一组多病因，临床表现多态性的综合征，以闭经、肥胖、多毛、不孕为主要临床表现，是临床治疗最棘手的疾病之一。我院对1998年1月～2002年10月的门诊及病房128例患者进行研究治疗，分析如下。     

Elevated serum chemerin in Chinese women with hyperandrogenic PCOS

Objectives: To compare serum chemerin levels between women with classic hyperandrogenic PCOS, euandrogenic PCOS and matched control subjects.

Research design and methods: This study was carried out at the Second XiangYa Hospital between July 2012 and April 2013. Sixty-seven women with PCOS and 20 controls were included. Blood pressure, body mass index (BMI), waist to hip ratio (WHR), fasting insulin, fasting plasma glucose and blood serum hormone and blood lipid were measured. Transvaginal ultrasound was performed. Serum chemerin was measured by ELISA.

Results: Serum chemerin was significantly higher in classic hyperandrogenic PCOS compared with euandrogenic PCOS and controls (311.07?±?141.87?ng/mL versus 228.03?±?119.66?ng/mL and 225.87?±?86.44?ng/mL, p?p?Conclusions: Serum chemerin level was increased in Chinese women with classic hyperandrogenic PCOS. Serum chemerin measurement offers a relatively moderate diagnostic potency with a sensitivity of 80.0% and a specificity of 47.6% at 200.94?ng/mL. This suggested that chemerin may be involved in the development of the metabolic syndrome of classic PCOS.     

Involvement of nitric oxide and the ovarian blood follicle barrier in murine follicular cyst development

OBJECTIVE: To test the involvement of nitric oxide in murine ovarian follicular cysts. DESIGN: Controlled animal study. SETTING: Academic research environment. ANIMAL(S): Immature female B6D2F1 mice at 23 +/- 2 days old.Ovarian cysts were induced by implanting miniosmotic pumps that delivered and maintained constant levels of hCG. Nitric oxide studies included the delivery of nitric oxide synthase (NOS) inhibitors, N(G)-nitro-L-arginine methyl ester (L-NAME), or N(G)-nitro-D-arginine methyl ester, by the same method.Ovulation assays measured cumulus oocyte complexes and blood follicle barrier (BFB) function. RESULT(S): Chronic treatment with hCG induced enlarged ovaries containing multiple follicular cysts, which were approximately double the size of follicles in sham-operated mice. These cysts enclosed few, if any granulosa cells, secreted high levels of testosterone, and had impaired ovarian BFB function. Inhibition of NOS by L-NAME during ovarian cyst formation reduced the size of follicular cysts, sustained normal testosterone levels, and maintained hormonal BFB reactivity in cystic follicles. CONCLUSION(S): Nitric oxide was found to be involved in the formation of hCG-induced murine follicular cysts and complications associated with these cysts were ameliorated by the NOS inhibitor L-NAME.     

High DHEAS/free testosterone ratio is related to better metabolic parameters in women with PCOS

Abstract

Aims: To demonstrate the effects of DHEAS/free testosterone (DHEAS/FT) ratio on metabolic parameters in women with and without polycystic ovary syndrome (PCOS).

Methods: The data of 91 women with PCOS and 66 women in the control group were collected retrospectively.

Results: DHEAS/FT of the control group was higher than that of PCOS group (684.93?±?300.54 to 517.2?±?300.8, p?<?0.001). DHEAS/FT correlated with BMI (r?=??0.352, p?=?0.001), WHR (r?=??0.371, p?=?0.0219), LDL (r?=??0.227, p?=?0.031), HOMA-IR (r?=??0.36, p?=?0.001) and FAI (r?=??0.639, p?=?0.001) negatively and with HDL (r?=?0.344, p?=?0.001) and SHBG (r?=?0.646, p?=?0.001) positively. In the control group, DHEAS/FT correlated with BMI (r?=??0.334, p?=?0.007), CRP (r?=??0.297, p?=?0.016) and FAI (r?=??0.399, p?=?0.01) negatively.

Conclusions: High DHEAS/FT ratios are related to a better metabolic phenotype in women with PCOS and low levels can be used to detect women with PCOS that have a higher risk of metabolic problems.     

Association of AQP8 in women with PCOS

Aquaporin 8 (AQP8) has been identified as a novel gene participating in female reproductive physiology. The present study was designed to determine whether an association exists between AQP8 and polycystic ovary syndrome (PCOS). This study recruited 192 women with PCOS and 191 controls. High-resolution melting and sequencing were employed to investigate the genotypes of six single-nucleotide polymorphisms within AQP8 (rs7198838, rs1076973, rs1076974, rs2287797, rs2287798 and rs2287796). A significant difference was found in rs2287798 between PCOS cases and controls (P = 0.0007). Possible associations between AQP8 genotypes and three different phenotypes of this syndrome were investigated. The results support the earlier evidence for a possible role of AQP8 in the pathogenesis of PCOS. Further studies are still needed to elucidate its functional role.Aquaporin 8 (AQP8) has been identified as a novel gene participating in female reproductive physiology. The present study was designed to determine whether there is an association between AQP8 and polycystic ovary syndrome (PCOS). This study recruited 192 women with PCOS and 191 controls. High-resolution melting and sequencing were employed to investigate the genotypes of six single-nucleotide polymorphisms within AQP8 (rs7198838, rs1076973, rs1076974, rs2287797, rs2287798 and rs2287796). We observed a significant difference in allele frequency of rs2287798 between PCOS cases and controls (P = 0.0007). The possible association between AQP8 genotypes and three different phenotypes of this syndrome in this locus were investigated. Our results support the earlier evidence for a possible role of AQP8 in the pathogenesis of PCOS. Further studies are still needed to elucidate its functional role.     

Hormonal contraceptive choice for women with PCOS: a systematic review of randomized trials and observational studies

Introduction: This paper provides a critical review of the data concerning the effects of combined hormonal contraceptives (CHC) for polycystic ovary syndrome (PCOS). The aim is to determine the best treatment option for each PCOS phenotype.

Study design: A literature search of the PubMed database was conducted for randomized clinical trials (RCTs) and observational studies published in any language prior to October 2013. Hyperandrogenism (HA) is the essential diagnostic criterion for PCOS and is frequently associated with insulin resistance (IR) or obesity. The combinations of these criteria define the different PCOS phenotypes and establish the scale of metabolic and cardiovascular risks.

Results and conclusions: 19 RCTs and eight observational studies evaluated issues related to the current objectives. CHC represent an effective and safe treatment in women with any PCOS phenotype. In HA/PCOS patients, any CHC analyzed in this review can be used for symptom relief. For patients with metabolic risk, overweight or moderate IR that does not require metformin, a vaginal contraceptive ring appears to be preferred to oral EE/DRP. In these patients, the combination of CHC and myo-inositol may be more effective in controlling endocrine and metabolic profiles. However, further research is needed to define the optimal duration and to clarify the effects of treatment on long-term metabolic outcomes. Future research should also focus on new CHC.     

Lower serum apelin levels in women with polycystic ovary syndrome

We tested differences in serum apelin levels between women with polycystic ovary syndrome (PCOS) and those with a healthy regular menstrual cycle, finding that apelin levels were higher in normal women and that apelin was positively correlated with apolipoprotein A levels.     

Association of betatrophin with metabolic characteristics in overweight/obese and lean women with PCOS

As a new hormone, betatrophin has gained attention as a potential new target to combat insulin resistance (IR) and diabetes. Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder among women of the reproductive age with long term sequelae which include IR and metabolic syndrome. The aim of this study is to evaluate the circulating plasma betatrophin levels in overweight/obese or lean women with or without PCOS and also to elucidate possible correlations with anthropometric and metabolic parameters. Thirty-two patients with PCOS as well as fifty-three control subjects were enrolled after obtaining informed written consent. Clinical and biochemical parameters of all subjects were determined. Plasma adiponectin, GLP-1 and betatrophin levels were measured by ELISA. Plasma betatrophin levels were significantly increased in lean patients with PCOS compared with lean and obese controls. Moreover, in PCOS group, betatrophin levels were significantly negatively correlated with waist hip ratio (WHR), fasting insulin level (FINS) and HOMA-IR, whereas, significantly positively correlated with adiponectin level. Multiple regression analysis showed that HOMA-IR was an independent factor influencing serum betatrophin levels. Further follow-up studies are needed to highlight whether and how increased betatrophin secretion play an important role in IR and carbohydrates metabolism in patients with PCOS.     

多囊卵巢综合征基础血清皮质醇水平及其昼夜规律变化

目的探讨多囊卵巢综合征(PCOS)患者基础血清皮质醇水平及其昼夜规律的变化。方法对2008年7月至2010年5月中山大学附属第一医院生殖医学中心63例PCOS患者(21例肥胖和42例非肥胖)及38名月经正常的健康妇女进行空腹8时(基础)及16时血清皮质醇浓度测定,并比较其昼夜规律消失的比例,同时分析影响基础皮质醇水平的可能相关因素。结果肥胖PCOS组、非肥胖PCOS组及健康对照组的基础皮质醇水平分别为(325.7±125.7)nmol/L,(407.6±165.6)nmol/L和(397.4±129.9)nmol/L。其中肥胖PCOS组基础皮质醇水平明显低于健康对照组(P<0.05)。16与8时皮质醇比值,肥胖(0.78±0.54)及非肥胖PCOS组(0.61±0.34)均较健康对照组(0.46±0.20)显著升高(P<0.05)。肥胖PCOS组皮质醇昼夜规律消失率明显高于健康对照组(47.6%vs.10.5%,P<0.05)。相关分析发现基础皮质醇水平与体重指数呈负相关(P<0.05)。结论 PCOS患者(尤其是肥胖PCOS患者)可能存在下丘脑-垂体-肾上腺轴(HPA轴)的功能紊乱。体重指数对皮质醇的代谢以及HPA轴的激活有重要的影响。     

Serum free fatty acid levels in PCOS patients treated with glucophage,magnesium oxide and spironolactone

Abstract

To assess the effect of glucophage, magnesium oxide and spironolactone in altering free fatty acids (FFAs), 36 PCOS women were randomly divided into three groups. Group 1 (n?=?14) was treated with 500?mg glucophage po bid, group 2 (n?=?10) was treated with 400?mg magnesium oxide po bid and group 3 (n?=?12) was treated with 50?mg spironolactone po bid for 12 weeks. A glucose tolerance test with 75?g glucose load was performed before and after treatment, collecting blood at 0, 1 and 2?h for insulin, glucose, FFA and aldosterone. Amount of FFA before and after treatment were compared by repeated measure ANOVA and represented as area under the curve. FFA levels before treatment were 0.83?±?0.23, 0.77?±?0.15 and 0.85?±?0.28 and after treatment were 0.77?±?0.48, 0.71?±?0.18 and 0.66?±?0.25 for glucophage, magnesium oxide and spironolactone-treated patients, respectively. The FFA levels were unchanged in the groups treated with glucophage and magnesium oxide but were significantly (p?<?0.03) decreased in the group treated with spironolactone. Since FFAs are known to be involved in the development of insulin resistance, these results suggest that spironolactone may be useful for lowering insulin resistance in PCOS patients.     

Irisin plasma concentration in PCOS and healthy subjects is related to body fat content and android fat distribution

Abstract

Irisin (Ir), a recently identified adipo-myokine, cleaved and secreted from the protein FNDC5 in response to physical activity, has been postulated to induce the differentiation of a subset of white adipocytes into brown fat and to mediate the beneficial effects on metabolic homeostasis. Metabolic syndrome (MS), a cluster of factors leading to impaired energy homeostasis, affects a significant proportion of subjects suffering from polycystic ovary syndrome (PCOS). The aim of our study was to investigate the relationship between Ir plasma concentrations and metabolic disturbances. The study group consisted of 179 PCOS patients and a population of 122 healthy controls (both groups aged 25–35 years). A subset of 90 subjects with MS was isolated. A positive association between Ir plasma level and MS in the whole group and in controls was found. In subjects with high adipose body content (>40%), Ir was higher than in lean persons (<30%). Our results showed a significant positive association between Ir concentration and android type of adipose tissue in the whole study group and in the control group. Understanding the role of Ir in increased energy expenditure may lead to the development of new therapeutics for obesity and obesity-related diseases.