Evaluation of the clinical significance of serum pentraxin-3 levels in patients with polycystic ovary syndrome (original) (raw)
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Is Pentraxin 3 a New Cardiovascular Risk Marker in Polycystic Ovary Syndrome?
Gynecologic and Obstetric Investigation, 2014
resistance indexes and lipid profile between the PCOS and control groups. CRP levels were significantly higher in obese PCOS and control subjects than in lean subjects, whereas no difference in PTX3 concentrations was observed between subgroups. Conclusion: PTX3 and CRP levels were similar in the PCOS group compared with the non-PCOS control group.
Assessment of relationship between hormones and insulin resistance in PCOS
IP innovative publication pvt. ltd, 2019
Introduction: Polycystic ovarian syndrome (PCOS) is the most common heterogenous disorder of reproductive age. Increased frequency of GnRH pulses from hypothalamus elevates LH levels this in turn causes increased androgen production. The chronic hyperandrogenic state have multiple long and short term complications which includes DM and CVD. Insulin resistance can be characterized as impaired action of insulin on glucose metabolism which increases risk of developing T2DM. Hyperandrogenism with hyperinsulinemia also leads to dyslipidemia. Aim: To estimate LH/FSH ratio, testosterone in PCOS patients and to correlate its significance with the insulin resistance. Materials and Methods: This case-control study was conducted on clinically, diagnosed 50 PCOS patients, aged 15 to 35 years were included as cases. Age-matched 50 apparently heal thy women were included as controls. Serum leutinising hormone(LH), Follicle stimulating hormone(FSH), testosterone, serum insulin were analysed by chemiluminiscence immunoassay(CLIA) on Maglumi 1000. Mindray BS 300, fully automated analyser was used for estimation of Total cholesterol(TC), High density lipoprotein(HDL), Triglyceride(TG), Fasting Blood Glucose (FBG), Low density lipoprotein (LDL) was calculated using Friedewald’s formula. Insulin resistance was assessed by HOMA IR. Descriptive statistics analysis was done using unpaired student’s t-test. Chi-square/ Fisher Exact test has been used to find the significance of study parameters on categorical scale. Pearson’s correlation coefficient was applied to analyse the correlation. p value <0.05 was considered statistically significant. Results: In our study the LH /FSH ratio, HOMA IR and Testosterone was increased in cases compared to controls with p 0.01 and for testosterone p 0.001. In contrast HDL decreased in cases compared to controls (p<0.001). Triglyceride (p<0.01) was higher in cases compared to controls in our study. However LDL and Total cholesterol were not significantly increased in cases however we can find that LDL was still increased in cases. Average BMI was within the normal range (p=0.06). On correlation study FSH showed a negligible negative correlation with HOMA IR and mild negative correlation with BMI. LH showed a positive correlation with both HOMA IR(r 0.45,p<0.01) and BMI(r 0.61, p<0.01). Whereas testosterone showed no correlation. LH/FSH ratio was positively correlated with HOMA IR(r 0.42, p<0.01) and also BMI(r 0.53, p <0.001). TC(r 0.31, p 0.02) showed significant positive correlation whereas LDL(r 0.18,p 0.21), TG(r 0.16,p 0.26) though positive showed negligible correlation with HOMA IR. BMI showed a significant positive correlation with HOMA IR (r 0.43,p <0.01). Conclusion: In our study we propose that in PCOS cases IR seems to underlie many clinical features of PCOS. It encompasses long term health problems like CVD, DM and increased exposure to estrogen can lead to endometrial carcinoma. It is need of the time to follow up the patient to early identify and prevent the consequences of this syndrome.
Clinical Endocrinology, 2008
Background Polycystic ovary syndrome (PCOS) is considered predominantly as a hyperandrogenetic syndrome and the evaluation of metabolic parameters and insulin sensitivity is not mandatory.Context PCOS diagnostic criteria [National Institute of Health (NIH), Rotterdam Consensus (ROT), Androgen Excess Society (AES)] are unanimous recognized. We aimed to assess in women with suspected PCOS whether the application of the three diagnostic criteria differently characterizes the metabolic profile and insulin sensitivity.Design Retrospective study in a cohort of women admitted to our Outpatient Clinic for suspected PCOS.Patients Two hundred and four women with suspected PCOS in comparison to a group of normal, age-matched Sicilian women (N = 34) without signs of metabolic syndrome.Measurements We evaluated hyperandrogenaemia and clinical hyperandrogenism, ovarian morphology, hypothalamo–hypophyseal axis and metabolic syndrome parameters. An oral glucose tolerance test (OGTT; 75 g glucose) measured areas under the curve (AUC) for insulin, C peptide and homeostasis model assessment of insulin-resistance (HOMA-IR) were performed.Results The prevalence of PCOS was 51% according to NIH, 83% to ROT and 70·6% to AES, and only 100 patients were qualified simultaneously under these three criteria. The prevalence of the metabolic syndrome in PCOS women was 26·92% (NIH), 21·77% (ROT) and 23·61% (AES), respectively. In comparison to healthy women, PCOS women showed increased fasting insulinaemia (PCOS/ROT: P = 0·028; PCOS/NIH: P = 0·007; PCOS/EAS: P = 0·023), 120 min insulin after OGTT insulinaemia (for the three criteria: P < 0·001), AUC2h insulin (for the three criteria: P < 0·001) and AUC2h C peptide (for the three criteria: P < 0·001).Conclusions Our study highlights the fact that regardless of the diagnostic criteria used, evaluation of the metabolic parameters and insulin sensitivity is important for a correct diagnosis of PCOS and a therapeutic approach.
2004
Since the 1990 NIH-sponsored conference on polycystic ovary syndrome (PCOS), it has become appreciated that the syndrome encompasses a broader spectrum of signs and symptoms of ovarian dysfunction than those de®ned by the original diagnostic criteria. The 2003 Rotterdam consensus workshop concluded that PCOS is a syndrome of ovarian dysfunction along with the cardinal features hyperandrogenism and polycystic ovary (PCO) morphology. PCOS remains a syndrome and, as such, no single diagnostic criterion (such as hyperandrogenism or PCO) is suf®cient for clinical diagnosis. Its clinical manifestations may include: menstrual irregularities, signs of androgen excess, and obesity. Insulin resistance and elevated serum LH levels are also common features in PCOS. PCOS is associated with an increased risk of type 2 diabetes and cardiovascular events.
Human Reproduction, 2013
Is it possible to distinguish metabolically healthy polycystic ovary syndrome (MH-PCOS) from metabolically unhealthy PCOS (MU-PCOS) by simple diagnostic tools such as body mass index (BMI), waist/hip ratio (WHR), at-risk category suggested by Androgen Excess Society (AES) and visceral adiposity index (VAI)? summary answer: VAI could be an easy and useful tool in clinical practice and in population studies for assessment of MU-PCOS. what is known already: VAI is a good indicator of insulin sensitivity and cardiometabolic risk in oligo-ovulatory women with PCOS. study design, size, duration: We conducted a cross-sectional study of 232 women with PCOS in a university hospital setting. participants/materials, setting, methods: Anthropometric, hormonal and metabolic parameters were evaluated. An oral glucose tolerance test measured areas under the curve (AUC) for insulin (AUC 2h insulin) and for glucose (AUC 2h glucose). Homeostasis model assessment of insulin resistance (HOMA2-IR), the Matsuda index of insulin sensitivity (ISI), the oral dispositional index (DIo) and VAI were determined. main results and the role of chance: The prevalence of MU-PCOS according to the different criteria was: BMI, 56.0%; WHR, 18.1%; at-risk criteria of AES, 72.0% and VAI, 34.5%. The likelihood that a woman would exhibit MU-PCOS (except when diagnosed by the WHR criterion) showed a significant positive association with high HOMA2-IR [
PCOS: Backgrounds, evidence and problems in diagnosing the syndrome
International Congress Series, 2005
PCOS constitutes a heterogeneous clinical picture harbouring different subsets of patients. Recently an attempt was made to define the diagnosis of PCOS based on existing clinical evidence. Oligo-or anovulation, clinical or biochemical hyperandrogenism and polycystic ovaries constitute the key clinical features on which the diagnosis should be based. No single diagnostic criterion is sufficient for clinical diagnosis. Based on this new consensus the spectrum of women with PCOS has been considerably broadened. The purpose of this paper is to review the evidence for this new classification and to address problems in diagnosing PCOS using these new criteria.
Polycystic ovary syndrome (PCOS), characterized by chronic anovulation and hyperandrogenism, is common in women of childbearing age. Most of these women also have insulin resistance, and insulin sensitizing agents-metformin and the thiazolidinediones-can restore ovulation and often fertility. Treatment of hirsutism and depression are important components of therapy. The increased risk for uterine cancer because of unopposed estrogen can be managed with progestin therapy. Women with PCOS are also at greater risk for both type 2 diabetes and cardiovascular disease.