Nesfatin-1 and Vitamin D levels may be associated with systolic and diastolic blood pressure values and hearth rate in polycystic ovary syndrome.

Obesity, insulin resistance (IR), inflammation, and hyperandrogenism may lead to polycystic ovary syndrome (PCOS) and hypertension. Nesfatin-1 (N1) may be related to IR, obesity, and hypertension. Furthermore, a vitamin D (VD) deficiency is associated with hypertension and PCOS. We aimed to investigate N1 and VD levels in PCOS that have an effect on systolic and diastolic blood pressure (BP) and heart rate (HR).This study included 54 patients with PCOS and 48 age-body mass index (BMI)-matched healthy controls. PCOS was diagnosed according to clinical practice guidelines. Ferriman-Gallwey scores (FGS) were calculated, while N1, VD, and other hormonal and biochemical parameters were measured for all subjects. Systolic and diastolic BP was measured as well. HR was calculated using an electrocardiogram.The levels of N1 (p < 0.001), high-sensitivity C-reactive protein (hs-CRP) (p = 0.036), homeostasis model assessment as an index of insulin resistance (HOMA-IR) (p < 0.001), systolic (p < 0.001) and diastolic (p < 0.001) BP and HR (p < 0.001) in the PCOS group were significantly higher than in the control group. However, the VD levels of the PCOS group were lower than the control group (p = 0.004). N1 had a strong positive correlation with BMI, HOMA-IR, hs-CRP, luteinizing hormone, systolic and diastolic BP, and HR. VD levels were negatively correlated with HOMA-IR and luteinizing hormone.Elevated N1 and decreased VD levels may be related to the presence of high-normal BP or hypertension in PCOS subjects.  N1 level may be associated with an increased BP due to its relation to inflammation and IR.

Relationships between C-kit expression and mean platelet volume in benign, preneoplastic and neoplastic endometrium.

BACKGROUND: c-Kit is a proto-oncogene that encodes a tyrosine kinase receptor (CD117). Mean platelet volume (MPV) is a useful marker for demonstrating thrombocyte function. We aimed to investigate whether c-kit is expressed in benign, preneoplastic and neoplastic endometrial tissues and whether MPV has a relation with c-kit expression and its intensity. MATERIALS AND METHODS: c-Kit expression was investigated immunohistochemically in 10 samples of normal endometrium (n=10), simple endometrial hyperplasia (5 cases with atypia and 10 cases without atypia), complex endometrial hyperplasia (10 cases with atypia and 10 cases without atypia) and endometrial cancer (EC) (10 cases grade I and 10 cases grade II) and MPV of all cases was checked. RESULTS: c-Kit expression was observed at very low rates in cases with normal endometrial tissues (NE) and in hyperplasia without atypia. c-Kit expression and immunostaining were strong in endometrial atypia and EC. MPV levels of complex atypical endometrial hyperplasia (CAEH) (p:0.002), EC grade I (ECG I) (p<0.001) and EC grade II (ECG II) (p<0.001) were significantly elevated when compared with the NE group. Both c-kit expression and intensity of immunostaining had a positive correlation with MPV level. CONCLUSIONS: While c-kit expression and intensity of immunostaining were mildly positive in NE and hyperplasia without atypia, they were clearly observed in EC and hyperplasia with atypia. As c-kit expression is related to the mutagenesis a long-term follow- up may be needed in these cases. A high MPV level may be a good test for demonstrating c-kit expression and intensity of immunostaining.

The role of hypoxia at primary dysmenorrhea, utilizing a novel hypoxia marker--SCUBE1.

STUDY OBJECTIVE: To determine the SCUBE1 levels in adolescents with primary dysmenorrhea. DESIGN: A prospective cross-sectional study. SETTING: A university hospital outpatient clinic, Rize, Turkey. PARTICIPANTS: A total of 40 adolescent girls, 15 on menses and 25 not on menses. INTERVENTIONS AND MAIN OUTCOME MEASURES: Demographic features and menstrual history of the participants were assessed and blood samples were obtained for detecting the platelet volume, platelet counts, and SCUBE1 levels of the participants. RESULTS: No difference was detected between the 2 groups in mean platelet volume, platelet count, and SCUBE1 levels. CONCLUSION: Future trials are required to investigate the relation between SCUBE1 levels and primary dysmenorrhea.

Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in patients with endometrial hyperplasia and endometrial cancer.

AIM: Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and platelet distribution width (PDW) may indicate the systemic inflammatory response associated with various cancers. We aimed to investigate the relationship between NLR, PLR, PDW and endometrial pathologies including hyperplasia and cancer. METHODS: In this study, 472 cases who underwent endometrial biopsy were included. Three groups were constituted with respect to biopsy results: group 1, endometrial cancer patients (n = 54); group 2, endometrial hyperplasia patients (n = 152); and group 3, patients with normal biopsy results (n = 281). White blood cell and platelet counts as well as NLR, PLR and PDW recorded from complete blood counts obtained on the same day of biopsy were compared in the three groups. RESULTS: Endometrial cancer patients were significantly older than the cases in the other two groups (P < 0.001). The NLR in group 1 was significantly higher than group 3 (P = 0.02). However, there was no difference between the three groups with respect to PLR (P = 0.167). PDW was increased in group 1 compared to group 3 (P < 0.001). CONCLUSION: Results of our study have shown that NLR, PLR and PDW are simple, readily available and robust inflammatory markers that may be used in the management of endometrial pathologies. However, the actual predictive potential of these biomarkers still warrants further trials.

Does low pentraxin-3 levels associate with polycystic ovary syndrome and obesity?

Pentraxin-3 (PTX3) a cytokine-inducible molecule is released from various tissues. Its level increases as a response to different inflammatory conditions. Polycystic Ovary Syndrome (PCOS) is considered as a proinflammatory state. The aim of this study was to investigate the association between PTX3 and various metabolic and hormonal parameters in PCOS patients. This study included 64 new diagnosed PCOS patients who had been never treated previously with PCOS and 46 healthy controls with matched age and body mass index (BMI). PTX3, biochemical and hormonal parameters of both groups were measured. The patients were divided into obese and non-obese subgroups according to BMI (above or lower than 25 kg/m²). PTX3, HOMA-IR and high sensitive C-reactive protein (hs-CRP) levels of these subgroups were compared. Serum PTX3 (p=0.013), hs-CRP (p=0.015) and HOMA-IR (p=0.023) levels of PCOS patients were significantly higher than the control group. Serum PTX3 has been found to have negative correlations with BMI (r=-0.318, p < 0.001), waist circumference (r=-0.306, p < 0.001), HOMA-IR (r=-0.324, p < 0.001) and hs-CRP (r=-0.206, p=0.031). Subgroup analysis revealed PCOS women with obesity to have significantly higher serum PTX3 level than non-obese PCOS subjects (p=0.012), non-obese controls (p=0.015) and obese controls (p=0.002). Women with new diagnosed PCOS especially obese subjects had significantly lower serum PTX3 than the control group. PTX3 has been found to be negatively correlated with BMI and insulin resistance. Low PTX3 level may have a role in the etiology of PCOS and in the formation of atherosclerotic diseases by stimulation of chronic inflammation.

Is there a relationship between mood disorders and dysmenorrhea?

OBJECTIVE: Menstrual problems are common among adolescent females. Mood changes are related to menstrual problems (menorrhagia, dysmenorrhea, and abnormal menstrual cycle length). The aim of this study was to determine the relationship between depressive symptoms, anxiety, and premenstrual syndrome (PMS) with dysmenorrhea in adolescent girls. METHODS: A total of 159 adolescent girls (aged 13-19 y) with regular menstrual cycles presenting to the gynecology clinic with any complaints were included in the study during April-May 2013. All of the participants filled up the sociodemographic data collection form, FACES Pain Rating Scale, Beck anxiety inventory (BAI), Beck depression inventory (BDI), and a questionnaire form on criteria for PMS. Mann-Whitney U and chi-square tests were used to analyze the data. RESULTS: The prevalence of dysmenorrhea was 67.9%. The mean BAI and BDI scores of the patients were 13.64 ± 12.81 and 11.88 ± 10.83, respectively. Statistically significant differences were observed between patients and control groups on the BAI and BDI scoring (P < .05). At least 1 of the symptoms of the PMS was detected in all of the participants and 29 (18.2%) of them were diagnosed as premenstrual dysphoric disorder (PMDD). The mean BAI score of the patients with PMS and PMDD were 9.65 ± 9.28 and 21.31 ± 15.75, respectively. The mean BDI score of the patients with PMS and PMDD were 8.39 ± 8.62 and 19.1 ± 11.85, respectively. Statistically significant differences were observed between PMS/PMDD and BAI/BDI scoring (P = .00). CONCLUSION: Adolescent girls with dysmenorrhea have an increased risk of depression and anxiety. These results of our study are significant in emphasizing the importance of a multidisciplinary approach to primary dysmenorrhea follow-up and treatment.

Labial adhesion with acute urinary retention secondary to vaginitis.

Labial adhesion occurs most often in infants and girls and is usually associated with low estrogen levels. Labial adhesion in the reproductive age group is extremely rare due to abundance of estrogen. Herein we present a case of almost complete labial adhesion with acute urinary retention in a 21-year-old virgin woman secondary to a probable untreated severe vaginitis.

Hand and wrist complaints in pregnancy.

PURPOSE: Hand and wrist complaints can decrease the quality of life of pregnant women, which can occur or aggravate during pregnancy and advance to chronic state if left untreated. The purpose of this study was to describe hand and wrist complaints in relation to pregnancy and assess their significance in pregnancy. METHODS: In a prospective cross-sectional study, 383 participants were randomly selected from among pregnant women on or over 28 weeks of gestation, attending the primary care maternal health clinic in a university hospital. The prevalence and severity of hand and wrist complaints were assessed using the Boston Carpal Tunnel Questionnaire (BCTQ). The symptomatic pregnant women were consulted by an orthopedist. The specific diagnoses of the patients were made based on patient history and physical examination. RESULTS: According to BCTQ scoring 258 (67.4 %) pregnant women were symptomatic. The diagnoses were as follows: asymptomatic 125 (32.6 %), nonspecific symptoms 138 (36 %), tendinitis 80 (20.9 %), carpal tunnel syndrome (CTS) 39 (10.2 %) and cubital syndrome 1 (0.3 %). There was no association noted between the diagnoses and numbers of pregnancies, occupational status, age, gestational weeks, weight gain or body mass index (BMI) (p > 0.05). CONCLUSION: The prevalence of hand and wrist complaints is high in pregnant women. All pregnant women should be investigated for hand and wrist complaints in routine antenatal checks to ensure good life quality during pregnancy and for avoiding these complaints advancing to chronic state. Further studies are needed to evaluate the effect of musculoskeletal systems disorders in pregnancy.

Posterior Reversible Encephalopathy Syndrome in a Postpartum Preeclamptic Woman without Seizure.

Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiological entity presenting with headache, confusion, visual disturbances or blindness, and seizures. Parieto-occipital white matter changes due to vasogenic oedema can be observed on imaging modalities. It rarely occurs without seizures and after delivery. We report a 33-year-old multigravida with a history of preeclampsia in term pregnancy complicated by PRES without seizures at the postpartum period. Clinical improvement with complete resolution without any complications was observed on the 6th day after delivery. Posterior reversible encephalopathy syndrome is reversible when early diagnosis is established and appropriate treatment is started without delay.

Disability and psychiatric symptoms in hyperemesis gravidarum patients.

PURPOSE: Nausea and vomiting is an important health problem which adversely affects the daily routine and quality of life in pregnant women. The purpose of this study was to measure the level of change in the quality of life, depression and anxiety in hyperemesis gravidarum (HG) patients in relation to social-demographic data and disease variables. METHODS: One hundred pregnant women hospitalized with the diagnosis of HG were included in the study. A total of 100 healthy pregnant women were also evaluated as the control group. All the patients in the study completed the socio-demographic data form, the Hospital Anxiety and Depression Scale (HADS-A and D) and Brief Disability Questionnaire (BDQ). RESULTS: The mean HADS-D subscale score was 7.09 ±3.91 in HG patients and 5.73 ± 3.32 in controls. The depression score in the HG patients were significantly higher than that of the control group (p = 0.009). The mean HADS-A subscale score was 7.73 ± 3.86, which was significantly higher in HG patients compared to 6.70 ± 3.31 in controls (p = 0.045). The mean BDQ score was 11.2 ± 4.40 in HG patients and 8.5 ± 3.31 in the control group of pregnant women, thus, significantly higher in the HG group as compared to controls (p < 0.0001). In the HADS-D, 52 patients in the HG group and 40 patients in the control group scored above the threshold value (p = 0.089). In the HADS-A, 28 patients in the HG group and 20 in the control group scored above the threshold value (p = 0.185). CONCLUSIONS: In patients with HG, a significant deterioration of physical and social health was encountered. HG disease is independent of any underlying psychiatric condition and adversely affects the quality of life of the sufferer.

Alterations of natriuretic peptides amino-terminal pro B-type natriuretic peptide and amino-terminal pro C-type natriuretic peptide during the pregnancy.

OBJECTIVE: The aim of this study was to determine the plasma levels of natriuretic peptides amino-terminal pro B-type natriuretic peptide (NT proBNP) and amino-terminal pro C-type natriuretic peptide (NT proCNP) during pregnancy and any possible changes occurring in each trimester. METHODS: This was a prospective longitudinal case-control study conducted in a University Hospital antenatal outpatient clinic. Subjects were all healthy pregnant women without a history of previous cardiac disease, hypertension or preeclampsia, and each patient was assessed during every trimester, and blood samples were collected for the measurement of NT proBNP and NT proCNP levels. RESULTS: Twenty pregnant women were followed-up during pregnancy without any complications. We obtained longitudinal levels of natriuretic peptides in each trimester. The mean NT proBNP levels were 14.95 ± 16.8, 9.37 ± 10.76, 52.48 ± 126.65 pmol/ml and the mean NT proCNP levels were 44.64 ± 41.64, 45.70 ± 47.03, 47.22 ± 55.09 pmol/l, respectively. No statistically significant alteration of plasma levels of natriuretic peptides was detected between trimesters. CONCLUSION: This is the first study evaluating the longitudinal levels of NT proCNP during the pregnancy, and demonstrates that NT proCNP remained constant, but NT proBNP levels do not significantly alter during pregnancy.

Primary fallopian tube carcinoma diagnosed preoperatively by cervical smear.

Primary fallopian tube carcinoma is a rare clinical entity that constitutes a diagnostic challenge in gynecological practice. Patients generally suffer from the three symptoms: vaginal bleeding, pelvic pain, and vaginal discharge; however, this is usually not sufficient for confirming the diagnosis preoperatively in most circumstances. In this case report, we present a 49-year-old woman whose cervical smear raised a suspicion for fallopian tube carcinoma. All preoperative examination measures such as ultrasonography, hysteroscopy, and endometrial aspiration were normal. Repeated cervical smears were consistent with adenocarcinoma presumably ensourcing from the fallopian tube. The patient underwent laparatomy,total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic para-aortic lymph node dissection. The primary serous papillary adenocarcinoma of the right fallopian tube was detected at the histopathological analysis, and the patient was referred for adjuvant chemotherapy. Cervical smear findings can be the only clue for the diagnosis of fallopian tube carcinoma.

Pregnancy in the setting of asymptomatic non-cirrhotic chronic portal vein thrombosis complicated by pre-eclampsia.

Portal vein thrombosis (PVT) can be chronic or acute in nature; it is characterized by a thrombus formation in the main portal vein and/or its right or left branches. Herein, we present a 36-year-old woman with asymptomatic noncirrhotic chronic PVT who developed preeclampsia in the later stage of pregnancy. This report will emphasize the clinical differential diagnosis, outcome, and management of pregnancies complicated by noncirrhotic PVT.

Plasma lipids and lipoproteins during pregnancy and related pregnancy outcomes.

PURPOSE: To study the effect of maternal lipid profile changes in pregnancy in relation to fetal growth and development, prognosis, and complications of pregnancy. METHODS: One thousand pregnant women between 17 and 48 years of age were included in this prospective longitudinal and uni-center study. Lipid profile tests [triglyceride (TG), total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL)] were first requested as part of the routine pregnancy follow-up in first antenatal visit (<14 weeks) then repeated in the last trimester (>28 weeks). The analysis included the medical, social-demographic, and nutritional status of the women as well. Primer outcome measures were defined as the association of the pregnancy-related lipid profile change to neonatal weight, the weight of the infant in third month and pregnancy complications (preeclampsia, gestational diabetes mellitus, IUGR, and preterm birth). RESULTS: The levels of TG, total cholesterol, HDL, LDL increased significantly as pregnancy progressed. The percentage of the change in the TG levels were higher in patients with well nutritional parameters (p = 0.033). As the percentage of change in the TG levels increased, the neonatal weight increased (p = 0.033) but no effect on the placental weight and the third month weight of the infant was seen. As the percent change in TG levels decreased, the risk of the preterm birth significantly increased. In women who were positive in 50 g screening test, but were uncomplicated with gestational diabetes mellitus, the percent change in cholesterol was lower (p = 0.010), the percent change in LDL was lower (p = 0.015), and the percent change in TG was higher (p = 0.032). CONCLUSION: In pregnancy, complex alterations occur in lipid metabolism. Percent change in TG is affected positively by the nutrition level. The neonatal weight also increases as well but postnatal weight is unaffected. Conversely TG levels significantly decrease in preterm birth. No association between preeclampsia and gestational diabetes mellitus with lipid profile changes were noted except in patients with glucose intolerance (>140 mg/dl in 50 g screening test) in which change in cholesterol, LDL was low and TG was high.

Prenatal diagnosis of a fetal intracranial immature teratoma.

Congenital intracranial teratoma is a rare disease. A fetus with a congenital intracranial teratoma presenting with a hydrocephalus at 27 weeks' gestation is presented. Prenatal ultrasonography and fetal magnetic resonance imaging demonstrated a huge, heterogeneous intracranial mass including the infra- and supratentorial region and polyhydramnios. At 28 weeks' gestation, a cesarean section was performed to avoid divisive operation during delivery. The infant died after 10 min from respiratory failure. Histological examination revealed the diagnosis of immature teratoma. Early detection of congenital intracranial tumors is crucial. The prognosis is poor with death usually occurring shortly after birth.

Body fat composition and distribution in women with polycystic ovary syndrome.

OBJECTIVES: The aims of the present study were to compare the distribution and accumulation of body fat in women with polycystic ovary syndrome (PCOS) and healthy controls matched for age and body mass index (BMI), and to investigate the association between androgen levels, insulin resistance and fat distribution. MATERIALS AND METHODS: Thirty-one PCOS women and 29 age- and BMI-matched healthy control women were evaluated in terms of subcutaneous adipose tissue thickness determined with a skinfold caliper and body composition analyzed by bioelectrical impedance analysis. Blood samples were obtained for determination of follicle-stimulating hormone, luteinizing hormone, 17beta-estradiol, 17-hydroxyprogesterone, basal prolactin, testosterone, dehydroepiandrosterone sulfate, sex hormone-binding globulin (SHBG), androstenedione, insulin and glucose levels. Insulin sensitivity was estimated by fasting glucose/insulin ratio and free androgen index (FAI) was calculated as 100 x testosterone/SHBG. Differences between means were analyzed by Student's t test or the Mann-Whitney U test according to distribution of the data. Correlation analysis was performed between the body fat distribution and parameters concerning insulin resistance and androgens. RESULTS: FAI was significantly higher in patients with PCOS compared with the control group (p = 0.001). Fasting insulin was significantly higher and fasting glucose/insulin ratio was significantly lower in the PCOS group vs. controls (p = 0.03 and 0.001, respectively). There was significantly less subcutaneous adipose tissue in the controls than the PCOS women at the triceps (p = 0.04) and subscapular region (p = 0.04). Waist-to-hip ratio of PCOS women was significantly higher than that of control subjects (p = 0.04). CONCLUSION: Upper-half type body fat distribution is linked with PCOS, high free testosterone levels and insulin resistance.

Protective effect of aprotinin on ischemia-reperfusion injury in rat ovary.

AIM: We investigated the effects of aprotinin on reperfusion injury in a controlled experimental rat torsion-detorsion model. METHODS: Thirty-two female Sprague-Dawley rats were divided into four groups. Sham operation was performed in group I; in group II only ovarian torsion was performed. In group III, torsion-detorsion was performed, plus 3 mL/kg saline was injected i.v. 30 min before detorsion. In group IV, torsion-detorsion was performed, plus aprotinin (30,000 KIU/kg) was injected 30 min before detorsion. Rats in the torsion group were killed after 360 degrees clockwise adnexial torsion for 3 h, and the ovaries were harvested. After 3 h of adnexial detorsion, the rats in the saline and aprotinin groups were killed and the adnexa were surgically removed. RESULTS: Ovarian tissue damage scores were significantly different among groups. Ovarian tissue and serum malondialdehyde levels in group III were significantly higher than those of groups I and IV (P<0.05). The serum levels of superoxide dismutase in group III were significantly lower than those of groups I and IV (P=0.01). Tissue and serum xanthine oxidase, nitric oxide, and tissue superoxide dismutase levels were comparable among groups (P>0.05). CONCLUSIONS: Aprotinin attenuates ischemia-reperfusion injury in a rat adnexial torsion-detorsion model.

Arterial stiffness and dipper/nondipper blood pressure status in women with preeclampsia.

INTRODUCTION: The aim of this study was to investigate the clinical relevance of dipper status in women with preeclampsia by comparing arterial stiffness index (SI) values, and dipper and nondipper status. METHODS: A total of 60 pregnant women in their third trimester were enrolled in the study. SI values were measured using a digital photoplethysmographic method (Pulse Trace System, Micro Medical Ltd., Gillingham, Kent, UK). Twenty-four-hour ambulatory blood pressure was measured by a SpaceLabs 90217 oscillometric device (SpaceLabs Inc., Redmond, WA, USA). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP) were recorded. Those preeclamptic women whose mean nighttime blood pressure measurements were at least 10% lower compared with mean daytime measurements were classified as dipper status, and those with a decrease of less than 10% were classified as nondipper status. RESULTS: Seventeen women were preeclamptic with a dipper status, 13 women had nondipper status preeclampsia, and 30 women were normotensive. SI values were significantly higher in preeclamptic women compared with normotensive women (8.8+/-1.2 m/s vs. 5.9+/-0.8 m/s, P<0.001), but SI values of preeclamptic women with dipper status and preeclamptic women with nondipper status did not differ significantly from each other (P=0.485). CONCLUSION: There was no significant difference in SI values between the dipper and nondipper preeclamptic groups. These results indicate that dipper and nondipper measurements may not be suitable for clinical follow-up of preeclamptic women.

Nausea and vomiting in early pregnancy: relationship with anxiety and depression.

OBJECTIVE: To investigate the association between either depression or anxiety early in pregnancy, and nausea and vomiting, in a clinical sample. METHODS: Anxiety and depression scores of 230 women were investigated by using the Hospital Anxiety and Depression Scale. Nausea and vomiting of pregnancy (NVP) were scored by using the Rhode's system. These scores and demographic data were compared and P < 0.05 was considered significant. RESULTS: A significant correlation between Rhode's score and both anxiety (r=0.388, P < 0.001) and depression score, (r=0.351, P < 0.001) was found. Gestational age showed and inverse correlation with anxiety scores (P=0.019). There was no significant correlation between demographic data and anxiety/depression scores, or Rhode's scores. CONCLUSION: There is an association between anxiety and depression early in pregnancyand severity of NVP.

Insulin sensitivity does not differentiate by hirsutism in non-obese women with polycystic ovary syndrome.

OBJECTIVE: Hirsutism is one of the component of polycystic ovary syndrome. According to the Rotterdam Consensus has concluded that principially obese women with polycystic ovary syndrome (PCOS) should be evaluated for the metabolic syndrome. The aim of the present study was to investigate the insulin sensitivity in PCOS women with and without hirsutism regardless of obesity. MATERIAL AND METHODS: Clinical characteristics, sex hormones and fasting glucose and insulin levels of fifty-eight women with PCOS were analyzed. Hirsutism has been evaluated through the Ferriman-Gallwey (FG) map scoring system. RESULTS: Twenty-two women (38%) were hirsute. They were not any significant difference between hirsute and nonhirsute women for their sex steroids and insulin sensitivity (P>0.05). There were no correlation among sex steroids, WHR and insulin sensitivity in relation to FG score in the subgroup with hirsutism (P>0.05). CONCLUSION: Our study suggests that normal weight and overweight women with hirsutism can have normal insulin sensitivity and normal levels of circulating androgens in PCOS women.