Serum calprotectin levels as markers of inflammation, insulin resistance and hyperandrogenism in women with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a common, complex endocrine, and metabolic disorder. Inflammation has been thought to play an important role in PCOS pathogenesis in recent years, and various inflammatory markers have been investigated; however, no definite conclusion has been reached. As a multifunctional regulatory protein in different inflammatory processes, calprotectin may play a role in the etiology of PCOS. Therefore, based on this hypothesis, we aimed to determine serum calprotectin concentrations in women with PCOS and to compare them with healthy controls. This cross-sectional study was conducted at a tertiary referral center during the study period. Forty-three women (n = 43) with PCOS and 47 women (n = 47) in the control group were enrolled in this cross-sectional study. Serum calprotectin concentrations were measured using enzyme-linked immunosorbent assay and compared with markers of glucose and lipid metabolism. Clinical characteristics and hormonal parameters were evaluated in both groups. Levels of serum calprotectin were measured as 347 ±â€…28.8 and 188 ±â€…15.3 ng/mL in the PCOS and healthy control groups, respectively (P = .009). The mean homeostatic model assessment for insulin resistance[1] index and total testosterone levels were significantly higher in the PCOS group than in the control group (both P < .001). Spearman's correlation test demonstrated linear correlations between calprotectin and C-reactive protein, waist circumference, insulin resistance index, and total testosterone levels in the PCOS group (all P < .05). Serum calprotectin levels were higher in women with PCOS. This biomarker may be an indirect sign of insulin resistance, hyperandrogenism, or chronic inflammation in women with PCOS.

Thiol/Disulfide Homeostasis in Patients with Molar Pregnancies.

Introduction: We aimed to investigate serum dynamic thiol and disulfide levels in patients with molar pregnancy (MP), and compare these concentrations with those of healthy pregnant women. Materials and Methods: Forty-one patients who were diagnosed with MP and 41 gestational age-matched healthy pregnant women were included in this prospective study. MP cases were separated in two groups as complete hydatidiform mole (CHM) and partial hydatidiform mole (PHM). Demographic features and thiol/disulfide homeostasis were recorded for each woman. Results: There was a significant correlation between the decrease in the total thiol and native thiol levels in MP patients. However, no significant difference was observed between CHM and PHM groups in terms of serum disulfide levels. Conclusion: OS is increased in MPs both in complete and partial moles, as determined by thiol/disulfide analysis.

The Relationship Between Breast Density, Bone Mineral Density, and Metabolic Syndrome Among Postmenopausal Turkish Women.

The relationship between metabolic syndrome (MetS) and menopause remains unclear. The effects of MetS on breast and bone density in this group of women are also not fully elucidated. Herein, we aimed to investigate the relationship between components of the MetS, mammographic breast density (MBD), and vertebral/femoral bone mineral density (BMD) in postmenopausal Turkish women. The study group consisted of postmenopausal women with MetS whereas controls postmenopausal women without MetS. All consecutive women who applied to our center for routine postmenopausal follow up and met the inclusion criteria, between July 2013 and October 2015 were included in the study. Menopause was defined as the cessation of menstruation for at least 1 year, and we used the definition of the MetS suggested by a joint interim statement. BMD of the spine and femur was measured by dual energy X-ray absorptiometry. The medical records of 390 postmenopausal were retrospectively reviewed. No significant differences were observed between the groups in terms of age, menopause type, and menopause duration (p > 0.05). Decreased MBD (for grade 1-2 and 3-4 densities) was associated with increased MetS risk (p = 0.017). Total femoral BMD, total lumber BMD, femoral neck BMD were significantly higher in postmenopausal women with MetS (p < 0,005). This study is the first report focusing on the relationship between MetS and breast/bone density. According to the results of our study, the presence of MetS in postmenopausal periods has a positive effect on both MBD and BMD.

The ratio of anterior anogenital distance to posterior anogenital distance: A novel-biomarker for polycystic ovary syndrome.

BACKGROUND: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. The etiopathogenesis of the disease remains uncertain. Additionally, a full consensus has not been reached regarding PCOS diagnostic criteria. Several attempts have been made to diagnose PCOS with a simple clinical biomarker, but most of them failed. This study aims to investigate the possible association between PCOS and anogenital distance (AGD), which is an important sign of intrauterine androgen exposure. METHODS: A prospective cohort study was conducted on 130 women. The study group contained 65 women with PCOS whereas 65 healthy women were recruited for the control group, all between 18 and 40 years in age. The groups were compared in terms of demographics and clinical and laboratory parameters. Both anterior and posterior AGDs and associated ratios were recorded for each woman. RESULTS: The mean ratio of anterior AGD to posterior AGD for the PCOS and control group were 4.4 ± 1.0 and 4.9 ± 1.0, respectively (p = 0.003). Regression analysis demonstrated that this ratio significantly and positively correlated with the waist to hip ratio and negatively correlated with the free androgen index. CONCLUSION: AGD was initially used to define sexual differentiation of animals. Subsequent human studies showed that boys have longer AGDs than girls. Recent studies supporting the hypothesis that extreme prenatal androgen exposure contributes to PCOS found that AGD in adult PCOS patients was longer than control PCOS patients. However, a novel biomarker other than AGD needs to be identified to standardize these measurements. This work represents the first study to evaluate the ratio of anterior AGD to posterior AGD in PCOS patients. In this study, AGD anterior and posterior measurements were longer in PCOS patients than in controls. However, the strongest predictor of PCOS is the ratio of anterior to posterior AGD.

Relationship between seasons and pregnancy rates during intrauterine insemination. A historical cohort

ABSTRACT BACKGROUND: The underlying cause of seasonal infertility in humans is unclear, but is likely to be ­multifactorial. OBJECTIVE: The aim of our study was to compare the pregnancy rates among infertile women who underwent induced ovulation and intrauterine insemination (IUI) with the season in which the fertility treatment was performed. DESIGN AND SETTING: This retrospective cohort study was conducted on 466 patients who were treated in the reproductive endocrinology and infertility outpatient clinic of a tertiary-level women's healthcare and maternity hospital. METHODS: Retrospective demographic, hormonal and ultrasonographic data were obtained from the patients' medical records. Clomiphene citrate or gonadotropin medications were used for induced ovulation. The patients were divided into four groups according to the season (spring, winter, autumn and summer) in which fertility treatment was received. Clinical pregnancy rates were calculated and compared between these four groups. RESULTS: There were no significant differences between the seasonal groups in terms of age, infertility type, ovarian reserve tests, duration of infertility, medications used or length of stimulation. A total of 337 patients (72.3%) were treated with clomiphene citrate and 129 (27.7%) with gonadotropin; no significant difference between these two groups was observed. The clinical pregnancy rates for the spring, winter, autumn and summer groups were 15.6% (n = 24), 8.6% (n = 9), 11.5% (n = 13) and 7.4% (n = 7), respectively (P = 0.174). CONCLUSIONS: Although the spring group had the highest pregnancy rate, the rates of successful IUI did not differ significantly between the seasonal groups.

Assessment of the Relationship Between Serum High Molecular Weight Adiponectin Hormone Levels and Insulin Resistance in Patients with Polycystic Ovary Syndrome.

The purpose of this study was to assess the rate of insulin resistance (IR) and the relationship between IR and high-molecular weight adiponectin (HMWA) in patients with polycystic ovary syndrome (PCOS). A cross sectional study involving 43 women with PCOS and 39 normal women was carried out over a period of nine months. Fasting glucose and insulin levels, lipid parameters and androgen levels were measured in all serum samples. HMWA was determined by enzyme-linked immunosorbent assay and IR was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR) index. The IR was more prevalent in the PCOS group than in the controls (p=0.002). Dehydroepiandrosterone sulfate, sex hormone binding globulin, free androgen index, total testosterone, insulin, and HOMA-IR levels were significantly higher in the PCOS group as compared to the control group (all p<0.05). Moreover, HMWA was significantly lower and negatively correlated with the clinical and biochemical hyperandrogenism in the PCOS group. HMWA and HOMA-IR were also associated with triglyceride, body mass index, and fat mass in this group. ROC curve analyses demonstrated that the AUC, indicative of the HMWA value for discriminating PCOS with IR, was 0.725, with a confidence interval of 0.615-0.835 (p=0.001). The serum HMWA levels are lower in patients with PCOS, which suggest that HMWA might be involved in the pathogenesis of PCOS. We also conclude that HMWA might be a strong determinant of IR in PCOS patients.

The relationship between breast density and bone mineral density in never users of postmenopausal hormone therapy.

BACKGROUND: Estrogen is known to affect both mammographic breast density and bone mineral density (BMD), but there are inconsistent results about the association of these density measurements in postmenopausal women. Furthermore, there are scarce data on the relationship between breast density and BMD in never users of postmenopausal hormone therapy. AIM: In this study, we examined the relationship between mammographic breast density and BMD in postmenopausal women who were never hormone replacement therapy users. METHODS: A total of 293 postmenopausal women were enrolled in this cross-sectional study. Mammograms and BMD measurements for screening purposes were obtained. Assessment of mammographic breast density was performed by using breast imaging reporting and data system classification. The BMD was measured using dual-energy X-ray absorptiometry of the lumbar spine and femoral neck. RESULTS: Grade 1 breast density was observed in 64 women (21.8 %), grade 2 in 113 women (38.6 %) and grades 3 and 4 in 116 (39.6 %) women. Breast density decreased with increasing age and body mass index (BMI). Meanwhile, no significant differences were detected in BMD measures of the hip (p = 0.14) and lumbar spine (p = 0.29) among the breast density categories. After adjusting for age and BMI, the differences in the mean BMD at the hip and lumbar spine across the breast density categories remained insignificant (p = 0.26 and 0.11, respectively). CONCLUSION: There is no evidence of a relationship between mammographic breast density and BMD in postmenopausal women who had never used hormone replacement therapy.

Comparison of pregnancy rates in PCOS patients undergoing clomiphene citrate and IUI treatment with different leading follicular sizes.

PURPOSE: The objective of the study was to compare the pregnancy rates in PCOS patients undergoing clomiphene citrate (CC) and intrauterine insemination (IUI) treatment with different leading follicular sizes. METHODS: A total of 358 infertile women with PCOS who underwent 563 clomiphene citrate and IUI treatment cycles were included in this prospective study. Treatment cycles were divided into three groups according to leading follicular size on the day of hCG administration: Group I: follicular size 17-18 mm (n = 177), Group II: 19-22 mm (n = 321), and Group III : >22 mm (n = 65). Pregnancy rates were evaluated. Treatment outcomes of the groups were further analyzed related to endometrial thickness measurement on the day of hCG. For this purpose, cycles were placed into three subgroups as follows: endometrial thickness <7, 8-9, and >9 mm. RESULTS: There was no statistically significant difference in clinical pregnancy rate per cycle between the groups (8.5, 10, and 9.2 % for Group I, II, and III, respectively, p = 0.86). In further analyses related to endometrial thickness, no significant difference was also found in pregnancy rate among the groups. CONCLUSION: This results suggest that pregnancy rate is not related to leading follicle size on the day of hCG administration in PCOS patients treated with CC and IUI. In addition, pregnancy rate in women with different follicular sizes is not influenced by the endometrial thickness.