Metformin and changes in serum lipid profile in lean patients with polycystic ovary syndrome.

Introduction: The aim of our study was to assess the values of total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides before and after treatment with metformin in lean patients with polycystic ovary syndrome (PCOS). Material and Methods: 32 patients received metformin 1500 mg per day in three divided doses. Lipids measurements were performed twice: before and after 6 months of treatment with metformin. Results: In lean patients with PCOS after treatment with metformin we observed: statistically significant lower LDL-C levels (4.16±0.79 mmol/l vs 3.4±0.86 mmol/l, p<0.05) and triglycerides levels (1.8±0.53 mmol/l vs 1.12±0.64 mmol/l, p<0.05). We observed an increase in HDL values and a decrease in total cholesterol values, but these changes were not statistically significant (1.5±0.71 mmol/l vs 1.71±0.69 mmol/l, p=0.09; 5.87±0.92 mmol/l vs 5.69±0.97 mmol/l, p=0.11). Conclusion: Our study showed that treatment of 1500 mg metformin for about six months among PCOS women results in an improvement in serum lipid profiles. We observed a significant decrease in LDL-C and triglycerides values after metformin therapy.

[Changes in blood pressure and heart rate by an increase in serum estradiol in women undergoing controlled ovarian hyperstimulation]. / Zmiany cisnienia tetniczego i czestosci serca pod wplywem wzrostu stezenia estradiolu w surowicy u pacjentek poddanych kontrolowanej stymulacji jajeczkowania.

UNLABELLED: The aim of the study was to evaluate changes in blood pressure and heart rate in women undergoing controlled ovarian stimulation (COH) in preparation for assisted reproduction techniques. Material and method: The comparison of blood pressure and heart rate measurements obtained from 5 women (age 35.3 +/- 9.4 years) was performed. The data were collected during the 24-hour ambulatory blood pressure monitoring (ABPM) using Holcard sphygmomanometer CR-07 Aspel S.A. at the beginning and in the last day of short protocol of COH with the use of triptorelin (Decapeptyl 0.1 mg/day--Ferring GmbH) and the total supply of Gonalu F 225 U/day--Merck Serono) and Menotropiny 75j FSH + LH 75 U/day (Merional Imed/lBSA). RESULTS: During COH the increase in the serum estradiol level was detected (54.03 +/- 9.4 pg/ml at baseline vs. 1128.7 +/- 208.6 pg/ml after COH, p < 0.001). However, there were no differences in SBP and DBP values before stimulation and on the day of its completion. Only the decrease of mean arterial pressure measured by oscillometric method was observed during the study (95.1 +/- 25.3 mmHg vs. 87.6 +/- 27.8 mmHg, p<0.02). Mean arterial pressure measured by oscillometric method decreased in the daytime measurements (98 +/- 27.3 mmHg vs. 92.8 +/- 26.5 mmHg, p<0.05) as well as in the nighttime measurements (84.4 +/- 17.4 mmHg vs. 78.8 +/- 14, 4 mmHg, p <0.05). After COH, the higher heart rate (HR) was measured (in overall ABPM statistics: baseline HR 68.5 +/- 12.8/min vs. 73.6 +/- 13.7/ min after COH, p<0.002 and also in daytime statistics: baseline HR70.8 +/- 13.6 / min vs. 76.3 +/- 15.5 / min after COH, p<0.002). CONCLUSIONS: The increase in serum estradiol level caused by COH leads to increase in heart rate and reduction in mean arterial pressure measured by oscillometric method. However, short-term increase in serum estradiol during COH is not associated with significant changes in systolic and diastolic blood pressure in women preparing for the in vitro procedure.

Reduction in the level of antibodies against heat shock proteins 60 during different hormonal protocols in postmenopausal women.

INTRODUCTION: In current literature, the immune-inflammatory theory of atherosclerosis is widely discussed. The role of how heat shock proteins 60 (HSP60) lead to the development of the atheromatous plaque is especially underlined. The aim of the study is to estimate the influence of three hormonal protocols on behavior of antibodies against HSP60. It determines the state of endothelium in postmenopausal women. MATERIAL AND METHODS: The study was carried out on 90 women between 2007 and 2012. All the women were in their menopausal age (51 ± 3 years), from the south region of Poland, with a follicle stimulating hormone (FSH) level above 25 mIU/ml, and with menopausal symptoms disturbing their normal daily activity. The study was done for a period of 6 months. Three groups of 30 randomized patients were formed. In the first group we used transdermal estrogen therapy in a 37.5 µg/24 h dose combined with a 10 mg dose of dydrogesterone. In the second group we applied transdermal estrogen therapy in a 50 µg/24 h dose with 2.5 mg of oral medroxyprogesterone. In both these groups, gestagens were administered continuously. In the third group, we prescribed continuous, oral, low-dose combined estrogen-gestagen therapy with 1 mg of ethinyl estradiol and 0.5 mg of norethisterone acetate. The control group consisted of 30 volunteers who were also from the south region of Poland, in good health, with menopausal symptoms, no menstrual period for the last 12 months, selected considering their age and weight, with an FSH level above 25 mIU/ml and with normal levels of thyroid stimulating hormone (TSH) and prolactin. All patients treated and in the control group were seronegative to Chlamydia pneumonia for the entire duration of the study. In the analysis conducted, nonparametric tests were used (Mann-Whitney U test, Wilcoxon test, Kruskal-Wallis test - ANOVA). RESULTS: After 6 months of hormonal therapy, we found that all schemes of treatment promote a significant reduction in antibodies against HSP60 in all treated groups vs. the control group. CONCLUSIONS: All of the investigated estrogen protocols have a favorable impact on the blood level of HSP60 antibodies in early postmenopausal women who have no cardiovascular risk factors. It triggers a better condition of endothelium.

Basal and metoclopramide induced prolactin secretion in lean PCOS women.

Polycystic ovary syndrome (PCOS) as well as hyperprolactinemia can cause infertility. In retrospective study the prolactin levels during the oral metoclopramide test among lean PCOS woman according to four phenotypes and free androgen index (FAI) were compared. The study population consisted of 314 lean PCOS women. The population was divided into four groups according to the FAI and menstrual cycle regularity. The group A consisted 126 women with FAI≥5 and irregular menstruation, the group B- 53 patients with FAI≥5 and regular menstruation. Group C- 70 patients with FAI<5 and irregular menstruation, group D - 65 patients with FAI<5 and regular menstruation. The ratio of prolactin value in 120th minute in the metoclopramide test to the basal prolactin value was higher in group D than in groups A and B. The prolactin basal concentration was higher in patients with FAI≥5 than in patients with FAI<5, (262.9 vs 228.9 µIU/ml; p<0.001). The ratio of prolactin in 60th minute (12.3 vs 16.7; p=0.006) and in the 120th minute (10.9 versus 13.3; p<0.001) of the metoclopramide test to the basal prolactin were lower in patients with FAI≥5. The prolactin secretion in lean PCOS women may be associated with their FAI.

The PCOS Patients differ in Lipid Profile According to their Phenotypes.

Polycystic ovary syndrome (PCOS) affects 4-18% of women of reproductive age. The number of reports exploring the lipid profiles among PCOS patients and number of studied patients are limited. The aim of our study was to assess the lipid profile separately in lean and non-lean women with polycystic ovary syndrome divided according to hyperandrogenemia, defined as free androgen index (FAI)≥5. The second aim was to compare the lipid profiles among lean and non-lean PCOS patients with respect to hyperandrogenemia and regularity of menstruation cycles. We evaluated 232 patients from Department of Endocrinological Gynecology, Jagiellonian University Medical College in Krakow diagnosed with PCOS. The population consisted of 166 lean and 66 non-lean women. We observed higher levels of total cholesterol, high-density lipoprotein cholesterol (HDL-C) in lean patients with FAI<5 than in lean patients with FAI≥5. There were no differences in lipid profile between non-lean patients with FAI≥5 and non-lean patients with FAI<5. Among lean patients higher total cholesterol levels were observed in those with irregular menstruation cycles and FAI<5 than in patients with FAI≥5 and regular cycles. There were no differences in lipid profiles between four phenotypes among non-lean PCOS patients. CONCLUSIONS: The results of our study showed differences in lipid profile between lean PCOS patients according to their phenotype based on androgens' level. This effect was abandoned by fat tissue mass in non-lean ones. Further studies should be conducted to explore these associations.