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ObjectiveTo investigate the mechanism of Xiaonang Tiaojing decoction（XNTJD）in improving polycystic ovary syndrome with insulin resistance（PCOS-IR）model rats based on anti-Müllerian hormone（AMH）/AMH type Ⅱ receptor（AMHRⅡ）signaling pathway. MethodForty-eight adult female SD rats were randomly divided into the blank group， model group， XNTJD group（11.4 g·kg-1·d-1） and Diane-35 group（0.21 g·kg-1·d-1）， PCOS-IR model was established by high-fat and high-sugar diet combined with letrozole in rats of all groups except the blank group， rats in the administration groups were given the corresponding dose of drugs by gavage for 15 days with an interval of 1 d every 4 d， normal saline of the same volume was given to the blank group and the model group. Estrous cycle was recorded daily during treatment. At the end of treatment， body weight and Lee's index were recorded， AMH， luteinizing hormone（LH）， LH/follicle stimulating hormone（FSH）， testosterone（T）and estradiol（E2）levels were measured by enzyme-linked immunosorbent assay（ELISA）， fasting plasma glucose（FPG）was measured by glucometer， fasting insulin（FINS） level was measured by radioimmunoassay（RIA）， and the insulin resistance index（HOMA-IR） and insulin sensitivity index（QUICKI）were calculated， triglyceride（TG）and total cholesterol（TC）levels were measured by automatic biochemical analyzer， hematoxylin-eosin（HE）staining was used to observe the morphological changes of the ovary， the levels of AMHRⅡ， bone morphogenetic protein-15（BMP-15）and Smad5 in ovarian tissues were detected by immunohistochemistry（IHC），Western blot was used to analyze the protein expression levels of AMHRⅡ， BMP-15 and Smad5. ResultCompared with the blank group， a large number of leukocytes were observed in the vaginal exfoliated cells of rats in the model group， mainly in diestrus， the levels of body weight， Lee's index， glucose-lipid metabolism indexes（FPG， FINS， HOMA-IR， TG， TC）， AMH and sex hormones（LH， LH/FSH， T）were significantly increased（P<0.01）， and QUICKI and E2 levels were significantly decreased（P<0.01）， there were more cystic bulges on the ovarian surface， more wet weight， more atretic and cystic dilated follicles in the ovarian tissues， and the thickness of granulosa cell layer was reduced without oocytes， the expression level of AMHRⅡ protein in ovarian tissues was significantly increased（P<0.01）， and the expression levels of BMP-15 and Smad5 proteins were significantly decreased（P<0.01）. Compared with the model group， the exfoliated cells in the vagina of rats treated with XNTJD group showed keratinocytes from the 5th to 6th day of treatment， and a stable estrous cycle gradually appeared， body weight， Lee's index， glucose-lipid metabolism indexes（FPG， FINS， HOMA-IR， TG， TC）， AMH and sex hormones（LH， LH/FSH， T）levels were significantly decreased（P<0.05， P<0.01）， QUICKI and E2 levels were significantly increased（P<0.01）， ovarian surface was smoother and lighter in wet weight， oocytes and mature follicles were observed in ovarian tissues， the thickness of granulosa cell layer increased and the morphology was intact， the expression levels of BMP-15 and Smad5 proteins were significantly increased（P<0.01）and the expression level of AMHRⅡ protein was significantly decreased（P<0.01）in ovarian tissues. ConclusionXNTJD may mediate the up-regulation of BMP-15 and Smad5 in ovarian tissues of PCOS-IR rats by down-regulating AMH/AMHRⅡ， thereby improving ovarian function， sex hormones and glucose-lipid metabolism levels in PCOS-IR rats.
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【Objective】 To investigate the role of LIF/LIFR/STAT3 pathway in endometrial receptivity in rats with polycystic ovary syndrome (PCOS). 【Methods】 Forty 21-day-old SD female rats were divided into normal (control) group, model group, sham-operation group, and LIF group with 10 rats in each. The rat model of PCOS was constructed by subcutaneous injection of prasterone sodium sulfate at the back of the neck. The serum levels of testosterone (T), glucose and insulin in each group were detected. The morphological changes of the uterus in each group were observed by HE staining, and the morphological changes of endometrium were measured. Immunohistochemistry, Western blotting, and Real-time fluorescence quantitative PCR(qRT-PCR) were used to determine the protein expression and mRNA expression of LIF and STAT3 in rat endometrium. 【Results】 Compared with control group, the levels of integrin avb3, serum T, insulin and glucose in PCOS rats were significantly increased (P=0.000, P=0.000, P=0.001). Supplementation of exogenous LIF could significantly reduce the levels of integrin avb3, serum T, glucose and insulin in PCOS rats (P=0.000, P=0.002, P=0.003, P=0.007). HE results showed that exogenous LIF could reduce uterine cavity and glandular morphology in PCOS rats and increase the equivalent diameter (P=0.000, P=0.000) and area (P=0.000, P=0.000) of uterine glands and glandular cavity, the ratio of glandular interstitial area (P=0.000), and the average endometrial thickness (P=0.006), with statistically significant differences. Immunohistochemistry, Western blotting, and qRT-PCR results showed that the expression levels of LIF and p-STAT3 protein and mRNA in model group were significantly decreased compared with control group. Compared with model group, the protein and mRNA expressions of LIF and p-STAT3 in LIF group were significantly increased (P<0.05). 【Conclusion】 Exogenous LIF supplementation can improve endometrial receptivity in PCOS rats, and its mechanism is related to the LIF/LIFR/STAT3 pathway.
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ObjectiveTo explore the effects and mechanisms of Kaiyu Zhongyutang on insulin resistance， glucose and lipid metabolism， psychological state， and embryo outcome in the infertile patients with polycystic ovary syndrome （PCOS） due to liver depression and kidney deficiency. MethodThe 126 infertile patients with PCOS due to liver depression and kidney deficiency who underwent in vitro fertilization-embryo transfer （IVF-ET） in the Department of Reproduction of the affiliated hospital of Nanjing university of Chinese medicine were randomly assigned into the observation （Kaiyu Zhongyutang + metformin） and control （metformin） groups. The two groups were compared in terms of traditional Chinese medicine （TCM） syndrome scores， body mass index （BMI）， glucose and lipid metabolism， homeostasis model assessment-insulin resistance （HOMA-IR）， interleukin （IL）-6， IL-8， C-reactive protein （CRP）， self-rating depression scale （SDS） score， self-rating anxiety scale （SAS） score， and clinical and laboratory scores of IVF after treatment. Result① After treatment， the observation group showed decreased scores of primary and secondary TCM syndromes and total TCM syndrome score （P < 0.05）， and the control group presented decreased scores of irritability and depression and total TCM syndrome score （P<0.05）. Compared with the control group， the observation group demonstrated reduced primary and secondary syndrome scores and total score after treatment （P<0.05）. ② After treatment， both groups showed decreased BMI， lowered levels of fasting insulin （FINS）， fasting plasma glucose （FPG）， cholesterol （TC）， triglyceride （TG）， low-density lipoprotein （LDL）， and HOMA-IR （P<0.05）， and elevated high-density lipoprotein （HDL） level （P<0.05）. Moreover， the observation group had lower BMI， FINS， FPG， TC， TG， LDL， and HOMA-IR and higher HDL than the control group （P<0.05）. ③ The treatment in both groups lowered the levels of IL-6， IL-8， and CRP and decreased SDS and SAS scores （P<0.05）. Moreover， the declines in the observation group were more obvious than those in the control group （P<0.05）. ④ Correlation analysis before treatment， IL-6， IL-8， and CRP had positive correlations with BMI， HOMA-IR， TC， TG， LDL， SDS， and SAS （P<0.05） and a negative correlation with HDL （P<0.05）. ⑤ The observation group showed reduced gonadotropin （Gn） using days and total Gn dose and higher two-pronuclear （2PN） fertilized oocytes， 2PN cleavage rate， normal fertilization rate， D3 transferable embryo number， D3 high-quality embryo number， high-quality embryo rate， and blastocyst formation rate than the control group （P<0.05）. ConclusionKaiyu Zhongyutang can treat PCOS patients by improving the emotional and reproductive functions and alleviating insulin resistance and glucose and lipid metabolism disorders. Moreover， it can reduce the Gn dose and Gn using days in the IVF process， improve the quality and maturity of eggs， increase the egg fertilization rate， enhance the potential of embryo development， and increase the rate of blastocyst formation by inhibiting inflammation.
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Objective:To investigate the effect of Guizhi Fulingwan on autophagy of ovarian granulosa cells in mice with polycystic ovary syndrome （PCOS）. Method:Twenty SD mice were randomized into a normal group （<italic>n</italic>=10） and a PCOS model group （<italic>n</italic>=10）， followed by PCOS modeling and <italic>in vitro</italic> culture of extracted ovarian granulosa cells. The ovarian granulosa cells of normal mice were classified into the control group and treated with 10% blank serum while those of PCOS mice into the experimental groups and with 10% Guizhi Fulingwan-containing serum at different concentrations （17.6， 35.1， 70.2 mg·kg<sup>-1</sup>） and 10% metformin-containing serum （25 mg·kg<sup>-1</sup>）， respectively， for 72 h. During the modeling， the changes in mouse body weight were measured. After modeling， the ovarian morphology was observed by microscopy， and the fasting blood glucose （FBG） was measured by Roche glucometer. Following the detection of fasting insulin （FI） and testosterone （T） levels by radioimmunoassay， the proliferation of ovarian granulosa cells was determined using cell counting kit-8 （CCK-8） to figure out the maximal dose of drug-containing serum that did not obviously affect the cell viability for subsequent assay. The autophagy of ovarian granulosa cells was examined by flow cytometry， and the protein expression levels of intracellular microtubule-associated protein 1 light chain 3Ⅰ （LC3Ⅰ）， LC3Ⅱ， Beclin1， and p62 were assayed by Western blott. Result:Compared with the blank group， the model group showed increased body weight and elevated FI， FBG， and T levels （<italic>P</italic><0.05，<italic>P</italic><0.01）， indicating the successful modeling of PCOS mice. Flow cytometric assay proved that the incubation with 10% Guizhi Fulingwan serum-containing medium resulted in a decline of autophagy （<italic>P</italic><0.05）. As demonstrated by Western blot assay results， the protein expression levels of Beclin1 and LC3 Ⅱ/Ⅰ in the model group increased significantly as compared with those of the blank group， whereas the expression level of p62 decreased significantly （<italic>P</italic><0.05，<italic>P</italic><0.01）. Compared with the model group， the medium- and high-dose Guizhi Fulingwan groups exhibited significantly down-regulated Beclin1 and LC3 Ⅱ/Ⅰ levels but remarkably up-regulated p62 （<italic>P</italic><0.05，<italic>P</italic><0.01）. Conclusion:Guizhi Fulingwan inhibits the autophagy of ovarian granulosa cells by down-regulating the protein expression levels of Beclin1 and LC3 Ⅱ/Ⅰ.
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ABSTRACT Objective The aim of this study was to assess the serum vitamin D level in a retrospective study in women with polycystic ovary syndrome (PCOS), according to the different phenotypes of the disease. Subjects and methods In this retrospective study, the records of 351 infertile women who were diagnosed with PCOS were examined, and 200 of them were enrolled in the study randomly in 4 PCOS phenotypes. Fifty normal ovulatory women with the history of male factor were selected as the control group. Parameters, including age, infertility duration, body mass index (BMI), hormone profile, as well as the serum vitamin D level were compared among the 4 phenotypes, with the P-value ≤ 0.05 considered statistically significant. Results The findings showed a higher serum vitamin D level in the control group than in PCOS patients, which was statistically significant (P < 0.001). In addition, there was no significant difference in the serum vitamin D level among the four phenotypes of PCOS. Conclusions No significant difference was found in the serum vitamin D level of the different phenotypes of PCOS. Further studies with larger sample sizes are recommended to be done to establish the role of the serum vitamin D level in PCOS patients.
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Humans , Female , Adolescent , Adult , Young Adult , Polycystic Ovary Syndrome/blood , Vitamin D/blood , Infertility, Female/blood , Phenotype , Polycystic Ovary Syndrome/genetics , Body Mass Index , Case-Control Studies , Retrospective StudiesABSTRACT
Objective: Polycystic ovary syndrome (PCOS), a common endocrine-metabolic dysfunction in reproductiveaged women, may be involved in compromised pregnancy and offspring outcomes. This study aimed to investigate whether maternal PCOS affects fetal growth, fetal development, and placental features. Methods: This retrospective case-control study included 60 pregnant women with PCOS (PCOS group) and 120 healthy pregnant women without PCOS (control group). Fetal magnetic resonance imaging (MRI) was performed followed by an ultrasound examination and indications for imaging, including known or suspected fetal pathology, history of fetal abnormality in previous pregnancy or in a family member, and concern for placenta accreta. Fetal MRI images were analyzed for head circumference (HC), abdomen circumference (AC), lung-to-liver signal intensity ratio (LLSIR, a prenatal marker of fetal lung maturity), lengths of liver and kidney diameters in fetuses, and placental relative signal intensity on T2-weighted single-shot fast spin echo (SSFSE) imaging (rSISSFSE), and placental relative apparent diffusion coefficient value (rADC). Data on height and weight of offspring were collected through telephone follow-up. Results: Compared to the control group, the PCOS group showed the following characteristics: (1) smaller biparietal diameter and femur length in fetuses (P=0.026 and P=0.005, respectively), (2) smaller HC in fetuses (evident after 32 weeks; P=0.044), (3) lower LLSIR and smaller dorsoventral length of liver in fetuses (evident before 32 weeks; P=0.005 and P=0.019, respectively), and (4) smaller placental thickness (evident before 32 weeks; P=0.017). No significant differences in placental rSISSFSE or rADC were observed between the groups (all P>0.05). No significant differences in height and weight of offspring during childhood existed between the groups (all P>0.05). Conclusions: There exist alterations of fetal growth, fetal development, and placental features from women with PCOS.
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OBJECTIVE@#To explore the therapeutic effect and partial mechanism of electroacupuncture (EA) for patients with insulin resistance (IR) polycystic ovary syndrome (PCOS).@*METHODS@#Seventy patients with IR-PCOS were randomly divided into an EA group (36 cases, 5 cases dropped off) and a medication group (34 cases, 4 cases dropped off). The patients in the medication group were treated with oral administration of metformin hydrochloride, 500 mg each time, twice a day. The patients in the EA group were treated with EA (continuous wave, 2 Hz of frequency) at Zusanli (ST 36), Zhongwan (CV 12), Qihai (CV 6), Yishu (EX-B 3), Shenshu (BL 23), Pishu (BL 20), Ciliao (BL 32) for 30 min, three times a week. One menstrual cycle or 4 weeks were taken as a course of treatment, and 3 continuous courses were given. The follow-up was 3 months. The lipid metabolism indexes of triacylglycerol (TG), total cholesterol (TC), high-density lipoprotein (HDL) and low-density lipoprotein (LDL), homeostasis model assessment-insulin resistance index (HOMA-IR) and testosterone (T) in serum were compared before and after treatment, and the clinical effects of the two groups were evaluated during the follow-up.@*RESULTS@#The total effective rate was 67.7% (21/31) in the EA group and 60.0% (18/30) in the medication group, with no significant difference between the two groups (>0.05). After treatment, the levels of serum T, HOMA-IR, LDL, TG and TC were decreased significantly in the two groups (<0.01, <0.05), and HDL was increased significantly (<0.01); the levels of TC in the EA group after treatment was lower than that in the medication group (<0.05).@*CONCLUSION@#EA may adjust some dyslipidemia in patients to correct IR and improve endocrine disorder of PCOS, which had superior/similar effects to metformin.
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Female , Humans , Acupuncture Points , Electroacupuncture , Insulin Resistance , Polycystic Ovary Syndrome , TherapeuticsABSTRACT
OBJECTIVE@#To evaluate the effectiveness and possible mechanism of acupuncture treatment for negative emotion in patients with polycystic ovary syndrome (PCOS).@*METHODS@#A total of 40 PCOS patients were randomly divided into an observation group and a control group, 20 cases in each one. Both groups received lifestyle interventions (exercise and diet guidance) on the 5th day of menstruation. On the basis of above treatment, the patients in the observation group received acupuncture at Guanyuan (CV 4), Zhongwan (CV 12), Guilai (ST 29), Futu (ST 32), Liangqiu (ST 34), Sanyinjiao (SP 6), Zusanli (ST 36), Hegu (LI 4), Shenmen (HT 7), Baihui (GV 20) as the main acupoints, and connected the electroacupuncture (continuous wave, 2 Hz, 30 min), once every other day, 3 times a week. The treatment for 1 month was as one course and 4 courses were required totally in both groups. Before and after treatment, the body mass index (BMI), ferriman-gallway (F-G) score, self-rating anxiety scale (SAS) score, self-rating depression scale (SDS) score, PCOS health-related quality of life questionnaire (PCOSQ) score were observed, meanwhile, serum sex hormone, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen (E), progestin (P), prolactin (PRL), testosterone (T), sex hormone-binding globulin (SHBG) and free androgen index (FAI) levels, and serumβ-endorphin levels were detected.@*RESULTS@#Compared with before treatment, the BMI, F-G score, SAS score, SDS score and serum FAI level were decreased and the PCOSQ score and the levels of serum SHBG andβ-endorphin were increased in the observation group after treatment (all <0.05). Compared with before treatment, the SDS score was decreased in the control group after treatment (<0.05). Compared with the control group, the F-G score, SDS score, SAS score, and serum FAI level were lower, and the PCOSQ score and serumβ-endorphin level were higher in the observation group after treatment (all <0.05).@*CONCLUSION@#Applying acupuncture to the treatment of patients with PCOS can effectively relieve anxiety and depression, and the mechanism may be related to the regulation on the levels of serumβ-endorphin and androgen.
Subject(s)
Female , Humans , Acupuncture Points , Acupuncture Therapy , Anxiety , Therapeutics , Depression , Therapeutics , Emotions , Gonadal Steroid Hormones , Blood , Polycystic Ovary Syndrome , Psychology , Therapeutics , Quality of LifeABSTRACT
Objective::To investigate the effect of Wenshen Zhuyang Tiaozhou method on sex hormones, insulin and ovulation in polycystic ovary syndrome (PCOS) patients with kidney-Yang deficiency syndrome based on phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway. Method::Totally 60 PCOS patients with kidney-Yang deficiency syndrome treated at the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from February 2017 to July 2018 were selected and divided into observation group and control group according to the random number table method, with 30 cases in each group. The control group was orally treated with ethinylestradiol and cycloproterone acetate tablets, in addition to this therapy, the observation group also received Wenshen Zhuyang Tiaozhou method. Both groups were followed up after three months of treatment. Sex hormone levels, fasting plasma glucose (FPG) and fasting insulin (FINS) levels were measured in all patients. Homeostasis model assessment-insulin resistance(HOMA-IR) was calculated by homeostasis model assessment method, and the expression levels of Akt and p-Akt proteins in endometrium were detected by Western blot. Result::After treatment, the levels of FSH and LH in both groups decreased, and the level of E2 sex hormone increased (P<0.05). After treatment, the levels of FSH and LH in observation group were lower than those in control group, whereas the level of E2 sex hormone was higher than that in control group (P<0.05). After treatment, the levels of FPG and FINS in two groups were significantly lower (P<0.05), while the levels of FPG and FINS in observation group were significantly lower than those in control group (P<0.05). After treatment, the ovarian volume and the number of sinusoidal oocytes in two groups decreased significantly, while the endometrial thickness increased (P<0.05). After treatment, the ovarian volume and the number of sinusoidal oocytes in observation group were significantly lower than those in control group, and the endometrial thickness was significantly lower than that in observation group (P<0.05). After treatment, the ovarian volume and the number of sinusoidal oocytes in observation group were significantly lower than those in control group, and the endometrial thickness was larger than that of control group (P<0.05). After treatment, the Akt and p-Akt proteins in the endometrium of observation group and control group were significantly decreased, while the Akt and p-Akt proteins in the endometrium of observation group were significantly lower than those of control group (P<0.05). Conclusion::Wenshen Zhuyang Tiaozhou method can effectively ameliorate the sex hormone level, regulate insulin and promote the recovery of ovarian function in PCOS patients with kidney-Yang deficiency syndrome. This may be related to the blocking of the phosphorylation of Akt and the inhibition of the activation of PI3K/Akt signaling pathway.
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OBJECTIVE@#Polycystic ovary syndrome (PCOS), a common endocrine-metabolic dysfunction in reproductive-aged women, may be involved in compromised pregnancy and offspring outcomes. This study aimed to investigate whether maternal PCOS affects fetal growth, fetal development, and placental features.@*METHODS@#This retrospective case-control study included 60 pregnant women with PCOS (PCOS group) and 120 healthy pregnant women without PCOS (control group). Fetal magnetic resonance imaging (MRI) was performed followed by an ultrasound examination and indications for imaging, including known or suspected fetal pathology, history of fetal abnormality in previous pregnancy or in a family member, and concern for placenta accreta. Fetal MRI images were analyzed for head circumference (HC), abdomen circumference (AC), lung-to-liver signal intensity ratio (LLSIR, a prenatal marker of fetal lung maturity), lengths of liver and kidney diameters in fetuses, and placental relative signal intensity on T2-weighted single-shot fast spin echo (SSFSE) imaging (rSI@*RESULTS@#Compared to the control group, the PCOS group showed the following characteristics: (1) smaller biparietal diameter and femur length in fetuses (P=0.026 and P=0.005, respectively), (2) smaller HC in fetuses (evident after 32 weeks; P=0.044), (3) lower LLSIR and smaller dorsoventral length of liver in fetuses (evident before 32 weeks; P=0.005 and P=0.019, respectively), and (4) smaller placental thickness (evident before 32 weeks; P=0.017). No significant differences in placental rSI@*CONCLUSIONS@#There exist alterations of fetal growth, fetal development, and placental features from women with PCOS.
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OBJECTIVE : To evaluate the effectiveness of metformin therapy in preventing early pregnancy loss in pregnant women with polycystic ovary syndrome (PCOS). MATERIALS AND METHODS : This is a prospective cohort study conducted in the Obstetric Department of Krishna Institute of Medical Sciences, Karad, Maharashtra, India for a period of 2 years. This study involved 100 nondiabetic pregnant women with PCOS. They were divided into two groups, namely, the group that received metformin throughout pregnancy (metformin group) and the group that got pregnant but, did not receive metformin (control group). A comparison was made between the two groups of patients with respect to certain basal characteristics (age, body mass index, previous obstetric outcome, serum glucose with free testosterone). Statistical analysis was performed using Chi-square test to compare the differences between the two groups. RESULTS : There were 50 patients who received metformin during pregnancy (metformin group) compared with 50 patients who did not receive the treatment (control group). The rate of early pregnancy loss in the metformin group was 10% (5/50) compared with 36% (18/50) in the control group (p < 0.001). For patients in the metformin group with a history of previous miscarriage, the rate of pregnancy loss was 45% (35 cases/50 pregnancies). CONCLUSION : Metformin therapy in pregnant women with PCOS was associated with a significant reduction in the rate of early pregnancy loss.
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Resumen El Síndrome de ovario poliquístico (SOP) es la enfermedad endocrina-metabólica más frecuente en las mujeres en edad reproductiva. A pesar de su alta prevalencia, hay pocas investigaciones que analizan los efectos de los cambios hormonales sobre la cognición de pacientes con SOP. Objetivo: comparar el rendimiento en habilidades cognitivas y los niveles de hormonas sexuales de un grupo de pacientes con SOP y con las de un grupo control. Método: Participaron 20 mujeres mayores de 21 años, sin tratamiento hormonal, dividas en dos grupos, el primero compuesto por 10 pacientes diagnosticadas con SOP según los criterios de Rotterdam (GSOP) y el otro, de control, compuesto por 10 mujeres sin diagnóstico de SOP (GCT). Se aplicaron las pruebas WAIS III y fluidez verbal semántica y fonológica de la batería NEUROPSI Atención y memoria, y se realizaron análisis sanguíneos de hormonas sexuales. Resultados: Las pacientes del GSOP obtuvieron puntajes inferiores a las del GCT en el CI Verbal (p=0.009), CI Total (p=0.029), índice de comprensión verbal (p=0.005), índice de memoria de trabajo (p=0.023) y en la prueba de fluidez verbal semántica (p=0.029). No se encontraron diferencias significativas en los niveles hormonales. Conclusión: el GSOP presentó menor rendimiento que el GCT en pruebas de tipo verbal, aunque no se presentó déficit en su ejecución. Se sugiere estudiar la relación de la insulinorresistencia con la cognición en pacientes con SOP.
Abstract Polycystic ovarian syndrome (PCOS) is the most common endocrine-metabolic disease in women of reproductive age. Despite its high prevalence, little research analyzes the effects of hormonal changes on cognition in patients with PCOS. Objective: To compare the performance in cognitive abilities and sexual hormone levels of a group of patients with PCOS and those of a control group. Method: Twenty women older than 21 years, without hormone treatment, divided in two groups, the first consisting by 10 patients diagnosed with PCOS according to the Rotterdam criteria (GSOP), and the other composed of 10 women without diagnosis of PCOS (GCT). WAIS III and semantic and phonological verbal fluency tests of the NEUROPSI attention and memory test battery were applied, and blood analyzes of sexual hormones were analyzed. Results: The GSOP patients obtained lower scores than the GCT in Verbal IQ (p=0.009), full scale IQ (p=0.029), verbal comprehension index (p=0.005), working memory index (p=0.023) and semantic verbal fluency test (p=0.029). No significant differences were found in sexual hormone levels. Conclusion: the GSOP showed lower performance than the GCT in verbal tests, although there was not deficit in its execution. It is suggested to study the relationship of insulin resistance with cognition in patients with GSOP.
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Aim:The aim of this study is to determine the prevalence of PCOS among different gynecological disorders at tertiary care hospital of Karachi and to assess the most frequent presenting complaint with associated complications among them. Study Design:Single-centered cross-sectional study.Place and Duration of Study:Gynecological clinic of Karachi at a Tertiary care Hospital during 3rd December 2018 to 29th March 2019.Methodology:Total 335 premenopausal women approached the clinic with different gynecological disorders during the period of four months and 305 patients agreed to participate. The patients were enrolled via convenient sampling technique. After taking the informed consent they were evaluated through clinical interviews, questionnaire, and anthropometric measurements. The diagnosis of PCOS was made by using Rotterdam criteria 2003. Menstrual irregularities were assessed via history. Clinical hyperandrogenism was evaluated by using modified Ferriman–Gallwey scale and Acne Global Grading System. Obesity was calculated through BMI. The Hamilton scale was used to appraise associated psychological disturbances.Results:PCOS was the most prevalent gynecological disorder (55.41%) among women of the premenopausal age. Overall, the most frequent presenting complaint was infertility but age related variations in symptoms showed that young adolescent and adulthood had more menstruation irregularities while, in late adolescent the chief complaint was infertility. Moreover, these patients were either overweight 32% or obese 46.2%. Other associated problems such as anxiety and migraine were more frequent in young adults and juveniles respectively.Conclusion:PCOS is the most common gynecological problemin our region. These women usually presents with altered complains that influence their physiological and psychological health which in turn effects the quality of life
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Polycystic ovary syndrome (PCOS) is a common gynecological reproductive endocrine and metabolic disorder disease. The clinical manifestations of PCOS are diversified, with and no ovulation, insulin resistance, hyperinsulinemia and polycystic ovaries as the main pathological and physiological changes, which can lead to non-ovulation infertility and ovulatory dysfunction infertility, cause complications, such as amenorrhea, diabetes, lipid metabolism and glucose metabolism disorder, and endanger the long-term health of the body. Traditional Chinese medicine (TCM) does not have the name of this disease, and classifies PCOS to the category of "amenorrhea", "infertility" and "abdominal mass kidney" according to its clinical manifestations. Compared with western medicine, TCM has a unique view in treating the disease, and believes that the disorders of liver, kidney and spleen functions jointly affect the occurrence and development of the disease. According to the literature review, kidney-deficiency syndrome is the main syndrome type of this disease, the kidney-tonifying method has achieved a good effect in clinic. Besides, the drug use is flexible and diversified, and both primary and secondary symptoms are taken into consideration. However, in the clinical application process, the application of kidney-tonifying method in PCOS has been affected by the thinking mode of "kidney-tonifying medicine for male diseases" to some extent. In view of this, the therapeutic effect of kidney-tonifying drugs in the treatment of PCOS is preliminarily demonstrated from several aspects of the relationship between kidney deficiency and reproduction, pathogenesis of PCOS, clinical research and experimental research of PCOS, in the expectation of providing theoretical and practical supports for kidney-tonifying therapy for PCOS and other gynecological diseases.
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Objective: To investigate the effect of dodder total flavone on polycystic ovary syndrome (PCOS) rat models induced by letrozole. Method: Except the blank group, the other rats were given letrozole 1 mg·kg-1 for 21 consecutive days to replicate PCOS animal model. On the 16th day of the modeling, the estrous cycle was detected by vaginal smear, and rat with persistent keratinization of vaginal epithelial cells were selected as the PCOS model rat. The model rats were randomly divided into model group, Dacin-35 group, and high, middle, low-dose dodder total flavonoids groups. The corresponding drugs were given for 21 consecutive days. At the end of the administration, materials were collected to calculate ovary index, and enzyme-linked immunosorbent assay(ELISA) was used to measure estrogen (E2), testosterone (T), gonadotropin-releasing hormone (GnRH), follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels of serum. The right ovary of rats was stained with haematoxylin-eosin (HE), and the pathological changes were observed by optical microscope. Androgen receptor(AR) expressions in hypothalamus, pituitary and ovary were detected by mmunohistochemistry. Result: Compared with the blank group, serum T, GnRH and LH levels, ovarian index and LH/FSH ratio were significantly increased, while FSH and E2 levels were significantly decreased (PPP2, T, GnRH and LH levels, ovarian index and LH/FSH ratio were significantly decreased in high, middle and low-dose dodder total flavonoids groups (P2 level was significantly increased (PP2 level in PCOS model rats was obviously increased in low-dose dodder total flavonoids group (PPConclusion: Dodder total flavonoids may play a protective role in PCOS model rats by regulating the secretion of estrogen and androgen and affecting the hypothalamic-pituitary-ovary axis pathway.
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Objective • To investigate the effects of ovarian granulosa cell androgen receptor splice variant insertion isoform (AR-ins) on the levels of sex hormones and insulin in patients with polycystic ovary syndrome (PCOS). Methods • Seventy-nine control patients (control group) of normal ovulation and one hundred and fifty-four PCOS patients (PCOS group) who received in vitro fertilization embryo transfer in the Assisted Reproductive Department of the International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine from Jun. 2017 to Jun. 2018 were recruited. The sociodemographic information, serum basic hormones and insulin data were collected according to medical history record, and the hormone levels were measured by chemiluminescence. The ovarian granulosa cells and follicular fluids of all the patients were collected. Nested PCR was used to identify the androgen receptor splice variant (AR SV) in the ovarian granulosa cells from PCOS patients, and then they were divided into two groups, i.e., PCOS Wt group (n=39) and PCOS AR-ins group (n=115). The levels of sex hormones and insulin in follicular fluids of the three groups were detected by chemiluminescence. The free androgen index (FAI) was calculated. The sociodemographic information, the levels of sex hormones and insulin in serum and follicular fluid of the three groups were compared by One-way ANOVA, Welch's ANOVA, Kruskal-Wallis H test and chi-square test. Results • Compared with the control group, the levels of serum sex hormone-binding globulin (SHBG) were significantly lower in the PCOS AR-ins group (P=0.000), and the levels of serum total testosterone (TT) (P=0.000), insulin (P=0.001) and FAI (P=0.000) were significantly higher in the PCOS AR-ins group. Compared with the control group and the PCOS Wt group, the differences of SHBG, TT, insulin levels and FAI in the follicular fluid in the PCOS AR-ins group were statistically significant (all P<0.05). Conclusion • PCOS patients with AR-ins have high androgen and insulin levels in serum, and this effect is more pronounced in the ovarian local microenvironment.
ABSTRACT
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of childbearing age, which features oligo-or anovulation, polycystic ovaries, hyperandrogenism and the related clinical signs, such as acne and hirsutism. At present, PCOS patients are considered to be in a long-time condition of chronic inflammation. It is reported that increased expression of inflammatory factors and/or increased levels of inflammation exist in peripheral blood, granulosa cells, follicular fluid, ovarian stroma, adipocytes and endometrial cells in patients with PCOS. Studies on the role of inflammatory factors in the pathogenesis of PCOS suggest that inflammatory factors may have an influence on the clinical outcome through affecting follicular development, androgen levels and so on.
ABSTRACT
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of childbearing age, which features oligo- or anovulation, polycystic ovaries, hyperandrogenism and the related clinical signs, such as acne and hirsutism. At present, PCOS patients are considered to be in a long-time condition of chronic inflammation. It is reported that increased expression of inflammatory factors and/or increased levels of inflammation exist in peripheral blood, granulosa cells, follicular fluid, ovarian stroma, adipocytes and endometrial cells in patients with PCOS. Studies on the role of inflammatory factors in the pathogenesis of PCOS suggest that inflammatory factors may have an influence on the clinical outcome through affecting follicular development, androgen levels and so on.
ABSTRACT
Objective To observe the clinical efficacy and safety of estradiol and progesterone combined with metformin or pioglitazone in the treatment of polycystic ovary syndrome(PCOS). Methods Totally 132 PCOS patients in our hospital were collected in this study. Patients were randomly divided into metformin group and pioglitazone group, 66 cases in each group. The expression of FSH, LH, T, and E2 was detected by electrochemiluminescence. TC, TG, LDL-C, and HDL-C was detected by colorimetry. HOMA-β and HOMA-IR were determined by the steady state model. The clinical efficacy and adverse reactions were compared between the two groups. Results FSH, LH, T and E2 levels had no significant difference between the two groups before treatment (P ＞ 0. 05). After treatment, FSH, LH and T were significantly decreased in the two groups, and E2 were significantly increased (P ＜ 0. 01). But, there was no significant differences of FSH, LH, T and E2 levels between the two groups after treatment (P ＞ 0. 05). The effective rate in metformin group was 90. 9％ (60 /66), and in pioglitazone group was 93. 9％ (62 /66). There was no significant difference between the two groups (P ＞ 0. 05). There was no significant difference in TC, TG, LDL-C, HOMA-and HOMA-IR levels between the two groups after treatment (P ＞ 0. 05). However, the level of HDL-C was significantly higher in pioglitazone group than that in metformin group (P ＜0. 05). The BMI of pioglitazone group was 25. 64 ± 5. 35kg /m2, which was significantly higher than that of 21. 31 ± 4. 13kg /m2 in metformin group (P ＜ 0. 05). The gastrointestinal adverse reaction rate was 13. 6％ in pioglitazone group, which was significantly lower than that of 27. 3％ in metformin group (P ＜ 0. 05). Conclusion The clinical efficacy of estradiol and progesterone combined with metformin or pioglitazone in treatment of PCOS was significantly. But pioglitazone significantly increased HDL-C, with lower gastrointestinal adverse reaction rate, and metformin can reduce the patient weight.
ABSTRACT
<p><b>OBJECTIVE</b>To observe the efficacy differences between acupuncture combined with medication and medication alone for infertility patients with polycystic ovary syndrome (PCOS).</p><p><b>METHODS</b>According to random number table, a total of 60 infertility patients with PCOS were randomly assigned into an observation group and a control group, 30 cases in each one. The patients in the control group were treated with diane-35 from the 3rd day into menstruation, and one menstrual cycle was taken as a session of treatment. At the same time of using diane-35, the patients in the observation group were treated with acupuncture at Guanyuan (CV 4), Qihai (CV 6), Sanyinjiao (SP 6), Zusanli (ST 36), Zigong (EX-CA 1), Shenshu (BL 23), Pishu (BL 20), Weishu (BL 21) and Ganshu (BL 18) during non-menstruation period; the acupuncture was given once every two days, three treatments per week. The patients in both groups were treated for two sessions. The basic sex hormone and body mass index (BMI) were compared between the two groups before and after treatment. After ovulation induction treatment, the endometrial thickness, amount of mature follicle, ovulation rate, clinical pregnancy rate, occurrence rate of ovarian hyperstimulation syndrome (OHSS) and the number of early spontaneous abortion were compared between the two groups during ovulation.</p><p><b>RESULTS</b>After treatment, the luteinizing hormone (LH), testosterone (T) and BMI reduced in the observation group (all <0.05), while only LH reduced in the control group (<0.05). The reducing of estradiol (E), T and BMI in the observation group was more significant than that in the control group (all <0.05). The ovulation rate was 93.3% (28/30) in the observation group, which was higher than 80.0% (24/30) in the control group (<0.05). The rate of clinical pregnancy was 43.3% (13/30) in the observation group, which was higher than 33.3% (10/30) in the control group (<0.05). The differences of endometrial thickness, amount of mature follicle, occurrence rate of OHSS and number of early spontaneous abortion were not significant between the two groups (all >0.05).</p><p><b>CONCLUSION</b>Acupuncture as adjunctive treatment could improve BMI, reduce the levels of LH, E and T, increase ovulation reaction and effectively shorten reproduction cycles in infertility patients with PCOS.</p>