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1.
AAPS PharmSciTech ; 22(5): 204, 2021 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-34258696

RESUMO

Hirsutism is a dermatological condition that refers to the excessive growth of hair in androgen-sensitive areas in women. Recently, the enhancement of the visible signs of a hairy female has taken special concern that affected the quality of life. The present study was developed to compare the follicular targeting effect of topical spironolactone (SP) or progesterone (PG)-loaded nanostructured lipid carrier (NLC) on the management of hirsutism. Four NLC formulations were prepared using cold homogenization techniques and pharmaceutically evaluated. SP-NLC and PG-NLC topical hydrogels were prepared to explore their pharmacological effect on letrozole induced polycystic ovarian syndrome (PCOS) in rats. Inflammatory mediators, antioxidant, and hormonal parameters were assayed. Additionally, histopathological examination was carried out to confirm the successful induction of PCOS. Results confirmed that all NLC formulations have a spherical shape with particle size ranged from 225.92 ± 0.41 to 447.80 ± 0.66 nm, entrapment efficiency > 75%, and zeta potential (- 31.4 to - 36.5 mV). F1 and F3 NLCs were considered as selected formulations for SP and PG, respectively. Female Wistar rats treated with F1 formulation for 3 weeks displayed better outcomes as manifested by the measured parameters as compared to the other tested groups. A significant reduction in hair follicle diameter and density was observed after topical application of SP or PG nano-gels. Finally, the outcomes pose a strong argument that the development of topically administered SP-NLC can be explored as a promising carrier over PG-NLC for more effectual improvement in the visible sign of hirsutism.


Assuntos
Portadores de Fármacos/administração & dosagem , Hirsutismo/sangue , Hirsutismo/tratamento farmacológico , Nanoestruturas/administração & dosagem , Progesterona/administração & dosagem , Espironolactona/administração & dosagem , Animais , Portadores de Fármacos/síntese química , Avaliação Pré-Clínica de Medicamentos/métodos , Feminino , Hidrogéis/administração & dosagem , Hidrogéis/síntese química , Inflamação/tratamento farmacológico , Inflamação/patologia , Nanoestruturas/química , Tamanho da Partícula , Progesterona/síntese química , Ratos , Ratos Wistar , Espironolactona/síntese química
2.
J Fam Pract ; 70(3): 147-149, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-34314340
3.
Eur J Endocrinol ; 185(2): 279-288, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34081616

RESUMO

Objective: It has been suggested that adverse early life exposures increase the risk of developing polycystic ovary syndrome (PCOS) in later life. We hypothesized that women born preterm would have more biochemical and clinical signs of PCOS than women born at term. Design: The ESTER Preterm Birth Study participants were born in Northern Finland and identified from the Northern Finland Birth Cohort and the Finnish Medical Birth Register. Altogether, 74 women born very or moderately preterm (<34 gestational weeks, VMPT), 127 born late preterm (at 34-36 weeks, LPT), and 184 born full term (≥37 weeks, controls) were included in the analysis (mean age: 23.2 years). Methods: We measured serum total testosterone and sex hormone-binding globulin (SHBG) and calculated the free androgen index (FAI). PCOS according to the clinical and biochemical signs was defined either as hirsutism and oligoamenorrhea (via questionnaire) or as oligoamenorrhea and elevated testosterone levels (>2.4 nmol/L). Results: Women born VMPT/LPT exhibited 33.0% (8.7, 62.8)/16.4% (-2.0, 38.1) higher testosterone, 28.5% (5.3, 45.9)/24.1% (5.6, 38.9) lower SHBG levels, and 64.6% (19.4, 127.1)/42.5% (11.1, 82.9) higher FAI than controls after adjusting for age and recruitment cohort, maternal BMI, smoking, and pregnancy disorders, parental education, history of hypertension, diabetes, myocardial infarction or stroke, and subject's birth weight s.d. Odds ratios for having PCOS were 1.67 (0.44, 6.23)/3.11 (1.26, 7.70). Conclusions: Women born preterm have a more hyperandrogenic hormonal profile, and those born LPT are approximately three times more likely at risk to have PCOS compared to women born at term.


Assuntos
Biomarcadores , Síndrome do Ovário Policístico/diagnóstico , Síndrome do Ovário Policístico/epidemiologia , Nascimento Prematuro/epidemiologia , Adulto , Crianças Adultas/estatística & dados numéricos , Androgênios/sangue , Biomarcadores/análise , Biomarcadores/sangue , Índice de Massa Corporal , Estudos de Casos e Controles , Feminino , Finlândia/epidemiologia , Idade Gestacional , Hirsutismo/sangue , Hirsutismo/diagnóstico , Hirsutismo/epidemiologia , Humanos , Recém-Nascido , Síndrome do Ovário Policístico/sangue , Síndrome do Ovário Policístico/etiologia , Gravidez , Complicações na Gravidez/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/etiologia , Fatores de Risco , Testosterona/sangue , Adulto Jovem
4.
J Clin Endocrinol Metab ; 105(10)2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32442282

RESUMO

CONTEXT: Epidemiologic studies of polycystic ovary syndrome (PCOS) are limited, especially in populations where diagnostic resources are less available. In these settings, an accurate, low-cost screening tool would be invaluable. OBJECTIVE: To test the use of a simple questionnaire to identify women at increased risk for PCOS and androgen excess (AE) disorders. STUDY DESIGN: Prospective cohort study from 2006-2010. SETTING: Community-based. PARTICIPANTS: Women aged 14 to 45 years. INTERVENTION: A screening telephone questionnaire consisting of 3 questions was tested, where participants were asked to self-assess the presence/absence of male-like hair and menstrual irregularity. Participants were then invited to undergo a direct examination, including completing a medical history and undergoing a modified Ferriman-Gallwey (mFG) hirsutism score, ovarian ultrasound, and measurement of circulating total and free testosterone, DHEAS, TSH, prolactin and 17-hydroxyprogesterone levels. MAIN OUTCOME MEASURE: Accuracy of questionnaire in predicting PCOS, AE, and irregular menses. RESULTS: Participants with self-assessed irregular menses and/or excess hair were labeled "Possible Androgen Excess (Poss-AE)" and those self-assessed with regular menses and no excess hair were labeled "Probable Non-Androgen Excess (Non-AE)." The study was completed in 206/298 (69%) of the Poss-AE and in 139/192 (73%) of the Non-AE. Of Poss-AE and Non-AE subjects, 82.5% and 15.8%, respextively, presented with PCOS. The calculated sensitivity, specificity, positive predictive value, and negative predictive value of the 3-question telephone survey to predict PCOS was 89%, 78%, 85%, and 83%, respectively. CONCLUSIONS: A simple telephone questionnaire, based on self-assessment of body hair and menstrual status, can be used with a high predictive value to identify women at risk for AE disorders, including PCOS, and to detect healthy controls. This approach could be an important tool for needed epidemiologic studies.


Assuntos
Androgênios/sangue , Hirsutismo/diagnóstico , Distúrbios Menstruais/diagnóstico , Síndrome do Ovário Policístico/epidemiologia , Autoavaliação (Psicologia) , Adolescente , Adulto , Androgênios/metabolismo , California , Feminino , Hirsutismo/sangue , Hirsutismo/epidemiologia , Humanos , Distúrbios Menstruais/sangue , Distúrbios Menstruais/epidemiologia , Pessoa de Meia-Idade , Síndrome do Ovário Policístico/sangue , Valor Preditivo dos Testes , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Autorrelato/estatística & dados numéricos , Telefone , Adulto Jovem
5.
J Endocrinol Invest ; 43(9): 1271-1281, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32166698

RESUMO

PURPOSE: The study aimed to investigate whether repeat number in the androgen receptor (AR) gene has any contribution to phenotypes of the disease of androgen excess (polycystic ovary syndrome (PCOS), idiopathic hyperandrogenemia (IHA) and idiopathic hirsutism (IH) in a cohort of Turkish women. METHODS: Three hundred and fifty-four voluntary premenopausal women (172 healthy controls and 182 patients with androgen excess disorders and idiopathic hirsutism) 18-45 years of age seen at an outpatient endocrine clinic at Erciyes University Hospital between January 2013 and December 2014 were included. All volunteers have undergone physical examination and biochemical evaluation. The polymorphic (CAG)n repeat of the human AR was determined by fragment analyses. RESULTS: Detailed clinical analyses of the patients ended up with 137 PCOS, 24 IHA, and 21 IH. Pairwise comparisons revealed the CAG repeat number differences between the PCOS and controls (p = 0.005) and IH and controls (p = 0.020). Women with CAG repeat length ≤ 17 had a significantly increased twofold risk for PCOS than those women with > 17 CAG repeats OR: 2.0 (95% CI 1.2-3.3, p = 0.005). Women with CAG repeat length ≤ 17 had a significantly increased threefold risk for IH than those women with > 17 CAG repeats OR: 2.9 (95% CI 1.2-7.3, p = 0.020). When correlation analysis was performed, a weak negative correlation was detected between the short allele and FGS score (r = - 0.131, p = 0.013) and a positive relationship between total testosterone and longer allele in the IHA group (r = 0.425, p = 0.039). Median repeat length of the shorter allele between oligomenorrhea and woman with normal menstrual cycle was found to be statistically significant (p = 0.017). CONCLUSION: This study indicated that the risk of PCOS and IH is associated with the inheritance of ARs with shorter CAG repeats.


Assuntos
Hirsutismo/genética , Hiperandrogenismo/genética , Síndrome do Ovário Policístico/genética , Receptores Androgênicos/genética , Repetições de Trinucleotídeos/genética , Adolescente , Adulto , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Estudos de Associação Genética , Predisposição Genética para Doença , Hirsutismo/sangue , Humanos , Hiperandrogenismo/sangue , Pessoa de Meia-Idade , Fenótipo , Síndrome do Ovário Policístico/sangue , Polimorfismo Genético , Testosterona/sangue , Turquia , Adulto Jovem
6.
J Clin Endocrinol Metab ; 105(4)2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-32025718

RESUMO

CONTEXT: An important element of the diagnosis of polycystic ovary syndrome is hyperandrogenism. OBJECTIVE: To determine the distribution of modified Ferriman-Gallwey (mF-G) scores, as a measure of facial and body hair growth, and associations between the mF-G scores and serum androgen concentrations, including 11-oxygenated androgens. DESIGN: Cross-sectional study of non-health-care-seeking women, aged 18 to 39 years, recruited from the eastern states of Australia from November 2016 to July 2017. PARTICIPANTS AND MEASUREMENTS: Participants provided an mF-G self-assessment that corresponded to their appearance when not using treatment for excess hair. Androgens were measured in 710 women by liquid chromatography and tandem mass spectrometry. RESULTS: The distribution of the mF-G scores was right-skewed. The median (range) mF-G score of all participants (73.1% Caucasian) was 5 (0-36). The mF-G scores were negatively associated with age (rs = 0.124; P < 0.0001) and positively associated with body mass index (BMI) (rs = 0.073; P < 0.0001). Only androstenedione remained significantly associated with mF-G scores when controlling for age and BMI. Cluster analysis identified 2 groups with mF-G score of < 10 and ≥ 10. Repeating the cluster analysis using the combined vector of mF-G score and androstenedione returned a similar cluster structure, and again separated the 2 groups at a mF-G score < 10 versus ≥ 10. CONCLUSIONS: A self-assessed mF-G score ≥ 10 is indicative of excess body hair. Androstenedione, as well as testosterone, should be measured when hyperandrogenism is being evaluated. The lack of association between mF-G scores and the 11-oxygenated androgens highlights the need for a better understanding of these steroids.


Assuntos
Androgênios/sangue , Cabelo/química , Cabelo/metabolismo , Hirsutismo/fisiopatologia , Adolescente , Adulto , Antropologia Física , Estudos Transversais , Feminino , Seguimentos , Hirsutismo/sangue , Humanos , Adulto Jovem
7.
Gynecol Endocrinol ; 36(8): 673-677, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31996062

RESUMO

Aim: To investigate the role of serum OKL38 levels in the development of polycystic ovary syndrome (PCOS) and clinical implications related to PCOS.Method: PCOS (n = 33) and ovulatory controls (n = 48) were recruited for the study. Anthropometric measurements were recorded, and blood samples for hormonal and biochemical parameters including serum OKL38 levels were obtained. The potential role of OKL38 on the development of PCOS, metabolic syndrome and cardiovascular disease (CVD) were investigated. Framingham risk score (FRS) was used for the determination of CVD risk.Results: Mean Ferriman-Gallway (FG) score, insulin, low-density lipoprotein (LDL), total cholesterol (TC) levels, and the homeostasis model assessment of insulin resistance index (HOMA-IR) were significantly increased (p < .05) in women with PCOS compared to controls. PCOS group had lower mean OKL38 level compared to controls (p < .0001) and OKL38 was negatively predictive for the diagnosis of PCOS after adjustment of variables that were significantly different between two groups. A negative association between OKL38 and metabolic syndrome in PCOS women was evident after adjustment for age, obesity, and abdominal obesity. OKL38 level was also negatively correlated with body mass index, waist-to-hip-ratio, fat composition, serum TC, LDL, free testosterone levels, FRS, and FG scores.Conclusion: OKL38 may have a partial role in the etiopathogenesis of PCOS and may protect development of metabolic syndrome and CVD in women with PCOS.


Assuntos
Proteínas Reguladoras de Apoptose/fisiologia , Biomarcadores/sangue , Síndrome do Ovário Policístico/etiologia , Adulto , Antioxidantes/metabolismo , Antioxidantes/fisiologia , Proteínas Reguladoras de Apoptose/sangue , Fatores de Risco Cardiometabólico , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etiologia , Estudos de Casos e Controles , Feminino , Hirsutismo/sangue , Hirsutismo/diagnóstico , Hirsutismo/etiologia , Humanos , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/etiologia , Obesidade/sangue , Obesidade/diagnóstico , Obesidade/etiologia , Síndrome do Ovário Policístico/sangue , Síndrome do Ovário Policístico/diagnóstico , Prognóstico , Fatores de Risco , Adulto Jovem
8.
J Steroid Biochem Mol Biol ; 198: 105554, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31805392

RESUMO

Non-classical congenital adrenal hyperplasia (NC-CAH) includes a group of genetic disorders due to a broad class of CYP21A2 variants identifying a disease-causing 'C' genotype. The heterozygous carriers of CYP21 mutations are at increased risk of developing clinically evident hyperandrogenism, even though clinical and laboratory characteristics are still underestimated. With the aim of obtaining a more accurate delineation of the phenotype of heterozygous carrier of CAH, we analyzed clinical, biochemical and molecular characteristics in a cohort of Sicilian subjects. Fifty-seven females with biallelic and monoallelic CYP21A2 variants classifying NC-CAH (24) and heterozygous carriers of CAH (33), respectively were selected. Forty-four females age-matched healthy controls were also enrolled and genotyped for CYP21A2. Clinical, hormonal and genetic data were collected. CYP21A2 monoallelic mutations, defining the heterozygous carriers state, were identified in subjects with clinical features including hirsutism, oligomenorrhoea, overweight and a PCO-like phenotype, particularly occurring in the age of adolescence. Consistently, levels of 17OHP and cortisol were found to be significantly different from NC-CAH. Overall, some clinical and laboratory findings including oligomenorrhea and 17OHP/cortisol ratio were observed as independent markers associated with carriers of CAH. Here we report a high prevalence of late-onset signs of polycystic ovary syndrome (PCOS) and hyperandrogenism in heterozygous carriers. The 17OHP/cortisol ratio may be a predictive tool to identify the carriers of CAH, even though specific cut-off values have not yet been identified.


Assuntos
Hiperplasia Suprarrenal Congênita/genética , Hiperandrogenismo/genética , Esteroide 21-Hidroxilase/genética , Adolescente , Hiperplasia Suprarrenal Congênita/sangue , Hiperplasia Suprarrenal Congênita/complicações , Adulto , Criança , Feminino , Heterozigoto , Hirsutismo/sangue , Hirsutismo/etiologia , Hirsutismo/genética , Humanos , Hidrocortisona/sangue , Hiperandrogenismo/sangue , Hiperandrogenismo/etiologia , Mutação , Oligomenorreia/sangue , Oligomenorreia/etiologia , Oligomenorreia/genética , Sobrepeso/sangue , Sobrepeso/etiologia , Sobrepeso/genética , Adulto Jovem
9.
J Cosmet Dermatol ; 19(2): 535-539, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31190433

RESUMO

BACKGROUND: Hirsutism is a common clinical condition encountered in day-to-day practice. The androgenic causes account for more than 80% of these patients and include polycystic ovary syndrome (PCOS), which affects about 70%-80% of hirsute women. The second most common cause is idiopathic hirsutism. Omentin-1 is an adipokine mainly produced by visceral adipose tissue. AIM: The current study aimed at evaluating omentin-1 levels in hirsute females with PCOS and in idiopathic hirsutism. PATIENTS AND METHODS: Eighty-five females were included in this study. They were classified into three groups: thirty hirsute patients with PCOS, thirty females with idiopathic hirsutism, and twenty-five healthy control females. The participants were subjected to history taking, physical and dermatological examination. A gynecological history and radiological examination of the ovary also were done. Serum testosterone and omentin-1 were measured by ELISA. RESULTS: Serum testosterone was statistically elevated in PCOS than other groups. Serum omentin-1 in females with idiopathic hirsutism was statistically significantly higher than control and PCOS. There was a significant inverse correlation between serum testosterone level and serum omentin-1 level. CONCLUSION: Omentin-1 may be involved in the pathogenic process of hirsutism.


Assuntos
Citocinas/sangue , Hirsutismo/sangue , Lectinas/sangue , Síndrome do Ovário Policístico/sangue , Adulto , Estudos de Casos e Controles , Feminino , Proteínas Ligadas por GPI/sangue , Hirsutismo/etiologia , Humanos , Síndrome do Ovário Policístico/complicações , Testosterona/sangue , Adulto Jovem
10.
Gynecol Endocrinol ; 36(2): 152-155, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31317814

RESUMO

The aim of this retrospective study was to evaluate the effects of a long-term treatment with α-lipoic acid (ALA) combined with myo-inositol (MI) on clinical and metabolic features of women with polycystic ovary syndrome (PCOS). Fifty-seven women with PCOS and a history of oligoamenorrhea were treated with MI and ALA (800 mg + 2000 mg per day). Forty-four of them had complete clinical charts and were considered eligible for the study. Information about cycle length and body mass index (BMI) was checked after 6, 12, and 24 months. After 12 months ovarian volume, total testosterone plasma levels and changes in hirsutism were also evaluated. The metabolic parameters were evaluated in 16 women after 6 and 18 months of the treatment. Cycle length was significantly reduced at 6 (p < .001), 12, and 24 months of treatment (p < .01). BMI showed a reduction only at 6 months (p < .05), thereafter returning similar to the basal values. No changes of testosterone and ovarian volume were observed. HOMA-IR and fasting insulin were unchanged, but the insulin response to a 3 h OGTT was improved after 6 (p < .01) and 18 months (p < .05) of treatment. No individual suffered from any adverse event. In conclusion, the combination of ALA and MI showed to be useful as long-term therapy in PCOS women, providing a normalization of the menstrual cycle and an amelioration of insulin levels with a high tolerability.


Assuntos
Hirsutismo/tratamento farmacológico , Inositol/uso terapêutico , Síndrome do Ovário Policístico/tratamento farmacológico , Testosterona/sangue , Ácido Tióctico/uso terapêutico , Adulto , Índice de Massa Corporal , Feminino , Hirsutismo/sangue , Hirsutismo/diagnóstico por imagem , Humanos , Resistência à Insulina/fisiologia , Tamanho do Órgão , Ovário/diagnóstico por imagem , Síndrome do Ovário Policístico/sangue , Síndrome do Ovário Policístico/diagnóstico por imagem , Estudos Retrospectivos , Resultado do Tratamento
11.
Endocrinol Metab (Seoul) ; 34(4): 374-381, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31884737

RESUMO

BACKGROUND: The modified Ferriman-Gallwey (mFG) score is the gold standard for the clinical evaluation of hirsutism. However, racial variations in terminal hair growth limit this tool. This study aimed to determine the mFG cut-off score among Filipino women and its association with biochemical hyperandrogenism. METHODS: A total of 128 Filipino women were included in this prospective cross-sectional study and were divided into two groups: a polycystic ovary syndrome (PCOS) group (n=28) and a non-PCOS group (n=100). The participants underwent mFG score determination, ovarian ultrasound conducted by a single sonographer, and hormone testing. The mFG cut-off score was determined based on the 95th percentile of the non-PCOS group. Logistic regression was used to analyze the relationship between mFG score and biochemical hyperandrogenism. RESULTS: Although the mFG score was generally low in both the PCOS and non-PCOS groups, the former exhibited a higher mean score than the latter (4.3±3.0 vs. 2.0±2.2, P<0.001). Normal values for the total mFG score ranged from 0 to 7. Using a cut-off score of 7, a higher proportion of hirsute women (mFG score ≥7) was observed in the PCOS group versus the non-PCOS group (17.9% vs. 5.0%, P=0.025). Elevated calculated free testosterone (FT) was also found to be significantly associated with hirsutism (odds ratio, 6.2; 95% confidence interval, 1.2 to 32.4 pmol/L; P=0.030). CONCLUSION: A score of 7 and above constitutes hirsutism in this population of Filipino women. Hirsute women are more likely than non-hirsute women to have elevated calculated FT.


Assuntos
Cabelo/crescimento & desenvolvimento , Hirsutismo/diagnóstico , Síndrome do Ovário Policístico/complicações , Adolescente , Adulto , Biomarcadores/análise , Índice de Massa Corporal , Estudos de Casos e Controles , Estudos Transversais , Feminino , Seguimentos , Hirsutismo/sangue , Hirsutismo/etiologia , Humanos , Pessoa de Meia-Idade , Filipinas , Prognóstico , Estudos Prospectivos , Testosterona/sangue , Adulto Jovem
12.
Horm Metab Res ; 51(4): 230-242, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31022739

RESUMO

We undertook a comprehensive search of all published original articles evaluating the diagnostic value of prostate-specific antigen (PSA) for the detection of polycystic ovary syndrome (PCOS). Finally, 25 studies with a total of 1865 participants (1104 cases and 761 controls) met the inclusion criteria. Mean serum PSA levels were significantly higher in PCOS women compared to healthy women [Standardized mean difference (SMD)=1.73 ng/ml, 95% CI=1.22 to 2.25, p<0.001]. Only 5 studies reported accuracy indicators and were included in the bivariate random-effects model; with a total of 509 samples that included 332 (65.22%) confirmed PCOS women. The sensitivity of serum PSA for the diagnosis of PCOS varied between 66.3 and 90.6%, and, the specificity ranged from 62.5-86.7%. Meta-analysis revealed a pooled sensitivity of 72.3% (95% CI 67.1-77.00%) and specificity of 74.6% (95% CI 67.5-80.8%) with an area under the summary ROC curve equal to 0.82 (95% CI 0.75-0.83). The summary estimates were 2.92 (95% CI 1.98-4.31) for positive LR and 0.37 (95% CI 0.26-0.51) for negative LR. The pooled estimate of diagnostic odds ratio (DOR) of serum PSA was 9.01 (95% CI 4.35-18.64). Considering the methodological weaknesses existed in studies, lack of sufficient data regarding the accuracy indicators, and the complexity of the exact pathophysiology of PSA secretion in women, the precise position of PSA, as a diagnostic test for the detection of PCOS, in clinical practice is undetermined, and further studies are still needed.


Assuntos
Síndrome do Ovário Policístico/sangue , Antígeno Prostático Específico/sangue , Estudos de Casos e Controles , Feminino , Hirsutismo/sangue , Humanos , Modelos Logísticos , Razão de Chances , Síndrome do Ovário Policístico/diagnóstico , Sensibilidade e Especificidade
13.
J Ovarian Res ; 12(1): 5, 2019 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-30665436

RESUMO

OBJECTIVE: The aim of this study was to determine the effect of vitamin D and probiotic co-administration on mental health, hormonal, inflammatory and oxidative stress parameters in women with polycystic ovary syndrome (PCOS). METHODS: This randomized, double-blinded, placebo-controlled clinical trial was carried out on 60 subjects, aged 18-40 years old. Subjects were randomly allocated to take either 50,000 IU vitamin D every 2 weeks plus 8 × 109 CFU/day probiotic (n = 30) or placebo (n = 30) for 12 weeks. RESULTS: Vitamin D and probiotic co-supplementation, compared with the placebo, significantly improved beck depression inventory [ß (difference in the mean of outcomes measures between treatment groups) - 0.58; 95% CI, - 1.15, - 0.02; P = 0.04], general health questionnaire scores (ß - 0.93; 95% CI, - 1.78, - 0.08; P = 0.03) and depression, anxiety and stress scale scores (ß - 0.90; 95% CI, - 1.67, - 0.13; P = 0.02). Vitamin D and probiotic co-supplementation was associated with a significant reduction in total testosterone (ß - 0.19 ng/mL; 95% CI, - 0.28, - 0.10; P < 0.001), hirsutism (ß - 0.95; 95% CI, - 1.39, - 0.51; P < 0.001), high-sensitivity C-reactive protein (hs-CRP) (ß - 0.67 mg/L; 95% CI, - 0.97, - 0.38; P < 0.001) and malondialdehyde (MDA) levels (ß - 0.25 µmol/L; 95% CI, - 0.40, - 0.10; P = 0.001), and a significant increase in total antioxidant capacity (TAC) (ß 82.81 mmol/L; 95% CI, 42.86, 122.75; P < 0.001) and total glutathione (GSH) levels (ß 40.42 µmol/L; 95% CI, 4.69, 76.19; P = 0.02), compared with the placebo. CONCLUSIONS: Overall, the co-administration of vitamin D and probiotic for 12 weeks to women with PCOS had beneficial effects on mental health parameters, serum total testosterone, hirsutism, hs-CRP, plasma TAC, GSH and MDA levels. TRIAL REGISTRATION: This study was retrospectively registered in the Iranian website ( www.irct.ir ) for registration of clinical trials ( IRCT20170513033941N37 ).


Assuntos
Síndrome do Ovário Policístico/terapia , Probióticos/administração & dosagem , Vitamina D/administração & dosagem , Vitaminas/administração & dosagem , Adolescente , Adulto , Proteína C-Reativa/análise , Método Duplo-Cego , Feminino , Glutationa/sangue , Hirsutismo/sangue , Hirsutismo/psicologia , Hirsutismo/terapia , Humanos , Inflamação/sangue , Inflamação/psicologia , Inflamação/terapia , Malondialdeído/sangue , Saúde Mental , Estresse Oxidativo/efeitos dos fármacos , Síndrome do Ovário Policístico/sangue , Síndrome do Ovário Policístico/psicologia , Testosterona/sangue , Adulto Jovem
14.
Fertil Steril ; 111(2): 389-396, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30527835

RESUMO

OBJECTIVE: To test the hypothesis that the polycystic ovary syndrome (PCOS) phenotype, or its component features, is less severe in adolescents than in young adult patients, in a referred (clinical) population. DESIGN: Cross-sectional study. SETTING: Tertiary-care academic medical center. PATIENT(S): Two hundred seventy-four adolescents and young adults aged 13.0-24.9 years with PCOS according to the National Institute of Health 1990 criteria. Patients were categorized as adolescents (AD: 13.0-18.9 years; n = 91) and young adults (YA: 19.0-24.9 years; n = 183). Adolescents were further categorized as early adolescents (Early-AD: 13.0-15.9 years; n = 31) and late adolescents (Late-AD: 16.0-18.9 years; n = 60). INTERVENTION(S): History, physical examination, hormonal assays with the use of standardized protocols. MAIN OUTCOME MEASURE(S): Unadjusted and adjusted odds ratios (ORs; adjusted for body mass index [BMI] when applicable) were calculated for biochemical hyperandrogenism (HA), hirsutism (HIR), acne, and degree of oligo/amenorrhea (OA). PCOS phenotypes were classified as HIR+HA+OA, HA+OA, and HIR+OA. RESULT(S): Our analysis demonstrated minimal significant difference in the prevalence of the three PCOS phenotypes, or component features, between AD and YA patients. The risks for obesity were higher for YA versus AD, and the risk of acne was lower for YA versus AD. There was no significant difference between Early-AD and Late-AD. BMI-adjusted models did not significantly modify the main findings. CONCLUSION(S): The present study suggests that the PCOS phenotype is established in early adolescence, remains constant into adulthood, and is not related to BMI.


Assuntos
Síndrome do Ovário Policístico/epidemiologia , Acne Vulgar/sangue , Acne Vulgar/diagnóstico , Acne Vulgar/epidemiologia , Adolescente , Fatores Etários , Alabama/epidemiologia , Amenorreia/sangue , Amenorreia/diagnóstico , Amenorreia/epidemiologia , Biomarcadores/sangue , Índice de Massa Corporal , Estudos Transversais , Sulfato de Desidroepiandrosterona/sangue , Feminino , Hirsutismo/sangue , Hirsutismo/diagnóstico , Hirsutismo/epidemiologia , Humanos , Hiperandrogenismo/sangue , Hiperandrogenismo/diagnóstico , Hiperandrogenismo/epidemiologia , Obesidade/diagnóstico , Obesidade/epidemiologia , Oligomenorreia/sangue , Oligomenorreia/diagnóstico , Oligomenorreia/epidemiologia , Fenótipo , Síndrome do Ovário Policístico/sangue , Síndrome do Ovário Policístico/diagnóstico , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , Globulina de Ligação a Hormônio Sexual/análise , Testosterona/sangue , Adulto Jovem
15.
Biol Trace Elem Res ; 191(1): 54-60, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30565017

RESUMO

Synergistic approach of magnesium and vitamin E may benefit clinical symptoms of patients with polycystic ovary syndrome (PCOS) through improving their metabolic profiles and reducing oxidative stress and inflammation. This study was designed to determine the effects of magnesium and vitamin E co-supplementation on hormonal status and biomarkers of inflammation and oxidative stress in women with PCOS. This randomized, double-blind, placebo-controlled trial was conducted among 60 women with PCOS, aged 18-40 years old. Participants were randomly divided into two groups to take 250 mg/day magnesium plus 400 mg/day vitamin E supplements or placebo (n = 30 each group) for 12 weeks. Fasting blood samples were taken at baseline and after the 12-week intervention to quantify related variables. Magnesium and vitamin E co-supplementation resulted in a significant reduction in hirsutism (ß - 0.37; 95% CI, - 0.70, - 0.05; P = 0.02) and serum high-sensitivity C-reactive protein (hs-CRP) (ß - 0.67 mg/L; 95% CI, - 1.20, - 0.14; P = 0.01), and a significant increase in plasma nitric oxide (NO) (ß 3.40 µmol/L; 95% CI, 1.46, 5.35; P = 0.001) and total antioxidant capacity (TAC) levels (ß 66.32 mmol/L; 95% CI, 43.80, 88.84; P < 0.001). Overall, magnesium and vitamin E co-supplementation for 12 weeks may benefit women with PCOS on hirsutism, serum hs-CRP, plasma NO, and TAC levels. Clinical trial registration number http://www.irct.ir : IRCT2017082733941N8.


Assuntos
Magnésio/administração & dosagem , Estresse Oxidativo/efeitos dos fármacos , Síndrome do Ovário Policístico/sangue , Vitamina E/administração & dosagem , Adolescente , Adulto , Biomarcadores/sangue , Método Duplo-Cego , Jejum/sangue , Feminino , Hirsutismo/sangue , Humanos , Inflamação/sangue
16.
Endocrinology ; 159(12): 4056-4064, 2018 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-30376052

RESUMO

The main clinical feature associated with hyperandrogenism in polycystic ovary syndrome (PCOS) in humans is hirsutism, where hair increases its length, pigmentation, and particularly its diameter. Currently, it is not known whether PCOS animal models also exhibit changes in the hair. Therefore, the aim of this study was to explore the wool characteristics in sheep prenatally androgenized (PA) with testosterone propionate. After 4 and 13 months of life, wool was collected from the top of the shoulder of both females and males (both androgenized and controls). The offspring sheep were followed for up to 19 months of life to evaluate testosterone and androstenedione serum levels by ultra-high-performance liquid chromatography-tandem mass spectrometry, determine insulin and glucose response to intravenous glucose tolerance test, and address estrus cyclicity during the second breeding season. PA male animals showed a reduction in wool fiber diameter at 4 months of age compared with controls (P = 0.02) but not at 13 months, whereas PA females showed increased hair diameter at 13 months (P = 0.002), with no difference at 4 months. No substantial changes in other hair parameters (length, color, and medullation) were identified. In addition, increased levels of serum testosterone were observed in PA female sheep compared with controls at 12 months (P = 0.03). Our results indicate for the first time, to our knowledge, that changes in wool fiber diameter observed in PA ewes replicate, at the translational level, the increase in hair diameter in hirsute women with PCOS.


Assuntos
Androgênios , Modelos Animais de Doenças , Hirsutismo , Síndrome do Ovário Policístico , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Ovinos , Virilismo/induzido quimicamente , Animais , Feminino , Teste de Tolerância a Glucose , Hirsutismo/sangue , Hirsutismo/induzido quimicamente , Hirsutismo/complicações , Hirsutismo/patologia , Hiperandrogenismo/sangue , Hiperandrogenismo/induzido quimicamente , Hiperandrogenismo/patologia , Masculino , Síndrome do Ovário Policístico/sangue , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/patologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal/sangue , Efeitos Tardios da Exposição Pré-Natal/patologia , Propionato de Testosterona , Virilismo/sangue , Virilismo/patologia
17.
BMJ Case Rep ; 20182018 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-29496685

RESUMO

Sertoli-Leydig cell tumour (SLCT) is a rare, androgen-secreting sex cord-stromal tumour of the ovary that usually occurs in young premenopausal women. The major clinical manifestations are virilisation and defeminisation. The following case describes an 88-year-old G1P1 woman, 40 years after menopause, who presented with flushing, hirsutism, voice changes and alopecia along with significantly elevated levels of testosterone. Postoperative report revealed a well-differentiated SLCT in the left ovary. This case is unique in that SLCT is a very rare cancer and even more so in an 88-year-old woman. Taking this case into consideration, it becomes reasonable to check androgen and oestrogen levels in postmenopausal women, not only in patients with signs of virilisation, but also in those with non-classical presentations, such as flushing or heat spells.


Assuntos
Alopecia/etiologia , Rubor/etiologia , Hirsutismo/etiologia , Neoplasias Ovarianas/complicações , Neoplasias Ovarianas/diagnóstico , Tumor de Células de Sertoli-Leydig/complicações , Tumor de Células de Sertoli-Leydig/diagnóstico , Idoso de 80 Anos ou mais , Alopecia/sangue , Feminino , Rubor/sangue , Hirsutismo/sangue , Humanos , Neoplasias Ovarianas/terapia , Ovário/cirurgia , Tumor de Células de Sertoli-Leydig/terapia , Testosterona/sangue
18.
J Cosmet Dermatol ; 17(3): 511-517, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28940857

RESUMO

BACKGROUND: Cutaneous features of hyperandrogenism in polycystic ovary syndrome (PCOS) include acne, hirsutism, seborrhea, androgenic alopecia (AGA), and acanthosis nigricans (AN). However, the relationships have not been well known broadly in terms of clinical hyperandrogenism and biochemical markers. OBJECTIVES: The aim of this study was to investigate biochemical and metabolic parameters in relation to cutaneous characters women in with and without PCOS. METHODS: This was a cross-sectional retrospective study including 186 women with PCOS and 113 age-matched without PCOS women. Acne grade, hirsutism, seborrhea, AGA, and AN were recorded. Hormonal and metabolic parameters were measured. RESULTS: The most common finding was acne, and AN was the least dermatological manifestations between PCOS and non-PCOS groups. The severity location and type of acne did not differ in PCOS women compared to non-PCOS women. Significant differences were found with respect to free androgen index (FAI) (P = .036), sex hormone-binding globulin (SHBG) (P = .023), and body mass index (BMI) (P = .001) between PCOS with acne and PCOS without acne groups. Overall, age (P = .005) was significantly decreased, while BMI (P = .004) was significantly higher in PCOS with hirsutism. The mean serum total testosterone (TT), dehydroepiandrosterone sulfate, and FAI were significantly elevated, but SHBG was decreased between PCOS with and without hirsutism groups. There were significantly different BMI (P = .018) and triglyceride (P = .024) except other hormonal parameter of without AGA group. CONCLUSION: This study indicated a strong correlation between hirsutism and metabolic abnormalities. Hirsutism is the most common cutaneous finding in PCOS women. Acne and AGA are associated with other manifestations of clinical hyperandrogenism, but not obvious markers of biochemical hyperandrogenemia and metabolic dysfunction.


Assuntos
Androgênios/sangue , Síndrome do Ovário Policístico/sangue , Globulina de Ligação a Hormônio Sexual/metabolismo , Dermatopatias/sangue , Dermatopatias/epidemiologia , Acantose Nigricans/sangue , Acantose Nigricans/epidemiologia , Acne Vulgar/sangue , Acne Vulgar/epidemiologia , Adulto , Fatores Etários , Alopecia/sangue , Alopecia/epidemiologia , Biomarcadores/sangue , Índice de Massa Corporal , Estudos de Casos e Controles , China/epidemiologia , Estudos Transversais , Dermatite Seborreica/sangue , Dermatite Seborreica/epidemiologia , Feminino , Hirsutismo/sangue , Hirsutismo/epidemiologia , Humanos , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Índice de Gravidade de Doença , Triglicerídeos/sangue , Adulto Jovem
19.
Clin Chim Acta ; 476: 103-106, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29175172

RESUMO

Two sisters with hirsutism presented with mild hirsutism and isolated, grossly elevated (>34.9nmol/L) serum concentrations of androstenedione measured by competitive, homogeneous immunoassay. The clinically discordant laboratory results prompted us to look for assay interference. In this immunoassay, horseradish peroxidase (HRP)-conjugated androstenedione competes with endogenous androstenedione for binding with the solid-phase polyclonal rabbit IgG antibodies. After a wash step, the amount of signal generated by the bound HRP conjugate is inversely proportional to the androstenedione concentration. Alternative analysis by tandem mass spectrometry (a good first line option for troubleshooting) and repeating the competitive immunoassay after polyethylene glycol treatment returned androstenedione concentrations within reference limits. These findings suggested that the original result was spuriously elevated due to assay interference. Additionally, the patient samples were pre-incubated with heterophile blocking reagents, normal rabbit IgG antibodies and HRP-conjugated normal goat IgG antibodies, followed by repeat measurement using the immunoassay. Only samples pre-incubated with HRP-conjugate returned significantly lower androstenedione (9.5 and 12.5nmol/L, respectively), implying neutralisation of the interfering antibodies. Androstenedione remained grossly elevated in the other experiments. This deductive exercise showed that the interference is due to autoantibodies against the HRP label used in the immunoassay. Another immunoassay using HRP label (5α-dihydrotestosterone) also produced gross elevation that was normal by tandem mass spectrometry analysis. Assay interferences, though not uncommon, are frequently overlooked. Laboratory results discordant with clinical features should prompt consideration of assay interference to avoid unnecessary investigations and treatment. This is the first report of autoantibodies against the HRP label used in immunoassay.


Assuntos
Androstenodiona/isolamento & purificação , Autoanticorpos/imunologia , Hirsutismo/diagnóstico , Peroxidase do Rábano Silvestre/imunologia , Imunoensaio , Adolescente , Androstenodiona/sangue , Androstenodiona/imunologia , Autoanticorpos/sangue , Criança , Feminino , Hirsutismo/sangue , Hirsutismo/imunologia , Peroxidase do Rábano Silvestre/sangue , Peroxidase do Rábano Silvestre/metabolismo , Humanos
20.
Reprod Sci ; 25(2): 269-275, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28558523

RESUMO

The objective of the study was to investigate the effects of 6 months of melatonin administration on clinical, endocrine, and metabolic features of women affected by polycystic ovary syndrome (PCOS). This is a prospective cohort study including 40 normal-weight women with PCOS between January and September 2016, enrolled in an academic research environment. Ultrasonographic pelvic examinations, hirsutism score evaluation, hormonal profile assays, oral glucose tolerance test, and lipid profile at baseline and after 6 months of melatonin administration were performed. Melatonin treatment significantly decreased androgens levels (free androgen index: P < .05; testosterone: P < .01; 17 hydroxyprogesterone: P < .01). Follicle-stimulating hormone levels significantly raised ( P < .01), and anti-Mullerian hormone serum levels significantly dropped after 6 months of melatonin treatment ( P < .01). No significant changes occurred in glucoinsulinemic and lipid parameters after treatment except a significant decrease of low-density lipoprotein cholesterol. Almost 95% of participants experienced an amelioration of menstrual cycles. Until now, only few data have been published about the role of melatonin in women with PCOS. This is the first study focused on the effects of exogenous oral melatonin administration on the clinical, endocrine, and metabolic characteristics of patients with PCOS. After 6 months of treatment, melatonin seems to improve menstrual irregularities and biochemical hyperandrogenism in women with PCOS through a direct, insulin-independent effect on the ovary. Based on our results, melatonin could be considered a potential future therapeutic agent for women affected by PCOS.


Assuntos
Hirsutismo/tratamento farmacológico , Hiperandrogenismo/tratamento farmacológico , Melatonina/farmacologia , Ciclo Menstrual/efeitos dos fármacos , Síndrome do Ovário Policístico/tratamento farmacológico , 17-alfa-Hidroxiprogesterona/sangue , Adulto , Glicemia , Feminino , Teste de Tolerância a Glucose , Hirsutismo/sangue , Hirsutismo/diagnóstico por imagem , Humanos , Hiperandrogenismo/sangue , Hiperandrogenismo/diagnóstico por imagem , Lipídeos/sangue , Melatonina/uso terapêutico , Ciclo Menstrual/sangue , Síndrome do Ovário Policístico/sangue , Síndrome do Ovário Policístico/diagnóstico por imagem , Estudos Prospectivos , Testosterona/sangue , Ultrassonografia , Adulto Jovem
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