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Body iron status and association with hyperinsulinaemia and hyperandrogenism in non-obese Indian women with polycystic ovarian syndrome  [PDF]
P. Supriya,Aparna R. Bitla,N. Rajendra Prasad,G. Rajagopal
Journal of Clinical and Scientific Research , 2012,
Abstract: Background: Increased body iron stores, insulin and androgen levels have been reported in obese women with polycystic ovarian syndrome (PCOS). However, the status of iron and the influence of hormonal profile on iron status in non-obese women with PCOS has not been studied. The present study was thus designed to deter- mine the iron status and hormones insulin and testosterone levels and their association with body iron status in non-obese women patients with PCOS.Methods: The present study included 33 non-obese women diagnosed as PCOS based on National Institutes of Health consensus 1990 criteria and 31 age-matched healthy women as controls. Height, weight, body mass index, fasting plasma glucose, iron status markers i.e., serum ferritin, iron, total iron binding capacity, insulin and testosterone levels were determined.Results: A significant increase in hormones insulin and testosterone levels (p<0.001) was found in patients with PCOS in comparison with controls. Similarly, a significant increase in serum ferritin levels was observed in PCOS patients compared to controls (p<0.05). A significant positive correlation was observed between serum insulin and testosterone levels (p<0.05). Similarly, a positive association was observed between serum testosterone and ferritin levels [p=0.007 odds ratio (OR) 7.0(1.715-28.568)].Conclusions: The present study demonstrates that body iron stores, as reflected by serum ferritin concentra- tions, are increased even in non-obese PCOS patients. Androgen excess is associated with increased body iron stores in these patients with the possible additive effects of hyperinsulinaemia, through its perpetuating effect on increased androgens and iron-sparing effect of reduced menstrual losses.
Comparison of clinical features and health manifestations in lean vs. obese Indian women with polycystic ovarian syndrome  [cached]
Majumdar Abha,Singh Tejshree
Journal of Human Reproductive Sciences , 2009,
Abstract: Aims: To study the prevalence of clinical manifestations in obese and lean polycystic ovarian syndrome (PCOS) women and their health hazards. Settings and Design: This prospective study was carried out in a tertiary care infertility clinic from 1.7.2005 till 31.12.2007. Materials and Methods: These women were diagnosed to have PCOS by the European Society of Human Reproduction and Embryology and the American Society of Reproductive Medicine, Rotterdam 2003 criteria. They were further divided into two groups according to their body mass index (BMI): Group A (n = 300), overweight and obese with BMI> 23 and Group B (n = 150), normal weight and lean with BMI ≤23. Stastical Analysis and Results: The prevalence of menstrual irregularities [79.2% vs. 44%, P = 0.000, 95% confidence interval (CI) = 0.26-0.44)] and clinical hyperandrogenism (74.2% vs. 50.6%, P = 0.000, 95% CI=0.14-0.32) was signifi cantly higher in the obese group, whereas android central obesity (waist to hip ratio> 0.85) was similar in both groups, irrespective of body weight (47.7% vs. 38%, P = 0.056, 95% CI=0.06 to +0.18). Comparative data of various health manifestations in lean vs. obese women with POCS [Table 4]. Of the health risk manifestations, hypertension occurred in both groups with a similar frequency (41% vs. 35.5%, P = 0.261, 95% CI=0.03 to +0.15). Group A showed an increased prevalence of IGT (25% vs. 10%, P = 0.000, 95% CI= 0.13-0.29) and type two diabetes mellitus (11.7% vs. 6%, P = 0.000, 95% CI= 0.13-0.29) as compared with group B. endometrial hyperplasia (EH) also showed an increase prevalence in Group A compared with Group B (5.6% vs. 2%, P = 0.055, 95% CI= 0.01-0.08), although not statistically significant. Conclusion: PCOS emerges as a clinically heterogeneous condition with increased prevalence of health risks such as hypertension, diabetes and EH. Of these, diabetes and EH appear to be more prevalent in the obese, putting them at a greater risk of morbid problems at a much younger age than the lean ones.
Association of obesity and insulin resistance with dyslipidemia in Indian women with polycystic ovarian syndrome  [cached]
Kalra Anuradha,Nair Sreekumaran,Rai Lavanya
Indian Journal of Medical Sciences , 2006,
Abstract: BACKGROUND: Dyslipidemia, diabetes and obesity are all potent cardiovascular risk factors that tend to cluster in women with polycystic ovary syndrome (PCOS). Metabolic disorders in patients with PCOS cannot be explained solely by the presence of obesity. OBJECTIVE: To study the correlation between insulin resistance and serum lipid profile in Indian women with PCOS. SETTING: Gynecology clinic of a tertiary care hospital. MATERIALS AND METHODS: In this prospective study done from April 2004 to December 2004, 65 women with PCOS had their body mass index (BMI) and waist hip ratio calculated. Fasting glucose, insulin and lipid profiles were also estimated in each case. Insulin resistance was defined by fasting glucose-to-insulin ratio £ 4.5. The association of obesity markers and insulin resistance with lipid parameters was then studied. Statistical analysis using student ′t′ and Mann Whitney U tests was done as indicated. RESULTS: Insulin resistance was seen in 50 of the 65 PCOS women. There was no correlation seen between markers of obesity such as BMI and waist/hip ratio with various lipid parameters. But in PCOS women with insulin resistance, the lipid profile was significantly different [high triglycerides, total cholesterol and lower high-density lipoprotein (HDL)] compared to insulin-sensitive women. The difference between the two groups for total cholesterol (P = 0.002), triglycerides (P = < 0.001) and HDL (P = < 0.001) was statistically significant but that for low-density lipoprotein (LDL) (P = 0.07) was not statistically significant. CONCLUSION: Insulin resistance is associated with dyslipidemia in women with PCOS, independent of obesity.
Biotechnological and clinical outcome of in vitro fertilization in non-obese patients with polycystic ovarian syndrome.  [cached]
Przemyslaw Ciepiela,Tomasz Baczkowski,Pawel Brelik,Anna Antonowicz
Folia Histochemica et Cytobiologica , 2008, DOI: 10.2478/4490
Abstract: INTRODUCTION Polycystic ovarian syndrome (PCOS) is a hormonal and metabolic disorder which poses problems with controlled ovarian stimulation (COH). It has been also postulated that PCOS patients have oocytes and embryos with poorer quality which affects IVF results. AIM To verify IVF outcome in non-obese patients with PCOS. MATERIALS AND METHODS IVF results of 71 non-obese PCOS patients with 243 non-obese non-POCS patients, regardless of stimulation protocol, from years 2004-2006 were compared. RESULTS Biotechnological results of PCOS patients in opposition to non-PCOS patients were respectively as follows: higher average number (10.19 vs. 7.61; p=0.001) and percentage (82.34% vs. 76.25%; p=0.025) of retrieved mature M2 oocytes; similar (77.01% vs. 76.75%; p=0.835) fertilization rate with higher average number of embryos (7.633 vs. 5.650 p=0.003); higher average number (4.830 vs. 3.304; p=0.001) and percentage (65.66% vs. 60.57%; p=0.006) of embryos with optimal Z1 and Z2 pronuclei pattern according to Scott; higher average number of class Aembryos (3.57 vs. 2.34; p=0.001). Similar number of embryos were transferred in both groups (2.408 vs. 2.485, p=0.552). Clinical results in PCOS and non-PCOS patients were as follows: similar stimulation duration (10.53 days vs. 10.31 days; p=0.639) with significant less gonadotropin total usage (1866.54 IU vs. 2276.18 IU; p=0.001). Also clinical pregnancy per transfer (57.75% vs. 41.98%; p=0.021) and delivery per transfer (45.07% vs. 32.51%; p=0.066) were more often in PCOS patients with comparable miscarriages (12,68% vs. 6,58%; p=0.131) and ectopic pregnancy (0.00% vs. 2.06%; p=0.591) rates, respectively. CONCLUSION PCOS in non-obese patients is linked with good biotechnological and clinical IVF outcome.
Biotechnological and clinical outcome of in vitro fertilization in non-obese patients with polycystic ovarian syndrome.  [cached]
Przemyslaw Ciepiela,Tomasz Baczkowski,Pawel Brelik,Anna Antonowicz
Folia Histochemica et Cytobiologica , 2008, DOI: 10.5603/4490
Abstract: INTRODUCTION Polycystic ovarian syndrome (PCOS) is a hormonal and metabolic disorder which poses problems with controlled ovarian stimulation (COH). It has been also postulated that PCOS patients have oocytes and embryos with poorer quality which affects IVF results. AIM To verify IVF outcome in non-obese patients with PCOS. MATERIALS AND METHODS IVF results of 71 non-obese PCOS patients with 243 non-obese non-POCS patients, regardless of stimulation protocol, from years 2004-2006 were compared. RESULTS Biotechnological results of PCOS patients in opposition to non-PCOS patients were respectively as follows: higher average number (10.19 vs. 7.61; p=0.001) and percentage (82.34% vs. 76.25%; p=0.025) of retrieved mature M2 oocytes; similar (77.01% vs. 76.75%; p=0.835) fertilization rate with higher average number of embryos (7.633 vs. 5.650 p=0.003); higher average number (4.830 vs. 3.304; p=0.001) and percentage (65.66% vs. 60.57%; p=0.006) of embryos with optimal Z1 and Z2 pronuclei pattern according to Scott; higher average number of class Aembryos (3.57 vs. 2.34; p=0.001). Similar number of embryos were transferred in both groups (2.408 vs. 2.485, p=0.552). Clinical results in PCOS and non-PCOS patients were as follows: similar stimulation duration (10.53 days vs. 10.31 days; p=0.639) with significant less gonadotropin total usage (1866.54 IU vs. 2276.18 IU; p=0.001). Also clinical pregnancy per transfer (57.75% vs. 41.98%; p=0.021) and delivery per transfer (45.07% vs. 32.51%; p=0.066) were more often in PCOS patients with comparable miscarriages (12,68% vs. 6,58%; p=0.131) and ectopic pregnancy (0.00% vs. 2.06%; p=0.591) rates, respectively. CONCLUSION PCOS in non-obese patients is linked with good biotechnological and clinical IVF outcome.
The Effect of Puberty on Interaction between Vitamin D Status and Insulin Resistance in Obese Asian-Indian Children  [PDF]
Rajesh Khadgawat,Tushanth Thomas,Monita Gahlot,Nikhil Tandon,Vin Tangpricha,Deepak Khandelwal,Nandita Gupta
International Journal of Endocrinology , 2012, DOI: 10.1155/2012/173581
Abstract: To study the effect of puberty on the relationship between serum 25-hydroxyvitamin D (25(OH)D) and parameters of insulin kinetics in obese Asian-Indian children. Material and Methods. The study population included 62 obese Asian-Indian children and adolescents in the age group of 6–17 years. Blood glucose, serum insulin, and serum 25(OH)D were measured. Total body fat was measured by dual energy X-ray absorptiometry. Indices of insulin resistance (HOMA-IR, AUC for insulin) and sensitivity (WBISI) were calculated after oral glucose tolerance test. Result. A total of 62 subjects (35 boys; mean age = 13.0 ± 3 years; BMI = 29.3 ± 4.8?kg/sq?M; 19 subjects in Tanner stage 1, 11 in stage 2, 6 in stage 3, 3 in stage 4, and 23 subjects in Tanner stage 5) were studied. All study subjects were vitamin D deficient with a mean serum 25(OH)D of 8.5 ± 4.2?ng/mL. No significant relationship was observed between serum 25(OH)D and parameters of insulin kinetics in prepubertal children. However, a significant inverse correlation was seen between serum 25(OH)D and HOMAIR ( , ) in postpubertal subjects. Conclusion. The relationship between vitamin D status and parameters of insulin kinetics are affected by puberty. 1. Introduction Vitamin D deficiency was once thought to exclusively affect bone metabolism, but now there is ample evidence of its role in many other conditions including metabolic syndrome, autoimmune diseases, and cancer [1]. Vitamin D receptors are recognized to be in numerous extraskeletal tissues, such as pancreas and muscle [2]. A systematic review by Pittas and colleagues [3] reported that vitamin D may have a beneficial effect on the action of insulin, either directly or indirectly. Several observational studies in adults, including the Framingham Heart Study [4], have reported an inverse association between vitamin D status and insulin resistance. However, data from children and adolescents do not consistently report this inverse relationship [5–10]. Even in studies reporting this association in adolescents and children, the strength of association has been found to be very modest [6]. Further, none of the studies in adolescents have studied the effect of puberty on this association. A fall in insulin sensitivity with compensatory increase in insulin secretion has been reported in puberty [11, 12]. High prevalence of cardiometabolic risk factors, including insulin resistance (64.8% of normal weight children had at least one cardiometabolic abnormality), even in healthy young children of normal weight, has been reported in Indian children and adolescents
Clinical Study and Outcome of Polycystic Ovarian Syndrome  [PDF]
Gayatri Linganagouda Patil,Geeta Hosanemati,LS Patil,Vijayanath V,Venkatesh M Patil,Rajeshwari R Surpur
Nepal Journal of Obstetrics and Gynaecology , 2011, DOI: 10.3126/njog.v6i1.5248
Abstract: Aims : Polycystic ovarian syndrome (PCOS) is one of the common Gynaecological condition of diverse etiology 30% of the infertile women have anovulation due to polycystic ovarian disease, 20-30% of them have hyperandrogenemia and hyperprolactenemia.
POLYCYSTIC OVARIAN DISEASE
SHAHID IRSHAD RAO
The Professional Medical Journal , 2006,
Abstract: Introduction: Poly Cystic Ovarian Disease (PCOD) is probably one of the most commonendocrinological disorders amongst the women during their reproductive years. Using USG criteria only 20-33% ofapparently healthy women in childbearing period, have been found to have PCOD in population study. Whereasprevalence of 4-10% in women of reproductive age is commonly reported when the diagnosis is based on clinical,biochemical and US scan features. Objective:-Diagnosis and management of polycystic ovarian disease. Setting SeyalMedical Centre, Multan. Duration From January 2002 to December 2003. Material and Methods: Sample size: 200patients. Results: Most of he patients were in the age group of 21-30 years. The youngest patient was of 17 years andeldest was of 42 years. Majority of the women were nulliparous or of low parity comprising 92% of cases. Thecommonest symptom was menstrual disorder in 168 Patients (84%). Ultrasound is very helpful for diagnosis of POD.About 80% of patients were diagnosed as PCOD on ultrasound. There is increased level of LH in 72% patients, 8%have raised prolactin levels. All patients were first treated with clomiphene citrate while surgical treatment is done inonly 30% of cases. GnRH analogue and purified FSH were not used because they are quite expensive. Conclusion:PCOD is found to be one of the commonest problem in reproductive years of life. Clomiphene citrate is first linetreatment in PCOD for infertility. Laparoscopic drilling has very good results especially in clomiphene resistant cases.
Defining prediabetes in polycystic ovarian syndrome  [PDF]
Mark P. Trolice
Open Journal of Obstetrics and Gynecology (OJOG) , 2011, DOI: 10.4236/ojog.2011.12008
Abstract: Objective: The article will review the associations between Prediabetes (PD) and Polycystic Ovarian Syndrome (PCOS) and present factors that decrease the progression of PD into type 2 diabetes mellitus (T2DM).Metformin will also be examined for its role in ovulation induction, pregnancy and ameliorating the metabolic syndrome. Study Design: Medline search. Methods of study: Keyword search: Prediabetes (PD), Polycystic Ovarian Syndrome (PCOS), Metformin, Glucose Tolerance Test (GTT), Type 2 Diabetes Mellitus. Results: As the most common endocrinopathy during the reproductive years, PCOS has a genetic multifactorial inheritance and is associated with a high risk of insulin resistance. The use of metformin has shown mixed results in this patient population as a therapy to improve ovulation function and the metabolic syndrome and showed no definitive reduction in the rate of miscarriage. PCOS patients are significantly predisposed to PD and T2DM. Conclusion: Lifestyle changes such as weight loss and physical activity reduce the progression of PD into T2DM in PCOS patients. The new AACE and ADA guidelines establish simplified methods of screening and treating PD. The role of metformin remains undefined in the infertile PCOS patient.
The Characterization of Obese Polycystic Ovary Syndrome Rat Model Suitable for Exercise Intervention  [PDF]
Chuyan Wu, Feng Lin, Shuwei Qiu, Zhongli Jiang
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0099155
Abstract: Objective To develop a new polycystic ovary syndrome (PCOS) rat model suitable for exercise intervention. Method Thirty six rats were randomly divided into three experimental groups: PCOS rats with high-fat diet (PF, n = 24), PCOS rats with ordinary diet (PO, n = 6), and control rats with ordinary diet (CO, n = 6). Two kinds of PCOS rat model were made by adjustment diet structure and testosterone injection for 28 days. After a successful animal model, PF model rats were randomly assigned to three groups: exercise with a continuation of high-fat diet (PF-EF, n = 6), sedentary with a continuation of high-fat diet (PF-SF, n = 6), exercise with an ordinary diet (PF-EO, n = 6). Fasting blood glucose (FBG) and insulin (FINS), estrogen (E2), progesterone (P), and testosterone (T) in serum were determined by RIA, and ovarian morphology was evaluated by Image-Pro plus 6.0. Results Body weight, Lee index, FINS increased significantly in PF rat model. Serum levels of E2 and T were significantly higher in PF and PO than in CO. Ovary organ index and ovarian areas were significant lower in PF than in CO. After intervention for 2 weeks, the levels of 1 h postprandial blood glucose (PBG1), 2 h postprandial blood glucose (PBG2), FINS and the serum levels of T decreased significantly in PF-EF rats and PF-EO rats. The ratio of FBG/FINS was significant higher in PF-EO rats than in PF-SF rats. Ovarian morphology showed that the numbers of preantral follicles and atretic follicles decreased significantly, and the numbers of antral follicles and corpora lutea increased significantly in the rats of PF-EF and PF-EO. Conclusion By combination of high-fat diet and testosterone injection, the obese PCOS rat model is conformable with the lifestyle habits of fatty foods and insufficient exercise, and has metabolic and reproductive characteristics of human PCOS. This model can be applied to study exercise intervention.
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