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[Display omitted] • The coexistence of mutant and wild-type mtDNA constitutes the heteroplasmy of mtDNA. • The ovary is a highly energy-intensive organ, and it relies heavily on mitochondrial function. • Mitochondrial heteroplasmy can potentially contribute to a variety of significant ovarian disorders. • Current strategies related to mitochondrial heteroplasmy are untargeted and have low bioavailability. • The exploration of new mitochondria-targeted therapeutic strategies may offer promising paths towards these diseases. The reportedly high mutation rate of mitochondrial DNA (mtDNA) may be attributed to the absence of histone protection and complete repair mechanisms. Mitochondrial heteroplasmy refers to the coexistence of wild-type and mutant mtDNA. Most healthy individuals carry a low point mutation load (<1 %) in their mtDNA, typically without any discernible phenotypic effects. However, as it exceeds a certain threshold, it may cause the onset of various diseases. Since the ovary is a highly energy-intensive organ, it relies heavily on mitochondrial function. Mitochondrial heteroplasmy can potentially contribute to a variety of significant ovarian disorders. In this review, we have elucidated the close relationship between mtDNA heteroplasmy and ovarian diseases, and summarized novel avenues and strategies for the potential treatment of these ovarian diseases. Mitochondrial heteroplasmy can potentially contribute to a variety of significant ovarian disorders, including polycystic ovary syndrome, premature ovarian insufficiency, and endometriosis. Current strategies related to mitochondrial heteroplasmy are untargeted and have low bioavailability. Nanoparticle delivery systems loaded with mitochondrial modulators, mitochondrial replacement/transplantation therapy, and mitochondria-targeted gene editing therapy may offer promising paths towards potentially more effective treatments for these diseases, despite ongoing challenges. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is prevalent in young females and is known to affect fertility. Minimal research has examined fertility perspectives in adolescents with PCOS, despite adult research revealing relationships between infertility and psychosocial well-being and quality of life. We examined fertility perspectives/concerns in adolescents with PCOS and an age- and body mass index (BMI)–matched control group and explored associations with quality of life. This was a cross-sectional study of female adolescents (13–21 years of age) with PCOS (n = 50) and age- and BMI-matched controls (n = 50), recruited at a large Midwestern pediatric center. Surveys assessed sociodemographics, hirsutism, fertility perspectives and quality of life. Descriptive statistics and Welch's 2-sample t-tests were used to examine fertility perspectives and quality of life. Of the 103 approached, 100 participants were enrolled (97% recruitment rate), with 50 participants in each group. Parenthood goals did not significantly differ between groups; >70% expressed desire to have biological children. However, PCOS participants reported significantly higher concerns about future fertility (p <.01) without differences in fertility knowledge or support (p =.53). Most PCOS participants stated they would feel angry if their provider withheld this information and reported wanting more information. Quality of life did not differ between groups. Our study suggests that irrespective of PCOS status, most adolescents aspire to parenthood. Notably, many with PCOS lack awareness of infertility risks but express heightened concerns. In contrast to adult studies, fertility concerns among adolescents with PCOS were not associated with decreased quality of life, suggesting that earlier fertility counseling may improve outcomes. [ABSTRACT FROM AUTHOR]

The aim of the present study was to evaluate the effects of different polycystic ovary syndrome (PCOS) phenotypes using first-trimester placental three-dimensional power Doppler indices and placental volume. In this prospective case-control study, 170 pregnant women who met the inclusion criteria were divided into five groups according to PCOS phenotype: non-PCOS control (n = 34), PCOS phenotype A (n = 34), PCOS phenotype B (n = 34), PCOS phenotype C (n = 34), and PCOS phenotype D (n = 34). The primary outcomes determined in the present study were the differences in placental volume and placental flow index (FI), vascularization flow index (VFI), vascularization index (VI), and uterine artery pulsatility index (PI) betweenthe PCOS groups and control group. The mean placental volume and VI were significantly decreased in the phenotype A, B, and C groups compared to the control group and PCOS phenotype D group. The mean FI and VFI were significantly decreased in the phenotype A and B groups compared to the control group and PCOS phenotype C and D groups. The mean testosterone, dehydroepiandrostenedione, sex-hormone binding globulin, free androgen index, and insulin resistance levels were significantly increased in the phenotype A, B, and C groups compared to the control group and PCOS phenotype D group. The results indicated that placental volume and placental vascular Doppler indices in the first trimester were more adversely affected in the PCOS A and B phenotypes than other PCOS phenotypes. • PCOS is a common endocrine disorder associated with adverse reproductive outcomes. • PCOS is classified into four phenotypes, demonstrating the syndrome's heterogeneity. • Hyperandrogenism and hyperinsulinemia can affect placentation. • We found that placental volume was decreased in the PCOS A and B phenotypes. • Placental vascular Doppler indices were decreased in the PCOS A and B phenotypes. [ABSTRACT FROM AUTHOR]

• Polycystic ovary syndrome (PCOS) is common worldwide. The syndrome refers to a group of disorders with multiple reproductive, metabolic, and endocrine elements. • PCOS affects women from fetal life throughout their lifespan, often decreasing reproductive ability and quality of life, and increasing other types of morbidity and mortality. It is often undiagnosed and untreated. • Management traditionally focuses on the treatment of hyperandrogenism and oligomenorrhea. Women with PCOS often have dyslipidemia, hypertension, obesity, and metabolic syndrome. Management plans should incorporate diagnosis and management of these factors, if present, because of the strong contribution to risk for atherosclerotic cardiovascular disease. • Understanding that the disease extends throughout life emphasizes the importance of continued screening for and treatment of risk factors to prevent cardiovascular disease throughout a woman's lifespan. • Given the complexities of the syndrome and heterogeneous manifestations, optimal management often requires a multi-disciplinary approach to provide counseling and support for lifestyle modification and addressing the full range of any reproductive, endocrine, and cardiometabolic abnormalities. Polycystic ovary syndrome (PCOS) is a common endocrinopathy worldwide with a heterogeneous clinical presentation including reproductive, metabolic, and endocrine elements. However, the assessment and management of PCOS remains inconsistent, with many women undiagnosed and untreated. We now also understand that the management of PCOS should extend throughout a woman's lifespan as many elements of the syndrome persist after menopause. Management has traditionally focused on the treatment of hyperandrogenism and oligomenorrhea. Women with PCOS often have dyslipidemia, hypertension, obesity, and metabolic syndrome, which may be worsened by the hormonal abnormalities, and are therefore at higher risk for cardiovascular disease morbidity and mortality, a risk that increases after menopause. While treatment with hormonal therapy, in particular combined oral contraceptives, may improve cardiovascular risk factors, management plans should incorporate specific diagnosis and management of these factors, if present, because of the strong contribution to the risk for atherosclerotic cardiovascular disease. Given the complexities of the syndrome, optimal management often requires a multi-disciplinary approach including the lipid and cardiometabolic specialist to provide counseling and support for lifestyle modification along with pharmacologic therapy as indicated to address the full range of any reproductive, endocrine, and cardiometabolic abnormalities. [ABSTRACT FROM AUTHOR]

Background: Artificial light at night, a well-recognized circadian clock disrupter, causes disturbances in endocrine homeostasis. However, the association of artificial light at night with polycystic ovary syndrome (PCOS) is still unknown. This study examines the effects of outdoor artificial light at night on sex hormones, glucose homeostasis markers, and PCOS prevalence in Anhui Province, China. Methods: We recruited 20,633 women of reproductive age from Anhui Medical University Reproductive Medicine Center. PCOS was diagnosed according to Rotterdam criteria. We estimated long-term (previous year) and short-term (previous month) artificial light at night values for residential addresses using 500 m resolution satellite imagery. We fitted multivariable models, using both linear and logistic regression, to estimate the association of artificial light at night with sex hormones, glucose homeostasis markers, and PCOS prevalence. Results: Both long-term and short-term exposure to outdoor artificial light at night were negatively associated with follicle-stimulating hormone and luteinizing hormone levels, while positively associated with testosterone, fasting insulin, homeostasis model assessment-insulin resistance, and homeostasis model assessment-insulin resistance-β levels. The second-highest quintile of artificial light at night was associated with increased PCOS prevalence (odds ratio [ORlong-term] = 1.4; 95% confidence interval [CI] = 1.2, 1.6 and ORshort-term = 1.3; 95% CI = 1.1, 1.5) compared with the lowest quintile. In addition, prevalence of PCOS was linearly associated with long-term exposure to artificial light at night, but nonlinearly associated with short-term exposure. This association was more evident in younger, obese or overweight, moderately educated, rural women, and for the summer and fall seasons. Conclusion: Outdoor artificial light at night may be a novel risk factor for PCOS. [ABSTRACT FROM AUTHOR]

Hirsutism is the abnormal excessive growth of coarse terminal hair over androgen-sensitive body areas. It is a very common endocrine pathology, affecting up to 10% of young females and has been linked with multiple conditions. Polycystic ovary syndrome (PCOS) and Idiopathic hirsutism encompass 90% of the cases. Patients presenting with hirsutism may require additional investigations and a plan with options for treatment. Mechanical hair removal is first-line management, along with lifestyle changes. Laser and phototherapy have been gaining popularity. The combined contraceptive pill is the preferred initial medical treatment offered, if not contraindicated, followed by anti-androgen therapy. Other emerging therapeutic options are inositol and vitamin D, especially in patients with PCOS. Treatment options should be discussed with patients, irrespective of the clinical severity, as they could be addressing underlying psychosocial concerns. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovarian syndrome [PCO] is a worldwide endocrine disorder affecting women of reproductive age. Diagnosis and differentiation of PCO phenotypes are crucial for disease prognosis, fertility outcome, and treatment planning. This study aims to assess arterial spin labeling perfusion (ASL) and diffusion-weighted imaging (DWI) derived metrics in the diagnosis of PCO, differentiation of its phenotypes, and correlation of these metrics with laboratory measurements. Results: ASL and DWI of the pelvis were performed on 72 PCO patients and another 20 age-matched control group. Two observers measured the blood flow (BF) and ADC in the ovarian stroma. Serum levels of testosterone, dehydroepiandrosterone sulfate (DHEAS), and body mass index (BMI) were calculated. BF values were significantly higher in PCO patients than in control cases (P = 0.001), with area under the curve (AUC) of (0.94 and 0.89) and accuracy of (96% and 92%) for both observers, respectively. Also, BF values were significantly higher in classic than in non-classic PCO cases (P = 0.001), with AUC of (0.92 and 0.90) and accuracy of (91%) for both observers, respectively. ADC values were significantly lower in PCO patients than in control cases (P = 0.001), with AUC of (0.85 and 0.84) for the first observer and second observer, respectively. ADC values were significantly lower in classic PCO patients than in non-classic patients (P = 0.001), with AUC of (0.85 and 0.84) and accuracy of (77% and 81%) for both observers, respectively. Combined values of BF and ADC showed an accuracy of 91% and 86% for differentiating patient from control cases for both observers, respectively, and an accuracy of 92% for differentiating classic from non-classic PCO phenotypes. A significant correlation was found between ADC, BF metrics, and both serum testosterone and DHEAS levels (P < 0.05). Conclusions: Combination of ASL and ADC can be used in PCO diagnosis and can help in the differentiation of its phenotypes. Serum levels of testosterone and DHEAS have a significant correlation with ADC and BF metrics. [ABSTRACT FROM AUTHOR]

Women with obesity and polycystic ovary syndrome (OPOS) are at high risk for infertility. However, the reproductive effects of metabolic surgery on women with infertility and OPOS have not been fully elucidated. We investigated the natural conception rates after metabolic surgery, and the variables associated with infertility in women with OPOS. Shanghai Sixth People's Hospital, Shanghai, China. This study included 72 women with infertility and OPOS who underwent metabolic surgery and were followed up for 4 years after surgery. Finally, 54 patients completed the study. Reproductive outcomes were assessed, along with changes in anthropometric parameters and metabolic indices before and 1 year after surgery (prepregnancy). Logistic regression analysis was used to identify variables influencing natural conception and delivery outcomes. After metabolic surgery, 35 patients (64.8%) became pregnant naturally, while 16 were still unable to conceive naturally. Preoperative body mass index (BMI) tended to be lower in the natural conception group than in the no natural conception group (38.9 ± 6.9 versus 43.6 ± 11.0 kg/m2, P =.070) and there were no significant differences in weight loss between the 2 groups after surgery. Logistic regression analysis showed that the BMI 1 year after surgery (prepregnancy) was an independent predictor of natural conception, and receiver operating characteristic analysis showed that a BMI of 27.0 kg/m2 was the optimal cutoff for predicting successful natural conception after surgery. Metabolic surgery can improve fertility in women with OPOS. Patients with a BMI < 27.0 kg/m2 1 year after surgery (prepregnancy) are more likely to become pregnant naturally and give birth. • Women with obesity and polycystic ovary syndrome are at high risk for infertility. • Metabolic surgery can improve fertility in women with obesity and polycystic ovary syndrome. • BMI 1 year after surgery (prepregnancy) is an independent indicator of natural conception after surgery. • Patients with a BMI < 27.0 kg/m2 1 year after surgery (prepregnancy) were more likely to have a natural conception and successful birth. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic ovary syndrome (PCOS) is a common disorder found in women of reproductive age in India. It has multigenic etiology, including genetic, lifestyle, stress, diet, exercise, and obesity. Methods: We have searched various databases such as PubMed and Google Scholar including the relevant literature on "PCOS." Results: Some of the most common clinical features observed are oligomenorrhea/amenorrhea, hyperandrogenemia, hyperinsulinemia, polycystic ovaries in ultrasonography, hirsutism, alopecia, acne, and acanthosis nigricans. Several studies have shown an association between PCOS and heart disease because of varied causes, including altered lipid/glucose metabolism, hypertension, systemic inflammatory conditions, vascular injuries, obesity, and hyperandrogenism. PCOS and hyperprolactinemia are the two most common etiologies of anovulation in women, although evidence linking them suggests independent origins of these conditions. Hence, PCOS influences the quality of life as its clinical manifestations may lead to fear of sexual unattractiveness, poor self-esteem, discontent with one's physical appearance, social anxiety, emotional changes, and mood swings, causing huge psychological distress. Conclusion: It is essential to focus on managing the patients' primary needs and reducing the impact of long-term risk factors when treating a patient with PCOS. The symptoms of a PCOS patient could be well managed when a variety of specialists work together, catering to a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Time-restricted eating (TRE) has become a popular strategy to treat obesity. TRE involves confining the eating window to 4–10 h per day and fasting for the remaining hours (14–20 h fast). During the eating window, individuals are not required to monitor food intake. The sudden rise in popularity of TRE is most likely due to its simplicity and the fact that it does not require individuals to count calories to lose weight. This feature of TRE may appeal to certain individuals with obesity, and this could help produce lasting metabolic health improvements. The purpose of this review is to summarize current evidence from randomized clinical trials of TRE (without calorie counting) on body weight and metabolic risk factors. The efficacy of TRE in various populations groups, including those with obesity, type 2 diabetes (T2DM), and polycystic ovary syndrome (PCOS), is also examined. In this review, Ezpeleta et al. summarize the evidence from randomized trials of time-restricted eating (TRE) on weight and metabolic risk factors. The efficacy of TRE in various populations, including those with obesity, type 2 diabetes, and polycystic ovary syndrome, is also examined. [ABSTRACT FROM AUTHOR]

This article analyzes the publications of women who suffer from Polycystic Ovary Syndrome (PCOS) in Facebook groups. PCOS is a metabolic syndrome experienced by a vast number of women of childbearing age. Some of its main symptoms are acne, weight gain, and unwanted hair. On the other hand, the treatment focuses on changing the lifestyle associated with diet control and adopting new habits. The analysis of statements and pictures posted by the participants of the groups, which express their before-after transformations, reveals that diagnosis, treatment, and perception of PCOS are currently deeply associated with aesthetic factors. Finally, we discuss how this event is linked to the historically produced binary gender pattern centered on body differences and how it illustrates the emphasis on self-enhancement, especially concerning its expression in body and aesthetic standards. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) treatment in adolescents currently focuses on lifestyle interventions, with pharmacological treatment options often limited to hormonal contraceptives. Several of these carry broad side-effect profiles and are not always accepted by young girls. There is growing interest in non-hormonal therapies for PCOS. We aimed to collate the evidence on the use of myoinositol or D-chiro-inositol in the improvement of PCOS symptoms in symptomatic adolescents. A systematic literature review identifying key articles from inception to March 2023. Participants: Female adolescents (aged 12–19 years) with PCOS or PCOS-like features. Intervention: Myoinositol or D-chiro-inositol with or without additional interventions. Comparison: Any other treatment, including lifestyle interventions, hormonal therapy, metformin or no treatment. The main outcome measure were improvement in symptoms, quality of life and adverse effects. Eight studies were included: two randomised open-label trials, one quasi-randomised and three non-randomised interventional studies, one case-control study and one cohort study. All studies showed improvements in some biochemical markers, metabolic parameters or clinical symptoms, but these were not reproducible across all studies. The benefit of myoinositol in adolescents with PCOS remains unclear, with limited high-quality evidence. This review highlights the need for robustly conducted research to inform clinical practice. [ABSTRACT FROM AUTHOR]

Periovarian adipose tissue (POAT) is a type of gonadal white adipose tissue that surrounds the ovary. POAT is a source of various bioactive molecules, such as adipokines, cytokines, chemokines, growth factors and hormones. Thereby it could influence crucial ovarian functions. Recent findings showed that removal of POAT affects folliculogenesis and steroidogenesis in the ovary. Furthermore, changes in the morphology and function of POAT were observed in women during menopause or polycystic ovary syndrome. Although the relationship between the body's energy status and fertility in females is generally well known, the contribution of POAT remains still elusive. Therefore, the objective of this review is summarizing the actual state of knowledge about POAT function in physiological and pathological processes within the ovary. [ABSTRACT FROM AUTHOR]

Copyright of Cukurova Medical Journal / Çukurova Üniversitesi Tip Fakültesi Dergisi is the property of Cukurova University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Obesity has become a serious medical condition where many factors can contribute to excess weight gain. The most common type of childhood obesity is simple obesity, which is due to gene-obesogenic environment interaction. Only a minority are due to pathological causes. Secondary causes of obesity, while less common, include these: genetic syndromes, drug-related obesity, as well as endocrine disorders (hypothyroidism, Cushing’s syndrome, growth hormone deficiency, hypogonadism, pseudohypoparathyroidism type Ia, insulinoma, hypothalamic obesity and polycystic ovary syndrome). Given that some conditions may be treatable, physicians must be aware of obesity due to endocrinopathies and distinguish them from simple obesity, and treat them properly. Although rare among children, early detection of the endocrine cause of obesity leads to reduced morbidity and, in some cases, reduced mortality in these individuals. The aim of this review is to summarize the current findings on obesity-related endocrinopathies in children (illustrated by clinical examples), highlighting aspects of pathogenetic mechanisms, genetics, the clinical diagnosis, growth, body mass index and possible therapeutic approaches. Early detection and correction of endocrine obesity is of paramount importance for obese children who could benefit from timely diagnosis and an improved management of obesity as many disturbances related to obesity can be reversed at the early stage, if weight loss is achieved. [ABSTRACT FROM AUTHOR]

Gonadotropin-releasing hormone agonist (GnRHa) has been used for central precocious puberty (CPP) or early and fast puberty. It was aimed to assess changes in body mass index (BMI), polycystic ovary syndrome (PCOS) frequency, and anti-Müllerian hormone (AMH) in girls who had been treated with GnRHa. Fifty-eight adolescent girls treated with GnRHa for CPP or early and fast puberty (3.75 mg/28 days), between 2011 and 2015, were re-evaluated in 2020–2022 at least 2 years after menstruation. Hormonal analyses were compared with 51 healthy adolescents. In the GnRHa-treated group, a statistically significant increase was observed when the BMI standard deviation score (SDS) at the beginning of the treatment was compared with the BMI SDS at the end of the treatment (p=0.038). A statistically significant decrease was observed when the BMI SDS at the end of the treatment was compared with the BMI SDS in late adolescence (p=0.012). When the BMI SDS at the beginning of the treatment was compared with the BMI SDS in late adolescence, it was observed that there was no statistically significant difference (p=0.196). Of the 58 girls in the GnRHa-treated group, 8 (14 %) had PCOS. Serum AMH levels did not differ between the GnRHa-treated and the control group. GnRHa treatment causes no adverse effect on BMI, at least in late adolescence. Girls treated with GnRHa were not found to be prone to developing PCOS. AMH levels were similar in the GnRHa-treated group as in the control group. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Polycystic ovary syndrome (PCOS) is a prevalent health condition that commonly affects adolescent girls and young women. The purpose of this study was to evaluate the correlation between levels of total glutathione (TG), reduced glutathione (GSH), superoxide dismutase (SOD), lipid peroxidation, and homocysteine with PCOS. PATIENTS AND METHODS: This study employed a cross-sectional case-control design, involving a target population of 305 Sudanese females. Among them, 205 individuals were categorized as cases, and 100 served as controls. The TG, GSH, SOD, lipid peroxidation, and homocysteine levels were measured in the serum of study participants through enzyme-linked immunosorbent essay. RESULTS: Total glutathione (1,174.5 ± 271.4 vs. 986.1 ± 191.5, p = 0.01), GSH (801.3 ± 132.2 vs. 748.6 ± 103.1, p = 0.007), SOD (225.2 ± 57.8 vs. 195.5 ± 49.6, p = 0.009), lipid peroxidation (3.4 ± 1.1 vs. 2.4 ± 0.7, p = 0.03), and homocysteine (14.9 ± 2.1 vs. 13.5 ± 1.6, p = 0.04), showed significant differences between the two groups (cases vs. controls). A moderate positive correlation between TG, GSH, SOD, lipid peroxidation, homocysteine, BMI, age, and duration of PCOS was observed. Furthermore, a strong positive correlation between BMI, age, and duration of PCOS was noted within the patient group. CONCLUSIONS: In conclusion, this study demonstrates that patients with PCOS have elevated levels of TG, GSH, SOD, lipid peroxidation, and homocysteine compared to the control group. These findings suggest a potential association between PCOS and oxidative stress, lipid metabolism, and homocysteine pathways. Moreover, the observed positive correlation with BMI, age, and duration of PCOS indicates the importance of these factors in disease progression. [ABSTRACT FROM AUTHOR]

One of the significant health issues affecting women that impacts their fertility and results in serious health concerns is Polycystic ovarian syndrome (PCOS). Consequently, timely screening of polycystic ovarian syndrome can help in the process of recovery. Finding a method to aid doctors in this procedure was crucial due to the difficulties in detecting this condition. This research aimed to determine whether it is possible to optimize the detection of PCOS utilizing Deep Learning algorithms and methodologies. Additionally, feature selection methods that produce the most important subset of features can speed up calculation and enhance the effectiveness of classifiers. In this research, the tri-stage wrapper method is used because it reduces the computation time. The proposed study for the Automatic diagnosis of PCOS contains preprocessing, data normalization, feature selection, and classification. A dataset with 39 characteristics, including metabolism, neuroimaging, hormones, and biochemical information for 541 subjects, was employed in this scenario. To start, this research pre-processed the information. Next for feature selection, a tri-stage wrapper method such as Mutual Information, ReliefF, Chi-Square, and Xvariance is used. Then, various classification methods are tested and trained. Deep learning techniques including convolutional neural network (CNN), multi-layer perceptron (MLP), Recurrent neural network (RNN), and Bi long short-term memory (Bi-LSTM) are utilized for categorization. The experimental finding demonstrates that with effective feature extraction process using tri stage wrapper method + CNN delivers the highest precision (97%), high accuracy (98.67%), and recall (89%) when compared with other machine learning algorithms. [ABSTRACT FROM AUTHOR]

OBJECTIVE: There is insufficient data on which cut-off value must be used to measure the increase in total testosterone (TT) compared to the upper limit of normal (CULN) in the diagnosis of androgen-secreting tumor (ASTM) in female individuals with premenopausal hirsutism (FIPH). PATIENTS AND METHODS: A total of 413 FIPH over 18 years of age who were admitted to the endocrinology clinic between May 2013 and 30 April 2018 were eligible for the study. Hormone profiles of the participants in the follicular phase and other information were obtained from their files. The androgen suppression ratio (ASR) was analyzed after 48 hours of low-dose dexamethasone suppression test (LDDST) in those whose TT CULN (nmol/L) increased two-fold. RESULTS: Idiopathic hirsutism was found in 193 participants (46.73%) and polycystic ovary syndrome (PCOS) in 200 (48.43%) and other sources of hirsutism; non-classical congenital adrenal hyperplasia (NCCAH) in 10 patients (2.42%), hyperprolactinemia in 6 patients (1.45%), ASTM of ovarian origin in 2 patients (0.48%), Cushing's disease in 1 patient (0.24%), and adrenal ASTM in 1 patient (0.24%). A cutoff value of two-fold CULN increase for TT sensitivity of 100% and a specificity of 99.5% in indicating an ASTM source, and ASR above 49% in LDDST sensitivity of 80% and a specificity of 100% in excluding an ASTM source, was used. CONCLUSIONS: At the TT level, a two-fold increase CULN in FIPH indicates an ASTM source. In addition, ASR after LDDST is a useful parameter in the exclusion of ASTM sources in the same patient population. [ABSTRACT FROM AUTHOR]

This study aimed to compare body image concerns in adolescents with and without PCOS. This cross-sectional study included 1076 adolescents, including 344 with PCOS and 732 without PCOS. The participants were asked to complete a comprehensive questionnaire that included demographic and reproductive parameters and the body image concerns inventory (BICI) which comprised two factors (1-dissatisfaction and embarrassment about one's appearance and 2-social function due to appearance concerns). Linear regression analysis was conducted to evaluate the effect of hyperandrogenism and/or abnormal uterine bleeding (AUB) and/or obesity on BICI and its domains both before and after adjustment for potential confounders. The result showed that adolescents with PCOS had a worse total BICI score and its domains (p < 0.05). In multivariable-adjusted regression models, adolescents with PCOS were more likely to have a high body image concern (β = 0.05, P < 0.001), while those with high household income were less likely to have body image concern (β = −0.08, P = 0.004). Considering hyperandrogenism status, those with high household income were also less likely to have high body image concern (β = −0.08, P = 0.004), and age of menarche (β = −0.01, P = 0.013) were also inversely associated with total BICI score. Likewise, considering obese status, only high household income (β = −0.08, P = 0.004) was inversely associated with total BICI score. Also, considering menstrual irregularity status, high household income (β = −0.08, P = 0.005), and age of menarche (β = −0.01, P = 0.01) were inversely associated with the total BICI score. Adolescents with PCOS had higher body image concerns. Apart from the being PCOS label, abnormal uterine bleeding was also a predictor of body image concern. Clinicians should pay attention to the greater influence of the PCOS label on altered body image in adolescents. • The PCOS label was associated with more body image concern in adolescents. • Abnormal uterine bleeding in adolescents was linked to body image concerns. • High household income and age of menarche were inversely associated with body image concerns. [ABSTRACT FROM AUTHOR]

Background Polycystic ovary syndrome is a common multifactorial endocrinopathy disorder affecting 5-15% of reproductive women worldwide. The CYP19 gene encodes key enzyme aromatase involved in androgen-toestrogen conversion which plays a crucial role in the pathophysiology of the syndrome. Very few studies have been done in the Indian population; hence, we investigated whether CYP19 gene rs2414096 SNP is associated with PCOS and hyperandrogenism susceptibility in Karnataka women. Methods Three-hundred subjects including 150 PCOS and 150 age-matched controls were involved in the current case-control study. Sex hormones and biochemical estimation were performed by ELISA. Sanger sequencing and PCR-RFLP were used to genotype the SNP rs2414096. Genotypic-phenotypic association was studied. Statistical analysis was performed. Results The GG genotype was more common in patients, while the GA genotype was more common in control women. LH/FSH was significantly increased in GG genotype in PCOS when compared with AA and GA genotypes. Variations of CYP19 rs2414096 were not statistically significant with PCOS. Conclusion CYP19 rs2414096 polymorphism was not associated with PCOS; however, the homozygous wild GG genotype may exhibit reduced aromatase activity with subsequent hyperandrogenism implicating endocrine abnormalities. [ABSTRACT FROM AUTHOR]

Pregnant polycystic ovary syndrome (PCOS) patients are at increased risk for myriad obstetric complications, with the placenta thought to play a key role in their development. We aimed to evaluate placental histopathology patterns in placentas of women with PCOS who underwent in-vitro-fertilization (IVF). This retrospective study utilized full gross and histopathologic assessment of placentas of all women who had IVF treatment and delivered at the Royal Victoria Hospital from 2009 to 2017, regardless of complications or mode of delivery. Pathologic findings included anatomic, inflammation, villous maturation, and vascular mal-perfusion features. Placentas of PCOS women were compared to those of ovulatory controls. Multivariate logistic regression was used to adjust results for confounding factors potentially associated with significant placental and perinatal characteristics. Women with PCOS (n = 47) were more likely to develop gestational diabetes mellitus compared to ovulatory controls (n = 1121) (38.3% vs. 9.8%, p < 0.001). Placentas from PCOS women were more likely circumvallate placentas (aOR 8.3, 95%CI 1.9–37.3) and more likely to have a hypercoiled umbilical cord (aOR 6.8 95%CI 1.3–36.8) and villitis of unknown etiology (aOR 6.1, 95%CI 1.5–25.6). There was an increased likelihood of chorangiosis (aOR 2.7, 95% CI 1.3–5.8), evidence of fetal vascular malperfusion based on one criteria (aOR 2.7, 95%CI 1.1–7.4), or more than one criteria (aOR 6.4, 95%CI 1.6–25.9), more nucleated fetal red blood cells (aOR 5.2, 95%CI 1.1–24.5), and a higher likelihood of chorangiomas (aOR 9.4, 95%CI 1.6–55.1) in placentas from PCOS women than in controls. IVF pregnancies' placental histopathological characteristics are significantly impacted by an underlying diagnosis of PCOS, including important anatomic changes and vascular placental abnormalities. • Polycystic ovary syndrome (PCOS) increases the risk for obstetric complications. • The placenta is thought to play a key role in their development. • Placentas of PCOS patients following IVF show anatomic and vascular abnormalities. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Changes in hormone levels, improper lipid metabolism, and oxidative stress all significantly contribute to the pathogenic process of polycystic ovarian syndrome (PCOS). According to earlier research, pioglitazone and alpha-lipoic acid are crucial in the emergence of PCOS. The beneficial effects of pioglitazone and alpha-lipoic acid on PCOS were examined in the current study. PATIENTS AND METHODS: The 120 patients with PCOS received three months of treatment in pioglitazone groups (n=40 case, 30 mg/time, 1 time/day), α-lipoic acid (n=40 case, 0.6 g/time, 1 time/day), and combination therapy (n=40 case, pioglitazone 30 mg/time, 1 time/day and α-lipoic acid, 0.6 g/time, 1 time/day). Before and after therapy, the following factors were evaluated: the hormonal profile, fasting serum insulin, body weight, body mass index (BMI), menstruation status, oxidative stress, and indications of lipid metabolism. RESULTS: The combination of pioglitazone and α-lipoic acid has a significantly improving effect on BMI, body weight, oxidative stress levels, lipid metabolism, and menstrual status. A significant increase in body weight, BMI, and follicle-stimulating hormone (FSH) levels were found in mice after being treated with α-lipoic acid alone. However, the use pioglitazone alone improves body weight, BMI, the calculation of insulin resistance index (HOMA-IR), Area under the curve (AUC)-insulin, fasting glucose/insulin (G/I) ratio, total testosterone, and malondialdehyde (MDA) levels in post-treatment than pre-treatment. CONCLUSIONS: These findings suggest that pioglitazone alone has a better effect than alpha-lipoic acid in improving oxidative stress levels, BMI, and menstrual cyclicity. Additionally, treatment with pioglitazone and alpha-lipoic acid did demonstrate a greater effect than monotherapy with each medication alone. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This systematic review and meta-analysis aim to evaluate whether treatment with metformin would reduce Anti-Müllerian Hormone levels in patients with polycystic ovary syndrome. A search was performed in Medline, Embase, Web of Science, and Cochrane Library databases and grey literature (Google Scholar). The following keywords were used in the search strategy: "Polycystic Ovary Syndrome", "Anti-Mullerian Hormone", "Metformin". The search was limited to human studies, with no language restriction. 328 studies were found, 45 studies were selected for full-text reading and 16 of those studies, six randomized controlled trial and 10 non-randomized studies were included. The synthesis of randomized controlled trials, metformin showed a reduction in serum levels of Anti-Müllerian Hormone compared to control groups (SMD – 0.53, 95 %CI − 0.84 to − 0.22, p < 0.001, I2 = 0 %, four studies, 171 participants, high quality of evidence). Six non-randomized studies evaluated data before and after the metformin intervention. The synthesis showed that using metformin reduced serum Anti-Müllerian Hormone values (SMD – 0.79, 95 %CI − 1.03 to − 0.56, p < 0.001, I2 = 0 %, six studies, 299 participants, low quality of evidence). Metformin administration in women with polycystic ovary syndrome is associated significantly with reduced Anti-Müllerian Hormone serum levels. • This study assesses whether treatment with metformin reduces AMH in PCOS women. • Metformin in women with PCOS reduce Anti-Müllerian Hormone serum levels. • Anti-Müllerian Hormone could be used to evaluate the treatment with insulin. [ABSTRACT FROM AUTHOR]

Copyright of Cukurova Medical Journal / Çukurova Üniversitesi Tip Fakültesi Dergisi is the property of Cukurova University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Polycystic ovary syndrome (PCOS), characterized by the androgen excess and arrest of antral follicles, is a common endocrine disorder among women lacking specific diagnostic biomarkers and therapeutic targets. Herein, we studied the molecular mechanism of miR-96-5p in the process of PCOS and its potential applications in PCOS. Clinically, we found that miR-96-5p significantly decreased in serum, follicular fluid and primary human granulosa cells (hGCs) of PCOS patients (n = 70) vs non-PCOS women (n = 60), as well as in the ovaries of 3-types of induced PCOS-like mice. Furthermore, we demonstrated that the elevated circulating miR-96-5p levels were significantly correlated with the PCOS disordered endocrine clinical features, and the area under the curve of receiver operating characteristic was 0.8344, with 75.71% specificity and 80% sensitivity. Mechanically, we identified miR-96-5p as an androgen-regulated miRNA that directly targets the forkhead transcription factor FOXO1. Inhibition of miR-96-5p decreased estrogen synthesis, while decreasing the cell proliferation index of KGN via regulating the expression of FOXO1 and its downstream genes. Inversely, inhibition of FOXO1 abrogated the effect of miR-96-5p on estrogen synthesis and proliferation index. Of note, ovarian intra-bursal injection of miR-96-5p agomir rescued the phenotypes of dehydroepiandrosterone-induced PCOS like mice. In conclusion, our results clarified a vital role of miR-96-5p in the pathogenesis of PCOS and might serve as a novel diagnostic biomarker and therapeutic target for PCOS. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is an endocrine disorder experienced by women of reproductive age and is marked by insulin resistance (IR) and menstrual cycle abnormalities. In this study, we set out to assess how the level of menstrual abnormalities relates to the degree of IR in women with PCOS. The participants in this study were 93 women diagnosed with PCOS and 100 controls with regular vaginal bleeding. Data was collected through blood samples, physical examinations, and medical histories. The primary outcome measures were body mass index (BMI), fasting glucose, fasting insulin, homeostatic model assessment for IR (HOMA-IR), and hormonal parameters. Values for BMI and HOMA-IR were higher in PCOS cases than in controls [(28.6 ± 1.9 vs. 23.7 ± 2.3) and (2.29 ± 2.87 vs. 1.48 ± 1.02), respectively]. Oligomenorrhea was documented in 79.4% of women with PCOS, with the others experienced vaginal bleeding intervals under 45 days. The greater the menstrual irregularity, the higher the levels of luteinizing hormone/follicle-stimulating hormone and testosterone. Among the PCOS group, those with vaginal bleeding intervals of above 90 days had a higher HOMA-IR values (2.46 ± 2.77), after adjustments for age and BMI, than the participants who went<45 days between periods (2.01 ± 2.14) and those whose interval was 45–90 days (2.09 ± 2.43). Most of the participants with PCOS had obvious oligomenorrhea of at least 6 weeks between episodes of vaginal bleeding and had significantly higher insulin resistance than did the controls. This suggests that insulin resistance in PCOS cases may be predicted by the presence of clinically overt menstrual dysfunction. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Polycystic ovary syndrome (PCOS) is a female endocrinopathy characterized by hyperandrogenemia, insulin resistance, glucose intolerance, dyslipidemia, non-alcoholic fatty liver disease (NAFLD), and obesity. Hepassocin (HPS) is a hepatokine involved in energy and lipid metabolism. We aimed to investigate the role of HPS in metabolic dysfunction and its relationship with fatty liver in patients with PCOS. PATIENTS AND METHODS: A total of 45 newly diagnosed PCOS patients and 42 healthy women of similar age were included in the study. Routine anthropometric, biochemical, and hormonal information were recorded. Serum HPS and high-sensitivity C-reactive protein (hsCRP) were measured, and NAFLD fibrosis score (NFS) and Fibrosis-4 (FIB-4) were calculated and correlated. RESULTS: HPS and hsCRP values of the PCOS group were found to be significantly higher than controls (p=0.005, p<0.001, respectively). A positive correlation was found between both HPS and hsCRP and luteinizing hormone (LH) (p<0.001). No correlation was observed between HPS and NFS and FIB-4, however, only a weak negative correlation was observed between hsCRP and FIB-4. A negative correlation was found between HPS and BMI, waist circumference, fat ratio, and HbA1c (p<0.05). In multivariate regression analysis for HPS, R-squared is 0.898, and hsCRP, neck circumference, fat amount, and LH are significant factors. CONCLUSIONS: NAFLD is an important dysmetabolic component of PCOS. Serum HPS is elevated in PCOS patients. We found a positive correlation between hsCRP and LH and a negative correlation between obesity indices, although we did not find an association between NFS and FIB-4, and HPS. In the future, largescale molecular studies of HPS may be beneficial. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Polycystic ovary syndrome (PCOS) increases non-alcoholic fatty liver disease (NAFLD) risk and severity in adults, but data in adolescents with diverse backgrounds are limited. We evaluated NAFLD prevalence and characterized NAFLD risk factors in overweight/obese adolescents by PCOS status. Retrospective study of overweight (n=52)/obese (n=271) female adolescents (12–18 years old), evaluated clinically 2012–2020, was conducted comparing PCOS patients to age-matched non-PCOS controls. NAFLD was defined as ALT≥44U/L x2 and/or ≥80U/L x1, hepatic steatosis on imaging, or NAFLD on biopsy, in absence of other liver disease. Metabolic comorbidities were captured. Log-binomial regression models estimated prevalence risk ratios (PR). NAFLD prevalence was 19.1 % in adolescents with PCOS (n=161), similar to those without (n=162) (16.8 %, p=0.6). Adolescents with PCOS were more likely to have insulin resistance, hypercholesterolemia, and higher triglycerides (p<0.05). Those with PCOS and concomitant type 2 diabetes (T2DM) did have increased NAFLD risk (PR 2.5, p=0.04), but those with PCOS without T2DM did not (PR 0.9, p=0.8). Adolescents with PCOS and NAFLD, compared to those with PCOS without NAFLD, had a higher prevalence of metabolic comorbidities including hypercholesterolemia (77 vs. 48 %), T2DM (29 vs. 8 %), and hypertriglyceridemia (65 vs. 37 %) (p<0.01). Almost 1 in 5 overweight/obese female adolescents had NAFLD, but PCOS did not increase NAFLD risk in this diverse cohort. Among young women with PCOS, concomitant T2DM did increase the risk for NAFLD. Closer monitoring of obesity comorbidities in adolescents with PCOS is essential for optimizing health and merits updating current guidelines. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Polycystic ovarian syndrome (PCOS) is a complex heterogeneous condition that affects women of reproductive age, conferring increased cardiovascular morbidity and mortality. The syndrome is characterized by oligomenorrhea, hyperandrogenism, and/or polycystic ovaries and is often associated with obesity and type 2 diabetes. Individuals are predisposed to PCOS by environmental factors and risk variants in genes mostly involved in ovarian steroidogenesis and/or insulin resistance. Genetic risk factors have been identified by both familial and genome-wide (GW) association studies. However, most genetic components are still unknown and missing heritability needs to be elucidated. To learn more about the genetic determinants of PCOS, we performed a GW study in genetically highly homogeneous peninsular families. PATIENTS AND METHODS: We conducted the first GW-linkage and linkage disequilibrium (i.e., linkage + association) study in Italian families with PCOS. RESULTS: We identified several novel risk variants, genes, and pathways potentially implicated in the pathogenesis of PCOS. Specifically, we detected 79 novel variants with significant GW-linkage and/or -association with PCOS across 4 inheritance models (p < 0.00005), of which 50 variants were within 45 novel PCOS-risk genes. CONCLUSIONS: This is the first GW-linkage and linkage disequilibrium study performed in peninsular Italian families and reporting novel genes in PCOS. [ABSTRACT FROM AUTHOR]

Patients with polycystic ovary syndrome (PCOS) report dissatisfaction with the diagnostic process and are more likely to have overweight or obesity. We wanted to understand the role that primary care physicians (PCPs) play in the diagnosis of PCOS and how they contribute to treatment of patients with PCOS and obesity. A cross-sectional online survey was completed by 251 patients with PCOS and obesity (BMI ≥30 kg/m2) and 305 healthcare providers (PCPs, obstetricians/gynecologists, reproductive and general endocrinologists). This paper focuses on the 75 PCPs treating patients with PCOS and obesity. In the most common patient journey, we found that most patients with PCOS and obesity (53%) have initial discussions about PCOS symptoms with PCPs. However, less than one quarter of patients receive a PCOS diagnosis (22%) or initial treatment (24%) for PCOS from a PCP. One quarter of patients also reported receiving a misdiagnosis from a PCP prior to their PCOS diagnosis. Compared to other healthcare providers surveyed, PCPs were the least comfortable making a PCOS diagnosis. Compared to PCPs without an obesity management focus, PCPs with an obesity management focus were more likely to diagnose patients themselves (38% vs 62%) and initiate PCOS treatment themselves (42% vs 57%). According to PCPs, difficulty with obesity management (47%) was the top reason that patients with PCOS and obesity stop seeing them for PCOS management. PCPs are often the initial medical touchpoint for patients with PCOS and obesity. However, PCPs play a smaller role in diagnosis and treatment of PCOS. Increasing education on obesity management may encourage PCPs to diagnose and treat more patients with PCOS and offer strategies to help patients with obesity management. Polycystic ovary syndrome (PCOS) is a condition where women may make more male hormones than usual, have irregular periods, and have trouble getting pregnant. PCOS can look very different in different patients. This can make it difficult to diagnose. Patients with PCOS are more likely to have obesity (unhealthy excess weight). Having obesity can make patients' PCOS worse and losing weight is an important treatment for PCOS. We wanted to learn more about what patients with PCOS and obesity experience as they try to manage their PCOS and the role of primary care doctors in diagnosing and treating patients with PCOS. To better understand this journey, 251 patients with PCOS and obesity and 75 primary care doctors who treat patients with PCOS and obesity took an online survey. Most patients (53%) first talked about PCOS symptoms with a primary care doctor. However, less than 25% of patients received a PCOS diagnosis or first treatment from a primary care doctor. One quarter of all patients said they were misdiagnosed by a primary care doctor before being diagnosed with PCOS. Primary care doctors were less comfortable than specialist doctors in diagnosing and treating patients with PCOS. Primary care doctors with a focus on weight management were more likely than other primary care doctors to diagnose and treat patients with PCOS themselves. Giving primary care doctors more educational support with PCOS diagnosis and weight management could help patients with PCOS get diagnosed earlier and treated better. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Oxytocin (OXT) controls appetite, promotes diet-induced energy expenditure, and may protect against obesity. Furthermore, the oxytocin system controls ovarian follicle luteinization and steroidogenesis as well as adrenal steroidogenesis, which if impaired might lead to anovulation and hyperandrogenism, signs found in women with polycystic ovarian syndrome (PCOS). PCOS is a common complex endocrine disorder of reproductive-age women, and it often presents with impaired glucose metabolism, insulin resistance (IR), and type 2 diabetes (T2D). The oxytocin receptor gene (OXTR) may confer a risk for PCOS, conceivably through dysregulation of metabolism, ovarian follicle maturation, and ovarian and adrenal steroidogenesis. Therefore, we aimed to investigate whether OXTR variants confer risk for PCOS. SUBJECTS AND METHODS: In 212 Italian subjects with T2D and PCOS, we have analyzed 22 single nucleotide polymorphisms (SNPs) within the OXTR gene for linkage to and/or linkage disequilibrium (LD, i.e., association) with PCOS. We tested whether the significant risk variants were independent or part of an LD block. RESULTS: We found 5 independent variants significantly linked to/in LD with PCOS within the peninsular families. CONCLUSIONS: This is the first study to report OXTR as a novel risk gene in PCOS. Functional and replication studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study was aimed at comparing the routine laboratory parameters and Galectin-1 levels of control and polycystic ovarian syndrome patients. PATIENTS AND METHODS: 88 patients diagnosed with polycystic ovary syndrome and 88 healthy controls were considered for the study. Age groups of the patients ranged from 18 to 40. Serum TSH, Beta HCG, glucose, insulin, HOMA-IR, Hb1A1c, triglyceride, total cholesterol, LDL FSH, LH, E2, prolactin, testosterone, SHBG, DHESO4, HDL, Gal-1 levels were analyzed for each subject. RESULTS: FSH, LH, LH/FSH, E2, prolactin, testosterone, SHBG, DHESO4, HDL and Gal-1 values of the subjects included in the study were statistically significantly different between the groups (p<0.05). Gal-1 and DHESO4 showed a strong positive connection (p=0.05). The sensitivity of Gal-1 level in PCOS patients was calculated as 0.997 and specificity as 0.716. CONCLUSIONS: High levels of Gal-1 in PCOS patients suggest that it increases due to overexpression in response to inflammation. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the effect of body mass index (BMI) before treatment on the cumulative live birth rate (CLBR) over multiple complete in vitro fertilization (IVF) cycles in patients with polycystic ovary syndrome (PCOS). This study is a single-center retrospective cohort study. It included 5016 patients with PCOS who started their first IVF cycle in our hospital between 2009 and 2018. Kaplan-Meier and log-rank tests were used for the comparison of CLBR across BMI groups. Univariate, multivariate models and stratification analysis were used to evaluate possible influencing factors of CLBR. Smoothing curve fitting was applied to present the correlation between BMI and CLBR. A one-line linear regression model was compared with a two-piecewise linear model using a log-likelihood ratio test. During the 8-year follow-up, 3604 women (71.85%) obtained at least one live birth. The study population was grouped according to BMI, with BMI ranging from [14.53–23.00) kg/m2 in the normal weight group, [23.00–27.50) kg/m2 in the overweight group, and [27.50–37.80] kg/m2 in the obese group, respectively. The CLBR of the obese group and the overweight group were significantly lower than the normal weight group. In the multivariate regression model, HR for CLBR was 0.86 [95%CI: 0.78–0.95] for the obese group, and 0.93 [0.86–1.00] for the overweight group, compared with the normal weight group as control. The curve fitting after adjustment for confounding factors and log-likelihood ratio test showed a one-line linear negative correlation between BMI and CLBR. We concluded that the BMI of PCOS patients had a negative one-line linear correlation with CLBR over multiple complete cycles. [ABSTRACT FROM AUTHOR]

This study investigated the discriminative value of serum telomerase levels in polycystic ovary syndrome (PCOS) and its relation to metabolic parameters. Patients aged 16–23 years old who visited an adolescent outpatient clinic were included in the study. Our study consisted of 45 non-obese girls with polycystic ovary syndrome (PCOS), while our control group consisted of 45 healthy girls with normal menstrual cycles and no signs of hyperandrogenism. During the early follicular phase, all individuals were analyzed for serum telomerase levels, blood cell count, biochemical parameters, basal hormone levels, lipid profile and homeostatic model assessment of insulin resistance (HOMA-IR) index. Serum telomerase levels in PCOS patients were considerably lower (80.0 ± 52.8 IU/mL) than in the controls (113.1 ± 54.9 IU/mL) (p=0.004). We observed that blood telomerase levels less than 108.6 distinguished PCOS group from healthy controls with a sensitivity of 73.33% and a specificity of 57.78%. Low-density lipoprotein cholesterol, HOMA-IR index, Ferriman–Gallwey score and dehydroepiandrosterone sulfate values were higher in the study group. Moreover, serum telomerase levels were inversely correlated with body mass index (r=−0.339, p=0.023) and triglycerides (r=−0.511, p=0.002) in this group. Telomerase levels were also considerably lower in patients with metabolic syndrome (p=0.005). Serum telomerase activity is lower in PCOS patients than in healthy controls. Furthermore, decreased serum telomerase levels may correlate well with the metabolic complications of PCOS. [ABSTRACT FROM AUTHOR]

Metformin is a biguanide, evolved as one of the most widely used medicines. The applications of this component include but are not limited to reducing blood glucose, weight loss, and polycystic ovary syndrome. Studies about other probable indications have emerged, indicating that this agent can also be utilized for other purposes. In this review, applications of metformin are noticed based on the current evidence. Metformin commonly is used as an off-label drug in non-alcoholic fatty liver disease (NAFLD), but it worsens inflammation and should not be used for this purpose, according to the latest research. Metformin decreased the risk of death in patients with liver cirrhosis. It is an effective agent in the prevention and improvement of survival in patients suffering hepatocellular carcinoma. There is evidence of the beneficial effects of metformin in colorectal cancer, early-stage prostate cancer, breast cancer, urothelial cancer, blood cancer, melanoma, and bone cancer, suggesting metformin as a potent anti-tumor agent. Metformin shows neuroprotective effects and provides a potential therapeutic benefit for mild cognitive impairment and Alzheimer's disease (AD). It also has been shown to improve mental function and reduce the incidence of dementia. Another condition that metformin has been shown to slow the progression of is Duchenne muscular dystrophy. Regarding infectious diseases, tuberculosis (TB) and coronavirus disease (COVID-19) are among the conditions suggested to be affected by metformin. The beneficial effects of metformin in cardiovascular diseases were also reported in the literature. Concerning renal function, studies showed that daily oral administration of metformin could ameliorate kidney fibrosis and normalize kidney structure and function. This study reviewed the clinical and preclinical evidence about the possible benefits of metformin based on recent studies. Numerous questions like whether these probable indications of metformin can be observed in non-diabetics, need to be described by future basic experiments and clinical studies. [ABSTRACT FROM AUTHOR]

Background: In recent years, humans have faced many diseases because of their lifestyle and environmental changes. One of these is polycystic ovary syndrome (PCOS), a hormonal condition that affects a large percentage of women of reproductive age. One in five (20%) Indian women have PCOS, making it one of the most prevalent causes for female infertility in women. Causes: The ovaries create small fluid-filled sacs called follicles, which fail to discharge eggs regularly, resulting in an imbalanced menstrual cycle. It is challenging for doctors to manually analyze disease symptoms, but this might be accomplished by utilizing machine-learning approaches to confirm that this category accurately identifies individuals with chronic diseases. Early identification and diagnosis of these diseases are important as they can prevent them from reaching their worst stage. Methods: This work aims to develop a Data-driven Computer Aided Diagnostic System (DCADS) using Synthetic Minority Oversampling Technique (SMOTE), correlation-based feature selection, and Machine Learning techniques to diagnose PCOS without the need for clinical testing. SMOTE oversamples the minority samples in the dataset and the important features are selected above the threshold value of 0.25 using the correlation-based feature selection method. Random Forest (RF), Support Vector Machine (SVM) and Logistic Regression (LR) are three machine-learning algorithms used to learn from the selected input features. The classification accuracy serves as the basis for the performance of the ML classifier. Because RF classifiers are more accurate than the other classifiers in this study, they have been employed in DCADS for non-clinical testing. The developed DCADS was tested using the PCOS dataset obtained from Kaggle and owned by Prasoon Kottarathil. Conclusion: Random forest achieves an overall accuracy of 92.024%, logistic regression achieves 90.18%, and SVM achieves 70.55% for the PCOS dataset. Gynecologists and women can diagnose PCOS using the developed DCADS without the need of clinical tests. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Polycystic ovarian syndrome (PCOS) is a complex heterogeneous disorder characterized by hyperandrogenism, irregular menses, and subfertility and often accompanied by other related comorbid disorders such as insulin resistance, obesity, and type 2 diabetes. Several genetic risk factors predispose to PCOS, but most are still unknown. Up to 30% of women with PCOS may have hyperaldosteronism. Blood pressure and the ratio of blood levels of aldosterone to renin are higher in women with PCOS compared to healthy controls, even if still in the normal range; and the aldosterone antagonist spironolactone has been used as therapy for PCOS, mainly due to its antiandrogenic activity. Thus, we aimed to investigate the potential pathogenetic role of the mineralocorticoid receptor gene (NR3C2) as the encoded NR3C2 product binds aldosterone and plays a role in folliculogenesis, fat metabolism, and insulin resistance. SUBJECTS AND METHODS: Within 212 Italian families with T2D and phenotyped for PCOS, we analyzed 91 single nucleotide polymorphisms in the NR3C2 gene. We tested the NR3C2 variants for linkage and linkage disequilibrium to the PCOS phenotype by using parametric analysis. RESULTS: We found 18 novel risk variants significantly linked to and/or associated with the risk of PCOS. CONCLUSIONS: We are the first to report NR3C2 as a risk gene in PCOS. However, our findings need to be replicated in other ethnic groups in order to reach more solid conclusions. [ABSTRACT FROM AUTHOR]