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Medical Archives (Sarajevo, Bosnia and... Aug 2020Polycystic Ovary Syndrome (PCOS), the most common endocrinological problem among women in the reproductive age, is characterized by chronic ovulatory dysfunction,...
INTRODUCTION
Polycystic Ovary Syndrome (PCOS), the most common endocrinological problem among women in the reproductive age, is characterized by chronic ovulatory dysfunction, hyperandrogenism, and raised Luteinizing hormone : Follicle Stimulating Hormone (LH:FSH) ratio. Obesity and insulin resistance have been linked to PCOS. However, there is recently a growing population of thin, lean women who are diagnosed with PCOS.
AIM
This study aimed to compare normal and high Body mass index (BMI) women with PCOS and to investigate the correlation between BMI and LH/FSH ratio.
METHODS
It was a case -control study at the Department of Obstetrics and Gynaecology, Qassim University clinic, Saudi Arabia. Women with PCOS were included in the study and were classified according to their BMI. Their computerized records were retrieved for the demographic, clinical, and laboratory data. The study groups were compared by the t-test and the Spearman correlation between BMI and LH/FSH ratio was calculated.
RESULTS
A total of 63 women were included in this study (normal BMI group: n=30, and high BMI group: n=33). There was no difference between the two groups in terms of the LH/FSH ratio (2.76 vs. 2.79, P=0.48). There was no significant correlation between BMI and LH/FSH ratio, prolactin, or Thyroid stimulating hormone (TSH ) levels (Spearman correlation with >0.05).
CONCLUSION
The data suggests that the body mass index was not correlated with increased LH/FSH ratio. Since LH/FSH ratio was the same in normal BMI women, healthcare professionals need to think about ways to normalize this ratio beyond weight reduction.
Topics: Adult; Body Mass Index; Case-Control Studies; Female; Follicle Stimulating Hormone; Humans; Incidence; Obesity; Polycystic Ovary Syndrome; Retrospective Studies; Saudi Arabia; Young Adult
PubMed: 33041447
DOI: 10.5455/medarh.2020.74.289-293 -
Frontiers in Endocrinology 2023
Topics: Female; Humans; Polycystic Ovary Syndrome; Epigenesis, Genetic
PubMed: 37766688
DOI: 10.3389/fendo.2023.1284351 -
South Dakota Medicine : the Journal of... Nov 2014
Topics: Female; Humans; Polycystic Ovary Syndrome
PubMed: 25490793
DOI: No ID Found -
Medicine Apr 2020Polycystic ovary syndrome (PCOS) affects reproductive-aged women and is associated with increased prevalence of serious clinical problems including: reproductive... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Polycystic ovary syndrome (PCOS) affects reproductive-aged women and is associated with increased prevalence of serious clinical problems including: reproductive implications, metabolic dysfunction, and cardiovascular risk. Physical activity offers several health benefits for women with PCOS. The aim of this systematic review was to synthesize evidence on the effect of different types of exercise on reproductive function and body composition for women with PCOS.
METHODS
This was a systematic review and meta-analysis of randomized controlled trials (RCTs) following recommended review methods. We searched 6 databases: Cumulative Index of Nursing and Allied Health Literature; Embase; MEDLINE (via Ovid); PubMed; Sport Discus; and Web of Science; and we developed search strategies using a combination of Medical Subject Headings terms and text words related to exercise interventions for women with PCOS. There was no restriction on language or publication year. The search was conducted on April 16, 2019 and updated on November 15, 2019. Two authors independently screened citations, determined risk of bias and quality of evidence with Grading of Recommendations Assessment, Development and Evaluation. We conducted meta-analyses following recommended guidelines, and report results using standardized mean difference (SMD).
RESULTS
Ten RCTs (nā=ā533) were included in this review. Studies tested the following interventions: aerobic, resistance, and combined (aerobic/resistance) training programs. Most studies were small (average 32, range 15-124 participants), and of relatively short duration (8-32 weeks). There was high heterogeneity for outcomes of reproductive function (menstrual cycle, ovulation, and fertility). We noted low certainty evidence for little to no effect of exercise on reproductive hormones and moderate certainty evidence that aerobic exercise reduced body mass index (BMI) in women with PCOS: BMI SMD -0.35, 95% confidence interval -0.56 to -0.14, Pā=ā.001.
CONCLUSION
For women with PCOS, evidence is limited to discern the effect of exercise on major health outcomes (e.g., reproductive function). There is moderate certainty evidence that aerobic exercise alone is beneficial for reducing BMI in women with PCOS. Future studies should be conducted with longer duration, larger sample sizes, and should provide detailed information on menstrual cycle and fertility outcomes.PROSPERO Systematic review registration: 2017 CRD42017058869.
Topics: Exercise Therapy; Female; Humans; Polycystic Ovary Syndrome; Randomized Controlled Trials as Topic
PubMed: 32311937
DOI: 10.1097/MD.0000000000019644 -
BMC Endocrine Disorders Apr 2023Polycystic Ovary Syndrome (PCOS) is a very common endocrine disorder with a variety of symptoms. Current treatment options include the contraceptive pill as well as... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Polycystic Ovary Syndrome (PCOS) is a very common endocrine disorder with a variety of symptoms. Current treatment options include the contraceptive pill as well as metformin, however both treatments are limited to specific symptoms and have common side effects.
METHODS
This phase IV study is a monocentric, double blinded randomized clinical trial comparing the effects of six months of probiotic intervention to a placebo, with an additional open-label metformin arm as a positive control in a total of 180 participants with PCOS. The first of three visits is the screening visit, where inclusion/exclusion criteria are assessed. At the first visit, they are randomised into one of the three treatment arms equally and receive their study medication. After six months, all assessments from the first two visits are repeated. The primary endpoint is the change in free testosterone levels after the intervention, while secondary endpoints include changes in hormonal and metabolic parameters associated with PCOS as well as the gut microbial composition and diversity after intervention.
DISCUSSION
Based on new insights into the role of the gut microbiome in PCOS development, this study is exploring the potential of using probiotics to treat women with PCOS symptoms. If successful, this new therapy approach could open a new realm of possibilities for treating PCOS. To our knowledge, this is the first study comparing probiotic intervention with not only placebo treatment, but also metformin. This study has been approved by the ethics committee of the Medical University of Graz (EC number 32-230 ex 19/20).
REGISTRATION
EudraCT number: 2020-000228-20.
CLINICALTRIALS
gov identifier: NCT04593459.
PROTOCOL VERSION
Version 1.5 dated 29th November 2021.
Topics: Humans; Female; Metformin; Polycystic Ovary Syndrome; Double-Blind Method; Probiotics
PubMed: 37062834
DOI: 10.1186/s12902-023-01294-6 -
European Review For Medical and... Apr 2021Recent studies have revealed that myo-inositol could be more influential in patients with polycystic ovary syndrome (PCOS). This study was aimed to determine and compare... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Recent studies have revealed that myo-inositol could be more influential in patients with polycystic ovary syndrome (PCOS). This study was aimed to determine and compare the effects of myo-inositol and metformin on hormonal and metabolic profiles and fertility outcomes.
MATERIALS AND METHODS
A comprehensive search was carried out among the English-language databases, including PubMed, Scopus, Cochrane Library, Google Scholar, and Web of Science, and the articles published from April 2010 to February 2019 were tracked down. The fixed and random-effects meta-analysis was used to estimate the pooled effect size. The meta-analysis was performed in Stata Version 14.0.
RESULTS
Nine studies with 331 patients treated with metformin and 307 patients treated with myo-inositol groups were included in the analysis. The research groups did not diverge significantly in terms of the basic characteristics, such as age and Body Mass Index (BMI). In the myo-inositol group, the levels of Luteinizing Hormone (LH) [12.55% (95% I: 11.41-13.68%)], S. testosterone [44.38% (95% CI: 38.09-50.67%)] and prolactin [7.97% (95% CI: 6.58- 9.37%)] were significantly higher than those recorded, i.e., LH [7.97% (95% CI: 6.58- 9.37%)], S. testosterone [8.48% (95% CI: 3.14-13.83%)] and prolactin [7.14% (95% CI: 1.50-14.79%)] for the metformin group (p<0.001).
CONCLUSIONS
Due to the dearth of related research and the high heterogeneity of the Randomized Clinical Trials (RCTs) included in other studies, the present systematic review could not establish any differences between metformin and myo-inositol concerning the hormonal profile and the ovarian function. However, the findings indicated that myo-inositol could improve fertility outcomes by modulating hyperandrogenism. Randomized trials are required to understand the mechanistic actions of myo-inositol in comparison with those of metformin regarding oocyte and embryo quality, fertilization, pregnancy, and live birth rates.
Topics: Female; Fertilization in Vitro; Humans; Hypoglycemic Agents; Inositol; Metformin; Polycystic Ovary Syndrome
PubMed: 33877679
DOI: 10.26355/eurrev_202104_25565 -
Frontiers in Endocrinology 2022
Topics: Female; Humans; Polycystic Ovary Syndrome; Risk Factors
PubMed: 36277701
DOI: 10.3389/fendo.2022.1030353 -
Frontiers in Endocrinology 2023
Topics: Female; Humans; Polycystic Ovary Syndrome
PubMed: 37588987
DOI: 10.3389/fendo.2023.1247679 -
The Journal of Clinical Endocrinology... Aug 2016Polycystic ovary syndrome (PCOS) is associated with reduced health-related quality of life (HRQOL) and increased prevalence of depressive and anxiety disorders. The... (Randomized Controlled Trial)
Randomized Controlled Trial
CONTEXT
Polycystic ovary syndrome (PCOS) is associated with reduced health-related quality of life (HRQOL) and increased prevalence of depressive and anxiety disorders. The impact of PCOS-specific treatments on these co-morbidities is unclear.
OBJECTIVE
To assess the impact of weight loss and decreasing hyperandrogenism on HRQOL and mood and anxiety disorders in women with PCOS.
DESIGN/SETTING/PARTICIPANTS
A secondary analysis of a randomized controlled trial (OWL-PCOS) of preconception treatment conducted at two academic centers in women (age, 18-40 years; body mass index, 27-42 kg/m(2)) with PCOS defined by Rotterdam criteria.
INTERVENTION
Continuous oral contraceptive pill (OCP) or intensive lifestyle intervention or the combination (Combined) for 16 weeks.
MAIN OUTCOME MEASURE(S)
Changes in HRQOL assessed by PCOSQ and SF-36 and prevalence of depression and anxiety disorder assessed by PRIME-MD PHQ.
RESULTS
The lowest scores were noted on the general health domain of the SF-36 and the weight and infertility domains on the PCOSQ. All three interventions resulted in significant improvement in the general health score on the SF-36. Both the OCP and Combined groups showed improvements in all domains of the PCOSQ (P < .01) compared to baseline scores. The Combined group had significant improvements in the weight, body hair, and infertility domains compared to a single treatment group (P < .05). In a linear regression model, change in weight correlated with improvements in the weight domain (P < .001) and physical well-being (P < .02), change in T correlated with improvements in the hair domain (P < .001), and change in both weight and T correlated with the infertility (P < .001) and menstrual domains (P < .05).
CONCLUSIONS
Both weight loss and OCP use result in significant improvements in several physical and mental domains related to quality of life, depressive symptoms, and anxiety disorders, and combined therapies offer further benefits in overweight/obese women with PCOS.
Topics: Adolescent; Adult; Androgens; Behavior Therapy; Combined Modality Therapy; Contraceptives, Oral; Female; Health Status; Humans; Life Style; Polycystic Ovary Syndrome; Preconception Care; Prognosis; Quality of Life; Surveys and Questionnaires; Treatment Outcome; Weight Loss; Young Adult
PubMed: 27253669
DOI: 10.1210/jc.2016-1896 -
Ugeskrift For Laeger Oct 2022Physical function (PF) is a strong predictor for length of stay, complications, readmission, and mortality among patients across different diagnoses. Still, systematic...
Physical function (PF) is a strong predictor for length of stay, complications, readmission, and mortality among patients across different diagnoses. Still, systematic assessment of PF in hospitalised patients is not common, and if, only among the oldest. In this review, we suggest implementation of an easily applicable and validated test battery using the Cumulated Ambulation Score for basic mobility, Handgrip strength for general muscle strength, and the 30s Chair Stand Test for combined function and muscle strength for early identification and treatment of reduced PF in adult patients across diagnoses.
Topics: Female; Adult; Humans; Insulin Resistance; Diabetes Mellitus, Type 2; Risk Factors; Polycystic Ovary Syndrome; Obesity
PubMed: 36331169
DOI: No ID Found