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Journal of Ovarian Research Jun 2024Endometriosis is a heritable, complex chronic inflammatory disease, for which much of the causal pathogenic mechanism remain unknown.Despite the high prevalence of...
INTRODUCTION
Endometriosis is a heritable, complex chronic inflammatory disease, for which much of the causal pathogenic mechanism remain unknown.Despite the high prevalence of ovarian chocolate cyst, its origin is still under debate.
METHODS
Prevailing retrograde menstruation model predicts that ectopic endometrial cells migrate and develop into ovarian chocolate cyst. However, other models were also proposed. Genome-wide association studies (GWASs) have proved successful in identifying common genetic variants of moderate effects for various complex diseases.
RESULTS
A growing body of evidence shows that the remodeling of retrograde endometrial tissues to the ectopic endometriotic lesions involves multiple epigenetic alterations, such as DNA methylation, histone modification, and microRNA expression.Because DNA methylation states exhibit a tissue specific pattern, we profiled the DNA methylation for ovarian cysts and paired eutopic endometrial and ovarian tissues from four patients. Surprisingly, DNA methylation profiles showed the ovarian cysts were closely grouped with normal ovarian but not endometrial tissues.
CONCLUSIONS
These results suggested alterative origin of ovarian cysts or strong epigenetic reprogramming of infiltrating endometrial cells after seeding the ovarian tissue. The data provide contributing to the pathogenesis and pathophysiology of endometriosis.
Topics: Female; Humans; DNA Methylation; Ovarian Cysts; Endometrium; Adult; Ovary; Endometriosis; Epigenesis, Genetic
PubMed: 38844959
DOI: 10.1186/s13048-024-01440-1 -
Frontiers in Endocrinology 2024Previous observational studies have identified a correlation between elevated plasma homocysteine (Hcy) levels and polycystic ovary syndrome (PCOS). This study aimed to...
OBJECTIVE
Previous observational studies have identified a correlation between elevated plasma homocysteine (Hcy) levels and polycystic ovary syndrome (PCOS). This study aimed to determine whether a causal relationship exists between Hcy and PCOS at the genetic level.
METHODS
A two-sample Mendelian Randomization (TSMR) study was implemented to assess the genetic impact of plasma levels of Hcy, folate, vitamin B12, and vitamin B6 on PCOS in individuals of European ancestry. Independent single nucleotide polymorphisms (SNPs) associated with Hcy (n=12), folate (n=2), vitamin B12 (n=10), and vitamin B6 (n=1) at genome-wide significance levels (<5×10) were selected as instrumental variables (IVs). Data concerning PCOS were obtained from the Apollo database. The primary method of causal estimation was inverse variance weighting (IVW), complemented by sensitivity analyses to validate the results.
RESULTS
The study found no genetic evidence to suggest a causal association between plasma levels of Hcy, folate, vitamin B12, vitamin B6, and PCOS. The effect sizes, determined through random-effect IVW, were as follows: Hcy per standard deviation increase, OR = 1.117, 95%CI: (0.842, 1.483), = 0.442; folate per standard deviation increase, OR = 1.008, CI: (0.546, 1.860), = 0.981; vitamin B12 per standard deviation increase, OR = 0.978, CI: (0.808, 1.185), = 0.823; and vitamin B6 per standard deviation increase, OR = 0.967, CI: (0.925, 1.012), = 0.145. The fixed-effect IVW results for each nutrient exposure and PCOS were consistent with the random-effect IVW findings, with additional sensitivity analyses reinforcing these outcomes.
CONCLUSION
Our findings indicate no causal link between Hcy, folate, vitamin B12, vitamin B6 levels, and PCOS.
Topics: Humans; Polycystic Ovary Syndrome; Female; Mendelian Randomization Analysis; Homocysteine; Polymorphism, Single Nucleotide; Vitamin B Complex; Folic Acid; Vitamin B 12; Genome-Wide Association Study; Vitamin B 6; Adult
PubMed: 38841299
DOI: 10.3389/fendo.2024.1393847 -
Journal of the College of Physicians... Jun 2024To compare the efficacies of common therapeutic regimens and their combinations, used in polycystic ovarian syndrome (PCOS) to improve fertility in reproductive-age... (Comparative Study)
Comparative Study
OBJECTIVE
To compare the efficacies of common therapeutic regimens and their combinations, used in polycystic ovarian syndrome (PCOS) to improve fertility in reproductive-age women.
STUDY DESIGN
A descriptive study. Place and Duration of the Study: Department of Obstetric Gynaecologist, Medicare Cardiac and General Hospital, Karachi, Pakistan, from November 2022 to July 2023.
METHODOLOGY
Out of 300 patients with the symptoms of menstrual irregularities and infertility, 152 were diagnosed as PCOS patients based on the ultrasound and hormonal assays and selected for study purpose. They were divided according to their therapeutic regimen into four treatment groups, treated by different therapeutic agents. Group A received metformin 500 mg/day (n = 38); Group B received metformin + myo-inositol 1g (n = 49); Group C received metformin + letrozole 2.5 mg (n = 36), and Group D received metformin + letrozole + myo-inositol (n = 29), orally for three months. All continuous variables, such as body mass index (BMI), FSH, LH, FT4, and FSI were analysed by applying t-test to all therapeutic groups, keeping p ≤0.05 as the level of significance.
RESULTS
HCG-positive was found as 86% (n = 33) in Group A, 63% (n = 31) in Group B, 52% (n = 19) in Group C, and 27% (n = 08) in Group D. There were statistically significant (p <0.001) changes in BMI, FSH, LH, FT4, and FSI as well. Metformin alone and metformin plus myo-inositol came out to be more effective than other regimens.
CONCLUSION
Metformin alone and myo-inositol plus metformin are effective therapeutic options in PCOS-induced infertility problems.
KEY WORDS
Polycystic ovarian syndrome, Infertility, Metformin, Myo-inositol, Letrozole, Menstrual irregularities.
Topics: Humans; Polycystic Ovary Syndrome; Female; Metformin; Inositol; Letrozole; Adult; Infertility, Female; Drug Therapy, Combination; Pakistan; Hypoglycemic Agents; Young Adult; Treatment Outcome; Body Mass Index
PubMed: 38840346
DOI: 10.29271/jcpsp.2024.06.654 -
Journal of Ovarian Research Jun 2024Polycystic Ovary Syndrome (PCOS) is a widespread endocrine disorder among women, characterized by symptoms like ovarian cysts, hormonal imbalance, and metabolic issues....
Enhancing angiogenesis and inhibiting apoptosis: evaluating the therapeutic efficacy of bone marrow mesenchymal stem cell-derived exosomes in a DHEA-induced PCOS mouse model.
BACKGROUND
Polycystic Ovary Syndrome (PCOS) is a widespread endocrine disorder among women, characterized by symptoms like ovarian cysts, hormonal imbalance, and metabolic issues. This research evaluates the therapeutic potential of Bone Marrow Mesenchymal Stem Cell-derived exosomes (BMSC-Exo) in treating PCOS symptoms within a mouse model.
METHODS
BMSC-Exo were isolated from NMRI mice, characterized using Transmission Electron Microscopy (TEM) and Nanoparticle Tracking Analysis (NTA), and administered to a PCOS mouse model induced by dehydroepiandrosterone (DHEA). The efficacy of BMSC-Exo was assessed in three groups of mice: a control group, a PCOS group, and a PCOS group treated with intravenous BMSC-Exo. Morphological changes in ovarian tissue were examined by Hematoxylin and Eosin (H&E) staining, apoptosis was determined using the TUNEL assay, and CD31 expression was analyzed through immunofluorescent staining to assess angiogenic activity.
RESULTS
The existence of BMSCs-Exo was confirmed via TEM and NTA, revealing their distinct cup-shaped morphology and a size range of 30 to 150 nanometers. H&E staining revealed that BMSCs-Exo treatment improved ovarian morphology in PCOS models, increasing corpora lutea and revitalizing granulosa cell layers, suggesting a reversal of PCOS-induced damage. TUNEL assays showed that BMSCs-Exo treatment significantly reduced apoptosis in PCOS-affected ovarian cells to levels comparable with the control group, highlighting its role in mitigating PCOS-induced cellular apoptosis. Immunofluorescence for CD31 indicated that BMSCs-Exo treatment normalized endothelial marker expression and angiogenic activity in PCOS models, suggesting its effectiveness in modulating the vascular irregularities of PCOS. Collectively, these findings demonstrate the therapeutic potential of BMSCs-Exo in addressing ovarian dysfunction, cellular apoptosis, and aberrant angiogenesis associated with PCOS.
CONCLUSION
The study substantiates the role of BMSC-Exo in mitigating the deleterious effects of PCOS on ovarian tissue, with implications for enhanced follicular development and reduced cellular stress. The modulation of CD31 by BMSC-Exo further highlights their potential in normalizing PCOS-induced vascular anomalies. These findings propel the need for clinical investigations to explore BMSC-Exo as a promising therapeutic avenue for PCOS management.
Topics: Animals; Female; Polycystic Ovary Syndrome; Exosomes; Apoptosis; Dehydroepiandrosterone; Mice; Disease Models, Animal; Mesenchymal Stem Cells; Neovascularization, Physiologic; Ovary; Angiogenesis
PubMed: 38840218
DOI: 10.1186/s13048-024-01445-w -
Wei Sheng Yan Jiu = Journal of Hygiene... May 2024To analyze the association between dietary fat intake and the risk of polycystic ovarian syndrome(PCOS).
OBJECTIVE
To analyze the association between dietary fat intake and the risk of polycystic ovarian syndrome(PCOS).
METHODS
PCOS patients treated in a tertiary hospital in Anhui Province from October 2021 to October 2022 were selected as the case group, and non-PCOS patients treated in the hospital during the same period were selected as the control group. A total of 262 subjects were included in the study, 131 were included in the case group and 131 in the control group. A semi-quantitative dietary frequency questionnaire was used to investigate the dietary intake in the past year, and the daily intake of various fatty acids and the ratio of fatty acid energy supply were calculated according to the food intake. Logistic regression analysis was used to investigate the association between dietary fat intake and the risk of PCOS.
RESULTS
The dietary intakes of total fat, fatty acid, saturated fatty acid and monounsaturated fatty acid in PCOS patients were higher than those in control group(P>0.05), and there was statistical significance in daily intakes of eicosapentaenoic acid between two groups(P<0.05). After adjusting for confounding factors such as long-term residence, occupation, family per capita monthly income, menstrual cycle regularity, menstrual volume, and weight loss experience, Logistic regression analysis showed that the ratio of fat supply to energy was positively correlated with the risk of PCOS(OR=1.622, 95%CI 1.237-2.127). The energy supply ratio of monosaturated fatty acids(OR=0.597, 95%CI 0.373-0.955) and polyunsaturated fatty acids(OR=0.585, 95%CI 0.372-0.921) were negatively correlated with the risk of PCOS(P<0.05).
CONCLUSION
The energy supply ratio of fat was positively correlated with the risk of PCOS, while the energy supply ratio of monosaturated fatty acids and the energy supply ratio of polyunsaturated fatty acids were negatively correlated with the risk of PCOS.
Topics: Humans; Polycystic Ovary Syndrome; Female; Dietary Fats; Adult; Risk Factors; Case-Control Studies; Surveys and Questionnaires; Fatty Acids; China; Young Adult; Diet
PubMed: 38839593
DOI: 10.19813/j.cnki.weishengyanjiu.2024.03.008 -
Abdominal Radiology (New York) Jun 2024Gynecological emergencies can often present with a myriad of non-specific signs and symptoms, posing a diagnostic challenge to the clinician. They can be grossly divided... (Review)
Review
Gynecological emergencies can often present with a myriad of non-specific signs and symptoms, posing a diagnostic challenge to the clinician. They can be grossly divided into uterine or adnexal pathologies. Uterine pathologies can be secondary to intracavitary accumulation of blood [like in patients with transverse vaginal septum, Robert's uterus, accessory and cavitated uterine mass, unicornuate uterus with contralateral non-communicating functional horn], bleeding per vaginum [like in patients with retained products of conception, enhanced myometrial vascularity], pyometra [secondary to pelvic inflammatory disease, cervical obstruction secondary to benign and malignant causes] or complications of fibroids [like red degeneration, torsion of subserosal fibroid]. The adnexal pathologies can range from ectopic pregnancy in a urine pregnancy test (UPT) positive patient to haemorrhagic ovarian cyst, ovarian torsion, ruptured dermoid cyst and tubo-ovarian abscess in a UPT negative patient. Multimodality imaging including ultrasound (USG), computed tomography (CT) scan and magnetic resonance imaging (MRI) can narrow down the differentials and help in formulating an accurate diagnosis. The objective of this article is to familiarize the readers with multimodality imaging findings in common as well as uncommon acute gynecological emergencies and provide an algorithmic imaging approach for acute gynecological emergencies. USG is typically used as the first line diagnostic modality in diagnosis of acute gynecological emergencies. CT scan & MRI are helpful as a problem-solving tool in acute gynecological emergencies when USG findings are indeterminate.
PubMed: 38836883
DOI: 10.1007/s00261-024-04399-1 -
Gynecological Endocrinology : the... Dec 2024Polycystic ovary syndrome (PCOS) and subclinical hypothyroidism (SCH) are prevalent gynecological conditions. However, the interrelationship between the two remains...
OBJECTIVES
Polycystic ovary syndrome (PCOS) and subclinical hypothyroidism (SCH) are prevalent gynecological conditions. However, the interrelationship between the two remains elusive. This study aims to elucidate the association between these conditions and determine the potential impact of SCH on the physiological and metabolic characteristics of patients with PCOS.
METHODS
This cross-sectional study enrolled 133 patients with PCOS from our Hospital. Participants were categorized into two groups: those with PCOS + SCH ( = 58) and those with PCOS ( = 75). Serum hormonal levels, metabolic markers, ovarian volume, and follicle count were compared between the groups.
RESULTS
There was a significant difference in BMI between the two groups, with a higher prevalence of obesity in the PCOS + SCH group ( = .014). Compared to the PCOS group, patients with PCOS + SCH had significantly higher levels of TSH ( < .001), triglycerides ( = .025), and HOMA-IR ( < .001), while LH levels were significantly lower ( = .048). However, multivariate linear regression analysis revealed that TSH, triglycerides, LH, and HOMA-IR were not determinants for the occurrence of SCH in patients with PCOS. Additionally, there was a notable reduction in follicle count in the left ovary for the PCOS + SCH group compared to the PCOS group ( = .003), and the overall follicle diameter of the PCOS + SCH group was also smaller ( = .010).
CONCLUSION
SCH may exert effects on the physiological and metabolic profiles of patients with PCOS. Further investigation into the relationship between these disorders is warranted to delineate their clinical implications.
Topics: Humans; Polycystic Ovary Syndrome; Female; Hypothyroidism; Cross-Sectional Studies; Adult; Ovary; Young Adult; Thyrotropin; Insulin Resistance; Luteinizing Hormone; Body Mass Index; Triglycerides; Ovarian Follicle
PubMed: 38835150
DOI: 10.1080/09513590.2024.2358219 -
Obesity Surgery Jul 2024Polycystic ovary syndrome (PCOS) is the most common reproductive endocrine disorder in women of reproductive age. It is difficult for patients with PCOS to achieve...
BACKGROUND
Polycystic ovary syndrome (PCOS) is the most common reproductive endocrine disorder in women of reproductive age. It is difficult for patients with PCOS to achieve weight loss with conventional treatment. The aim of this study was to investigate weight loss and changes in hypothalamic-pituitary axis hormone levels in patients with PCOS combined with obesity after sleeve gastrectomy.
METHODS
A retrospective analysis of 12 patients without PCOS and 24 patients with PCOS who underwent bariatric surgery at Beijing Luhe hospital from 2020 to 2022 was performed. The study assessed the changes in body weight and hormonal indexes of the hypothalamic-pituitary axis before and six months after the surgery.
RESULTS
Patients with PCOS experienced greater weight loss compared to those without the condition. Following surgery, individuals with PCOS showed lower levels of postoperative testosterone, prolactin, and free testosterone indices compared to preoperative levels. Additionally, postoperative LH and FSH levels were higher than preoperative levels. Analysis of thyroid axis hormone levels revealed that FT3 and TSH levels were notably reduced in patients with PCOS postoperatively. Furthermore, growth hormone levels were found to be elevated in patients with PCOS following surgery.
CONCLUSION
Bariatric surgery enhances hormone levels in the hypothalamic-pituitary axis in women with PCOS, leading to greater improvements in patients with PCOS compared to those with simple obesity.
Topics: Humans; Female; Polycystic Ovary Syndrome; Retrospective Studies; Adult; Hypothalamo-Hypophyseal System; Weight Loss; Testosterone; Obesity, Morbid; Gastrectomy; Bariatric Surgery; Young Adult; Body Weight; Treatment Outcome
PubMed: 38829463
DOI: 10.1007/s11695-024-07273-7 -
Frontiers in Endocrinology 2024Reproduction ability requires a certain amount of body fat that is necessary for ovulation, menstruation and pregnancy. Fat tissue represents an endocrine organ with...
BACKGROUND
Reproduction ability requires a certain amount of body fat that is necessary for ovulation, menstruation and pregnancy. Fat tissue represents an endocrine organ with high metabolic activity as it produces adipokines such as leptin and adiponectin. Our aim is to examine potential associations between women of reproductive age's ovarian reserves and their levels of leptin and adiponectin.
METHOD
74 women between 19 and 40 years of age consented to take part. Based on the patterns of their ovarian reserves, the women were divided into three main groups: women with adequate ovarian reserves (AOR - Group A, n=30), women with polycystic ovary syndrome (PCOS - Group B, n=31) and women with depleted ovarian reserves (DOR - Group C, n=13). Among these groups, several biochemical and demographic parameters were statistically compared.
RESULTS
Compared to the other two groups, women with DOR had statistically higher age and follicle stimulation hormone (FSH) levels. For estradiol (E2) and thyroid-stimulating hormone (TSH), no statistically significant difference was seen between the groups. In addition, women with PCOS had higher body mass index (BMI), luteinizing hormone (LH), total testosterone (TT), 17 hydroxyprogesterone (17-OHP), dehydroepiandrosterone (DHEA), anti-Mullerian hormone (AMH), and antral follicle count (AFC) than the other two groups. In line with expectations, women with DOR also had lower levels of AMH and AFC than the other two groups. Women with PCOS had higher leptin levels than the other two groups, but there was no statistically significant difference. Women with PCOS had lower levels of adiponectin than the other groups, however the difference was not statistically significant.
CONCLUSION
The way we classified women in our study according to their ovarian reserves is completely consistent with what has been published internationally. The ovarian reserve in women of reproductive age is not strongly correlated with leptin and adiponectin levels. For safe conclusions, more research including a greater number of samples is required.
Topics: Humans; Female; Leptin; Adiponectin; Ovarian Reserve; Adult; Young Adult; Polycystic Ovary Syndrome; Body Mass Index; Reproduction; Ovary
PubMed: 38828407
DOI: 10.3389/fendo.2024.1369248 -
International Journal of Surgery Case... Jul 2024Cystic lymphangioma is rare benign tumor that results from a lymphatic system malformation. The mesenteric location is even more uncommon.
INTRODUCTION
Cystic lymphangioma is rare benign tumor that results from a lymphatic system malformation. The mesenteric location is even more uncommon.
CASE REPORT
We report the case of a menopausal 63-year-old woman who presented with a persistent painful well-defined mass of the pelvis. On ultrasound and computed tomography, the mass appeared as thick-walled unilocular homogenous cyst in favor of an ovarian cystadenoma. During laparotomy, the misdiagnosis was confirmed as the tumor was found to be embedded in the mesentery of the ileum. Subsequent histopathological examination confirmed the benign cystic lymphangioma diagnosis.
DISCUSSION
Mesenteric cystic lymphangioma is rare peritoneal tumor of the adult. Clinically, it often masquerades as other abdominopelvic masses like ovarian cysts. Differential diagnosis is often challenging because of the overlapping clinical abdominal presentation and radiological features. Histopathological is the gold standard in diagnosing mesenteric cystic lymphangioma. Surgery is the mainstay treatment, and the recurrence rate is low if negative surgical margins are achieved.
CONCLUSION
Mesenteric cystic lymphangioma often mimics more frequent and potentially malignant lesions. It is essential for surgeons to remain vigilant for the possibility of this diagnosis when evaluating abdominopelvic cystic masses.
PubMed: 38824741
DOI: 10.1016/j.ijscr.2024.109846