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 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The paper concerns the treatment results of 113 women with PCO-S by laparoscopic (102) and microlaparoscopic (11) ovarian electrocautery. All of them were qualified for operation on the basis of the following criteria: menstrual cycle disturbances (oligo-/amenorrhoea), anovulation, hirsutism, obesity, LH/FSH ratio > 2 and when more than 10 follicles of < 8 mm diameter are seen in the ovary under theca albuginea in USG examination. During the one year after operation these women were observed. In the first group (patients after laparoscopy) ovulation occurred in 86 (84%) and pregnancy in 54 (53%); accordingly in the second group (women after microlaparoscopy) ovulation occurred in 9 (83%) and pregnancy in 4 (45%). The treatment results by microlaparoscopic and laparoscopic ovarian electrocautery are similar, but the method by microlaparoscopy is easier to carry out in selected cases.
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PMID:[The effects of micro-laparoscopic ovarian electrocautery as a method of polycystic ovary syndrome treatment]. 1159 50

Hyperinsulinaemia and insulin resistance are usually associated phenomena of obesity and the polycystic ovary syndrome (PCO syndrome). On the other hand the PCO syndrome and obesity are often associated with disorders of the menstrual cycle and/or sterility. The authors examined 35 women aged 21 to 38 years (x = 27 +/- 4.4) with a history of anovulation cycles and/or sterility. 24 of them (68.6%) suffered from PCO syndrome. Their mean BMI was 28.95 kg/m2. 11 patients had a normal body weight, 6 were overweight and 18 were obese. The authors used the oral glucose tolerance test (oGTT) and during minute 0 and 120 blood samples were collected for assessment of the blood sugar and plasma insulin. Insulin levels in minute 0 (Io above 20 and in minute 120 (I120) above 65 uIU/ml were classified as hyperinsulinaemia. In the follicular stage of the anovulation cycle the authors assessed FSH, LH, testosterone, progesterone and prolactin. Hyperinsulinaemia ws recorded in 16 of 35 women. The mean insulin level at minute 0 was 11.9 +/- 1.3 and during minute 120 54.2 +/- 8.1 uIU/ml. The authors found significant differences in levels of I0 (6.4 +/- 1.2 vs. 16.1 +/- 1.9 uIU/ml, p < 0.01) and I120 (17.5 +/- 3 vs. 71.3 +/- 10.3 uIU/ml, p < 0.01) between obese and non-obese patients, Also in patients with the PCO there was a statistically significant difference in insulin levels of slim (BMI less than 25) as compared with obese women (BMI more than 30) (p < 0.01). A positive correlation was found between insulin levels and BMI (p < 0.01) and a liminal correlation between insulin and testosterone (p = 0.05). Patients with hyperinsulinaemia were treated with oral antidiabetics from the group of biguanides--metformin for a period of three months. During metformin treatment the insulin level declined and subsequently the menstrual cycle became normal in 11 of 16 patients with hyperinsulinaeia (68.7%), incl. two women who became pregnant. The results indicate a possible new indication of metformin in the treatment of ovarian hyperandrogenism in insulin resistant patients.
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PMID:[Hyperinsulinemia and disorders of the menstrual cycle]. 1196 79

Clinical characteristics of PCOS Syndrome Two fundamental characteristics: hyperandrogenism and anovulation which lead to hirsutism and oligo-or amenorrhea. Other features include obesity, acanthosis nigricans, and metabolic disruption (insulin resistance with hyperinsulinemia, glucose intolerance, or type II diabetes mellitus). Complementary tests Serum testosterone and DHEA-S levels: to exclude androgen-producing tumors. Serum 17-hydroxyprogesterone level: to exclude congenital adrenal hyperplasia, 21-hydroxylase deficiency. Ultrasound: increased size of the ovaries and central stroma with presence of peripheral follicular cysts (8-10) measuring about 8 mm in diameter. Pathophysiology Therapeutic approaches Therapeutic approaches
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PMID:[Polycystic ovaries in 2001: physiology and treatment]. 1198 85

A clinical, descriptive, and transversal study was conducted in a group of patients with chronic anovulation and sterility, to correlate insulin resistance, determined by the fasting glucose/insulin ratio, with body fat composition using anthropometrics parameters and the interaction of light near infrared region method, we studied 41 young patients with chronic anovulation and sterility. Based on their body mass index, all patients had obesity or overweight. Similarly, most of them presented with a percentage of body fat over the recommended limits. Forty percent of all studied patients had a fasting glucose/insulin ratio below 4.5, which corresponds to insulin resistance. The correlation between the percentage of body fat and fasting glucose/insulin ratio was significant, as was the correlation between body mass index and the percentage of body fat. We found overweight or obesity in the majority of our patients, and insulin resistance in almost half of them. Such disturbances were positively associated with the percentage of body fat and android distribution. Therefore, we recommend a routinely anthropometrics evaluation in these patients as well as fasting glucose/insulin ratio determination in order to act in an early stage over the natural history of metabolic syndrome, whose common denominator is insulin resistance.
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PMID:[Insulin-glucose ratio and body fat composition in patients with chronic anovulation and sterility]. 1201 50

Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women and is defined by hyperandrogenic chronic anovulation with the exclusion of secondary causes, such as congenital adrenal hyperplasia or an androgen secreting tumor. PCOS women are uniquely insulin resistant. It is estimated that 5% of the female population is affected. The underlying genetic defect in insulin action is unknown. Obesity aggravates the underlying predisposition to insulin resistance. Diagnostic criteria which focus on menstrual irregularity are more likely to identify insulin resistant women. About 40% of PCOS women display glucose intolerance (either impaired glucose tolerance or type 2 diabetes) in response to an oral glucose challenge. Additionally women display multiple other risk factors for cardiovascular disease including dyslipidemia and elevated circulating inflammatory markers. The lack of a clear etiologic mechanism to the syndrome has led in the past to a multitude of symptom-oriented treatments with few therapies improving all aspects of the endocrine syndrome of PCOS. Recently treatments resulting in improved insulin sensitivity, either through weight loss/exercise programs or pharmaceutical, have been shown to improve both the endocrine and metabolic abnormalities in the syndrome. Anti-diabetic agents in PCOS have been examined in a number of randomized studies which have shown a treatment benefit. Further indications for these agents such as the prevention of pregnancy loss or the conversion to type 2 diabetes still need to be investigated in properly designed studies.
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PMID:Polycystic ovary syndrome. Long term sequelae and management. 1203 49

The polycystic ovary syndrome (PCOS) is a condition characterized by hyperandrogenism and chronic oligo-anovulation. However, many features of the metabolic syndrome are inconsistently present in the majority of women with PCOS. Approximately 50% of PCOS women are overweight or obese and most of them have the abdominal phenotype. Obesity may play a pathogenetic role in the development of the syndrome in susceptible individuals. In fact, insulin possesses true gonadotrophic function and an increased insulin availability at the level of ovarian tissue may favour excess androgen synthesis. Obesity, particularly the abdominal phenotype, may be partly responsible for insulin resistance and associated hyperinsulinemia in women with PCOS. Therefore, obesity-related hyperinsulinemia may play a key role in favouring hyperandrogenism in these women. Other factors such as increased estrogen production rate, increased activity of the opioid system and of the hypothalamic-pituitary-adrenal axis, decreased sex hormone binding globulin synthesis and, possibly, high dietary lipid intake, may be additional mechanisms by which obesity favours the development of hyperandrogenism in PCOS. Irrespective of the pathogenetic mechanism involved, obese PCOS women have more severe hyperandrogenism and related clinical features (such as hirsutism, menstrual abnormalities and anovulation) than normal-weight PCOS women. This picture tends to be more pronounced in obese PCOS women with the abdominal phenotype. Body weight loss is associated with beneficial effects on hormones, metabolism and clinical features. A further clinical and endocrinological improvement can also be achieved by adding insulin-sensitizing agents and/or antiandrogens to weight reduction programmes. These obviously emphasize the role of obesity in the pathophysiology of PCOS.
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PMID:Obesity and the polycystic ovary syndrome. 1208 Apr 40

PCOS is the most frequent endocrine disorder of premenopausal women. The common clinical signs of PCOS are hirsutism, menstrual irregularities with chronic anovulation and a trend toward overweight or obesity. Diagnosis is based upon high plasma levels of androgens and the ultrasound image of polycystic ovaries. The high prevalence of PCOS at first degree female relatives suggest an important genetic component of this syndrome. Linking studies in sisters presenting phenotypical traits of PCOS and in their parents allowed the investigation of certain candidate genes presumed to be involved in the physiopathology of PCOS. The genes encoding enzymes involved in androgen synthesis, protein transducers of insulin signals and the paracrine regulating factors of gonadotrophins and ovarian function have been analysed. To date, no determinant gene mutation was reported. However, several loci were detected, especially a locus within the insulin receptor. Mutations or gene polymorphisms and their function remain to be identified. These research attempts should explain the physiopathology of PCOS and open new therapeutic perspectives. The usage of medication increasing the sensitivity to insulin action is an example of applying these particular aspects.
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PMID:[Genetics of the polycystic ovarian syndrome and therapeutic perspectives ]. 1208 37

The relationship between the body weight and the function of hypothalamopituitary-ovarian axis was longtime studied. Frisch and Ravell (1971) have proposed the hypothesis that the onset of menarche is strong related to the achievement of a critical body weight. These authors observed that, despite the decrease in the last 120 years of the menarche age from 16.5 to 12.5 year-old, the body weight at which the menarche appears remains unchanged, 47.5 +/- 0.5 Kg. Many studies show the importance of both, body weight and fat mass percentage, in the appearance of menarche at puberty, or in the restoration of menses after the weight loss amenorrhea. Primary or secondary underweight amenorrhea can be associated to an eating disorder (anorexia nervosa, bulimia nervosa, or the alternation of these to clinical conditions), to severe exercise (athletes, gymnasts, dancers) or to malnutrition. The connected signal between metabolic status and reproductive function may be represented by the substances like: insulin, amino acids, IGFPB-I, leptin. The low levels of leptin were found in underweight female with oligo or amenorrhea. By the other hand, obesity is not a primary factor causing chronic anovulation. However, obesity may aggravate an already existing subtle defect in some women and result in amenorrhea.
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PMID:[The influence of body weight upon the function of ovarian axis]. 1209 75

Polycystic ovary syndrome (PCOS) is a common but complex endocrine disorder and is a major cause of anovulation and consequent subfertility. It is also associated with a metabolic disturbance, characterized by hyperinsulinaemia and insulin resistance that carries an increased risk of type 2 diabetes in later life. Despite its prevalence little is known about its aetiology, but there is increasing evidence for an important genetic involvement. On the basis of experimental observations in the prenatally androgenized sheep and rhesus monkey, and supported by data from human studies, we propose that the clinical and biochemical features of PCOS can arise as a consequence of genetically determined hypersecretion of androgens by the ovary during, or very likely long before, puberty. The resulting hyperandrogenism results in 'programming' of the hypothalamic-pituitary unit to favour excess LH secretion, and encourages preferential abdominal adiposity that predisposes to insulin resistance. The severity of hyperinsulinaemia and insulin resistance (which has a profound influence on the phenotype of PCOS) is further influenced by both genetic factors (such as polymorphism in the insulin gene regulatory region) and environmental factors, notably obesity. This hypothesis therefore suggests a unifying, 'linear' model to explain the aetiology of the heterogeneous phenotype.
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PMID:Developmental origin of polycystic ovary syndrome - a hypothesis. 1209 57

Polycystic ovary syndrome (PCOS) is a common endocrine condition with reproductive and metabolic consequences, including anovulation, infertility and an increased prevalence of diabetes mellitus. Obesity, central obesity and insulin resistance are strongly implicated in its etiology and reduction of these risk factors should be a central treatment focus. Short-term weight loss has been consistently successful in reducing insulin resistance and restoring ovulation and fertility. However, problems arise with maintaining weight loss and precisely quantifying the associated long-term benefits of risk factor change. Although recent research indicates modest long-term lifestyle changes might reduce the extent of impaired glucose tolerance and delay the conversion to diabetes mellitus in the general population, this has not yet been examined in women with PCOS. Current conservative treatment should emphasize sustainable weight loss through dietary modification and exercise. Modifying additional lifestyle factors, including alcohol consumption, psychosocial stressors and smoking, are also crucial in long-term treatment of PCOS.
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PMID:The role of lifestyle modification in polycystic ovary syndrome. 1212 86


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