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Background: Polycystic ovary syndrome (PCOS) is one of women’s most common endocrine disorders that can cause anxiety, psychological distress, and reduced quality of life (QOL). Aims and Objectives: The present study aimed to determine the effectiveness of a 9-week mindfulness-based meditation program on the QOL and general health parameters in young women with PCOS. Materials and Methods: This study was implemented on women diagnosed with PCOS based on Rotterdam criteria. The program was conducted for 9 weeks, beginning with a 15 min session and gradually increasing it to 60 min. The program included techniques on breath focus, body scan, “Om” chanting, mindful breathing, thinking, seeing, and listening. Pre-intervention questionnaires were given to the participants. These were a PCOS questionnaire (PCOSQ), a general health-related QOL questionnaire, and a five-item questionnaire for acne problems. Responses of participants were analyzed using 22 SPSS statistical software. Results: There was a significant difference in the mean of pre- and post-intervention Likert scale response values for the 26-item PCOSQ. There was no significant difference in the mean of pre- and post-intervention Likert scale response values for the acne questionnaire. Prior to the intervention only 8% reported “excellent” health, after the intervention 63% reported “very good.” 42% reported a reduction in pain, and 71% reported that they were calm and peaceful “most of the time.” Conclusion: Results showed that mindfulness meditation intervention had caused a significant change in general health and QOL of patients with PCOS.
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Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. Its prevalence varies with the type of diagnostic criteria used. PCOS is also associated with social stigma and lack of knowledge. Due to its heterogeneous presentation, symptoms and complications of PCOS may vary from person to person. Aims and Objectives: The aim of this study was to determine the prevalence and knowledge regarding PCOS in young college-going girls in Central India. Materials and Methods: This is a questionnaire-based study. The study included 18 questions assessing knowledge and prevalence of PCOS. Results: We included 371 participants in the study with a mean age of 20.77 ± 2.11 years. The mean body mass index of all the participants was around 20.4 kg/m2. The prevalence of PCOS as per the Rotterdam criteria was found to be 9.4% in our study. Conclusion: We investigated PCOS prevalence and knowledge among young girls in Central India. Most individuals in our survey understood that lifestyle changes such as exercise, healthy sleep, and diet can help manage and prevent PCOS, but adherence is still low. Lifestyle has a major influence on PCOS’s multifactorial pathogenesis. PCOS awareness needs to be raised through more programs.
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Background: Effective ovulation induction is crucial in management of polycystic ovarian syndrome (PCOS) related infertility. Clomiphene citrate (CC) has long been the first line of treatment for inducing ovulation in women with PCOS. Letrozole, an aromatase inhibitor, has emerged as a promising alternative to CC for ovulation induction. The present study was aimed to compare efficacy and safety of letrozole versus CC for ovulation induction in women with PCOS.Methods: This study consists of 384 PCOS women, randomized into two groups: Letrozole (2.5 mg/day) and CC (50 mg/day), both administered from day 3 to day 7 of the menstrual cycle. The primary outcome was the ovulation rate, confirmed by serum progesterone levels >10 ng/ml. Secondary outcomes included clinical pregnancy rate, live birth rate, endometrial thickness, adverse effects, cost-effectiveness, and patient satisfaction. Participants were monitored through transvaginal ultrasound and serum progesterone measurements.Results: Ovulation was achieved in 76.0% of participants in the letrozole group compared to 55.2% in the CC group (p<0.001). Clinical pregnancy rates were significantly higher in the letrozole group (44.8%) compared to the CC group (28.1%) (p<0.001). Similarly, live birth rates were higher with letrozole (36.5% vs. 22.4%; p=0.002). Endometrial thickness was greater in the letrozole group (8.7 mm vs. 7.5 mm; p<0.001). Adverse effects, were significantly lower in the letrozole group.Conclusions: Letrozole is more effective than CC in inducing ovulation and achieving higher pregnancy and live birth rates in women with PCOS.
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Background: In spite of the serious consequences that polycystic ovary syndrome (PCOS) can have on the mental health aspects of sufferers, most of the researches conducted in this field have dealt with the medical aspects of this disease, and its effects and psychological aspects have received far less attention in the literature. The aim of this study was to determine the frequency of depression and anxiety in infertile women with and without PCO referred to Ardabil infertility center.Methods: This case-control study was conducted on 99 women with polycystic ovary syndrome and 96 infertile women for other reasons who referred to the infertility center of Ardabil city in 2022. The diagnosis of polycystic ovary syndrome in this study was based on the Rotterdam criteria. Mood disorders including depression and anxiety were determined based on the Beck standard test. After collecting the data, it was analyzed using descriptive and analytical statistics by statistical package for the social sciences (SPSS) software version 26.Results: Most of the underlying diseases among them were related to bleeding with 71 cases (36.6%) and then related to hair growth with 43 cases (22.2%). Among the studied women, the rate of depression was 53 (27.3%) and 184 (94.8%) had a low level of anxiety. Among women with PCOS, 38 (38.4%) and among women without PCOS, 15 (15.8%) had depression. Statistically, there was a significant relationship between depression and PCOS.Conclusion: The rate and severity of depression in PCOS patients was significantly higher than non-PCOS infertile patients.
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Polycystic ovary syndrome (PCOS) is a complex and multifaceted disorder that has been extensively studied from various angles, including genomics, metabolomics, and other multiomics approaches. This narrative review seeks to provide an updated understanding of PCOS, with a particular focus on metabolomics. PCOS encompasses four primary phenotypes: Classic PCOS with or without polycystic ovary morphology, ovulatory PCOS, and non-hyperandrogenic PCOS. Each phenotype exhibits distinct clinical and biochemical characteristics. Classic PCOS, characterized by hyperinsulinemia, insulin resistance (IR), and metabolic complications, has garnered significant attention in recent studies. In the pursuit of unraveling PCOS’s pathophysiology, researchers have embraced a multiomics approach, exploring the genome, epigenome, transcriptome, exosomes, proteome, and metabolome. The genomic landscape of PCOS includes genes related to androgen synthesis, regulation, insulin receptors, and growth factors, among others. Epigenetic mechanisms have also been investigated, revealing the roles of non-coding RNA, histone acetylation, and deacetylation. Transcriptomic biomarkers and mitochondrial RNAs targets, such as miR-9 and miR-32, have been explored in granulosa cells of PCOS patients. Metabolomics studies have identified various biomarkers and metabolic pathways that differentiate PCOS from healthy individuals. A diverse range of alterations in carbohydrate and lipid metabolism has been observed, shedding light on the underpinnings of PCOS-related metabolic dysfunction. These studies have uncovered numerous biomolecules with potential relevance to PCOS, including kininogen 1, cytoketatin 9, and many others. In addition, the intricate relationships between IR, inflammation, and metabolic factors have been elucidated. Recent research extends beyond high-end research centers, even using urine samples to identify metabolomic markers for PCOS. This approach has led to the discovery of distinct biomarker panels related to metabolic pathways that differentiate PCOS from healthy subjects. In summary, PCOS is a complex and heterogeneous condition, withmultiomics studies offering promising avenues for a deeper understanding of its pathophysiology. These studies may ultimately provide valuable insights that can revolutionize the diagnosis and treatment of PCOS, ending a century- long scientific expedition with a crescendo of discoveries.
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Background: Oligoanovulation, hyperandrogenism, and polycystic ovaries are signs of Polycystic Ovary Syndrome (PCOS). Genetic and environmental factors cause this diverse illness. Androgen excess disrupts follicular development, causing histopathological abnormalities. Dysregulated luteinizing hormone (LH) secretion causes hyperandrogenism. Oestrogen synthesis is affected by feedback mechanisms, which are worsened by obesity. Lifestyle adjustments, hormonal contraceptives, metformin for glucose intolerance, clomiphene citrate for infertility, and metformin in IVF to reduce risks are used to manage. This systematic review aims to thoroughly examine and summarise the many clinical characteristics of PCOS patients. Methods: Researchers who studied the physical traits of PCOS patients used a variety of search engines, such as PubMed and Google Scholar, as well as Boolean logic, to find relevant studies. In addition to clinical data, authentic websites included extra information. PRISMA analysis was used to guide the selection of journals, which resulted in eliminating duplicates and identifying ten relevant journals for further examination. Results: PCOS is characterized by several clinical characteristics, the most prevalent of which are raised levels of androgens, hirsutism, and an elevated ratio of luteinizing hormone to follicle-stimulating hormone (LH/FSH). The menstrual cycle can be restored with metformin medication, which has a noteworthy therapeutic effect. Studies highlight the intricacy of PCOS highlighting the importance of individualized care strategies for its myriad symptoms. Conclusion: The systematic review highlights the multifaceted clinical features of PCOS and underscores the importance of tailored management strategies for addressing its complexity.
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Background: Cancer is referred to as a disease in which few body cells proliferate in an uncontrol manner and invade other parts of the body. The human body comprises trillions of cells, and cancer can practically develop anywhere. The human body's cells typically proliferate and divide into new cells as required by the body. Old cells are replaced by new ones when they die due to injury or ageing. Methods: A descriptive correlation study was conducted among 100 adolescent breast cancer women. Convenient sampling was employed to choose the study region. A stratified proportionate random sampling technique was used to select the patients from the Obstetrical and Gynaecological unit of Kerudi Hospital, Bagalkot, India. Sociodemographic information was gathered using a structured sociodemographic profile. The quality of life (QOL) and depression were assessed using numerical rating scale. The objectives of the study analysed data. Results: A significant negative correlation was found between overall quality of life (OQOL) scores and depression. A positive correlation existed between the psychological domain and depression, physical domain, social domain, environmental domain, and total quality of life (TQOL). The sociodemographic characteristics of cancer patients and their depression ratings did not significantly correlate. Conclusion: The study results reveal depression and QOL of breast cancer patients. Based on the findings of this study, we emphasize the interventional research and recommendations for enhancing all aspects of QOL and reducing the psychological impact of depression in the later life of breast cancer patients.
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Saraca asoca (Roxb.) Willd. [Family: Fabaceae (Caesalpiniaceae)], commonly known as Ashoka, is a medicinal plant used for many gynecological disorders, including polycystic ovary syndrome (PCOS). PCOS is a common gynecological disorder affecting the ovarian steroidogenesis pathway, leading to hormonal imbalance. In this study, 56 ligands reported from S. asoca were selected and computationally analyzed for their binding affinity to the targets from the ovarian steroidogenesis pathway- aromatase, 17betahydroxysteroid dehydrogenase type 1 (17?-HSD1), androgen, and estrogen receptors (? and ?). Molecular docking was performed by Autodock Vina, density functional theory (DFT) was performed by Gaussian software, and absorption, distribution, metabolism, excretion, and toxicity (ADMET) properties were checked using ADMETLab. Among the 56 compounds, higher docking scores were obtained for procyanidin B2 with ?11.7 and ?10.4 kcal/mol against aromatase and 17?-HSD1, respectively, and leucopelargonidin with ?10 and ?9.1 kcal/mol against androgen receptor and estrogen ? receptor followed by epicatechingallate, amyrin, procyanidin B1, leucocyanidin and ellagic acid. ADMETLab prediction showed that all the top seven compounds fulfilled the criteria for drug-likeness. DFT analysis showed improved chemical and biological reactivity with a substantial transfer of charge between electron-donor to electron-acceptor groups for all seven compounds. Here, we put forth procyanidin B2 and leucopelargonidin with high binding energy scores against aromatase and 17?-HSD1 as potential inhibitors of excess estrogen and testosterone biosynthesis in PCOS women.
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Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases in women. In recent years, the effects of vitamin D receptor (VDR) gene variants and VitD3 levels on clinical features of PCOS have been frequently described. In this study, we aimed to determine the relationship between VDR ApaI, TaqI and Cdx2 gene variants and VitD3 levels in PCOS patients. Patients were divided into two groups: BMI\25 and BMIC25. VDR genotypes were determined by real-time polymerase chain reaction (PCR) and serum VitD3 levels were examined by ELISA. We observed that frequencies of the Apa1 AC genotype, C allele and Cdx2 T allele are increased in the BMIC25 group compared to BMI\25 group. Also, the ApaI C allele, Taq1 AA genotype and A allele, Cdx2 CC genotype and C allele are associated with increased triglyceride, total cholesterol, LDL-cholesterol levels in patients with BMIC25. When examining the relationship between VitD3 levels and clinical profiles in all PCOS patients, regardless of BMI distinction, it is determined that there is a positive correlation between LDL-cholesterol and ftestosterone levels. The present findings suggest that VDR variants are one of the most important risk factors for PCOS, especially for patients with BMIC25.
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Background: Polycystic ovarian syndrome (PCOS) is a common endocrinopathy affecting women of reproductive age group. It is a multifactorial disease characterized by different levels of anomalies related to reproduction and metabolism, including insulin resistance (IR), hyperinsulinemia, dyslipidaemia, and obesity. Vitamin D impacts physiological processes, including calcium homeostasis, glucose homeostasis, and bone metabolism. The effect of supplementation with vitamin D on the clinical traits of vitamin D-deficient PCOS patients was investigated in this study. Methods: A prospective observational study was conducted on 129 PCOS patients aged 18–35 at Kamala Nehru Memorial Hospital, Allahabad, during May 2017–2018. Following screening for inclusion and exclusion criteria and gaining consent, all women meeting the Rotterdam criteria for PCOS had a comprehensive clinical examination, including waist circumference, body weight, body mass index (BMI), and waist-hip ratio (WHR). Vitamin D supplementation was prescribed for six months, and its effect on clinical characteristics was observed. SPSS version 16 was used to assess the data and examine the impact of treatment; a paired t-test was used. Results: The mean BMI (p=0.176) and change in weight (p=0.582) were reduced post-six months of supplementation with vitamin D, showing a non-significant association of BMI and weight with vitamin D supplementation. Similarly, the mean WHR showed no change (p=0.253). Conclusion: The clinical parameters, including weight, BMI, and WHR, remained unchanged after vitamin D supplementation. Although vitamin D intake did not influence clinical characteristics, its positive benefits are implied by the improvement in risk measures and the absence of side effects.
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@#Objective To use the ultra-performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)to authenticate the chemical composition of Morinda citrifolia,and further experiments verify that Morinda citrifolia regulate miR-223-3p/NLRP3 signaling pathway to inhibit the inflammatory response in rats with polycystic ovary syndrome(PCOS).Methods Use UPLC-MS/MS analyze the chemical composition of Morinda citrifolia.SD female rats were randomly divided into three groups:normal control group(n=5),PCOS model group(n=5)and Morinda citrifolia gavage group(n=5).HE staining observe the morphology of ovarian histology,ELISA method detect the expression levels of testosterone(T),luteinizing hormone(LH),follicle stimulating hormone(FSH),interleukin(IL)-1βand IL-18,RT-qPCR detect the mRNA expression of miR-223-3p and NLRP3,and Western blot detect the protein expression of NLRP3.Results UPLC-MS/MS identify 641 chemical composition of Morinda citrifolia,including luteolin,Apigenin,emodin and other composition.Compared with the normal control group,the number of cell layers of ovarian granule in the PCOS model group is reduced,and follicular cystic dilation,atresia follicles increased,T and LH levels increased(P<0.05),FSH levels decreased(P<0.05),IL-18 and IL-1β levels increased(P<0.05),and ovarian tissue miR-223-3p mRNA expression decreased(P<0.01),NLRP3 mRNA and protein expression increased(P<0.01)in PCOS model group.Compared with the PCOS model group,the proportion of follicles at all levels is normal,the number of granule cell layers increased,T and LH levels decreased(P<0.05),FSH levels increased(P<0.05),IL-18 and IL-1β levels decreased(P<0.05),miR-223-3p mRNA expression in ovarian tissue increased((P<0.05),NLRP3 mRNA and protein expression decreased(P<0.05)in Morinda citrifolia gavage group.Conclusion Morinda citrifolia can improve the ovary pathological state of PCOS rats,change the abnormal sex hormones and reduce the levels of inflammatory factors IL-18 and IL-1β.The mechanism maybe regulate the miR-223-3p/NLRP3 signaling pathway to inhibit the inflammatory response in PCOS rats.
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Objective To study the regulation effects of Bazhen Decoction combined with Baizhu Fuzi Decoction on glucose metabolism and estrogen level in rats with polycystic ovary syndrome.Methods The rat model of polycystic ovary syndrome was established by subcutaneous injection of human chorionic gonadotropin(HCG)combined with insulin.Rats were randomly divided into the polycystic ovary syndrome group,the Baizhu Fuzi Tang group(6.4 g/kg),the Bazhen Tang group(9.2 g/kg),the Bazhen Tang combined with Baizhu Fuzi Tang group(11.55 g/kg)and the diethylstilbestrol group(0.5 mg/kg).A blank control group(unmodulated rats)was set up with 10 rats in each group.The uterine index of rats was determined and calculated.Fasting blood glucose(FBG),2 h postprandish blood glucose(2 h PBG)and fasting insulin(FINS)were determined and insulin sensitivity index(ISI)and insulin resistance index(IR)were calculated.Serum estradiol(E2),testosterone(T),luteinizing hormone(LH),follicle stimulating hormone(FSH),prolactin(PRL),anti-Mullerian tube hormone(AMH)and insulin-like growth factor 1(IGF-1),C-reactive protein(CRP),interleukin(IL)-6,tumor necrosis factor(TNF)-α,total peroxidase activity(T-AOC),superoxide dismutase(SOD)and malondialdehyde(MDA)levels in ovarian tissue were detected by enzyme-linked immunosorbent assay(ELISA).The pathological changes of ovarian tissue were detected by hematoxylin-eosin(HE)staining.Real-time quantitative polymerase chain reaction(qPCR)was used to determine mRNA levels of ARA70,CBP,SCR1 and HOXA10 in endometrium and mRNA expressions of AMPK,GLUT4 and PPARγ in ovarian tissue.Western blot assay was used to determine expression levels of AMPK,GLUT4 and PPARγ in ovarian tissue.Results Compared with the polycystic ovary syndrome group,uterine index,FINS,FBG,2 h PBG,IR levels,serum T,LH,FSH,PRL,AMH,IGF-1 levels,ovarian tissue CRP,IL-6,TNF-α,T-AOC and MDA level,endometrial ARA70,CBP,SCR1 mRNA level of rats decreased significantly in the Baizhu Fuzi decoction group,the Bazhen decoction group and the Bazhen decoction combined with Baizhu Fuzi decoction group(P＜0.05).ISI level,serum E2 level,ovarian tissue SOD level,endometrial HOXA10 mRNA level,ovarian tissue AMPK,GLUT4 and PPARγ mRNA and protein levels were significantly increased(P＜0.05).The above indexes were significantly changed in the Bazhen decoction and Bazhu Fuzi decoction group than those of the Bazhu Fuzi decoction group and the Bazhen decoction group(P＜0.05).Conclusion Bazhen Decoction combined with Baizhu Fuzi Decoction can regulate glucose metabolism,inhibit ovarian tissue oxidation and inflammatory damage,improve endometrium tolerance,regulate estrogen level,and improve the progression of polycystic ovary syndrome in rats.The mechanism may be related to the regulation of AMPK/GLUT4/PPARγ pathway.
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BACKGROUND:At present,many drugs used in the treatment of polycystic ovary syndrome are super-designated drugs,and the treatment of patients with polycystic ovary syndrome still faces great challenges.Studies have shown that human umbilical cord mesenchymal stem cells can repair ovarian function,but few studies have reported their therapeutic effect on polycystic ovary syndrome. OBJECTIVE:To investigate the therapeutic effect of human umbilical cord mesenchymal stem cells on polycystic ovary syndrome,and to preliminarily explore the correlation between mitochondrial autophagy and the improvement of polycystic ovary syndrome by human umbilical cord mesenchymal stem cells. METHODS:Polycystic ovary syndrome mouse model was established by subcutaneous injection of dehydroepiandrosterone for 20 days into C57BL/6J mice.Human umbilical cord mesenchymal stem cells(2×106)were injected through the caudal vein.After treatment,vaginal secretions were collected for 10 consecutive days to detect the estrus cycle of mice.At 2 weeks after treatment,the levels of sex hormones in the peripheral blood of mice,including luteinizing hormone and follicle-stimulating hormone,were detected by ELISA.Hematoxylin-eosin staining was used to evaluate ovarian histopathology.Finally,mitochondrial autophagy in ovaries was observed by transmission electron microscopy. RESULTS AND CONCLUSION:(1)After human umbilical cord mesenchymal stem cell therapy,follicles at different stages(primitive follicles,primary follicles,and secondary follicles)appeared in the ovary of polycystic ovary syndrome mice,and luteal tissue could be seen,indicating that ovulation function of mice was effectively improved.(2)Polycystic ovary syndrome mice treated with human umbilical cord mesenchymal stem cells had sex hormone levels.(3)Untreated polycystic ovary syndrome mice were found to be in the estrous stage for a long time,lacking estrous interphase and estrous phase,but after human umbilical cord mesenchymal stem cell therapy,the estrous cycle returned to a normal level.(4)After treatment with human umbilical cord mesenchymal stem cells,the mitochondrial autophagy of polycystic ovary syndrome mice was significantly reduced.(5)The results show that human umbilical cord mesenchymal stem cells can effectively improve the symptoms of endocrine disorders and promote ovulation in polycystic ovary syndrome mice,which may be related to the inhibition of mitochondrial autophagy.
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Objective:To investigate the correlation between the expression of serum preprotein convertase subtilisin/kexin type 9 (PCSK9), secreted frizzled related protein-4 (SFRP-4) and sex hormone, glucose and lipid metabolism in obese polycystic ovary syndrome (PCOS) patients.Methods:A total of 130 patients with polycystic ovary syndrome diagnosed and treated in Xuzhou Maternal and Child Health Hospital from April 2021 to October 2022 were selected as the study subjects, the patients were divided into obese group (60 cases) and non obese group (70 cases) according to body mass index. Enzyme linked immunosorbent assay was applied to detect the serum levels of PCSK9 and SFRP-4. The correlation between serum PCSK9, SFRP-4 levels and sex hormones (luteinizing hormone, testosterone, follicle stimulating hormone), glucose metabolism indicators [fasting blood glucose (FPG), glycosylated hemoglobin (HbA 1c), fasting insulin (FINS), homeostatic model assessment insulin resistance index (HOMA-IR)], lipid metabolism indexes [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)] in patients with obese polycystic ovary syndrome was analyzed by Pearson method. Results:The serum levels of PCSK9 and SFRP-4 in obese group were significantly higher than those in non obese group: (679.36 ± 162.21) μg/L vs. (421.68 ± 103.74) μg/L, (302.87 ± 70.58) μg/L vs. (184.21 ± 52.45) μg/L, the difference was statistically significant ( P<0.05). Compared with the non obese group, the obese group had significantly higher levels of luteinizing hormone and testosterone: (18.36 ± 5.34) U/L vs. (9.47 ± 2.21) U/L, (3.61 ± 0.97) nmol/L vs. (3.02 ± 0.84) nmol/L ( P<0.05), and significantly lower levels of follicle stimulating hormone: (7.28 ± 1.62) U/L vs. (8.03 ± 2.10) U/L, with statistically significant differences ( P<0.05); the levels of FPG, HbA 1c, FINS and HOMA-IR in obese group were significantly higher than those in non obese group: (5.46 ± 0.67) mmol/L vs. (5.04 ± 0.49) mmol/L, (7.96 ± 0.98)% vs. (6.68 ± 0.77)%, (34.08 ± 3.64) U/L vs. (23.67 ± 2.52) U/L, 8.27 ± 1.84 vs. 5.30 ± 1.52, and the differences were statistically significant ( P<0.05); compared with the non obese group, the obese group had significantly increased levels of TC, TG and LDL-C: (4.86 ± 0.67) mmol/L vs. (4.12 ± 0.54) mmol/L, (1.64 ± 0.36) mmol/L vs. (1.06 ± 0.21) mmol/L and (2.81 ± 0.56) mmol/L vs. (2.14 ± 0.42) mmol/L ( P<0.05), and HDL-C level was significantly reduced: (1.11 ± 0.25) mmol/L vs. (1.52 ± 0.40) mmol/L, with statistically significant differences ( P<0.05); the levels of serum PCSK9 and SFRP-4 in obese polycystic ovary syndrome patients were positively correlated with luteinizing hormone, testosterone, FPG, HbA 1c, FINS, HOMA-IR, TC, TG and LDL-C ( P<0.05), and negatively correlated with follicle stimulating hormone and HDL-C ( P<0.05). Conclusions:The serum PCSK9 and SFRP-4 levels in obese polycystic ovary syndrome patients are elevated, which is related to sex hormones, glucose and lipid metabolism.
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Objective:To explore the effect of acupuncture combined with Huatan and Progesterone prescription on patients with polycystic ovary syndrome(phlegm-dampness and difficulty).Methods:Total 128 patients with polycystic ovary syndrome(phlegm-dampness and difficulty)were treated in the Third Affiliated Hospital of Beijing University of Chinese Medicine from Septem-ber 2017 to March 2021,and randomly divided into control group and observation group,with 64 patients in each group.Control group received conventional treatment in Western medicine,and observation group was treated with acupuncture and the Huatan and Progesterone prescription.After 3 menstrual cycles,the efficacy was compared.Results:After treatment,serum TGF-β1,IL-6 and high-sensitivity C-reactive protein(HS-CRP)levels of observation group were lower than that of control group(P<0.05),insulin resis-tance index(HOMA-IR),endometrial thickness and ovarian volume in observation group were lower than those in control group(P<0.05),serum estrogens(E2)level in observation group was higher than that in control group,while levels of luteinizing hormone(LH)and follicle-stimulating hormone(FSH)were lower than that in control group(P<0.05).After treatment,ovulation rate(79.69%)and pregnancy rate(57.81%)in observation group were higher than those in control group,and there was no significant difference in abor-tion rate between the two groups(P>0.05).Total incidence of adverse reactions in observation group(7.81%)was lower than that in control group(21.88%),and the difference was statistically significant(P<0.05).Conclusion:For patients with polycystic ovary syn-drome(phlegm-dampness and difficulty),combined acupuncture and Huatan and Progesterone prescription has significant effect,which can help to reduce inflammatory reaction,reduce insulin resistance,promote ovulation and pregnancy,and improve clinical efficacy.
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AIM To investigate the effects of astragaloside IV on improving insulin resistance(IR)in obese rat model of polycystic ovary syndrome(PCOS),and to analyze its effect on ovarian MAPK/ERK pathway as well.METHODS The obese PCOS rat models established by feeding of letrozole combined with high-fat and high-sugar diet were randomly divided into the model group,the metformin(135 mg/kg)group and the low-dose and high-dose astragaloside Ⅳ(25,50 mg/kg)groups,with 8 rats in each group in contrast to those of the control group.After 21 days oral administration,the rats had their body weight recorded;their ovarian index calculated;their levels of fasting blood glucose(FBG),serum triglyceride(TG),total cholesterol(TC),follicle-stimulating hormone(FSH),testosterone(T),estradiol(E2),luteinizing hormone(LH)and fasting insulin(FINS)measured;their HOMA-IR and LH/FSH values calculated;their ovarian expressions of MAPK/ERK pathway related proteins detected by Western blot;and their ovarian expression of vascular endothelial growth factor(VEGF)protein detected by immunofluorescence staining.RESULTS Compared with the control group,the model group showed increased polycystic pathological changes,levels of body weight,ovarian index,serum TG,TC,LH,FSH,T,FINS,and FBG,values of LH/FSH and HOMA-IR,and ovarian p-ERK1/2/ERK1/2,p-MEK1/2/MEK1/2,p-Raf/Raf,and VEGF protein expressions(P<0.01);and decreased serum E2 level(P<0.01).Compared with the model group,both astragaloside Ⅳ and metformin groups shared significantly alleviated ovarian polycystic lesions,and decreased body weight,levels of ovarian index,serum TG,TC,LH,FSH,T,FINS,and FBG,values of LH/FSH and HOMA-IR,ovarian p-ERK1/2/ERK1/2,p-MEK1/2/MEK1/2,p-Raf/Raf,and VEGF protein expressions(P<0.05,P<0.01),and increased serum E2 level(P<0.05,P<0.01).CONCLUSION Upon the obese PCOS rat models,astragaloside Ⅳ can antagonize their IR,improve their hormone levels and alleviate their ovarian lesions via inhibiting the activation of MAPK/ERK pathway.
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“Deficiency cause， cold accumulation， and qi stagnation” originates from Essentials from the Golden Cabinet （《金匮要略》）， which is a guiding principle for the pathogenesis of women's diseases， pioneering the differentiation and treatment of women's diseases based on patterns， and having a profound influence on future generations. Following the classical principles and simplifying the complexities， this paper explored the pathogenesis and mechanism of polycystic ovary syndrome （PCOS） from the perspective of “deficiency cause， cold accumulation， and qi stagnation”， and believed that depletion of essence and blood， long-term accumulation of internal cold， and qi constraint and blood stasis are the causes of PCOS， with depletion of essence and blood， and lack of nourishment of zang-fu （脏腑） organs as the root， and cold pathogen invasion， qi constraint and blood stasis as the branch. The main treatment principle is “treating deficiency with supplementation”， and dispelling pathogen while reinforcing healthy qi， along with “treatment of cold by warming” and “treatment of stagnation by dispersing”. This is of great significance for the treatment of polycystic ovary syndrome. Clinically， these methods can be used flexibly to guide treatment and formula selection for PCOS， with the goal of harmonizing qi and blood and regulating menstruation.
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Objective:To explore the diagnostic value of ultrasound elastography (UE) in patients with obese polycystic ovary syndrome (PCOS).Methods:A total of 86 PCOS patients diagnosed in the Second People′s Hospital of Beilun District, Ningbo City from June 2019 to April 2022 were selected as the study group, including 32 patients with body mass inde(BMI) ≥25 kg/m 2 (obese group) and 54 patients with BMI < 25 kg/m 2 (non-obese group). Another 40 women with healthy physical examination and matching age and BMI of the study group were selected as the normal control group. All of them underwent routine vaginal ultrasound and UE examination, and the differences of parameters in each group were compared. The receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic efficacy of relevant parameters for PCOS and obesity PCOS. Results:The number of follicles and ovarian volume in the study group were higher than those in the normal control group, and the PI and RI of ovarian interstitial artery were lower than those in the normal control group: (17.50 ± 3.23) unit vs. (8.15 ± 2.01) unit, (12.97 ± 3.20) ml vs. (5.36 ± 1.82) ml, 0.82 ± 0.14 vs. 0.93 ± 0.20, 0.52 ± 0.12 vs. 0.58 ± 0.10, there were statistical differences ( P<0.05). The number of follicles and ovarian volume in the obese group were significantly higher than those in the non-obese group: (18.98 ± 3.45) unit vs. (16.62 ± 3.17) unit, (15.00 ± 3.15) ml vs. (11.77 ± 2.63) ml, there were statistical differences ( P<0.05); but the PI and RI between the obese group and the non-obese group had no significant differences ( P>0.05). In the study group, 56 cases (65.12%) had type 1 elastic pattern, which was significantly higher than 4 cases (10.00%) in the normal control group ( χ2 = 17.61, P<0.01). The elastic pattern was no significant difference between the obese group and the non-obese group ( P>0.05). The elastic coefficient (B/A ratio) in the study group was higher than in the normal control group:7.86 ± 1.51 vs. 4.53 ± 1.10, there was statistical difference ( P<0.05). The B/A ratio in the obese group was higher than that in the non-obese group and the normal control group: 8.76 ± 1.35 vs. 7.32 ± 1.34, 4.53 ± 1.10, there were statistical differences ( P<0.05). The ROC curve analysis showed that the area under the curve (AUC) of B/A ratio for the diagnosis of PCOS was 0.962, when the cut-off value was 5.56, the corresponding sensitivity and specificity were 93.02% and 87.50%. The AUC of B/A ratio for the diagnosis of obese PCOS was 0.788, when the cut-off value was 8.35, the corresponding sensitivity and specificity were 78.12% and 85.19%. Conclusions:The UE has great diagnostic value for PCOS and certain discrimination performance for obese PCOS.
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Objective To investigate the role of PPARγ/GluT4 axis in insulin resistance(IR),cell proliferation and apoptosis of granulosa cells.Methods A total of 45 married women with PCOS who received routine IVF-ET assisted pregnancy treatment in Center of Reproductive Medicine,Qinghai Provincial People's Hospital were enrolled in this study from August 2018 to August 2020.All the patients were divided into IR group(PCOS-IR group,HOMA-IR≥2.57,n=23)and non-IR group(PCOS-NIR group,HOMA-IR<2.57,n=22)according to HOMA-IR.Meanwhile,21 married patients with infertility due to male or fallopian tube factors were enrolled as control group(Con).miR-27a mimics,miR-27a inhibitors(miR-27a inhibitor)and corresponding controls(mimics NC and inhibitor NC)transfected PCOS-IR granulosa cells,which were then divided into miR-27a mimics group,miR-27a inhibitor group,mimics-NC group and inhibitor-NC group.Double luciferase report test confirmed that miR-27a binded to PPARγ.Cell proliferation and apoptosis were detected by CCK-8 method and Annexinv-FITC/PI method.The expression of miR-27a,GluT4,PPARγ,Bax related to B lymphomas-2,Cleaved caspase-3 and B lymphomas-2(Bcl-2)were detected by RT-qPCR and Western blot respectively.Results Compared with Con group,the expression of miR-27a increased(P<0.01),while the expression of PPARγ mRNA and protein decreased in PCOS-NIR and PCOS-IR groups(P<0.01).Compared with PCOS-NIR group,the expression of miR-27a increased(P<0.05),while the expression of PPARγ mRNA and protein decreased in PCOS-IR group(P<0.01).The double luciferase report showed that there was a targeted binding site between PPARγ and miR-27a.Compared with inhibitor-NC group,the cell activity increased at 24 h,48 h,72 h and 96 h in miR-27a inhibitor group(P<0.05 or P<0.01),while the apoptosis rate decreased inmiR-27a inhibitor and mimics-NC group(P<0.05 or P<0.01).Compared with miR-27a inhibitor group,the apoptosis rate increased,and the cell activity decreased at 24,48,72 and 96 h in mimics-NC and miR-27a mimics groups(P<0.05 or P<0.01).Compared with the inhibitor-NC group,the expression of miR-27a,Bax and Cleaved caspase-3 increased(P<0.05 or P<0.01),while the expression of GluT4,PPARγ and Bcl-2 decreased in miR-27a mimics group(P<0.01).In miR-27a inhibitor group,the protein expressions of GluT4,PPARγ and Bcl-2 increased(P<0.05 or P<0.01),while miR-27a,Bax and Cleaved caspase-3 decreased(P<0.01).Compared with miR-27a inhibitor group,the expressions of miR-27a,Bax and Cleaved caspase-3 increased(P<0.01),while the expressions of GluT4,PPARγ and Bcl-2 decreased in mimics-NC and miR-27a mimics groups(P<0.05 or P<0.01).Conclusion The expression level of miRNA-27a is related to IR,cell proliferation,and apoptosis of granulosa cells,which may be related to PPARγ signal path.
ABSTRACT
Objective To investigate the serum Ectodysplasin A(EDA)levels in women with polycystic ovary syndrome(PCOS)and explore the correlation of EDA and insulin resistance(IR).Methods A total of 256 newly diagnosed PCOS patients in Guangzhou First People's Hospital from September 2020 to September 2022 were selected.Taking BMI=25 kg/m2 as the cut-off point,the patients with PCOS were divided into obese subgroup(n=143)and non-obese subgroup(n=113).Among them,43 PCOS received six months of Liraglutide intervention.123 healthy women were normal control group(NC),which were divided into healthy obese subgroup(n=10)and healthy non-obese subgroup(n=113).Serum EDA and related biochemical indexes were detected in both groups.The correlation between serum EDA and metabolic index were analyzed.Results The serum EDA level in PCOS group was higher than that in NC group[(272.59±68.52)vs(214.51±61.36)pg/ml,P<0.05].Serum EDA in obese subgroup was higher than that in no-obese subgroup in PCOS patients[(301.11±55.81)vs(236.84±66.25)pg/ml,P<0.01].After the intervention of Liraglutide,serum EDA in PCOS women markedly decreased[(294.71±57.81)vs(336.0±61.23)pg/ml,P<0.05].EDA levels were correlated positively with body mass index(BMI),waist hip ratio(WHR),fasting blood glucose(FPG),2 hPG,fasting insulin,2 hIns,homeostasis model assessment for insulin resistance(HOMA-IR),TC,LDL-C and testosterone.Multiple stepwise regression analysis showed that BMI and HOMA-IR were independent risk factors of serum EDA.Conclusion Serum EDA is elevated in PCOS patients,especially when combined with obesity,which may be related to IR.Liraglutide intervention can significantly reduce EDA levels in PCOS patients.