Impaired Respiratory Function in Women With PCOS Compared With Matched Controls From a Population-Based Study.

CONTEXT: Increased prevalence of asthma has been reported from epidemiological studies in women with polycystic ovary syndrome (PCOS). OBJECTIVE: To investigate respiratory function in women with PCOS compared with controls in a clinical setting. DESIGN: An 8-year clinical follow-up study including self-reported asthma diagnoses and spirometry of women with PCOS randomized to metformin or placebo during pregnancy in the original studies (the Pilot and the PregMet-study), compared with matched controls from a population-based cohort study (The HUNT Study). SETTING: Secondary and tertiary care centers. PARTICIPANTS: A total of 145 women with PCOS (54% of original cohort) were matched 1:3 to controls, on gender, age, and smoking-status. MAIN OUTCOMES AND MEASURES: Self-reported doctor-diagnosed asthma (DDA), percentage of predicted forced expiratory volume in the first second of expiration (FEV1 % predicted), percentage of predicted forced vital capacity (FVC % predicted). RESULTS: Women with PCOS reported more DDA compared with controls (19% vs 9%; P < 0.01). Spirometry indicated a combined obstructive (FEV1 % predicted, 93.7 vs 102.0; P < 0.01) and restrictive (FVC % predicted, 94.5 vs 103.7; P < 0.01) respiratory impairment in PCOS compared with controls. Metformin in pregnancy did not affect respiratory function at follow-up. CONCLUSION: Women with PCOS reported higher prevalence of DDA compared with controls matched for age and smoking status. In addition, respiratory function was decreased, with both obstructive and restrictive components. Further insight to the underlying pathogenesis of these observations is needed. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov: The PregMet study: NCT00159536. The Pilot study: NCT03259919.

Prolactin and breast increase during pregnancy in PCOS: linked to long-term metabolic health?

Objective To explore whether gestational prolactin and breast increase are markers of metabolic health in pregnancy and on long-term, in PCOS. Design Follow-up study. Women with PCOS, according to the Rotterdam criteria (n = 239), former participants of the randomized controlled trial (RCT) PregMet were invited, 131 participated in the current follow-up study, at mean 8 years after pregnancy. Methods Metformin 2000 mg/day or placebo from first trimester to delivery in the original RCT. No intervention in the current study. Prolactin was analyzed in the first trimester and at gestational week 32 and metabolic characteristics which are part of the metabolic syndrome and measures of glucose homeostasis were examined. Metabolic health was also evaluated according to breast increase versus lack of breast increase during pregnancy. Results Prolactin increase in pregnancy was negatively correlated to BMI (P = 0.007) and systolic blood pressure (P ≤ 0.001) in gestational week 32. Prolactin at gestational week 32 was negatively correlated to BMI (P = 0.044) and visceral fat area (P = 0.028) at 8-year follow-up in an unadjusted model. Prolactin at gestational week 32 showed no associations to metabolic health at follow-up when baseline BMI was adjusted for. Women who reported lack of breast increase during pregnancy, had higher BMI (P = 0.034), waist-hip ratio (P = 0.004), visceral fat area (P = 0.050), total cholesterol (P = 0.022), systolic (P = 0.027) and diastolic blood pressure (P = 0.011) at 8-year follow-up. Conclusion High prolactin levels and breast increase in pregnancy were associated with a more favorable long-term metabolic health in women with PCOS. Both prolactin and breast increase may be mediated by gestational BMI.

Does Metformin Treatment During Pregnancy Modify the Future Metabolic Profile in Women With PCOS?

Context: Worldwide, metformin is prescribed to improve pregnancy outcome in polycystic ovary syndrome (PCOS). Metformin may also benefit future health by modulating increased metabolic stress during pregnancy. Objective: To investigate whether metformin during pregnancy modified future metabolic health in women with PCOS. Design: Follow-up study of a randomized controlled trial that compared metformin with placebo in women with PCOS. Mean follow-up period was 7.7 years (range, 5 to 11 years). Setting: Three university hospitals, seven local hospitals, and one gynecological specialist practice. Participants: Women with PCOS according to Rotterdam criteria; all former participants in the Metformin in Pregnant PCOS Women Study. Intervention: Metformin 2000 mg daily or placebo from first trimester to delivery in the original study. No intervention in the present follow-up study. Main Outcomes and Measures: Main outcome measure was weight gain in the follow-up period. Weight, body mass index (BMI), waist and hip circumferences, and blood pressure (BP) were registered. Body composition was assessed by bioelectrical impedance analysis, and fasting lipids, glucose, and insulin were analyzed. Results: Of 239 invited women, 131 (55%) participated in the follow-up. Weight gain was similar in women given metformin (2.1 ± 10.5 kg) and women given placebo (1.8 ± 11.2 kg) at 7.7 years' follow-up after pregnancy (P = 0.834). No difference was found in BMI, waist/hip ratio, BP, body composition, lipids, glucose and insulin levels, or prevalence of metabolic syndrome at follow-up between those treated with metformin and those treated with placebo during pregnancy. Conclusion: Metformin treatment during pregnancy did not influence the metabolic profile in women with PCOS at 7.7 years of follow-up.

Minor diurnal and activity-induced variations in daytime peripheral blood platelet counts do not have any major impact on platelet yield by platelet apheresis.

Physical activity alters systemic levels of several angioregulatory cytokines that affect microvascular endothelial cells and can be assumed to influence vascular permeability. This may alter platelet release to the bone marrow microcirculation and thereby the levels of circulating platelets. We investigated effects of physical activity on angioregulatory chemokines (CXCL8, 9, 10 and 11) and peripheral blood platelet counts before and after intensive physical activity in young adults, and also compared platelet yields obtained by platelet apheresis performed in the morning and in the afternoon in 20 healthy donors. Physical activity increased serum CXCL10 levels and platelet counts but did not alter the other chemokine concentrations. In the apheresis donors, there was only a minor increase in platelet counts during the day, and the platelet yields did not differ significantly between platelet concentrates collected early in the morning and late in the afternoon. In conclusion, minor intra-individual variations in platelet counts do not seem to have major influence on platelet yields by platelet apheresis.