The impact of metformin treatment on adiponectin and resistin levels in women with polycystic ovary syndrome: a prospective clinical study.

Women with polycystic ovary syndrome (PCOS) are often characterized by adiposity and insulin resistance (IR). Recent studies in patients with obesity and diabetes mellitus type 2 (DMt2) indicate that adiponectin and resistin may play a role in the pathophysiology of IR. The aim of this study was to identify a possible correlation between the plasma levels of adiponectin and resistin and IR in patients with PCOS. Thirty-one women of reproductive age were enrolled in this prospective study after being diagnosed with PCOS and IR according to Rotterdam and American Diabetes Association (ADA) criteria, respectively. Every patient was treated with a daily dose of 1275 mg metformin for 6 months. Adiponectin, resistin, and the primary hormonal and metabolic parameters of the syndrome were evaluated at entry and endpoint of treatment. Adiponectin plasma levels were reduced after metformin treatment, but resistin levels were not significantly affected. Our study suggests that circulating levels of adiponectin should be evaluated with skepticism in patients with PCOS. The adipokine's role in the manifestation of IR in PCOS remains unclear and needs further investigation.

The prevalence of phenotypic subgroups in Greek women with polycystic ovarian syndrome.

BACKGROUND: Since 2003, when the American Society for Reproductive Medicine (ASRM) and European Society of Human Reproduction and Embryology (ESHRE) sponsored consensus established criteria for polycystic ovarian syndrome (PCOS) diagnosis, the phenotypic spectrum of the syndrome has been significantly broadened. PURPOSE OF THE STUDY: This survey makes an effort to distinguish PCOS according to phenotypic expression and to estimate its prevalence in a Greek population. MATERIALS AND METHODS: Greek women from 18 to 35 years of age, who visited the outpatient department, claiming either irregular menstruation (oligo- or anovulation, OA) or clinical manifestations of hyperandrogenemia (HA) were recruited. They gave full disease history and underwent clinical examination, including transvaginal ultrasound (TVUS) scan to identify PCO morphology. Blood samples were collected to perform hormonal and metabolic analyses. Acute or chronic disorders were excluded. Finally, 266 PCOS women constituted the study population. CONCLUSIONS: The full-blown phenotype (HA+OA+PCO) is the predominant phenotype in this Greek population.

Efficacy and safety of DT56a compared to hormone therapy in Greek post-menopausal women.

BACKGROUND: Hormone therapy (HT) is the treatment of choice for the alleviation of menopausal symptoms; concerns, however, about its concomitant long-term health risks have limited its use. DT56a is a unique enzymatic isolate of soybeans. The purpose of our study was to evaluate the efficacy and safety of DT56a, compared to HT, in symptomatic post-menopausal women. SUBJECTS AND METHODS: Eighty-nine post-menopausal women were studied prospectively. Women with climacteric symptoms were randomly assigned to receive eitherDT56a (no.=27) or oral low dose continuous combined HT (no.=26). Symptomatic women not wishing to receive any treatment served as controls (no.=36). Menopausal symptoms as assessed through the Kupperman index, serum lipids and lipoproteins, calcium, as well as bone mineral density (BMD), endometrial thickness, and mammography were assessed at baseline and at 12 months. RESULTS: Patients receiving HT and DT56a showed a significant and independent decrease in menopausal symptoms (mean difference in Kupperman score, DT56a group: -3.98, HT group -5.601, no treatment group +1.76, p-value <0.001). Lumbar spine BMD T-score was significantly lower in women receiving no treatment, as opposed to the two treatment arms which showed no significant change (No treatment, baseline: -0.60, final: -0.85, p=0.001; HT, baseline: -84, final -0.99, p=0.79; DT56a, baseline -0.51, final: -0.76, p=0.75). No differences in femoral bone density, ET or mammography classification were detected in any of the treatment arms. Likewise, serum lipids or lipoproteins did not differ between the three groups. CONCLUSIONS: DT56a decreased menopausal symptoms significantly and in the same degree as HT.

Comparing classic and newer phenotypes in Greek PCOS women: the prevalence of metabolic syndrome and their association with insulin resistance.

OBJECTIVE: Recently, it has been debated whether the new polycystic ovary syndrome (PCOS) phenotypes, according to the Rotterdam criteria, share the same metabolic risk with the classic ones (National Institutes of Health 1990). Our study sought to compare the prevalence of metabolic syndrome (MS) and glucose homeostasis disorders in Greek women with classic and new PCOS phenotypes. MATERIALS AND METHODS: Two hundred and sixty-six Greek PCOS women were recruited and divided into groups according to two of the three Rotterdam criteria that they fulfilled. Two subgroups were formed; the first represented the classic phenotypes and the second the new phenotypes. The clinical, biochemical, and ultrasound characteristics of both groups were explored. All subjects were evaluated for MS and underwent a 2-h glucose tolerance test to assess insulin resistance (IR) as measured by the homeostasis model assessment (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and MATSUDA indices. RESULTS: 62.4% of PCOS women were classified as classic NIH phenotypes of which 32 women had MS (prevalence 19.6%). Only 4 patients categorized in the newer phenotypic groups had MS (prevalence 4.1%). Among the subjects with classic phenotypes, 11.7% exhibited impaired glucose tolerance (3-fold higher percentage compared to patients with newer phenotypes). Regarding IR indices, HOMA-IR was significantly higher and QUICKI significantly lower for classic phenotypes. CONCLUSIONS: Greek PCOS women with classic phenotypes are at increased risk for MS and impaired glucose homeostasis compared to women with newer phenotypes. A subclassification of PCOS permits the earlier recognition and closer surveillance of women whose metabolic profile indicates potential risks for adverse health outcomes.

Hemodynamic alterations and wall properties in large arteries of young, normotensive, and non-obese women with polycystic ovary syndrome.

Young, normotensive, and non-obese women with polycystic ovary syndrome (PCOS) may present abnormal hemodynamic alterations (HA). The purpose of this study was to investigate heart rate (HR), intima-media thickness (IMT), and diameter (DCCA) in the common carotid arteries (CCA), flow velocities, and resistance index in both extracranial carotid and vertebral arteries (VA), in the abdominal aorta (AO) and in the renal arteries (RA) in PCOS women and matched controls. This was a case-control study conducted at a tertiary University Hospital. We studied 53 PCOS women and 53 healthy matched volunteers as controls. The previously reported parameters were assessed using color Doppler ultrasonography. HR, IMT in the CCA, and peak systolic velocity in all examined arteries were significantly increased in PCOS women compared to controls. On the contrary, DCCA was significantly decreased in PCOS women compared to controls. End diastolic velocity (EDV) in both VA and RA, in the AO and in the left extracranial carotid system was significantly increased in the PCOS group compared to controls. Furthermore, the peripheral resistance (PR) of AO and right external carotid artery was also found to be increased while in both RA and in left VA, PR was decreased. No further statistical significant HA in EDV and PR were noted. The results of this study provide evidence for a mild hyperdynamic circulation in young, normotensive, non-obese women with PCOS compared to controls, indicating a mild sympathetic activation at an early age, which may be an underlying cause of hypertension and cardiovascular risk.

Successful full-term pregnancies with assisted reproduction supported with prednisolone, acetylsalicylic acid and high progesterone doses in a lupus patient.

We present two rare cases of successful full-term pregnancies in a young woman suffering from lupus erythematosus for two years, who had subfertility problems and two missed abortions, before and after the diagnosis of lupus, with assisted reproduction. She received 10 mg of prednisolone daily from ovulation induction (with recombinant FSH--50 IU) until delivery, together with acetylsalicylic acid from ovulation induction until the 37th week of gestation and finally progesterone in high doses from the last insemination until the 12th week of gestation.