Insulin-like growth factor (IGF) system and hormonal-metabolic profile in women with polycystic ovary syndrome.

AIM of the study was to compare serum levels of IGF-1, IGF-2 and insulin­like growth factor­binding protein 3 (IGFBP-3) among non­obese and obese PCOS women, and to assess their relationship to metabolic and hormonal parameters.    METHODS: The study included 64 women diagnosed with PCOS (age 28.9 ± 5 years); 30 of them with BMI > 27 and 34 with BMI lower than 27. All subjects were examined for parameters of glucose and lipid metabolism, steroid hormones and serum IGF-1, IGF-2 and IGFBP-3 levels. RESULTS: No significant differences in serum IGFBP-3 (p=0.534), IGF-1 (p=0.29) and IGF-2 (p=0.56) between two groups have been detected. IGFBP-3 was in positive correlation with total cholesterol (p=0.026), LDL cholesterol (p=0.03) and triacylglycerols (p=0.022). IGF-1 were negatively correlated with insulin (p=0.022), HOMA IR (p=0.033), triacylglycerols (p=0.0196) and waist circumference (p=0.049). A positive correlation was detected between IGF-1 and HDL cholesterol (p=0.025). No significant relationship was observed between IGF-1 and steroid hormones. CONCLUSION: Serum levels of IGF-1, IGF-2 and IGFBP-3 in obese PCOS women do not differ from those detected in non­obese PCOS women. IGF-1 negatively correlated with metabolic parameters, indicating that lower IGF-1 may represent an important predictor of metabolic syndrome (MS) in PCOS women. All peptides seem to have little effect on ovarian steroidogenesis in PCOS (Tab. 1, Fig. 1, Ref. 30).

Is Apelin a new biomarker in patients with polycystic ovary syndrome?

Polycystic ovary syndrome (PCOS) is associated with multiple risk factors for cardiovascular diseases, including insulin resistance, diabetes mellitus type 2, obesity, hypertension, and dyslipidaemia. Many studies have assessed the role of adipokines in the etiopathogenesis of PCOS, however, no single biomarker has been recognized to be in causal relation to the syndrome. Apelin has been identified as a new adipokine linked to obesity and insulin resistance. Some studies demonstrated that the apelin / apelin receptor could play a pivotal role in the pathogenesis of polycystic ovary syndrome, however the other yielded controversial results. Underlying mechanisms of possible involvement of apelin/apelin receptor complex are discussed.

Relationship between steroid hormones and metabolic profile in women with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is commonly associated with a higher cardiometabolic risk. The relationship between steroid hormones and cardiometabolic profile in PCOS has been evaluated, but no single hormonal predictor of this association has been identified to determine. To determine the relationship between steroid hormones and cardiometabolic risk factors in PCOS women. Study included 64 women diagnosed with PCOS. Fasting blood samples were analyzed for biochemical, metabolic parameters and sex steroid hormones. PCOS women with BMI>/-27 had significantly higher serum free testosterone (FT), free androgen index (FAI), estrone (E1) (p=0.014, p=0.02, p=0.01) than those with normal weight. In all subjects E1 positively correlated with BMI (p=0.0067), serum insulin (p=0.0046), HOMA-IR (p=0.0125) and negatively with HDL-cholesterol (p=0.009). FAI positively correlated with serum cholesterol (p=0.0457), triacylglycerols (TAG) (p=0.0001), HOMA-IR (p=0.037), and glycemia (p=0.0001), negatively with HDL-cholesterol (p=0.029). In multiple linear regression model E1 most significantly predicted HOMA-IR, whereas FT/FAI predicted HDL-cholesterol and BMI. We conclude that PCOS women with marked overweight or obesity have higher FT, FAI and E1 as compared with nonobese PCOS subjects. E1 and FT may predict worse cardiometabolic profile in PCOS.

The effect of alfacalcidiol and metformin on phenotype manifestations in women with polycystic ovary syndrome - a preliminary study.

Aim of this study was to evaluate the effect of vitamin D supplementation in obese, insulin resistant and vitamin D deficient PCOS women on biochemical and clinical hyperandrogenism and menstrual irregularity in comparison to effect of metformin or combined metformin plus vitamin D therapy. Thirty nine PCOS women were randomized into three groups and treated with alfacalcidiol (Group 1), combined alfacalcidiol and metformin therapy (Group 2) and metformin (Group 3) for 6 months. Serum TST, fTST, DHEAS, LH and LH/FSH were measured before and after six months of treatment. Menstrual cycle regularity, hirsutism, acne and pregnancy rate were assessed at the same time. There was a significant decrease in TST levels in the Group 2 and slight but not significant decrease in the Group 3. No significant changes in other parameters (fTST, DHEAS, LH, LH/FSH) have been found after 6 months therapy in all three groups. An improvement of menstrual cycle was detected in 78 % of patients in Group 1 (p<0.04), 80 % in the Group 2 (p<0.03) and in 90 % in the Group 3 (p<0.002), respectively. There was no significant improvement of acne and hirsutism in all three groups (all p not significant). Pregnancy rate was higher in the Group 3 as compared with Groups 1 and 2 (67 % vs. 0 % and 25 %, respectively), however without statistical significance. Vitamin D administration has no significant effect on androgen levels and clinical features of hyperandrogenism in obese vitamin D deficient PCOS women. However, it can potentiate effect of metformin on testosterone levels and LH/FSH ratio but not on clinical hyperandrogenism and pregnancy rate.

[Is polycystic ovary syndrome associated with autoimmune thyroiditis?]. / Je syndróm polycystických ovárií asociovaný s autoimunitnou tyreoiditídou?

INTRODUCTION: Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women of fertile age and lately there is a discussion about its possible association with autoimmune diseases. The aim of the study was to examine incidence of autoimmune thyreoiditis (AIT) in PCOS women. PATIENTS AND METHODS: 64 PCOS patients were enrolled and 68 healthy menstruating women served as controls. All subjects were examined for thyrotropin (TSH), free thyroxin (fT4) and the presence as well as titers of antithyroid antibodies aTG (anti-thyreoglobulin) and aTPO (anti-thyreoperoxidase). RESULTS: There was no difference between PCOS and controls in average TSH levels (2.37 ± 1.46 mIU/l vs 2.37 ± 1.46 mIU/l) (p = 0.953), and fT4 levels (16.36 ± 5.34 pmol/l vs 16.49 ± 2.32 pmol/l) (p = 0.852). Autoantibodies titers were also non-significant aTG (53.09 ± 157.07 IU/ml vs 29.8 ± 100.77 IU/ml, p = 0.386) and aTPO (59.74 ± 149.03 IU/ml vs 45 ± 204.77 IU/ml, p = 0.805). However, PCOS women had significantly higher prevalence of aTPO (18.75 vs 7.35%, p = 0.045). On the other hand, the overall prevalence of AIT was similar in both groups. CONCLUSION: Our results show PCOS patients have slightly but significantly higher positivity of aTPO antibodies but the prevalence of AIT was insignificant.