Role of C type natriuretic peptide in polycystic ovary syndrome

OBJECTIVE

To evaluate serum C-type natriuretic peptide (CNP) and androgen concentrations in women with polycystic ovary syndrome (PCOS), and compare them with the healthy group.

METHODS

The present study was carried out prospectively at the Near East University Hospital, between July 15, 2019 and September 1, 2020. Out of the 90 patients aged between 18 and 40 years old who were enrolled, the final study population consisted of 36 patients with PCOS and 30 healthy women.

RESULTS

Body mass index, free androgen index, serum androstenedione, total testosterone, free testosterone, and CNP were significantly higher and serum sex-hormone-binding globulin level was lower in the PCOS group.

CONCLUSION

We revealed that serum CNP levels are high in PCOS patients. The mechanism of the relationship between this increase and hyperandrogenism or anovulation is not known, but these findings provide a direction for new studies.

CLINICALTRIALS

GOV: NCT04006171.

Comparison of stromal thickness and doppler findings in polycystic ovary syndrome and healthy women with ultrasonographic evidence of polycystic ovaries? A cross-sectional study

The purpose of the study was to compare the ovarian stromal blood flow and stromal thickness (ST) of polycystic ovary syndrome (PCOS) patients, with healthy women with polycystic ovarian morphology (PCOM) and normal ovarian morphology (NOM). A total of 220 participants were recruited and the three study groups were determined by diagnostic criteria (PCOS n = 106, PCOM n = 68, NOM n = 46). Clinical, hormonal and ultrasonographic measurements of ovaries were assessed and compared. PCOS patients showed statistically higher androgen levels, insulin resistance, hirsutism score, ovarian ST and stromal blood flow compared to PCOM and NOM. The correlation between free androgen index (FAI) and ST was measured. FAI was significantly highly correlated with left ovarian ST (0.83; p < .001) and right ovarian ST (0.83; p < .001). According to the results of this study, the ovarian ST which can be considered as ultrasonographic indicator of FAI, can be used in PCOS diagnosis. Also, it can be suggested that there is no statistically significant difference in ovarian ST and doppler findings between healthy women with PCOM or NOM. ROC analysis was used to measure diagnostic utility of ST. Impact StatementWhat is already known on this subject? Although it is known that ovarian stromal blood flows and stromal thickness are increased in PCOS disease compared to healthy women, they are not included in the diagnostic criteria.What the results of this study add? In the results of this study, it was determined that ovarian stromal blood flow and stromal thickness were increased in PCOS patients, as previously reported in the literature. In addition, these ultrasound measurements were found to be increased in PCOS patients compared to healthy women with PCO morphology, and stromal thickness measurements were strongly correlated with the free androgen index in PCOS patients.What the implications are of these findings for clinical practice and/or further research? Ovarian ST and/or S/A ratio may be an ultrasonograpic indicator of FAI, and may be used in PCOS diagnostic criterias. In the future, it can be revealed whether they vary in patients with different components of the syndrome, by examining these parameters in different PCOS phenotypes.

The importance of inflammation markers in polycystic ovary syndrome

OBJECTIVE

This study aimed to examine inflammation markers in patients with polycystic ovary syndrome (PCOS) and to compare them with healthy women.

METHODS

This prospective study was conducted by examining patients who applied to the Near East University Gynecology and Obstetrics Outpatient Clinic between January 2019 and January 2020. A total of 110 PCOS patients with 135 control groups were compared in terms of metabolism, hormonal factors, and inflammation markers.

RESULTS

The neutrophil count, neutrophil-lymphocyte ratio (NLR), platelet, platelet-lymphocyte ratio (PLR), platelecrit (PCT), erythrocyte cell distribution width, platelet distribution width, mean platelet volume, and C-reactive protein (CRP) values were found to be statistically significantly higher in patients with PCOS. There was a positive correlation between inflammation markers and serum androgens. Also, a positive correlation was observed between inflammation markers and cardiovascular risk parameters. In receiver operating characteristic curve analysis, the most valuable parameter in distinguishing PCOS patients from healthy controls was serum CRP levels [areas under the curve (AUC)=0.928, 95%CI 0.894-0.963, p<0.001, 92.6% sensitivity, and 82.7% specificity].

CONCLUSIONS

Serum CRP, neutrophil count, and PCT and NLR levels are valuable markers that show the inflammatory process in PCOS patients.

Smoking reduces ovarian stromal blood flow in polycystic ovary syndrome patients

OBJECTIVES

The objective of the current research is to compare hormonal, metabolic and ovarian stromal blood flow outcomes in smoking versus non-smoking polycystic ovary syndrome (PCOS) patients.

MATERIAL AND METHODS

79 PCOS women (Group 1) and 79 healthy subjects (Group 2) were recruited. Both groups were subdivided according to their smoking habits. Ovarian stromal blood flow was assessed with pulsatility and resistance index for both ovaries and compared among smoking women.

RESULTS

The smokers in the PCOS group had statistically significant higher levels of pulsatility and resistance index in both ovaries compared to nonsmoker PCOS patients (p < 0.001). Comparison of ovarian stromal blood flow indexes shows that pulsatility and resistance index for both ovaries is statistically significantly high in smoking healthy patients compared to the nonsmoking group (p < 0.001). There is a positive correlation between smoking and free androgen index (r = 0.866, p < 0.001) for PCOS patients and healthy women.

CONCLUSIONS

Smoking reduces ovarian blood flow in PCOS patients and healthy subjects. Smoke components effect the vascular structure and form endothelial injuries that may reduce ovarian tissue perfusion. In this study, the positive correlation between smoking and free androgen index shows that the main effect of smoking on ovarian blood flow may be through androgen metabolism.

The effect of myoinositol on ovarian blood flows in women with polycystic ovary syndrome

To evaluate whether 4 gram myoinositol and 400 mcg folic acid(MYO) therapy has any effects on ovarian stromal blood flow by using pulsed and color Doppler at 3 months follow-up period in polycystic ovary syndrome (PCOS). One-hundred eighty patients were designed into six groups; Group 1: PCOS patients that received OCP containing 30 mcg ethinyl estradiol (EE) plus 3 mg drospirenone (DRP); Group 2: PCOS patients that received MYO; Group 3: PCOS patients that received no medication. Group 4: Healthy patients that received OCP; Group 5: Healthy patients that received MYO; Group 6: Healthy patients that received no medication. Resistance index (RI) and pulsatility index (PI) of both ovaries were assessed. There was a significant increase in RI and PI of both ovarian stromal blood flow women with PCOS who received OCP (Group 1, p < .001) and MYO (Group 2, p < .001). The rate of increment in both RI and PI values were similar for OCP users (Group 1) and MYO users(Group2) in PCOS patients. MYO therapy reduced ovarian vascularization in both PCOS and healthy users after 3 months and this decrease is especially noticeable in women with PCOS compared to healthy women. OCP therapy also reduced ovarian vascularization just like MYO therapy.

Myo-inositol administration positively effects ovulation induction and intrauterine insemination in patients with polycystic ovary syndrome: a prospective, controlled, randomized trial

Objectıve: The aim of the study is to investigate the effect of myo-inositol (MYO) on pregnancy rates of patients diagnosed with polycystic ovary syndrome (PCOS) who undergone controlled ovulation induction and intrauterine insemination (IUI).

METHODS

A total of 196 infertile patients diagnosed with PCOS and admitted to Dokuz Eylul University Faculty of Medicine were included in the study between March 2013 and May 2016. The patients in group 1 (n = 98) were given 4 g MYO and 400 μg folic acid before and during ovulation induction. The patients undergone controlled ovarian hyperstimulation (COH) with recombinant FSH and IUI. The patients in group 2 (n = 98), were given recombinant FSH directly and 400 μg folic acid. The primary outcome measure of this study was the clinical pregnancy rate.

RESULTS

In group 1, 9 patients conceived spontaneous pregnancy. During COH + IUI treatment three cycles were canceled in group 1 and 8 cycles in group 2. Total rFSH dose and cycle duration were significantly lower and clinical pregnancy rates were higher in group 1. The pregnancy rate for group 1 was %18.6 and for group 2 was %12.2. Conclusıons: This study shows that MYO should be considered in the treatment of infertile PCOS patients. MYO administration increases clinical pregnancy rates, lowers total rFSH dose and the duration of the ovulation induction.