OBJECTIVE: Polycystic ovarian syndrome (PCOS) is a heterogenous dysfunctional endocrinologic disorder with unknown etiology, clinically characterized by obesity, chronic anovulation, masculinization and infertility. Recently, the association between polycystic ovarian syndrome and insulin resistance have been brought up and insulin resistance is one of the most important factor related to the development of obesity. However, not all polycystic ovarian syndrome patients are obese, it would give a clue to understanding pathophysiology of obesity and PCOS if insulin resistance could be classified according to the degree of obesity in PCOS. Thus, we performed this prospective study to know the relationship between insulin resistance and obesity in the patients with PCOS. METHODS: Fourty eight polycystic ovary patients were included at Samsung Cheil Hospital from April to October 2002. These patients were grouped according to obeseness. HOMA index was used to evaluate insulin resistance calculated by using fasting blood sugar and serum insulin level. RESULTS: Twenty patients (41%) were classified as obese group, twenty eight patients (59%) had normal body mass index. Increased insulin resistance was observed in the patients with polycystic ovarian syndrome. And it was significantly higher in the obese patients compared to the patients with normal body mass index (6.8+/-2.8 vs. 2.7+/-0.9, t-test, p<0.01). CONCLUSION: For increased insulin resistance, immediate management would be needed in the patients of polycystic ovarian syndrome, especially combined with obesity.
Anovulation ; Blood Glucose ; Body Mass Index ; Fasting ; Female ; Humans ; Infertility ; Insulin Resistance* ; Insulin* ; Obesity* ; Ovary ; Polycystic Ovary Syndrome* ; Prospective Studies

Anti-Müllerian hormone (AMH) is a member of the transforming growth factor (TGF)-beta superfamily and mainly expressed by the granulosa cells of ovarian follicles. In women AMH is only expressed in ovarian follicles and therefore can be used for the evaluation of the ovarian reserve function and the prediction of ovary ageing and ovarian response during in vitro fertilization (IVF) treatment. This article summarizes the clinical application of AMH, especially in evaluating ovarian reserve functions.
Anti-Mullerian Hormone ; blood ; Biomarkers ; blood ; Female ; Fertilization in Vitro ; Follicle Stimulating Hormone ; blood ; Humans ; Ovarian Follicle ; physiology ; Ovarian Hyperstimulation Syndrome ; prevention & control ; Ovary ; physiology ; Polycystic Ovary Syndrome ; blood

OBJECTIVETo explore the relationships of sex hormone and insulin with various TCM syndrome types of polycystic ovarian syndrome (PCOS) and their significance.

METHODSLevels of testosterone (T), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E2), and insulin (INS) in 120 patients with PCOS were determined respectively, among them, 30 patients were classified by TCM syndrome differentiation as Shen-yin deficiency type (SYiD), 30 as Shen-yang deficiency type (SYaD), 30 as Pi-yang deficiency type (PYD) and 30 as Gan-stagnancy transformed heat type (GSH).

RESULTSIt was shown that T level in SYiD, serum LH and LH/FSH ratio in SYaD, PRL in GSH and INS in PYD patients were higher as compared with those in patients of other three types (P < 0.05 or P < 0.01), except for the above-mentioned, the differences in all the paired comparisons of all the indexes between TCM types were insignificant.

CONCLUSIONElevated level of T, LH and LH/FSH ratio, PRL and INS are correlated with the TCM syndrome type of SYiD, SYaD, GSH and PYD in patients with PCOS respectively, and being the clinical characteristics of the corresponding syndromes.

Adult ; Diagnosis, Differential ; Female ; Follicle Stimulating Hormone ; blood ; Humans ; Insulin ; blood ; Luteinizing Hormone ; blood ; Medicine, Chinese Traditional ; Polycystic Ovary Syndrome ; blood ; diagnosis ; Prolactin ; blood ; Syndrome ; Testosterone ; blood

OBJECTIVETo observe the effect of sequential method of nourishing yin and tonifying yang on serum sex hormone levels in rats with polycystic ovary syndrome (PCOS), and to explore its possible mechanisms.

METHODSPCOS rat models were established by injecting dehydroepiandrosteron (DHEA) subcutaneously. A total of 70 21-day female SD rats were randomly divided into seven groups, ten in each group: the normal control, the model control, the yin nourishing, the yang tonifying, the sequential method, the Westem medicine, and the combined medication. Rats in all groups were treated by gastrogavage for twelve successive days. Serum testosterone (T) and estradiol (E2) were detected by chemoluminescence method. Serum androstenedione (A), follicle stimulating hormone (FSH), luteinizing hormone (LH), insulin (INS), and insulin-like growth factor-I (IGF-I) were detected by radioimmunoassay (RIA).

RESULTSSerum levels of A, T, and E2 were significantly higher in the model control group than in the normal control group (P < 0.05, P < 0.01). Serum levels of A and T were obviously lower in the sequential group than in the model control group with significant difference (P < 0.01). The serum E2 level was obviously lower in the sequential group than in the model control group (P < 0.05). Serum levels of INS and IGF-I were significantly higher in the model control group than in the normal control group (P < 0.05). Serum levels of INS and IGF-I were significantly lower in the sequential group than in the model control group (P < 0.01).

CONCLUSIONSThe sequential method of nourishing yin and tonifying yang can lower serum levels of A, T, E2, INS, and IGF-I, and reverse its endocrine disturbance in PCOS rats. One of its mechanisms in decreasing serum levels of A, T, E2 might be possibly through lowering serum levels of INS and IGF-I.

Animals ; Female ; Gonadal Steroid Hormones ; blood ; Medicine, Chinese Traditional ; methods ; Polycystic Ovary Syndrome ; blood ; therapy ; Rats ; Rats, Sprague-Dawley

It is the intent of this investigation to gain an insight into the relationship of serum total adiponectin with polycystic ovary syndrome (PCOS) and insulin resistance. Fifty-eight PCOS patients were enrolled (29 with high serum insulin level and 29 without), at the same time, 29 non-PCOS women with normal weight were included as control. The influencing factors of total adiponectin, PCOS and insulin resistance were analyzed. The serum total adiponectin of PCOS patients and all participants were found to be negatively related to waist hip ratio (r = -0.39, r = -0.36) and InHOMA-IR (r = -0.53, r = -0.45), respectively. Adiponectin was not a protective factor of PCOS (P > 0.1), but it was that of PCOS-insulin resistance (OR = 0.81; 95% CI: 0.67-0.97; P = 0.02). LH/FSH (OR = 1.51; 95% CI: 1.16-1.96; P = 0.01) and InHOMA-IR (OR = 1.26; 95% CI: 1.10-1.44; P = 0.01) were risk factors of PCOS, and waist hip ratio was that of PCOS-insulin resistance (OR = 8.57; 95% CI, 2.14-34.30, P = 0.01). Adiponectin might influence fasting insulin and InHOMA-IR (B = -0.22, P = 0.001; B = -0.02, P = 0.002). These data signify that adiponectin is not directly related with PCOS, but it is related with PCOS-HL Adiponectin might participate in the pathophysiologic mechanism of PCOS by influencing insulin sensitivity.
Adiponectin ; blood ; Adult ; Female ; Humans ; Insulin Resistance ; physiology ; Polycystic Ovary Syndrome ; blood ; physiopathology ; Waist-Hip Ratio ; Young Adult

OBJECTIVES: The purpose of this study was to determine whether women with PCOS have greater subclinical atherosclerosis and evaluate the relationship to risk factors for atherosclerosis. METHODS: Women with PCOS(n=24) and age and body mass index(BMI)-matched cycling women(n=16) as control group underwent carotid scanning for the measurement of the IMT. We compared IMT and plaque between cases and controls, assessed some risk factors for atherosclerosis, and analyzed factors affecting IMT. RESULTS: There was no difference between the groups in waist-hip ratio(WHR) and in the levels of total cholesterol, triglyceride(TG), LDL, Lp(a), fibrinogen, homocystein, plasminogen activator inhibitor 1. However, HDL was significantly lower, and systolic and diastolic blood pressure, fasting blood sugar or insulin concentration and IMT was significantly higher in PCOS group than control group (51.1+/-11.6 vs 60.4+/- 10.0mg/dl, 119.4+/-12.5 vs 109.0+/-11.6mmHg, 79.1+/-11.1 vs 68.9+/-7.8mmHg, 93.6+/-11.1 vs 85.0+/-5.9 mg/dl, 8.9+/-5.2 vs 5.0+/-3.3milliunit/ml, 0.57+/-0.12 vs 0.49+/-0.11mm respectively, all p<.05). In the analysis of correlation between the IMT and clinical characteristics, PCOS status, BMI, systolic and diastolic blood pressure, fasting blood sugar or insulin concentration, TG, HDL, fibrinogen were significantly independent variables (Coefficients of correlation were 0.358, 0.461, 0.452, 0.349, 0.405, 0.466, 0.478, -0.433, 0.349 respectively, all p<.05). The factors affecting IMT by multivariate regression were PCOS status and fasting insulin concentration. CONCLUSIONS: We concluded that women with PCOS might have an increased risk of subclinical atherosclerosis and insulin resistance was assumed to be the main risk factor of atherosclerosis.
Atherosclerosis* ; Blood Glucose ; Blood Pressure ; Cholesterol ; Fasting ; Female ; Fibrinogen ; Humans ; Insulin Resistance* ; Insulin* ; Ovary* ; Plasminogen Activator Inhibitor 1 ; Polycystic Ovary Syndrome ; Risk Factors

BACKGROUND/AIMS: Serum levels of highly sensitive C-reactive protein (hsCRP), a vascular inflammatory marker, may predict the development of cardiovascular disease (CVD) and type 2 diabetes. Women with polycystic ovary syndrome (PCOS) are at greater risk for type 2 diabetes and CVD. The aim of this study was to compare hsCRP levels between normal weight women with PCOS and controls with a normal menstrual cycle and to determine the factors associated with serum hsCRP levels. METHODS: Thirty-nine lean PCOS patients and 24 healthy, regular cycling women were enrolled in this study. We performed anthropometric measurements, fat computed tomography (CT), and blood sampling to determine blood chemistry and levels of hsCRP, gonadotropins, testosterone, and sex-hormone binding globulin. We also conducted 75-g oral glucose-tolerance test and euglycemic hyperinsulinemic clamp to assess insulin sensitivity. RESULTS: Serum hsCRP concentrations were higher in women with PCOS than in women with regular mensturation. However, this difference was no longer significant after adjusting for body mass index (BMI). hsCRP levels were correlated with waist circumference (r=0.46, p<0.01), BMI (r=0.46, p<0.01), visceral fat area (r=0.45, p<0.01), and systolic (r=0.42, p<0.05) and diastolic blood pressure (r=0.39, p<0.05). hsCRP also tended to be negatively associated with insulin-mediated glucose uptake (IMGU) (r=-0.31, p=0.07). A multiple regression analysis revealed that BMI (beta=0.29, p<0.05), systolic blood pressure (beta=0.39, p<0.01), and IMGU (beta=-0.31, p<0.05) predicted serum hsCRP levels in women with PCOS. CONCLUSIONS: PCOS by itself does not seem to be associated with increased hsCRP levels, whereas known CVD risk factors affect serum hsCRP levels in PCOS.
Adult ; Body Mass Index ; C-Reactive Protein/*analysis ; Cardiovascular Diseases/etiology ; Female ; Humans ; Polycystic Ovary Syndrome/*blood/complications ; Regression Analysis

OBJECTIVETo establish a rat model of polycystic ovarian syndrome accompanied with insulin resistance (PCOS-IR), and to observe the effects of Bushen Tongmai Recipe (BSTMR) on insulin resistance and ovulation dysfunction in the model.

METHODSSodium prasterone sulfate at the daily dose of 9 mg/100 g was subcutaneously injected to female SD rats, 23-day old, for 20 days, and fed with high-fat forage for 80 days to establish the rat model of PCOS-IR. The model rats were randomized into the model group and the treated group administered with BSTMR. Besides, a group consisted of 15 healthy rats was set up as a normal control. Ovarian histological changes and ovulation condition in rats were examined with hematoxylin and eosin (HE) staining; fasting blood glucose (FBG) was determined by glucose oxidase method; serum levels of fasting insulin (FINS), serum testosterone (T), estradiol (E2), progesterone (P), follicle stimulating hormone (FSH) and luteotrophic hormone (LH) were detected by radioimmunoassay (RIA).

RESULTSCompared with the normal group, in the model group, the mean number of corpus luteum, ovulation rate, FSH level and insulin sensitive index (ISI) were lower significantly (P <0.01), and levels of FBG, FINS, T, E2 and LH were higher (P<0.05, P <0.01). Compared with the model group, in the treated group, the mean number of corpus luteum, ovulation rate, levels of FSH and ISI were higher, and levels of FINS, T and E, were lower (all P <0.01).

CONCLUSIONRat model of PCOS-IR could be established by sodium prasterone sulfate and high-fat forage, and the insulin resistance and ovulation dysfunction in the model rats could be improved by BSTMR.

Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Female ; Insulin ; blood ; Insulin Resistance ; Ovulation ; Polycystic Ovary Syndrome ; metabolism ; physiopathology ; Rats

OBJECTIVE: To observe the effect of acupuncture on vascular endothelial function in patients of polycystic ovary syndrome (PCOS) with impaired glucose tolerance (IGT) and normal glucose tolerance (NGT). METHODS: A total of 140 patients with PCOS were divided into an IGT group (70 cases, 11 dropped off) and a NGT group (70 cases, 9 cases dropped off). The patients in the two groups were treated with full-cycle acupuncture at Zhongwan (CV 12), Guanyuan (CV 4), Qihai (CV 6), Tianshu (ST 25), etc. once every other day, 3 times a week, for 3 months. Before and after treatment, TCM symptom score, insulin resistance index [including fasting plasma glucose (FPG), 2-hour blood glucose (2hPG), fasting serum insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR)] and vascular endothelial related factors [including asymmetric dimethylarginine (ADMD), endothelin-1 (ET-1), malondialdehyde (MDA), nitric oxide (NO)] were compared between the two groups; in addition, the obese subgroup and non-obese subgroup of the two groups were further compared. RESULTS: Compared before treatment, the TCM symptom scores, ADMD, ET-1 and MDA after treatment were decreased ( CONCLUSION Acupuncture could improve vascular endothelial function in PCOS patients, IGT patients have better efficacy than NGT patients, and obese patients have better efficacy than non-obese patients.
Acupuncture Therapy ; Blood Glucose ; Female ; Glucose ; Glucose Intolerance/therapy* ; Humans ; Insulin ; Insulin Resistance ; Polycystic Ovary Syndrome/therapy*

OBJECTIVETo observe the effect and mechanism of acupuncture on infertility of rats with polycystic ovarian syndrome (PCOS).

METHODSPCOS rat model was induced by subcutaneous injection of oil solution of dehydroepiandrosterone (DHEA) in immature (24-day-old) female rats for continuous 20 days. Rats for control were given with same dose of oil for instead. PCOS rats were randomly divided into the model group untreated and the acupuncture group treated by needling acupoints of Guanyuan (CV4), Zhongji (CV3), Sanyin-jiao (SP6) and Zigong (CX-CA1), 15 min once a day for 5 continuous days, starting from the 80th day after birth. All rats were sacrificed at terminal of the treatment, their uterus and bilateral ovaries were dissected for observation and blood levels of sex hormones were measured.

RESULTScompared with the model group, the number of implanted blastocyte and blastocyte implantation rate were higher and the blood levels of testosterone (T) and estradiol (E2) were lower in the acupuncture group (P < 0.05); but the difference between groups in serum levels of follicular stimulating hormone, luteinizing hormone and progesterone were of statistical insignificance (P > 0.05). Moreover, the wet weight of ovary was lower and the equipotent diameter and area of glandular organ and cavity, area ratio of gland and the stroma, and mean thickness of endometria were higher in the acupuncture group than those in the control group (P < 0.05).

CONCLUSIONAcupuncture can conspicuously downregulate the expressions of serum levels of T and E2, improve the development of ovaries and uterus, promote ovulation, enhance endometrial receptivity, and advance blastocyte implantation.

Acupuncture Therapy ; Animals ; Estradiol ; blood ; Female ; Infertility, Female ; blood ; therapy ; Polycystic Ovary Syndrome ; blood ; therapy ; Rats ; Rats, Sprague-Dawley ; Testosterone ; blood