OBJECTIVE: To evaluate the relationship between serum gonadotropin level and parameters related to insulin resistance in Korean women with polycystic ovary syndrome (PCOS). METHODS: This retrospective study included 138 women aged 18 to 35 years who were newly diagnosed with PCOS according to the Rotterdam consensus. Participants were divided into three groups based on the serum luteinizing hormone to follicle-stimulating hormone (LH/FSH) ratio in the early follicular phase: group 1 (LH/FSH <1), group 2 (1.0≤ LH/FSH >2.0), and group 3 (LH/FSH ≥2.0). The correlations between the LH/FSH ratio and various metabolic parameters were evaluated using Pearson correlation coefficients. RESULTS: Patients with higher LH/FSH ratios showed higher total antral follicle counts and higher total ovarian volume. In the comparison of anthropometric and biochemical parameters among the three groups, the waist to hip ratio was the only parameter that differed significantly among the groups (P=0.003). Correlation analysis revealed no significant correlations between serum LH/FSH ratios and biochemical parameters related to insulin resistance. However, after adjustments for age and body mass index, a significant correlation between total cholesterol level and serum LH/FSH ratio was observed (r=0.221, P=0.018). CONCLUSION: Most parameters related to insulin resistance, with the exception of total cholesterol level, are unrelated to the inappropriate pattern of serum gonadotropin secretion in Korean women with PCOS.
Body Mass Index ; Cholesterol ; Consensus ; Female ; Follicle Stimulating Hormone ; Follicular Phase ; Gonadotropins* ; Humans ; Insulin Resistance ; Insulin* ; Luteinizing Hormone ; Polycystic Ovary Syndrome* ; Retrospective Studies ; Waist-Hip Ratio

We aimed to evaluate associations between the ratio of serum estrone (E1) to estradiol (E2) and parameters related to serum glucose metabolism and insulin resistance in women with polycystic ovary syndrome (PCOS). Methods: In total, 133 women between the ages of 18 and 35 diagnosed with PCOS were enrolled in this study. All participants with PCOS underwent blood tests to determine hormonal and biochemical metabolic parameters and a standard 2-hour 75-g oral glucose tolerance test. They were divided into two groups according to the serum E1-to-E2 ratio: group 1 (E1/E2 ratio <2.0) and group 2 (E1/E2 ratio ≥2.0). Results: In the comparative analysis, the waist-to-hip ratio (WHR) was the only clinical variable that was significantly different between the two groups. Patients with a higher E1/E2 ratio showed higher fasting insulin levels, homeostasis model for insulin resistance, and postprandial glucose level at 2 hours (PPG2). In a correlation analysis, only PPG2 was significantly related to the serum E1/E2 ratio. However, after controlling for the confounding effects of body mass index (BMI) and WHR, fasting glucose was also significantly correlated with the serum E1/E2 ratio. Conclusion: Women with PCOS with a higher serum E1/E2 ratio were found to be more likely to show higher fasting insulin and postprandial glucose levels. Significant correlations were found between the serum E1/E2 ratio and both fasting and postprandial serum glucose levels after adjusting for BMI and WHR in women with PCOS.

Objective: The aim of the present study was to evaluate the predictive capability of fasting-state measurements of glucose and insulin levels alone for abnormal glucose tolerance in women with polycystic ovary syndrome (PCOS). Methods: In total, 153 Korean women with PCOS were included in this study. The correlations between the 2-hour postload glucose (2-hr PG) level during the 75-g oral glucose tolerance test (OGTT) and other parameters were evaluated using Pearson correlation coefficients and linear regression analysis. The predictive accuracy of fasting glucose and insulin levels and other fasting-state indices for assessing insulin sensitivity derived from glucose and insulin levels for abnormal glucose tolerance was evaluated using receiver operating characteristic (ROC) curve analysis. Results: Significant correlations were observed between the 2-hr PG level and most fasting-state parameters in women with PCOS. However, the area under the ROC curve values for each fasting-state parameter for predicting abnormal glucose tolerance were all between 0.5 and 0.7 in the study participants, which falls into the “less accurate” category for prediction. Conclusion Fasting-state measurements of glucose and insulin alone are not enough to predict abnormal glucose tolerance in women with PCOS. A standard OGTT is needed to screen for impaired glucose tolerance and type 2 diabetes mellitus in women with PCOS.

Objective: The aim of the present study was to evaluate the predictive capability of fasting-state measurements of glucose and insulin levels alone for abnormal glucose tolerance in women with polycystic ovary syndrome (PCOS). Methods: In total, 153 Korean women with PCOS were included in this study. The correlations between the 2-hour postload glucose (2-hr PG) level during the 75-g oral glucose tolerance test (OGTT) and other parameters were evaluated using Pearson correlation coefficients and linear regression analysis. The predictive accuracy of fasting glucose and insulin levels and other fasting-state indices for assessing insulin sensitivity derived from glucose and insulin levels for abnormal glucose tolerance was evaluated using receiver operating characteristic (ROC) curve analysis. Results: Significant correlations were observed between the 2-hr PG level and most fasting-state parameters in women with PCOS. However, the area under the ROC curve values for each fasting-state parameter for predicting abnormal glucose tolerance were all between 0.5 and 0.7 in the study participants, which falls into the “less accurate” category for prediction. Conclusion Fasting-state measurements of glucose and insulin alone are not enough to predict abnormal glucose tolerance in women with PCOS. A standard OGTT is needed to screen for impaired glucose tolerance and type 2 diabetes mellitus in women with PCOS.

OBJECTIVES: To determine the association between polymorphisms in tumor necrosis factor-alpha (TNF-alpha), and TNF-beta genes, and changes in bone mineral density (BMD) after hormone therapy (HT) in postmenopausal Korean women. MATERIALS & METHODS: The TNF-alpha G(-308)A, C(-857)T, C(-863)A, T(-1031)C, and TNF-beta A252G polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) or Taqman assay in 218 postmenopausal Korean women receiving sequential HT for 1 year. Bone mineral density (BMD) at the lumbar spine and femoral neck was examined by dual energy X-ray absorptiometry. Serum levels of bone specific alkaline phosphatase (BAP), osteocalcin (OST), type I C-telopeptide breakdown products (CTX), parathyroid hormone (PTH), calcium, and phosphorus were measured using enzyme-linked immunosorbent assay (ELISA), immunoassay, and atomic absorptiometry, respectively. RESULTS: The TNF-alpha G(-308)A, C(-857)T, C(-863)A, T(-1031)C, and TNF-beta A252G polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) or Taqman assay in 218 postmenopausal Korean women receiving sequential HT for 1 year. Bone mineral density (BMD) at the lumbar spine and femoral neck was examined by dual energy X-ray absorptiometry. Serum levels of bone specific alkaline phosphatase (BAP), osteocalcin (OST), type I C-telopeptide breakdown products (CTX), parathyroid hormone (PTH), calcium, and phosphorus were measured using enzyme-linked immunosorbent assay (ELISA), immunoassay, and atomic absorptiometry, respectively CONCLUSIONS: The TNF-alpha G(-308)A, C(-857)T, C(-863)A, T(-1031)C, and TNF-beta A252G polymorphisms are not associated with changes in BMD after HT in postmenopausal Korean women.
Absorptiometry, Photon ; Alkaline Phosphatase ; Bone Density ; Calcium ; Collagen Type I ; Enzyme-Linked Immunosorbent Assay ; Female ; Femur Neck ; Humans ; Immunoassay ; Lymphotoxin-alpha ; Osteocalcin ; Parathyroid Hormone ; Peptides ; Phosphorus ; Spine ; Tumor Necrosis Factor-alpha

Contraceptives, Oral, Combined ; Female ; Humans ; Polycystic Ovary Syndrome ; Retrospective Studies ; Ultrasonography

Hot flush is one of the most commonly reported symptoms during menopause and it is referred to as vasomotor symptoms along with night sweats. I have summarized the current available knowledge on the relationships between hot flush to other menopausal symptoms and the related chronic diseases to menopause in this article.
Chronic Disease ; Female ; Menopause ; Sweat

Mayer-Rokitansky-Kuster-Hauser syndrome (MRKHS) is characterized by vaginal agenesis with variable Mullerian duct abnormalities. We report here a case of uterine adenomyosis which developed from a hypoplastic uterus in a patient with MRKHS. A 55-year-old postmenopausal woman visited a university hospital for pelvic mass. She had underwent vaginoplasty via the McIndoe procedure for MRKHS at 15 years of age. Pelvic magnetic resonance imaging showed a 5.4 x 4.8 x 4.7 cm mass suspicious for a uterine myoma. She received total abdominal hysterectomy with bilateral salpingo-oophorectomy, and neither the cervix nor endometrium was found grossly in the surgical specimen. The final histologic diagnosis was uterine adenomyosis.
Adenomyosis* ; Cervix Uteri ; Diagnosis ; Endometrium ; Female ; Humans ; Hysterectomy ; Leiomyoma ; Magnetic Resonance Imaging ; Middle Aged ; Uterus*

OBJECTIVE: The aim of the present study was to investigate the relationship between ovarian follicle count and volume on ultrasonography and serum hormone levels including the levels of the anti-Mullerian hormone (AMH) and gonadotropin in women with the polycystic ovary syndrome (PCOS). METHODS: A total of 118 Korean women aged 18-35 years who were newly diagnosed with PCOS at a university hospital were included in this study. Serum LH, FSH, and AMH levels were measured in the early follicular phase, and the total antral follicle count (TFC) and the total ovarian volume (TOV) were assessed by ultrasonography. The correlations between serum hormonal parameters and ultrasonography characteristics in women with PCOS were evaluated using Pearson's correlation coefficients and a linear regression analysis. RESULTS: Serum AMH levels were significantly correlated with serum LH levels and LH/FSH ratios, and TFC and TOV were significantly correlated with each other on ultrasonography. Serum AMH and LH levels and the LH/FSH ratio were significantly correlated with TFC. Statistically significant correlations between TOV and the LH level (r=0.208, p=0.024) and the LH/FSH ratio (r=0.237, p=0.010) were observed. However, the serum AMH level was not significantly correlated with the ovarian volume, and this result did not change after adjusting for age and body mass index. CONCLUSION: Serum AMH is not related to the ovarian volume in women with PCOS. My results suggest that serum LH level and the LH/FSH ratio may be more useful than the serum AMH level for representing the status of the ovarian volume in women with PCOS.
Anti-Mullerian Hormone* ; Body Mass Index ; Female ; Follicular Phase ; Gonadotropins ; Humans ; Linear Models ; Lutein* ; Luteinizing Hormone* ; Ovarian Follicle ; Polycystic Ovary Syndrome* ; Ultrasonography

Osteoporosis is a skeletal disorder characterized by compromised bone strength resulting in a predisposition to fracture. Osteoporosis-related fractures can lead to pain, disability, and increased healthcare costs. This study aimed to explore different pharmacological treatments for osteoporosis. Various treatments are used to prevent and treat osteoporosis, particularly in postmenopausal women and elderly men, but the approach needs to be individually tailored. Bisphosphonates are most commonly used to treat osteoporosis. Bisphosphonates and denosumab are mainly used during the initial phase of therapy for most patients with osteoporosis, including those with a high risk of fracture. In younger postmenopausal women, menopausal hormone therapy (including tibolone) and selective estrogen receptor modulators may be considered as alternatives for fracture prevention. Parathyroid hormone therapy is recommended for osteoporosis treatment in elderly patients with an increased risk of multiple vertebral fractures. Dual energy X-ray absorptiometry (DXA) is the mainstay for monitoring the treatment response, and clinicians may consider alternative treatments if a significant decrease in bone mineral density is detected (using DXA or bone turnover markers) or if recurrent fractures occur during treatment. For postmenopausal women undergoing long-term bisphosphonate treatment, the risk of fracture should be reassessed after 3 to 5 years, and a “drug holiday” should be considered if the risk of fracture is low-to-moderate. Therapy should be continued for patients who continue to exhibit a high risk of fracture, or alternatively, switching to other treatments may be considered.
Absorptiometry, Photon ; Aged ; Bone Density ; Bone Remodeling ; Denosumab ; Diphosphonates ; Drug Therapy ; Female ; Health Care Costs ; Humans ; Male ; Osteoporosis ; Parathyroid Hormone ; Selective Estrogen Receptor Modulators