Objective: To analyze the difference in blood uric acid levels between patients with polycystic ovary syndrome (PCOS) and healthy women of childbearing age, and to investigate the correlation between body composition and blood uric acid levels. Methods: A total of 153 eligible childbearing age patients with PCOS treated at Tianjin Medical University General Hospital from January 2018 to March 2022 were selected, and 153 healthy women with normal menstruation were selected as the control group. Fasting blood uric acid levels were measured by venous blood test, and body composition was measured by a body composition analyzer. Group comparisons were made to analyze the correlation between body composition and blood uric acid levels. Results: The incidence of hyperuricemia was higher in patients with PCOS than that in the control group [30.1% (46/153) vs 2.0% (3/153)], with a statistically significant difference (χ²=44.429, P<0.001). Blood uric acid level was also significantly higher in patients with PCOS than that in the control group [(371±98) vs (265±67) μmol/L; t=11.170, P<0.001]. Among PCOS patients, there were statistically significant differences in weight, body mass index (BMI), body fat mass, skeletal muscle mass, percent body fat, lean body weight, fat mass/lean body weight, percent skeletal muscle, and visceral fat level between the hyperuricemia group and the normal blood uric acid group (all P<0.001), but no significant difference was observed in waist-hip ratio (P=0.348). The following body composition indicators: weight, BMI, waist-hip ratio, body fat mass, skeletal muscle mass, percent body fat, visceral fat level, lean body weight, and fat mass/lean body weight in all subjects, the PCOS patients and the control group, were positively correlated with blood uric acid levels (all P<0.01). The blood uric acid level in PCOS obese patients was higher than that in non-obese PCOS patients, and the difference was statistically significant [(425±83) vs (336±91) μmol/L; t=6.133, P<0.001]. The blood uric acid level in central obesity PCOS patients was also higher than that in non-central obesity PCOS patients [(385±95) vs (299±79) μmol/L], the difference was statistically significant (t=4.261, P<0.001). The blood uric acid level in normal-weight obese PCOS patients was higher than that in normal-weight non-obese PCOS patients [(333±73) vs (277±54) μmol/L], and the difference was statistically significant (t=2.848, P=0.006). Blood uric acid levels in normal-weight [(315±74) vs (255±67) μmol/L], overweight [(362±102) vs (276±57) μmol/L], and obese PCOS patients [(425±83) vs (303±74) μmol/L] were all higher than those in the corresponding control groups, with statistically significant differences (all P<0.001). Conclusions: PCOS patients have a higher incidence of hyperuricemia than healthy women of childbearing age. Blood uric acid levels are closely correlated with body composition indicators, such as weight, BMI, waist-hip ratio, body fat mass, skeletal muscle mass, percent body fat, and visceral fat level. Body composition analysis of women with PCOS could help identify potentially obese people more accurately and carry out individualized treatment, thereby reducing the risk of metabolic abnormalities.
Humans ; Female ; Polycystic Ovary Syndrome/complications* ; Uric Acid ; Hyperuricemia/complications* ; Insulin ; Body Composition/physiology* ; Obesity/complications* ; Body Mass Index

INTRODUCTION: To harmonise the diagnostic processes of polycystic ovary syndrome (PCOS) and enable clinicians to provide better patient care, it is critical to understand the knowledge gaps in PCOS diagnosis. We evaluated how clinicians in endocrinology, family medicine, general practice and gynaecology diagnose PCOS. METHODS: This cross-sectional survey involved 208 clinicians from specific subspecialties across various healthcare settings in Singapore. RESULTS: A total of 160 responses were included in the final analysis. Among all the diagnostic criteria, the Rotterdam 2003 criteria was most frequently used (66.3%). More than half of the gynaecologists reported having a standardised workplace protocol while the majority from other specialties reported otherwise. A large percentage of respondents (60.5%) were unable to identify the correct PCOS clinical features, which is concerning. Only 8.8% of respondents used clinical and biochemical hyperandrogenism, menstrual disturbances and pelvic ultrasound to diagnose PCOS without performing unnecessary and incorrect investigations. Most clinicians recognised insulin resistance/type 2 diabetes mellitus and fertility problems as complications while only a few recognised psychological complications. Many clinicians (37.3%) sought standardisation of PCOS diagnosis and management guidelines for improvement in PCOS care and 81.9% of respondents would appreciate standardised educational materials. CONCLUSION This is the first study to the best of our knowledge that gives an insight into the diagnostic and management processes of PCOS among various healthcare institutions in Singapore. This study calls for greater harmonisation of diagnostic processes and holistic evidence-based management of patients with PCOS through standardised workplace protocols and patient education resources.
Cross-Sectional Studies ; Diabetes Mellitus, Type 2/complications* ; Female ; Humans ; Polycystic Ovary Syndrome/therapy* ; Singapore ; Surveys and Questionnaires

Polycystic ovary syndrome (PCOS) presents with a spectrum of conditions resulting from androgen excess, anovulation and metabolic syndrome. Patients with PCOS may see their primary care physicians for various presentations, including hirsutism, acne, menstrual irregularities, infertility, obesity, and psychiatric disorders such as anxiety and depression. Management of these patients should include screening for Type 2 diabetes mellitus, dyslipidaemia and hypertension. Treatment should be targeted to each patient's phenotype and personal expectations such as desire for pregnancy. Psychological well-being due to the effects on physical appearance is also an important consideration. Diet and exercise are major components in the management of patients with PCOS and obesity. The first-line therapy for fertility and metabolic syndrome in PCOS is lifestyle modification with diet and exercise, followed by pharmacological therapy.
Acne Vulgaris ; complications ; Diet ; Exercise ; Female ; Hirsutism ; complications ; Humans ; Metabolic Syndrome ; complications ; Obesity ; complications ; therapy ; Phenotype ; Polycystic Ovary Syndrome ; complications ; therapy ; Primary Health Care ; methods ; Self Care ; Treatment Outcome

Polycystic ovary syndrome (PCOS) is the most common metabolic and endocrine disorder in women. However, there is no agreement concerning how to diagnose and treat PCOS worldwide. Three practice guidelines or consensuses, including consensus from the European Society of Human Reproduction and Embryology (ESHRE)/the American Society for Reproductive Medicine (ASRM) in Rotterdam, diagnosis criteria and consensus in China, and clinical practice guideline from the Endocrine Society (ES) in the United States are widely recognized. The present paper may provide some guidance for clinical practice based on a comparative analysis of the above three practice guidelines or consensuses.
Adolescent ; Adult ; Consensus ; Female ; Humans ; Hyperandrogenism ; etiology ; Infertility, Female ; etiology ; Insulin Resistance ; Menstrual Cycle ; Obesity ; etiology ; Polycystic Ovary Syndrome ; complications ; diagnosis ; psychology ; therapy ; Practice Guidelines as Topic

BACKGROUNDPolycystic ovary syndrome (PCOS) and its characteristic symptoms have been associated with physical and psychological issues in women of reproductive age. The current study was conducted in response to the dearth of systematic research related to psychological functioning and quality of life in patients with PCOS in Southwest China, and to determine whether patients with PCOS exhibit poorer mental health (MH) compared to healthy women of the same age and living in the same region, without a PCOS diagnosis.

METHODSWe enrolled 120 outpatients with PCOS and 100 healthy controls in this study. Standardized questionnaires were administered to assess general MH conditions (General Health Questionnaire-12-item version), anxiety (State-Trait Anxiety Inventory), depression (Beck Depression Inventory), as well as health-related quality of life (HRQoL) measured using the 36-item short-form health survey. The independent samples t-test was conducted for continuous study variables. For categorical variables, the Pearson Chi-square test, Fisher's exact test, and logistic regression were performed.

RESULTSThe prevalence of anxiety (13.3% vs. 2.0%) and depression (27.5% vs. 3.0%) was higher in patients with PCOS compared to the controls (both P< 0.05). Patients with PCOS had decreased HRQoL. Patients with PCOS who had fertility requirements were more likely to be anxious and depressed than those without fertility requirements (anxiety: 22.6% [12/53] vs. 5.9% [4/67], χ2 = 7.117, P = 0.008; depression: 37.7% (20/53) vs.19.4% (13/67), χ2 = 4.988, P = 0.026).

CONCLUSIONSPCOS and related symptoms may be risk factors for depression and anxiety. Professionals should be concerned with the MH of women with PCOS, and psychological therapy should be considered.

Adult ; Anxiety ; diagnosis ; etiology ; China ; Depression ; diagnosis ; etiology ; Female ; Humans ; Mental Disorders ; diagnosis ; etiology ; Polycystic Ovary Syndrome ; complications ; physiopathology ; psychology ; Psychiatric Status Rating Scales ; Quality of Life ; Surveys and Questionnaires ; Young Adult

Polycystic Ovary Syndrome (PCOS), one of the most common endocrine disorders occurring during reproductive age, is characterized by ovulatory dysfunction, biochemical or clinical hyperandrogenism, and polycystic ovaries.1 Its prevalence ranges from 5% to 10% based on population studies, and largely depends on the diagnostic criteria used, and ethnicity of the population being investigated. PCOS is currently considered a syndrome with metabolic and reproductive consequences that could affect women's health during different stages of reproductive age. There is increasing body of evidence suggesting a negative effect of PCOS on fertility and pregnancy outcomes.
Pregnancy Complications ; Polycystic Ovary Syndrome

A 26-year-old unmarried woman with irregular menstruation for 4 years was admitted for an intrauterine space-occupying mass. Pathological examination before surgery showed moderately to poorly differentiated endometrial adenocarcinoma. The patient underwent laparoscopically assisted epifascial panhysterectomy with bilateral salpingo-oophorectomy. Pathological examination of the surgical specimens reported moderately to poorly differentiated endometrial adenocarcinoma and stage II clear cell carcinoma. The patient then received chemotherapy and remained alive without evidence of recurrence. Young women with polycystic ovarian syndrome are at high risk of developing endometrial carcinoma, but concurrent clear cell carcinoma is rare. Careful evaluation before and after treatment are essential to improve the patients prognosis.
Adenocarcinoma ; complications ; diagnosis ; therapy ; Adult ; Endometrial Neoplasms ; complications ; diagnosis ; therapy ; Female ; Humans ; Laparoscopy ; Polycystic Ovary Syndrome ; complications ; Uterine Neoplasms ; complications ; diagnosis ; therapy

OBJECTIVETo investigate the therapeutical effects of visfatin and metformin on insulin resistance and reproductive endocrine disorder in rats with polycystic ovary syndrome (PCOS).

METHODSForty female Wistar rats were divided into 4 equal groups, and in groups A, B and C, the rats were injected subcutaneously with dehydroepiandrosterone (DHEA) for PCOS modeling, with group D as the blank control injected with soybean oil. Vaginal smears and serological testing were taken to assess the modeling. After the modeling, the rats in group A received 10 µg reorganized visfatin injection and those in group B were treated with metformin (14 mg/100 g) on a daily basis for 15 days. Serum levels of T, LH, FSH, FINS and blood glucose levels during OGTT were measured before and after the treatments, and HOMA-IR and LH to FSH ratio were calculated. The ovaries were then dissected for pathological examination.

RESULTSIn groups A and B, FINS, FPG, T, HOMA-IR and blood glucose levels during OGTT were significantly decreased after the treatments (P<0.05), which resulted in recovery of regular menses in 8 (80%) rats in group A and 7 (77.8%) rats in group B with the development of normal follicles. Visfatin and metformin produced equivalent therapeutic effects in improving the insulin resistance and hyperandrogenism in PCOS rats.

CONCLUSIONVisfatin and metformin have equivalent therapeutic effects in improving insulin resistance and hyperandrogenism and in promoting the recovery of regular menses and development of normal follicles in PCOS rats.

Animals ; Female ; Humans ; Insulin Resistance ; Metformin ; pharmacology ; Nicotinamide Phosphoribosyltransferase ; pharmacology ; Polycystic Ovary Syndrome ; complications ; drug therapy ; Rats ; Rats, Wistar

To investigate the clinical effect of tonifying the kidney and promoting blood circulation to promote oocyte decoction in the treatment of anovulatory infertility caused by polycystic ovary syndrome. Sixty cases were selected from the out-patient department of Xiyuan hospital of China academy of Chinese medical sciences and the Chinese academy of traditional Chinese medicine, Chinese medicine out-patient department. Sixty patients with PCOS patients were randomly divided into the treatment group and the control group, with 30 cases and 30 cases respectively. The treatment group was given decoction of the reinforcing kidney, activating blood circulation and ovarian stimulation compound recipe. The control group was treated with clomiphene. Through the treatment of 1-2 courses, in the treatment group the pregnancy rate was 56.67%, the ovulation rate 61%; in control group of clomiphene citrate ovulation ratepregnancy rate was 30% , 72.84% of ovulation rate. The difference was significant between two groups (P < 0.05), the pregnancy rate in the treatment group was higher than the control group. The treatment group has regulatory effect on FSH, LH and their ratio, and increase E2 level, decrease T, PRL, INS and other hormone levels, contributing to the mature development of the follicles and endometrium growth, increase the ovulation rate and pregnancy rate. The control group on FSH, E2 increased, LH, T, PRL and INS showed no obvious effect.
Adult ; Drugs, Chinese Herbal ; pharmacology ; Female ; Fertility Agents, Female ; pharmacology ; Humans ; Infertility, Female ; drug therapy ; etiology ; Kidney ; drug effects ; Ovulation ; drug effects ; Ovulation Induction ; Polycystic Ovary Syndrome ; complications

OBJECTIVETo observe the therapeutic effect of resolving method of Chinese medicine (CM) on the lipid metabolism in polycystic ovary syndrome (PCOS) patients accompanied with non-alcoholic fatty liver disease (NAFLD), to analyze the correlation between PCOS and NAFLD, and to study its mechanisms.

METHODSTotally 70 female PCOS patients in the reproductive age (20 -40 years old) were recruited. Among them, 35 PCOS patients accompanied with NAFLD were recruited as Group A, and 35 PCOS patients without complicated NAFLD were recruited as Group B. At the same time, 20 healthy female volunteers were recruited as the control group. All subjects had their personal medical records after relevant questionnaire. Their clinical data including body height (BH), body weight (BW), body mass index (BMI), waist circumference (WC), hip circumference (HC), testosterone (T), prolactin (PRL), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), leptin, fasting blood glucose (FBG), fasting insulin (FINS), 2 h postprandial blood glucose (2 h PBG), homeostatic model assessment for insulin resistance (HOMA-IR), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), etc. were detected. Patients in Group A were treated by the resolving method for 3 months. The follow-up was continued for 6 months after ending treatment.

RESULTSThe levels of BW, BMI, WHR, T, LH, LH/FSH, leptin, FINS, 2 h PBG, HOMA-IR, and LDL-C were significantly higher in Group B than in the control group (P < 0.05). The level of FSH was significantly lower in Group B than in the control group (P < 0.05). The levels of BW, BMI, WC, HC, waist-hip-ratio (WHR), leptin, FINS, 2 h PBG, HOMA-IR, TG, LDL-C, ALT, and AST were significantly higher in Group A than in Group B (P < 0.05). The HDL-C level was significantly lower in Group A than in Group B (P < 0.05). In Group A after treatment by resolving method of CM, the menstrual cycle was recovered in 83.87% patients (26/31 cases), reduced fatty liver degree or disappearance of fatty liver degree occurred in 32.26% patients (10/31 cases), with the total effective rate being 85.71% (24/28 cases).48.28% (14/29) patients were pregnant. The levels of BW, BMI, FBG, leptin, TG, ALT, and AST significantly decreased when compared with those before treatment (P < 0.05). The level of SHBG significantly increased (P < 0.05). There was no significant difference in the levels of HOMA-IR, FINS, T, FSH, LH, or LH/FSH between before and after treatment (P > 0. 05).

CONCLUSIONSThe metabolic disorder of glycolipid exists in PCOS patients, and more serious in PCOS patients accompanied with NAFLD. Resolving method can effectively restore the metabolic disturbance in PCOS patients accompanied with NAFLD, recover their fatty liver degrees, recover normal menstrual cycles, and elevate their pregnancy rates. Further studies are necessary on whether its mechanisms lie on lowering leptin levels and correcting lipid metabolisms to relieve patient's clinical symptoms.

Adult ; Case-Control Studies ; Fatty Liver ; complications ; metabolism ; therapy ; Female ; Humans ; Lipid Metabolism ; Medicine, Chinese Traditional ; methods ; Non-alcoholic Fatty Liver Disease ; Polycystic Ovary Syndrome ; complications ; metabolism ; therapy ; Pregnancy ; Pregnancy Rate ; Young Adult