Structural and functional profiles of the gut microbial community in polycystic ovary syndrome with insulin resistance (IR-PCOS): a pilot study.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder predominantly affecting women of reproductive age. Clinical manifestations are diverse including hyperandrogenism, anovulation, infertility and increased risk of metabolic diseases besides psychosocial dysfunction. This review provides information on the problem of PCOS in India, its pathophysiology, genetics and an overview of current management options to instigate further research in this field. Prevalence of PCOS in India ranges from 3.7 to 22.5 per cent depending on the population studied and the criteria used for diagnosis. Abnormalities in leptin-adiponectin (adipocyte biology), oxidative stress and autoimmunity are among the mechanisms studied regarding pathogenesis of PCOS. Many candidate gene studies have shown associations with PCOS in various studies. Studies have consistently demonstrated the relationship between the well-known manifestation of hyperandrogenism among Indian PCOS women and the metabolic morbidities including insulin resistance, glucose intolerance and cardiovascular risk. Management of individual components of PCOS can be achieved by medications or surgical methods, though further clarification regarding pathogenesis of PCOS is needed to sharpen our therapeutic armamentarium.

Epidemiology, pathogenesis, genetics & management of polycystic ovary syndrome in India.

Insulin: its role in the central control of reproduction.

Aim
Experimental in vitro studies have shown that bisphenol A affects steroidogenesis, folliculogenesis and ovarian morphology The aim of this study was to investigate the role of the endocrine disruptor bisphenol A in the aetiopathogenesis of polycystic ovary syndrome (PCOS) in adolescents and its relationship with metabolic parameters, insulin resistance and obesity in this population

Methods
A total of 112 girls with PCOS and 61 controls between 13 and 19 years of age were enrolled in the study Serum bisphenol A levels were measured by high-pressure liquid chromatography An oral glucose tolerance test was also performed

Results
Adolescents with PCOS had markedly increased serum bisphenol A levels (mean: 11 ng/mL 95% CI: 10–12) than controls (mean: 08 ng/mL 95% CI: 06–09, p = 0001) When we compared the subgroups according to obesity, the main factor determining the significant increase in bisphenol A was the presence of PCOS, but not obesity (p = 0029) Bisphenol A was significantly correlated with total testosterone (r = 052), free testosterone (r = 044), dehydroepiandrosterone sulphate (r = 037) and Ferriman–Gallwey score (r = 043) (p < 005)

Conclusion
Adolescents with PCOS had higher serum bisphenol A levels than controls, independent of obesity Bisphenol A concentrations were significantly correlated with androgen levels, leading us to consider that bisphenol A might play a role in the aetiopathogenesis of PCOS in adolescents

The endocrine disruptor bisphenol A may play a role in the aetiopathogenesis of polycystic ovary syndrome in adolescent girls

Aim

Recently, the roles of insulin receptor (INSR) and insulin receptor substrate (IRS) polymorphisms in polycystic ovary syndrome (PCOS) have been extensively studied, with conflicting results. Therefore, we conducted the present systematic review and meta-analysis to better evaluate associations of INSR and IRS polymorphisms with PCOS.



Methods

We searched PubMed, Medline, EMBASE, Google Scholar and China National Knowledge Infrastructure for eligible articles up to December 2015. Odds ratios (OR) and 95% confidence intervals (CI) were used to evaluate associations of INSR and IRS polymorphisms with PCOS.



Results

A total of 28 articles including 2975 PCOS patients and 3011 control subjects were analyzed. The overall analyses and subgroup analyses revealed that IRS-1 Gly972Arg polymorphism was significantly associated with PCOS for the Caucasian population in GG versus GA (OR = 0.57, 95%CI 0.37–0.89), GG versus GA + AA (OR = 0.57, 95%CI 0.36–0.89), GA versus GG + AA (OR = 1.74, 95%CI 1.13–2.69) and G versus A (OR = 0.63 95%CI 0.43–0.92). Also, IRS-2 Gly1057Asp polymorphism was significantly associated with PCOS for the Asian ethnicity in GG versus GA (OR = 0.45, 95%CI 0.24–0.83), GG versus AA (OR = 0.32, 95%CI 0.19–0.53), GG versus GA + AA (OR = 0.35, 95%CI 0.21–0.57), AA versus GG + GA (OR = 2.14, 95%CI 1.43–3.20), and G versus A (OR = 0.43, 95%CI 0.32–0.58). However, we detected no significant association between INSR His 1058 C/T polymorphism and PCOS.



Conclusion

Our findings suggest that IRS-1 Gly972Arg polymorphism is associated with PCOS in the Caucasian ethnicity, and IRS-2 Gly1057Asp polymorphism is correlated with PCOS in the Asian ethnicity. However, INSR His 1058 C/T polymorphism may not be implicated in PCOS. © 2016 Japan Society of Obstetrics and Gynecology

Associations of insulin receptor and insulin receptor substrates genetic polymorphisms with polycystic ovary syndrome: A systematic review and meta-analysis

Polycystic ovary syndrome (PCOS) is the most common and a complex female endocrine disorder, and is one of the leading cause of female infertility. Here, we aimed to investigate the association of single-nucleotide polymorphism of INS, INSR, IRS1, IRS2, PPAR-G and CAPN10 gene in the pathogenesis of PCOS. A hospital-based, observational case–control study was carried on 169 PCOS and 169 control women in the southern region of India. Genotype was carried out by real-time polymerase chain reaction. A chi-square (χ
 2) test was performed and the genotypes were verified to comply with the Hardy–Weinberg equilibrium. Odds ratio and 95% confidence interval were calculated to assess the relative risk. Comparison of clinical characteristics of women with PCOS and controls reveal an increase in body mass index (BMI), luteinizing hormone / follicle stimulating hormone (LH/FSH) ratio, glucose levels, insulin, testosterone, hirsutism and antral follicular count in PCOS women. The variant rs1801278 (P=0.002; OR = 2.88; 95% CI = 1.43, 5.80) show an association with PCOS. In the genotypic (P=0.0002) and allelic models (P=0.000), significance persisted even after Bonferroni correction. The genotypes of SNPs strongly influence BMI, LH, LH/FSH ratio, ovarian volume and antral follicular count in PCOS women. The study results were suggestive of a positive association between Gly972Arg of IRS1 and PCOS in the south Indian population, while INS, IRS2, PPAR-G and CAPN10 failed to show any association with PCOS in our studied population. Further studies focussing the role of IRS1 are warranted to delineate its implication towards PCOS.

Single-nucleotide polymorphism of INS, INSR, IRS1, IRS2, PPAR-G and CAPN10 genes in the pathogenesis of polycystic ovary syndrome

Polycystic ovary syndrome must be recognized as a serious issue due to its implication on long term health regardless of an individual’s age. PCOS and insulin resistance are interlinked, as approximately 40 % of women with PCOS are insulin resistant. However, the detailed molecular basis for insulin resistance that is coupled with PCOS remains poorly understood. To review the published evidence that polymorphisms in genes that are involved in insulin secretion and action are associated with an increased risk of PCOS. We reviewed articles published through November 2012 which concerned polymorphisms of genes related to insulin signaling and glucose homeostasis as well as their associations with PCOS. The articles were identified via Medline searches. No consistent evidence emerged of a strong association between the risk of PCOS and any known gene that is related to insulin signaling and glucose homeostasis. Moreover, recent genome-wide association studies are inconsistent in identifying the associations between PCOS and insulin metabolism genes. Many of the studies reviewed were limited by heterogeneity in the PCOS diagnosis and by not have having a sufficient number of study participants. Further studies are warranted to determine predisposing risk factors which could modify environmental factors and thus reduce the risk of PCOS. Large genome-wide association studies devoted solely to PCOS will be necessary to identify new candidate genes and proteins that are involved in PCOS risk.

/pdf/genetic-variants-associated-with-insulin-signaling-and-r0nnfvjwcm.pdf

Genetic variants associated with insulin signaling and glucose homeostasis in the pathogenesis of insulin resistance in polycystic ovary syndrome: a systematic review

The objective of this study was to evaluate and compare the clinical, biochemical, hormonal and gynecological aspects of polycystic ovary syndrome at a hospital in South India. The observational, case-controlled study was conducted from April 2011 to January 2014 and recruited 192 polycystic ovary syndrome patients and 205 normal women. Clinical history and biochemical and hormonal analysis were carried out. Correlation was tested between testosterone and other clinical findings. Variables were further analyzed using logistic regression with adjusted odds ratio with a 95% confidence interval. About 16% of polycystic ovary syndrome women were obese and 91% reported to have an increased waist/hip ratio. Oligomenorrhea was observed in 74% women with polycystic ovary syndrome. The tested variables revealed that body mass index, waist/hip ratio, hirsutism, testosterone, insulin, ovarian volume and follicular count were elevated in polycystic ovary syndrome patients compared to the control subjects. Increased testosterone levels correlated positively with luteinizing hormone/follicle-stimulating hormone ratio (p=0.023), hirsutism (p=0.001) and antral follicular count (p=0.004) in polycystic ovary syndrome patients in the studied population. Waist/hip ratio could possibly be a better risk indicator than body mass index. Increased testosterone levels, ovarian volume and antral follicular count or combination of these have been considered to be risk factors in developing polycystic ovary syndrome patients.

/pdf/a-case-controlled-comparative-hospital-based-study-on-the-2dx759lsc0.pdf

A Case-controlled Comparative Hospital-based Study on the Clinical, Biochemical, Hormonal, and Gynecological Parameters in Polycystic Ovary Syndrome

To study the role of MRI in diagnosing pregnancy-associated obstetric and gynecological complications. We prospectively studied 48 pregnant and postpartum women, aged between 20 and 45 years, who were referred for MRI between August 2016 and April 2018 with suspected pregnancy-associated obstetric and gynecological complication. MRI findings were confirmed by intra-operative or histological findings. Out of the 48 patients, there were 32 women with suspected placenta accreta, 5 pregnant women with 6 ectopic pregnancies (1 patient had two gestational sacs), 3 with ovarian pathologies, 3 with uterine pathologies, 3 with abruptio placenta, and 2 with miscellaneous pathologies. In our study, there was an accuracy of 81.6% with sensitivity of 100% and specificity of 50%. There was 100% accuracy in predicting abruptio placenta, ovarian, uterine, and miscellaneous pathologies by MRI. There was 83.4% and 75% accuracy in predicting ectopic pregnancy and placenta accreta, respectively, by MRI. MRI is very useful to diagnose pregnancy-associated obstetric and gynecological complications. It will be an important complementary tool to sonography and thereby facilitate better patient management.

/pdf/role-of-magnetic-resonance-imaging-in-pregnancy-associated-58if4d2j6m.pdf

Role of magnetic resonance imaging in pregnancy-associated obstetric and gynecological complications

/pdf/efficacy-of-mifepristone-in-preinduction-cervical-ripening-1cvye3z2.pdf

Usha Rani Godla

Papers

Single-nucleotide polymorphism of INS, INSR, IRS1, IRS2, PPAR-G and CAPN10 genes in the pathogenesis of polycystic ovary syndrome

Genetic variants associated with insulin signaling and glucose homeostasis in the pathogenesis of insulin resistance in polycystic ovary syndrome: a systematic review

A Case-controlled Comparative Hospital-based Study on the Clinical, Biochemical, Hormonal, and Gynecological Parameters in Polycystic Ovary Syndrome

Role of magnetic resonance imaging in pregnancy-associated obstetric and gynecological complications

Efficacy of Mifepristone in Preinduction Cervical Ripening in Term Pregnancy