The effects of synbiotic supplementation on hormonal status, biomarkers of inflammation and oxidative stress in subjects with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. Prevalence and characteristics of the polycystic ovary syndrome in overweight and obese women. Effects of Chinese Green Tea on Weight, and Hormonal and Biochemical Profiles in Obese Patients With Polycystic Ovary Syndrome—A Randomized Placebo-Controlled Trial Laparoscopic ovarian drilling in the treatment of polycystic ovary syndrome: how many punctures per ovary are needed to improve the reproductive outcome? Is there a dose-response relationship of metformin treatment in patients with polycystic ovary syndrome? Results from a multicentric study. Insulin resistance improvement by cinnamon powder in polycystic ovary syndrome: A randomized double‐blind placebo controlled clinical trial Diamel Therapy in Polycystic Ovary Syndrome Reduces Hyperinsulinaemia, Insulin Resistance, and Hyperandrogenaemia Serum orexin-A (OXA) level decreases in polycystic ovarian syndrome Depression in women with polycystic ovary syndrome: clinical and biochemical correlates. Combined oral contraceptives plus spironolactone compared with metformin in women with polycystic ovary syndrome: a one-year randomized clinical trial. Prevalence of polycystic ovary syndrome (PCOS) in first-degree relatives of patients with PCOS. The role of orlistat combined with lifestyle changes in the management of overweight and obese patients with polycystic ovary syndrome A simple screening approach for assessing community prevalence and phenotype of polycystic ovary syndrome in a semi-urban population in Sri Lanka. The effect of synbiotics pomegranate juice on cardiovascular risk factors in PCOS patients: a randomized, triple-blinded, controlled trial Clinical and biochemical characterization of women with polycystic ovary syndrome in North Rhine-Westphalia. Nonalcoholic fatty liver disease in women with polycystic ovary syndrome. The Pregnancy in Polycystic Ovary Syndrome study: baseline characteristics of the randomized cohort including racial effects. Development of a health-related quality-of-life questionnaire (PCOSQ) for women with polycystic ovary syndrome (PCOS). Probiotic supplementation and the effects on weight loss, glycaemia and lipid profiles in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial Obesity, weight loss, and the polycystic ovary syndrome: effect of treatment with diet and orlistat for 24 weeks on insulin resistance and androgen levels. Hypothalamic-pituitary-adrenal axis sensitivity to opioids in women with polycystic ovary syndrome. Effect of Short-Term Standard Therapeutic Regimens on Neuropeptide Y and Adipose Tissue Hormones in Overweight Insulinresistant Women with Polycystic Ovary Syndrome
Background To our knowledge , no reports are available indicating the effects of synbiotic supplementation on hormonal status , biomarkers of inflammation and oxidative stress in subjects with polycystic ovary syndrome ( PCOS ) . This research was done to assess the effects of synbiotic supplementation on hormonal status , biomarkers of inflammation and oxidative stress in subjects with PCOS . Methods This r and omized double-blind , placebo-controlled trial was conducted on 60 subjects diagnosed with PCOS according to the Rotterdam criteria . Subjects were r and omly assigned into two groups to take either synbiotic ( n = 30 ) or placebo ( n = 30 ) for 12 weeks . Endocrine , inflammation and oxidative stress biomarkers were quantified at baseline and after the 12-week intervention . Results After the 12-week intervention , compared with the placebo , synbiotic supplementation significantly increased serum sex hormone-binding globulin ( SHBG ) ( changes from baseline in synbiotic group : + 19.8 ± 47.3 vs. in placebo group : + 0.5 ± 5.4 nmol/L , p = 0.01 ) , plasma nitric oxide ( NO ) ( changes from baseline in synbiotic group : + 5.5 ± 4.8 vs. in placebo group : + 0.3 ± 9.1 μmol/L , p = 0.006 ) , and decreased modified Ferriman Gallwey ( mF-G ) scores ( changes from baseline in synbiotic group : − 1.3 ± 2.5 vs. in placebo group : − 0.1 ± 0.5 , p = 0.01 ) and serum high-sensitivity C-reactive protein ( hs-CRP ) ( changes from baseline in synbiotic group : − 950.0 ± 2246.6 vs. in placebo group : + 335.3 ± 2466.9 ng/mL , p = 0.02 ) . We did not observe any significant effect of synbiotic supplementation on other hormonal status and biomarkers of oxidative stress . Conclusions Overall , synbiotic supplementation for 12 weeks in PCOS women had beneficial effects on SHBG , mFG scores , hs-CRP and NO levels , but did not affect other hormonal status and biomarkers of oxidative stress . Trial registration This study was retrospectively registered in the Iranian website ( www.i rct .ir ) for registration of clinical trials ( I RCT 201509115623N53 ) , on 2015–09 - 27 We prospect ively estimated the prevalence of the polycystic ovary syndrome ( PCOS ) , as defined by the NIH/NICHHD 1990 endocrine criteria , in a population of 154 Caucasian women of reproductive age reporting spontaneously for blood donation .  Anthropometric data ; the presence of hirsutism , acne , and and rogenic alopecia ; and the menstrual history were recorded by a single investigator . In 145 women , blood sample s were also obtained for measurement of serum and rogen levels .  PCOS was defined by the presence of 1 ) oligomenorrhea , 2 ) clinical and /or biochemical hyper and rogenism , and 3 ) exclusion of hyperprolactinemia , thyroid disorders , and nonclassic 21-hydroxylase deficiency . Hirsutism was defined by a modified Ferriman-Gallwey score of 8 or more , acne was considered as a sign of hyper and rogenism when persistent after the second decade of life , and hyper and rogenemia was defined by an increase in circulating testosterone or dehydroepi and rosterone sulfate or an increase in the free and rogen index above the 95th percentile of the control values derived from the nonhirsute , nonacneic women having regular menses who were not receiving hormonal therapy . PCOS was present in 10(6.5 % ) , hirsutism was present in 11 ( 7.1 % ) , and acne was present in 19 ( 12.3 % ) of the 154 women . Our results demonstrate a 6.5 % prevalence of PCOS , as defined , in a minimally biased population of Caucasian women from Spain . The polycystic ovary syndrome , hirsutism , and acne are common endocrine disorders in women BACKGROUND Surprisingly , the prevalence of polycystic ovary syndrome ( PCOS ) in otherwise unselected overweight or obese women is unknown , despite obesity being frequent in patients with PCOS . We conducted the present study to obtain an unbiased estimate of the prevalence of PCOS in unselected overweight and obese premenopausal women from Spain . METHODS All premenopausal women reporting to the Department of Endocrinology , Hospital Universitario Ramón y Cajal , for dietary treatment of overweight or obesity from May 2002 to December 2005 were prospect ively recruited . Women referred for any other reason were automatically excluded to avoid selection bias . Diagnosis of PCOS relied on the presence of clinical and /or biochemical hyper and rogenism , oligo-ovulation , and exclusion of secondary causes . Anthropometric measurements , hirsutism scores , and and rogen , gonadotropin , metabolic , and lipid profiles were obtained . RESULTS Of a total of 113 consecutive women recruited , 32 ( 28.3 % ) were diagnosed as having PCOS ( 95 % confidence interval , 20.0%-36.6 % ) . The prevalence of PCOS was not different when considering the degree of obesity . Another 3 women presented with hyper and rogenemia without oligo-ovulation , 2 had idiopathic hirsutism , 2 had chronic oligomenorrhea without clinical or biochemical hyper and rogenism , and 2 had oligomenorrhea with hyperprolactinemia , precluding the diagnosis of PCOS . The remaining 72 women ( 63.7 % ) had no evidence of hyper and rogenism or reproductive abnormalities . CONCLUSIONS Our results demonstrate a 28.3 % prevalence of PCOS in overweight and obese women from Spain , which is markedly increased compared with the 5.5 % prevalence of PCOS in lean women of our country . Therefore , PCOS must be routinely ruled out in overweight and obese premenopausal women seeking advice for weight loss Objectives : To study the effects of green tea on body weight , and biochemical and hormonal profiles in obese Chinese women with polycystic ovary syndrome ( PCOS ) . Methods : Thirty-four obese Chinese women with PCOS were r and omized into either treatment with green tea capsules or placebo for 3 months . The anthropomentric measurements , and biochemical and hormonal profiles before and after treatment in each group were compared . Results : The body weight of the green tea group decreased by a nonsignificant 2.4 % after treatment ; whereas the body weight , body mass index ( BMI ) , and body fat content of the control group were significantly higher after 3 months . There were no differences in any of the hormone levels measured in either group . The biochemical profiles of the two groups were also similar except that there was a small but significant rise in the triglyceride level in the green tea group . Fewer patients in the green tea group remained amenorrhoeic , but this was not significantly different from the control group . Conclusions : Green tea supplementation did not significantly reduce body weight in obese women with PCOS , nor did it alter the glucose or lipid metabolism AIM To evaluate the biochemical , clinical and reproductive results after laparoscopic ovarian drilling that carried out a different number of punctures in the ovaries . METHODS Sixty-three clomiphene-citrate-resistant women with polycystic ovary syndrome ( PCOS ) underwent laparoscopic ovarian drilling using insulated needle cautery . Patients were allocated to two groups : group I ( n = 26 ) had five punctures per ovary , and group II ( n = 37 ) had 10 punctures per ovary .  Biochemical and clinical data , before and after the procedure along with the reproductive outcome , were compared between the two groups . RESULTS There were no significant differences in terms of body mass index , and insulin and glucose levels before and after the procedure between the two groups . And rogen levels and luteinizing hormone concentrations showed a statistically significant decrease after the treatment . The clinical and reproductive outcome , including menses cyclicity , ovulation , and pregnancy rates were similar in both groups . CONCLUSION Laparoscopic ovarian drilling is an effective treatment in clomiphene-citrate-resistant women with PCOS . Five , instead of > or = 10 , punctures per ovary are sufficient to ameliorate the hyper and rogenic status in these women , improving their clinical and reproductive outcome STUDY QUESTION Do different dosages of metformin account for different clinical and biochemical outcomes in women with polycystic ovary syndrome ( PCOS ) and do basal anthropometric and metabolic characteristics of the patients provide any indications regarding the dose required to reach the target effect ? SUMMARY ANSWER Different doses of metformin exerted the same effects on clinical , biochemical and metabolic parameters in patients affected by PCOS . WHAT IS KNOWN AND WHAT THIS PAPER ADDS Since the insulin-sensitizing agents came into use in the management of PCOS , metformin has shown a positive benefits -risks ratio . Nonetheless , therapeutic schedules are not well st and ardized . This is the first study which systematic ally analyses the effect of different doses of metformin on clinical , hormonal and metabolic features of PCOS . On the basis of our results , higher doses are no more effective than lower doses . DESIGN A multicentric cohort prospect i ve study . A total of 250 PCOS women were enrolled , 49 lost to follow-up . Menstrual cyclicity , hormonal assays , oral glucose tolerance test , lipid profile and ultrasonographic pelvic examination were evaluated at the baseline and after 6 months of metformin treatment at different doses ( 1000 , 1500 and 1700 mg ) . PARTICIPANTS AND SETTING A total of 201 PCOS patients completed the study without protocol violations in three university hospitals : seventy-three patients from Centre A ( treated with metformin 500 mg twice a day ) , 60 patients from Centre B ( treated with metformin 500 mg three times a day ) and 68 patients from Centre C ( treated with metformin 850 mg twice a day ) . MAIN RESULTS AND THE ROLE OF CHANCE Metformin exerted an overall positive effect on the clinical and endocrine-metabolic features of PCOS . The degree of these effects was independent of the administered dosage in every range of basal body mass index ( BMI ) . When patients were stratified according to their insulinaemic status , scattered inter-doses differences were found in some of the outcome measures . Patients who exhibited an increase of > 2 menstrual cycles/year were considered as responders to treatment . Responders had a higher basal BMI than non-responders and showed a greater reduction in plasma testosterone levels after metformin treatment , but other outcome measures did not differ significantly . Total insulin secretion in the 180 min following the glucose tolerance test before metformin treatment ( basal AUC-I ) was significantly correlated with the decrease in insulin secretion induced by metformin in both the whole group and in responders , but only correlated with the variation in the number of cycles in responders . BIAS , CONFOUNDING AND OTHER REASONS FOR CAUTION The different doses were administered in different centres , and between-centre variation is a potential confounding factor . GENERALIZABILITY TO OTHER POPULATION S The paradigm of using the minimum effective dose of metformin could be pursued in other pathological conditions characterized by insulin resistance . STUDY FUNDING /COMPETING INTEREST(S ) No funding or competing interests to declare Our aim is to assess the effect of cinnamon powder capsules on insulin resistance , anthropometric measurements , glucose and lipid profiles , and and rogens of women with polycystic ovarian syndrome ( PCOS ) . Out of 80 women that were diagnosed as PCOS by Rotterdam Criteria , 66 were enrolled in this r and omized double-blind placebo-controlled clinical trial . All of the PCOS women were taking medroxy progesterone acetate 10 mg/day for the last 10 days of their menstrual cycles . The cases were r and omly allocated to 2 groups . The women in the first group were treated by cinnamon powder capsules 1.5 g/day in 3 divided doses for 12 weeks and the second group by similar placebo capsules .  Anthropometric measurements , fasting blood sugar , fasting insulin , blood glucose 2 hr after taking 75 g oral glucose , HbA1c , testosterone , dehydroepi and rosterone sulphate , homeostatic model assessment for insulin resistance , triglyceride , and cholesterol ( low-density lipoprotein , high-density lipoprotein , and total ) before and after the intervention were evaluated and compared as outcome measures . Fasting insulin ( p = .024 ) and homeostatic model assessment for insulin resistance ( p = .014 ) were reduced after 12 weeks in the cinnamon group compared with the placebo . There was also a significant decrease in low-density lipoprotein in cinnamon group ( p = .004 ) as compared with baseline that caused significant difference with placebo ( p = .049 ) . However , changes in other outcome measurements did not lead to statistically significant difference with placebo . The present results suggest that complementary supplementation of cinnamon significantly reduced fasting insulin and insulin resistance in women with PCOS For to determine the effect of Diamel on the insulin resistance , insulin sensitivity , and sexual hormones results in women with polycystic ovary syndrome ( PCOS ) . A study was carried out on 37 patients with this disorder . A triple-blind clinical trial was design ed in which the Diamel food supplement was compared with a placebo .  The women with reproductive ages were r and omly distributed in two groups , with 18 and 19 women respectively , and they took Diamel or placebo and were followed up during 6 months with clinical and biochemical evaluation . A significant decrease in the HOMA-IR from the initial value at six months was observed in the group with Diamel . The insulin sensitivity improved considerably in this group . The rate of menstrual recovery was higher in the group with Diamel , and two patients from this group obtained pregnancy . The hormone levels shows a significant decrease in testosterone at 3 months in the group with Diamel compared with the control group . The LH also decreases in the same group when comparing the start with 6 months . We concluded that the Diamel decreases insulin resistance and improves sensitivity to this hormone in women with PCOS , with improvement in the levels of LH and testosterone Abstract Aim : In the current study , we aim ed to investigate whether serum orexin-A ( OXA ) levels are different in polycystic ovary syndrome ( PCOS ) subjects . Material s and methods : Thirty-six women with PCOS and 40 healthy , age and body mass index-matched controls were included in the prospect i ve cross-sectional study . All subjects underwent venous blood draws during the early follicular phase after overnight fasting .  Serum OXA levels were measured with an enzyme immunoassay ( EIA ) . The relationships between the serum OXA levels and the anthropometric and metabolic parameters were also assessed . Results : The serum OXA levels were lower in the women with PCOS compared to the control group . The serum OXA levels were correlated negatively with systolic blood pressure , the Ferriman-Gallway score and LH and free testosterone levels . Conclusion : Our results indicate that serum OXA levels decrease in the serum of women with PCOS BACKGROUND We assessed the prevalence of mood disturbance among women with prospect ively documented polycystic ovary syndrome ( PCOS ) . METHODS Thirty-two women with PCOS completed the Center for Epidemiological Studies -Depression Rating Scale ( CES-D ) . Clinical and biochemical characteristics were assessed . RESULTS Sixteen women had CES-D scores indicative of depression . Depression was associated with greater insulin resistance ( P=0.02 ) and higher body mass index ( P=0.05 ) . Women receiving oral contraceptives  for the treatment of PCOS were less depressed than patients not receiving treatment ( P=0.03 ) . LIMITATIONS Possible selection bias , use of a screening tool alone without further diagnostic evaluation of depression , small sample s size and lack of direct comparison with an age matched control group , should be considered in interpretation of these results . CONCLUSION Findings suggest a high prevalence of depression among women with PCOS , and an association between depression and PCOS markers OBJECTIVE We aim ed to compare a combined oral contraceptive ( COC ) plus the anti and rogen spironolactone with the insulin sensitizer metformin in women with polycystic ovary syndrome ( PCOS ) . DESIGN We conducted a r and omized , parallel , open-label , clinical trial comparing COC ( 30 μg of ethinylestradiol and 150 μg of desogestrel ) plus spironolactone ( 100 mg/day ) with metformin ( 850 mg b.i.d . ) for one year in women with PCOS ( EudraCT2008 - 004531 - 38 ) . METHODS The composite primary outcome included efficacy ( amelioration of hirsutism , and rogen excess and menstrual dysfunction ) and cardiometabolic safety ( changes in the frequencies of disorders of glucose tolerance , dyslipidemia and hypertension ) . A complete anthropometric , biochemical , hormonal and metabolic evaluation was conducted every three months and data were su bmi tted to intention-to-treat analyses . RESULTS Twenty-four patients were assigned to COC plus spironolactone and 22 patients to metformin . Compared with metformin , COC plus spironolactone caused larger decreases in hirsutism score ( mean difference 4.6 points , 95 % CI : 2.6 - 6.7 ) , total testosterone ( 1.1 nmol/L , 0.4 - 1.7 ) , free testosterone ( 25 pmol/L , 12 - 39 ) , and rostenedione ( 5.5 nmol/L , 1.8 - 9.2 ) and dehydroepi and rosterone sulfate ( 2.7 μmol/L , 1.4 - 4.0 ) . Menstrual dysfunction was less frequent with COC plus spironolactone ( OR : 0.06 , 95 % CI : 0.02 - 0.23 ) . No differences were found in frequencies of abnormal glucose tolerance ( OR : 1.7 , 95 % CI : 0.7 - 4.4 ) , dyslipidemia ( OR : 0.6 , 95 % CI : 0.2 - 1.8 ) or hypertension ( OR : 0.3 , 95 % CI : 0.5 - 2.0 ) . No major adverse events occurred and biochemical markers were similarly safe with both treatments . CONCLUSIONS COC plus spironolactone was more effective than metformin for symptoms of PCOS showing similar safety and overall neutral effects on cardiometabolic risk factors OBJECTIVE To determine the rate of clinical ly evident polycystic ovary syndrome ( PCOS ) among first-degree female relatives within families with a prob and affected by PCOS . DESIGN Clinical and biochemical evaluation of the mothers and sisters of 93 patients with PCOS . The diagnosis of PCOS was established by : [ 1 ] a history of oligomenorrhea , [ 2 ] clinical evidence ( i.e. , hirsutism ) or biochemical evidence ( i.e. , elevated total or free T ) of hyper and rogenism , and [ 3 ] the exclusion of related disorders . SETTING Tertiary care university . PATIENT(S ) Patients with PCOS and their mothers and sisters . INTERVENTION(S ) Interview , physical examination , and hormonal testing on blood sample s were performed for all subjects . MAIN OUTCOME MEASURE(S ) The presence of hirsutism and hyper and rogenemia was determined in the mothers and sisters of the patients with PCOS . RESULT ( S ) Of the 78 mothers and 50 sisters evaluated clinical ly , 19 ( 24 % ) and 16 ( 32 % ) were affected with PCOS , respectively . A higher rate of PCOS was observed when only premenopausal women not taking hormones ( i.e. , untreated ) were considered ( i.e. , 35 % of mothers and 40 % of sisters ) , consistent with amelioration of symptoms with hormonal therapy or aging . These rates of PCOS are significantly higher than that observed in our general population ( approximately 4 % ) and suggest the involvement of a major genetic component in the disorder . CONCLUSION ( S ) The rates of PCOS in mothers and sisters of patients with PCOS were 24 % and 32 % , respectively , although the risk was higher when considering untreated premenopausal women only Obesity is frequently present in women with the polycystic ovary syndrome ( PCOS ) and aggravates insulin resistance ( IR ) and hyper and rogenemia . We aim ed to assess the effects of orlistat combined with lifestyle changes in overweight and obese women with PCOS and body mass index ( BMI ) ‐matched controls In most of South Asia , prevalences and phenotypes of  polycystic ovary syndrome ( PCOS ) among women in the community are unknown . The authors aim ed to estimate prevalence and phenotype in a community setting in Sri Lanka and to test a valid , feasible screening approach to early diagnosis . A community-based , cross-sectional study was carried out in 2005 - 2006 . A r and om sample of 3,030 women aged 15 - 39 years was selected by cluster sampling proportionate to population size . An interviewer-administered question naire was utilized to screen for " probable cases " of PCOS based on menstrual history and clinical manifestations of hyper and rogenism . Selected " probable cases " underwent clinical , biochemical , and ovarian ultrasound  assessment . The response rate was 96.2 % ( n = 2,915 ) . A total of 220 ( 7.5 % ) " probable cases " were identified : 209 women with oligo/amenorrhea ( 95 % ) and 11 women with hirsutism ( 5 % ) . Further evaluation of the 220 probable cases confirmed 164 newly diagnosed cases of PCOS based on the 2003 Rotterdam diagnostic criteria . With 19 previously diagnosed cases already present , total prevalence was 6.3 % ( 95 % confidence interval : 5.9 , 6.8 ) . Of the women with " oligo/amenorrhea and /or hirsutism , " 91.1 % were confirmed to have PCOS ; 99.4 % of women with " regular cycles in the absence of clinical hyper and rogenism " were confirmed as normal . The most common phenotypes of PCOS were oligo/amenorrhea and polycystic ovaries ( 91.4 % ) and oligo/amenorrhea and hirsutism ( 48.3 % ) Purpose Polycystic ovarian syndrome ( PCOS ) is one of the most common metabolic and endocrine disorders . Functional foods like pomegranate and probiotics are those that are considered to have beneficial effects on metabolic diseases beyond their basic nutritional value . So , we aim ed to evaluate the effect of synbiotic pomegranate juice ( SPJ ) on cardiovascular risk factors on PCOS patients . Methods This was a r and omized , triple-blinded , 8-week trial . Participants were r and omly assigned to receive 300 mL/day of pomegranate juice ( PJ ) , synbiotic beverage ( SB ) , synbiotic pomegranate juice ( SPJ ) , or placebo beverage ( PB ) . Biochemical indices ( lipid profile , Total Antioxidant Capacity ( TAC ) , Malondialdehyde ( MDA ) , high sensitive C-Reactive Protein ( hs-CRP ) ) and blood pressure were assessed before and after the intervention . Results Participants in the PJ , SB , and SPJ groups experienced improvement in their lipid profile , oxidative stress , inflammation , and blood pressure during the time . Compared to placebo , Total Cholesterol ( TC ) was lower in the SB group ( P < 0.01 ) , LDL-c was lower in the SPJ and SB groups ( P < 0.01 ) , and HDL-c was higher in the SPJ and PJ groups ( P < 0.01 ) . With regards to oxidative stress and inflammation , when compared with placebo , MDA was lower in the SPJ , SB , and PJ groups ( P < 0.001 ) , TAC was increased in the SPJ and PJ groups ( P $ $ < $ $ < 0.001 ) , and hs-CRP was decreased in the PJ group ( P = 0.02 ) . Blood pressure ( BP ) was lower in the SPJ and PJ groups compared to placebo ( P < 0.001 ; P < 0.01 , respectively ) . Conclusions Consuming daily SPJ for 8 weeks improved metabolic , oxidative , inflammatory , and BP outcomes in females with PCOS . This trial was registered in the Iranian Registry of Clinical Trials ( I RCT 20170207032439N2 ) Polycystic ovary syndrome ( PCOS ) , defined as the combination of oligoanovulation and hyper and rogenism , affects more than 5 % of women of reproductive age . Insulin resistance and hyperinsulinemia appear to play an important role in its pathogenesis . Here , we will present a characterization of a PCOS cohort from North Rhine-Westphalia in Germany . Clinical features , family history as well as endocrine and metabolic parameters were prospect ively recorded from 200 successive patients . All patients were evaluated for insulin resistance and beta-cell-function by oral glucose tolerance test .  Patient data were compared with those of 98 age-matched control women . PCOS patients showed significantly higher BMI , body fat mass and and rogen levels as well as impaired glucose and insulin metabolism . A positive family history of PCOS and diabetes was more frequent in PCOS patients . Insulin resistance ( 71 % ) was the most common metabolic abnormality in PCOS patients followed by obesity ( 52 % ) and dyslipidemia ( 46.3 % ) , with an incidence of 31.5 % for the metabolic syndrome . C-reactive protein and other cardiovascular risk factors were frequently elevated even in young PCOS patients . While the clinical characteristics and endocrine parameters of this German PCOS cohort were heterogeneous , they were comparable to those from other Caucasian population BACKGROUND / AIMS Insulin resistance is a common feature of both nonalcoholic fatty liver disease ( NAFLD ) and polycystic ovary syndrome ( PCOS ) , therefore , we hypothesize that PCOS and NAFLD may coexist . The aim of the present study was to determine the frequency and characteristics of NAFLD in women with PCOS . METHODS A prospect i ve study of patients with PCOS and no current pharmacological treatment was conducted . NAFLD was diagnosed by abdominal ultrasound following exclusion of alcohol consumption , viral , or autoimmune liver disease . Anthropometric variables , serum levels of glucose , insulin , lipids and aminotransferases , and HOMA index were determined . RESULTS Forty-one PCOS patients ( mean age : 24.6+/-7.2yr , mean body mass index [ BMI ] : 30.3+/-7.0kg/m(2 ) ) were included ; 26 of 41 PCOS patients ( 63.4 % ) had insulin resistance and 17 ( 41.5 % ) had NAFLD . Nine of the NAFLD patients ( 64 % ) also had abnormal aminotransferases .  Women with NAFLD and PCOS had a higher HOMA index and a higher waist-hip ratio than those with normal ultrasound . Patients with PCOS showed a higher frequency of NAFLD ( 41 % vs. 19 % ) and insulin resistance ( 63 % vs. 35.5 % ) than a control group . CONCLUSIONS NAFLD is frequent in patients with PCOS confirming a relevant clinical association between these two conditions . Women with PCOS should be screened for liver disease OBJECTIVE To report the baseline characteristics and racial differences in the polycystic ovary syndrome ( PCOS ) phenotype from a large multicenter clinical trial ( PPCOS ) . DESIGN Double-blind , r and omized trial of three treatment regimens ( with extended release metformin or clomiphene citrate ) . SETTING Academic medical centers . PATIENT(S ) Six hundred twenty-six infertile women with PCOS , aged 18 - 39 years , with elevated T levels and oligomenorrhea ( exclusion of secondary causes ) , seeking pregnancy , with > or = 1 patent fallopian tube , normal uterine cavity , and a partner with sperm concentration > or = 20 x 10(6)/mL in > or = 1 ejaculate . INTERVENTION(S ) Baseline characterization . MAIN OUTCOME MEASURE(S ) Historical , biometric , and biochemical measures of PCOS . RESULT ( S ) There were no significant differences in baseline variables between treatment groups . The overall mean ( + /-SD ) age of the subjects was 28.1 + /- 4.0 years , and the mean body mass index was 35.2 kg/m2 ( + /-8.7 ) .  Polycystic ovaries ( PCOs ) were present in 90.3 % of the subjects , and the mean volume of each ovary was 10 cm3 or more . Of the subjects , 7 % had ovaries that were discordant for PCO morphology . At baseline , 18.3 % of the subjects had an abnormal fasting glucose level ( > 100 mg/dL ) . Asians tended to have a milder phenotype , and whites and African Americans were similar in these measures . CONCLUSION ( S ) The treatment groups were well matched for baseline parameters , and we have added further information to the PCOS phenotype OBJECTIVE To develop a self-administered question naire for measuring health-related quality of life ( HRQL ) in women with polycystic ovary syndrome ( PCOS ) . METHODS We identified a pool of 182 items potentially relevant to women with PCOS through semistructured interviews with PCOS patients , a survey of health professionals who worked closely with PCOS women , and a literature review . One hundred women with PCOS completed a question naire in which they told us whether the 182 items were relevant to them and , if so , how important the issue was in their daily lives . We included items endorsed by at least 50 % of women in the analysis plus additional items considered crucial by clinicians and an important subgroup of patients in a factor analysis . We chose items for the final question naire taking into account both item impact ( the frequency and importance of the items ) and the results of the factor analysis . RESULTS Over 50 % of the women with PCOS labelled 47 items as important to them . Clinicians chose 5 additional items from the infertility domain , 4 of which were identified as important by women who were younger , less educated , married , and African-American . The Cattell 's Scree plot from a factor analysis of these 51 items suggested 5 factors that made intuitive sense : emotions , body hair , weight , infertility , and menstrual problems . We chose the highest impact items from these 5 domains to construct a final question naire , the Polycystic Ovary Syndrome Question naire ( PCOSQ ) , which includes a total of 26 items and takes 10 - 15 minutes to complete . CONCLUSIONS We have used established principles to construct a question naire that promises to be useful in measuring health-related quality of life . The question naire should be tested prior to , or concurrent with , its use in r and omized trials of new treatment approaches Abstract The aim of the current study was to assess the effects of probiotic supplementation on weight loss , glycaemia and lipid profiles in women with polycystic ovary syndrome ( PCOS ) . In a r and omized , double-blind , placebo-controlled trial , 60 women with PCOS were r and omized to receive probiotic capsule ( n = 30 ) or placebo ( n = 30 ) for 12 weeks . Consumption of probiotic supplements result ed in a significant reduction in weight ( −0.5 ± 0.4 vs. + 0.1 ± 1.0 kg , p = 0.004 ) and BMI ( −0.2 ± 0.2 vs. + 0.03 ± 0.4 kg/m2 , p = 0.004 ) compared with the placebo . In addition , compared with the placebo , probiotic administration was associated with a significant decrease in fasting plasma glucose ( −2.4 ± 8.4 vs. + 2.1 ± 7.0 mg/dL , p = 0.02 ) , serum insulin concentrations ( −2.0 ± 5.8 vs. + 1.6 ± 5.0 μIU/mL , p = 0.01 ) , homoeostasis model of assessment -insulin resistance ( −0.5 ± 1.4 vs. + 0.3 ± 1.1 , p = 0.01 ) , homoeostatic model assessment -beta cell function ( −7.5 ± 22.3 vs. + 6.3 ± 21.7 , p = 0.01 ) , serum triglycerides ( −13.3 ± 51.3 vs. + 13.6 ± 37.1 mg/dL , p= 0.02 ) and a significant increase in quantitative insulin sensitivity check index ( QUICKI ) ( + 0.006 ± 0.01 vs. −0.005 ± 0.02 , p = 0.01 ) . When we adjusted the analysis for baseline values of biochemical parameters , age and baseline BMI , except for QUICKI ( p = 0.08 ) , other findings did not alter . We found that probiotic supplementation among PCOS women for 12 weeks had favourable effects on weight loss , markers of insulin resistance , triglycerides and VLDL-cholesterol concentrations OBJECTIVE To investigate the combined effect of diet and orlistat , for 24 weeks , on anthropometric features , hormonal parameters , and indices of insulin resistance in obese women with polycystic ovary syndrome ( PCOS ) and in obese women without the syndrome . DESIGN Prospect i ve clinical study . SETTING Department of obstetrics and gynecology in a major university in Greece . PATIENT(S ) Eighteen selected women with PCOS were matched for age and body mass index with 14 obese control women . INTERVENTION(S ) Subjects were prescribed an energy-restricted diet , and orlistat ( 120 mg , 3 times per d ) was administered to all subjects for 24 weeks . MAIN OUTCOME MEASURE(S ) At baseline , week 12 , and week 24 , after an overnight fast , blood sample s were collected , and serum levels of FSH , LH , PRL , T , Delta(4)A , DHEAS , 17 alpha-hydroxyprogesterone , sex hormone-binding globulin , glucose , and insulin were measured . RESULT ( S ) Testosterone levels were significantly decreased with treatment in women with PCOS ; this decrease was attributed to the first trimester , whereas T levels did not change during the second 12-week period . In women with PCOS , insulin levels and HOMA-IR values were decreased during the first 12 weeks , whereas no significant change was observed during the second trimester . CONCLUSION ( S ) Orlistat administration , combined with diet , for 24 weeks , result ed in significant weight loss and improvement of insulin resistance in obese women , with or without PCOS . Moreover , T levels were significantly decreased in women with PCOS . There appears to be a trend during the first 12-week period for greater improvement of metabolic and hormonal parameters in women with PCOS OBJECTIVE To evaluate the influence of the opioid system on the hypothalamic-pituitary-adrenal axis in women with polycystic ovary syndrome ( PCOS ) . DESIGN Controlled clinical study . SETTING Academic research environment . PATIENT(S ) Eight lean and 12 obese women with PCOS , and seven lean and 5 obese control subjects . INTERVENTION(S ) Each patient received an i.v . bolus of naloxone at a dose of 125 microgram per kilogram of body weight ; 48 hours later , each patient received 16 mg of loperamide p.o . MAIN OUTCOME MEASURE(S ) Sample s were collected for 2 hours for the naloxone test and for 3 hours for the loperamide test .  Levels of adrenocorticotropic hormone ( ACTH ) and cortisol were measured in all plasma sample s. RESULT ( S ) The obese women with PCOS had a greater ACTH and cortisol response to opiate blockade than either the lean women with PCOS or the control subjects , but there was no difference between the lean or obese control subjects and the lean women with PCOS . There was no difference in the responsiveness of the hypothalamic-pituitary-adrenal axis to loperamide between the PCOS and control groups . CONCLUSION ( S ) The data indicate that the sensitivity of the hypothalamic-pituitary-adrenal axis to opioids can not be altered in women with PCOS . However , abnormalities of the hypothalamic-pituitary-adrenal axis in women with PCOS could be central in origin , as suggested by the effects of naloxone administration , and probably are related to the anthropometric characteristics of these hyper and rogenic patients Effect of Short-Term St and ard Therapeutic Regimens on Neuropeptide Y and Adipose Tissue Hormones in Overweight Insulinresistant Women with Polycystic Ovary Syndrome Aim : The study was aim ed at elucidating the influence of a 3-month treatment with routine therapeutic regimens - oral hormonal contraceptives ( OHC ) with anti and rogenic activity ( a st and ard combination of ethynil estradiol 35 μg plus cyproterone acetate 2 mg ) in combination with insulin sensitizing agents - metformin ( Group I ) and rosiglitazone ( Group II ) on adipose tissue hormones and hypothalamic neuropeptide Y ( NPY ) in women with polycystic ovary syndrome . Patients and methods : The study included 66 overweight insulin resistant women with PCOS according to the recent ESHRE-ASRM criteria r and omized into 2 age-matched therapeutic groups . Results : Significant decrease of leptin ( P < 0.01 ; P = 0.001 , resp . ) , resistin ( P < 0.01 ; P < 0.01 , resp . ) , tumour necrosis factor α ( TNFα ) ( P = 0.001 ; P < 0.001 , resp . ) , and NPY ( P < 0.05 ; P < 0.001 , resp . ) was observed in both groups after treatment . These findings were in parallel with a significant decrease in the anthropometric parameters of body weight in the metformin group only . No significant changes in hormonal characteristics of the groups were found except for a significant decrease in and rostenedione and DHEA-S ( P < 0.05 ) in the metformin group and in 17-OH-progesterone ( P < 0.05 ) in the rosiglitazone  group . HDL-cholesterol rose and diastolic blood pressure fell significantly ( P < 0.05 ) in the metformin group . Conclusion : Our data suggest beneficial effects of the treatment on potential cardiovascular risk in insulin resistant PCOS women . Эффект кратковременного при-менения стандартных терапев-тических режимов на нейропетид y и на гормоны жировой ткани у инсулин-резистентных женщин с поликистозным овариальным синдромом ( pcos ) и с избыточной массой тела Цель : Исследование ставит себе целью изучить эффект трехмесячного лечения с помощью рутин-ных терапевтических режимов ( оральные гормо-нальные контрацептивы ) , обладающих анти-андрогенной активностью ( стандартная комбинация - этинил эстрадиол 35 jug + ципротерон ацетат 2 mg ) в комбинации с метформином группа I и росиглитазоном - группа II на гормоны жировой ткани и на гипоталамический нейропептид Y ( NPY ) у женщин с PCOS . Пациенты и методы : Исследование охватывает 66 инсулин-резистентных женщин с PCOS и с избыточной массой тела . Диагноз поставлен по критериям ESHRE-ASRM ( рандомизация - две тера-певтические группы близкие по возрасту ) . Результаты : И в обеих группах после лечения отмечено сигнификантное уменьшение лептина ( Р < 0.01 ; Р = 0.001 , респ . ) , резистина ( Р < 0.01 ; Р < 0.01 , респ . ) , опухоли некротизирующего фактора a ( TNFa ) ( Р = 0.001 ; Р < 0.001 , респ . ) и NPY ( P < 0.05 ; Р < 0.001 , респ . ) . Эти результаты параллельны сигнификантному уменьшению антропометрических параметров массы тела только в группе женщин , леченных метформином . Не наблюдаются сигнифи-кантные изменения гормональных показателей и в обеих группах за исключением сигнификантного уменьшения андростерона и DHEA-S ( Р < 0.05 ) в группе , леченной метформином и 1 7-ОН-прогестерона ( Р < 0.05 ) в группе , леченной росиглитазоном . После лечения метформином HDL -холестерол повы-шается , а диастолическое артериальное давление сигнификантно снижается ( Р < 0.05 ) . Выводы : Полученные данные показывают благо- приятный эффект лечебных схем на потенциальные сердечно-сосудистые факторы риска у инсулин-резистентных женщин с PCOS
The findings suggest that pro-/synbiotic supplementation may improve glucose homeostasis parameters , hormonal , and inflammatory indices in women with PCOS
This study aim ed to systematic ally review r and omized clinical trials ( RCTs ) to clarify the effects of pro-/synbiotic supplementation on anthropometric and biochemical measurements in women with polycystic ovary syndrome ( PCOS ) .