Gynecological Endocrinology最新文献

Background: This study aimed to investigate the impact of body mass index (BMI) and Polycystic Ovary Syndrome (PCOS) subtypes on periodontal parameters in Chinese women with PCOS and periodontitis.

Method: We conducted a retrospective case-control study analyzing data from 88 women with PCOS and 82 healthy controls. Participants were categorized by BMI (<24.0 kg/m²and ≥24.0 kg/m²) and PCOS subtypes. We compared periodontal parameters [including probing depth (PD), gingival bleeding index (GBI)] and reproductive hormone-related parameters.

Results: Women with PCOS and periodontitis had a significantly higher GBI (2.71 ± 0.53) compared to controls (2.25 ± 0.41, p < 0.0001). Among patients with BMI <24.0 kg/m², those with PCOS had a younger age [25.00(5.00) vs. 26.00(6.00) years, p < 0.05], lower PD [3.24(0.55) mm vs. 3.43 (0.48) mm, p < 0.01], and higher GBI [2.63(0.76) vs. 2.23(0.55), p < 0.0001]. For BMI ≥24.0 kg/m², PCOS patients had a higher GBI [2.91(0.36) vs. 2.38(0.59), p < 0.01] but a lower percentage of severe periodontal disease (p < 0.05).

Conclusion: PCOS could potentially worsen gingival inflammation among women already suffering from periodontitis, and a higher BMI might further intensify this correlation.

Objective: To investigate the differences in the metabolic indicators and sex hormones between obese and non-obese patients with polycystic ovary syndrome (PCOS), and their impacts on endometrial receptivity (ER).

Methods: We selected 255 individuals with PCOS, and categorized them into the obese groups, including the OP group (obese patients with PCOS) and the ON group (obese patients without PCOS), and selected 64 individuals who were categorized in the non-obese groups, namely, the control groups, which comprise the NP group (non-obese patients with PCOS) and the NN group(non-obese patients without PCOS). The one-way analysis of variance (ANOVA) and Mann-Whitney U tests were used to compare the metabolic indicators, and sex hormone-associated and ER-associated indicators between the groups. The correlation between the aforementioned clinical markers and ER was analyzed using the Pearson's correlation coefficient.

Results: (1) In comparison with the NP group, the OP group exhibited higher levels (p < .01) of free androgen index (FAI), anti-müllerian hormone (AMH), fasting insulin (FINS), insulin level within 60 min, 120 min, and 180 min-60minINS, 120minINS, and 180minINS, respectively, fasting blood glucose (FBG), blood glucose level within two hours (2hGlu), homeostatic model assessment for insulin resistance (HOMA-IR), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), waist-to-hip ratio (WHR), waist circumference, hip circumference, the ratio of the maximum blood flow velocity of the uterine artery during systole to the blood flow velocity of the uterine artery at the end of diastole (uterine artery S/D), and blood flow resistance index (RI) of the uterine artery. In comparison with the NP group, the OP group exhibited lower levels (p < .01) of sex hormone binding globulin (SHBG), dehydroepiandrosterone (DHEA), high molecular weight adiponectin (HMWA), and high-density lipoprotein cholesterol (HDL-C). (2) In the PCOS group, RI was significantly positively correlated with FAI, FINS, 120minINS, HOMA-IR, and WHR (p < .01), and significantly negatively correlated with SHBG, HDL-C, and HMWA (p < .01); uterine artery S/D was significantly positively correlated with FAI, FINS, 2hGlu, HOMA-IR, LDL-C, and WHR (p < .01), significantly positively correlated with 120minINS and FBG (p < .05), and significantly negatively correlated with SHBG and HMWA (p < .01).

Conclusion: (1) The OP group exhibited obvious metabolic disorders and poor ER, which was manifested as low levels of SHBG and HMWA, and high levels of FAI, HOMA-IR, WHR, uterine artery S/D, and RI. (2) In patients with PCOS, there was a substantial correlation between ER-associated indicators RI and uterine artery S/D and FAI, FINS, 120minINS, HOMA-IR, WHR, SHBG, and HMWA.

Objective: evaluate the efficacy and tolerability of PureCyTonin against hot flashes (HF) in breast cancer survivors (BCS).

Methods: a prospective, multicenter, randomized, double-blind placebo-controlled trial was conducted in Italy.

Interventions: administration of PureCyTonin or placebo, for 3 months. Effectiveness was investigated through the compilation of a daily diary for HF and of validated questionnaires (Menopause Rating Scale (MRS), Pittsburgh Sleep Quality Index (PSQI), Visual Analogical Scales (VAS) for HF, sweating, irritability, fatigue, sleep, quality of life), carried out before starting the treatment (T0), after 1 month (T1) and after 3 months (T2). Any side effects and HF diary were recorded at each visit.

Results: 19 women were randomized to receive PureCyTonin and 20 to placebo. At T2 compared to T0, in the PureCyTonin group, we found a reduction in the number of HF (p = 0.02) measured by daily diary. An improvement in the subjective perception of women regarding HF intensity (p = 0.04), sweat nuisance (p = 0.02), irritability (p = 0.03) and fatigue (p = 0.04) was observed through VAS scale measurement at T2 compared to T0.The total MRS score was significantly better in the PureCyTonin group at T1 (p = 0.03) compared to T0.

Conclusions: PureCyTonin significantly reduces HF number after 3 months of therapy in BCS and it is well-tolerated.

Background: Iron metabolism plays a significant role in the development of metabolic disorders in women with polycystic ovary syndrome (PCOS). Despite the importance of hepcidin, a key iron regulator, current research on serum hepcidin levels in PCOS patients shows conflicting results.

Methods: PubMed, Embase, Web of Science, Cochrane Library and the China National Knowledge Infrastructure (CNKI) database were systematically searched from their inception to 9 September 2023. The search aimed to identify studies in English and Chinese that examined hepcidin levels in women with PCOS compared to healthy control subjects. Standardized mean differences (SMDs) with corresponding 95% confidence intervals (95% CIs) were calculated to evaluate the difference in serum hepcidin levels between women with and without PCOS.

Results: The meta-analysis included a total of 10 eligible studies, which encompassed 499 PCOS patients and 391 control subjects. The pooled analysis revealed a significant reduction in serum hepcidin levels among the PCOS patients compared to the healthy controls (SMD = -3.49, 95% CI: -4.68 to -2.30, p < .05). There was no statistically significant difference in serum hepcidin levels between PCOS patients with a body mass index (BMI) < 25 and those with a BMI ≥ 25 (p > .05).

Conclusion: The serum hepcidin levels of women with PCOS were significantly lower than those of healthy controls, which suggests that serum hepcidin could be a potential biomarker for PCOS.

Objective: To synthesize the primary evidence on the efficacy and safety of visnadine on symptoms of sexual dysfunction (SD) in heterosexual women.

Methods: We conducted a systematic review of randomized clinical trials (RCTs) with a primary search without language restriction in PubMed/Medline, Scopus, Embase, Web of Science, Cochrane Library, and international clinical trial registries. Trials reporting the use of visnadine by any route in women with SD were eligible. We performed screening, data extraction, and risk of bias assessment in a double-blind approach. The primary outcomes were the Female Sexual Function Index (FSFI) and its domains. Secondary outcomes were safety, arousal, lubrication, pleasure, orgasm, negative sensations, duration, and overall satisfaction.

Results: Initially, 242 records were retrieved. We selected nine papers for full-text reading and finally included two RCTs: one with a parallel design and one with a crossover design with a total of 96 patients. One study compared visnadine aerosol with a placebo, while the other compared different frequencies of visnadine aerosol use. Visnadine use showed a statistically significant improvement (p < 0.05) in overall FSFI scores, regardless of the frequency of use. A meta-analysis was not possible due to the high clinical and methodological heterogeneity between available studies.

Conclusion: RCTs regarding the use of visnadine for the Female SD are scarce and methodologically limited. This preliminary evidence shows visnadine as a potentially effective and safe option to alleviate some of the clinical symptoms of SD in heterosexual women. However, future better-designed randomized studies with larger sample numbers are required.

Premature ovarian insufficiency (POI) is a common gynecological endocrine disease, which seriously affects women's physical and mental health and fertility, and its incidence is increasing year by year. With the development of social economy and technology, psychological stressors such as anxiety and depression caused by social, life and environmental factors may be one of the risk factors for POI. We used PubMed to search peer-reviewed original English manuscripts published over the last 10 years to identify established and experimental studies on the relationship between various types of stress and decreased ovarian function. Oxidative stress, follicular atresia, and excessive activation of oocytes, caused by Stress-associated factors may be the main causes of ovarian function damage. This article reviews the relationship between psychological stressors and hypoovarian function and the possible early intervention measures in order to provide new ideas for future clinical treatment and intervention.

Objective: Anthropometric measurement provides a simple, noninvasive approach to evaluate obesity in pregnant women. We aimed to develop a predictive model utilizing anthropometric index for gestational diabetes mellitus (GDM), the most common obesity-related complications during pregnancy.

Methods: A prospective cohort of 4709 women was enrolled in Qingdao, China. Logistic regression model was constructed to determine the association of body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) in the first trimester (<14 weeks' gestation) with GDM. The discrimination ability for GDM was assessed using areas under the receiver operating characteristic (ROC) curve (AUC). Delong tests were performed to compare AUC values between different measures.

Results: The GDM incidence was 19.50%. GDM risk increased with VAT during early pregnancy, and the risk increased by 117% (OR = 2.17, 95% CI: 1.23-2.83) to 326% (OR = 4.26, 95% CI: 2.29-7.91) in pregnant women with the second quartile or above after adjusting for confounders (all p<.05). Combined index using VAT and BMI demonstrated superior predictive power for GDM compared with BMI alone (p<.05), but didn't differ from VAT (p>.05). Overall, VAT was positively correlated with GDM occurrence, outperforming BMI, WHR, WHtR and SAT in the predicative model. A first-trimester VAT cutoff of 27.05 mm might be promising for GDM risk stratification.

Conclusions: First-trimester routine ultrasound screening may facilitate earlier identification and intervention of GDM. Pregnant women with VAT above the optimal threshold (27.05 mm) might benefit from targeted GDM monitoring.

Objective: To disclose the relationships between serum LH and reproductive outcomes in Gonadotropin-releasing hormone (GnRH) antagonist protocol pretreated with luteal estradiol.

Methods: 371 patients, pretreated with estradiol, followed the GnRH antagonist protocol. They were divided into four groups based on the quartiles of serum LH levels on the day of gonadotropin (Gn) initiation(LH_GI) and trigger (LH_trigger). Data on various pregnancy outcomes were collected.

Results: As serum LH_GI increased, anti-Müllerian hormone (AMH) level, antral follicle count (AFC), LH_trigger, estradiol (E₂) and P on the trigger day, E₂/oocytes, and oocyte numbers increased and peaked in Q4, while Gn dose decreased. Good-quality embryo and blast formation rates increased and peaked in Q3. LH_GI <3.93 mIU/ml impaired ongoing pregnancy rate and LBR. After adjusting for AMH and AFC, the impacts were not significant. As LH_trigger increased, E₂/oocytes and good-quality embryo rate increased and peaked in T4 and implantation rate increased and peaked in T3. LH_trigger <1.49 mIU/ml independently influenced clinical pregnancy rate (CPR) after adjusting for AMH and AFC. LH_GI was positively related to AMH, AFC, LH_trigger, blast formation rate and negatively related to BMI, age and Gn dose. LH_trigger was positively related to E2/oocytes and good quality embryo rate.

Conclusions: Lower serum LH represents as a potential indicator for embryo quality and reproductive outcomes in GnRH antagonist fixed protocol pretreated with estradiol. Early identification of excessive suppression of LH levels will benefit individuals with normal ovarian reserve more.