Gynecological Endocrinology最新文献

To analyze and evaluate the correlation between different lipid metabolism levels and endometriosis. The literatures on lipid metabolism and endometriosis published in databases were searched and collected. The search was conducted up to December 2023. The meta-analysis was conducted using Review Manager 5.4.1 software, with odds ratios (ORs) or standardized mean difference (SMD), confidence intervals (CIs), and heterogeneity (I²) being calculated. The literature bias was evaluated by drawing funnel plot. Five hundred and eighty-four literatures were retrieved, and finally, 7 literatures were included in this study. Meta-analysis showed that the level of total cholesterol (TC) in endometriosis groups was higher than control group [SMD = 1.70, 95%CI (0.60-2.80), p = 0.003], while triglyceride (TG) [SMD=-0.24, 95%CI (-0.68-0.21), p = 0.300], low-density lipoprotein (LDL) [SMD = 0.22, 95%CI (-0.34 - 0.78), p = 0.440] and high-density lipoprotein (HDL) [SMD = 0.06, 95%CI (-0.14 - 0.25), p = 0.550] was not statistically significant. Sensitivity analysis indicated that the combined effect size results were stable and reliable [SMD = 1.70, 95%CI (0.60-2.80), p = 0.030]. Funnel plot results showed publication bias. Patients with endometriosis have abnormal blood lipid level, and higher TC level may be a risk factor for endometriosis. The impact of blood lipid metabolism on endometriosis may provide new insights into the pathogenesis and treatment prognosis of endometriosis.

This study amed to investigate the combined use of probiotics and metformin on metabolic parameters in patients with polycystic ovary syndrome (PCOS). 138 patients with PCOS were retrospectively included from January to December 2023 and divided into metformin (n = 70) and probiotics-metformin combination (n = 68) groups based on their clinical treatment regimens. After the three-month intervention, the combination group showed significantly greater improvements compared to the metformin group in high-density lipoprotein cholesterol levels (p < 0.001), insulin levels (p < 0.001), and adiponectin levels (p = 0.033). The combination group also exhibited more significant reductions in weight (p = 0.006), waist circumference (p = 0.037), hip circumference (p = 0.044), and waist-hip ratio (p = 0.031). No significant differences were observed between the groups in changes to other metabolic parameters, hormonal profiles, inflammatory markers, or quality of life assessments (p > 0.05). This retrospective pilot study suggests that the addition of probiotics to metformin therapy may improve HDL levels, insulin sensitivity, anthropometric measurements, and adiponectin levels compared to metformin alone in patients with PCOS.

Background: Abnormal uterine bleeding (AUB) impacts the quality of life of women globally. While international classifications and frameworks exist, there are still critical unmet needs in awareness, diagnosis, treatment, and patient support. To better understand these, the lived experiences of patients with AUB shared on social media can offer valuable insights.

Objective: To identify and analyze unmet needs in the management of AUB as expressed during social media discussions.

Methods: Using the social media listening tool Sprinklr Social (Sprinklr Inc.), public posts from X (X Corp.) related to AUB from seven countries (Brazil, China, India, Mexico, Pakistan, Saudi Arabia, Ukraine) over a 10-year period (2014-2024) were analyzed. Posts were categorized by topic, sentiment, and emotion; further analyses assessed patients' unmet needs and feelings.

Results: A total of 926 posts were included. Analysis revealed five critical unmet needs: lack of awareness and understanding (41.8%), impact on wellbeing (27.6%), diagnosis issues (10.9%), dissatisfaction with treatment options (9.7%), and undervalued impact and advocacy (8.6%). Posts about diagnosis and symptoms carried the most negative sentiments; many patients expressed frustration over delayed diagnoses and dissatisfaction with treatment options. Additionally, the emotional and psychological burden of AUB was a recurring theme, suggesting the need for more holistic care approaches.

Conclusions: Gaps in AUB management were identified, with strong emphasis on the need for better patient education, more effective diagnostic processes, and personalized treatment strategies. Incorporating patient voices during the development of treatment guidelines and healthcare policies is crucial for addressing these unmet needs and improving patient outcomes.

Inflammation exerts an essential role in gestational diabetes mellitus (GDM), but the relationship between peripheral blood inflammatory markers and GDM remains unclear. The purpose of this study was to explore the relationship between inflammatory markers and GDM in US adults. Data were extracted from the National Health and Nutrition Examination Survey. Five inflammatory markers were derived from complete blood count. Survey-weighted multivariable logistic regression models were used to assess the association between inflammatory markers and GDM. Restricted cubic splines and subgroup analyses were conducted to validate the stability of the results. Finally, a total of 2363 women aged 20-44 were included based on specific criteria, with 229 self-reported GDM cases (9.69%). The increased lymphocyte-monocyte ratio (LMR) was associated with the higher risk of GDM, aOR = 1.82 (CI:1.30-2.56). Compared with the lowest tertile, the highest tertile group of LMR showed a significantly increased risk of GDM, aOR = 2.24 (CI: 1.28-2.85). Conversely, the highest tertile group of systemic inflammation response index (SIRI) was negatively associated with GDM, aOR = 0.61 (95% CI: 0.40-0.94). And high platelet-lymphocyte ratio (PLR) levels are related to a lower risk of GDM. No non-linear relationships were observed. Furthermore, subgroup analysis revealed that the association between LMR, SIRI, and GDM remained consistent with the overall results. Our study indicated that LMR, PLR, and SIRI may be potential predictors of GDM. Further large-scale prospective study is needed to investigate the role of LMR, PLR and SIRI in GDM.

Nearly 50% of women with functional hypothalamic amenorrhea (FHA) reveal polycystic ovarian morphology (PCOM), a known risk factor for ovarian hyperstimulation syndrome. However, gonadotropin releasing hormone-agonist (GnRH-a) triggers are not recommended in FHA, since an inadequate endogenous surge in luteinizing hormone (LH) is expected. We aimed to challenge this concept and evaluated LH levels after GnRH stimulation in FHA-women with and without PCOM. In a retrospective cohort study, 82 women with FHA, who underwent a GnRH stimulation test, were included. Thirty-five women revealed PCOM (42.7%). Twenty minutes after GnRH stimulation, there was an increase of serum LH levels in FHA-PCOM (median basal: 2.7 mIU/mL, IQR 1.1-4.6 versus median stimulated: 13.5 mIU/mL, IQR 7.8-21.6, p < 0.001) and in FHA-nonPCOM patients (median basal: 2.5 mIU/mL, IQR 0.5-3.9 versus median stimulated: 5.7 mIU/mL, IQR 2.4-13.9, p < 0.001). Overall, positive correlations (p < 0.001) were found between basal and stimulated LH levels. In FHA-PCOM patients, 42.9% of patients revealed stimulated LH levels >15 mIU/mL, while this was the case in 19.1% of FHA-nonPCOM patients (p = 0.034). In women with FHA-PCOM, ovulation induction with a GnRH-a trigger might be feasible. Future research should focus on the prediction of an adequate response to GnRH triggers in the IVF setting.

Gestational diabetes mellitus (GDM) affects 9-25% of pregnancies. Undiagnosed or poorly managed GDM is associated with both short- and long-term complications in the fetus and mother. The pathogenesis of GDM is complex and has not yet been fully elucidated. Several biomarkers found in maternal serum have the potential for the early diagnosis of GDM. The aim of this narrative review was to explore novel biomarkers that have not been comprehensively described in previous reviews. We believe these biomarkers may allow for the detection of GDM in the early stages of pregnancy, enabling timely proper treatment and potentially preventing complications for both the mother and the fetus.

Objective: Endometriosis is an estrogen-dependent disease wherein isoflavones interact with estrogen receptors. Daidzein-rich isoflavone aglycones (DRIAs) have been shown to inhibit cell proliferation and aromatase activity in vitro and in vivo. This study aims to investigate the effects of DRIAs on the enzymes involved in estrogen metabolism in endometriosis.

Study design: Stromal cells isolated from ovarian endometriomas (OESCs) were cultured with DRIAs. Ovarian endometrioma (OE) specimens were obtained from patients who were treated with or without DRIAs. The gene expressions involved in estrogen metabolism and 17β-hydroxysteroid dehydrogenase (HSD17β) 1 activity were analyzed using RT-PCR and thin layer chromatography, respectively.

Results: HSD17β1 expression in OE specimens was evaluated using immunohistochemical staining. DRIA treatment significantly suppressed HSD17β1 expression and elevated estrogen sulfotransferase (EST) levels in OESCs; however, no differences were observed in HSD17β2, HSD17β7, HSD17β12, and steroid sulfatase (STS) levels. HSD17β1 enzyme activity was inhibited by DRIAs. Furthermore, immunohistochemical analysis confirmed that HSD17β1 expression was suppressed in the OE specimens of patients undergoing treatment with DRIAs.

Conclusions: DRIA treatment could suppress abnormal estrogen production via EST stimulation as well as the inhibition of aromatase and HSD17β1 activities, suggesting therapeutic potential in endometriosis that needs to be confirmed by our ongoing clinical trial. ay.

Background: Endometriosis is a chronic condition affecting physical health, emotional well-being, and socioeconomic stability. While pain is a well-recognized determinant of health-related quality of life (HR-QoL), the role of pain experience over employment status remains underexplored. Objective: To determine among women with endometriosis whether employment status independently contributes to HR-QoL, beyond clinical symptoms. Methods: This cross-sectional study was conducted at the University Hospital of Geneva. Women with a confirmed diagnosis of endometriosis were included. Employment status was categorized as full-time employment (>80%), part-time employment (≤80%), voluntary unemployment, and involuntary unemployment. HR-QoL was measured using the Endometriosis Health Profile-30 (EHP-30). Results: A total of 324 patients were included (mean age 32 ± 7.2 years); 78.2% had deep infiltrating endometriosis, and 34.5% reported prior surgery. Regarding employment, 63.2% were employed (51.5% full-time, 11.7% part-time), while 36.7% were unemployed, including 26.2% by choice. Full-time and part-time employment were linked to lower EHP-30 pain scores, with part-time employment showing a stronger association (β = -34.48, 95% CI: -58.00 to -10.88, p = 0.006) than full-time employment (β = -20.57, 95% CI: -40.70 to -0.43, p = 0.046). Unemployed women actively seeking work exhibited worse HR-QoL, particularly in social support (β  = 34.95, 95% CI: 1.89 to 70.80, p = 0.048) and overall HR-QoL burden (β  = 168.27, 95% CI: 30.60 to 205.91, p = 0.019). Conclusion: Employment status is an independent predictor of HR-QoL in women with endometriosis. Beyond pain, professional identity and social integration play key roles in endometriosis burden.

Background: Obesity-related polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with infertility and metabolic dysfunction. While bone morphogenetic protein-15 (BMP-15) plays a recognized role in ovarian function, its specific impact on infertility in obese PCOS patients remains unclear Objective: This study aimed to investigate the influence of BMP-15, NOD-like receptor protein 3 (NLRP3), and interleukin-18 (IL-18) on infertility in this population and to evaluate their predictive clinical value. Methods: Clinical data from 185 obese PCOS patients were retrospectively analyzed. Univariate and logistic regression analyses identified infertility-related factors. Results: Results showed an infertility rate of 34.43%, with significant differences in BMP-15, NLRP3, IL-18, Morisky Medication Adherence Scale (MMAS-8), and Connor-Davidson Resilience Scale (CD-RISC) scores between infertility and non-infertility groups. NLRP3, IL-18, and MMAS-8 emerged as risk factors, while BMP-15 and CD-RISC were protective.In an obese PCOS mouse model, BMP-15 administration improved metabolic parameters, restored hormonal balance, reduced ovarian inflammation, and preserved fertility. Conclusion: These findings suggest that BMP-15 plays a protective role in PCOS-related infertility by modulating metabolic and inflammatory pathways. BMP-15 may serve as a valuable biomarker and therapeutic target for early identification and intervention in obese PCOS patients at risk of infertility.