Objective:This study was designed to:1 measure,for the first time,metastin (kisspeptin) levels in women with polycystic ovary syndrome (PCOS),a condition associated with hypersecretion of LH and hyperandrogenemia; and...Objective:This study was designed to:1 measure,for the first time,metastin (kisspeptin) levels in women with polycystic ovary syndrome (PCOS),a condition associated with hypersecretion of LH and hyperandrogenemia; and 2 investigate the possible correlations between metastin and PCOS-related reproductive and metabolic disturbances. Design:Clinical study. Setting:University hospital. Patient(s):Twenty-eight obese and overweight (body mass index BMI > 25 kg/m2) women with PCOS,28 normal weight (BMI < 25 kg/m2) women with the syndrome,and 13 obese and overweight controls (ovulatory women without clinical or biochemical hyperandrogenemia)-were selected. Intervention(s):Blood samples were collected between day 3 and day 6 of a spontaneous bleeding episode in the PCOS groups and a menstrual cycle of the controls,at 9:00 AM,after an overnight fast. Main Outcome Measure(s):Circulating levels of LH,FSH,PRL,T,Δ4-androstenedione (A),DHEAS,17α-OH-P,sex hormone-binding globulin (SHBG),insulin,glucose,and metastin were measured. Result(s):Both normal weight women with PCOS and obese controls were less insulin resistant and had significantly higher metastin levels,compared to obese and overweight women with the syndrome. Plasma kisspeptin levels were negatively correlated with BMI,free androgen index,and indices of insulin resistance. Conclusion(s):These results indicate that metastin is negatively associated with free androgen levels. The PCOS-associated insulin resistance and consequent hyperinsulinemia probably contribute to this effect by 1 stimulating androgen synthesis by the polycystic ovary (PCO) and 2 suppressing SHBG production in the liver.展开更多
Objective: To assess the association between serum adrenal cortex autoantibodies and histologically confirmed autoimmune lymphocytic oophoritis. Design: Controlled, prospective. Setting: Tertiary research center. Pati...Objective: To assess the association between serum adrenal cortex autoantibodies and histologically confirmed autoimmune lymphocytic oophoritis. Design: Controlled, prospective. Setting: Tertiary research center. Patient(s): Two hundred sixty-six women with 46,XX spontaneous premature ovarian failure. Intervention(s): Ovarian biopsy in 10 women. Main Outcome Measure(s): Serum adrenal cortex autoantibodies assessed by indirect immunofluorescence and autoimmune oophoritis assessed by immunohistochemical lymphocyte markers. Result(s): We obtained a histologic diagnosis of autoimmune oophoritis in four women who tested positive for adrenal cortex autoantibodies and excluded this diagnosis in ovarian biopsies from six women who tested negative for adrenal cortex autoantibodies (4/4 vs 0/6). Women with histologically confirmed autoimmune oophoritis had a greater total ovarian volume as assessed by transvaginal sonography (11.4 ±5.6 mL vs 1.5 ±0.4 mL) (mean ±SEM). They were also more likely to have subclinical adrenal insufficiency and clinical signs of androgen deficiency (3/4 vs 0/6). Overall, 10/266 women tested positive for adrenal cortex autoantibodies (3.8%, 95%confidence interval: 1.8%-6.5%). Conclusion(s): In women who present with 46,XX spontaneous premature ovarian failure as their primary concern there is a clear association between serum adrenal cortex autoantibodies and the presence of histologically confirmed autoimmune oophoritis.展开更多
文摘Objective:This study was designed to:1 measure,for the first time,metastin (kisspeptin) levels in women with polycystic ovary syndrome (PCOS),a condition associated with hypersecretion of LH and hyperandrogenemia; and 2 investigate the possible correlations between metastin and PCOS-related reproductive and metabolic disturbances. Design:Clinical study. Setting:University hospital. Patient(s):Twenty-eight obese and overweight (body mass index BMI > 25 kg/m2) women with PCOS,28 normal weight (BMI < 25 kg/m2) women with the syndrome,and 13 obese and overweight controls (ovulatory women without clinical or biochemical hyperandrogenemia)-were selected. Intervention(s):Blood samples were collected between day 3 and day 6 of a spontaneous bleeding episode in the PCOS groups and a menstrual cycle of the controls,at 9:00 AM,after an overnight fast. Main Outcome Measure(s):Circulating levels of LH,FSH,PRL,T,Δ4-androstenedione (A),DHEAS,17α-OH-P,sex hormone-binding globulin (SHBG),insulin,glucose,and metastin were measured. Result(s):Both normal weight women with PCOS and obese controls were less insulin resistant and had significantly higher metastin levels,compared to obese and overweight women with the syndrome. Plasma kisspeptin levels were negatively correlated with BMI,free androgen index,and indices of insulin resistance. Conclusion(s):These results indicate that metastin is negatively associated with free androgen levels. The PCOS-associated insulin resistance and consequent hyperinsulinemia probably contribute to this effect by 1 stimulating androgen synthesis by the polycystic ovary (PCO) and 2 suppressing SHBG production in the liver.
文摘Objective: To assess the association between serum adrenal cortex autoantibodies and histologically confirmed autoimmune lymphocytic oophoritis. Design: Controlled, prospective. Setting: Tertiary research center. Patient(s): Two hundred sixty-six women with 46,XX spontaneous premature ovarian failure. Intervention(s): Ovarian biopsy in 10 women. Main Outcome Measure(s): Serum adrenal cortex autoantibodies assessed by indirect immunofluorescence and autoimmune oophoritis assessed by immunohistochemical lymphocyte markers. Result(s): We obtained a histologic diagnosis of autoimmune oophoritis in four women who tested positive for adrenal cortex autoantibodies and excluded this diagnosis in ovarian biopsies from six women who tested negative for adrenal cortex autoantibodies (4/4 vs 0/6). Women with histologically confirmed autoimmune oophoritis had a greater total ovarian volume as assessed by transvaginal sonography (11.4 ±5.6 mL vs 1.5 ±0.4 mL) (mean ±SEM). They were also more likely to have subclinical adrenal insufficiency and clinical signs of androgen deficiency (3/4 vs 0/6). Overall, 10/266 women tested positive for adrenal cortex autoantibodies (3.8%, 95%confidence interval: 1.8%-6.5%). Conclusion(s): In women who present with 46,XX spontaneous premature ovarian failure as their primary concern there is a clear association between serum adrenal cortex autoantibodies and the presence of histologically confirmed autoimmune oophoritis.
