When differences in age and weight between PCOS patients and controls are negligible, PCOS is not associated with a higher risk of pregnancy complications.

No abstract

No abstract

Insulin resistance is a frequent (although not constant) abnormality in both obese and nonobese women with polycystic ovary syndrome (PCOS). It plays a key role in the predisposition to type 2 diabetes, which is the most important health consequence of the syndrome. Identification of patients with insulin resistance is significant both for follow-up and for therapeutic reasons. The aim of the study was to evaluate the relationships between insulin sensitivity, measured by euglycemic clamp, and both endocrine and metabolic indices and to identify the best model for predicting insulin sensitivity. A total of 41 nonobese women fulfilling the diagnostic criteria for PCOS were enrolled in the study. None of the androgens correlated with the insulin sensitivity index. All clamp parameters correlated with SHBG, triglycerides, and body mass index, although no correlation was found with waist to hip ratio or waist circumference. The close relationship between insulin sensitivity and SHBG was documented by factor analysis and by its presence in all prediction models as the most significant (or even the single) predictor of the insulin sensitivity index. In conclusion: 1) a decreased level of SHBG can be used as a single reliable parameter in the prediction of insulin sensitivity in nonobese women with PCOS; and 2) waist to hip ratio, waist circumference, and androgen concentrations have no predictive value. (J Clin Endocrinol Metab 87: 5821-5825, 2002) D ECREASED INSULIN SENSITIVITY has been documented in both obese and nonobese women with polycystic ovary syndrome (PCOS), but the prevalence of insulin resistance is not known (1, 2). Although there is no prospective study, it is assumed that it is the subgroup of women with PCOS and concurrent insulin resistance that is at increased risk of diabetes and possibly cardiovascular disease (3, 4). Identification of patients with impaired insulin sensitivity is significant, both for follow-up and for long-term therapy.In our study, we investigated a large group of nonobese women fulfilling the generally accepted diagnostic criteria of PCOS, using the euglycemic clamp. The aim of the study was to evaluate the relationships between insulin sensitivity and endocrine and metabolic indices, and possibly to identify a parameter or its combination, that would be applicable in clinical practice to predict insulin sensitivity. Subjects and Methods SubjectsA total of 41 patients were enrolled in the study, based on the following diagnostic criteria of PCOS: 1) oligomenorrhea from menarche; 2) an increased concentration of testosterone (0.5-2.63 nm/liter), androstenedione (1.57-5.4 nm/liter), or dehydroepiandrosterone (DHEA) (0.8 -10.5 nm/liter); and 3) clinical manifestation of hyperandrogenism (acne, hirsutism, or both). Only nonobese women with a body mass index (BMI) under 30 kg/m 2 , above 18 yr of age, who had not used hormonal therapy during the previous 6 months, were included. All patients were informed about the study protocol and signed an informed consent. The Local Ethics Com...

Introduction: Lymphocyte subpopulations are identified by the uniform CD classification (Cluster of Differentiation) and can be accurately differentiated with monoclonal antibodies using the method of flow cytometry. With the aid of cordocentesis it is possible to perform studies on the status and development of cellular immunity as early as in the second trimester of pregnancy. Objective: To compare lymphocyte subpopulations present in fetuses with chromosomal abnormalities (Down’s syndrome (DS), Edwards’ syndrome (ES)) and fetuses with normal karyotype. Study Design: Prospective observational study. Methods: We examined a total of 61 pregnant women with an average age of 31.5 years (20– 46 years). Results: In fetuses with DS we found a significant decrease in B lymphocytes (CD19),a decrease in the subpopulations of multi-reactive B-cells (CD5+CD19+, B-CLL),and a decrease in the index of CD4/CD8 and class II HLA-DR. In contrast, the representation of NK cells expressing /CD3-CD (16 + 56)+/ was greatly increased. In ES we found a decrease in T lymphocytes (CD3), a decrease in T-helper lymphocytes (monocytes CD4), a decreased index of CD4/CD8 and a greater representation of NK cells /CD3-CD (16 + 56)+/. Conclusion: We determined the normal values of lymphocyte subpopulations in physiological fetuses. We demonstrated that the immunological defect of the affected fetuses is already present antenatally, and can be reliably diagnosed in the second trimester of pregnancy.