Introduction. Chronic inflammation and oxidative stress conditions have been reported in women with polycystic ovary syndrome (PCOS). Peroxiredoxin 4 (Prx4) is a related antioxidant in insulin synthesis. We hypothesized that insulin resistance in these women is associated with total oxidant status (TOS) and inflammatory factors. Materials and Methods. Two hundred three people including 104 PCOS patients and 99 healthy women, who were matched for age and body mass index (BMI), entered the study. Waist circumference of the participants was measured; serum glucose, lipid profile, insulin, Prx4, TOS, hs-CRP, and TNF-α were also evaluated. Results. The Prx4 level was significantly lower in PCOS than in the control group. In addition, marked increase was observed in the concentration of TOS, hs-CRP, and TNF-α in PCOS, compared to the healthy women. There was a positive correlation of TOS with hs-CRP, TNF-α, and HOMA-IR. The risk of PCOS for subjects with high hs-CRP was 60 times greater than those who had low serum hs-CRP concentration; after performing multiple logistic regression analyses with the backward method, TNF-α was considered as an effective biomarker to predict PCOS β = 49.087 (all p < 0.05 ). Conclusion. This study identified increased oxidative stress and inflammation in PCOS; this may be due to decrease in the antioxidants, such as Prx4.

Background & Objective: The present study was conducted to determine testosterone and ferritin levels in women with polycystic ovary syndrome (PCOS) and investigate its relationship with body mass index (BMI) Materials & Methods: In this case-control study, 104 PCOS cases and 99 controls were included. The concentration of testosterone, ferritin, lipid profile, insulin, glucose, and androgen was measured in fasting blood samples. Results: Testosterone level was equal to 1.08 ± 0.50 and 0.85 ± 0.42 in the case and control groups, respectively (P< 0.001). Values of ferritin (123.45 ± 18.21ng/dl vs. 92.14 ± 17.74 ng/dl in control group, p< 0.001), insulin (11.41 ± 3.84 µU/ml vs. 7.02 ± 3.29 µU/ml in control group, p< 0.001), and insulin resistance (11.41 ± 3.84 vs.7.02 ± 3.29 in control group, p< 0.001) were also measured. There was a significant relationship between serum concentration of testosterone and ferritin with BMI) p<0.001). The role of ferritin to predict PCOS was significant (ß:-1.1, P< 0.001). Conclusion: According to the findings of the present study, the levels of testosterone and ferritin were increased in patients with PCOS. Although elevated testosterone levels are effective in PCOS, ferritin concentration is an important factor in predicting and exacerbating the disease.

Background: There is an association between inflammatory factors and polycystic ovary syndrome (PCOS) and most of women with PCOS experience the symptoms of hirsutism. The purpose of this study was to evaluate the role of obesity in PCOS occurrence, which is linked with inflammation and hirsutism. Methods: This study was designed as a case-control research. It was performed on 102 women with PCOS and 102 healthy women as controls who were age-matched. Serum concentrations of testosterone, estradiol (E2), IL-1, IL-6, high-sensitivity c-reactive protein (hs-CRP), and aromatase activity were measured in blood samples. Statistical tests including unpaired t-tests, Mann-Whitney U test, Kruskal-Wallis, Spearman’s correlation, and Chi-square tests were used for data analysis. Statistical significance was set at p<0.05. Results: A significant difference was found between hs-CRP, IL-1, and IL-6 in PCOS patients and healthy individuals (p<0.001). Aromatase activity was markedly lower in PCOS cases. The serum level of IL-1 (p=0.392) and IL-6 (p=0.764) was not different between overweight and normal weight women. In both studied groups (case and control), hirsutism frequency was markedly higher in individuals with BMI ≥25 kg/m2 (p<0.05). Inflammatory factors significantly affected the PCOS group (p<0.05). However, logistic regression showed that hs-CRP increment is more effective on increasing the risk of PCOS (OR: 6.324, p<0.001). Conclusion: In this study, hs-CRP, IL-1, and IL-6 levels increased in all PCOS women. Although the incidence of hirsutism in PCOS is associated with obesity, in PCOS pathogenesis, only IL-1 and IL-6 were independent of BMI.

BackgroundThe aim of this study was to compare the effect of spinal anesthesia (SPA), paracervical block (PB), and general anesthesia (GA), on pain, the frequency of nausea and vomiting and analgesic requirements in diagnostic hysteroscopy.MethodsThis single-center, non-randomized, parallel-group, clinical trial was conducted on 66 diagnostic hysteroscopy candidates who were selected by convenience sampling at Fatemieh Hospital, in Hamadan, Iran, in 2021.ResultsThe mean pain score during recovery and the need for analgesic injections was found to be significantly higher in the GA group compared to that in the SPA group (pain: 3.77 ± 2.25 vs. 0.10 ± 0.30, P &lt; 0.001), (analgesic: 50 vs. 0%, P &lt; 0.001) and PB group (pain: 3.77 ± 2.25 vs. 0.90 ± 1.37, P &lt; 0.001), (analgesic 50 vs. 10%, P &lt; 0.001), respectively. However, no statistically significant difference was observed between the mean pain score between SPA and PB groups (0.10 ± 0.30 vs. 0.90 ± 1.3, P = 0.661). In addition, there were no significant differences between groups on nausea/vomiting after operation (P = 0.382). In adjusted regression analysis (adjusting for age, weight, gravid, abortion, and cause of hysteroscopy), the odds ratio (OR) of pain score during recovery was increased in PB (OR: 4.471, 95% CI: 1.527–6.156, P = 0.018) and GA (OR: 8.406, 95% CI: 2.421–9.195, P = 0.001) groups compared with the SPA group. However, in adjusting based on times of surgery duration, anesthesia duration, recovery and return of motor function, the ORs of pain score between groups was not statistically significant.ConclusionDespite reduced pain during recovery in patients receiving SPA, duration of anesthesia, recovery period, and return of motor function were significantly prolonged compared to those receiving PB or GA. It seems that PB with less recovery time and faster return of motor function than SPA and also mild pain during recovery compared to GA can be a good option for hysteroscopy.Clinical trial registrationhttp://www.irct.ir, identifier IRCT20120915010841N26.

10.30699/jambs.30.139.116Background & Objective: It has been reported that low concentration of zinc in serum is associated with insulin resistance (IR), also appears to be a relationship between insulin and leptin. In this study the possibility of increased leptin concentration and zinc deficiency was evaluated. Their relationship with overweight and IR was also investigated in women with polycystic ovary syndrome (PCOS). Materials & Methods:In this case-control study, 104 PCOS cases and 99 healthy individuals as control were included. Blood specimens were collected from participants post overnight fasting period; zinc concentrations (spectrophotometry method), leptin (ELISA method), insulin (ECLIA method), lipid profiles and glucose were measured with enzymatic method. The homeostasis model assessment (HOMA) index determined the IR level.Results: Zinc level was 87.20 ± 11.32 μg/dl in PCOS group, and 113.68 ± 8.31μg/dl in control group. Leptin concentration was 23.06 ± 3.33 ng/mL and 19.37 ± 3.34 ng/mL, and IR was 2.37 ± 0.83 and 1.45 ± 0.74 in case and control groups, respectively (all p<0.001). Zinc had marked negative correlation with leptin, insulin, and IR (p<0.001). According to the subject, which waist circumference and body mass index (BMI) parameters were confounding factors, hyperleptinemia and zinc decrement significantly affected PCOS subjects. In contrast, only zinc decrement had an association with PCOS, after eliminating the confounding factors (OR: 0.782, p<0.001). Conclusion:Zinc reduction is more effective on PCOS than hyperleptinemia. Hyperleptinemia has association with waist circumference and BMI; it can also affect PCOS. Zinc deficiency is a more effective factor than an increase in leptin concentration in women with PCOS.