The basal serum AMH level could be utilized effectively to predict OHSS and thus to direct the selection of mild COS protocols.

Abstract-The role of testosterone on the development of hypertension is controversial, especially in women with polycystic ovary syndrome (PCOS) who have higher prevalence of obesity and insulin resistance than women without PCOS. Little is known about the association between serum testosterone level and blood pressure in young women with PCOS. In the 151 young Taiwanese women with PCOS enrolled in this cross-sectional study, we measured the body mass index, waist circumference, blood pressure, fasting glucose, fasting insulin, lipid profile, and hormone profiles. The free androgen index, total testosterone, and sex hormone-binding globulin, but not the level of dehydroepiandrosterone sulfate, significantly correlated with both systolic blood pressure (SBP) and diastolic blood pressure (DBP). In multiple linear regression models adjusted for age, body mass index, and other anthropometric, metabolic, and hormonal variables, the level of serum free androgen index or total testosterone, but not the sex hormone-binding globulin, were independently related to SBP and DBP. The age-and body mass index-adjusted least-square mean of serum-free androgen index levels were significantly different between the highest quartile and other quartiles of the SBP and DBP levels. The high bioavailable testosterone levels (free androgen index: Ն19%) in women with PCOS increased the risk of elevated blood pressure (SBP Ն130 mm Hg and/or DBP Ն85 mm Hg) with an odds ratio of 3.817 (Pϭ0.029; 95% CI: 1.14 to 12.74) after adjustment for age, anthropometric measures, and metabolic profiles. Our results suggest that the characteristic hyperandrogenemia in young women with PCOS was associated with an elevated SBP and DBP independent of age, insulin resistance, obesity, or dyslipidemia. Key Words: polycystic ovary syndrome Ⅲ testosterone Ⅲ systolic blood pressure Ⅲ diastolic blood pressure Ⅲ hypertension W omen with polycystic ovary syndrome (PCOS) are characterized by clinical and/or biochemical hyperandrogenism, oligomenorrhea, and the presence of polycystic ovaries. 1 PCOS is a heterogenous medical condition. Because large individual variation is present with respect to hyperandrogenism in terms of clinical manifestations and biochemistry, not all women with PCOS have elevated testosterone levels. Indeed, some women with PCOS without elevated testosterone levels may have acne, hirsutism, and/or androgenic alopecia that may arise as a result of the elevated androgens secreted by adipose tissue and the adrenal glands rather than the testosterone secreted from the ovaries.Although the increased risk of atherosclerotic cardiovascular disease and hypertension in women with PCOS remains controversial, 2,3 a variety of intriguing metabolic disturbances related to the risk for cardiovascular disease and hypertension are commonly found in a large proportion of women with PCOS, such as obesity, insulin resistance, dyslipidemia, and the metabolic syndrome. 4 Women with PCOS have been reported to have reduced vascular compliance, 5 vascular endothelial...

Snail, a key inducer of epithelial-mesenchymal transition (EMT), plays an important role in cancer metastasis. To better understand the role of Snail in the metastasis of ovarian carcinoma, expression of Snail was knocked down by antisense-Snail in the highly metastatic ovarian cancer cell line HO8910PM. Gene array analysis revealed that blocking Snail expression suppressed the activity of matrix metalloproteinases (MMPs) and upregulated TIMP3, an MMP inhibitor. These findings suggest that Snail interacts with MMP during tumor invasion and metastasis. In addition, we examined the role of Snail in an ovarian cancer orthotopic model by using the antisense-Snail HO8910PM cell line. We found that the size of primary ovarian cancer tumor and the number of metastatic lesions were significantly reduced when Snail was knocked down. Confirming our initial findings, the activity of MMP2 was greatly inhibited in tumors from antisense-Snail cells. Furthermore, immunohistochemical analysis on ovarian cancer progression tissue array demonstrated that the expression of Snail was significantly higher in metastatic lesions, and Snail expression correlated with the stage of ovarian cancer. Interestingly, in early-stage tumors, Snail was localized in both the cytoplasm and nucleus. In late stage and metastatic lesions, the level of Snail was elevated, and Snail was localized to the nucleus. The expression level and nuclear localization of Snail were also inversely correlated with E-cadherin expression. Overall, our study indicates that Snail plays a critical role in tumor growth and metastasis of ovarian carcinoma through regulation of MMP activity.

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