Polycystic Ovary Syndrome: Pathogenesis, Treatment and Secondary Associated Diseases

Khaleel

Baghdad J. Biochem. Appl. Biol. Sci.

2022

Background and objective: Polycystic ovarian syndrome (PCOS) is a common endocrinologic disorder among women of childbearing age. Coronavirus disease 2019 (COVID-19) is an acute respiratory disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aimed to determine the levels of renin, d-dimer, and some relevant biomarkers in patients with PCOS (with and without COVID-19) compared with non-PCOS patients (with and without COVID-19). Methods: This cross-sectional study included 120 women [80 PCOS women (40 with COVID-19 and 40 without COVID-19) and 40 non-PCOS women (20 with COVID-19 and 20 without)] with age range of 15–40 years old. Blood samples were collected from participants, and biochemical assays were carried out. Renin and d-dimer levels were determined using the enzyme-linked-immunosorbent-assay (ELISA), lipid-profile and fasting blood glucose concentrations were assessed by using the colorimetric methods, and hormones were evaluated by VIDAS. Results: Renin and d-dimer levels were found to be significantly higher in PCOS-women groups compared to non-PCOS group. In addition, the results showed that hormones, fasting blood glucose, and lipid-profile are significantly increased in PCOS patients compared to non-PCOS women, while high-density-lipoprotein and follicle-stimulating-hormone levels were low when comparing PCOS patients with non-PCOS ones. The results also showed that a highly significant increase in renin and d-dimer levels can be detected in PCOS patients with COVID-19. Conclusions: In the present study, we found there is a possible relationship between renin and d-dimer in PCOS patients who are also COVID-19 infected.

Section: Discussionmentioning

confidence: 99%

Estimation of renin and d-dimer levels in women with polycystic ovary disease with or without coronavirus infection

Khaleel

Baghdad J. Biochem. Appl. Biol. Sci.

2022

“…The major androgens include dehydroepiandrosterone, dehydroepiandrosterone sulfate (DHEAS), androstenedione, testosterone, and dihydrotestosterone, with the latter two having the highest affinity for the androgen receptor and the greatest potency. In healthy women, testosterone is largely bound by sex hormone binding globulin and albumin, leaving only approximately 1% freely circulating as bioactive "free testosterone" (8) . The pilosebaceous unit expresses 5a-reductase, which converts testosterone to the highly potent dihydrotestosterone.…”

Section: Patient Assessmentmentioning

confidence: 99%

Irregular Menstruation, Acne, Hirsutism, and the Possibility with PCOS

Apriliana¹,

Restiana²,

Dalope³

et al. 2022

ijmsci

Background: PCOS was a common hormonal disorder caused by hyperandrogenism so the ovaries enlarged with many small follicles appear like cysts. The aetiology still unknown, but mounting evidence suggests that can be complex multigenic disorder with strong epigenetic and environmental influences. Therapeutic options include combined oral contraception, antiandrogens, etc. Case Presentation: Ms. N, 17 years old, came to polyclinic of RSAL Mintohardjo evaluated for amenorrhea. Her parents didn’t have comorbid conditions. The patient started Menarche at the age of 14, soon thereafter developed a secondary amenorrhea. On examination her BMI was 18.4kg/m², pulse-92/min and BP-115/80 mm of hg. She had a hirsute score (Ferriman-Gallway) of 8 and had no acanthosis nigricans. No abnormality on the other systemic examination and no laboratory tests were carried out. Patient given with combination hormonal pills. Hormonal birth control can help with PCOS symptoms, but it is not the only option. Lifestyle changes, such as losing weight and exercising more, may help. Discussion: PCOS involves primary defects in hypothalamic–pituitary axis, insulin, and ovarian function. Excess LH levels lead to hyperandrogenism in PCOS. Conclusion: All women with abnormal menstrual patterns should be evaluated for underlying PCOS, signs of hyperandrogenism, hormone profile, and pelvic ultrasonography to visualize the ovaries. Early diagnosis and treatment can avoid potential complications. Birth control pills (combined hormonal) can used for long-term treatment in women who didn’t want to pregnant. The birth control pills may help regulate menstrual bleeding, reduce excessive hair growth and acne, and decrease the risk of endometrial cancer.

“… 11 Insulin sensitizers have been suggested as a potential treatment for this illness since insulin resistance and hyperinsulinemia have an important role in its pathophysiology. 12 , 13 Consequently, improving insulin resistance with lifestyle changes or by taking a diabetes medication is part of the current PCOS treatment. 14 …”

Section: Introductionmentioning

confidence: 99%

The Effect and Safety Assessment of Metformin and DLBS3233 (A Bioactive Fraction of Lagerstroemia speciosa and Cinnamomum burmannii) on Improving Metabolic Parameters in Women with Polycystic Ovary Syndrome

Hidayat¹,

Mulyantoro²,

Damas³

et al. 2023

IJWH

Background: Polycystic ovary syndrome (PCOS) can lead to compensatory hyperinsulinemia with consequent metabolic abnormalities in women. In this study, DLBS3233 and Metformin were used to be tested. DLBS3233 itself is the new insulin-sensitizing drug, a combinationbioactive-fraction derived from two Indonesian herbals, Lagerstroemia speciosa and Cinnamomum burmannii. DLBS3233 alone and in combination with metformin were evaluated for efficacy and safety in insulin-resistant women with polycystic ovary syndrome (PCOS). Methods: A randomized, double-blind, 3-arm, double-dummy, non-inferiority, and also a controlled clinical study was conducted at the Dr. Kariadi Hospital, Indonesia, between October 2014 and February 2019. The study involved 60 female subjects (with 20 female subjects in each group) that had polycystic ovary syndrome (PCOS).Treatment I consists of one placebo capsule twice per day and one 100 mg DLBS3233 capsule once per day. Treatment II consists of one placebo caplet once per day and one 750 mg Metformin XR caplet twice per day. Treatment III consists of one 750 mg Metformin XR caplet twice per day and one 100 mg DLBS3233 capsule once per day. Results: In treatment I, the homeostatic model assessment for insulin resistance (HOMA-IR) levels were 3.55, 3.59, and 3.80 at pretest, 3 months, and 6 months after intervention, respectively. In treatment II, the HOMA-IR level were 4.00, 2.21, and 4.40 at pretest, 3 months, and 6 months after intervention respectively. In treatment III, the HOMA-IR levels were 3.30, 2.86, and 3.12 at pretest, 3 months, and 6 months after intervention, respectively. There was no apparent difference existed in the fasting plasma glucose (FPG), high-density lipoprotein (HDL), triglycerides, ferriman-gallwey scores (FGS), and safety assessment on vital signs and laboratory examinations (liver function and renal function) in all groups. Conclusion: Either DLBS3233 alone or the DLBS3233/Metformin combination showed no significant efficacy and did not negatively affect cardiovascular function, liver and kidney function in PCOS subjects.