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Pioglitazone Reduces Central Obesity in Polycystic Ovary Syndrome Women

DGYE-2011-0033.R1 4

Asadipooya, Kamyar (contact); Kalantar-Hormozi, Mohammadreza; Nabipour, Iraj

Objective: Based on the role of polycystic ovary syndrome as a cause of metabolic syndrome with chronic anovulation, obesity, hyperinsulinemia and hyperandrogenism, development of effective treatment for its obesity is a priority. Materials/Methods: We designed a study, involving 52 patients of 19 to 36 years of age, to test the pioglitazone in women with polycystic ovary syndrome. Subjects were assigned to receive pioglitazone for three months. Body mass index, waist circumference and hip circumference were measured before and after 3 months of pioglitazone prescription. Results: Fifty patients completed the study. No complication reported during the study period. Waist circumference, hip circumference and waist to height ratio decreased significantly. Body weight and body mass index increased. No significant improvement was seen in acne, acanthosis, hirsutism and menstrual irregularities. Conclusion: Pioglitazone has beneficial effects on central obesity of the patients with polycystic ovary syndrome but other clinical consequences of the syndrome may not improve with the drug.

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Anthropometric indices of central obesity how discriminators of metabolic syndrome in Brazilian women with polycystic ovary syndrome.

DGYE-2010-0349.R2 4

Costa, Eduardo Caldas; de Sá, Joceline Cássia Ferezini; Soares, Elvira Maria Mafaldo; Lemos, Telma Maria Araújo Moura; Maranhão, Técia Maria de Oliveira; de Azevedo, George Dantas

Background: Central obesity is highly prevalent in women with polycystic ovary syndrome (PCOS) and is strongly associated with metabolic syndrome (MetS).

Objectives: To define cut-off points of waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), and conicity index (C-Index) to discriminate metabolic syndrome (MetS) in Brazilian women with PCOS.

Methods: In a cross-sectional study, anthropometric, biochemical and clinical parameters were measured in 113 Brazilian PCOS women (27.2 ± 4.5 years). Receiver operating characteristic (ROC) analysis was used to find out the cut-off points of anthropometric indices to predict MetS according with National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III) criteria.

Results: Considering the ROC curve analysis the WC and WHtR had a similar performance in predicting MetS and these parameters were better than WHR and C-Index. The optimal cut-off values of the anthropometric indices for discriminate MetS were: WC = 95 cm; WHtR = 0.59; WHR = 0.88; and C-Index = 1.25. By using these cut-off points the sensitivity and specificity rates of WC and WHtR were higher than those observed for WHR and C-Index.

Conclusion: Our results indicated that WC and WHtR are more accurate than WHR and C-Index to predict MetS in Brazilian PCOS women.

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Serum Anti-Müllerian hormone, inhibin B, and total inhibin levels in women with hypothalamic amenorrhea and anorexia nervosa

DGYE-2011-0052 5

Luisi Stefano; Ciani Valentina; Podfigurna-Stopa Agnieszka; Lazzeri Lucia; De Pascalis Flavio; Meczekalski Blazej; Petraglia Felice

Objective: To evaluate whether neuroendocrine forms of secondary amenorrhea (hypothalamic and anorexia nervosa) affect serum anti-Müllerian hormone, inhibin B and total inhibin levels.

Methods: Amenorrheic women (n=82) (aged between 16-35 years old) according to diagnosed with neuroendocrine forms of amenorrhea: hypothalamic amenorrhea (n=64), anorexia nervosa (n=18), and healthy women (n=41) (control group) were enrolled. Serum anti-Müllerian hormone, inhibin B and total inhibin levels were measured by specific ELISA.

Results: No statistically significant difference of anti-Müllerian hormone serum levels between women with hypothalamic amenorrhea, anorexia nervosa and control group was observed. Serum inhibin B and total inhibin levels in women with hypothalamic amenorrhea (P<0.0001), anorexia nervosa (P<0.05) resulted significantly lower than in control healthy women.

Conclusion: The present data showed that neuroendocrine forms of amenorrhea are associated with an impaired inhibin secretion while not anti-Müllerian hormone. These data indirectly support that anti-Müllerian hormone is an excellent marker of ovarian reserve and its secretion is not influenced by the hypothalamic-ovarian axis activity.

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Myeloperoxidases and polycystic ovary syndrome

DGYE-2010-0336.R1 4

Ribeiro, Alessandra ; Scapinelli, Alessandro; Tamanaha, Sonia; Oliveira, Ricardo; Kowastch, Ingrid; Junior, Wilson; Aoki, Tsutomu; Aldrighi, Jose

New biological markers are emerging trying to identify earlier cardiovascular high risk subjects. Myeloperoxidases have been involved in the role atherosclerosis process, by the beginning of the endothelial dysfunction up to the plaque rupture and clinical manifestation, it has been demonstrated that this enzyme has also a prognostic value. We aimed to assess myeloperoxidases levels in PCOS patients with insulin resistance (IR), considering that this women represent a high risk group for cardiovascular disease. We developed a transversal study, comprising 26 patients with PCOS and insulin resistance (IR) and 30 controls (PCOS without IR). IR was considered with HOMA-IR>/=3.0. IR absence was considered when HOMA-IR <3.0, triglycerides < 200, BMI < 28.7, and BMI< 27.8 in patients with familial history of type 2 diabetes. All patients went through anamnesis, physical exam, transvaginal ultrasound and blood samples. Insulin resistant PCOS patients had higher levels of myeloperoxidase (22.3 x 18.1, p=0.047), and also higher BMI. Myeloperoxidase levels correlated directly with insulin. In conclusion, insulin resistant PCOS young patients have higher myeloperoxidase levels.

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• December, 2011 •

Editorial

Dear GynEndocrinologists,
Are you ready for Good Ol’ Santa Claus?

Also this year has come to an end. December is a special month, the month of the annual summary, when one thinks about the year making the sum of victories and defeats in the hopes that the following year will bring more fortune and happiness. But December is also the time to remember what happened in the World. Winds of war and revolution have begun to blow in Tunisia in January, spreading to other countries of North Africa as Egypt as Lybia bringing the disappearance of historical leaders such as Mubarak and al-Qaddafi. The economic downturn has dominated the end of the year. Europe has repeatedly risked default and the long-awaited globalization has made many people poor and few people very rich. What else? Nature did not help, as well. In March a massive earthquake and the following tsunami devastated Japan, killing over 13.000 people and leading to the disaster at the Daiichi nuclear power plant. In parallel, one of the worst U.S. tornado seasons stroked Alabama killing over 1.000 people. Good news? King Abdullah of Saudi Arabia has granted women the right to vote and to run for office in future elections … This is something that we really welcome. Equal rights and duties for both genders. This is something worth being written in our letter to Santa Claus…
In our small community, we are waiting to receive the gift of an exciting ISGE 2012 congress. We are now at the deadline for submission of abstracts and posters for the 2012 World Congress of Gynecological Endocrinology. Hurry up! Don’t miss the chance to be with all those count in this field in Florence! The scientific program has never been as exciting… In addition, with the Society’s contibution to 100 young researchers under 34 years, the Congress will be flooded by young and sharp brains striving to show their cutting edge research. See who they are on the official website of the Congress.
Happy Holiday Season to all the GynEndocrinologists!!

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