| 1. |
- Hudecova, Miriam, et al.
(författare)
-
Androgen levels, insulin sensitivity, and early insulin response in women with polycystic ovary syndrome : a long-term follow-up study
- 2011
-
Ingår i: Fertility and Sterility. - : Elsevier BV. - 0015-0282 .- 1556-5653. ; 95:3, s. 1146-1148
-
Tidskriftsartikel (refereegranskat)abstract
- Thirty-four women with polycystic ovary syndrome who previously had participated in studies with intravenous glucose tolerance test and hyperinsulinemic, euglycemic clamp between 1987 and 1995 underwent anthropometric, endocrine (T and sex-hormone binding globulin serum concentration), and metabolic (intravenous glucose tolerance test, hyperinsulinemic, euglycemic clamp, and androgens) measurements. Free androgen levels and β-cell function decreased over time in women with polycystic ovary syndrome, but insulin sensitivity remained unaltered.
|
|
| 2. |
- Hudecova, Miriam, et al.
(författare)
-
Diabetes and impaired glucose tolerance in patients with polycystic ovary syndrome-a long term follow-up
- 2011
-
Ingår i: Human Reproduction. - : Oxford University Press (OUP). - 0268-1161 .- 1460-2350. ; 26:6, s. 1462-1468
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The overall risk of developing diabetes mellitus and glucose intolerance seems to be higher in women with polycystic ovary syndrome (PCOS) than in healthy women. The aim of this long-term follow-up study was to examine glucose tolerance and insulin sensitivity in middle-aged women previously diagnosed with PCOS in comparison with age-matched healthy controls. Methods: Women diagnosed with PCOS between 1987 and 1995 were invited to participate in the study. A total of 84 PCOS patients and 87 control subjects participated. Anthropometric (BMI, waist/hip ratio) and metabolic parameters (oral glucose tolerance test) were measured. Insulin sensitivity was expressed by the Matsuda index and beta cell function by the insulinogenic index. PCOS women were sub-grouped according to phenotype at the index assessment (with or without hyperandrogenism) and persistence of PCOS symptoms at the follow-up (persisting or resolved PCOS). Results: Eighteen (21.4%) PCOS patients and four (4.5%) controls had developed type 1 or type 2 diabetes or impaired glucose tolerance (IGT) at the follow-up investigation (P < 0.05). Matsuda insulin sensitivity index was lower and the insulinogenic index was increased in women with previously diagnosed PCOS compared with control subjects. In addition, PCOS patients with or without hyperandrogenism, and PCOS patients with persisting and resolved PCOS all had lower Matsuda insulin sensitivity index and increased insulinogenic index in comparison with controls. Conclusions: IGT and type 2 diabetes occurred more often in PCOS patients. Independent on PCOS phenotype at index assessment and persistence of PCOS symptoms at the follow-up investigation, women with PCOS had lower insulin sensitivity but a well-preserved beta cell function in comparison with control subjects.
|
|
| 3. |
- Hudecova, Miriam, 1971-, et al.
(författare)
-
Endothelial function in patients with polycystic ovary syndrome : a long-term follow-up study
- 2010
-
Ingår i: Fertility and Sterility. - : Elsevier BV. - 0015-0282 .- 1556-5653. ; 94:7, s. 2654-2658
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate pulse wave reflection and endothelial-dependent vasodilatation (EDV) in PCOS patients and age-matched healthy controls. Design: Long-term follow-up study. Setting: Department of Women’s and Children’s Health, Uppsala University, Sweden. Patient(s): Sixty-seven PCOS patients with a mean age of 43.3 years at the follow-up investigation and 66 age-matched controls. Intervention: Aplanation tonometry before and after b-2 receptor agonist (terbutaline) challenge. Main outcome measure(s): Baseline augmentation index (AI) aorta, baseline AI-radial, and change in AI-radial following terbutaline administration as a measure of EDV. Result(s): There was no difference in baseline AI-aorta between PCOS patients and control subjects. Change in AI-radial following terbutaline administration was less pronounced in PCOS patients in comparison to control subjects. This difference remained when adjusted for use of combined oral contraceptives/hormone replacement therapy and postmenopausal status but not after adjustment for BMI. Conclusion(s): Middle-aged PCOS patients display signs of endothelial dysfunction in comparison to age-matched controls, but this is largely due to the increased prevalence of independent risk factors for cardiovascular disease found in this group.
|
|
| 4. |
- Hudecova, Miriam, et al.
(författare)
-
Long-term follow-up of patients with polycystic ovary syndrome : reproductive outcome and ovarian reserve
- 2009
-
Ingår i: Human Reproduction. - : Oxford University Press (OUP). - 0268-1161 .- 1460-2350. ; 24:5, s. 1176-1183
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The purpose of the present study was to examine long-term reproductive outcome and ovarian reserve in an unselected population of women with polycystic ovary syndrome (PCOS). METHODS A total of 91 patients with confirmed PCOS and 87 healthy controls were included in the study. Patients had been diagnosed between 1987 and 1995 and at the time of the follow-up, subjects were 35 years of age or older. RESULTS: Among women who had attempted a pregnancy, 86.7% of PCOS patients and 91.6% of controls had given birth to at least one child. Among PCOS patients who had given birth, 73.6% had done so following a spontaneous conception. Mean ovarian volume and the number of antral follicles in PCOS patients were significantly greater than in control women (P < 0.001, respectively). PCOS patients also had higher serum concentrations of anti-Müllerian hormone and lower follicle-stimulating hormone levels. CONCLUSIONS: Most women with PCOS had given birth, and the rate of spontaneous pregnancies was relatively high. Together with the ultrasound findings and the hormonal analyses, this finding could imply that PCOS patients have a good fecundity, and an ovarian reserve possibly superior to women with normal ovaries.
|
|
| 5. |
- Hudecova, Miriam, 1971-, et al.
(författare)
-
Long-term Reproductive and Metabolic Consequences of PCOS
- 2012
-
Ingår i: Current diabetes reviews. - : Bentham Science Publishers Ltd.. - 1875-6417 .- 1573-3998. ; 8:6, s. 444-451
-
Tidskriftsartikel (refereegranskat)abstract
- Polycystic ovary syndrome (PCOS) is associated with reproductive and metabolic consequences. The review of findings indicate that the long-term reproductive outcomes of women with PCOS are surprisingly similar compared to women with normal ovaries, and that they have an ovarian reserve possibly superior to women with normal ovaries. The typical features of PCOS, specifically the anovulatory cycles tend to normalize over time, but in spite of a decrease over time, free androgen levels remain elevated compared to age-matched control subjects. Women with PCOS diagnosed at young age continue to display reduced insulin sensitivity in the perimenopausal age, independent from phenotypic expression of PCOS, both at diagnosis and at follow-up. Insulin resistance does not seem to deteriorate further, however. Overall, the accumulated data from several European cohort studies of older women with a previous diagnosis of PCOS suggest an increased incidence of type 2 diabetes, increased prevalence of several features of the metabolic syndrome, but no increased incidence of mortality from CVD.
|
|
| 6. |
- Hudecova, Miriam, 1971-, et al.
(författare)
-
Prevalence of diabetes, impaired glucose tolerance and insulin sensitivity in patients with polycystic ovary syndrome - a long term follow-up
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: The aim of this long-term follow-up study was to examine glucose tolerance and insulin sensitivity in middle-aged women previously diagnosed with PCOS in comparison with age-matched healthy controls. Methods: Women diagnosed with PCOS between 1987 and 1995 were invited for the study. 84 PCOS patients and 87 control subjects, randomly selected from the general population, participated in the study. Anthropometric and metabolic parameters, including an oral glucose tolerance test, were examined. Results: Eighteen (21.4 %) PCOS patients had type 1 or type 2 diabetes or impaired glucose tolerance at the follow-up investigation, which was significantly more common than in control subjects (4.5 %), p < 0.05. Following the adjustment for BMI, insulin sensitivity measured by the Matsuda insulin sensitivity index was significantly lower in women with PCOS and the insulinogenic index, as a measure of beta-cell function, was elevated in PCOS patients in comparison to control subjects. Furthermore, both women with persisting and resolved PCOS at the follow-up investigation displayed decreased Matsuda insulin sensitivity index and increased insulinogenic index in comparison with control subjects. Women without clinical signs of hyperandrogenism at the index assessment displayed higher fasting insulin and proinsulin plasma concentrations than controls at the follow-up investigation. In addition, they had lower Matsuda insulin sensitivity index and higher insulinogenic index than controls. When adjusted for BMI, there was also a trend towards significantly lower Matsuda insulin sensitivity index and increased insulinogenic index at the follow-up investigation among women who had presented with hyperandrogenism at the index assessment. Conclusion: IGT and type 2 diabetes occurred more often in PCOS patients. Independent of PCOS phenotype at index assessment and persistence of PCOS symptoms at the follow-up investigation, women with PCOS had lower insulin sensitivity and increased beta-cell function in comparison with control subjects.
|
|
| 7. |
- Hudecova, Miriam, 1971-
(författare)
-
Reproductive and Metabolic Consequences of the Polycystic Ovarian Syndrome
- 2010
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Polycystic ovary syndrome (PCOS) is a complex clinical condition characterized by hyperandrogenism and chronic oligo/anovulation. Infrequent ovulation and metabolic alterations in women with PCOS are associated with subfertility and probably increased miscarriage rates compared with normal fertile women. The overall risk of developing type 2 diabetes and impaired glucose tolerance (IGT) is three- to sevenfold higher in PCOS women, and the onset of glucose intolerance seems to occur at an earlier age than in healthy controls. Women with PCOS also have several risk factors for cardiovascular disease, although it is unclear whether they actually experience more cardiovascular events than other women. Very few studies assessing the long-term reproductive and metabolic consequences in older women with previously confirmed PCOS have been conducted. In this long-term follow-up of women with PCOS, 84 women with a diagnosis of PCOS between 1987 and 1995 and age at the follow-up > 35 years and an age-matched population-based group of control women participated. Data on reproductive outcome, ovarian reserve, endothelial function, insulin sensitivity and beta-cell function were collected. According to our results most women with PCOS had given birth and the rate of spontaneous pregnancies was relatively high. The rate of miscarriages was not increased in PCOS patients and the ultrasound findings together with increased levels of anti-müllerian hormone suggested that their ovarian reserve is superior to women of similar age. PCOS women displayed signs of endothelial dysfunction, but this was largely due to the increased prevalence of independent risk factors for cardiovascular disease such as increased BMI, triglycerides and blood pressures. IGT and type 2 diabetes occurred more often in PCOS women. Free androgen levels and beta-cell function decreased over time whereas insulin sensitivity remained unchanged. Obesity at young age and progressive weight-gain rendered them more prone to be insulin resistant at the follow-up. Beta-cell function was increased in PCOS women in comparison with control subjects but declined over time. Independent of PCOS phenotype at the index assessment and persistence of PCOS symptoms at the follow-up investigation, premenopausal women with PCOS had lower insulin sensitivity and increased beta cell function in comparison with control subjects. Conclusion: The long-term reproductive outcomes of PCOS are similar compared to women with normal ovaries. Although symptoms and androgen levels are normalized over time, women with PCOS continue to display reduced insulin sensitivity and increased beta-cell function and they also have an increased risk of IGT and type 2 diabetes.
|
|
| 8. |
- Lindgren, Karin Elvine, 1984-, et al.
(författare)
-
Differences in secretome in culture media when comparing blastocysts and arrested embryos using multiplex proximity assay
- 2018
-
Ingår i: Upsala Journal of Medical Sciences. - : TAYLOR & FRANCIS LTD. - 0300-9734 .- 2000-1967. ; 123:3, s. 143-152
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to assess different patterns of the human embryo secretome analysed as protein levels in culture media. Furthermore, analyses to correlate protein levels with quality and timing to development of human embryos were performed.Material and methods: Human day-2 cryopreserved embryos were cultured for four days in an EmbryoScope((R)) with a time-lapse camera, and embryo quality was evaluated retrospectively. After culture, the media were collected and relative levels of secreted proteins were analysed using Proseek Multiplex Assays. Protein levels were evaluated in relation to timing to development and the ability to form a blastocyst.Results: Specific patterns of timing of development of blastocysts were found, where a difference in time to start of cavitation was found between high- and low-quality blastocysts. There appeared to be a correlation between specific protein patterns and successful formation of morulae and blastocysts. Embryos developing into blastocysts had higher levels of EMMPRIN than arrested embryos, and levels of caspase-3 were lower in high- versus low-quality blastocysts. Also, higher levels of VEGF-A, IL-6, and EMMPRIN correlated with shorter times to morula formation.Conclusions: The secretome and timing to development differ in embryos forming blastocysts and those that become arrested, and in high- versus low-quality blastocysts. The levels of certain proteins also correlate to specific times to development.
|
|
| 9. |
|
|
| 10. |
- Lindholm, Åsa Maria, 1958-, et al.
(författare)
-
Tissue Plasminogen Activator and Plasminogen Activator Inhibitor 1 in Overweight and Lean Patients with Polycystic Ovary Syndrome
-
Annan publikation (populärvet., debatt m.m.)abstract
- Objective: Disturbances in the fibrinolytic system are predictors of future cardiovascular events. The aim of the present study was to compare PAI-1 activity and tPA mass concentration between patients with polycystic ovary syndrome (PCOS) and control subjects. Design: 135 PCOS patients (lean and overweight) and 81 healthy controls were recruited for the study. Blood samples for PAI-1 activity and tPA mass were collected together with anthropometric measures. Results: Overweigth PCOS patients displayed increased tPA mass concentration in comparison with controls (p < 0.05), and this finding was consistent regardless of whether patients displayed signs of hyperandrogenism or not. When hyperandrogenism was introduced as a prerequisite for the PCOS diagnosis, overweight PCOS patients displayed increased PAI-1 activity as well, p < 0.05. Lean PCOS patients did not differ in terms of PAI-1 activity or tPA mass concentration in comparison to controls. Conclusion: Overweight women with PCOS have impaired fibrinolysis, in particular if they also display objective biochemical markers of hyperandrogenism.
|
|
