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Abstract Objective To evaluate the association between polycystic ovary syndrome (PCOS) and metabolic syndrome (MetS), adding liver assessment through elastography and ultrasound, for correlation with non-alcoholic fatty liver disease (NAFLD). Metabolic syndrome occurs in~43% of women with PCOS, and NAFLD is the hepatic expression of MetS. Methods One hundred women, 50 with PCOS and 50 controls, matched by age (18- 35 years) and body mass index (BMI) were included, restricted to patients with overweight and obesity grade 1, at the Assis Chateaubrian Maternity School, Universidade Federal do Ceará, Brazil. For the diagnosis of PCOS, we adopted the Rotterdam criteria, and for the diagnosis of MetS, the criteria of the National Cholesterol Education Program (NCEP/ATP III). Hepatic elastography and ultrasound were performed to assess liver stiffness and echotexture, respectively. Results The average ages were 29.1 (±5.3) and 30.54 (±4.39) years, for the PCOS and the control group, respectively. Patients with PCOS had a risk 4 times higher of having MetS, odds ratio (95% confidence interval)=4.14, than those in the control group. Women with PCOS had higher average of abdominal circumference (100.9±9.08 cm vs 94.96±6.99 cm) and triglycerides (162±54.63 mg/dL vs 137.54±36.91mg/dL) and lower average of HDL cholesterol (45.66±6.88 mg/dL vs 49.78±7.05 mg/dL), with statistically significant difference. Hepatic steatosis was observed on ultrasound in women with PCOS; however, with no statistically significant difference. There was no change to NAFLD at elastography in any group. Conclusion Women with PCOS had 4-fold higher frequency of MetS andmore hepatic steatosis, with no statistically significant difference. There was no change in liver stiffness between the groups at elastography. The results can be extended only to populations of overweight and obesity grade 1, with PCOS or not. They cannot be generalized to other untested groups.

Resumo Objetivo Avaliar a associação entre a síndrome do ovário policístico (SOP) e a síndrome metabólica (SM), agregando avaliação do fígado por elastografia e ultrassonografia, para correlação com doença hepática gordurosa não alcoólica (DHGNA). A SM ocorre em cerca de 43% dasmulheres comSOP, e DHGNA é a expressão hepática da SM. Métodos Foramincluídas 100 mulheres, pareadas por idade (18-35 anos) e índice de massa corporal (IMC), 50 comSOP e 50 controles com sobrepeso e obesidade grau I, na Maternidade-Escola Assis Chateaubriand, Brasil. Para o diagnóstico de SOP, adotamos os critérios de Rotterdam e, para o diagnóstico de SM, os critérios do National Cholesterol Education Program (NCEP/ATP III). Elastografia hepática e ultrassonografia foram realizadas para avaliar a rigidez e a ecotextura do fígado, respectivamente. Resultados As médias de idade foram de 29,1 (±5,3) e 30,54 (±4,39) anos para os grupos SOP e controle, respectivamente. Pacientes com SOP apresentaram risco 4 vezes maior de SM do que aquelas no grupo controle [[razão de chances (intervalo de confiança de 95%) = 4,14]. Mulheres com SOP tiveram maior média de circunferência abdominal (100,9±9,08cm vs 94,96±6,99 cm) e triglicérides (162±54,63 mg/dL vs 137,54±36,91 mg/dL) e menor média de colesterol HDL (45,66±6,88 mg/dL vs 49,78±7,05mg/dL), com diferença estatisticamente significativa. Esteatose hepática foi observada em ultrassonografias de mulheres com SOP, porém sem diferença estatisticamente significativa. Não houve mudança para DHGNA na elastografia em nenhum dos grupos. Conclusão Mulheres com SOP tiveram frequência quatro vezes maior de SM e mais esteatose hepática, sem diferença estatisticamente significativa. Não houve mudança na rigidez do fígado entre os grupos na elastografia. Os resultados podem ser estendidos apenas a populações com sobrepeso e obesidade grau 1, com SOP ou não. Eles não podem ser generalizados para outros grupos não testados.

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Background: Polycystic ovary syndrome (PCOS) is a gynecological endocrine disorder, results in menstrual abnormalities, androgynism and infertility. In the case of women or others animals with PCOS wishing to treat infertility with the aim of becoming pregnant, the most commonly used is metformin hydrochloride. Recent studies have analyzed the combination of metformin hydrochloride with melatonin in oncological treatment but not to treatment of polycystic ovary syndrome (PCOS). The aim of the present study was to analyze the effectiveness of the combination of metformin hydrochloride and melatonin in the treatment of PCOS to improve the fertility of rats and your hormonal alterations. Materials, Methods & Results: This study was carried out in strict accordance with the recommendations in the Guide for the Care and Use of Laboratory Animals of the National Institutes of Health. The protocol was approved by the Committee on the Ethics of Animal Experiments of the University of Federal Rural of Pernambuco (Permit Number: 23081.009130/2010). A total of 50 albino Wistar rats were used. The animal laboratory of an academic research environment, were randomly separated into five groups consisting of 10 females each. After inducing PCOS, the rats were treated with metformin hydrochloride, and/or melatonin, and the results compared with standard and ultrasound confirmed. [...]

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Background: Polycystic ovary syndrome (PCOS) is a gynecological endocrine disorder, results in menstrual abnormalities, androgynism and infertility. In the case of women or others animals with PCOS wishing to treat infertility with the aim of becoming pregnant, the most commonly used is metformin hydrochloride. Recent studies have analyzed the combination of metformin hydrochloride with melatonin in oncological treatment but not to treatment of polycystic ovary syndrome (PCOS). The aim of the present study was to analyze the effectiveness of the combination of metformin hydrochloride and melatonin in the treatment of PCOS to improve the fertility of rats and your hormonal alterations. Materials, Methods & Results: This study was carried out in strict accordance with the recommendations in the Guide for the Care and Use of Laboratory Animals of the National Institutes of Health. The protocol was approved by the Committee on the Ethics of Animal Experiments of the University of Federal Rural of Pernambuco (Permit Number: 23081.009130/2010). A total of 50 albino Wistar rats were used. The animal laboratory of an academic research environment, were randomly separated into five groups consisting of 10 females each. After inducing PCOS, the rats were treated with metformin hydrochloride, and/or melatonin, and the results compared with standard and ultrasound confirmed. [...](AU)

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OBJECTIVE: Determine the effectiveness of in vitro maturation of oocytes in the infertility treatment in high altitude women with polycystic ovaries. DESIGN: descriptive and retrospective study. PARTICIPANTS: Women with polycystic ovaries and infertility. INTERVENTIONS: there were 11 women from locations above 7,546 feet above sea level with polycystic ovaries and infertility in which were performed in vitro maturation of oocytes, followed by intracytoplasmic sperm injection, culture and embryo vitrification. After that, the endometrium was prepared and the embryos were thawed and transferred. Main results mesurements: oocytes maturation, fertilization, clinical pregnancy and implantation rates. RESULTS: Oocytes maturation rate was 86.1%; fertilization rate 90.3%; clinical pregnancy rate 36.4% and implantation rate 17.4%. CONCLUSIONS: In vitro maturation of oocytes is an effective technique in the infertility treatment of high altitude women with polycystic ovaries.

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Atrial natriuretic peptide (ANP) is known to regulate ovarian functions, such as follicular growth and steroid hormone production. The aim of the present study was to investigate the natriuretic peptide system in a rat model of chronic anovulation, the rat polycystic ovary. Adult female Wistar rats received a single subcutaneous injection of 2mg estradiol valerate to induce polycystic ovaries, while the control group received vehicle injection. Two months later, their ovaries were quickly removed and analyzed. Polycystic ovaries exhibited marked elevation of testosterone and estradiol levels compared to control ovaries. The levels of ANP and the expression of ANP mRNA were highly reduced in the polycystic ovaries compared to controls. By immunohistochemistry, polycystic ovaries showed weaker ANP staining in stroma, theca cells and oocytes compared to controls. Polycystic ovaries also had increased activity of neutral endopeptidase, the main proteolytic enzyme that degrades natriuretic peptides. ANP receptor C mRNA was reduced and ANP binding to this receptor was absent in polycystic ovaries. Collectively, these results indicate a downregulation of the natriuretic peptide system in rat polycystic ovary, an established experimental model of anovulation with high ovarian testosterone and estradiol levels. Together with previous evidence demonstrating that ANP inhibits ovarian steroidogenesis, these findings suggest that low ovarian ANP levels may contribute to the abnormal steroid hormone balance in polycystic ovaries.

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Objetivo: analisar a frequência da síndrome dos ovários policísticos em mulheres que realizaram a ultrassonografia emuma clínica em Natal/RN no período de agosto a dezembro de 2009. Metodologia: trata-se de um estudo quantitativo comabordagem descritiva e epidemiológica de frequência. Foi desenvolvido a partir de coleta de exames de imagem em umaclínica privada em Natal/RN onde foram analisadas 540 ultrassonografias. Resultados: encontrou-se uma frequência de13,00% dos exames de imagem que apresentaram hipótese diagnóstica sugestiva de ovários policísticos. A média de idadedas mulheres que realizam o exame foi de 35 a 46 anos. Conclusão: percebeu-se na realização da pesquisa que a hipótesediagnóstica do achado da ultrassonografia de maneira isolada não é suficiente para diagnosticar a síndrome dos ováriospolicísticos. Há necessidade de considerar os sinais e sintomas de hirsutismo, acne ou alopecia androgênica, anovulaçãocrônica associada a distúrbio menstrual como oligo/amenorreia e infertilidade.(AU)

Objective: to analyze the frequency of polycystic ovaries syndrome in women who underwent ultrasonography at a clinic in Natal, Rio Grande do Norte, Brazil, within the period from August to December 2009. Methodology: this is a quantitative study with a descriptive and epidemiological approach based on frequency. It was developed through the collection of image examinations in a private clinic in Natal, Rio Grande do Norte, Brazil, where 540 sonograms were analyzed. Results: a frequency of 13.00% of the imaging studies which showed a suggestive diagnosis of polycystic ovaries was found. The average age of women who underwent the exam ranged from 35 to 46 years. Conclusion: it was perceived during the research that the diagnostic hypothesis through the ultrasound finding alone is not enough to diagnose polycystic ovaries syndrome. There is a need to consider the signs and symptoms of hirsutism, acne, or androgenic alopecia, chronic anovulation associated to a menstrual disorder such as oligo/amenorrhea, and infertility.(AU)

Objetivo: analizar la frecuencia del síndrome de ovarios poliquísticos en mujeres que se sometieron a la ultrasonido en una clínica en Natal, Rio Grande do Norte, Brasil, en el período de agosto a diciembre de 2009. Metodología: esto es un estudio cuantitativo con abordaje descriptiva y epidemiológica de frecuencia. Fue desarrollado a partir de la recogida de exámenes de imagen en una clínica privada en Natal, Rio Grande do Norte, Brasil, donde se analizaron 540 ultrasonidos. Resultados: se encontró una frecuencia de 13,00% de los exámenes de imagen que mostraron hipótesis diagnóstica sugestiva de ovarios poliquísticos. La edad promedio de las mujeres que se someten al examen fue de 35 a 46 años. Conclusión: se percibió en la investigación que la hipótesis diagnóstica del hallado del ultrasonido de forma aislada no es suficiente para diagnosticar el síndrome de ovarios poliquísticos. Es necesario tener en cuenta los signos y síntomas de hirsutismo, acné o alopecia androgénica, anovulación crónica asociada a desorden menstrual como oligo/amenorrea y infertilidad.(AU)

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El síndrome de ovarios poliquísticos excede el eje reproductivo por su frecuente asociación con alteraciones metabólicas y cardiovasculares. Objetivo: basado en lo anterior se realizó un estudio descriptivo transversal para determinar la frecuencia y las características de las alteraciones lipídicas en un grupo de mujeres con síndrome de ovarios poliquísticos y su relación con las alteraciones en la sensibilidad a la insulina. Se estudiaron 23 mujeres según los criterios de la Androgen Excess Society, se realizaron determinaciones hormonales y lipídicas así como glucemia e insulinemia en ayunas para evaluar sensibilidad a la insulina. Resultados: 95,6 por ciento de las pacientes presentaron dislipidemia. La disminución de las lipoproteínas de alta densidad (cHDL) y apolipoproteínas (Apo) A-I fueron las alteraciones lipídicas más frecuentes (91,3 y 87,0 por ciento, respectivamente) mientras que el aumento de los triglicéridos (Tg) y del colesterol total (Ct) fueron infrecuentes (13 y 4,3 por ciento, respectivamente). Los índices lipídicos calculados: Tg/cHDL, Ct/cHDL, cHDL/cLDL y Apo B/A-I tuvieron valores medios superiores en las mujeres con insulinorresistencia, el índice Apo B/A-I fue el que mostró mayor diferencia en mujeres con insulinorresistencia y sin esta. La frecuencia de las alteraciones lipídicas en las mujeres estudiadas fue alta pero no todas se relacionan con la insulinorresistencia, lo cual sugiere que en la expresión del síndrome de ovarios poliquísticos podrían intervenir múltiples factores metabólicos y hormonales(AU)

The polycystic ovaries syndrome to exceed the reproductive axis due to its frequent association with metabolic and cardiovascular alterations. Objetive: based on above mentioned a cross-sectional and descriptive study was conducted to determine the frequency and the characteristic of lipid alterations en a group of women diagnosed with polycystic ovaries and its relation to alterations in insulin-sensitivity. Methods: twenty three women were studied according to Androgen Excess Society criteria, hormonal and lipid determinations were made as well as fasting glycemia and insulinemia to assess the insulin-sensitivity. RESULTS: the 95,6 percent of patients presenting with dyslipemia. The more frequent lipid alterations were a decrease of the high density lipoproteins (cHDL) and apolipoproteins (Apo) (91,3 and 87,0 percent, respectively) whereas the increase of triglycerides(Tg) and the total cholesterol (tC) were infrequent (13 and 4,3 percent, respectively). The estimated lipid rates: Tg/cHDL, Ct/cHDL, cHDL/cLDL and Apo B/A-I had higher mean values in women with insulin-resistance; the Apo B/A-I rate had the greater difference in women with insulin-resistance and without it. The lipid alterations frequency in study women suggest that in expression of polycystic ovaries syndrome could be involved many metabolic and hormonal factors(AU)

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The present study had the objective of obtaining information about fertility in rats treated with dexamethasone for 10 and 15 days consecutively, to polycystic ovaries, induced by constant illumination. It was used 40 albino rats (Rattus norvegicus albinus), aged 90 days, form the lineage Wistar, which were split, randomly, in four groups, each constituted of 10 animals, namely: Group I - rats kept in a clear/dark cycle for 12/12 hours, and after 100 days submitted to fertility evaluation (control); Group II - rats kept under constant illumination during 100 days and then submitted to fertility evaluation; Group III - rats kept under constant illumination during 100 days, then treated with dexamethasone for 10 days and submitted to fertility evaluation; Group IV - rats kept under constant illumination during 100 days, then treated with dexamethasone for 15 days and submitted to fertility evaluation. The results showed that the number of implanted sites was 38(G1), 37(G2), 32(G3) and 06(G4). The reduction in group IV was due to the high mortality during the experiment, probably because of the prolonged treatment with dexamethasone. These sites presented similar histological aspects. The macroscopic analysis of the neonates haven't shown any indication of malformation. Also, abortion haven't been observed. The treatment with dexamethasone for 10 days in rats does not affect the fertility and the development of the lungs, liver and kidneys of neonates, while the administration during 15 days leads to a high maternal mortality.

El estudio tuvo el objetivo de obtener informaciones sobre la fertilidad en ratas tratadas con dexametasona por 10 y 15 días seguidos, para ovarios poliquísticos, inducidos por iluminación constante. Se utilizó 40 ratas albinas (Rattus norvegicus albinus) con 90 días de edad, del linaje Wistar, las cuales fueron divididas, en cuatro grupos, cada uno constituido por 10 animales: Grupo I - ratas mantenidas en ciclo claro/oscuro de 12/12 horas, y después de 100 días sometidas a la evaluación de la fertilidad (control); Grupo II- ratas mantenidas bajo iluminación constante, durante 100 días, y luego sometidas a la evaluación de la fertilidad ; Grupo III - ratas mantenidas bajo iluminación constante, a lo largo de 100 días, y posteriormente tratadas con dexametasona por diez días, y sometidas a la evolución de la fertilidad; Grupo IV - ratas mantenidas bajo iluminación constante, durante 100 días, en seguida tratadas con dexametasona por 15 días, y sometidas a la evaluación de la fertilidad. Los resultados mostraron que el número de sitios implantados fue 38(GI), 37(G2), 32(G3), y 06(G4). La reducción en el grupo IV fue como consecuencia de la alta mortalidad durante la experiencia, probablemente en función del largo tratamiento con dexametasona. Esos sitios presentaron aspectos histológicos semejantes. El análisis macroscópico de los neonatos no mostró ningún vestigio de malformación. Tampoco fueron observados abortos. El tratamiento con dexametasona por 10 días en ratas, no afecta la fertilidad y el desarrollo de los pulmones, hígado y riñones de neonatos, mientras que la administración por 15 días lleva a una alta mortalidad materna.

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A síndrome dos ovários policísticos (SOP) é uma desordem endócrina heterogênea com prevalência de 5 a 10 por cento nas mulheres em idade reprodutiva. Na SOP, há associação com vários fatores de risco para desenvolvimento de doença cardiovascular, como resistência à insulina, dislipidemia, diabetes mellitus, hipertensão arterial, disfunção endotelial, obesidade central, síndrome metabólica e marcadores pró-inflamatórios crônicos. A prática de exercício físico, juntamente com orientação nutricional, tem sido recomendada como estratégia de primeira linha no tratamento da oligomenorréia, hirsutismo, infertilidade e obesidade nas mulheres com SOP. Nesse sentido, o objetivo da presente revisão foi analisar o papel específico do exercício e/ou atividade física nas modificações da composição corporal, sistema cardiovascular, níveis plasmáticos bioquímicos e hormonais e função reprodutiva de mulheres com SOP.

The polycystic ovaries syndrome (POS) is a heterogeneous endocrinal disorder prevalent in 5 to 10 percent of women in reproductive age. In POS, there is an association with risk factors linked to the development of cardiovascular disease such as insulin resistance, dislipidemia, diabetes mellitus, arterial hypertension, endothelial dysfunction, central obesity, metabolic syndrome and chronic pro-inflammatory markers. Physical exercise practice together with nutritional guidance have been recommended as first rate strategies in the treatment of oligomenorrhea, hirsutism, infertility and obesity in POS women. This way, the objective of the present review was to analyze the specific role played by exercise and/or physical activity in changes of the body shape, in biochemical and hormonal plasmatic levels, and in the POS women’s reproductive function.

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