Publications by authors named "Rosana Maria Dos Reis"

60 Publications

Phosphatidylcholine and L-acetyl-carnitine-based freezing medium can replace egg yolk and preserves human sperm function.

Transl Androl Urol 2021 Jan;10(1):397-407

Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

Background: Conventional cryopreservation methods induce chemical and mechanical damage to the sperm membranes. The cryoprotectant potential of phospholipids of vegetal origin as soybean lecithin has been investigated as a substitute for egg yolk in diluents used for the cryopreservation of human spermatozoa. Therefore, the objective of this study was comparing the efficacy of a synthetic cryoprotectant supplemented with L-α-phosphatidylcholine (PC) and L-acetyl-carnitine (ANTIOX-PC) and the standard egg-based TEST-yolk buffer (TYB) in preserving sperm motility and chromatin quality in cryopreserved semen samples.

Methods: Prospective experimental study in which semen samples from 63 men with normal sperm motility and 58 men with low sperm motility were included and analyzed both before and after cryopreservation using ANTIOX-PC or TYB freezing media. Sperm quality was evaluated by routine semen analysis and DNA fragmentation index using the Terminal deoxynucleotidyl transferase dUTP nick end labeling assay.

Results: Differences in the post-thaw progressive motility and DNA fragmentation index were not detected between TYB and ANTIOX-PC cryoprotectants in both normal and low sperm motility groups (P>0.05). However, ANTIOX-PC medium retained higher non-progressive motility and lower percentage of immotile sperm when compared to TYB medium, resulting in a greater total motile sperm count (P<0.05), regardless baseline values of motility characteristic of the normospermic or asthenozoospermic samples.

Conclusions: ANTIOX-PC medium was effective to protect human sperm during a freeze-thaw cycle compared to the TYB medium. A clinically relevant advantage in better preserving kinetic parameters as higher total motility and lower immotile post-thawed sperm from ANTIOX-PC, in normal and low motility semen samples, demonstrated the positive impact of phospholipid and antioxidant treatment on sperm cryotolerance with high potential for egg yolk lipids replacement and biosafety.
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http://dx.doi.org/10.21037/tau-20-1004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7844480PMC
January 2021

Physical Performance Regarding Handgrip Strength in Women with Polycystic Ovary Syndrome.

Rev Bras Ginecol Obstet 2020 Dec 21;42(12):811-819. Epub 2020 Dec 21.

Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.

Objective:  The present study aimed to investigate the physical performance of handgrip strength (HGS) in women with polycystic ovary syndrome (PCOS).

Methods:  A case-control study that included 70 women with PCOS and 93 age-matched healthy women aged between 18 and 47 years with body mass index (BMI) between 18 Kg/m-39.9 Kg/m. The serum levels of total testosterone, androstenedione, insulin, estradiol, thyroid-stimulating hormone (TSH), prolactin, sex hormone-binding globulin (SHBG), and 17-hydroxyprogesterone (17-OHP) were measured. The free androgen index (FAI) and the homeostatic model assessment of insulin resistance (HOMA-IR) were calculated. The body composition regions of interest (ROIs) were assessed by dual-energy X-ray absorptiometry (DXA), and the handgrip strength (HGS) was evaluated for both the dominant and the non-dominant hands with a manual Sammons Preston (Bolingbrook, IL, US) bulb dynamometer.

Results:  Women with PCOS had high serum levels of total testosterone ( 0.01), androstenedione ( = 0.03), and insulin ( 0.01), as well as high FAI ( 0.01) and HOMA-IR ( = 0.01) scores. Compared with the non-PCOS group, the PCOS group had greater total lean mass in the dominant hand ( < 0.03) and greater HGS in both the dominant and the non-dominant hands ( 0.01). The HGS was correlated with lean mass ( 0.01).

Conclusion:  Women with PCOS have greater HGS. This may be associated with age and BMI, and it may be related to lean mass. In addition, the dominance effect on muscle mass may influence the physical performance regarding HGS in women with PCOS.
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http://dx.doi.org/10.1055/s-0040-1718953DOI Listing
December 2020

Sexual Practices During Adolescence.

Rev Bras Ginecol Obstet 2020 Nov 30;42(11):731-738. Epub 2020 Nov 30.

Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

Adolescence is characterized by significant biological and psychological changes. During this time, the increased production of androgens leads to increased sexual behavior, and this may contribute to early initiation of sexual activity. The objectives of the present cross-sectional study of adolescents enrolled in state schools in the city of Ribeirão Preto, state of São Paulo, Brazil, were to determine the average age at the first sexual intercourse (sexarche), the average number of sexual partners, and the frequency of contraceptive and condom use. Information on the age at sexarche, number of sexual partners, use of different contraceptive methods, and use of condoms were obtained using a semistructured questionnaire. Quantitative variables are expressed as means and standard deviations (SDs), and qualitative variables as absolute and relative frequencies. The chi-squared test was used for comparisons of qualitative variables, and the Student -test for comparisons of continuous variables. All statistical analyses were performed using SAS (version 9.4, North Carolina State University, USA). We evaluated 202 students who answered the questionnaire, 69 males (36.36%) and 133 females (63.64%). The age at sexarche for men ranged from 7 to 18 years old, and for women from 7 to 17 years old. Forty-eight girls (36.01%) and 21 boys (30.43%) were in the first year of high school, 66.94% of adolescents reported sexual intercourse, and 56.25% used a condom during the first sexual intercourse. A total of 36.72% of students said they had safe sex most of the time, and 83.59% said that the first sexual intercourse happened because they "had a crush on" the other person.
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http://dx.doi.org/10.1055/s-0040-1713411DOI Listing
November 2020

Differential DNA methylation pattern and sperm quality in men with varicocele.

Fertil Steril 2020 Oct 22;114(4):770-778. Epub 2020 Jul 22.

Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil. Electronic address:

Objective: To study the global DNA methylation pattern in spermatozoa of patients with varicocele as well as investigate their semen quality.

Design: Prospective observational case-control study.

Setting: University-affiliated hospital.

Patient(s): A total of 26 men with varicocele and 26 fertile men without the disorder.

Interventions: Analysis of semen quality and sperm DNA methylation patterns.

Main Outcome Measure(s): Semen quality evaluated by semen analysis, and sperm DNA methylation patterns investigated using the Infinium MethylationEPIC BeadChip platform.

Result(s): Men with varicocele displayed decreased semen quality. The sperm DNA methylation analysis showed that men with varicocele exhibit global hypomethylation in comparison with the control group. A total of 59 differentially methylated CpG sites were identified, most of them hypomethylated in the varicocele group. In regional analyses, 1,695 DNA regions were differentially methylated in men with varicocele. These regions show associations with gamete generation, meiotic and meiosis cell cycle, and semen quality based on gene ontology analysis.

Conclusion(s): Gene ontology results suggest that changes in methylation may be associated with the low semen quality phenotype observed in some varicocele patients because the observed differentially methylated regions in varicocele patients are related to male reproductive pathways. Additionally, the varicocele grade may influence the magnitude of global sperm DNA methylation change. To our knowledge, this is the first report analyzing changes at a regional or CpG-specific level in men with varicocele.
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http://dx.doi.org/10.1016/j.fertnstert.2020.04.045DOI Listing
October 2020

COVID-19 and Assisted Reproduction: A Point of View on the Brazilian Scenario.

Rev Bras Ginecol Obstet 2020 06 30;42(6):305-309. Epub 2020 Jun 30.

Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

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http://dx.doi.org/10.1055/s-0040-1713795DOI Listing
June 2020

Concordance in prediction body fat percentage of Brazilian women in reproductive age between different methods of evaluation of skinfolds thickness.

Arch Endocrinol Metab 2020 May-Jun;64(3):257-268

Faculdade de Medicina de Ribeirão Preto, Setor de Reprodução Humana, Departamento de Ginecologia e Obstetrícia, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.

Objective: To assess the utility of bioimpedance (BIA) and skinfolds thickness (SF) in body fat percentage measuring (%BF) compared to the reference method dual-energy x-ray absorptiometry (DXA) in Brazilian reproductive age women, as well as to estimate of inter- and intra-observer precision for SF.

Subjects And Methods: 170 women aged 18-37 years with BMI between 18 and 39.9 kg/m2 were selected for this cross-sectional study. Body density was evaluated through equations proposed by Jackson, Pollock and Ward (1980) (EqJPW) and Petroski (1995) (EqPET), and %BF was estimated by BIA, DXA and Siri's formula (1961). The SF were measured by two separate observers: A and B (to determine inter-observer variability), who measured the folds at three times with 10-minute interval between them (to determine intra-observer variability - we used only observer A).

Results: The %BF by DXA was higher than those measured by SF and BIA (p<0.01, for all) of 90 volunteers. The Lin coefficient of agreement was considered satisfactory for %BF values obtained by EqJPW and BIA (0.55) and moderate (0.76) for sum of SF (ΣSF) values obtained by EqJPW and EqPET. No agreement was observed for the values obtained by SF (EqJPW and EqPET), BIA and DXA. Analysis of inter- and intra-observer of 59 volunteers showed that different measures of SF thickness met acceptability standards, as well as the % BF.

Conclusion: BIA and SF measurements may underestimate %BF compared with DXA. In addition, BIA and SF measurements are not interchangeable with DXA. However, our results suggest the equation proposed by Jackson, Pollock and Ward (three skinfolds) compared to BIA are interchangeable to quantify the %BF in Brazilian women in reproductive age. Furthermore, our results show acceptable accuracy for intra- and inter-observer skinfold measurements. Arch Endocrinol Metab. 2020;64(3):257-68.
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http://dx.doi.org/10.20945/2359-3997000000246DOI Listing
June 2020

Telomere length is not altered in girls with idiopathic central precocious puberty treated with a GnRH analog - leuprolide acetate.

Gynecol Endocrinol 2020 Dec 4;36(12):1119-1123. Epub 2020 Jun 4.

Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.

Background: Idiopathic central precocious puberty (iCPP) presents a disproportionate advancement of bone age and maturation, as well as metabolic and endocrinological changes that may be related to effects on telomere biology.

Objective: To investigate the telomere length in iCPP girls treated with GnRHa.

Study Design: Observational case-control study with 85 girls, including 45 iCPP treated with GnRHa and 40 controls. It was analyzed age, height, weight and body mass index (BMI), insulin, triglycerides, testosterone, insulin resistance by HOMA, and telomere length by real-time PCR. Statistical analyses were determined by Wilcoxon test and Spearman correlation was carried out.

Results: Weight, BMI, insulin level and HOMA index were higher in the iCPP than in the control group ( < .01); without difference between mean ages. The telomere length did not differ between iCPP and control group. However, a negative correlation was observed between the telomere length and age in iCPP ( = .0009) and control group ( = .014), and weight in the iCPP ( = .017).

Conclusions: We did not observe any difference in the telomere length in the iCPP and control group. Even though, some characteristics of the disease, such as increased weight and body fat, negatively influence the telomere biology.
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http://dx.doi.org/10.1080/09513590.2020.1770212DOI Listing
December 2020

Effects of continuous and intermittent aerobic physical training on hormonal and metabolic profile, and body composition in women with polycystic ovary syndrome: A randomized controlled trial.

Clin Endocrinol (Oxf) 2020 08 20;93(2):173-186. Epub 2020 May 20.

Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP) Ribeirão Preto, Ribeirão Preto, Brazil.

Objective: To evaluate the effects of continuous (CA) and intermittent (IA) aerobic training on hormonal and metabolic parameters and body composition of women with polycystic ovary syndrome (PCOS).

Design: Prospective, interventional, randomized study.

Methods: Randomized controlled training (RCT) with sample allocation and stratification into three groups: CAT (n = 28) and IAT (n = 29) training and no training [control (CG), n = 30]. Before and after 16 weeks of intervention (CAT or IAT) or observation (CG), hormonal and metabolic parameters, body composition and anthropometric indices were evaluated. Aerobic physical training on a treadmill consisted of 30- to 50-minute sessions with intensities ranging from 60% to 90% of the maximum heart rate.

Results: In the CA group, there was reduction in waist circumference (WC) (P = .045), hip circumference (P = .032), cholesterol (P ≤ .001), low-density lipoprotein (P = .030) and testosterone (P ≤ .001). In the IAT group, there was a reduction in WC (P = .014), waist-to-hip ratio (P = .012), testosterone (P = .019) and the free androgen index (FAI) (P = .037). The CG showed increases in WC (P = .049), total body mass (P = .015), body fat percentage (P = .034), total mass of the arms (P ≤ .001), trunk fat percentage (P = .033), leg fat percentage (P = .021) and total gynoid mass (P = .011).

Conclusion: CAT and IAT training reduced anthropometric indices and hyperandrogenism in PCOS, whereas only IAT training reduced the FAI. Furthermore, only CAT training improved the lipid profile.
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http://dx.doi.org/10.1111/cen.14194DOI Listing
August 2020

Increased Sympathetic Cardiac Autonomic Modulation after Two Consecutive Tilt Tests in Women with Polycystic Ovary Syndrome.

Rev Bras Ginecol Obstet 2020 Feb 30;42(2):81-89. Epub 2020 Mar 30.

Department of Gynecology and Obstetrics, Medical School of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

Objective:  The present study aimed to analyze cardiac autonomic modulation via spectral and symbolic analysis of heart rate variability (HRV) in women with polycystic ovary syndrome (PCOS) who were subjected to two consecutive tilt tests.

Methods:  A total of 64 women were selected and divided into 2 groups: control (without PCOS), and PCOS. Concentrations of follicle-stimulating hormone, luteinizing hormone, prolactin, estradiol, homocysteine, sex hormone-binding globulin, thyroid stimulating hormone, fasting insulin, testosterone, androstenedione, and 17-hydroxyprogesterone levels, triglycerides, free androgen index (FAI), and homeostasis assessment model (HOMA-IR) were assessed. Cardiac autonomic modulation was evaluated by spectral and symbolic analyses during two consecutive tilt tests (two moments) and supine moments before, between and after (three moments) the tilt tests.

Results:  Women with PCOS had higher fasting insulin, HOMA-IR indexes, testosterone and FAI. Additionally, we observed that the PCOS group had greater sympathetic autonomic cardiac modulation in supine 2, tilt 1, and supine 3 moments compared with controls.

Conclusion:  Women with PCOS had higher autonomic sympathetic cardiac modulation even after a second tilt test. No adaptation to this provocative test was observed. Spectral analysis was more sensitive for identifying differences between groups than the symbolic analysis.
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http://dx.doi.org/10.1055/s-0040-1701467DOI Listing
February 2020

The effects of aerobic physical exercises on body image among women with polycystic ovary syndrome.

J Affect Disord 2020 02 9;262:350-358. Epub 2019 Nov 9.

Ribeirão Preto Medical School, Human Reproduction sector, Departament of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil.

Background: Both physical and mental health care for women with polycystic ovary syndrome (PCOS) require a multidisciplinary approach. We evaluated the effects of continuous (CAT) and intermittent (IAT) aerobic training in different protocols that measure body image, anxiety, depression and sexual dysfunction in women with PCOS.

Methods: In this controlled clinical trial, women with PCOS were randomly allocated for 16 weeks to 1 out of 3 groups: CAT (n = 28), IAT (n = 29), or control group (CG, n = 30). For data collection, we used the Body Shape Questionnaire (BSQ), Figure Rating Scale (FRS), Female Sexual Function Index (FSFI), Hospital Anxiety and Depression Measurement Scales (HADS).

Results: No effects of CAT, IAT or CG groups were identified in the perceptual dimension of body image. The dis(satisfaction) grade improved after exercise in the CAT group (p ≤ 0.01) compared to the CG, as well as improved within CAT and IAT groups. Total FSFI, and HADS-A and HADS-D scores improved after exercise in the both groups. At baseline and after the study period, there were positive correlations between scores for dis(satisfaction), HADS-A and HADS-D scores. HADS-A and HADS-D scores had a negative correlation with FSFI total in the IAT (p = =0.02) group compared to the CG, as well as within CAT and IAT groups.

Limitations: The participants were not matched for body mass index (normal, overweight and obese) which may interfere on body image dimensions.

Conclusion: Aerobic exercise improves sexual function and indices related to anxiety and depression. Likewise, it interferes in cognitive-affective dimension of the body image.
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http://dx.doi.org/10.1016/j.jad.2019.11.025DOI Listing
February 2020

Prevalence and characteristics of polycystic ovary syndrome in Brazilian women: protocol for a nation-wide case-control study.

BMJ Open 2019 10 22;9(10):e029191. Epub 2019 Oct 22.

Department of Gynecology and Obstetrics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

Introduction: Brazil is a large country, with a population of mixed ethnic background and broad variation in dietary and physical activity traits across its five main regions. Because data on Brazilian women with polycystic ovary syndrome (PCOS) are still scarce, a nation-wide collaborative study was designed to determine the prevalence of metabolic and reproductive abnormalities and the presence of anxiety and depression in Brazilian women with PCOS. In addition, the study aims at describing how these characteristics are distributed across PCOS phenotypes and at detecting associations with regional demographic and lifestyle aspects, genetic variants, and epigenetic markers.

Methods And Analysis: The Brazilian PCOS study is being conducted in the outpatient clinics of eight university hospitals within the public healthcare network (Unified Health System) across the country. Additional centres will be included following completion of the research ethics approval process. The sample includes women with PCOS according to Rotterdam criteria at inclusion in the study and a control group of healthy women matched by age, socioeconomic status and geographical region. Data will be collected in each centre and incorporated into a unified cloud database. Clinical, demographic, socioeconomic, psychological, metabolic, epigenetic and genotypic variables will be evaluated. The data resulting from this study will be useful to guide specific public strategies for primary and secondary prevention of metabolic and reproductive comorbidities in the PCOS population of Brazil.

Ethics And Dissemination: The study protocol was approved by each local Research Ethics Committee. Written informed consent will be obtained from each participant. During data collection, analysis and publication, care will be taken to ensure confidentiality of participant information. Study results will be published in peer-reviewed journals and disseminated at international conferences. This research protocol was registered with the Research Ethics Committee of HCPA, through Plataforma Brasil.

Trial Registration Number: CAAE 18082413.9.1001.5327.
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http://dx.doi.org/10.1136/bmjopen-2019-029191DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6830701PMC
October 2019

Continuous versus intermittent aerobic exercise in the improvement of quality of life for women with polycystic ovary syndrome: A randomized controlled trial.

J Health Psychol 2019 Sep 9:1359105319869806. Epub 2019 Sep 9.

1 Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil.

Polycystic ovary syndrome predisposes alterations which contribute to the reduction of quality of life. This randomized controlled clinical trial study was to evaluate the effect of two protocols of aerobic exercise on quality of life in women with polycystic ovary syndrome. Women were allocated to three groups: continuous aerobic training ( = 28), intermittent aerobic training ( = 29), and control group (no training;  = 30). Testosterone levels, body composition indices, and quality of life were assessed at baseline and after 16 weeks of intervention. Both protocols were effective to improve testosterone levels, anthropometric indices, and quality of life in polycystic ovary syndrome women. Thus, these protocols should be included in the clinical environment to improve clinical parameters psychological, biological and social health to this population.
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http://dx.doi.org/10.1177/1359105319869806DOI Listing
September 2019

Association of measures of central fat accumulation indices with body fat distribution and metabolic, hormonal, and inflammatory parameters in women with polycystic ovary syndrome.

Arch Endocrinol Metab 2019 Jul 29;63(4):417-426. Epub 2019 Jul 29.

Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brasil.

Objective: To investigate the associations among visceral adiposity index (VAI), lipid accumulation product (LAP), body fat percentage (%), and android/gynoid ratio (A/G ratio) in women with polycystic ovary syndrome (PCOS) and verify if the parameters representative of visceral obesity correlate with and exhibit the same frequency as body composition variables; anthropometric indices; and metabolic, hormonal, and inflammatory parameters.

Subjects And Methods: This was a cross-sectional study that included 94 women with PCOS. Hormonal, metabolic, and inflammatory parameters were analyzed in all women. Free androgen index (FAI) and homeostasis model assessment (HOMA-IR), as well as LAP, VAI, and anthropometric indices, were calculated. The regions of interest (ROIs) in body composition and body composition indices were evaluated using a dual X-ray absorptiometry (DXA). Overall, 32 variables were selected as markers of body fat distribution.

Results: Among the 32 markers evaluated, 29 correlated with LAP, whereas 25 correlated with VAI, 19 with body fat (%), and 30 with A/G ratio. Additionally, some markers correlated with the four adiposity indices evaluated: ROIs, except for total mass and leg fat (%); body composition (body mass index, waist circumference, and hip circumference) indices; fasting insulin; and C-reactive protein.

Conclusion: LAP and VAI may be sensitive measures for screening and preventing metabolic syndrome and insulin resistance in PCOS, with LAP being more sensitive than VAI, and the A/G ratio may be more sensitive than body fat percentage.
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http://dx.doi.org/10.20945/2359-3997000000157DOI Listing
July 2019

Body image and its relationships with sexual functioning, anxiety, and depression in women with polycystic ovary syndrome.

J Affect Disord 2019 06 6;253:385-393. Epub 2019 May 6.

Ribeirão Preto Medical School, Human Reproduction Sector, Departament of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto 14049-900 SP, Brazil.

Background: Polycystic ovary syndrome (PCOS) is associated with lower levels of satisfaction with body image, which can affect sexuality and social well-being. Thus, we evaluated body image in women with PCOS and its association with body dis(satisfaction), anthropometric indices, sexual function, anxiety, and depression.

Methods: In this cross-sectional study, 94 women of reproductive age were grouped by body mass index (BMI) and sexual function. The Female Sexual Function Index (FSFI), Body Shape Questionnaire (BSQ), Figure Rating Scale (FRS), hospital anxiety (HADS-A) and depression (HADS-D) measurement scales, and anthropometric indices were used for data collection.

Results: Women with PCOS presented with perceptual distortions of self-image independent of sexual function and BMI. There were negative correlations between HADS-A and HADS-D scores and the FSFI total score, and HADS-D scores had positive correlations with weight, anthropometric indices, and BSQ total score. The degree of dis(satisfaction) was a predictor of FSFI total score, depression, and anxiety, and the FSFI total score was predicted by HADS-D. Desired and ideal-gender BMIs were risk factors for sexual dysfunction, and overweight and obesity were risk factors for the degree of dis(satisfaction).

Limitations: This study had the limitations of using a cross-sectional design and it investigated a restricted number of clinical/biochemical parameters, as well as lacked objective measures of acne and hirsutism, and a control group.

Conclusions: Perception and cognitive-affective dimensions appear to play important roles in body image dysfunction in women with PCOS, and impact sexual dysfunction and depression associated the syndrome. Furthermore, these results provide additional treatment considerations for women with PCOS.
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http://dx.doi.org/10.1016/j.jad.2019.05.006DOI Listing
June 2019

Women with Polycystic Ovarian Syndrome Exhibit Reduced Baroreflex Sensitivity That May Be Associated with Increased Body Fat.

Arq Bras Cardiol 2019 04 28;112(4):424-429. Epub 2019 Feb 28.

Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP - Brazil.

Background: Polycystic ovarian syndrome (PCOS) women have a high prevalence of obesity and alterations in cardiovascular autonomic control, mainly modifications in heart rate variability (HRV) autonomic modulation. However, there are few studies about other autonomic control parameters, such as blood pressure variability (BPV) and baroreflex sensitivity (BRS). In addition, there are still doubts about the obesity real contribution in altering autonomic control in these women.

Objective: To investigate BPV and BRS autonomic modulation alterations in PCOS women, as well as, to evaluate whether these alterations are due PCOS or increased body fat.

Methods: We studied 30 eutrophic volunteers [body mass index (BMI) < 25 kg/m2] without PCOS (control group) and 60 volunteers with PCOS divided into: eutrophic (BMI < 25 kg/m2, N = 30) and obese women (BMI > 30 kg/m2, N = 30). All volunteers were submitted to anthropometric evaluation, hemodynamic and cardiorespiratory parameters record at rest and during physical exercise, analysis of HRV, BPV and spontaneous BRS. The differences in p less than 5% (p < 0.05) were considered statistically significant.

Results: Related to eutrophics groups, there were no differences in autonomic parameters evaluated. The comparison between the PCOS groups showed that both PCOS groups did not differ in the BPV analysis. Although, the obese PCOS group presented lower values of spontaneous BRS and HRV, in low frequency and high frequency oscillations in absolute units.

Conclusion: Our results suggest that obesity did little to alter HRV in women with PCOS, but it may influence the spontaneous BRS.
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http://dx.doi.org/10.5935/abc.20190031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459434PMC
April 2019

The relationship among sperm global DNA methylation, telomere length, and DNA fragmentation in varicocele: a cross-sectional study of 20 cases.

Syst Biol Reprod Med 2019 Apr 2;65(2):95-104. Epub 2019 Jan 2.

a Department of Gynecology and Obstetrics, Ribeirão Preto Medical School , University of São Paulo , Ribeirão Preto, São Paulo , Brazil.

Varicocele pathophysiology is related to increased oxidative stress, which might result in loss sperm DNA integrity as well as in genomic instability. Sperm telomere shortening and loss of global DNA methylation are the main features of genomic instability, leading to cell senescence and death, whereas sperm DNA fragmentation (SDF) characterizes the loss of chromatin integrity. We hypothesize that sperm genomic stability and DNA integrity is reduced in infertile men with moderate and large-sized varicoceles, thus being candidate markers of sperm quality in varicocele-related infertility. Here, we assessed the sperm global DNA methylation, telomere length, and SDF in men with and without clinically palpable varicoceles. While the rates of SDF and telomere length were not statistically different between varicocele patients and controls, global sperm DNA methylation seems to be lower in men with varicocele (49.7% ± 20.7%) than controls (64.7% ± 17.1%). A negative correlation between SDF and sperm motility and a positive correlation between sperm morphology and telomere length were observed. Our results suggest that varicocele may result in genomic instability, in particular, global DNA hypomethylation. However, a large sample size may confirm these findings. The understanding of the molecular mechanisms involved in the pathophysiology of varicocele-related infertility may help to better select candidates for varicocele repair.
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http://dx.doi.org/10.1080/19396368.2018.1557762DOI Listing
April 2019

Hyperandrogenism Enhances Muscle Strength After Progressive Resistance Training, Independent of Body Composition, in Women With Polycystic Ovary Syndrome.

J Strength Cond Res 2018 Sep;32(9):2642-2651

Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.

Kogure, GS, Silva, RC, Miranda-Furtado, CL, Ribeiro, VB, Pedroso, DCC, Melo, AS, Ferriani, RA, and Reis, RMd. Hyperandrogenism enhances muscle strength after progressive resistance training, independent of body composition, in women with polycystic ovary syndrome. J Strength Cond Res 32(9): 2651-2660, 2018-The effects of resistance exercise on muscle strength, body composition, and increase in cross-sectional area of skeletal muscle (hypertrophy) were evaluated in women with polycystic ovary syndrome (PCOS). This case-control study included 45 PCOS and 52 non-PCOS women, with age between 18-37 years and body mass index of 18-39.9 kg·m. Subjects performed a program of progressive resistance training (PRT), 3 times per week for 4 months. Biochemical characteristics were measured before and after PRT. Muscle strength evaluated by 1 maximum repetition test and body composition and hypertrophy indicator, evaluated by anthropometry, were measured at baseline, at 8 weeks, and at 16 weeks after PRT. Progressive resistance training produced an increase in maximum strength (bench press, p = 0.04; leg extension, p = 0.04) in the PCOS group; however, no changes were observed in body composition between groups. Concentration of testosterone decreased in both PCOS and non-PCOS groups (p < 0.01, both) after PRT, as well as glycemia (PCOS, p = 0.01; non-PCOS, p = 0.02) and body fat percentage (p < 0.01, both). An increase in hypertrophy indicators, lean body mass (LBM), and maximum strength on all exercises was observed in both PCOS and non-PCOS groups (p < 0.01). This training protocol promoted increases in muscle strength in PCOS women, and improved hyperandrogenism and body composition by decreasing body fat and increasing LBM and muscle strength in both PCOS and non-PCOS groups. Therefore, it is suggested that resistance exercise programs could promote health and fitness in women of reproductive age, especially functional capacity of strength those with PCOS.
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http://dx.doi.org/10.1519/JSC.0000000000002714DOI Listing
September 2018

Hormonal contraception in women with polycystic ovary syndrome: choices, challenges, and noncontraceptive benefits.

Open Access J Contracept 2017 2;8:13-23. Epub 2017 Feb 2.

Department of Gynecology and Obstetrics, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

Polycystic ovary syndrome (PCOS) is an endocrine disorder among women of reproductive age characterized by chronic anovulation and polycystic ovary morphology and/or hyperandrogenism. Management of clinical manifestations of PCOS, such as menstrual irregularities and hyperandrogenism symptoms, includes lifestyle changes and combined hormonal contraceptives (CHCs). CHCs contain estrogen that exerts antiandrogenic properties by triggering the hepatic synthesis of sex hormone-binding globulin that reduces the free testosterone levels. Moreover, the progestogen present in CHCs and in progestogen-only contraceptives suppresses luteinizing hormone secretion. In addition, some types of progestogens directly antagonize the effects of androgens on their receptor and also reduce the activity of the 5α reductase enzyme. However, PCOS is related to clinical and metabolic comorbidities that may limit the prescription of CHCs. Clinicians should be aware of risk factors, such as age, smoking, obesity, diabetes, systemic arterial hypertension, dyslipidemia, and a personal or family history, of a venous thromboembolic event or thrombophilia. This article reports a narrative review of the available evidence of the safety of hormonal contraceptives in women with PCOS. Considerations are made for the possible impact of hormonal contraceptives on endocrine, metabolic, and cardiovascular health.
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http://dx.doi.org/10.2147/OAJC.S85543DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774551PMC
February 2017

Prognostic factors in intrauterine insemination cycles.

JBRA Assist Reprod 2018 Mar 1;22(1):2-7. Epub 2018 Mar 1.

Sector of Human Reproduction, Department of Gynecology and Obstetrics - Ribeirão Preto Medical School, São Paulo University, Brazil.

Objective: This study aimed to evaluate the clinical pregnancy rate of intrauterine insemination cycles in relation to patient age, cause of infertility, ovulation induction method, number of mature follicles and sperm with progressive motility.

Methods: This retrospective observational study included 237 intrauterine insemination cycles performed from 2011 to 2015 at the Assisted Reproduction Service of the Hospital das Clínicas of the Ribeirão Preto Medical School, University of São Paulo. Student's t-test was used to compare quantitative variables and the chi-square test was used to compare qualitative variables.

Results: Patient age was inversely and significantly correlated with pregnancy rates (p=0.001) (Pregnant women = 32.56±5.64 years, non-pregnant women = 36.64±5.03 years). Cause of infertility, ovulation induction method, number of mature follicles and sperm with progressive motility were not associated with pregnancy rates. The overall clinical pregnancy rate was 7.59%. In the subgroup of patients (n=102 cycles) considered ideal for intrauterine insemination (age ≤35 years, unexplained infertility, ovarian factor infertility or minimal endometriosis, and a partner with sperm count ≥2.5 × 10 retrieved on the day of insemination) the pregnancy rate was 12.74%.

Conclusion: In the studied group, female patient age was the only variable significantly correlated with intrauterine insemination success rates.
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http://dx.doi.org/10.5935/1518-0557.20180002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5844652PMC
March 2018

Nutritional Counseling Promotes Changes in the Dietary Habits of Overweight and Obese Adolescents with Polycystic Ovary Syndrome.

Rev Bras Ginecol Obstet 2017 Dec 30;39(12):692-696. Epub 2017 Oct 30.

Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

 To evaluate the effects of nutritional counseling on the dietary habits and anthropometric parameters of overweight and obese adolescents with polycystic ovary syndrome (PCOS).  This was a prospective, longitudinal and auto-controlled study. Thirty adolescents aged 13-19 years-old, diagnosed with PCOS received nutritional counseling and were followed-up for 6 months. After the follow-up period, the results were evaluated through body weight, body mass index (BMI) and waist circumference (WC).  Sixty-percent of the adolescents adhered to the nutritional counseling and, of these, 50% lost weight. Adolescents who lost weight changed their dietary habits by adopting hypocaloric diets and eating more meals per day, as per nutritional counseling. The waist circumference (WC) decreased significantly, although the body weight decreased non-significantly after adoption of a hypocaloric diet.  Although there was no significant weight loss, there was a considerable reduction in the WC associated with hypocaloric diets and with eating a greater number of meals per day.
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http://dx.doi.org/10.1055/s-0037-1607458DOI Listing
December 2017

Genetics and epigenetics of varicocele pathophysiology: an overview.

J Assist Reprod Genet 2017 Jul 18;34(7):839-847. Epub 2017 May 18.

Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo (USP), 3900 Bandeirantes Ave, São Paulo, Ribeirão Preto, 14049-900, Brazil.

Varicocele is found in approximately 20% of adults and adolescents and in 19-41% of men seeking treatment for infertility. It is associated with a decrease in sperm count as well as sperm motility and morphology. The currently accepted description of the pathophysiology of varicocele does not explain all its clinical manifestations; therefore, other factors such as genetic and epigenetic changes, associated with the environment, might be involved in causing infertility and decrease in sperm quality. It has been reported that the varicocele-induced deterioration of testicular function is progressive and interferes with fertility; hence, early and efficient assessment of the genetic manifestations in patients would be important for developing future medical interventions. Chromosomal disorders, mutations, polymorphisms, changes in gene expression, and epigenetic changes have all been reported to be associated with varicocele. Several studies are underway to unravel the genetic basis of this disease, as it is important to understand the origin and the aggravating factors to ensure appropriate guidance and intervention. Here, we review the available literature regarding the genetic and epigenetic changes associated with varicocele, and how these alterations are related to the different clinical manifestations of the disease.
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http://dx.doi.org/10.1007/s10815-017-0931-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476544PMC
July 2017

Progressive Resistance Training as Complementary Therapy for Polycystic Ovarian Syndrome.

Rev Bras Ginecol Obstet 2017 06 18;39(6):255-257. Epub 2017 May 18.

Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

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http://dx.doi.org/10.1055/s-0037-1602705DOI Listing
June 2017

The telomere attrition rate is not accelerated in women born small for gestational age: A birth cohort study.

Gene 2017 Feb 18;600:16-20. Epub 2016 Nov 18.

Department of Obstetrics and Gynecology, Medical School of Ribeirão Preto, University of São Paulo, Brazil.

Background: Physiologically, a reduction in telomere length (LTL) occurs with aging, but epigenetic changes may accelerate telomere shortening and also facilitate the onset of oxidative/inflammatory stress and the development of clinical/metabolic comorbidities in life spam. Although individuals born small for gestational age (SGA) may be related to those epigenetic changes, the assessment of LTL in individuals born SGA has yielded conflicting results (only cross-sectional studies) and has not been carried out in longitudinal studies. We performed a birth cohort study to evaluate the rate of telomere erosion in women born SGA in comparison to women born appropriate for gestational age (AGA) assessed at two different time points during the third decade of life. In our research, born SGA or AGA showed no difference in LTL shortening during a period of five years in the third decade of life. Our finding may have implications for understanding the natural history of diseases in lifespan because the same women (under the influence of similar environmental factors) may be accessed in different phases of life. Thus, the analysis of the present cohort population at a more advanced age may reveal a dynamics of telomere shortening different from here and its possible relation with onset of age-related diseases.
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http://dx.doi.org/10.1016/j.gene.2016.11.030DOI Listing
February 2017

Quality of Life in Women with Polycystic Ovary Syndrome after a Program of Resistance Exercise Training.

Rev Bras Ginecol Obstet 2016 Jul 29;38(7):340-7. Epub 2016 Jul 29.

Division of Human Reproduction, Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.

Purpose Aerobic exercises may improve quality of life (QoL) in women with polycystic ovary syndrome (PCOS). However, there is no data on the effect of resistance exercise training (RET) programs on the QoL of women with PCOS. Thus, this study aimed to assess the effect of a 16-week RET program on QoL in PCOS women. Methods This 16-week case-control study enrolled 43 women with PCOS (PCOS group, PCOSG) and 51 healthy pre-menopausal controls aged 18 to 37 years (control group, CG). All women underwent a supervised RET program for 16 weeks, and were evaluated in two different occasions: week-0 (baseline), and week-16 (after RET). Quality of life was assessed using the 36-Item Short Form Health Survey (SF-36). Results Testosterone reduced significantly in both groups after RET (p < 0.01). The PCOSG had improvements in functional capacity at week-16 relative to week-0 (p = 0.02). The CG had significant improvements in vitality, social aspects, and mental health at week-16 relative to week-0 (p ≤ 0.01). There was a weak correlation between social aspects of the SF-36 domain and testosterone levels in PCOS women. Conclusion A 16-week RET program modestly improved QoL in women with PCOS.
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http://dx.doi.org/10.1055/s-0036-1585457DOI Listing
July 2016

Resistance Exercise Impacts Lean Muscle Mass in Women with Polycystic Ovary Syndrome.

Med Sci Sports Exerc 2016 Apr;48(4):589-98

Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, BRAZIL.

Purpose: This study investigated the effects of progressive resistance training (PRT) on lean muscle mass (LMM) in women with or without polycystic ovary syndrome (PCOS) and its effects on metabolic factors and concentrations of related steroid hormones.

Design: This was a nonrandomized, therapeutic, open, single-arm study.

Participants: All in all, 45 sedentary women with PCOS and 52 without (non-PCOS), 18-37 yr of age, with body mass indexes (BMI) of 18-39.9 kg·m(-2) of all races and social status, performed PRT three times a week for 4 months. Before and after PRT, the concentrations of hormones and metabolic factors and waist circumference were measured. LMM and total body fat percentage were determined using dual-energy x-ray absorptiometry. Clinical characteristics, LMM, and fasting glucose were adjusted for confounding covariables and compared using general linear mixed models. Each patient's menstrual history was taken before study enrollment and after PRT.

Results: PRT resulted in reduced plasma testosterone and fasting glucose levels. After PRT, the androstenedione concentration increased and the sex hormone-binding globulin concentration decreased in women with PCOS. The waist circumference was reduced (P < 0.01) and the muscle mass index, lean mass (LM)/height2, increased in women with PCOS (P = 0.04). Women with PCOS showed increased muscle mass indexes of appendicular LM/height2 (P = 0.03) and LM/height2 (P < 0.01) compared with the baseline. Total LM and trunk LM were elevated in women with PCOS (P = 0.01) at the baseline and after PRT.

Conclusion: To our knowledge, this is the first report to show that resistance exercise alone can improve hyperandrogenism, reproductive function, and body composition by decreasing visceral fat and increasing LMM, but it has no metabolic impact on women with PCOS.
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http://dx.doi.org/10.1249/MSS.0000000000000822DOI Listing
April 2016

A Nonrandomized Trial of Progressive Resistance Training Intervention in Women With Polycystic Ovary Syndrome and Its Implications in Telomere Content.

Reprod Sci 2016 May 18;23(5):644-54. Epub 2015 Nov 18.

Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil

Background: Physical activity is known to relieve the metabolic complications of polycystic ovary syndrome (PCOS), and exercise is also associated with telomere biology. We investigated the changes induced by progressive resistance training (PRT) in telomere content and metabolic disorder in women with PCOS and controls.

Participants And Methods: Forty-five women with PCOS and 52 healthy women aged 18 to 37 years were submitted to PRT. A linear periodization of PRT was prepared based on a trend of decreasing volume and intensity throughout the training period. The volunteers performed PRT 3 times a week for 4 months. The participants' physical characteristics and hormonal concentrations were measured before and after PRT, as telomere content that was measured using quantitative real-time polymerase chain reaction.

Results: Briefly, Progressive resistance training reduced waist circumference, body fat percentage, plasma testosterone and sex hormone-binding globulin concentrations, glycemia, and free androgen index. Fasting insulin and insulin resistance index were greater in women with PCOS. Androstenedione and homocysteine increased after PRT. There were no differences in telomere content between controls (0.96 ± 0.3 before vs 0.85 ± 0.21 after) and women with PCOS (0.94 ± 0.33 before vs 0.88 ± 0.39 after). Adjusted analysis showed telomere shortening after PRT in all women (0.95 ± 0.31 before vs 0.86 ± 0.31 after; P = .03). In women with PCOS, increased homocysteine levels were related to telomere reduction and increased androstenedione was positively correlated with telomere content after PRT.

Conclusions: Progressive resistance training had positive effects on the hormonal and physical characteristics of women with PCOS and controls, but telomere content was reduced and homocysteine level increased in all participants.
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http://dx.doi.org/10.1177/1933719115611753DOI Listing
May 2016

Impact of Physical Resistance Training on the Sexual Function of Women with Polycystic Ovary Syndrome.

J Sex Med 2015 Jul 18;12(7):1584-90. Epub 2015 May 18.

Gynecology and Obstetric Department, Ribeirão Preto Medical School of University of São Paulo, Ribeirão Preto, Brazil.

Introduction: There is a need for specific measures to address overall care in women with polycystic ovary syndrome (PCOS). Physical resistance training (PRT) has been shown to improve certain body parameters. However, the effect of PRT on the sexual function of PCOS women has not been evaluated.

Aim: The study aimed to assess sexual function and emotional status of PCOS women after 16 weeks of PRT.

Methods: This case-control study involved 43 women with PCOS and 51 control ovulatory women, aged 18-37 years. All women were subjected to a supervised PRT protocol for 16 weeks and evaluated at the end of the program. Sexual function was assessed at baseline and after PRT protocol.

Main Outcome Measures: The main outcome measure used was the Female Sexual Function Index (FSFI).

Results: Of the 43 women with PCOS, 30 (69.70%) had a basal total FSFI score ≤ 26.55 and 24 of them (58.54%) had a score ≤ 26.55 after PRT (P = 0.08). Of the 51 control women, 32 (62.7%) and 27 (52.9%) had FSFI scores < 26.55 at baseline and after PRT, respectively (P = 0.06). Control women experienced a significant improvement in pain domain score after PRT (P < 0.03). PCOS women experienced significant increases in total score and in the desire, excitement and lubrication domains after PRT (P < 0.01 each). After PRT, there was a significant difference between the PCOS and control groups in the sexual desire domain (4.09 ± 1.29 vs. 3.75 ± 1.42, P = 0.04). Significantly fewer women in the PCOS group were at risk of depression (P < 0.01) and anxiety (P < 0.02) after than before PRT, whereas the differences in the control group were not significant. Mean depression and anxiety scores were reduced significantly in both the PCOS (P < 0.01 each) and control (P < 0.01) groups.

Conclusions: PRT significantly enhanced total score and the desire, excitement, and lubrication domains of the FSFI in PCOS women. PRT reduced pain, and total depression and anxiety scores in both groups.
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http://dx.doi.org/10.1111/jsm.12909DOI Listing
July 2015

Presentation and treatment of uterine leiomyoma in adolescence: a systematic review.

BMC Womens Health 2015 Jan 22;15. Epub 2015 Jan 22.

Department of Gynecology and Obstetrics - Ribeirao Preto Medical School, University of Sao Paulo, Avenida Bandeirantes, 3900 - 8th floor - Monte Alegre, Ribeirão Preto, SP, Brazil.

Background: Uterine leiomyoma is the most common gynecological tumor in the reproductive years. However, it is extremely rare in adolescence (<1%), with few reports found in the literature. The biological behavior of such tumors in this age group is unknown, as well as the best possible treatment for this population. We aimed to analyze all available reports of uterine leiomyoma in adolescence.

Methods: A systematic review was performed at PubMed/MEDLINE and EMBASE. Between 1965 and 2014, 19 reports were found on uterine leiomyoma in patients under 18 years. The following parameters were discussed: age, tumor diameter, symptoms, clinical treatments, surgical treatments, hemodynamic changes.

Results: Mean age was 15.35 (14-17) years. Mean tumor diameter was 12.28 cm (3-30) and median diameter was 10 cm. Most patients presented with symptoms (87.5%), including abnormal uterine bleeding (10/18) and pelvic/abdominal pain (6/18). A pelvic mass was the most common finding. Two patients required transfusion due to anemia. One patient underwent abdominal hysterectomy, and the others underwent myomectomy. Mean follow-up was 1 year and 8 months, and only case recurred, after 6 months.

Conclusion: Leiomyomas' biologic behavior in adolescents may be different from that of older women, but their molecular characteristics still haven't been analyzed. Optimal treatment is still not defined, but myomectomy has several advantages in this population. Leiomyomas must be remembered as an important differential diagnosis of pelvic mass in adolescents.
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http://dx.doi.org/10.1186/s12905-015-0162-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4308853PMC
January 2015

Inflammatory biomarkers and telomere length in women with polycystic ovary syndrome.

Fertil Steril 2015 Feb 20;103(2):542-7.e2. Epub 2014 Nov 20.

Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil. Electronic address:

Objective: To analyze whether leukocyte telomere length (LTL) is impaired in women with polycystic ovary syndrome (PCOS).

Design: Case-control study.

Setting: Hospital.

Patient(s): A total of 274 women, including 150 patients with PCOS and 124 controls.

Intervention(s): None.

Main Outcome Measure(s): Body mass index (BMI), waist circumference, systemic arterial pressure, lipid profile, E(2), LH, T, androstenedione, PRL, TSH, sex hormone-binding globulin, C-reactive protein (CRP), homocysteine, free androgen index, and the homeostatic model of insulin sensitivity (HOMA-IR) index were analyzed. The LTL evaluation was measured by quantitative polymerase chain reaction.

Result(s): The PCOS group had higher values for weight, BMI, waist circumference, systolic arterial pressure, triglycerides, LH, T, insulin, CRP, free androgen index, and HOMA-IR compared with the control group. Sex hormone-binding globulin and E(2) levels were lower in the PCOS group than in the control group. The LTL did not differ between groups. Age, BMI, and HOMA-IR had no significant effect on LTL. The inflammatory biomarkers CRP and homocysteine were negatively correlated with LTL in patients with PCOS.

Conclusion(s): Our results showed no differences in LTL between patients with PCOS and controls, but CRP and homocysteine biomarkers negatively correlated with LTL in the PCOS group.
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http://dx.doi.org/10.1016/j.fertnstert.2014.10.035DOI Listing
February 2015

Women with polycystic ovary syndrome have greater muscle strength irrespective of body composition.

Gynecol Endocrinol 2015 Mar 28;31(3):237-42. Epub 2014 Nov 28.

Department of Obstetrics and Gynecology, Ribeirão Preto Medical School, University of Sao Paulo , Ribeirão Preto, SP , Brazil.

The aim of this study was to compare metabolic parameters, body composition (BC) and muscle strength of women with and without polycystic ovary syndrome (PCOS). This was a case-control study that evaluated 40 women with PCOS and 40 controls. Androgens and insulin resistance were measured. BC was based on dual-energy X-ray absorptiometry. Isometric handgrip and maximal dynamic muscle strength (1-RM) strength tests were performed. Median total testosterone (p < 0.01), free androgen index (p < 0.01), insulin (p < 0.01) and homeostasis model assessment-insulin resistance (p = 0.02) were higher and sex hormone binding globulin (SBHG) (p = 0.04) was lower in the PCOS group. Normoweight women with PCOS had higher percentages of android body fat. However, the prevalence of android fat distribution was higher in the PCOS than in the control group (p = 0.04). The strength 1-RM in bench press (p < 0.01), muscle strength relative to lean muscle mass in the dominant lower limb (p = 0.04) and isometric handgrip strength tests (p = 0.03) was higher in the PCOS group. PCOS was a determinant of strength in the bench press exercise (p = 0.04). The hyperandrogenism was a predictor of increased strength in biceps curl exercises (p = 0.03) in the dominant lower limb (p = 0.02) and isometric handgrip strength (p = 0.03). In conclusion, women with PCOS have greater muscle strength and a higher prevalence of central obesity, but no difference in BC. Muscle strength may be related to high androgen levels in these women.
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http://dx.doi.org/10.3109/09513590.2014.982083DOI Listing
March 2015