Dagmara Pluta

Background: The relationship between low-grade inflammation and anti-Müllerian hormone (AMH) in Polyendocrine Metabolic Ovarian Syndrome (PMOS) remains incompletely understood. This study aimed to compare inflammatory markers and AMH concentrations between non-obese women with PMOS and controls and to assess the associations between these markers and AMH. Methods: This single-centered retrospective study involved 92 patients divided into two groups: a control group of 45 patients and 47 patients newly diagnosed with PMOS according to Rotterdam criteria. Results: Compared with controls, patients with PMOS had significantly higher median concentrations of CRP (3.902 vs. 1.038), IL-6 (4.15 vs. 2.28), and TNF-α (3.35 vs. 1.95), as well as higher white blood cell and lymphocyte counts. Median AMH (6.47 vs. 3.04), LH (8.77 vs. 6.93), and testosterone (0.415 vs. 0.317) concentrations were also significantly higher in the PMOS group. Conversely, NLR and PLR were higher in controls. When both groups were analyzed together, AMH correlated positively with IL-6 (r = 0.53), CRP (r = 0.53), TNF-α (r = 0.54), LH (r = 0.50), and testosterone (r = 0.44). In the pooled cohort, AMH correlated positively with CRP, IL-6, and TNF-α. Although TNF-α was significantly associated with AMH in the initial multivariable quantile regression models, these associations were no longer statistically significant after adjustment for PCOS/control status. Group status remained significantly associated with AMH at the 90th percentile. Conclusions: No statistically significant correlations were found between AMH levels and inflammatory markers in non-obese patients with PMOS or in healthy women.

Polycystic ovary syndrome (PCOS) is a hormonal disorder with complex, multifactorial and still not fully explained etiopathogenesis. It is believed that the cause is a combination of genetic and environmental factors. Background: With the aim to better understand PCOS etiology, the study examines body composition and compares the occurrence of lipid disorders and visceral adipose tissue depending on the adopted Rotterdam phenotypes. Methods: The study included 242 patients classified into four classic Rotterdam phenotypes. Clinical data from patients were collected and carefully analyzed to determine the relationship between the occurrence of lipid disorders and the visceral adiposity index (VAI). Results: The results obtained after assessing the differences between the Rotterdam phenotypes were not statistically significant. Differences in the levels of coefficients included in the VAI equation in the given phenotypes were also analyzed, as follows: waist circumference (p-value = 0.3415), BMI (p-value = 0.7112), TG [mmol/L] (p-value = 0.5341) and HDL [mmol/L] (p-value = 0.2302). None of the differences were statistically significant. Conclusions: Although the results did not show a clear association between VAI and the individual Rotterdam PCOS phenotypes, this coefficient can be used in the assessment of cardiometabolic risk in women with PCOS regardless of the adopted classification.

Background/objectives: Polycystic ovary syndrome (PCOS) and metabolic dysfunction-associated steatotic liver disease (MASLD) are common co-morbidities in women of reproductive age. PCOS is highly heterogeneous and is, therefore, divided into four phenotypes. MASLD leads to numerous systemic complications. Studies to date have shown an association between PCOS and MASLD. This study was designed to compare the FIB-4 score (based on age, alanine aminotransferase, aspartate aminotransferase and platelet count) and the results of shear wave elastography in assessing the risk of developing MASLD by patients with PCOS divided by phenotypes. Methods: The study enrolled 242 women age 18–35 years with PCOS diagnosed according to Rotterdam criteria, hospitalized at the Department of Gynaecological Endocrinology of the University Clinical Centre in Katowice. The study subjects were assigned to phenotypes A to D. Clinical and biochemical assessments were performed (including androgens and metabolic parameters), and the FIB-4 index was calculated. Liver fibrosis was evaluated by shear wave elastography. To balance the group sizes of phenotypes, oversampling with replacement was applied (PROC SURVEYSELECT, SAS), increasing the number of observations for phenotypes B, C, and D fivefold. Statistical analyses were performed based on data distribution (Shapiro–Wilk test), using ANOVA or the Kruskal–Wallis test with Dunn’s correction. Statistical significance was set at p < 0.05. Results: The FIB-4 score was the highest in phenotype B patients (0.50 ± 0.15), and the lowest in phenotypes A and C (0.42 ± 0.14). The highest rate of positive elastography findings was recorded in phenotype A patients (34.7%) and the lowest in phenotype C group (13.5%). Significant differences between the phenotypes were also found in terms of androgen levels, insulin, HOMA-IR, and the lipid profile. Among patients with positive elastography, the highest FIB-4 scores were recorded in phenotype C group (0.44 ± 0.06), but the differences between the phenotypes were not statistically significant. Conclusions: The FIB-4 score was the highest in phenotype B patients and differed significantly from phenotypes A, C and D. In the elastography exam, the fibrosis index was statistically significantly higher in phenotype A compared to other phenotypes. No correlation was detected between the FIB-4 index and positive elastography. The findings suggest that the FIB-4 index may be used for MASLD screening, but its usefulness as a predictor of eligibility for elastography requires more research.

The aim of present study was to investigate the association between serum calcium, iron, magnesium, copper levels and insulin resistance in women with full blown phenotype of polycystic ovary syndrome (PCOS) compared to women with not-full blown phenotype. 104 women, aged 18–39, in the first phase of menstrual cycle, diagnosed with PCOS based on the Rotterdam Criteria, were qualified for the study. Patients were divided into two groups: group I contained women with full blown PCOS (phenotype A) and group II contained women with not-full blown PCOS (phenotypes B, C and D). Whole study population was divided on group X containing women with proper insulin sensitivity and group Y containing women with insulin resistance. The study found that women with full blown PCOS had lower level of magnesium compared with not-full blown phenotypes. Also, the level of copper was lower in group with proper insulin sensitivity compared to group with insulin resistance. Serum cooper content showed a negative correlation with Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) in group with full blown phenotype. Magnesium level showed positive correlation with level of calcium and cooper in group with proper insulin sensitivity. Level of iron content showed a negative correlation with sex hormone binding globulin (SHBG) and HOMA-IR showed a positive correlation with age and body mass index (BMI) in group with insulin resistance. Either level of calcium showed positive correlation with iron and cooper in group with insulin resistance. Keywords: insulin resistance polycystic ovary syndrome phenotypes micronutrients

Objectives: The aim of this study is to analyze correlation between vitamin D level and BMI in polycystic ovary syndrome (PCOS) women. Material and methods: The study group consisted of 311 patients with PCOS. Patients were categorized according to four phenotypes. All of the women participating in the study had their blood tested in the appropriate phase of the menstrual cycle and after proper preparation for the tests. The ultrasound examination and anthropometric measurements were performed. Results: Vitamin D concentration was assessed in all study subgroups. The majority of patients had vitamin D deficiency or insufficient level. Variables included in the study, such as level of vitamin D, low density lipoprotein (LDL), sex hormone binding globulin (SHBG), testosterone, androstenedione, Anti-Müllerian Hormone (AMH) and BMI were correlated. A negative correlation was observed with the the level of SHBG, vitamin D and AMH. Subsequently, positive correlations were shown with testosterone, LDL and free testosterone level. An analysis of the correlation between BMI and vitamin D concentration showed that in phenotype I of PCOS this correlation was statistically significant and in the remaining PCOS phenotypes the correlation was close to statistical significance. Conclusions: Most PCOS patients have a deficiency or insufficient level of vitamin D. Women with PCOS have shown a significant negative correlation between BMI and SHBG serum level and between BMI and AMH level. A positive correlation exists between BMI and total and free testosterone and LDL. There is a negative correlation between BMI and vitamin D level in PCOS patients and in phenotype I this correlation was statistically significant. Objectives: The aim of this study is to analyze correlation between vitamin D level and BMI in polycystic ovary syndrome (PCOS) women. Material and methods: The study group consisted of 311 patients with PCOS. Patients were categorized according to four phenotypes. All of the women participating in the study had their blood tested in the appropriate phase of the menstrual cycle and after proper preparation for the tests. The ultrasound examination and anthropometric measurements were performed. Results: Vitamin D concentration was assessed in all study subgroups. The majority of patients had vitamin D deficiency or insufficient level. Variables included in the study, such as level of vitamin D, low density lipoprotein (LDL), sex hormone binding globulin (SHBG), testosterone, androstenedione, Anti-Müllerian Hormone (AMH) and BMI were correlated. A negative correlation was observed with the the level of SHBG, vitamin D and AMH. Subsequently, positive correlations were shown with testosterone, LDL and free testosterone level. An analysis of the correlation between BMI and vitamin D concentration showed that in phenotype I of PCOS this correlation was statistically significant and in the remaining PCOS phenotypes the correlation was close to statistical significance. Conclusions: Most PCOS patients have a deficiency or insufficient level of vitamin D. Women with PCOS have shown a significant negative correlation between BMI and SHBG serum level and between BMI and AMH level. A positive correlation exists between BMI and total and free testosterone and LDL. There is a negative correlation between BMI and vitamin D level in PCOS patients and in phenotype I this correlation was statistically significant.

The coexistence of polycystic ovary syndrome (PCOS) and liver steatosis has been studied for years. The gold standards for the diagnosis of liver steatosis are liver biopsy and magnetic resonance imaging (MRI), which are invasive and expensive methods. The main aim of this study is to check the usefulness of lipid accumulation product (LAP) and free androgen index (FAI) in the diagnosis of liver steatosis. The Ideal IQ MRI was performed in 49 women with PCOS phenotype A to assess the degree of liver steatosis, which was expressed with the proton density fat fraction (PDFF). Anthropometric examination and laboratory tests were performed, and the LAP and FAI were calculated. The correlation between MRI results and LAP, FAI, and one of the FAI components, sex hormone binding globulin (SHBG), was checked using statistical tests. There is a statistically significant correlation between PDFF and LAP and also between PDFF and FAI. LAP = 70.25 and FAI = 5.05 were established as cut-offs to diagnose liver steatosis. The SHBG is not a statistically significant parameter to predict liver steatosis. The study showed that especially LAP, but also FAI, can be used to predict liver steatosis with high specificity and sensitivity.

Thyroid disorders are one of the most common endocrinopathies in women of reproductive age. Measurement of TSH (thyroid-stimulating hormone) concentration in women planning pregnancy/pregnant is a golden standard of thyroid function assessment. When the laboratory findings do not correspond with the clinical signs, it is reasonable to mark macro-TSH. Thyroid disorders are one of the most common endocrinopathies in women of reproductive age. Measurement of TSH (thyroid-stimulating hormone) concentration in women planning pregnancy/pregnant is a golden standard of thyroid function assessment. When the laboratory findings do not correspond with the clinical signs, it is reasonable to mark macro-TSH.

Background. Polycystic ovary syndrome (PCOS) and hypothyroidism are the most common endocrinological disorders among women of reproductive age. Since hypothyroidism occurs more frequently in PCOS patients, it is vital to explain its clinical impact. Aim. To evaluate the impact of subclinical hypothyroidism (SCH) and its treatment on the metabolic profile of patients with PCOS. Methods. 190 women with PCOS phenotype A were enrolled in the case-control study. They were divided into three groups: 38 women with PCOS and subclinical hypothyroidism, 76 women with PCOS and SCH under thyroid replacement therapy, and 76 women with PCOS and normal thyroid function (control group). Serum lipids, fasting glucose, and insulin, as well as oral glucose tolerance tests were performed. Results. In the analyzed parameters, there were no statistic differences between the groups in relation to thyroid function. BMI turned out to be the main factor dividing the patients in terms of serum lipids, fasting glucose, fasting insulin, and oral glucose tolerance test. TSH was associated with total cholesterol and LDL cholesterol levels, whereas BMI has a dominant impact on HDL cholesterol, triglycerides, glucose, and insulin resistance. Conclusions. SCH is associated with mild lipid serum alterations in women with PCOS, but it is BMI to have a dominant impact on glucose and insulin. It seems that treatment of SCH in PCOS does not significantly alter lipid and glucose metabolism.

We investigated the relationship between selected body composition (BC) parameters and included 55 women diagnosed with PCOS and 29 women in which PCOS was excluded. Hormone concentration and BC parameters were assessed during hospitalization. Women with PCOS had higher concentration of luteinizing hormones, total testosterone, androstenedione, and Anti-Müllerian hormones compared to women that were not diagnosed with PCOS. We did not observe any significant differences in the BC parameters between both groups as well as between four PCOS phenotype subgroups. Only in the group of women with PCOS was the concentration of sex hormone binding globulin and free testosterone correlated with all investigated BC parameters. Correspondence analysis did not confirm unambiguously associations between phenotypes of PCOS and the value of BC parameters, while logistic regression revealed that increased Anti-Müllerian hormone concentration and the value of body mass index could be useful parameters in differentiating women with PCOS and women with other disorders. The ROC analysis performed on the entire group of women also confirmed that the concentration of Anti-Müllerian hormones could be a powerful parameter to categorize women as suffering from PCOS.