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  • Original Article

    Adrenal Androgen Predictive Effects on Clinical andMetabolic Abnormalities of Polycystic Ovary Syndrome

    Rev Bras Ginecol Obstet. 2022;44(2):142-153

    Summary

    Original Article

    Adrenal Androgen Predictive Effects on Clinical andMetabolic Abnormalities of Polycystic Ovary Syndrome

    Rev Bras Ginecol Obstet. 2022;44(2):142-153

    DOI 10.1055/s-0041-1741030

    Views5

    Abstract

    Objective

    To examine the possible effects of adrenal prohormones in the prediction of clinical and metabolic abnormalities in women with polycystic ovary syndrome (PCOS).

    Methods

    The present study enrolled 299 normal cycling non-PCOS, 156 normoandrogenemic, and 474 hyperandrogenemic women with PCOS. Baseline characteristics were compared using a chi-squared test or analysis of variance (ANOVA) as appropriate. The roles of adrenal prohormones and their ratios with total testosterone in predicting co-occurring morbidities in women PCOS were evaluated using univariate and multivariate logistic regression analyses.

    Results

    Adrenal hyperandrogenism per dehydroepiandrosterone sulfate (DHEAS) levels were found in 32% of women with PCOS. In non-PCOS women, dehydroepiandrosterone (DHEA) and its sulfate had no predictive role concerning clinical, anthropometric, and metabolic parameters. In PCOS women, mainly in the hyperandrogenemic group, DHEA showed to be a significant predictor against most anthropometric-metabolic index abnormalities (odds ratio [OR]=0.36-0.97; p<0.05), and an increase in triglycerides (TG) levels (OR=0.76; p=0.006). Dehydroepiandrosterone sulfate presented a few predictive effects regarding PCOS-associated disorders. In controls, DHEAS predicted against the increase in estimated average glucose (OR= 0.38; p=0.036). In the normoandrogenic group, it predicted against elevation in the waist/hip ratio (WHR) (OR= 0.59; p=0.042), and in hyperandrogenemic PCOS women, it predicted against abnormality in the conicity index (CI) (OR=0.31; p=0.028).

    Conclusion

    Dehydroepiandrosterone was shown to be a better predictor of abnormal anthropometric and biochemical parameters in women with PCOS than DHEAS. Thus, regarding adrenal prohormones, DHEA measurement, instead of DHEAS, should be preferred in PCOS management. The effects of androgen prohormones on the prediction of PCOS abnormalities are weak.

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  • Review Article

    Morphology and Biochemistry of Ovulation Morfologia e bioquímica da ovulação

    Rev Bras Ginecol Obstet. 2021;43(6):480-486

    Summary

    Review Article

    Morphology and Biochemistry of Ovulation Morfologia e bioquímica da ovulação

    Rev Bras Ginecol Obstet. 2021;43(6):480-486

    DOI 10.1055/s-0041-1731379

    Views1

    Abstract

    The process of ovulation involves multiple and iterrelated genetic, biochemical, and morphological events: cessation of the proliferation of granulosa cells, resumption of oocyte meiosis, expansion of cumulus cell-oocyte complexes, digestion of the follicle wall, and extrusion of the metaphase-II oocyte. The present narrative review examines these interrelated steps in detail. The combined or isolated roles of the folliclestimulating hormone (FSH) and luteinizing hormone (LH) are highlighted. Genes indiced by the FSH genes are relevant in the cumulus expansion, and LH-induced genes are critical for the resumption ofmeiosis and digestion of the follicle wall. A nonhuman model for follicle-wall digestion and oocyte release was provided.

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    Morphology and Biochemistry of Ovulation Morfologia e bioquímica da ovulação

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