G. Morgante

Effects of clomiphene citrate on insulin-like growth factor binding protein I, insulin-like growth factor I and insulin resistance in polycystic ovary syndrome

well documented. The objective of the present study was to investigate the direct action of serotonin (5HT), catecholamines, acetylcholin (AC) and histamine (H) on progesterone (P4) and estradiol (E2) secretion of human granulosa cells (GCs) cultured in serum-free condition. Study Methods Human GCs were isolated from preovulatory follicular fluid using a Percoll gradient centrifugation method. Using Linbro Plate multiwell tissue dishes, 2 cm in diameter, 2 x 105 GCs were cultured per well in McCoy 5A medium. Treatment of with various nemotransmitters were carried out betwen the 3rd and 4th day of culture. Supernatants from cultures were collected after 96 h and stored at -20 “C until assayed. P4 was measured in the culture media samples using the COATRIA 1251-P, the E2 concentrations were measured by a direct RIA kit from Baxter Merz + Dade AG. Analysis of variance was used to determine statistical significance between the control and treatment groups. Results : Serotonin exhibited a significant stimulatory effect on P4 secretion by human GCs. The observed effect was dose-related and inhibited by the specific serotonin antagonist mianserin. The E2 secretion was also stimulated but without dose-dependency. We observed an inhibitory effect of noradrenaline on P4 secretion by GCs, however dopamine significantly stimulated E2 secretion. Both effect could be inhibited by propranolol. Acetylcholine significantly stimulated P4 secretion by GCs in a dose-related manner. Estradiol secretion secretion was also stimulated by AC, but this effete did not shows dose dependency. Atropine could be blocked the stimulatory effect of AC. We observed a dose-related stimulatory effect of H in E2 by GCs. This response was specifically blocked by the Hl-receptor antagonist terfenadine. P4 production in response to H stimulation was independent of dose at a limit of significance. Conclusions : The observed effects of nemotransmitters may have a phisiological role in the regulation of granulosa cell function during the menstrual cycle.

Effect of folic acid supplementation on the cardiovascular risk factor homocysteine in postmenopausal women

Study Methods: 987 women during post-menopause were examined for our study and they underwent a screening ecographic examination. Subsequently we identified all the patients who suffered from ovarian cystic proliferation (?) and they were examined by eco-doppler and hemodynamical determination of CA-125. The cut-off of resistance index has been fixed (LOSO) according to international literature. We divided the patients into two study groups: in the first group patients (37.7%) receiving substitutive treatment (HRT) were examined; the second group included patients (64.3%) not receiving HRT treatment. Every three months the patients of both groups underwent a transvaginal ecographical follow-up. We identified some patients (11.8%) out of 987 women, sufferin from unilocular cysts: 29% of these patients received HRT treatment and the remaining 71% did not. Both serum CA-125 and the resistance index were normal in every patient. Results: During our monitoring we observed: in the first group 29.4% of cysts had disappeared, 8.8% were reduced in dimension; 26.4& had increased their dimension; 35.4% had remained inchanged; in the second group : 30% of cysts had disappeared; 3.6% were riduced in dimension; 25.3 had increased their dimension; 41% had remained unchanged. There was non evidence of any remarkable statistical correlatio, so that our results concluded that the predominance of ovarian cysts in the two groups amount to 9.6% in the first one and 13% in the second one. Conclusions: The reduced dimensions of a lot of cysts or their progressive disappearing, together with the high index of resistance to Doppler-echo and the regular serum CA-125 levels, led us to a diagnosis of begin cysts. Our results could suggest us a conservative management about simple cysts occurring in post-menopausal women, based on a limited followup by transvaginal echo serum monitoring. Neverthless further studies are necessary in order to evaluate the influence of HRT on ovarian cysts.

Biochemical markers of bone turnover modifications in climateric women

Objective: Bone mineral density (BMD) measured by densitometry is the elective parameter for the diagnosis of osteopenia and osteoporosis. Biochemical markers have been proposed as sensitive indicators of high bone turnover and for monitoring response to anti-resorptive treatment. Study Methods: We conducted a retrospective study to investigate the values of biochemical markers of bone metabolism with a view to early diagnosis of osteoporosis and monitoring of hormone replacement and calcitonin therapy. The subjects were 415 women with a mean age of 51*8 years (43-62 years) in periand post-menopause, recruited at the Menopause Center of Obstetrics and Gynecology Department of Siena University and divided in 5 groups. In all subjects was performed bone densitometry and taken a blood sample for assayed biochemical markers [Osteocalcin (OC), Parathyroid hormone (PrH), type 1 procollagen (PICP), Calcitonin (CT)]. Results: Three groups of women were divided into two subgroups: those with normal and those with low BMD (~1 SD). Basal concentrations of PCPl, OC, mH and CT were compared in the various groups. Two groups of postmenopausal women with BMD below the normal were treated with estrogen replacement therapy and with unmodified eel calcitonin. We evaluated whether some of these biochemical markers of bone turnover could enable the identification of women with low BMD and whether could be useful for monitoring the results of antiresorptive therapies. Conclusions: Markers of bone formation (PICP and OC) make it possible to distinguish women with high turnover who are therefore at risk for osteoporosis from women with low turnover in menopause. A good correlation was also found between changes in levels of these markers and changes in BMD during treatments, which suggests that the PICP and OC would be useful for monitoring response to anti-resorptive therapy.