Stanisław Radowicki

Depression in relation to biochemical parameters and age in women with polycystic ovary syndrome.

OBJECTIVE The phenotype of women with PCOS changes with age. The study was aimed to address whether changes in biochemical parameters associated with age of the patients correlate with depression severity measured with the use of screening tools. STUDY DESIGN This was a single center observational study. Women with PCOS meeting the Rotterdam criteria for PCOS were recruited. Hormonal and clinical parameters including symptoms of hyperandrogenism, age, BMI, androgen and blood lipids were analyzed in 60 patients (median age 27, median BMI 23 kg/m(2)) together with evaluation of depressive symptoms with the use Beck Depression Inventory, Patient Health Questionnaire-Nine Item (PHQ-9), Quick Inventory of Depressive Symptomatology-Self Report 16 Item (QIDS-SR16). RESULTS The prevalence of depression was equal 22-33% depending on the questionnaire. The older women tended to present significantly higher BMI, SBP, waist circumference and lower androstenedione and DHEAS values than the younger group of patients. The prevalence of depression was higher in the group of older patients, however without statistical significance. Among the cohort of older patients (age ≥ 27 years, n = 29) significant correlates of depression included: nonHDL, LDL, HDL, total cholesterol (p < 0.05), even after controlling for BMI. In the younger study cohort (age < 27, n = 28) the only significant correlates included BMI and waist circumference. CONCLUSION Women with PCOS reporting depressive symptoms present higher levels of androgens and blood lipids. Clinicians treating women with PCOS should be aware that this group of patients is at increased risk of depression irrespectively of age and phenotype.

A molecular and cytogenetic investigation of FMR1 gene premutations in Polish patients with primary ovarian insufficiency

OBJECTIVE The aim of this study was to determine the prevalence of premutations in the FMR1 gene that cause primary ovarian insufficiency (POI) in a group of affected women. STUDY DESIGN Forty DNA samples were purified from peripheral blood collected from women with ovarian failure who were under 40 years of age. A routine cytogenetic test was performed to eliminate chromosomal aberrations as the cause of POI. The DNA was analysed by polymerase chain reaction (PCR) with primers specific to the FMR1 gene region. The PCR products were then separated in denaturing polyacrylamide gels using an ABI Prism 377 sequencer. RESULTS Cytogenetic analysis of the samples revealed two X/autosome translocations. DNA analysis identified FMR1 gene premutations in three patients. The frequency of X/autosome translocations in the studied group was 2/40 (5.0%), and the frequency of FMR1 gene premutations was 3/38 cases (7.9%). Thus, genetic tests allowed for the identification of POI in five (12.5%) out of 40 women. CONCLUSION FMR1 gene premutation is a common genetic cause of POI.

Prostate specific antigen (PSA) in diagnosis of polycystic ovarian syndrome – a new insight

Abstract Introduction: Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder and cause of androgen excess in women. Prostate specific antigen (PSA) could be a new marker of hyperandrogenism in PCOS. Objective: The aim of the study was to assess the concentration PSA (total PSA - TPSA and free PSA - fPSA) in 165 patients with PCOS and 40 healthy female controls, the relationship between PSA (TPSA and fPSA) and hormonal parameters and to determine the performance of PSA in diagnosis of PCOS. Results: Total PSA was higher in PCOS group versus controls. The fPSA was below the lower detection levels among all patients. The median value of FAI was 4.31 in PCOS patients versus 1.79 in controls, p < 0.001. There was a correlation of TPSA and tT (r= 0.173, p = 0.027) and TPSA and FAI (r = 0.2603, p = 0.001). AUC for FAI was 82.1%, threshold 2.56 nmol/l, for tT AUC 80.5%, threshold 0.54 ng/ml, for TPSA AUC 66.3%, threshold 0.005 ng/ml. The ROC analysis for A AUC 62.7%, threshold 3.95 ng/ml. Conclusion: PCOS women have higher serum concentration of TPSA than controls. TPSA positively correlate with T and FAI, which is the best marker for hyperandrogenic states and has better accuracy for tT and total PSA serum levels in diagnostic of PCOS.

Serum leptin concentration in women of reproductive age with euthyroid autoimmune thyroiditis.

Abstract Introduction: Autoimmune thyroid disease (AITD) with elevated anti-thyroid peroxidase antibody (aTPO) levels appears in 12–25% of all women, apart from thyroid dysfunction. High titers of aTPO are more common in women with polycystic ovary syndrome and endometriosis. Elevated aTPO has been associated with infertility and poorer quality of life among euthyroid women, and may be related to other factors. Objectives: The aim of the study was to measure differences in serum leptin concentration between AITD+ and AITD− patients. Setting, patients and main outcome measures: The sample was comprised of 74 women who were hospitalized in the Department of Gynecological Endocrinology, Medical University of Warsaw. Data collected included age, body mass index (BMI), and serum aTPO, serum thyroid stimulating hormone (TSH), serum fT4, serum follitropin (FSH), serum estradiol and serum leptin. AITD positive status was defined as serum aTPO greater than 5.6 mIU/ml. Results: Serum leptin concentrations were significantly higher in AITD+ patients compared to AITD− patients (17.13 ng/ml [SD 7.66] versus 12.78 ng/ml [SD 7.28]; p < 0.05). No differences by AITD status were found in age, BMI, TSH, FSH, estradiol and fT4. Conclusions: Serum leptin concentrations were higher in patients with AITD than in patients without AITD.

Morphological changes in endometrium of hemodialyzed women of reproductive age

Aim. The aim of the study was to evaluate endometrial morphology and its correlation with hormonal profile in uremic women of reproductive age undergoing hemodialysis. Materials and methods. Sixty-three hemodialyzed women aged 18–45 years were enrolled into the study, 38 of whom gave their informed consent to undergo endometrial aspiration biopsy and measurement of hormonal profile. Results. Abnormal endometrial morphology was noted in 79% of the hemodialyzed women. Atrophic endometrium was observed in almost all uremic patients with secondary amenorrhea. Endometrial biopsy revealed one case of adenocarcinoma in situ. Analysis of the relationship between hormonal profile and endometrial morphology revealed the substantial influence of estradiol on endometrium. Conclusions. Abnormal endometrial changes are often noted in uremic women of reproductive age undergoing hemodialysis. Endometrial biopsy should be carried out as a safe and convenient procedure for the detection of pathological changes in uremic women.

The duration of pregnancy in ecologically-challenged area. The effects of environmental pollution with aromatic hydrocarbons on the angiogenesis and elements of the mesenchymal tissue of the human placenta

INTRODUCTION The literature presents only few reports regarding the effects of elevated levels of aromatic hydrocarbons (AH) on the functions of the human placenta. The effects of environmental contamination with AH (including phenol and 1-hydroxypyrene) have certain negative effects on parenchymal organs such as human placenta. OBJECTIVE The paper aimed to assess the effects of elevated levels of AH on the placental angiogenesis and elements of the mesenchymal tissue of the placenta. MATERIAL AND METHODS Tissue material from 50 afterbirths from Płock constituted a study group, whereas 50 afterbirths from Kutno constituted a control group. Immunohistochemical reactions with the peroxidase method using LSAB kits (DAKO) were performed. The extent and intensity of reactions were analysed. The levels of phenols and 1-hydroxypyrene in the excreted urine of pregnant women (undergoing delivery) were detected using gas chromatography and colorimetry. RESULTS The levels of phenol and 1-hydroxypyrene in the excreted urine were demonstrated to be statistically significantly higher in patients living in the area of Płock. Statistically significantly higher expression of antibodies indicating placental angiogenesis was observed in the placentas in the Płock group (p < 0.01). Moreover, lower expression of vimentin indicating reactions with proteins in mesenchymal cells was observed in the Kutno group (p < 0.01). CONCLUSIONS Pregnancy in the environment with elevated levels of aromatic hydrocarbons has detrimental effects on the human placenta. The foetus is protected by activation of adaptation and compensation mechanisms that are manifested as significant angiogenesis and greater development and differentiation of mesenchymal cells compared to the control group.

Cell-free fetal DNA testing in prenatal diagnosis: Recommendations of the Polish Gynecological Society and the Polish Human Genetics Society

This paper contains a joint position of the Polish Gynecological Society and Polish Human Genetics Society on the cell-free fetal DNA testing in prenatal diagnosis. We present situations where the cell-free fetal DNA testing should be applied and cases in which performing of the test is not useful. We indicate what diagnostic steps should be performed before the test and how the test results should be interpreted and followed.