Yaqin Mo

Prevalence of polycystic ovary syndrome in unselected women from southern China

OBJECTIVE The objective was to determine the prevalence and metabolic parameters of polycystic ovary syndrome (PCOS) in southern China. STUDY DESIGN The study was observational with a parallel study. Participants were studied in a medical examination center. A population of 915 women of reproductive age was investigated at the time of their annual physical examination to determine the prevalence of PCOS in unselected women from southern China. RESULTS Our results demonstrated a 2.2% (20/915) prevalence of PCOS. Women with PCOS had higher levels of luteinizing hormone and higher luteinizing hormone/follicle-stimulating hormone ratios than those in the other groups. Women with PCOS had higher fasting insulin levels and lower fasting glucose/fasting insulin ratios than women in any of the other groups. CONCLUSIONS Some clinical and biochemical characteristics were apparent in PCOS patients in our population, and ethnic differences may be considered when studying the clinical and metabolic features of PCOS in China.

Cryopreservation of human ovarian tissue by solid-surface vitrification

OBJECTIVE To cryopreserve human ovarian tissue using solid-surface vitrification (SSV) technique for the first time. STUDY DESIGN Human ovarian slices from each of 26 patients were randomly allocated to fresh, SSV, and slow-freezing groups, respectively. Histological observation and the TUNEL assay of the tissue were performed after cryopreservation. In vitro culture was done to study the initial recruitment of follicles and hormone production ability after SSV/slow-freezing. RESULTS The majority of primordial follicles were maintained intact through either SSV or the slow-freezing method. No statistically significant destructive effect of SSV or slow-freezing for primordial follicles and stromal cells was found using the TUNEL assay. In the SSV and slow-freezing groups, estradiol and progesterone were secreted continuously during 10 days in culture, and the proportions of growing follicles increased significantly comparing to the uncultured fresh group. The follicular proportions and the concentrations of estradiol and progesterone exhibited no statistically significant differences between the SSV and slow-freezing groups. CONCLUSION SSV is an effective, simple and inexpensive alternative for human ovarian tissue cryopreservation.

Defining hirsutism in Chinese women: A cross-sectional study

OBJECTIVE To determine the normative cut-off score that defines hirsutism among Chinese women, and the effect of age, menstrual irregularities, and polycystic ovaries on the same. DESIGN Cross-sectional, population-based study. SETTING A multistage systematic cluster random sampling among 16 communities from two rural and two city regions. PATIENT(S) A representative sample of 2,988 women aged 20-45 years from the general population of Southern China. INTERVENTION(S) Subjects underwent physical and ultrasound evaluations. MAIN OUTCOME MEASURE(S) Terminal hair growth was assessed using the modified Ferriman-Gallwey (mFG) scoring system. RESULT(S) An mFG score ≥5 was observed in 10% and a score of ≥2 in 25% of the subjects. Cluster analysis identified an mFG score of 5 as the cut-off value that defines abnormal terminal facial and body hair growth in a male pattern (i.e., hirsutism) in the total population; scores of 6, 5, and 4 for women aged 20-25, 26-30, and >30 years, respectively. Defined by these cut-off values, the prevalence of hirsutism in our total population was 10.5%; and decreased with increasing age: 14.4%, 10.7%, 7.9%, 3.6%, and 1.5%, respectively, in women aged 20-25, 26-30, 31-35, 36-40, and 41-45 years. Furthermore, the incidence of acne, menses irregularities, polycystic ovaries, and acanthosis nigricans were significantly increased among the hirsute women. CONCLUSION(S) An mFG score of 5 or greater indicates hair growth above the norm among women in the general Southern Chinese population, a cut-off value that decreases with increasing age.

Association of biochemical hyperandrogenism with type 2 diabetes and obesity in Chinese women with polycystic ovary syndrome.

To evaluate the effect of hyperandrogenism on metabolic disorders among patients with polycystic ovary syndrome (PCOS) diagnosed using the Rotterdam criteria.

Metabolic abnormalities in adolescents with polycystic ovary syndrome in south china

BackgroundAdults with polycystic ovary syndrome (PCOS) can have multiple metabolic abnormalities. However, studies in the adolescent population are still limited and these results seem to vary widely. This study was to investigate the metabolic abnormalities in adolescents with PCOS in South China and the potential risk factors contributed to these health risks.MethodsAnthropometric measurements and biochemical parameters were evaluated in 128 adolescents with PCOS and their age- and BMI-matched controls.ResultsThe prevalence of pre-diabetes, insulin resistance, hyperinsulinemia, dyslipidemia and metabolic syndrome in adolescents with PCOS was 11.7%, 46.9%, 29.7%, 22.7% and 4.7%, respectively. 16.3%, 74.4%, 67.4%, 39.5% and 14% of the PCOS subjects with BMI > 85th had pre-diabetes, insulin resistance, hyperinsulinemia, dyslipidemia and metabolic syndrome, whereas 9.4%, 32.9%, 10.6%, 14.1% and 0% of the PCOS subjects with BMI < 85th had such disturbances.ConclusionsAdolescents with PCOS in South China had more metabolic abnormalities than their age- and BMI-matched non-PCOS counterparts. Obesity could worsen insulin resistance, hyperinsulinemia and metabolic syndrome in PCOS adolescents.

Low prevalence of the metabolic syndrome but high occurrence of various metabolic disorders in Chinese women with polycystic ovary syndrome

OBJECTIVE Variations in the prevalence of metabolic syndrome (MetS) among women with polycystic ovary syndrome (PCOS) in different races were reported. We sought to report this prevalence and its components in Chinese women with PCOS and compared these characteristics with healthy controls. DESIGN Anthropometric measurements and biochemical parameters were evaluated in 578 PCOS patients diagnosed by the Rotterdam criteria and 281 age- and body mass index (BMI)-matched controls. International Diabetes Federation criteria for MetS were used. RESULTS The prevalence of MetS was 16.8% in this study, and 60.7% of patients displayed at least one component of MetS. Among the patients, the rates of dyslipidemia, impaired fasting glucose, and elevated blood pressure were 41.6, 19.8, and 16.1% respectively; the rates of these corresponding components in age- and BMI-matched controls were 14.6, 5.3, and 5.7% respectively. In PCOS patients, the prevalence of MetS was 0.0, 3.9, 20.2, and 51.1% for four different BMI groups respectively; the prevalence of MetS was 7.3, 14.9, 24.2, and 42.4% in the four age groups respectively. Nearly 90% of patients diagnosed with MetS belonged to overweight and obese groups. BMI and age rather than free testosterone, free androgen index, fasting insulin, or sex hormone-binding globulin were included in formulation for predicting MetS according to multivariable logistic regression. CONCLUSIONS Low prevalence of MetS but high occurrence of various metabolic disorders was found in women with PCOS compared with age- and BMI-matched controls in this study. BMI and age appeared to contribute more to developing MetS than other parameters associated with insulin resistance or hyperandrogenism.

Appropriate BMI levels for PCOS patients in Southern China

BACKGROUND This study was designed to establish appropriate body mass index (BMI) level for PCOS women and to compare metabolic abnormalities between PCOS women and control women in Southern China. METHODS This clinical cross-sectional study included 999 PCOS patients (857 adults and 142 adolescents) and 922 age-matched controls (742 adults and 180 adolescents). RESULTS The proportion of PCOS patients with a BMI above 23 kg/m(2) was 34.63%. Serum insulin, triglycerides, waist and waist/hip (W/H) measurements were all correlated positively with BMI in PCOS women. Prevalence of metabolic syndrome in Chinese PCOS patients was 18.9%. Receiver-operating characteristic analysis suggested that at the point of BMI > or =23 kg/m(2), the diagnostic power to detect metabolic disorders was at its best. CONCLUSIONS PCOS patients with a BMI of 23 kg/m(2) or beyond may have a higher risk of metabolic disorders. Using an appropriate BMI level may help to improve attention to metabolic disorders among PCOS patients in Southern China.

Elevated serum anti-mullerian hormone in adolescent and young adult Chinese patients with polycystic ovary syndrome

ZusammenfassungZIEL DER STUDIE: Erhebung der Serum-konzentrationen des Anti-Müller Hormons (AMH) bei adoleszenten und jungen erwachsenen chinesischen Patienten mit polycystischem Ovar Syndrom (PCOS) und Evaluierung seines diagnostischen Wertes im Rahmen des PCOS. DESIGN: Die Konzentration des AMHs wurde im Serum von 47 adoleszenten und jungen erwachsenen chinesischen Patienten mit PCOS und von 40 alters-gematchten Kontrollen gemessen. Das diagnostische Potential der AMH Konzentrationen wurde durch Erstellen von Receiver Operating Characteristics (ROC) Kurven geprüft. ERGEBNISSE: Die Serum AMH Konzentrationen waren bei den PCOS-Patienten höher als bei den Kontrollen (9,85 ± 4,93 ng/mL vs. 7,13 ± 3,02 ng/mL, P = 0,002) und korrelierten signifikant positiv mit dem mittleren Volumen des Ovars der PCOS Patienten (r = 0,319, P = 0,029). Die Fläche unter der ROC Kurve erreichte einen Wert von 0,664 (0,551–0,778, 95 % Konfidenz Intervall). Der beste Kompromiss zwischen Spezifität (70 %) und Sensitivität (61,7 %) wurde bei einem cut-off Wert von 8 ng/ml erhoben. SCHLUSSFOLGERUNGEN: Die Serum AMH Konzentrationen sind bei adoleszenten und jungen erwachsenen chinesischen Patienten mit PCOS erhöht. Die Messung der Serum AMH Konzentrationen bietet allerdings nur eine relativ schwache diagnostische Trennschärfe mit einer Sensitivität von 61,7 % und einer Spezifität von 70 % bei einem Grenzwert von 8 ng/ml.SummaryPURPOSES: To explore the serum anti-mullerian hormone (AMH) level in adolescent and young adult Chinese patients with polycystic ovary syndrome (PCOS), and to evaluate its diagnostic value for PCOS. STUDY DESIGN: Serum AMH was measured in a cohort of 47 adolescent and young adult Chinese patients with PCOS and 40 age-matched controls. Its diagnostic potential was evaluated by Receiver Operating Characteristic (ROC) curves. RESULTS: The serum AMH level was higher in PCOS patients than in controls (9.85 ± 4.93 ng/mL vs. 7.13 ± 3.02 ng/mL, P = 0.002), and positively related to the mean ovarian volume in PCOS patients (r = 0.319, P = 0.029). The area under the ROC curve for AMH reached a value of 0.664 (0.551–0.778, 95% confidence interval). The best compromise between specificity (70%) and sensitivity (61.7%) was obtained with a cut-off value of 8 ng/mL. CONCLUSIONS: Serum AMH levels are elevated in adolescent and young adult Chinese patients of PCOS. Serum AMH measurement offers a relatively poor diagnostic potency with a sensitivity of 61.7% and a specificity of 70% at 8 ng/mL.

Increased plasma metastin levels in adolescent women with polycystic ovary syndrome

OBJECTIVE This study was designed to: (1) measure metastin levels in women with polycystic ovary syndrome (PCOS) and in adolescent controls; (2) investigate the possible correlations between metastin and PCOS-related reproductive and metabolic disturbances. STUDY DESIGN The study was a clinical study. Nineteen adolescent women with PCOS, twenty-three adult women with the syndrome, and twenty adolescent controls were selected. Blood samples were collected between day 1 and day 5 of a spontaneous bleeding episode in the PCOS groups and of a menstrual cycle of the controls at 9 a.m. after an overnight fast. Circulating levels of LH, FSH, prolactin, testosterone (T), free testosterone, DHEAS, sex hormone-binding globulin, insulin, glucose and metastin were measured. RESULT(S) Plasma metastin levels are increased in adolescent women with PCOS compared to adolescent controls. Plasma metastin levels were positively correlated with LH levels, 2-h glucose levels and T levels. CONCLUSION(S) These results indicate that metastin is increased in adolescent PCOS women. The increased metastin levels were positively correlated with LH and T levels, and may affect the development of PCOS in adolescents.

Determining the normal cut-off levels for hyperandrogenemia in Chinese women of reproductive age

OBJECTIVE To determine the normative cut-off levels of free testosterone (FT), dehydroepiandrosterone sulfate (DHEAS) and total testosterone (TT) among reproductive age women in China. STUDY DESIGN A total of 450 reference subjects without known factors affecting androgen levels were selected from a total study population of 904 presumably healthy women undergoing annual check-ups. The upper limits of normal levels of biochemical androgens were computed by k-means cluster analysis, with the results categorized by age and expressed as both concentrations and percentiles. RESULTS The upper limits (cut-off levels) of normal FT, DHEAS and TT levels as determined by k-means cluster analysis are 26 pmol/L, 4.92 μmol/L and 2.39 nmol/L, respectively, in the selected reference subjects. The corresponding percentiles of the cut-off levels of FT (91.8th vs. 87.9th), DHEAS (69.8th vs. 67.6th) and TT (90.0 th vs. 83.8th) were all higher in the reference subjects than in the total study population, suggesting that there were fewer abnormal subjects with elevated androgens in the healthier reference population than in the total study population. The level of DHEAS significantly declined by age (P < 0.05), whereas there was no significant difference in the mean FT or TT levels between age groups among these women of reproductive age. CONCLUSIONS The normal hyperandrogenism cut-off values for FT, DHEAS and TT are 26.00 pmol/L, 4.92 μmol/L and 2.39 nmol/L, respectively, among women of reproductive age in China who are without factors that might affect androgen levels. The cut-off levels in percentiles are 91.8th for FT, 69.8th for DHEAS and 90.0 th for TT.