Polycystic ovary syndrome (PCOS) affects many women of reproductive age, including ovarian and metabolic dysfunction. Major therapeutic goals include weight loss and improved insulin resistance. The effects of weight loss and increased insulin sensitivity of glucagon-like peptide-1 (GLP-1) receptor agonists provide another opportunity and pathway for the treatment of PCOS patients, especially those with metabolic abnormalities. This paper reviews the metabolism and reproductive outcomes about GLP-1 receptor agonists for PCOS by searching for literatures of clinical trials from PubMed in the past 10 years, in oder to provide new ideas and clinical evidence for clinical treatment of PCOS.
Objective To compare the efficacy and incidence of complications between laparoscopic surgery and laparotomy on women with polycystic ovarian syndrome (PCOS). Methods We did a systematic literature search for studies from Ovid Database, MEDLINE, EMbase, Cochrane Library (Issue 2, 2008), Chinese Biological Medicine Database, CNKI, Chinese VIP Database, and WANFANG Database on internet. The search time was from establishment of each database to December, 2008. Randomized controlled trials and non-randomized controlled trials were collected. The search was no limitation in language. We manually searched current and conference abstracts, and searched relevant reviews and their reference. RevMan 5.0 software was used for meta-analysis. Results Five non-randomized trials involving 417 patients were included. The results of meta-analyse showed that the short-term pregnancy rate in patients underwent laparoscopic surgery was significantly higher than that in patients underwent laparotomy (RR=1.42, 95% CI 1.13 to 1.80, P=0.003). The long-term pregnancy rate in patients underwent laparoscopic surgery and laparotomy was comparable (RR=0.85, 95%CI 0.68 to 1.07, P=0.17). The regular menstruation in patients underwent laparoscopic surgery and laparotomy was comparable (RR=0.91, 95%CI 0.79 to 1.05, P=0.18). The uterine adhesions in patients underwent laparoscopic surgery was significantly lower than that in patients underwent laparotomy (RR=0.02, 95%CI 0.00 to 0.18, P=0.000 2). The intra-abdominal adhesions of patients underwent laparoscopic surgery was significantly lower than that in patients underwent laparotomy (RR=0.02, 95%CI 0.00 to 0.13, Plt;0.000 1).Conclusions The limited evidence at present shows that the incidence and degree of pelvic adhesions occurred in patients with PCOS after laparoscopic surgery is much lower than those after laparotomy. It is not quite sure at this point about whether the pregnancy rate and regular menstruation of laparoscopic surgery are better than those of lararotomy or not. More evidence from high qualified multi-center studies is needed.
ObjectiveTo systematically review the efficacy of vitamin D supplementation on patients with polycystic ovary syndrome (PCOS).MethodsPubMed, EMbase, The Cochrane Library, Web of Science, EBSCO, CBM, WanFang Data, CNKI and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of vitamin D supplementation for PCOS from inception to July 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 11 RCTs involving 692 patients were included. The results of meta-analysis showed that compared with placebo, vitamin D could reduce the level of hypersensitive C-reactive protein (hs-CRP) (MD=−0.54, 95%CI −1.00 to −0.08, P=0.02) and total testosterone (MD=−0.17, 95%CI −0.29 to −0.05, P=0.004), and increase endometrial thickness (MD=1.78, 95%CI 0.49 to 3.06, P=0.007). However, there were no significant differences between two groups in the incidence of sex hormone binding globulin (SHBG) level and hypertrichosis’s score (mF-G) (P>0.05).ConclusionsCurrent evidence indicates that vitamin D supplementation can significantly reduce the level of total testosterone and hs-CRP, and increase endometrial thickness of PCOS. Due to the limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusions.
目的:探讨二甲双胍合并克罗米芬在治疗多囊卵巢综合征中的作用,为多囊卵巢综合征的治疗提供合理依据。方法:80例患者给予二甲双胍合并克罗米芬治疗,比较治疗前后临床症状、内分泌和生化指标的变化情况,与单一给予克罗米芬促排卵治疗比较排卵、妊娠情况。结果:用药后体重指数(BMI)、腰臀比(WHR)、空腹胰岛素(FINS)、睾酮(T)促黄体生成素(LH)、LH/FSH明显下降,Plt;0.05;雌二醇(E2)、促卵泡生成素(FSH)改变不明显,联合用药后排卵、妊娠率明显高于单一克罗米芬治疗,Plt;0.05。结论:二甲双胍合并克罗米芬可改善临床症状,提高排卵、妊娠率,降低LH/FSH比值、LH、T水平,提高胰岛素的敏感性。
ObjectiveTo systematically review the association of micronucleus and polycystic ovary syndrome (PCOS).MethodsPubMed, OVID, Elsevier, CNKI, WanFang Data and CBM databases were electronically searched to collect case-control studies on the association of micronucleus and PCOS. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 5 case-control studies were included, in which 170 patients were in the case group and 148 in the control group. The results of meta-analysis showed: there were significant differences between the two groups for micronucleus frequency (MD=2.02%, 95%CI 1.63% to 2.41%, P<0.000 01) in peripheral blood lymphocytes and micro nucleated cells frequency (MD=2.43%, 95%CI 0.10% to 4.76%, P=0.04) in oral epithelial cells.ConclusionThe current evidence shows that micronucleus is associated with PCOS. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.
ObjectiveTo systematically review the efficacy of acupuncture for PCOS infertility.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials (RCTs) of acupuncture for PCOS infertility from inception to January 5th, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 28 RCTs involving 2 192 patients were included. The results of meta-analysis showed that compared with western medicine alone, acupuncture could increase the pregnancy rate (RR=1.80, 95%CI 1.45 to 2.23, P<0.000 01) and ovulation rate (RR=1.33, 95%CI 1.15 to 1.54, P=0.000 1), and reduce levels of LH (SMD=−0.62, 95%CI −0.96 to −0.28, P=0.000 4) and LH/FSH (SMD=−0.65, 95%CI −1.02 to −0.29, P=0.000 5). Acupuncture combined with western medicine could increase the pregnancy rate (RR=1.75, 95% CI 1.50 to 2.03, P<0.000 01) and ovulation rate (RR=1.29, 95%CI 1.18 to 1.41, P<0.000 01), decrease levels of LH (SMD=−1.09, 95%CI −1.64 to −0.53, P=0.000 1), LH/FSH (SMD=−1.30, 95%CI −2.35 to −0.25, P=0.02), and levels of T (SMD=−1.13, 95%CI −1.59 to −0.66, P<0.000 01).ConclusionsCurrent evidence shows that acupuncture alone or combined with western medicine can significantly improve ovulation rate, pregnancy rate and reduce hormone level. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, which may result in infertility. Because of the complicated etiology and high morbidity, it has attracted wild attention of researchers around the world. The large quantity of blood specimens that have been obtained from multicenter clinical trials (PCOSAct) are precious resources for clinical research. It could not only contain clinical data of the related diseases but also provide vital guidance for the diagnosis and treatment of the disease. This paper discusses the collection, processing, storage, and testing of blood specimens as well as the potential problems, and emphasizes the importance of specimen quality for high quality clinical research. The purpose of this paper is to provide experience and reference for the standardized construction of biobank in future and improve the management of blood specimen in clinical trials.
ObjectiveTo quantify cytokine and chemokine mRNA expression in follicular fluid cells obtained at the time of oocyte retrieval before IVF in women with and without polycystic ovary syndrome (PCOS). MethodsBetween January and August 2014, 80 subjects undergoing IVF-ET were chosen to be studied. Among them, 40 had PCOS, and the other 40 were controls. Follicular fluid cells were subjected to quantitative RT-PCR to evaluate growth-regulated oncogene-α (GRO-α), tumor necrosis factor-α (TNF-α), interleukins (IL-6, IL-8) expression relative to β-actin. And the chemokine was measured in serum and follicular fluids by immunoassays. These mRNA transcriptions production was proved by sequencing. ResultsGRO-α, TNF-α, IL-6 and IL-8 mRNA were expressed in follicular fluid cells. Their expressions were significantly higher in PCOS compared with controls (P<0.05). They were also detected higher in PCOS than controls in serum and follicular (P<0.05), but the difference of IL-6 level between PCOS and controls in lean patients was not statistically significant (P>0.05). ConclusionGRO-α, IL-8, TNF-α, and IL-6 may play important roles in the occurrence and development of PCOS. PCOS may be a chronic immunological inflammatory disease.
Objective To explore the differential expression of circular RNAs (circRNAs) in polycystic ovary syndrome (PCOS) by bioinformatics, and predict the microRNAs (miRNAs) associated with them. Methods The expression profile of cumulus cells gene chip in PCOS was searched in the Gene Expression Omnibus database, and differential circRNAs were screened by GEO2R tool of the database. The Gene Ontology and Kyoto Encyclopedia of Genes and Genomes signaling pathways of different circRNA genes were analyzed using the DAVID 6.8 database. Circular RNA interactome was used to predict the potential regulated miRNAs. Cytoscape software was used to establish circRNA-miRNA network map. The potential regulatory miRNAs were predicted by the 10 circRNAs with the most significant differences in up-regulation and down-regulation. Results A total of 247 circRNAs were obtained in PCOS, and 277 miRNAs binding to up-regulated circRNA genes and 125 miRNAs binding to down-regulated circRNA genes were predicted. The top 10 miRNAs that could bind to multiple differential circRNAs were hsa-miR-557, hsa-miR-507, hsa-miR-224, hsa-miR-136, hsa-miR-127-5p, hsa-miR-579, hsa-miR-502-5p, hsa-miR-186, hsa-miR-1253, and hsa-miR-432. Conclusion The differential expression analysis of circRNAs is helpful to understand the main role of circRNAs in PCOS, and the prediction of potential regulated miRNAs can help to understand the pathogenesis of the disease.