The aim of this study was to investigate the possible influence of a family history of PCOS on male reproductive health by comparing the spermiogram parameters of patients diagnosed with a first-degree relative with PCOS with those of a control group without such a family history.

This prospective study included 51 male participants aged 19-39 years, 25 of whom had a first-degree relative diagnosed with PCOS, while 26 formed the control group. Semen samples were collected and analyzed according to the World Health Organization (WHO) 2021 guidelines.

In this study, the spermiogram results of 51 patients aged between 19 and 39 years with a mean age of 31.50 ± 4.80 years were analyzed. The median sperm concentration (0.6 vs. 11.1 million/ml; p = 0.024) was significantly lower in the study group and the median total progressive motile sperm concentration (3.7 vs. 3.0 million/ml; p = 0.010) was significantly lower in the control group. Comorbidities were more common in the study group, including hair loss (64%; p < 0.001) and gynecomastia (25%; p = 0.008). Robust regression analysis revealed that semen concentration was significantly higher in subjects with dyslipidemia (+95.973 million/ml; p < 0.001), as was sperm motility (+49.081 units; p < 0.001) and TPMSC (+74.028 million/ml; p < 0.001).

Men with family history of PCOS have distinct reproductive and metabolic features, including lower median sperm concentration and higher incidence of alopecia and gynecomastia. Dyslipidemia significantly predicted improved sperm concentration and motility.

Balance issues have been reported to be common among females with overweight or obesity with associated fall risks. Despite the increasing reports of the negative impacts of obesity on balance and cognition, there is a scarcity of research aimed at evaluating effective interventions. To examine the effects of rebound exercises on cognition and balance among females with overweight and obesity. This Quasi-experimental study used the purposive sampling method to recruit 20 female students (aged 17-35 years) with overweight and obese at the Evangel University Akaeze, Ebonyi State Nigeria. Rebound exercise intervention was administered to all participants at the gym for 30 minutes in each session, three times a week for six weeks, while their cognitive performances, stationary balance, and dynamic balance were measured pre-and post-trial using Trail Marking Test Apparatuses, Unilateral Pedal Tests, and Meter Backward Walk Test respectively. There was a significant (p < 0.001) difference in the participants' cognition values across weeks 1, 3, and 6 with a progressive improvement over time. There was also a significant (p < 0.05) difference in the participants' static and dynamic balance values across weeks 1, 3, and 6 with a progressive improvement in balance performance over time. Rebound exercise significantly improved the cognition and balance of females with overweight or obese. This finding suggests a promising intervention to improve balance and cognitive-related problems in this population. Registered retrospectively in the Pan African Clinical Trial Registry, identification number for the registry is PACTR202405746557031. Dated 2 May 2024.

Inocutis tamaricis is a medicinal fungus with significant pharmacological activity. In this study, ultra-high performance liquid chromatography-high resolution mass spectrometry (UPLC/MS) was used to conduct a comprehensive non-targeted metabolomics analysis of the metabolites of wild fruiting body (WF), cultured fruiting body (CF), and liquid cultured mycelium (LCM). Orthogonal partial least square discriminant analysis (OPLS-DA) was used to compare the three culture methods, to describe the regulatory effect of specific culture methods on metabolite distribution and yield of I. tamaricis, and the differential metabolites were enriched and analyzed to identify key metabolic pathways. The results showed significant differences in the types and abundances of active substances produced in different culture methods. There were 35 compounds in common, the WF, CF, and LCM had their unique metabolites, which were 39, 16, and 29 respectively, confirming the significant differences in the metabolites in different cultures, six key metabolic pathways were identified, including unsaturated fatty acid biosynthesis, linoleic acid, and α-linolenic acid metabolism, etc.

The pathogenesis of obesity is complex and incompletely understood, with an underlying interplay between our genetic architecture and obesogenic environment. The public understanding of the development of obesity is shrouded in myths with widespread societal misconceptions. Body Mass Index (BMI) is a highly heritable trait. However, despite reports from recent genome-wide association studies, only a small proportion of the overall heritability of BMI is known to be lurking within the human genome. Other non-genetic heritable traits may contribute to BMI. The gut microbiome is an excellent candidate, implicating complex interlinks with hypothalamic control of appetite and metabolism via entero-endocrine, autonomic, and neuro-humeral pathways. The neonatal gut microbiome derived from the mother via transgenerational transmission (vaginal delivery and breastfeeding) tends to have a permanence within the gut. Conversely, non-maternally derived gut microbiota manifest mutability that responds to changes in lifestyle and diet. We should all strive to optimize our lifestyles and ensure a diet that is replete with varied and unprocessed plant-based foods to establish and nurture a healthy gut microbiome. Women of reproductive age should optimize their gut microbiome, particularly pre-conception, ante- and postnatally to enable the establishment of a healthy neonatal gut microbiome in their offspring. Finally, we should redouble our efforts to educate the populace on the pathogenesis of obesity, and the role of heritable (but modifiable) factors such as the gut microbiome. Such renewed understanding and insights would help to promote the widespread adoption of healthy lifestyles and diets, and facilitate a transition from our current dispassionate and stigmatized societal approach towards people living with obesity towards one that is epitomized by understanding, support, and compassion.

Diet and physical activity modifications are prescribed to women with polycystic ovary syndrome (PCOS). This study aimed to evaluate the correlation between physical activity and nutrition-related knowledge, attitudes and practices with obesity indices in young women with PCOS.

A cross-sectional study.

Universities located in Shiraz.

308 young college women (age: 21.51±0.82 years, body mass index (BMI): 23.78±4.36 kg/m2) with PCOS who studied in several universities in Shiraz from February to August 2023 participated in the study voluntarily.

Participants filled out a modified Wellness Knowledge, Attitude and Behaviour Instrument, performed the step test to measure their maximum rate of oxygen consumption (VO2max), and their weight, height and waist circumference were measured to estimate their BMI and waist-to-height ratio (WHtR). Pearson product moment correlation and linear regression tests were used for data analysis.

No significant correlation was found between physical activity knowledge and both attitudes (r=0.014, p=0.804) and practices (r=0.49, p=0.399). However, a significant correlation was observed between physical activity attitudes and practices (r=0.125, p=0.028). In terms of nutrition, there were significant weak correlations between nutrition knowledge and attitude (r=0.228, p<0.001) as well as moderate correlations between nutrition attitude and practices (r=0.456, p<0.001), while no significant correlation was found between nutrition knowledge and practices (r=0.093, p=0.102). Additionally, significant negative weak correlations were noted between WHtR and VO2max (r=-0.178, p=0.003), and between BMI and VO2max (r=-0.211, p<0.001), while regression analysis indicated that VO2max is a stronger predictor of WHtR than physical activity practices and significantly predicts BMI.

Nutrition and physical activity knowledge were not correlated with practices, while attitude was positively correlated with practices. VO2max demonstrated a stronger association with obesity indices compared with physical activity practices, although further research is warranted to confirm these findings.

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting adolescent and young adult females, yet global data on its burden and trends remains limited.

We analyzed data from the Global Burden of Disease Study 2021 for females aged 10-24 years in 204 countries (1990-2021). Metrics included cases, age-standardized incidence (ASIR), prevalence (ASPR), disability-adjusted life years (ASDR), and average annual percentage changes (AAPCs). Future trends (2022-2036) and disease reduction gaps were assessed.

From 1990 to 2021, global PCOS cases increased by 56% (incidence), 59% (prevalence), and 58% (DALYs). ASIR rose from 49.45 to 63.26 per 100,000, with an AAPC of 0.8. Southeast Asia, East Asia, and Oceania had the fastest growth, while high-SDI regions bore the highest burden. Girls aged 10-14 showed the steepest age-specific increase. Nationally, the largest increases occurred in Equatorial Guinea, Maldives, and Myanmar, while Italy saw a decline. Forecasts through 2036 indicate continued increases in ASIR (+8.32%), ASPR (+10.87%), and ASDR (+10.39%). Frontier analysis highlighted unachieved reduction potential, especially in high-SDI countries.

PCOS burden among adolescents and young adults has significantly risen globally with disparities by region, SDI, and age, warranting urgent and equitable public health strategies.

Polycystic ovary syndrome (PCOS) is an endocrine disorder in women of fertile age which may also affect the labor market attachment. We investigated labor market attachment trajectories among working age women diagnosed with PCOS.

A cohort of 157,356 women born in 1975-1977 were followed annually between the ages of 30 and 39, using data from Swedish administrative registers. Multinomial logistic regression was employed to assess associations between being diagnosed with PCOS (after the age of 15) and belonging to the identified clusters of labor market attachment trajectories.

Women with PCOS spent less time in employment and were more dependent on sickness benefits during the follow-up time than those without PCOS. Five labor market attachment clusters were identified: stable employment, education into employment, labor market exclusion, continuously unstable position, long-term sickness. Compared to being in the stable employment cluster, women diagnosed with PCOS were more likely to experience long-term sickness [RRR (relative risk ratio): 1.97 (CI: 1.90-2.05)], and education into employment [RRR: 1.11 (CI: 1.07-1.15)].

PCOS can lead to disadvantaged labor market outcomes. Better strategies are needed to prevent economic exclusion among women diagnosed with PCOS.

The rising prevalence of obesity in the Kingdom of Saudi Arabia (KSA) poses a significant public health challenge. Estimates of the economic cost of obesity are crucial for prioritizing healthcare interventions, guiding policy choices, and justifying budget allocations aimed at reducing obesity prevalence. This study aimed to estimate the cost of obesity in the KSA in 2022.

A prevalence-based cost-of-illness approach was used to determine the cost of obesity. This analysis encompasses 29 diseases, namely obesity and twenty-eight diseases attributable to obesity. Both direct and indirect costs were considered. The annual cost of treatment for each obesity-attributable disease was obtained from the hospital records of one tertiary hospital in the KSA. Data on direct non-medical costs were obtained from the patient survey. The human capital approach was used to estimate the indirect costs of morbidity and mortality.

The total economic burden of obesity (2022 values) was estimated at US$116.85 billion from a societal perspective and US$109.67 billion from a healthcare system perspective. From a societal perspective, the total direct medical cost accounted for the largest portion of the total cost (94%). In terms of direct medical costs, the cost of treating diseases attributable to obesity was substantially greater than the cost of treating obesity itself. According to the sensitivity analysis, the total cost ranged from 3.4% of the country's Gross domestic product (GDP) when the unit cost of treatment was reduced by 74% to 9.5% of the country's GDP when the prevalence of obesity and its comorbidities was reduced by 5%.

Obesity imposes a substantial economic burden on the healthcare system and society in the KSA. Interventions aimed at promoting healthier lifestyles to reduce the prevalence and incidence of obesity and its comorbidities are highly warranted to alleviate the impact of obesity in the country.

Polycystic ovary syndrome (PCOS) is linked to non-alcoholic fatty liver disease (NAFLD). Biochemical, sex hormonal, and anthropometric indicators have been explored for screening NAFLD in PCOS patients. However, the accuracy of NAFLD screening using these indicators in PCOS patients remains uncertain. This study aimed to identify biochemical, sex hormonal, and anthropometric indicators associated with NAFLD in overweight and obese PCOS patients and assess the diagnostic efficacy of combined indicators.

This cross-sectional study (Clinical trial number ChiCTR1900020986; Registration date January 24th, 2019) involved 87 overweight or obese women with PCOS (mean age 29 ± 4 years). Measurements included anthropometric indices, biochemistry, sex hormone levels, and liver proton density fat fraction (PDFF). Correlation analysis, intergroup comparisons, and logistic regression analysis were used to identify risk factors for NAFLD (PDFF > 5.1%). The receiver operating characteristic curve, area under the curve (AUC), sensitivity, specificity, positive predictive value, and negative predictive value were used to determine cut-off values and evaluate diagnostic accuracy.

Liver PDFF was 7.69% (3.93%, 14.80%) in overweight and obese PCOS patients, with 67.8% diagnosed with NAFLD. NAFLD was associated with increased body mass index (BMI), abdominal circumference (AC), and triglyceride, total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), glucose, insulin, and free testosterone (FT) levels, and with decreased high-density lipoprotein-cholesterol (HDL-C) and sex hormone-binding globulin (SHBG) levels (P < 0.05). Risk factors for NAFLD in PCOS included BMI > 26.8 kg/m2, AC > 88.3 cm, triglyceride > 1.57 mmol/L, TC > 4.67 mmol/L, LDL-C > 3.31 mmol/L, glucose > 4.83 mmol/L, insulin > 111.35 pmol/L, FT > 7.6 pg/mL and SHBG < 25 nmol/L (β = 1.411-2.667, P < 0.005). A multi-indicator model including triglycerides, LDL-C, glucose, insulin, and SHBG showed higher diagnostic accuracy (AUC = 0.899, P < 0.001) for screening NAFLD in PCOS patients than single indicators (AUC = 0.667-0.761, P < 0.05).

Overweight and obese PCOS patients have higher incidences of liver PDFF and NAFLD. A multi-indicator model including triglycerides > 1.57 mmol/L, LDL-C > 3.31 mmol/L, glucose > 4.83 mmol/L, insulin > 111.35 pmol/L, and SHBG < 25 nmol/L is highly accurate for screening NAFLD in overweight and obese PCOS patients.

Polycystic ovary syndrome (PCOS) is a prevalent metabolic and endocrine disorder affecting women of reproductive age, particularly those with obesity. This syndrome is characterized by clinical/biochemical hyperandrogenism and/or ovulatory dysfunction, which can result in infertility.

To investigate the prevalence of PCOS in candidates for bariatric surgery and to examine the correlation between PCOS and sex hormones in women with obesity.

A retrospective study analyzed 577 bariatric surgery candidates from 2015 to 2021 using RStudio. Normally distributed data were expressed as x ± s and compared with ANOVA or T-test, while the Kruskal-Wallis test was used for non-normal data. Count data, presented as M [Q1, Q3], were analyzed with the Chi-square test. Logistic regression identified influencing factors, with P < 0.05 indicating statistical significance.

The findings of our study reveal that the prevalence of PCOS among bariatric surgery candidates stands at 14.04%. Conversely, high-density lipoprotein cholesterol (HDL-C) levels tended to decrease with higher BMI categories (P = 0.02). Compared to the non-PCOS group, the PCOS group exhibits lower age and HDL-C levels. Still, they showed significantly elevated HOMA-IR, fasting blood glucose (FBG), luteinizing hormone (LH), total testosterone (TT), and luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratio (P < 0.05). The logistic regression analysis of PCOS indicates that, compared to the control group, those with FBG levels exceeding 7 mmol/L (OR = 2.28, 95% CI 1.19 to 4.37, P = 0.01) and individuals with TT levels greater than 2.01 ng/ml (OR = 2.36, 95% CI 1.23 to 4.71, P = 0.01) exhibited an increased risk of PCOS.

PCOS is highly prevalent among female bariatric surgery candidates. It is significantly associated with younger age, lower HDL, higher FBG, and elevated TT levels. These factors may also serve as indicators for evaluating PCOS improvement and assessing surgical outcomes postoperatively.

Leptin (LEP) is implicated in the pathogenesis of polycystic ovary syndrome (PCOS). This study investigates the mechanism of LEP in PCOS. The baseline information of 80 PCOS patients and matched controls was analyzed, with serum and follicular fluid (FF) LEP and LEP receptor (LEPR) levels, telomerase activity, and relative telomere length (TL) measured. The correlation of FF LEP with telomerase activity and TL was analyzed. The viability and apoptosis of KGN cells (the ovarian granulosa cells) treated with gradient LEP were assessed. LEP-LEPR interaction was examined. LEPR, v-myc avian myelocytomatosis viral oncogene homolog (c-MYC), and telomerase reverse transcriptase (TERT) levels and c-MYC protein expression in the TERT promoter region were determined. Nuclear c-MYC translocation was detected. LEP was upregulated in sera and FF of PCOS patients. FF LEP positively correlated with telomerase activity and TL. Low-concentration LEP facilitated KGN cell proliferation, and high-concentration LEP dose-dependently suppressed cell proliferation, promoted apoptosis, upregulated LEPR, and increased telomerase activity and relative TL. LEP-LEPR interaction upregulated c-MYC and facilitated its nuclear accumulation. c-MYC enrichment in the TERT promoter region upregulated TERT, altering telomerase activity and TL and inducing cell apoptosis. Briefly, LEP/LEPR activates c-MYC, modulates TERT expression, and increases telomerase activity and TL, thus inducing ovarian granulosa cell apoptosis and participating in PCOS.

Polycystic Ovarian Syndrome is one of the major prevalent causes of infertility reported worldwide nearly 6-26 %, especially in girls hitting puberty and women at their childbearing age. The main clinical manifestations include irregular menstrual cycle, small cysts on one or both ovaries, chronic oligo-anovulation, and hirsutism. The etiological criteria are very complex and related to many factors like obesity, insulin sensitivity, inflammation, hyperandrogenism, diabetes mellitus type II, cardiovascular diseases, and dysbiosis of gut microbiota. The given review focuses on managing PCOS through probiotics by analyzing the effects on the symptoms of the disease. The probiotics effective in treating PCOS belong to Bifidobacterium, Lactobacilli, Clostridium, Enterococcus, and other Lactic acid bacteria. Its significance in PCOS is mainly due to the antagonizing of the growth of pathogenic microorganisms, increasing intestinal mucus layer production, reducing intestinal permeability, and modulating the gastrointestinal immune system. Also, their interaction with certain hormones such as insulin, androgen, and estrogen through short-chain fatty acids influences fertility. More research is necessary to validate these results. Probiotic supplements could be a viable option for treating PCOS in adults.

Background/Objectives: Hirsutism is excessive male-patterned hair in postpubertal women with multifactorial etiology and is an indicator of hyperandrogenism associated with polycystic ovary syndrome (PCOS). Indeed, it can be caused by the enhanced peripheral conversion of androgen precursors to testosterone, as in idiopathic hirsutism (IH). Moreover, hirsutism can be caused by hirsutism-related hyperandrogenic syndromes like non-classic congenital adrenal hyperplasia (NCAH) and idiopathic hyperandrogenism (IHA). Methods: In this study, we characterized a large cohort of Portuguese women referred for hirsutism and estimated the prevalence of PCOS, NCAH, IHA, and IH. The levels of androgens and gonadotropins and body mass index (BMI) were measured and compared with controls. The correlation between each variable was calculated. Results: In the cohort, we found a prevalence of PCOS of 56.2%, IH of 20.2%, IHA of 17.3%, and NCAH of 6.2%. Subjects with PCOS were the only ones showing a significant difference in BMI compared to the controls and had the lowest levels of sex hormone-binding globulin (SHBG). Those with NCAH were younger and more hirsute with higher levels of testosterone, among other androgens. Those with IH had lower luteinizing hormone (LH) and LH/follicle-stimulating hormone (FSH) ratios than those with PCOS. Those with IH had lower SHBG levels compared to the controls and a higher free androgen index (FAI). Those with IHA had higher androgens compared to those with IH, in particular, adrenal-derived androgens. Conclusions: The pathogenesis of hirsutism is complex, and the contributions of the pituitary gland, ovaries, adrenals, adipose tissue, and liver have to be ascertained to understand the clinical manifestations and delineate appropriate treatments. This study sheds new light on the fine hormonal regulation of these diseases.

Time-restricted eating (TRE) manages weight effectively, but choosing how long and what time window remain debatable. Although an 8:00 a.m. to 16:00 p.m. time frame is reported to show positive results in most weight loss trial, its safety and efficacy in overweight and obese women with polycystic ovary syndrome (PCOS) is uncertain. This randomized controlled trial is conducted to evaluate the safety and efficacy of TRE in specific populations.

This study aims to assess the 6-month effects of TRE on weight change, metabolic improvement, reproductive recovery, and health-related quality of life in overweight and obese women with polycystic ovary syndrome (PCOS), compared to those who did not receive TRE.

This randomized controlled trial will enroll 96 overweight and obese women with polycystic ovary syndrome (PCOS), who will be randomly assigned to either a TRE group (with an eating window from 8:00 a.m. to 16:00 p.m.) or a control group (without eating time restrictions), with 49 participants in each group. Evaluators and data analysts will remain blinded to group allocation throughout the study. The primary outcomes, including changes in weight and body mass index (BMI), will be assessed weekly. Secondary outcomes, encompassing alterations in sex hormones, metabolic parameters, body composition, sleep quality, quality of life, anxiety, and depression, will be evaluated monthly. Compliance and safety will be continuously monitored throughout the study. Additionally, a 6-month follow-up will be conducted at the end of the trial to assess the long-term effects of TRE. Statistical analysis will include the Anderson-Darling test for normality, T-test/Wilcoxon test based on distribution, mixed-effects models for assessing time/group effects, Cox model for time-to-event analysis, repeated ANOVA for change analysis, and sensitivity analysis. All tests will be conducted using appropriate software, with a significance level set at P<0.05. Missing data will be imputed.

The purpose of this study protocol is to further evaluate the effects of TRE in overweight and obese women with PCOS through a randomized controlled trial (RCT). Findings from this study are expected to provide new dietary intervention strategies for overweight and obese PCOS participants.

This study has received ethics approval from the Medical Ethics Committee of the University of South China (Number: NHHL027). Participants are included after signing informed consent. Results will be submitted for publication in peer-reviewed journals.

Trail registration number: ChiCTR2400086815.

Polycystic ovary syndrome (PCOS) is a primary endocrine disorder affecting premenopausal women involving metabolic dysregulation. We aimed to screen serum biomarkers in PCOS patients using untargeted lipidomics and ensemble machine learning. Serum from PCOS patients and non-PCOS subjects were collected for untargeted lipidomics analysis. Through analyzing the classification of differential lipid metabolites and the association between differential lipid metabolites and clinical indexes, ensemble machine learning, data preprocessing, statistical test pre-screening, ensemble learning method secondary screening, biomarkers verification and evaluation, and diagnostic panel model construction and verification were performed on the data of untargeted lipidomics. Results indicated that different lipid metabolites not only differ between groups but also have close effects on different corresponding clinical indexes. PI (18:0/20:3)-H and PE (18:1p/22:6)-H were identified as candidate biomarkers. Three machine learning models, logistic regression, random forest, and support vector machine, showed that screened biomarkers had better classification ability and effect. In addition, the correlation of candidate biomarkers was low, indicating that the overlap between the selected biomarkers was low, and the combination of panels was more optimized. When the AUC value of the test set of the constructed diagnostic panel model was 0.815, the model's accuracy in the test set was 0.74, specificity was 0.88, and sensitivity was 0.7. This study demonstrated the applicability and robustness of machine learning algorithms to analyze lipid metabolism data for efficient and reliable biomarker screening. PI (18:0/20:3)-H and PE (18:1p/22:6)-H showed great potential in diagnosing PCOS.

Polycystic ovary syndrome (PCOS) is a significant contributor to female infertility and other various metabolic disorders. This systematic review estimates the prevalence of PCOS among infertile women in the Gulf Cooperation Council (GCC) countries.

The study searched five databases (PubMed, Embase, CINAHL, Web of Science, and SCOPUS), from their inception to 2022 for observational studies conducted in GCC countries. Eligible studies included data on PCOS prevalence among infertile women. A random-effects model assessed the pooled prevalence, stratified by age, BMI, and infertility type.

Out of 855 records screened, seven studies were deemed eligible. Four (57.1 %) studies were conducted in Saudi Arabia, while the remaining three studies were carried out in Qatar, Kuwait, and Oman, respectively. The pooled prevalence of PCOS was 30.0 % (95 % CI: 29.0-38.0 %, I-squared: 91.98 %). PCOS prevalence was higher in obese (BMI: ≥30 kg/m2) women (27.0 %, 95 % CI: 22.0-32.0 %) than those with normal (18.5-24.9 kg/m2) BMI (18.0 %, 95 % CI: 11.0-26.0 %). Women aged 35 or older had a PCOS prevalence of 59.0 % (95 % CI: 45.0-72.0 %), compared to 30.0 % (95 % CI: 29.0-36.0 %) in age group 15-24 years old. Primary infertility was associated with higher PCOS prevalence (37.0 %, 95 % CI: 29.5-46.0 %) than secondary infertility (17.0 %, 95 % CI: 13.0-21.0 %).

In four out of six GCC countries, PCOS was diagnosed in three out of every ten infertile women. Older age, obesity, and primary infertility were linked to higher PCOS prevalence. Screening for PCOS in these high-risk groups could improve fertility outcomes.

Uterine physiology encompasses the intricate processes governing the structure, function, and regulation of the uterus, a pivotal organ within the female reproductive system. The escalating prevalence of obesity has emerged as a significant global health issue, profoundly impacting various facets of well-being, including female reproductive health. These effects extend to uterine structure and function, influencing reproductive health outcomes in women. They encompass alterations in uterine morphology, disruptions in hormonal signaling, and inflammatory processes. Insulin and leptin, pivotal hormones regulating metabolism, energy balance, and reproductive function, play crucial roles in this context. Insulin chiefly governs glucose metabolism and storage, while leptin regulates appetite and energy expenditure. However, in obesity, resistance to both insulin and leptin can develop, impacting uterine function. Inflammation and oxidative stress further exacerbate the development of uterine dysfunction in obesity. Chronic low-grade inflammation and heightened oxidative stress, characteristic of obesity, contribute to metabolic disruptions and tissue damage, including within the uterus. Obesity significantly disrupts menstrual cycles, fertility, and pregnancy outcomes in women. The accumulation of excess adipose tissue disrupts hormonal equilibrium, disturbs ovarian function, and fosters metabolic irregularities, all of which detrimentally impact reproductive health.

Polycystic ovary syndrome (PCOS) is a multifactorial disease, which is closely related to obesity. This study evaluated the efficacy of bariatric surgery on obesity complicated with PCOS through meta-analysis. PubMed, Cochrane, EMbase, and WOS databases were searched from 2012 to November 2022. Studies on the efficacy of bariatric surgery in the treatment of obesity combined with PCOS were included. Outcome indicators included menstrual abnormalities, BMI, free testosterone, hypertrichosis, and ovarian volume. Methodological quality of the included studies was evaluated, and statistical analysis was performed using RevMan 5.3 software. Finally, 9 studies were included, and the results of meta-analysis were as follows: After weight loss surgery, menstrual irregularity decreased (RR = -0.83, 95%CI:-1.00∼-0.65, P < 0.00001), and BMI decreased significantly (MD = -13.64, 95%CI:-16.29∼-10.99, P < 0.00001). Free testosterone levels decreased (MD = -22.70, 95 % CI: -36.07 ∼ -9.34, P < 0.00001), the incidence of hypertrichosis decreased (RR = 0.63, 95%CI: 0.45-0.88, p = 0.007 < 0.01), and the ovarian volume decreased (MD = -3.09, 5%CI: -5.76 ∼ -0.42, P < 0.00001).

Acupuncture has been increasingly used in obese people, yet no bibliometric analysis of acupuncture studies for obesity exists. This bibliometric study analyzed research trends, cooperation, and knowledge dissemination on acupuncture for obesity over the past 20 years to inform future directions.

To investigate the characteristics, hotspots, and frontiers of global scientific output in acupuncture research for obesity over the past two decades.

We retrieved publications on acupuncture for obesity published from 2004 to 2023 from the Web of Science Core Collection. Using Citespace, VOSviewer, and Bibliometrix, we analyzed and visualized the publications, countries, institutions, authors, journals, and keywords from various angles.

A total of 357 articles were retrieved. The results showed that the number of annual publications on acupuncture for obesity has increased over time. China had the most publications (217 articles, 60.87 %), with Chengdu University of Traditional Chinese Medicine (24 articles, 6.72 %) as the most prolific institution. Ergene Neyhan, Huang Wei, and Zhou Zhongyu were the most productive authors (9 articles), and the article published by Cho SH in 2009 was the most cited article (60 citations). The most published journal was Evidence-based Complementary and Alternative Medicine, while the Journal of American Journal of Chinese Medicine was the most frequently cited. Recently, "electroacupuncture" "insulin resistance" and "systematic review" appeared frequently. The research hotspots and trends of acupuncture for obesity mainly focus on interventions, hotspot diseases, and mechanism exploration. According to keyword analysis, randomized controlled trials of catgut embedding and mechanistic studies of gut flora are the trends for future research.

Although China is the leading producer, multinational co-operation still needs to be strengthened. Currently, the main interventions for obesity were acupuncture and electroacupuncture, and the hot diseases were obesity combined with polycystic ovary syndrome and metabolic syndrome. In addition, randomised controlled trials of catgut embedding and mechanistic studies of gut flora may be potential directions for future research in the field of acupuncture for obesity.

The reproductive age of women is particularly vulnerable to the effects of polycystic ovarian syndrome (PCOS). High levels of testosterone and other male hormones are frequent contributors to PCOS. It is believed that miscarriages and ovulation problems are majorly caused by PCOS. A recent study found that 31.3% of Asian women have been afflicted with PCOS. Healing women with life-threatening disorders associated with PCOS requires more research. In prior research, methods have involved autonomously classified PCOS using a number of different machine learning techniques. ML-based approaches involve hand-crafted feature extraction and suffer from low performance issues, which cannot be ignored for the accurate prediction and identification of PCOS.

Hence, predicting PCOS using cutting-edge deep learning methods for automated feature engineering with better performance is the prime focus of this study.

The proposed method suggests three lightweight (LSTM-based, CNN-based, and CNN-LSTM-based) deep learning models, incorporating SMOTE for dataset balancing to obtain a valid performance.

The proposed three models tend to offer an accuracy of 92.04%, 96.59%, and 94.31%, an ROC-AUC of 92.0%, 96.6%, and 94.3%, the number of parameters of 6689, 297, and 13285, and a training time of 67.27 s, 10.02 s, and 18.51 s, respectively. In addition, the DeLong test is also performed to compare AUCs to assess the statistical significance of all three models. Among all three models, the SMOTE + CNN models performs better in terms of accuracy, precision, recall, AUC, number of parameters, training time, DeLong's p-value over the other.

Moreover, a performance comparison is also carried out with other state-of-the-art PCOS detection studies and methods, which validates the better performance of the proposed model. Thus, the proposed model provides the greatest performance, which can lead to a reduction in the number of failed pregnancies and help in finding PCOS in the early stages.

We conducted a systematic review and meta-analysis on dairy consumption and its association with anthropometric measurements, blood glucose status, insulin levels, and testosterone levels in women with Polycystic Ovary Syndrome.

This study conducted a comprehensive literature search using electronic databases like MEDLINE, Scopus, PubMed, Web of Science, and Google Scholar to identify observational and interventional studies investigating the relationship between dairy product consumption and Polycystic Ovary Syndrome. A meta-analysis was performed on clinical trial studies that examined the effect of a low starch/low dairy diet in Polycystic Ovary Syndrome subjects. Statistical analyses were performed using Stata version 16.0 (Stata Corporation, College Station, Texas, USA), and statistical significance was defined as p-value < 0.05.

Of the 1,313 citations reviewed, our systematic review identified 11 studies that met the inclusion criteria, comprising six case-control studies, four clinical trials, and one cross-sectional study. The case-control studies found limited evidence of an association between dairy consumption and Polycystic Ovary Syndrome. The result of the clinical trial studies in meta-analysis showed that reducing dairy intake along with reducing starch intake led to statistically significant improvements in anthropometric and metabolic measures including mean weight (Standardized mean difference: -8.43 (95% CI: -9.01, -7.86)), Body mass index (-3.14 (95% CI: -3.35, -2.92), waist circumference (-6.63 (95% CI: -10.70, -2.57)) and Waist-to-Height Ratio (-0.04 (95% CI: -0.07, -0.01), insulin fasting (-18.23 (95% CI: -22.11, -14.36)), insulin 120 minutes (-94.05 (95% CI: -157.67, -30.42)), HbA1c (-0.27 (95% CI: -0.37, -0.17)), Ferryman-Gallwey score (-2.07 (95% CI: -2.98, -1.16)) and total testosterone (-9.97 (95% CI: -14.75, -5.19)). No significant reduction was found in fasting glucose, 2 hours glucose, percent of fat mass, and mean free testosterone after intervention.

The findings of this systematic review show limited evidence about the association between dairy consumption and Polycystic Ovary Syndrome. The interventional studies suggest that a low-dairy/low-starch diet may improve some anthropometric and metabolic measures in women with Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by chronic ovulation dysfunction and overproduction of androgens. Women with PCOS are commonly accompanied by insulin resistance (IR), which can impair insulin sensitivity and elevate blood glucose levels. IR promotes ovarian cysts, ovulatory dysfunction, and menstrual irregularities in women patients, leading to the pathogenesis of PCOS. Secreted frizzled-related protein 4 (SFRP4), a secreted glycoprotein, exhibits significantly elevated expression levels in obese individuals with IR and PCOS. Whereas, whether it plays a role in regulating IR-induced PCOS still has yet to be understood. In this study, we respectively established in vitro IR-induced hyperandrogenism in human ovarian granular cells and in vivo IR-induced PCOS models in mice to investigate the action mechanisms of SFRP4 in modulating IR-induced PCOS. Here, we revealed that SFRP4 expression levels in both mRNA and protein were remarkably upregulated in the IR-induced hyperandrogenism with elevated testosterone in the human ovarian granulosa cell line KGN. Under normal conditions without hyperandrogenism, overexpressing SFRP4 triggered the remarkable elevation of testosterone along with the increased nuclear translocation of β-catenin, cell apoptosis and proinflammatory cytokine IL-6. Furthermore, we found that phytopharmaceutical disruption of SFRP4 by genistein ameliorated IR-induced increase in testosterone in ovarian granular cells, and IR-induced PCOS in high-fat diet obese mice. Our study reveals that SFRP4 contributes to IR-induced PCOS by triggering ovarian granulosa cell hyperandrogenism and apoptosis through the nuclear β-catenin/IL-6 signaling axis. Elucidating the role of SFRP4 in PCOS may provide a novel therapeutic strategy for IR-related PCOS therapy.

Polycystic ovary syndrome (PCOS) is a heterogeneous condition, defined by oligo-/anovulation, hyper-androgenism and/or polycystic ovaries. Metabolic complications are common in patients suffering PCOS, including obesity, insulin resistance and type-2 diabetes, which severely compromise the clinical course of affected women. Yet, therapeutic options remain mostly symptomatic and of limited efficacy for the metabolic and reproductive alterations of PCOS. We report here the hormonal, metabolic and gonadal responses to the glucagon-like peptide-1 (GLP1)-based multi-agonists, GLP1/Estrogen (GLP1/E), GLP1/gastric inhibitory peptide (GLP1/GIP) and GLP1/GIP/Glucagon, in two mouse PCOS models, with variable penetrance of metabolic and reproductive traits, and their comparison with metformin. Our data illustrate the superior efficacy of GLP1/E vs. other multi-agonists and metformin in the management of metabolic complications of PCOS; GLP1/E ameliorates also ovarian cyclicity in an ovulatory model of PCOS, without direct estrogenic uterotrophic effects. In keeping with GLP1-mediated brain targeting, quantitative proteomics reveals changes in common and distinct hypothalamic pathways in response to GLP1/E between the two PCOS models, as basis for differential efficiency. Altogether, our data set the basis for the use of GLP1-based multi-agonists, and particularly GLP1/E, in the personalized management of PCOS.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with reproductive dysfunction and metabolic abnormalities, particularly characterized by insulin resistance and chronic low-grade inflammation. Multiple clinical studies have clearly demonstrated the significant efficacy and safety of the combination of Bailing capsules (BL) in the treatment of PCOS, but its pharmacological effects and mechanisms still require further study.

To evaluate the effect of BL on improving PCOS in mice and explore the mechanism.

In this study, Dehydroepiandrosterone (DHEA) injection was administered alone and in combination with a high-fat and high-sugar diet to induce PCOS-like mouse. They were randomly divided into five groups: normal group (N), PCOS group (P), Bailing capsule low-dose group (BL-L), Bailing capsule high-dose group (BL-H) and Metformin + Daine-35 group (M + D). Firstly, the effects of BL on ovarian lesions, serum hormone levels, HOMA-IR, intestinal barrier function, inflammation levels, along with the expression of IRS1, PI3K, AKT, TLR4, Myd88, NF-κB p65, TNF-α, IL-6, and Occludin of the ovary, liver and colon were investigated. Finally, the composition of the gut microbiome of fecal was tested.

The administration of BL significantly reduced body weight, improved hormone levels, improved IR, and attenuated pathological damage to ovarian tissues, up-regulated the expression of IRS1, PI3K, and AKT in liver. It also decreased serum LPS, TNF-α, and IL-6 levels, while downregulating the expression of Myd88, TLR4, and NF-κB p65. Additionally, BL improved intestinal barrier damage and upregulated the expression of Occludin. Interestingly, the abundance of norank_f__Muribaculacea and Lactobacillus was down-regulated, while the abundance of Akkermansia was significantly up-regulated.

The results of the study showed that BL exerts a treatment PCOS effect, which may be related to the modulation of the gut microbiota, the improvement of insulin resistance and the intestinal-derived LPS-TLR4 inflammatory pathway. Our research will provide a theoretical basis for the clinical treatment of PCOS.

Polycystic ovary syndrome (PCOS) is a leading cause of infertility, with an estimated worldwide prevalence between 5% and 15%. We conducted a case-control study with 121 PCOS patients and 155 controls to assess the association between coffee intake and the presence of having a diagnosis of PCOS in women in Murcia, Spain. The PCOS diagnosis was determined following Rotterdam criteria (the presence of two of the following three conditions: hyperandrogenism, oligo-anovulation, and/or polycystic ovarian morphology). Coffee consumption was assessed using a validated food frequency questionnaire. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multiple logistic regression. Coffee consumption was categorized into never, less than one cup per day, one cup per day, and two or more cups per day. We found a significant inverse linear trend: the higher the coffee consumption, the lower the probability of having PCOS in multivariable analysis (p-trend = 0.034). Women who presented with PCOS were less likely to drink one cup of coffee compared to those who had never drunk coffee (OR = 0.313, 95% CI: 0.141-0.69). The consumption of at least one cup of coffee per day may be associated with a decrease in PCOS symptoms.

This study aimed to investigate the association between obesity and herpes zoster (HZ) occurrence. This study used data covering 2 million people in Taiwan in 2000, which were obtained from the National Health Insurance Research Database. The cohort study observed aged 20-100 years with obesity from 2000 to 2017 (tracking to 2018). Obesity was indicated by the presence of two or more outpatient diagnoses or at least one admission record. And, obesity was categorized into non-morbid obesity and morbid obesity. Patients with HZ before the index date were excluded. The obesity cohort and control cohort were matched 1:1 according to age, sex, comorbidities, and index year. There were 18,855 patients in both the obesity and control cohorts. The obesity cohort [adjusted hazard ratio (aHR) 1.09] had a higher risk of HZ than the control cohort. Further analysis, the morbid obesity group (aHR 1.47), had a significantly higher risk of HZ than the non-morbid obesity group. Among the patients without any comorbidities, the patients with obesity had a significantly higher risk of developing HZ than the patients without obesity (aHR 1.18). Obese patients are at a higher risk of HZ development, especially in the patients with morbid obesity. Weight reduction is critical for preventing the onset of chronic diseases and decreasing the risk of HZ in patients with obesity.

Polycystic ovary syndrome (PCOS), is a health problem observed in women of reproductive age. Different diets, physical activity recommendations and lifestyle changes can be effective in dealing with the symptoms of PCOS. Nutrition is indeed an essential part of the treatment of the disease as it directly affects body weight loss, insulin resistance, lipid profile, hormones, and dermatological complaints such as acne. Polyphenols, simply classified as flavonoids and non-flavonoids, are bioactive components found in plant-based foods. The most common polyphenols in the diet are flavanols, flavonols, flavanone, anthocyanins. In particular, polyphenols which are compounds naturally found in foods, have antioxidant, anticancer, anti-inflammatory, antimutagenic benefits along with many other ones. In the treatment of PCOS, polyphenols may help reduce the symptoms, improve insulin resistance and poor lipid profile, and cure hormonal disorders. It has been reported that polyphenols are influential in menstrual cycle disorders and enable a decrease in body weight, hyperandrogenism, estrogen, testosterone, luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratios and LH. For adequate daily intake of polyphenols, which are found in high amounts in fruits and vegetables, at least 5 portions of fruits and vegetables should be consumed in addition to a healthy nutrition pattern. In this review, the effects of various polyphenols on polycystic ovary syndrome are discussed.

Obesity, a rapidly expanding epidemic worldwide, is known to exacerbate many medical conditions, making it a significant factor in multiple diseases and their associated complications. This threatening epidemic is linked to various harmful conditions such as type 2 diabetes mellitus, hypertension, metabolic dysfunction-associated steatotic liver disease, polycystic ovary syndrome, cardiovascular diseases (CVDs), dyslipidemia, and cancer. The rise in urbanization and sedentary lifestyles creates an environment that fosters obesity, leading to both psychosocial and medical complications. To identify individuals at risk and ensure timely treatment, it is crucial to have a better understanding of the pathophysiology of obesity and its comorbidities. This comprehensive review highlights the relationship between obesity and obesity-associated complications, including type 2 diabetes, hypertension, (CVDs), dyslipidemia, polycystic ovary syndrome, metabolic dysfunction-associated steatotic liver disease, gastrointestinal complications, and obstructive sleep apnea. It also explores the potential mechanisms underlying these associations. A thorough analysis of the interplay between obesity and its associated complications is vital in developing effective therapeutic strategies to combat the exponential increase in global obesity rates and mitigate the deadly consequences of this polygenic condition.

Polycystic ovary syndrome (PCOS) is a multifactorial disorder and obesity occurs in 38% to 88% of these women. Although hyperandrogenism may contribute to telomere lengthening, increased body mass index (BMI) is associated with telomere erosion. We sought to compare leukocyte telomere length (LTL) in PCOS women with normal, overweight, and obese BMI. We evaluated the relationship between LTL and clinical variables of PCOS and inflammatory biomarkers independent of BMI. A total of 348 women (243 PCOS and 105 non-PCOS) were evaluated for anthropometric measures, total testosterone, androstenedione, estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), sex hormone-binding globulin (SHBG), free androgen index (FAI), fasting insulin and glycemia, lipid profile, homocysteine, C-reactive protein (CRP) and homeostatic model of insulin resistance (HOMA-IR). LTL was measured by qPCR. The PCOS group presented higher weight, waist circumference, BMI, testosterone, LH, fasting insulin, FAI, and HOMA-IR, and lower E2, SHBG, and fasting glycemia measures compared with the non-PCOS. When stratified by BMI, LTL was increased in all subgroups in PCOS compared to non-PCOS. However, in the PCOS group, LTL was lower in overweight (P = 0.0187) and obese (P = 0.0018) compared to normal-weight women. The generalized linear model showed that BMI, androstenedione, homocysteine, and CRP were associated with telomere biology. Women with PCOS had longer LTL, however, overweight or obesity progressively contributes to telomere shortening and may affect reproductive outcomes of PCOS, while androstenedione may increase LTL.

(1) Background: FABMs (fertility awareness-based methods) are methods that rely on the observation of clinical signs related to fertility found in women, the so-called fertility bioindicators. They can be a valuable tool for diagnosing monthly cycle disorders and infertility, for example, among patients with PCOS (polycystic ovary syndrome). Until now, it has been difficult for women with PCOS to use FABM, due to the difficulty of describing fertility bioindicators and their disorders due to the biology of the syndrome. The new InVivo sympto-thermal method with standardized cervical mucus assessment may provide a valuable diagnostic and therapeutic tool for observing the monthly cycle in this group of women. (2) Methods: The monthly cycle was evaluated in a group of 32 women of reproductive age. A total of 108 monthly cycle observation cards were analyzed: 35 monthly cycle cards were collected from 18 women with PCOS, and 73 monthly cycle cards collected from 14 healthy women. In addition, 32 pairs of macroscopic and microscopic images were evaluated: 17 pairs from the study group (four subjects) and 15 pairs from women in the control group (six subjects). (3) Results: We showed that in the group of patients with PCOS, menstruation was longer (p = 0.000814), the number of mucus peaks was statistically higher (p = 0.040747), and the interquartile range (IQR) of the duration of the follicular phase (calculated according to the BBT) was significantly higher (8 days) compared to women in the control group. We also observed that among all the women studied, the microscopic image of cervical mucus correlated with the cycle phase described in the observation card, as determined by reference to the BBT chart, provided that it showed the correct features. (4) Conclusions: Systematic maintenance of monthly cycle observation charts using the InVivo method can be an important supplement to the medical history, as it allows for a thorough assessment of, among others, the timing of monthly bleeding, cervical mucus symptoms, BBT changes, and the duration of the follicular and luteal phases among both healthy and PCOS women.

Metformin is a synthetic biguanide used as an antidiabetic drug in type 2 diabetes mellitus, achieved by studying the bioactive metabolites of Galega officinalis L. It is also used off-label for various other diseases, such as subclinical diabetes, obesity, polycystic ovary syndrome, etc. In addition, metformin is proposed as an add-on therapy for several conditions, including autoimmune diseases, neurodegenerative diseases, and cancer. Although metformin has been used for many decades, it is still the subject of many pharmacodynamic and pharmacokinetic studies in light of its extensive use. Metformin acts at the mitochondrial level by inhibiting the respiratory chain, thus increasing the AMP/ATP ratio and, subsequently, activating the AMP-activated protein kinase. However, several other mechanisms have been proposed, including binding to presenilin enhancer 2, increasing GLP1 release, and modification of microRNA expression. Regarding its pharmacokinetics, after oral administration, metformin is absorbed, distributed, and eliminated, mainly through the renal route, using transporters for cationic solutes, since it exists as an ionic molecule at physiological pH. In this review, particular consideration has been paid to literature data from the last 10 years, deepening the study of clinical trials inherent to new uses of metformin, the differences in effectiveness and safety observed between the sexes, and the unwanted side effects. For this last objective, metformin safety was also evaluated using both VigiBase and EudraVigilance, respectively, the WHO and European databases of the reported adverse drug reactions, to assess the extent of metformin side effects in real-life use.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting 5-20% of reproductive-age women. However, the treatment of PCOS is mainly based on symptoms and not on its pathophysiology. Neuroendocrine disturbance, as shown by an elevated LH/FSH ratio in PCOS patients, was thought to be the central mechanism of the syndrome, especially in lean PCOS. LH and FSH secretion are influenced by GnRH pulsatility of GnRH neurons in the hypothalamus. Kisspeptin is the main regulator of GnRH secretion, whereas neurokinin B (NKB) and dynorphin regulate kisspeptin secretion in KNDy neurons. This study aims to deepen the understanding of the neuroendocrine disorder in lean PCOS patients and its potential pathophysiology-based therapy. A cross-sectional study was performed at Dr. Cipto Mangunkusumo Kencana Hospital and the IMERI UI HRIFP cluster with 110 lean PCOS patients as subjects. LH, FSH, LH/FSH ratio, kisspeptin, NKB, dynorphin, leptin, adiponectin, AMH, fasting blood glucose, fasting insulin, HOMA-IR, testosterone, and SHBG were measured. Bivariate and path analyses were performed to determine the relationship between variables. There was a negative association between dynorphin and kisspeptin, while NKB levels were not associated with kisspeptin. There was no direct association between kisspeptin and the LH/FSH ratio; interestingly, dynorphin was positively associated with the LH/FSH ratio in both bivariate and pathway analyses. AMH was positively correlated with the LH/FSH ratio in both analyses. Path analysis showed an association between dynorphin and kisspeptin levels in lean PCOS, while NKB was not correlated with kisspeptin. Furthermore, there was a correlation between AMH and the LH/FSH ratio, but kisspeptin levels did not show a direct significant relationship with the LH/FSH ratio. HOMA-IR was negatively associated with adiponectin levels and positively associated with leptin and FAI levels. In conclusion, AMH positively correlates with FAI levels and is directly associated with the LH/FSH ratio, showing its important role in neuroendocrinology in lean PCOS. From the path analysis, AMH was also an intermediary variable between HOMA-IR and FAI with the LH/FSH ratio. Interestingly, this study found a direct positive correlation between dynorphin and the LH/FSH ratio, while no association between kisspeptin and the LH/FSH ratio was found. Further research is needed to investigate AMH and dynorphin as potential therapeutic targets in the management of lean PCOS patients.

Polycystic ovary syndrome (PCOS) has previously been associated with several comorbidities that may have shared genetic, epigenetic, developmental or environmental origins. PCOS may be influenced by prenatal androgen excess, poor intrauterine or childhood environmental factors, childhood obesity and learned health risk behaviors. We analyzed the association between PCOS and several relevant comorbidities while adjusting for early-life biological and socioeconomic conditions, also investigating the extent to which the association is affected by familial risk factors.

This total-population register-based cohort study included 333,999 full sisters, born between 1962 and 1980. PCOS and comorbidity diagnoses were measured at age 17-45 years through national hospital register data from 1997 to 2011, and complemented with information on the study subjects´ early-life and social characteristics. In the main analysis, sister fixed effects (FE) models were used to control for all time-invariant factors that are shared among sisters, thereby testing whether the association between PCOS and examined comorbidities is influenced by unobserved familial environmental, social or genetic factors.

Three thousand five hundred seventy women in the Sister sample were diagnosed with PCOS, of whom 14% had obesity, 8% had depression, 7% had anxiety and 4% experienced sleeping, sexual and eating disorders (SSE). Having PCOS increased the odds of obesity nearly 6-fold (adjusted OR (aOR): 5.9 [95% CI:5.4-6.5]). This association was attenuated in models accounting for unobserved characteristics shared between full sisters, but remained considerable in size (Sister FE: aOR: 4.5 [95% CI: 3.6-5.6]). For depression (Sister FE: aOR: 1.4 [95% CI: 1.2-1.8]) and anxiety (Sister FE: aOR: 1.5 [95% CI: 1.2-1.8), there was a small decrease in the aORs when controlling for factors shared between sisters. Being diagnosed with SSE disorders yielded a 2.4 aOR (95% CI:2.0-2.6) when controlling for a comprehensive set of individual-level confounders, which only decreased slightly when controlling for factors at the family level such as shared genes or parenting style. Accounting for differences between sisters in observed early-life circumstances influenced the estimated associations marginally.

Having been diagnosed with PCOS is associated with a markedly increased risk of obesity and sleeping, sexual and eating disorders, also after accounting for factors shared between sisters and early-life conditions.

Obesity-related hypogonadotropic hypogonadism is a well-characterized condition in men (termed male obesity-related secondary hypogonadism; MOSH); however, an equivalent condition has not been as clearly described in women. The prevalence of polycystic ovary syndrome (PCOS) is known to increase with obesity, but PCOS is more typically characterized by increased gonadotropin-releasing hormone (GnRH) (and by proxy luteinizing hormone; LH) pulsatility, rather than by the reduced gonadotropin levels observed in MOSH. Notably, LH levels and LH pulse amplitude are reduced with obesity, both in women with and without PCOS, suggesting that an obesity-related secondary hypogonadism may also exist in women akin to MOSH in men. Herein, we examine the evidence for the existence of a putative non-PCOS "female obesity-related secondary hypogonadism" (FOSH). We précis possible underlying mechanisms for the occurrence of hypogonadism in this context and consider how such mechanisms differ from MOSH in men, and from PCOS in women without obesity. In this review, we consider relevant etiological factors that are altered in obesity and that could impact on GnRH pulsatility to ascertain whether they could contribute to obesity-related secondary hypogonadism including: anti-Müllerian hormone, androgen, insulin, fatty acid, adiponectin, and leptin. More precise phenotyping of hypogonadism in women with obesity could provide further validation for non-PCOS FOSH and preface the ability to define/investigate such a condition.

Metabolic health is characterized by optimal blood glucose, lipids, cholesterol, blood pressure, and adiposity. Alterations in these characteristics may lead to the development of type 2 diabetes mellitus or dyslipidemia. Recent evidence suggests that female reproductive characteristics may be overlooked as risk factors that contribute to later metabolic dysfunction. These reproductive traits include the age at menarche, menstrual irregularity, the development of polycystic ovary syndrome, gestational weight change, gestational dysglycemia and dyslipidemia, and the severity and timing of menopausal symptoms. These risk factors may themselves be markers of future dysfunction or may be explained by shared underlying etiologies that promote long-term disease development. Disentangling underlying relationships and identifying potentially modifiable characteristics have an important bearing on therapeutic lifestyle modifications that could ease long-term metabolic burden. Further research that better characterizes associations between reproductive characteristics and metabolic health, clarifies underlying etiologies, and identifies indicators for clinical application is warranted in the prevention and management of metabolic dysfunction.

Polycystic ovarian syndrome (PCOS) is a common problem among young women. It is characterized mainly by hyperandrogenism features, such as hirsutism, menstrual problems, and anovulation. Diagnosis is based on the existence of 2 items out of, oligo-ovulation, hyperandrogenism features, and ultrasounds findings. Cardiovascular complications such as hypertension are a prevalent serious condition in these patients which is mainly predisposed by the high levels of androgens, and insulin resistance. High blood pressure should be controlled well to prevent the progression of other serious conditions. Various antihypertensive drugs could be prescribed. However, in selecting an antihypertensive medication, other therapeutic properties of the drug should also be considered. Up to now, many clinicians do not differ between PCOS patients with hypertension and other hypertensive patients. However, being aware of the potential effects of each hypertension drug could help to choose better options for the patient. Here is a brief review of how each antihypertensive drug could affect PCOS women and if they cause any improvement in the disorder progression.

Polycystic ovary syndrome (PCOS) is the most common metabolic-endocrine disorder impacting the health and quality of life of women over the lifespan. Evidence-based data on the scope of adverse health outcomes in those affected by PCOS is critical to improve healthcare and quality of life in this population. The aim of this study was to determine the prevalence of adverse health outcomes in those with PCOS compared to age-matched controls.

We conducted a retrospective observational case-control study in those diagnosed with PCOS and age-matched controls using the Alberta Health Services Health Analytics database and the International Classification of Diseases, for the period from 2002-2018 in Alberta, Canada.

The cohort consisted of n = 16,531 exposed PCOS cases and n = 49,335 age-matched un-exposed controls. The prevalences of hypertension, renal disease, gastrointestinal disease, eating disorders, mental illness, depression-anxiety, rheumatoid arthritis, respiratory infections, and all malignancies were 20%-40% (P < 0.0001) higher in those with PCOS, compared to controls. The prevalence of obesity, dyslipidemia, nonalcoholic fatty liver disease, and type 2 diabetes was 2-3 fold higher in those with PCOS (P < 0.001). Cardiovascular, cerebrovascular, and peripheral vascular disease were 30%-50% higher, and they occurred 3-4 years earlier in those with PCOS (P < 0.0001); a 2-fold higher prevalence of dementia occurred in those with PCOS, compared to controls.

These findings provide evidence that PCOS is associated with a higher prevalence of morbidities over the lifespan, and the potential scope of the healthcare burden in women affected by PCOS.

Food and nutrition-related factors, including foods and nutrients consumed, dietary patterns, use of dietary supplements, adiposity, and exposure to food-related environmental contaminants, have the potential to impact semen quality and male and female fertility; obstetric, fetal, and birth outcomes; and the health of future generations, but gaps in evidence remain. On 9 November 2022, Tufts University's Friedman School of Nutrition Science and Policy and the school's Food and Nutrition Innovation Institute hosted a 1-d meeting to explore the evidence and evidence gaps regarding the relationships between food, nutrition, and fertility. Topics addressed included male fertility, female fertility and gestation, and intergenerational effects. This meeting report summarizes the presentations and deliberations from the meeting. Regarding male fertility, a positive association exists with a healthy dietary pattern, with high-quality evidence for semen quality and lower quality evidence for clinical outcomes. Folic acid and zinc supplementation have been found to not impact male fertility. In females, body weight status and other nutrition-related factors are linked to nearly half of all ovulation disorders, a leading cause of female infertility. Females with obesity have worse fertility treatment, pregnancy-related, and birth outcomes. Environmental contaminants found in food, water, or its packaging, including lead, perfluorinated alkyl substances, phthalates, and phenols, adversely impact female reproductive outcomes. Epigenetic research has found that maternal and paternal dietary-related factors can impact outcomes for future generations. Priority evidence gaps identified by meeting participants relate to the effects of nutrition and dietary patterns on fertility, gaps in communication regarding fertility optimization through changes in nutritional and environmental exposures, and interventions impacting germ cell mechanisms through dietary effects. Participants developed research proposals to address the priority evidence gaps. The workshop findings serve as a foundation for future prioritization of scientific research to address evidence gaps related to food, nutrition, and fertility.