Endometrial markers of polycystic ovary syndrome (literature review)

Polycystic ovary syndrome (PCOS) is the most common endocrine disease in women and has a significant impact on various aspects of their health and the quality of life. The epidemiology of PCOS is well understood, while the prevalence of this syndrome depends on diagnostic criteria used, the characteristics of the population sample, and vary from 6-10 % to 15 % and higher. A number of studies suggest that the endometrium in women with PCOS differs from the normal endometrium morphologically and functionally. PCOS is associated with infertility problems, higher incidence of pregnancy complications and with increased risk of endometrial cancer, especially when obesity is present. The purpose of this review was to systematize the available data on molecular markers of endometrial pathology associated with PCOS. The information search was conducted using Internet resources (PubMed, EMBASE); literature sources for the period 1992-2016 were analyzed. Although the available information on the pathology of the endometrium is inconsistent, as a result of the analysis of published data, several mechanisms of endometrial disorders characteristic of PCOS have been identified: changes of hormonal effects (changes in hormone receptor expression, HOXA gene expression, changes in the synthesis of sex hormone binding globulin, enzymes involved in the metabolism of sex hormones in situ in the endometrium), hyperinsulinemia and disturbance of the glucose transport system, ratio of proinflammatory and antiinflammatory factors. Authors conclude that the majority of analyzed studies report an increased prevalence of histologically confirmed hyperplasia or endometrial cancer in women with PCOS. However, there are no clinical guidelines and approaches to prognosis of endometrial changes women with PCOS. It is still unclear if endometrial biopsy is necessary for all women with PCOS. The clinical significance of endometrial markers requires further investigation

ADOLESCENT REPRODUCTIVE HEALTH IN MAJOR ETHNIC GROUPS IN EASTERN SIBERIA LIVING IN COUNTRYSIDE

The paper presents the results of the cross-sectional epidemiological study of 96 teenagers of 14-17 years old of Mongoloid and Caucasoid populations living in countryside (village Bayanday, Irkutsk region). 3 ethnic groups were divided: 62 Mongoloid (Buryats, 65.3 %), 17 children of mixed marriages (metises; 17.9 %), 17 Caucasians (Russian, 16.8 %), including 47 boys(49.5 %, with an average age of 14,82 ± 0,79 years) and 49 girls (50.5 %, mean age 15,33 ± 0,15 years). The incidence of endocrine diseases, special ethnic characteristics of the endocrine and reproductive abnormalities and of certain hormones concentrations in Russian, mongrels and Buryat adolescents were established. Study of health major ethnic groups in Eastern Siberia, living in the countryside, set a higher frequency of reproductive abnormalities (with 43.7 % of girls and 31 % of boys). The high frequency of diseases of the endocrine system in Buryats and metises (50 % 52 %) compared to the Russian teens (12 %), basically hypothalamic syndrome of puberty and obesity. In 11-25 % of adolescents of studied ethnic and gender groups thyroid hyperplasia were established. However the median of FT4 and TSH were within the reference range, and the median of TSH was significantly higher in Russian teenagers both gender groups in comparison with the Mеtis and the Buryats. We have identified ethnic differences in the structure of the reproductive disease in boys: puberty delay and obesity, hyperprolactinaemia and testosterone decline, diagnosed more frequently in Mongoloids. Installed hormonal differences between groups of girls of the main ethnic groups suggest a role for testosterone in the reproductive disorders in Caucasians, prolactin the Mongoloid, which without appropriate correction can lead to infertility in reproductive age. The role of the environment on the development of hormonal disorders and the formation of the reproductive abnormalities in Caucasians, as identified by the hormonal changes teens Angarsk is 7-10 times higher than those found in adolescents Caucasian population living in countryside, which requires further study

FREQUENCY CHARACTERISTICS OF THE GENES OF THE SECOND PHASE OF DETOXIFICATION OF XENOBIOTICS IN WOMEN OF rUSSIAN AND BURYAT ETHNIC GROUPS

The article presents the results of the analysis of the distribution of genotypes and alleles of polymorphic loci gene GSTP1 (*A, *B, *C, *D), GSTT1 (del) and GSTM1 (del) in 28 women Russian and 30 women of Buryat ethnic groups. As a result, the work showed a statistically significant difference in genotype AC gene GSTP1 among the study groups. As carriers of other genotypes of genes GSTP1, GSTT1, and GSTM1 showed no significant differenc

Features of Chronic Endometritis in Women of Reproductive Age with Polycystic Ovary Syndrome

Background. The prevalence of chronic endometritis among women of reproductive age reaches 68 %. Polycystic ovary syndrome (PCOS) is a common cause of reproductive disorders. Data on the characteristics of the manifestation of chronic endometritis in patients with PCOS are incredibly insufficient. PCOS is known as closely associated with metabolic syndrome and chronic systemic inflammation. However, there is no information on the role of chronic systemic inflammation in the pathogenesis of chronic endometritis in women with PCOS.The objective. Determination of the clinical and morphological features of chronic endometritis in women  with polycystic ovary syndrome and to establish the role of systemic inflammation and hormones of the  hypothalamic-pituitaryovarian axis in chronic endometritis associated with PCOS. Materials and methods. We performed a cross-sectional study from May 2017 to December 2019 and examined 198 women of reproductive age (33.71 ± 5.93 years) during annual preventive examinations. We used clinical, instrumental, and laboratory research methods, including hormonal, biochemical,  immunohistochemical techniques, and statistical analysis.Results. Of the 198 women examined chronic endometritis was diagnosed in 76 patients, including 15 patients with PCOS. Chronic endometritis in PCOS is characterized by a relative decrease in the duration of the menstrual cycle and less pronounced lymphoid infiltration of endometrial tissue. The risk of chronic endometritis in women of reproductive age is not associated with changes in gonadotropins, prolactin, and  manifestations of clinical and biochemical hyperandrogenism. Chronic endometritis is not accompanied by an increase in the concentration of C-reactive protein. At the same time, BMI, waist circumference, and leptin are considered «anti-risk» factors for chronic endometritis.Conclusion. The specific clinical manifestations of chronic endometritis in PCOS allows us to consider them as diagnostically significant. The revealed negative associations of chronic endometritis with BMI, waist  circumference, and leptin require further investigation of the role of adipose tissue products in the control of local and systemic inflammation

Endometrial morphology in women of reproductive age with PCOS

Background. Polycystic ovary syndrome is the most common endocrine disease in women, affecting various aspects of health. The results of several studies indicate an increased prevalence of hyperplasia or endometrial cancer in women with PCOS, but there are no clinical recommendations on the need for assessing the endometrial condition in PCOS and approaches to predictions. Aim: to determine the frequency and structure of endometrial pathology among reproductive-aged patients with PCOS. Materials and methods. In a cross-sectional survey, we examined 1200 women who are subject to annual preventive examination. The research period was May - December 2017. The diagnosis of PCOS was made according to the consensus criteria adopted in May 2003 in Rotterdam. Participants signed informed consent for the survey. Results. We found 102 women with a verified diagnosis of PCOS. 56 of them completed their participation in the study; the median age was 32.19 ± 5.67 years. All patients underwent a biopsy of the endometrium with immunohistochemical examination. Features of the structure of the endometrium: a normal endometrial characteristic in 24 women (42.9 %), chronic endometritis -18 specimens (58.1 %), abnormal hypoplastic endometrium - 6 (19.4 %), simple endometrial hyperplasia -1 (3.2 %) adenocarcinoma -1 (3.2 %), proliferative endometrium with disorders - 7(22.6 %). Conclusions. In the examined women with PCOS there was a high incidence of histologically confirmed endometrial pathology, in the structure of which chronic endometritis predominates. The foregoing necessitates new research and development of clinical protocols for the timely detection of endometrial pathology in PCOS

CHARACTERISTICS OF PITUITARY-OPVARIAN-ADRENAL AXIS IN ADOLESCENT GIRLS WITH HYPERPROLACTINEMIA OF VARIOUS GENESIS

The article presents the results of examination of 97 adolescent girls (mean age 14,96 ± 0,26 years) with hyperprolactinemia (PRL levels above 700 IU/ml): 30 adolescent girls with pituitary microprolactinoma (mean age 14,7 ± 3.2 years) and 67 adolescent girls with functional hyperprolactinemia (mean age 14,6 ± 3,4 years). The control group included 35 healthy adolescent girls (mean age 15,8 ± 0,89 years). Hyperprolactinemia (tumor and non-neoplastic) in puberty leads to disorders of sexual development and ovarian-menstrual cycle, followed by neurological symptoms. Elevated concentrations of testosterone, cortisol, DHEA, 17-OH-progesterone and LH/FSH ratio were shown in adolescents with hyperprolactinemia compared to the control group. Macroprolactinemia was estimated in 16,4—20 % of girls with hyperprolactinemia

A high‐resolution view of the coordination environment in a paramagnetic metalloprotein from its magnetic properties

Metalloproteins constitute a significant fraction of the proteome of all organisms and their characterization is critical for both basic sciences and biomedical applications. A large portion of metalloproteins bind paramagnetic metal ions, and paramagnetic NMR spectroscopy has been widely used in their structural characterization. However, the signals of nuclei in the immediate vicinity of the metal center are often broadened beyond detection. In this work, we show that it is possible to determine the coordination environment of the paramagnetic metal in the protein at a resolution inaccessible to other techniques. Taking the structure of a diamagnetic analogue as a starting point, a geometry optimization is carried out by fitting the pseudocontact shifts obtained from first principles quantum chemical calculations to the experimental ones

Russian clinical practice guidelines «congenital adrenal hyperplasia»

Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive diseases characterized by a defect in one of the enzymes or transport proteins involved in the cortisol synthesis in the adrenal cortex. The most common form of CAH, which occurs in more than 90% of cases, is a 21-hydroxylase enzyme deficiency. The latter is subdivided into nonclassical and classic (salt-losing and virilizing) forms. The prevalence of classic forms of 21-hydroxylase deficiency ranges from 1: 14,000 to 1:18,000 live births worldwide. According to the data of neonatal screening in the Russian Federation, the prevalence of the disease in some regions ranges from 1: 5000 to 1: 12000, in the country as a whole - 1: 9638 live newborns. The non-classical form of CAH occurs more often - from 1: 500 to 1: 1000 among the general population. In second place is the hypertensive form of CAH - a deficiency of 11β-hydroxylase, which, according to the literature, occurs in about 1 per 100,000 newborns. These clinical guidelines were compiled by a professional community of narrow specialists, approved by the expert council of the Ministry of Health of the Russian Federation, and updated the previous version published in 2016. The clinical guidelines are based on systematic reviews, meta-analyses and original articles, and scientific work on this issue in the Russian Federation and other countries. The purpose of this document is to provide clinicians with the most up-to-date, evidence-based guidelines for the CAH diagnosis and treatmen

Analysis of magnetic anisotropy and the role of magnetic dilution in triggering SMM behaviour in a family of CoII YIII dinuclear complexes with easy plane anisotropy

Three new closely related CoIIYIII complexes of general formula [Co mu L mu X Y NO3 2] X NO3 1, benzoate, 2 and 9 anthracenecarboxylato, 3 have been prepared with the compartmental ligand N,N ,N trimethyl N,N bis 2 hydroxy 3 methoxy 5 methylbenzyl diethylenetriamine H2L . In these complexes CoII and YIII are triply bridged by two phenoxide groups belonging to the dideprotonated ligand L2 and one ancillary anion X . The change of the ancillary bridging group connecting CoII and YIII ions induces small differences in the trigonally distorted CoN3O3 coordination sphere with a concomitant tuning of the magnetic anisotropy and intermolecular interactions. Dc magnetic, HFEPR and FD FT THz EPR measurements and ab initio theoretical calculations demonstrate that CoII ions in compounds 1 3 have large and positive D values amp; 61566;50 cm 1 which decrease with increasing the distortion of the pseudo octahedral CoII coordination sphere. Dynamic ac magnetic susceptibility measurements indicate that compound 1 exhibits field induced SMMs behaviour, whereas compound 2 and 3 only display this behaviour when are magnetically diluted with diamagnetic ZnII Zn Co 1 10 . In view of this, it is always advisable to use magnetic diluted complexes, in which intermolecular interactions and QTM would be at least partly suppressed, so that hidden SIM could emerge. Field and temperature dependence of the relaxation times indicate the prevalence of the Raman process in all these complexes above approximately 3