Abstract
The prevalence of the isolated ultrasonographic finding of polycystic
ovaries (PCO) in the Finnish population and among women with a history of
gestational diabetes (GDM) and changes in the present carbohydrate metabolism
were investigated in the present study. One aim of this study was to investigate
the prevalence of the recently discovered variant type LH (v-LH) in PCOS and to
compare patient cohorts from Finland, the Netherlands, the United Kingdom and the
United States of America. In addition, this study attempted to evaluate the
nature of the ovarian streoidogenic response of women with PCOS to exogenously
administered human chorionic gonadotrophin (hCG), human menotrophin (hMG) and
follicle stimulating hormone (FSH). The effect of metformin on ovarian
steroidogenesis was also studied.
The prevalence of PCO was significantly higher in younger (≤ 35
years, 21.6%) than among older women (in ≥ 36 years, 7.8%). The overall
prevalence of PCO
in Finnish women was 14.2%. Women with previous GDM revealed a high prevalence of
PCO (39.4%). The carrier frequency of the v-LHb allele in the entire study
population was 18.5%. The frequency of the v-LH carrier was significantly lower
in obese PCOS subjects in the Netherlands (2.0%) and Finland (4.5%). Women with
previous GDM had impaired insulin sensitivity and β-cell function. They also
had
higher adrenal androgen secretion than the control women. Women with PCO and
previous GDM had marked hyperinsulinemia which was not explained by obesity.
Obese PCOS women achieved peak peripheral serum T concentrations at 48 hours
after a hCG injection, preceded by peak levels of 17-OHP and E2 at 24 hours. In
contrast, all steroids measured in the control women reached their maximum serum
concentrations at 96 hours. HMG stimulated the production of ovarian androgens
more efficiently than a urinary FSH after pituitary suppression with a
gonadotrophin releasing hormone agonist (GnRHa).
In conclusion, the prevalence of PCO is common in healthy Finnish women and
even more common in women with a history of GDM. The ultrasonographic appearance
of PCO may be a predictive factor with regards abnormal glucose tolerance during
and after pregnancy and, these women should therefore be advised as to possible
consequences. The high overall frequency of the v-LH allele in women in general
and its low frequency in obese PCOS patients suggests that v-LH plays a role in
reproductive functions and may counteract the pathogenesis of PCOS in obese
individuals. The differences observed in steroid responses to hCG between normal
and PCOS women might be explained by higher theca cell activity or mass in
polycystic ovaries. Women with PCOS did not show a distinctly exaggerated
steroidogenic response to hMG or FSH administration compared with control women.
FSH administration also resulted in increased A and T production.
| Identifer | oai:union.ndltd.org:oulo.fi/oai:oulu.fi:isbn951-42-6426-6 |
| Date | 27 June 2001 |
| Creators | Koivunen, R. (Riitta) |
| Publisher | University of Oulu |
| Source Sets | University of Oulu |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/doctoralThesis, info:eu-repo/semantics/publishedVersion |
| Format | application/pdf |
| Rights | info:eu-repo/semantics/openAccess, © University of Oulu, 2001 |
| Relation | info:eu-repo/semantics/altIdentifier/pissn/0355-3221, info:eu-repo/semantics/altIdentifier/eissn/1796-2234 |
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