Abstracts selezionati

espandi

Ibrahim Mohammed, Morley D. Hollenberg, Hong Ding, Chris R. Triggle

A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends LifespanFront. Endocrinol. 12:718942. doi: 10.3389/fendo.2021.718942
Download

Abstract

The numerous beneficial health outcomes associated with the use of metformin to treat patients with type 2 diabetes (T2DM), together with data from pre-clinical studies in animals including the nematode, C. elegans, and mice have prompted investigations into whether metformin has therapeutic utility as an anti-aging drug that may also extend lifespan. Indeed, clinical trials, including the MILES (Metformin In Longevity Study) and
TAME (Targeting Aging with Metformin), have been designed to assess the potential benefits of metformin as an anti-aging drug. Preliminary analysis of results from MILES indicate that metformin may induce anti-aging transcriptional changes; however it remains controversial as to whether metformin is protective in those subjects free of disease.
Furthermore, despite clinical use for over 60 years as an anti-diabetic drug, the cellular mechanisms by which metformin exerts either its actions remain unclear. In this review, we have critically evaluated the literature that has investigated the effects of metformin on aging, healthspan and lifespan in humans as well as other species. In preparing this review, particular attention has been placed on the strength and reproducibility of data and quality of the study protocols with respect to the pharmacokinetic and pharmacodynamics properties of metformin. We conclude that despite data in support of anti-aging benefits, the evidence that metformin increases lifespan remains controversial. However, via its ability to reduce early mortality associated with various diseases, including diabetes, cardiovascular disease, cognitive decline and cancer, metformin can improve healthspan thereby extending the period of life spent in good health. Based on the available evidence we conclude that the beneficial effects of metformin on aging and healthspan are primarily indirect via its effects on cellular metabolism and result from its anti-hyperglycemic action, enhancing insulin sensitivity, reduction of oxidative stress and protective effects on the endothelium and vascular function.
espandi

Fei Li , Ying Chen , Aiqin Niu , Yajing He, Ying Yan
Nomogram Model to Predict the Probability of Ovarian Hyperstimulation Syndrome in the Treatment of Patients With Polycystic Ovary SyndromeFront. Endocrinol. 12:619059. doi: 10.3389/fendo.2021.619059
Download

Abstract

Objective: The objective of this study was to explore the risk factors of ovarian hyperstimulation syndrome (OHSS) in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and to establish a nomogram model evaluate the probability of OHSS in PCOS patients.
Methods: We retrospectively analyzed clinical data from 4,351 patients with PCOS receiving IVF/ICSI in our reproductive medical center. The clinical cases were randomly divided into a modeling group (3,231 cases) and a verification group (1,120 cases) according to a ratio of about 3:1. The independent risk factors correlation with the occurrence of OHSS was identified by logistic regression analysis. Based on the selected independent risk factors and correlated regression coefficients, we established a nomogram model to predict the probability of OHSS in PCOS patients, and the predictive accuracy of the model was measured using the area under the receiver operating curve (AUC).
Results: Univariate and multivariate logistic regression analyses showed that FSH (OR, 0.901; 95% CI, 0.847–0.958; P<0.001), AMH (OR, 1.259; 95% CI, 1.206–1.315; P<0.001), E2 value on the day of hCG injection (OR, 1.122; 95% CI, 1.021–1.253; P<0.001), total dosage of Gn used (OR, 1.010; 95% CI, 1.002–1.016; P=0.041), and follicle number on the day of hCG injection (OR, 0.134; 95% CI, 1.020–1.261; P=0.020) are the independent risk factors for OHSS in PCOS patients. The AUC of the modelling group is 0.827 (95% CI, 0.795–0.859), and the AUC of the verification group is 0.757 (95% CI, 0.733–0.782).
Conclusion: The newly established nomogram model has proven to be a novel tool that can effectively, easily, and intuitively predict the probability of OHSS in the patients with PCOS, by which the clinician can set up a better clinical management strategies for conducting a precise personal therapy.
espandi

Andrea Giannini , Marta Caretto , Andrea R. Genazzani, Tommaso Simoncini
Neuroendocrine Changes during Menopausal TransitionEndocrines 2021, 2(4), 405-416
Download

Abstract

Menopause is the permanent cessation of menstrual cycles following the loss of ovarian follicular activity. Quality of life of postmenopausal woman is the result of a series of psychobiological transformations, that see in the reduction of sex hormones and steroids the etiopathogenetic determinant moment. Symptoms of menopause range from somatic side such as metabolic changes, increased cardiovascular disease, irregular vaginal bleeding, urogenital symptoms, vaginal dryness, osteoporosis and risk of bones fractures to changes of central nervous system as vasomotor symptoms, sleep disruption, mood changes, migraine, sexual dysfunctions. It is fundamental to know the mechanisms underlying changes in the central nervous system during menopause, related to hypoestrogenism, to be able to create appropriate target therapy for patients, improving their quality of life. In fact, the central nervous system is now one of the major targets of sex steroids that cannot be achieved disregard when dealing with the problem of choice of a particular type of MHT.
espandi

Veronica Tomatis, Christian Battipaglia, Alessandro D. Genazzani
Thyroid, Adrenal, PRL Impairments and Ovarian FunctionEndocrines 2021, 2(3), 212-225
Download

Abstract

Endocrine axes (prolactin, thyroid and adrenal axes) directly and indirectly modulate and drive human female central functions, mainly behavior and reproduction. Though having distinct abilities, they greatly act both at peripheral as well as at neuroendocrine levels, so as to participate in the control of reproduction. Any event that changes these balanced activities produces specific peripheral signals that induce abnormal functions centrally, thus triggering menstrual disorders such as oligomenorrhea or amenorrhea. It is clear that the knowledge of the relationships that exist between the different endocrine axes becomes essential for the choice of therapeutical approach. This review aims to focus on the main aspects of the physiopathology of the endocrine diseases that might be at the basis of that interference with female reproductive capacity.
espandi

Agostino Ruotolo, Mariarosaria Di Tommaso, Irene Cetin, Felice Petraglia
How maternal flavor education may prevent childhood obesity?European Gynecology and Obstetrics. 2021; 3(3):125-128
Download

Abstract

Childhood obesity has been associated with a number of perinatal factors, in particular a specific maternal phenotype characterized by nutritional and metabolic imbalance that increases the supply of nutrients to the feto-placental unit and leads to excessive fetal growth and fat mass deposition. A varied and balanced maternal diet could, through prenatal flavor education, play a role in preventing obesity in later life. Factors predisposing individuals to make dietary choices that may be antithetical to health, are: 1) innate flavor preferences, driven by evolution, and 2) harmful consequences of not being exposed to the flavors of healthy foods at the beginning of life. We focus on scientific evidence that suggests how early experience of flavors can influence the future food choices of infants
espandi

Dmitri I. Dozortsev, Antonio Pellicer, Michael P. Diamond
Oscillations of estradiol and gonadotropins are a missing link to solving the mystery of mono-ovulation in humansFertil Steril 2021, 3: 630-632
Download

Abstract

Regulation of follicular development leading to monoovulation remains one of the unsolved mysteries of human reproduction. The current working hypothesis in part postulates that as multiple follicles grow, they produce estradiol, which exerts continued negative feedback on the folliclestimulating hormone (FSH) synthesis. As the availability of FSH declines to a threshold sufficient to sustain the development of only a single follicle (with the higher number of FSH receptors), it becomes dominant, destined to be the only one that will eventually ovulate. Other factors, including Inhibin B and the pulsatile nature of FSH, also may have a role, as may local factors, such as bone morphogenetic protein 15 and some other peptides, in follicular competition in primates. However, in humans, there is compelling evidence that the mono-ovulation conundrum must be explained at the systemic level.
espandi

Jiby Jolly Benjamin , Maheshkumar Kuppusamy , Teena Koshy , Maruthy Kalburgi Narayana, Padmavathi Ramaswamya
Cortisol and polycystic ovarian syndrome – a systematic search and meta-analysis of case–control studiesGYNECOLOGICAL ENDOCRINOLOGY 2021, VOL. 37, NO. 11, 961–967

Abstract

Background: Polycystic ovarian syndrome (PCOS) has become an emerging disorder affecting women of reproductive age group. Its intricate presentation of signs and symptoms makes it a disease of interest to research. While there are varied hypotheses related to its cause and pathogenesis, role of stress in this disease is yet to be grounded. There is emerging body of evidence on cortisol and PCOS, although it is currently equivocal.
Methods: Medline, Embase, Pubmed, Science Direct, Google Scholar, and Scopus were searched from March 1985 to March 2020 using MeSH terms. After dual quality assessments and data abstraction, the final articles were included for meta-analysis.
Results: Forty-one studies qualified for the analysis. Pooled meta-analysis showed that the level of cortisol was significantly higher in PCOS when compared to healthy controls (standard mean difference [SMD] ¼ 0.83, 95% confidence interval [CI] ¼ 0.42–1.23) with highly significant heterogeneity (I 2 ¼ 94%). Subgroup analysis done based on type of sample stated high effect size for blood cortisol levels (SMD ¼ 0.9, 95%CI ¼ 0.32; 1.51) compared to overall effect.
Conclusions: This systematic review and meta-analysis on cortisol and PCOS have helped in generating evidence regarding the role of cortisol in the pathogenesis of PCOS and the use of cortisol estimation as a potential stress marker in PCOS.
espandi

Julie Coll ee, Marie Mawet, Linda Tebache, Michelle Nisolle and Geraldine Brichant
Polycystic ovarian syndrome and infertility: overview and insights of the putative treatments GYNECOLOGICAL ENDOCRINOLOGY 2021, VOL. 37, NO. 10, 869–874

Abstract

Infertility concerns 15% of the couples. Management of female infertility requires a complete history of the patient followed by a physical, gynecological and endocrine examination. Infertility etiology will be investigated thanks to different tests including ovarian function and reserve assessment, search for uterine abnormalities and evaluation of tubal permeability. Polycystic ovarian syndrome (PCOS) is a predominant cause of infertility and a common gyne-endocrine disorder affecting 7 to 15% of women in reproductive age. Behavioral, medical and surgical treatments have been evaluated in order to improve the fertility of women with PCOS. Lifestyle modifications (stop smoking, physical exercise and weight loss when necessary) are of the utmost importance. Clomiphene citrate remains the first line of medical treatment of infertility in women with PCOS in absence of other male or female causes of infertility. Use of metformin solely for infertility is not recommended in absence of metabolic anomaly and new treatment as myoinositol is emerging. Surgical techniques aiming to enhance ovulation and pregnancy rate are an option when medical treatment failed. Ovarian drilling by laparoscopy or by transvaginal hydrolaparoscopy is taking a larger place in the treatment of infertility. In vitro maturation and fertilization remain the third-line of treatment in PCOS.

n3/2021

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

I Quaderni AIGE

I prossimi appuntamenti Aige

Le alterazioni del ciclo riproduttivo

12° Corso Strategie integrative, neuro-attive, e terapie ormonali in Ginecologia Endocrinologica