This meta-analysis of randomized controlled trials (RCTs) was performed to summarize the effects of probiotics, prebiotics, and synbiotics on insulin resistance (IR), lipid profiles, anthropometric indices, and C-reactive protein (CRP) level for polycystic ovary syndrome (PCOS). We searched 8 databases from their inception until 1st October, 2020. The effect sizes were expressed as standardized mean difference (SMD) with 95% confidence intervals (95% CI). Subgroup analyses were undertaken for further identification of effects of probiotics, prebiotics, and synbiotics, based on the following aspects: (1) type of intervention (probiotics, prebiotics, or synbiotics); (2) study duration (≥ 12 weeks or < 12 weeks); (3) number of probiotic strains (multi strains or single strain); (4) probiotic dose (≥ 2 × 108 colony-forming units [CFU] or < 2 × 108 CFU). A total of 17 eligible RCTs with 1049 participants were included. Results showed that probiotic, prebiotic, and synbiotic intake decreased fasting plasma glucose (SMD, -1.35; 95% CI, -2.22 to -0.49; p = 0.002), fasting insulin (SMD, -0.68; 95% CI, -1.08 to -0.27; p = 0.001), homeostatic model of assessment for IR (SMD, -0.73; 95% CI, -1.15 to -0.31; p = 0.001), triglycerides (SMD, -0.85; 95% CI, -1.59 to -0.11; p = 0.024), total cholesterol (SMD, -1.09; 95% CI, -1.98 to -0.21; p = 0.015), low-density lipoprotein cholesterol (SMD, -0.84; 95% CI, -1.64 to -0.03; p = 0.041), very-low-density lipoprotein cholesterol (SMD, -0.44; 95% CI, -0.70 to -0.18; p = 0.001), and increased quantitative insulin sensitivity check index (SMD, 2.00; 95% CI, - 0.79 to 3.22; p = 0.001). However, probiotic, prebiotic, and synbiotic supplements did not affect anthropometric indices, high-density lipoprotein cholesterol, and CRP levels. Subgroup analysis showed that probiotic or prebiotic might be the optimal choice for ameliorating IR or lipid profiles, respectively. Additionally, the effect was positively related to courses and therapeutical dose. Overall, the meta-analysis demonstrates that probiotic, prebiotic, or synbiotic administration is an effective and safe intervention for modifying IR and lipid profiles.

• MeSH
• HDL-cholesterol MeSH
• inzulinová rezistence * MeSH
• lidé MeSH
• prebiotika MeSH
• probiotika * terapeutické užití   MeSH
• synbiotika * MeSH
• syndrom polycystických ovarií * metabolismus   MeSH
• triglyceridy MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH

The ovarian follicle is the basic functional unit of the ovary, comprising theca cells and granulosa cells (GCs). Two different types of GCs, mural GCs and cumulus cells (CCs), serve different functions during folliculogenesis. Mural GCs produce oestrogen during the follicular phase and progesterone after ovulation, while CCs surround the oocyte tightly and form the cumulus oophurus and corona radiata inner cell layer. CCs are also engaged in bi-directional metabolite exchange with the oocyte, as they form gap-junctions, which are crucial for both the oocyte's proper maturation and GC proliferation. However, the function of both GCs and CCs is dependent on proper follicular angiogenesis. Aside from participating in complex molecular interplay with the oocyte, the ovarian follicular cells exhibit stem-like properties, characteristic of mesenchymal stem cells (MSCs). Both GCs and CCs remain under the influence of various miRNAs, and some of them may contribute to polycystic ovary syndrome (PCOS) or premature ovarian insufficiency (POI) occurrence. Considering increasing female fertility problems worldwide, it is of interest to develop new strategies enhancing assisted reproductive techniques. Therefore, it is important to carefully consider GCs as ovarian stem cells in terms of the cellular features and molecular pathways involved in their development and interactions as well as outline their possible application in translational medicine.

• MeSH
• fyziologická neovaskularizace * MeSH
• kmenové buňky metabolismus   MeSH
• kumulární buňky metabolismus   MeSH
• lidé MeSH
• primární ovariální insuficience metabolismus   MeSH
• syndrom polycystických ovarií metabolismus   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

Vitamin D3 is well-known as a major regulator of calcium and phosphorus homeostasis. A growing body of evidence highlights its crucial role in the regulation of reproductive processes in females. The role of vitamin D3 in the female reproductive tract has been extensively investigated because its receptor is abundant in reproductive organs, including ovary. Importantly, besides expression of vitamin D3 receptor, the ovary is an extrarenal site of vitamin D3 metabolism. The influence of vitamin D3 on follicular development and ovarian steroidogenesis has been investigated. Furthermore, vitamin D3 deficiency has also been associated with polycystic ovary syndrome, premature ovarian failure and ovarian cancer. The objective of this review is to summarize our knowledge about the contribution of vitamin D3 to physiological and pathological processes within the ovary.

• MeSH
• cholekalciferol metabolismus   MeSH
• lidé MeSH
• nedostatek vitaminu D metabolismus   MeSH
• ovarium metabolismus   patologie   MeSH
• receptory kalcitriolu metabolismus   MeSH
• syndrom polycystických ovarií metabolismus   patologie   MeSH
• vápník metabolismus   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Gestational diabetes mellitus (GDM) and polycystic ovary syndrome (PCOS) are distinct pathologies with impaired insulin sensitivity as a common feature. The aim of this study was to evaluate the response of fat tissue adipokines and gastrointestinal incretins to glucose load in patients diagnosed with one of the two disorders and to compare it with healthy controls. Oral glucose tolerance test (oGTT) was performed in 77 lean young women: 22 had positive history of GDM, 19 were PCOS patients, and 36 were healthy controls. Hormones were evaluated in fasting and in 60 min intervals during the 3 h oGTT using Bio-Plex ProHuman Diabetes 10-Plex Assay for C-peptide, ghrelin, GIP, GLP1, glucagon, insulin, leptin, total PAI1, resistin, visfatin and Bio-Plex ProHuman Diabetes Adipsin and Adiponectin Assays (Bio-Rad). Despite lean body composition, both PCOS and GDM women were more insulin resistant than controls. Significant postchallenge differences between the GDM and PCOS groups were observed in secretion of adipsin, leptin, glucagon, visfatin, ghrelin, GIP, and also GLP1 with higher levels in GDM. Conversely, PCOS was associated with the highest resistin, C-peptide, and PAI1 levels. Our data suggest that decreased insulin sensitivity observed in lean women with GDM and PCOS is associated with distinct hormonal response of fat and gastrointestinal tissue to glucose load.

• MeSH
• dospělí MeSH
• gastrointestinální trakt metabolismus   MeSH
• gestační diabetes metabolismus   MeSH
• hormony krev   MeSH
• inzulin krev   MeSH
• inzulinová rezistence MeSH
• krevní glukóza metabolismus   MeSH
• lidé MeSH
• omezení příjmu potravy metabolismus   MeSH
• syndrom polycystických ovarií metabolismus   MeSH
• těhotenství MeSH
• tuková tkáň metabolismus   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

V poslednom období pribúdajú dôkazy o možnom vplyve vitamínu D (VD) na reprodukčné funkcie u žien aj u mužov. V súčasnosti je najviac preskúmaný vzťah VD ku klinickým a laboratórnym prejavom syndrómu polycystických ovárií (PCOS). Zistilo sa, že pacientky s PCOS majú nižšie hladiny vitamínu D v sére a majú vyššiu prevalenciu jeho deficitu v porovnaní s kontrolami. Niektoré štúdie dokumentovali aj vzťah vitamínu D k hladinám androgénov pri tomto ochorení, iné zase zistili iba vzťah VD k metabolickým parametrom (hmotnosť, inzulínová rezistencia, lipidový profil). Niekoľko intervenčných štúdií potvrdilo, že substitúcia VD u hypovitaminóznych žien s PCOS zlepšila metabolické ukazovatele a časť autorov dokumentovala aj zlepšenie ovariálnych funkcií a hyperandrogenémie. Vitamín D teda môže predstavovať aditívnu liečbu u hypovitaminóznych žien s PCOS s cieľom zlepšiť jeho fenotypové prejavy. To si vyžaduje ďalšie randomizované intervenčné štúdie na väčších súboroch pacientiek.

Currently there is growing evidence on possible influence of vitamin D (VD) on reproductive function in both females and males. The relationship between VD and clinical or laboratory manifestations of polycystic ovary syndrome (PCOS) seems to be mostly evaluated. Patients with PCOS have been demonstrated to have significantly lower levels of serum VD and they also have the higher prevalence of vitamin D deficiency as compared to controls. Some studies documented the relation of VD to serum androgen levels, other found that VD correlated with metabolic parameters (body weight, insulin resistance and lipid profile) only. Several interventional studies demonstrated that VD replacement improved these metabolic parameters in PCOS women with VD deficiency. On the other hand some studies also documented improvement of ovarian function and androgen levels. Also vitamin D replacement may represent an additional treatment in VD deficient PCOS women with the aim to improve phenotypic manifestations. It requires further randomized interventional studies on larger groups of patients.

• MeSH
• antimülleriánský hormon metabolismus   MeSH
• inzulinová rezistence MeSH
• kalcitriol metabolismus   MeSH
• kombinovaná farmakoterapie MeSH
• lidé MeSH
• metabolický syndrom metabolismus   MeSH
• metformin terapeutické užití   MeSH
• nedostatek vitaminu D * farmakoterapie   metabolismus   patofyziologie   MeSH
• ovariální folikul metabolismus   MeSH
• potravní doplňky MeSH
• syndrom polycystických ovarií * farmakoterapie   metabolismus   patofyziologie   MeSH
• vitamin D * fyziologie   metabolismus   terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• přehledy MeSH

Syndróm polycystických ovárií (PCOS) je heterogénne a komplexné endokrinné ochorenie, ktoré v ženskej populácii patrí medzi najrozšírenejšie endokrinopatie a je najčastejšou príčinou hyperandrogenizmu, oligoanovulácie a infertility. Inzulínová rezistencia patrí medzi dôležité patogenetické faktory ovplyvňujúce hyperandrogenémiu u väčšiny žien s PCOS (60–80 %). Medzi klinické prejavy PCOS patria reprodukčné poruchy, metabolické črty a psychologické dôsledky. Reprodukčné poruchy zahŕňajú hyperandrogenizmus, menštruačné poruchy, infertilitu a tehotenské komplikácie ako včasné potraty, gestačný diabetes a tehotenstvom indukovanú hypertenziu. K neskorým metabolickým rizikám PCOS patria diabetes mellitus 2. typu, dyslipidémia, artériová hypertenzia a porucha funkcie endotelu. Dostupné dáta potvrdzujú u žien s PCOS častejší výskyt kardiovaskulárnych ochorení. Hlavne u obéznych žien je PCOS častejšie asociovaný s nealkoholovou steatózou pečene, syndrómom spánkového apnoe a endometriálnym karcinómom. Literatúra uvádza kontroverzné údaje o asociácii medzi PCOS a autoimunitou. Ženy s PCOS sú viac náchylné k nedostatočnému sebavedomiu s častejším výskytom úzkosti, depresie, bipopárnej poruchy, anxiety a porúch príjmu potravy. Kľúčové slová: autoimunita – diabetes mellitus – gravidita – inzulínová rezistencia – metabolický syndróm – poruchy menštruačného cyklu – syndróm polycystických ovárií

Polycystic ovary syndrome (PCOS) is a heterogeneous and complex endocrine disease which among the female population belongs to the most widespread endocrinopathies and it is the most frequent cause of hyperthyroidism, anticoagulation and infertility. Insulin resistance is one of the important diabetology factors impacting hyperglycaemia in a majority of women with PCOS (60–80 %). Clinical expressions of PCOS include reproduction disorders, metabolic characteristics and psychological implications. Reproduction disorders include hyperthyroidism, menstruation cycle disorders, infertility and pregnancy complications as well as early abortions, gestational diabetes and pregnancy induced hypertension. Long-term metabolic risks of PCOS include type 2 diabetes mellitus, dyslipidemia, arterial hypertension and endothelial dysfunction. The available data confirms higher incidence of cardiovascular diseases in women with PCOS. In particular among obese women PCOS is more frequently associated with non-alcoholic hepatic steatosis, sleep apnoea syndrome and endometrial cancer. The literature includes some controversial data about the relationship between PCOS and autoimmunity. Women with PCOS are more prone to suffer from insufficient confidence with higher incidence of anxiety, depression, bipolar disorder and eating disorders. Key words: autoimmunity – diabetes mellitus – pregnancy – insulin resistance – metabolic syndrome – menstrual disorders – polycystic ovary syndrome

• MeSH
• dospělí MeSH
• dyslipidemie MeSH
• fenotyp MeSH
• hypertenze MeSH
• kardiovaskulární nemoci MeSH
• komplikace těhotenství MeSH
• lidé MeSH
• nádory endometria MeSH
• prevalence MeSH
• retrospektivní studie MeSH
• syndrom polycystických ovarií * diagnóza   komplikace   metabolismus   patofyziologie   MeSH
• těhotenství MeSH
• ženská infertilita etiologie   MeSH
• změny tělesné hmotnosti MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• přehledy MeSH

• MeSH
• diabetes mellitus metabolismus   MeSH
• endokrinní systém MeSH
• insulinu podobný růstový faktor I metabolismus   MeSH
• insulinu podobný růstový faktor II metabolismus   MeSH
• lidé MeSH
• metabolické nemoci kostí metabolismus   MeSH
• metabolické nemoci metabolismus   MeSH
• myši MeSH
• nemoci endokrinního systému metabolismus   MeSH
• obezita metabolismus   MeSH
• poruchy růstu metabolismus   MeSH
• regulace genové exprese MeSH
• syndrom polycystických ovarií metabolismus   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• myši MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• komentáře MeSH
• souhrny MeSH

• MeSH
• inositol * aplikace a dávkování   farmakologie   metabolismus   MeSH
• inzulinová rezistence MeSH
• lidé MeSH
• metabolický syndrom * farmakoterapie   metabolismus   MeSH
• syndrom polycystických ovarií farmakoterapie   metabolismus   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH

Úvod: Syndróm polycystických ovárií (PCOS) je jednou z najčastejšie sa vyskytujúcich endokrinopatií žien reprodukčného veku s prevalenciou 4–18 %. Okrem poruchy menštruačného cyklu s následnými poruchami plodnosti, hyper­androgenémie a jej kožných prejavov, nachádzame u týchto žien aj početné metabolické abnormality, a to vysoký výskyt jednotlivých prejavov metabolického syndrómu (MetS) a kardiovaskulárnych rizikových faktorov. Výskyt hypovitaminózy D v populácii pacientov so znakmi MetS, ako aj v skupine žien s PCOS, potencuje skúmanie o možnom podiele vitamínu D na fenotypovom prejave PCOS. Cieľ štúdie: Určiť saturáciu organizmu vitamínom D u žien s PCOS a v kontrolnej skupine (KS), posúdiť vzťah hypovitaminózy D k jednotlivých znakom MetS pri PCOS. Metódy: 25(OH)D, základné antropometrické a metabolické parametre, celkové množstvo tukového tkaniva a jeho distribúcia v androidnej a gynoidnej oblasti boli stanovené v súbore 99 žien s diagnózou PCOS podľa Rotterdamských kritérií a u 66 žien KS. Výsledky: Nepotvrdili sme signifikantný rozdiel v priemerných sérových hladinách 25(OH)D medzi PCOS a KS (24,79 ± 10,77 vs 25,07 ± 10,14 ng/ml, p = 0,868). Pacientky s PCOS spĺňajúce kritéria MetS mali signifikantne nižšie hodnoty 25(OH)D v porovnaní s PCOS bez MetS (20,6 ± 8,3 vs 25,9 ± 11,3 ng/ml; p = 0,049). Hypovitaminózne PCOS pacientky mali vyššie hladiny triacylglycerolov s hraničnou signifikanciou (1,44 ± 0,93 vs 1,03 ± 0,46; p = 0,051) a trend k vyššiemu HOMA-indexu: medián/percentil: 2,24 (1,38; 3,51) vs 1,85 (1,04; 3,68); p = 0,467 v porovnaní s PCOS ženami s normálnou saturáciou vitamínom D. 25(OH)D pozitívne koreloval s HDL-cholesterolom (r = 0,159; p = 0,043) u všetkých jedincov. Záver: Nízke hladiny 25(OH)D nie sú asociované s PCOS samotným, ale s jednotlivými zložkami MetS pri PCOS.

Introduction: The polycystic ovarian syndrome (PCOS) is one of the most frequently occurring endocrinopathies among women of childbearing potential with a 4-18% prevalence. Besides the menstrual cycle disorder with subsequent fertility problems, hyperandrogenaemia and its skin manifestations, we also find multiple metabolic abnormalities among these women, namely a high occurrence of individual manifestations of the metabolic syndrome (MetS) and cardiovascular risk factors. The occurrence of hypovitaminosis D among a population of patients with MetS symptoms, as well as among a group of women with PCOS extends the research on a possible effect of vitamin D on the phenotypic manifestation of PCOS. Target of the study: Establish the organism saturation with vitamin D among women with PCOS and in the control cohort (CC), evaluate the relation of hypovitaminosis D to individual symptoms of MetS in PCOS. Methods: 25(OH)D, basic anthropometric and metabolic parameters, the overall amount of fat tissue and its distribution across the android and gynoid regions were established for a cohort of 99 women diagnosed with PCOS according to the Rotterdam criteria and for 66 women in the control cohort. Results: We have not confirmed a significant difference in the average serum levels of 25(OH)D between PCOS and CC (24.79 ± 10.77 vs 25.07 ± 10.14 ng/ml, p = 0.868). The patients with PCOS meeting the MetS criteria had significantly lower values of 25(OH)D as compared with PCOS without MetS (20.6 ± 8.3 vs 25.9 ± 11.3 ng/ml, p = 0.049). PCOS patients with hypovitaminosis had higher levels of triglycerides of limit significance (1.44 ± 0.93 vs 1.03 ± 0.46, p = 0.051) and a trend toward a higher HOMA-index (median [percentile]: 2.24 [1.38; 3.51] vs 1.85 [1.04; 3.68], p = 0.467) as compared with the women manifesting PCOS with normal vitamin D saturation. 25(OH)D correlated positively with HDL-cholesterol (r = 0.159, p = 0.043) among all individuals. Conclusion: Low levels of 25(OH)D are associated with individual elements of the MetS in the PCOS, though not with the PCOS itself.

• MeSH
• dospělí MeSH
• lidé MeSH
• metabolický syndrom * MeSH
• mladý dospělý MeSH
• nedostatek vitaminu D * metabolismus   patofyziologie   MeSH
• prospektivní studie MeSH
• syndrom polycystických ovarií * metabolismus   patofyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH

Syndrom polycystických ovarií (PCOS) je nejčastější endokrinopatie žen ve fertilním věku. V jeho patogenezi hraje roli hyperandrogenismus, ovariální dysfunkce, inzulínová rezistence, obezita a nadměrná sekrece luteinizačního hormonu. Mezi hlavní klinické projevy patří porucha menstruačního cyklu a hirzutismus. PCOS je doprovázen zvýšeným rizikem porušené glukózové tolerance (2krát), diabetes mellitus 2. typu (4krát) a metabolického syndromu (2krát). Není zatím jasné, zda je PCOS provázený i vyšším rizikem kardiovaskulárních příhod. Dále se PCOS častěji spojuje s depresí a s nealkoholickou steatohepatitidou. V terapii poruchy menstruačního cyklu se uplatňují kombinovaná hormonální kontraceptiva (COC) nebo gestageny, v terapii hirzutismu COC nebo antiandrogeny. Screening diabetu je doporučeno provádět pomocí orálního glukózového tolerančního testu, a to u štíhlých žen nad 40 let anebo dříve, pokud mají další rizikové faktory diabetu, a u všech obézních.

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women in their fertile years. Pathogenic mechanisms include hyperandrogenism, ovarian dysfunction, insulin resistance, obesity and increased secretion of luteinising hormone. The main clinical symptomes are menstrual cycle irregularity and hirsutism. PCOS is accompanied by increased risk of impaired glucose tolerance (2x), diabetes mellitus (4x) and of metabolic syndrome (2x). It is not clear, if PCOS is also associated with the increased risk of cardiovascular events. Moreover, depression and steatohepatitis are more common in the patients than usual as well. Combined hormonal contraceptives (COC) and gestagens are used in treatment of irregular menstrual cycle. Hirsutism is treated by COC or by antiandrogens. It is recommended to screen diabetes with oral glucose tolerance test in non-obese women over the age of 40 years, or earlier if they have other risk factors of diabetes, and in all obese women.

• MeSH
• diagnostické techniky endokrinologické klasifikace   MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• farmakoterapie metody   MeSH
• komorbidita MeSH
• lidé MeSH
• syndrom polycystických ovarií * diagnóza   epidemiologie   etiologie   farmakoterapie   komplikace   metabolismus   terapie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH