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Porto Alegre, Brazil

Radavelli-Bagatini S.,Federal University of Rio Grande do Sul | Blair A.R.,University of Melbourne | Proietto J.,University of Melbourne | Spritzer P.M.,Federal University of Rio Grande do Sul | And 2 more authors.
Journal of Endocrinology | Year: 2011

Infertility, associated with oligo/anovulation, increased ovarian volume, numerous follicular cysts, and metabolic disturbances such as obesity and insulin resistance (IR) are characteristics common to polycystic ovary syndrome (PCOS), the most common endocrine disorder in women of reproductive age. Here, we show that New Zealand obese (NZO) mice display similar metabolic characteristics such as obesity, leptin insensitivity, glucose intolerance, and IR. Importantly, NZO mice are poor breeders; however, the mechanism for this has not been investigated. The aim of this study was to assess the ovarian structure/morphology and sex hormone levels in female NZO and lean C57BL/6J control mice. Twenty-five NZO and twenty female control mice were studied at three different ages (young, adult, and aged). The animals were weighed, an insulin tolerance test was carried out, and blood was collected for measurement of hormone levels. The ovaries were removed for histological analysis. As expected, NZO mice presented higher body weights (P=0.001), increased basal plasma glucose (P=0.001), and insulin levels (P=0.001) as well as IR, compared with control mice. NZO mice showed an increased ovarian volume, reduced numbers of corpora lutea, and higher total follicle numbers (P=0.0001). The number of primordial follicles increased (P=0.02) at the young stage, as well as the amount of atretic follicles (P=0.03), in NZO compared with control mice. NZO mice also displayed reduced plasma LH and increased estradiol levels. In conclusion, NZO mice show a poor breeding performance due to decreased ovulation, increased number of primordial and atretic follicles, and ovarian size. Given that NZO mice are obese, hyperinsulinemic and insulin resistant, they are suitable for investigating pathophysiological mechanisms linking metabolic alterations with reproductive defects. © 2011 Society for Endocrinology.


Casanova G.,Gynecological Endocrinology Unit | Dos Reis A.M.,Federal University of Minas Gerais | Spritzer P.M.,Federal University of Rio Grande do Sul
Climacteric | Year: 2015

Objective: To assess the effects of oral low-dose and non-oral hormone therapy (HT) on ultra-sensitive C-reactive protein (CRP), atrial natriuretic peptide (ANP), and cardiovascular risk factors in postmenopause. Methods: In this randomized, cross-over study, 44 recently postmenopausal women, with no clinical evidence of cardiovascular disease, received oral low-dose HT (estradiol 1 mg + drospirenone 2 mg/day) for 3 months. Forty-two patients received non-oral, conventional HT (1.5 mg/day percutaneous 17β-estradiol gel or equivalent for nasal route) for 3 months followed by 200 mg/day micronized progesterone by the vaginal route (14 days during each menstrual period). After 3 months, patients were crossed over without washout. Post-HT vs. pre-HT measures were determined: lipids, glucose, body mass index, waist circumference, fibrinogen, CRP-stratified levels, and ANP levels. The study was registered at clinical trials.gov (NCT01432028). Results: The mean age was 51±3 years and the mean time since the menopause was 22±10 months. CRP-stratified high levels decreased in a higher number of non-oral HT patients, who moved to intermediate and low levels (p=0.02). No effect of HT was observed on ANP levels (baseline 67.4 (18.4-104.5), low-dose oral 43.5 (14.4-95.9), non-oral 39.8 (15.5-67.5) pg/ml). Markers of endothelial function did not worsen with either low-dose oral or non-oral HT: von Willebrand factor (baseline 118±37%, low-dose oral 119±38%, non-oral 108±3%, p<0.01), fibrinogen (baseline 356±58 mg/dl; low-dose oral 343±77 mg/dl; non-oral 326±71 mg/dl, p<0.01). Conclusions: Low-dose oral and non-oral HT for 6 months had neutral or beneficial effects in recently postmenopausal women with no clinical evidence of cardiovascular disease. © 2015 International Menopause Society.


Spritzer P.M.,Gynecological Endocrinology Unit
Fertility and Sterility | Year: 2010

The aim of this study was to compare clinical, hormonal, and metabolic variables in women with classic polycystic ovary syndrome (PCOS), in ovulatory women presenting hirsutism, normal androgen levels, and polycystic ovaries (H+PCO), and in a group with isolated hirsutism (IH) presenting with normal ovaries and androgen levels. Waist circumference, triglycerides, and homeostasis model assessment values were significantly higher in classic PCOS even after adjustment for body mass index, and metabolic syndrome was three times more frequent in classic PCOS than in H+PCO or IH (31.3% vs. 11.9% vs. 9%), but no differences were observed regarding metabolic profile and cardiovascular risk factors between the H+PCO and IH groups, which presented with significantly more metabolic syndrome than normal controls when only overweight and obese women were considered. Copyright © 2010 American Society for Reproductive Medicine, Published by Elsevier Inc.


Spritzer P.M.,Gynecological Endocrinology Unit | Spritzer P.M.,Federal University of Rio Grande do Sul | Lecke S.B.,Gynecological Endocrinology Unit | Lecke S.B.,University of Porto | And 2 more authors.
Reproduction | Year: 2015

Polycystic ovary syndrome (PCOS), a complex condition that affects women of reproductive age, is characterized by ovulatory dysfunction and androgen excess. Women with PCOS present higher prevalence of obesity, central adiposity, and dyslipidemia, and face increased risk of type 2 diabetes. PCOS is closely linked to functional derangements in adipose tissue. Adipocytes seem to be prone to hypertrophy when exposed to androgen excess, as experienced by women with PCOS, and both adipose tissue hypertrophy and hyperandrogenism are related to insulin resistance. Hypertrophic adipocytes are more susceptible to inflammation, apoptosis, fibrosis, and release of free fatty acids. Disturbed secretion of adipokines may also impact the pathophysiology of PCOS through their influence on metabolism and on sex steroid secretion. Chronic low-grade inflammation in PCOS is also related to hyperandrogenism and to the hypertrophy of adipocytes, causing compression phenomena in the stromal vessels, leading to adipose tissue hypoperfusion and altered secretion of cytokines. Lifestyle changes are the first-line intervention for reducing metabolic risks in PCOS and the addition of an insulin-sensitizing drug might be required. Nevertheless, there is not sufficient evidence in favor of any specific pharmacologic therapies to directly oppose inflammation. Further studies are warranted to identify an adipokine that could serve as an indirect marker of adipocyte production in PCOS, representing a reliable sign of metabolic alteration in this syndrome. © 2015 Society for Reproduction and Fertility.


Silva T.R.,Gynecological Endocrinology Unit | Alves B.C.,Gynecological Endocrinology Unit | Maturana M.A.,Gynecological Endocrinology Unit | Spritzer P.M.,Gynecological Endocrinology Unit | Spritzer P.M.,Federal University of Rio Grande do Sul
Journal of the American College of Nutrition | Year: 2013

Objectives: To investigate the relationship between habitual physical activity and dietary intake, body composition, metabolic and hormonal variables, and cardiovascular risk factors in postmenopausal women with no evidence of cardiovascular disease. Methods: In this cross-sectional study, 105 women (mean age: 55.2 ± 4.9 years) consulting for climacteric symptoms underwent anthropometric and hormonal assessment. Usual dietary intake was assessed with a food frequency questionnaire and habitual physical activity was assessed with a digital pedometer. Participants were classified as physically inactive (<6000 steps daily) or physically active (≥6000 steps daily). Results: Compared to the inactive group, active women had higher protein, total fat, cholesterol, iron, calcium, and the antioxidant micronutrients zinc and selenium intake as well as differences on food groups: higher meat, egg, and whole-dairy intake and lower intake of chips. Active participants also presented lower diastolic blood pressure (p = 0.012), ultrasensitive C-reactive protein (us-CRP; p = 0.011), fasting glucose (p = 0.003), fasting insulin (p = 0.019), and homeostasis model assessment index (p = 0.017). After adjustment for age and time since menopause, the risk for metabolic syndrome increased with physical inactivity (odds ratio [OR] = 3.55, 95% confidence interval [CI], 1.08-11.66), us-CRP (OR = 6.57, 95% CI, 2.20-19.56), and percentage body fat (OR = 5.65, 95% CI, 1.19-28.89). Conclusion: Both physical activity and dietary choices may have contributed toward a more favorable cardiovascular profile and lower risk of metabolic syndrome in postmenopausal women. © 2013 Copyright Taylor and Francis Group, LLC.

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