human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Given that polycystic ovary syndrome ( PCOS ) is associated with oligo-ovulatory infertility and is an inherited trait , we hypothesized that the families of patients with PCOS are smaller than those of matched controls . However , our study of 106 white patients with PCOS , ages 18 - 45 , and 53 healthy eumenorrheic nonhirsute white controls did not indicate a difference in family size between the groups ; these results have important implication s for the design of prospect i ve studies of the heritability and genetics of PCOS Estimates of the prevalence of the polycystic ovary syndrome ( PCOS )  in the general population have ranged from 2 - 20 % . The vast majority of these reports have studied White population s in Europe , used limited definitions of the disorder , and /or used bias population s , such as those seeking medical care . To estimate the prevalence of this disorder in the United States and address these limitations , we prospect ively determined the prevalence of PCOS in a reproductive-aged population of 369 consecutive women ( 174 White and 195 Black ; aged 18 - 45 yr ) , examined at the time of their preemployment physical .  Body measures  were obtained , and body hair was quantified by a modified Ferriman-Gallwey ( F-G ) method . All exams were initially performed by 2 trained nurses , and any subject with an F-G score above 3 was reexamined by a physician , the same for all patients . Of the 369 women , 277 ( 75.1 % ) also agreed to complete a question naire and have additional blood drawn . Subjects were studied regardless of current estrogen/progestin hormonal use ( 28.5 % ) . PCOS was defined as 1 ) oligoovulation , 2 ) clinical hyper and rogenism ( i.e. hirsutism ) and /or hyper and rogenemia , and 3 ) exclusion of other related disorders , such as hyperprolactinemia , thyroid abnormalities , and non-classic adrenal hyperplasia . Hirsutism was defined by a F-G score of 6 or more , and hyper and rogenemia was defined as a total or free testosterone , and rostenedione , and /or dehydroepi and rosterone sulfate level above the 95th percentile of control values [ i.e. all eumenorrheic women in the study , who had no hirsutism ( F-G < or = 5 ) or acne and were receiving no hormonal therapy ; n = 98 ] . Considering all 369 women studied , White and Black women had similar mean ages ( 29.4 + /- 7.1 and 31.1 + /- 7.8 yr , respectively ) , although White women had a lesser body mass than Black women ( 24.9 + /- 6.1 vs. 29.2 + /- 8.1 kg/m2 , respectively ; P < 0.001 ) . Of these 7.6 % , 4.6 % , and 1.9 % demonstrated a F-G score of 6 or more , 8 or 10 , respectively , and there was no significant racial difference , with hirsutism prevalences of 8.0 % , 2.8 % , and 1.6 % in Whites , and 7.1 % , 6.1 % , and 2.1 % in Blacks , respectively . Of the 277 women consenting to a history and hormonal evaluation , 4.0 % had PCOS as defined , 4.7 % ( 6 of 129 ) of Whites and 3.4 % ( 5 of 148 ) of Blacks . In conclusion , in our consecutive population of unselected women the prevalence of hirsutism varied from 2 - 8 % depending on the chosen cut-off F-G score , with no significant difference between White and Black women . Using an F-G score of 6 or more as indicative of hirsutism , 3.4 % of Blacks and 4.7 % of Whites had PCOS as defined . These data suggest that PCOS may be one of most common reproductive endocrinological disorders of women BACKGROUND Polycystic ovarian syndrome ( PCOS ) is a controversial endocrine pathology and , recently , it has been suggested that the condition is hereditary . The aim of this study was to prospect ively determine in daughters of patients with PCOS , by ultrasonographic ( US ) and colour Doppler analyses , the incidence of polycystic ovaries and search any correlation with specific hormonal parameters . METHODS Fifteen prepubertal offspring ( Group I ) of patients with PCOS and 10 normal control prepubertal girls ( Group II ) were su bmi tted to clinical , auxological , and basal hormonal assay . In addition all patients were su bmi tted to US and colour Doppler ovarian and uterine evaluation . RESULTS Among Group I girls the prevalence of polycystic ovaries was 93 % , whereas no subjects among Group II had polycystic ovaries . The ovarian volume ( 2.76 + /- 1.21 ml versus 0.87 + /- 0.46 ml ; P < 0.001 ) and the number of small sized follicles ( 5.36 + /- 2.2 versus 0.75 + /- 0.92 ; P < 0.001 ) were significantly higher in Group I than Group II patients . In addition , a normal stromal score and an absent stromal vascularization was observed in the control group . The hormone levels did not differ between the two groups . CONCLUSION In conclusion we speculate that polycystic ovaries in childhood may be considered a sign of genetic predisposition to PCOS and that environmental factors may express the adult clinical and hormonal presentation of the syndrome OBJECTIVE To verify whether healthy daughters with polycystic ovaries ( PCO ) of patients with polycystic ovary syndrome ( PCOS ) have an increased risk of cardiovascular disease in comparison with healthy controls . DESIGN Prospect i ve observational study . SETTING University hospital . PATIENT(S ) Seventeen eumenorrheic daughters with PCO of patients with PCOS ( group 1 ) and 20 healthy volunteers ( group 2 ) with regular ovulatory cycles . INTERVENTION(S ) Fasting blood sampling , ultrasonographic and Doppler analyses , 24-hour ambulatory blood pressure monitoring . MAIN OUTCOME MEASURE(S ) Medical examination ; blood measurement of nitrites and nitrates , biochemical and hormonal parameters ; utero-ovarian ultrasonographic analysis and color Doppler evaluation of uterine and stromal ovarian arteries ; brachial artery flow-mediated vasodilatation ; 24-hour ambulatory blood pressure monitoring . An oral  glucose tolerance test was performed to analyze glucose , insulin , and C-peptide levels . RESULT ( S ) At Doppler analysis a significantly higher uterine and a lower ovarian artery pulsatility index was found in group 1 compared with group 2 . The brachial artery diameter , after the reactive hyperemia , showed a greater vasodilatation in controls in comparison with women with PCO . The 24-hour blood pressure monitoring demonstrated that patients with PCO have significant higher 24-hour , daytime , and nighttime diastolic and mean arterial pressure values than controls . The nitrites and nitrates plasma levels were lower in group 1 compared with group 2 . The glucose and insulin plasma values were higher in patients with PCO than in controls . CONCLUSION ( S ) Eumenorrheic nonhirsute daughters of patients with PCOS who have PCO appearance on ultrasound have an increased cardiovascular risk The aim of this study was to obtain evidence for the genetic basis of polycystic ovaries ( PCO ) and premature male pattern baldness ( PMPB ) by screening first-degree relatives of women affected by polycystic ovary syndrome ( PCOS ) . Because of the high prevalence of PCO in the general population , we also studied first-degree relatives of ten asymptomatic control volunteers of reproductive age . The prob and s were recruited prospect ively from infertility and endocrine clinics , where they presented with various clinical symptoms of PCOS . Each had PCO , on transvaginal ultrasound scan . The families of 29 prob and s and 10 volunteers agreed to take part in the study .  Clinical , ultrasound , and biochemical parameters were used to define PCO/PCOS . All female relatives had an ovarian ultrasound scan and hormone profile performed . History was used to assign status in postmenopausal women . All male relatives were assessed for early onset ( < 30 yr old ) male pattern baldness , by photographs . All relatives were assigned affected ( PCO/PMPB ) or nonaffected status , and segregation analysis was performed . Of the relatives of 29 PCOS prob and s , 15 of 29 mothers ( 52 % ) , 6 of 28 fathers ( 21 % ) , 35 of 53 sisters ( 66 % ) , and 4 of 18 brothers ( 22 % ) were assigned affected status . First-degree female relatives of affected individuals had a 61 % chance of being affected . Of the first-degree male relatives , 22 % were affected . Of a total of 71 siblings of PCOS prob and s , 39 were affected , giving a segregation ratio of 39/32 ( 55 % ) , which is consistent with autosomal dominant inheritance for PCO/PMPB . In the control families , 1 of 10 prob and s ( 10 % ) , 1 of 10 mothers ( 10 % ) , no fathers , 2 of 13 sisters ( 15 % ) , and 1 of 11 brothers ( 9 % ) were affected . Of a total of 24 siblings , 3 were affected ( 13 % ) , giving a segregation ratio ( observed/expected ) of 3/12 , which was significantly different from autosomal dominant inheritance . The inheritance of PCO and PMPB is consistent with an autosomal dominant inheritance pattern in PCOS families , perhaps caused by the same gene . There was no such genetic influence in families of women without PCOS . Sisters of PCOS prob and s with polycystic ovarian morphology were more likely to have menstrual irregularity and had larger ovaries and higher serum and rostenedione and dehydroepi and rosterone-sulfate levels than sisters without PCO . This suggests a spectrum of clinical phenotype in PCOS families . Men with PMPB had higher serum testosterone than those without . Collectively , these data are consistent with a role for genetic differences in and rogen synthesis , metabolism , or action in the pathogenesis of PCOS OBJECTIVE To determine the rate of clinical ly evident polycystic ovary syndrome ( PCOS ) among first-degree female relatives within families with a prob and affected by PCOS . DESIGN Clinical and biochemical evaluation of the mothers and sisters of 93 patients with PCOS . The diagnosis of PCOS was established by : [ 1 ] a history of oligomenorrhea , [ 2 ] clinical evidence ( i.e. , hirsutism ) or biochemical evidence ( i.e. , elevated total or free T ) of hyper and rogenism , and [ 3 ] the exclusion of related disorders . SETTING Tertiary care university . PATIENT(S ) Patients with PCOS and their mothers and sisters . INTERVENTION(S ) Interview , physical examination , and hormonal testing on blood sample s were performed for all subjects . MAIN OUTCOME MEASURE(S ) The presence of hirsutism and hyper and rogenemia was determined in the mothers and sisters of the patients with PCOS . RESULT ( S ) Of the 78 mothers and 50 sisters evaluated clinical ly , 19 ( 24 % ) and 16 ( 32 % ) were affected with PCOS , respectively . A higher rate of PCOS was observed when only premenopausal women not taking hormones ( i.e. , untreated ) were considered ( i.e. , 35 % of mothers and 40 % of sisters ) , consistent with amelioration of symptoms with hormonal therapy or aging . These rates of PCOS are significantly higher than that observed in our general population ( approximately 4 % ) and suggest the involvement of a major genetic component in the disorder . CONCLUSION ( S ) The rates of PCOS in mothers and sisters of patients with PCOS were 24 % and 32 % , respectively , although the risk was higher when considering untreated premenopausal women only We have prospect ively studied , by interview , clinical examination and biochemical evaluation , the relatives of 195 consecutive PCOS patients in order to : 1 ) accurately determine the prevalence of PCOS , as defined by current endocrinological criteria , among first-degree relatives of affected patients , and 2 ) determine the overall accuracy of prob and -only and family member ( self report ) interview for the detection of clinical ly evident PCOS within families . We noted that 35 % of mothers and 40 % of sisters of patients with PCOS will be affected by PCOS themselves . Overall , the interview using a st and ardized form , whether of the prob and or the family relative directly , appears to be a reliable predictor of affected status in mothers . Alternatively , approximately 50 % of sisters will be missed using the prob and interview , although self-reporting appears to be a reasonably reliable predictor of affected status for these relatives . While we are unable to exclude an autosomal or X-linked dominant mode of inheritance , the heritability of PCOS is probably more complex , similar to that of diabetes mellitus type 2 and cardiovascular disease . In absence of molecular diagnostic markers , a positive family history appears to be the most informative risk factor for the development PCOS CONTEXT The pren 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Given that polycystic ovary syndrome ( PCOS ) is associated with oligo-ovulatory infertility and is an inherited trait , we hypothesized that the families of patients with PCOS are smaller than those of matched controls . However , our study of 106 white patients with PCOS , ages 18 - 45 , and 53 healthy eumenorrheic nonhirsute white controls did not indicate a difference in family size between the groups ; these results have important implication s for the design of prospect i ve studies of the heritability and genetics of PCOS Estimates of the prevalence of the polycystic ovary syndrome ( PCOS )  in the general population have ranged from 2 - 20 % . The vast majority of these reports have studied White population s in Europe , used limited definitions of the disorder , and /or used bias population s , such as those seeking medical care . To estimate the prevalence of this disorder in the United States and address these limitations , we prospect ively determined the prevalence of PCOS in a reproductive-aged population of 369 consecutive women ( 174 White and 195 Black ; aged 18 - 45 yr ) , examined at the time of their preemployment physical .  Body measures  were obtained , and body hair was quantified by a modified Ferriman-Gallwey ( F-G ) method . All exams were initially performed by 2 trained nurses , and any subject with an F-G score above 3 was reexamined by a physician , the same for all patients . Of the 369 women , 277 ( 75.1 % ) also agreed to complete a question naire and have additional blood drawn . Subjects were studied regardless of current estrogen/progestin hormonal use ( 28.5 % ) . PCOS was defined as 1 ) oligoovulation , 2 ) clinical hyper and rogenism ( i.e. hirsutism ) and /or hyper and rogenemia , and 3 ) exclusion of other related disorders , such as hyperprolactinemia , thyroid abnormalities , and non-classic adrenal hyperplasia . Hirsutism was defined by a F-G score of 6 or more , and hyper and rogenemia was defined as a total or free testosterone , and rostenedione , and /or dehydroepi and rosterone sulfate level above the 95th percentile of control values [ i.e. all eumenorrheic women in the study , who had no hirsutism ( F-G < or = 5 ) or acne and were receiving no hormonal therapy ; n = 98 ] . Considering all 369 women studied , White and Black women had similar mean ages ( 29.4 + /- 7.1 and 31.1 + /- 7.8 yr , respectively ) , although White women had a lesser body mass than Black women ( 24.9 + /- 6.1 vs. 29.2 + /- 8.1 kg/m2 , respectively ; P < 0.001 ) . Of these 7.6 % , 4.6 % , and 1.9 % demonstrated a F-G score of 6 or more , 8 or 10 , respectively , and there was no significant racial difference , with hirsutism prevalences of 8.0 % , 2.8 % , and 1.6 % in Whites , and 7.1 % , 6.1 % , and 2.1 % in Blacks , respectively . Of the 277 women consenting to a history and hormonal evaluation , 4.0 % had PCOS as defined , 4.7 % ( 6 of 129 ) of Whites and 3.4 % ( 5 of 148 ) of Blacks . In conclusion , in our consecutive population of unselected women the prevalence of hirsutism varied from 2 - 8 % depending on the chosen cut-off F-G score , with no significant difference between White and Black women . Using an F-G score of 6 or more as indicative of hirsutism , 3.4 % of Blacks and 4.7 % of Whites had PCOS as defined . These data suggest that PCOS may be one of most common reproductive endocrinological disorders of women BACKGROUND Polycystic ovarian syndrome ( PCOS ) is a controversial endocrine pathology and , recently , it has been suggested that the condition is hereditary . The aim of this study was to prospect ively determine in daughters of patients with PCOS , by ultrasonographic ( US ) and colour Doppler analyses , the incidence of polycystic ovaries and search any correlation with specific hormonal parameters . METHODS Fifteen prepubertal offspring ( Group I ) of patients with PCOS and 10 normal control prepubertal girls ( Group II ) were su bmi tted to clinical , auxological , and basal hormonal assay . In addition all patients were su bmi tted to US and colour Doppler ovarian and uterine evaluation . RESULTS Among Group I girls the prevalence of polycystic ovaries was 93 % , whereas no subjects among Group II had polycystic ovaries . The ovarian volume ( 2.76 + /- 1.21 ml versus 0.87 + /- 0.46 ml ; P < 0.001 ) and the number of small sized follicles ( 5.36 + /- 2.2 versus 0.75 + /- 0.92 ; P < 0.001 ) were significantly higher in Group I than Group II patients . In addition , a normal stromal score and an absent stromal vascularization was observed in the control group . The hormone levels did not differ between the two groups . CONCLUSION In conclusion we speculate that polycystic ovaries in childhood may be considered a sign of genetic predisposition to PCOS and that environmental factors may express the adult clinical and hormonal presentation of the syndrome OBJECTIVE To verify whether healthy daughters with polycystic ovaries ( PCO ) of patients with polycystic ovary syndrome ( PCOS ) have an increased risk of cardiovascular disease in comparison with healthy controls . DESIGN Prospect i ve observational study . SETTING University hospital . PATIENT(S ) Seventeen eumenorrheic daughters with PCO of patients with PCOS ( group 1 ) and 20 healthy volunteers ( group 2 ) with regular ovulatory cycles . INTERVENTION(S ) Fasting blood sampling , ultrasonographic and Doppler analyses , 24-hour ambulatory blood pressure monitoring . MAIN OUTCOME MEASURE(S ) Medical examination ; blood measurement of nitrites and nitrates , biochemical and hormonal parameters ; utero-ovarian ultrasonographic analysis and color Doppler evaluation of uterine and stromal ovarian arteries ; brachial artery flow-mediated vasodilatation ; 24-hour ambulatory blood pressure monitoring . An oral  glucose tolerance test was performed to analyze glucose , insulin , and C-peptide levels . RESULT ( S ) At Doppler analysis a significantly higher uterine and a lower ovarian artery pulsatility index was found in group 1 compared with group 2 . The brachial artery diameter , after the reactive hyperemia , showed a greater vasodilatation in controls in comparison with women with PCO . The 24-hour blood pressure monitoring demonstrated that patients with PCO have significant higher 24-hour , daytime , and nighttime diastolic and mean arterial pressure values than controls . The nitrites and nitrates plasma levels were lower in group 1 compared with group 2 . The glucose and insulin plasma values were higher in patients with PCO than in controls . CONCLUSION ( S ) Eumenorrheic nonhirsute daughters of patients with PCOS who have PCO appearance on ultrasound have an increased cardiovascular risk The aim of this study was to obtain evidence for the genetic basis of polycystic ovaries ( PCO ) and premature male pattern baldness ( PMPB ) by screening first-degree relatives of women affected by polycystic ovary syndrome ( PCOS ) . Because of the high prevalence of PCO in the general population , we also studied first-degree relatives of ten asymptomatic control volunteers of reproductive age . The prob and s were recruited prospect ively from infertility and endocrine clinics , where they presented with various clinical symptoms of PCOS . Each had PCO , on transvaginal ultrasound scan . The families of 29 prob and s and 10 volunteers agreed to take part in the study .  Clinical , ultrasound , and biochemical parameters were used to define PCO/PCOS . All female relatives had an ovarian ultrasound scan and hormone profile performed . History was used to assign status in postmenopausal women . All male relatives were assessed for early onset ( < 30 yr old ) male pattern baldness , by photographs . All relatives were assigned affected ( PCO/PMPB ) or nonaffected status , and segregation analysis was performed . Of the relatives of 29 PCOS prob and s , 15 of 29 mothers ( 52 % ) , 6 of 28 fathers ( 21 % ) , 35 of 53 sisters ( 66 % ) , and 4 of 18 brothers ( 22 % ) were assigned affected status . First-degree female relatives of affected individuals had a 61 % chance of being affected . Of the first-degree male relatives , 22 % were affected . Of a total of 71 siblings of PCOS prob and s , 39 were affected , giving a segregation ratio of 39/32 ( 55 % ) , which is consistent with autosomal dominant inheritance for PCO/PMPB . In the control families , 1 of 10 prob and s ( 10 % ) , 1 of 10 mothers ( 10 % ) , no fathers , 2 of 13 sisters ( 15 % ) , and 1 of 11 brothers ( 9 % ) were affected . Of a total of 24 siblings , 3 were affected ( 13 % ) , giving a segregation ratio ( observed/expected ) of 3/12 , which was significantly different from autosomal dominant inheritance . The inheritance of PCO and PMPB is consistent with an autosomal dominant inheritance pattern in PCOS families , perhaps caused by the same gene . There was no such genetic influence in families of women without PCOS . Sisters of PCOS prob and s with polycystic ovarian morphology were more likely to have menstrual irregularity and had larger ovaries and higher serum and rostenedione and dehydroepi and rosterone-sulfate levels than sisters without PCO . This suggests a spectrum of clinical phenotype in PCOS families . Men with PMPB had higher serum testosterone than those without . Collectively , these data are consistent with a role for genetic differences in and rogen synthesis , metabolism , or action in the pathogenesis of PCOS OBJECTIVE To determine the rate of clinical ly evident polycystic ovary syndrome ( PCOS ) among first-degree female relatives within families with a prob and affected by PCOS . DESIGN Clinical and biochemical evaluation of the mothers and sisters of 93 patients with PCOS . The diagnosis of PCOS was established by : [ 1 ] a history of oligomenorrhea , [ 2 ] clinical evidence ( i.e. , hirsutism ) or biochemical evidence ( i.e. , elevated total or free T ) of hyper and rogenism , and [ 3 ] the exclusion of related disorders . SETTING Tertiary care university . PATIENT(S ) Patients with PCOS and their mothers and sisters . INTERVENTION(S ) Interview , physical examination , and hormonal testing on blood sample s were performed for all subjects . MAIN OUTCOME MEASURE(S ) The presence of hirsutism and hyper and rogenemia was determined in the mothers and sisters of the patients with PCOS . RESULT ( S ) Of the 78 mothers and 50 sisters evaluated clinical ly , 19 ( 24 % ) and 16 ( 32 % ) were affected with PCOS , respectively . A higher rate of PCOS was observed when only premenopausal women not taking hormones ( i.e. , untreated ) were considered ( i.e. , 35 % of mothers and 40 % of sisters ) , consistent with amelioration of symptoms with hormonal therapy or aging . These rates of PCOS are significantly higher than that observed in our general population ( approximately 4 % ) and suggest the involvement of a major genetic component in the disorder . CONCLUSION ( S ) The rates of PCOS in mothers and sisters of patients with PCOS were 24 % and 32 % , respectively , although the risk was higher when considering untreated premenopausal women only We have prospect ively studied , by interview , clinical examination and biochemical evaluation , the relatives of 195 consecutive PCOS patients in order to : 1 ) accurately determine the prevalence of PCOS , as defined by current endocrinological criteria , among first-degree relatives of affected patients , and 2 ) determine the overall accuracy of prob and -only and family member ( self report ) interview for the detection of clinical ly evident PCOS within families . We noted that 35 % of mothers and 40 % of sisters of patients with PCOS will be affected by PCOS themselves . Overall , the interview using a st and ardized form , whether of the prob and or the family relative directly , appears to be a reliable predictor of affected status in mothers . Alternatively , approximately 50 % of sisters will be missed using the prob and interview , although self-reporting appears to be a reasonably reliable predictor of affected status for these relatives . While we are unable to exclude an autosomal or X-linked dominant mode of inheritance , the heritability of PCOS is probably more complex , similar to that of diabetes mellitus type 2 and cardiovascular disease . In absence of molecular diagnostic markers , a positive family history appears to be the most informative risk factor for the development PCOS CONTEXT The pren 
    Output:
    