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: We prospect ively estimated the prevalence of the polycystic ovary syndrome ( PCOS ) , as defined by the NIH/NICHHD 1990 endocrine criteria , in a population of 154 Caucasian women of reproductive age reporting spontaneously for blood donation .  Anthropometric data ; the presence of hirsutism , acne , and and rogenic alopecia ; and the menstrual history were recorded by a single investigator . In 145 women , blood sample s were also obtained for measurement of serum and rogen levels .  PCOS was defined by the presence of 1 ) oligomenorrhea , 2 ) clinical and /or biochemical hyper and rogenism , and 3 ) exclusion of hyperprolactinemia , thyroid disorders , and nonclassic 21-hydroxylase deficiency . Hirsutism was defined by a modified Ferriman-Gallwey score of 8 or more , acne was considered as a sign of hyper and rogenism when persistent after the second decade of life , and hyper and rogenemia was defined by an increase in circulating testosterone or dehydroepi and rosterone sulfate or an increase in the free and rogen index above the 95th percentile of the control values derived from the nonhirsute , nonacneic women having regular menses who were not receiving hormonal therapy . PCOS was present in 10(6.5 % ) , hirsutism was present in 11 ( 7.1 % ) , and acne was present in 19 ( 12.3 % ) of the 154 women . Our results demonstrate a 6.5 % prevalence of PCOS , as defined , in a minimally biased population of Caucasian women from Spain . The polycystic ovary syndrome , hirsutism , and acne are common endocrine disorders in women 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 We assessed the prevalence of mood disturbance among women with prospect ively documented polycystic ovary syndrome ( PCOS ) . METHODS Thirty-two women with PCOS completed the Center for Epidemiological Studies -Depression Rating Scale ( CES-D ) . Clinical and biochemical characteristics were assessed . RESULTS Sixteen women had CES-D scores indicative of depression . Depression was associated with greater insulin resistance ( P=0.02 ) and higher body mass index ( P=0.05 ) . Women receiving oral contraceptives  for the treatment of PCOS were less depressed than patients not receiving treatment ( P=0.03 ) . LIMITATIONS Possible selection bias , use of a screening tool alone without further diagnostic evaluation of depression , small sample s size and lack of direct comparison with an age matched control group , should be considered in interpretation of these results . CONCLUSION Findings suggest a high prevalence of depression among women with PCOS , and an association between depression and PCOS markers BACKGROUND To evaluate the effects of long-term acipimox administration on glucose-induced insulin secretion and peripheral insulin sensitivity in polycystic ovarian syndrome ( PCOS ) , 20 PCOS subjects ( eight lean and 12 obese ) and 14 body mass index-matched controls ( seven lean and seven obese ) were investigated . METHODS Fasting blood sample s were collected for basal hormone and lipoprotein assays , after which patients underwent an oral glucose tolerance test ( OGTT ) . The following day a euglycaemic-hyperinsulinaemic clamp was performed . After 4 - 6 weeks of treatment with acipimox at a dose of 250 mg given orally three times a day , the patients repeated the study protocol . RESULTS No significant differences were found in the glucose , insulin or C-peptide responses to OGTT before and after anti-lipolytic drug administration in any group , nor was there any effect on insulin sensitivity . Concerning the lipid profile , acipimox administration led to a significant decrease of cholesterol and low-density lipoprotein levels in obese PCOS patients as well as in obese and lean controls . Lower triglycerides were found after the drug administration in both obese groups . Post-treatment free fatty acid levels were not significantly different when compared with basal values . CONCLUSIONS Acipimox does not appear to be an effective insulin-lowering drug in PCOS , even if it can be used in obese women with PCOS as an additional therapeutic agent to ameliorate the atherogenic lipid profile of the syndrome Objective To investigate trends in obesity prevalence in recent years and to predict the obesity prevalence in 2015 in European population s. Methods Data of 97 942 participants from seven cohorts involved in the European Prospect i ve Investigation into Cancer and Nutrition ( EPIC ) study participating in the Diogenes project ( named as “ Diogenes cohort ” in the following ) with weight measurements at baseline and follow-up were used to predict future obesity prevalence with logistic linear and non-linear ( leveling off ) regression models . In addition , linear and leveling off models were fitted to the EPIC-Potsdam data set with five weight measures during the observation period to find out which of these two models might provide the more realistic prediction . Results During a mean follow-up period of 6 years , the obesity prevalence in the Diogenes cohort increased from 13 % to 17 % . The linear prediction model predicted an overall obesity prevalence of about 30 % in 2015 , whereas the leveling off model predicted a prevalence of about 20 % . In the EPIC-Potsdam cohort , the shape of obesity trend favors a leveling off model among men ( R2 = 0.98 ) , and a linear model among women ( R2 = 0.99 ) . Conclusion Our data show an increase in obesity prevalence since the 1990ies , and predictions by 2015 suggests a sizeable further increase in European population s. However , the estimates from the leveling off model were considerably lower OBJECTIVE To measure the prevalence of obesity in Australian adults and to examine the associations of obesity with socioeconomic and lifestyle factors . DESIGN AusDiab , a cross-sectional study conducted between May 1999 and December 2000 , involved participants from 42 r and omly selected districts throughout Australia . PARTICIPANTS Of 20,347 eligible people aged > or = 25 years who completed a household interview , 11,247 attended the physical examination at local survey sites  ( response rate , 55 % ) . MAIN OUTCOME MEASURES Overweight and obesity defined by body mass index ( BMI ; kg/m(2 ) ) and waist circumference ( cm ) ; sociodemographic factors ( including smoking , physical activity and television viewing time ) . RESULTS The prevalence of overweight and obesity ( BMI > or = 25.0 kg/m(2 ) ; waist circumference > 80.0 cm [ women ] or > or = 94.0 cm [ men ] ) in both sexes was almost 60 % , defined by either BMI or waist circumference . The prevalence of obesity was 2.5 times higher than in 1980 . Using waist circumference , the prevalence of obesity was higher in women than men ( 34.1 % v 26.8 % ; P < 0.01 ) . Lower educational status , higher  television viewing time and lower physical activity time were each strongly associated with obesity , with television viewing time showing a stronger relationship than physical activity time . CONCLUSIONS The prevalence of obesity in Australia has more than doubled in the past 20 years . Strong positive associations between obesity and each of television viewing time and lower physical activity time confirm the influence of sedentary lifestyles on obesity , and underline the potential benefits of reducing sedentary behaviour , as well as increasing physical activity , to curb the obesity epidemic OBJECTIVE Although prospect i ve studies indicate that insulin resistance and insulin secretory dysfunction predict type 2 diabetes , they provide limited information on the relative contributions of both abnormalities to worsening glucose tolerance at different developmental stages of the disease . We therefore assessed the predictive effect of insulin resistance and insulin secretory dysfunction separately for the progression from normal glucose tolerance ( NGT ) to impaired glucose tolerance ( IGT ) and from IGT to diabetes . RESEARCH DESIGN AND METHODS  Insulin-stimulated glucose disposal ( M ) ( hyperinsulinemic clamp ) , acute insulin secretory response ( AIR ) ( 25-g intravenous glucose tolerance test ) , and body composition  ( hydrodensitometry or dual-energy X-ray absorptiometry ) were measured in 254 Pima Indians with NGT and in 145 Pima Indians with IGT , who were then followed for 0.5 - 13 years . RESULTS After follow-ups of 4.4 + /- 3.1 and 5.5 + /- 3.4 years , 79 ( 31 % ) of the subjects with initial NGT had developed IGT , and 64 ( 44 % ) of the subjects with initial IGT had developed diabetes . In proportional-hazards analyses with adjustment for age , sex , and percent body fat , low M and low AIR were independent predictors of both the progression from NGT to IGT ( relative hazards [ 95 % CI ] for 10th vs. 90th percentile : M 2.4 [ 1.2 - 4.7 ] , P < 0.02 ; AIR 2.1 [ 1.1 - 4.1 ] , P < 0.04 ) and from IGT to diabetes ( M 2.5 [ 1.3 - 5.0 ] , P < 0.01 ; AIR 1.8 [ 0.99 - 3.3 ] , P = 0.055 ) . CONCLUSIONS During each stage of the development of type 2 diabetes , insulin resistance and insulin secretory dysfunction are independent predictors of worsening glucose tolerance and are , therefore , both targets for the primary prevention of the disease OBJECTIVE --To assess the validity of the 1990 US weight guidelines for women that support a substantial gain in weight at approximately 35 years of age and recommend a range of body mass index ( 
    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: We prospect ively estimated the prevalence of the polycystic ovary syndrome ( PCOS ) , as defined by the NIH/NICHHD 1990 endocrine criteria , in a population of 154 Caucasian women of reproductive age reporting spontaneously for blood donation .  Anthropometric data ; the presence of hirsutism , acne , and and rogenic alopecia ; and the menstrual history were recorded by a single investigator . In 145 women , blood sample s were also obtained for measurement of serum and rogen levels .  PCOS was defined by the presence of 1 ) oligomenorrhea , 2 ) clinical and /or biochemical hyper and rogenism , and 3 ) exclusion of hyperprolactinemia , thyroid disorders , and nonclassic 21-hydroxylase deficiency . Hirsutism was defined by a modified Ferriman-Gallwey score of 8 or more , acne was considered as a sign of hyper and rogenism when persistent after the second decade of life , and hyper and rogenemia was defined by an increase in circulating testosterone or dehydroepi and rosterone sulfate or an increase in the free and rogen index above the 95th percentile of the control values derived from the nonhirsute , nonacneic women having regular menses who were not receiving hormonal therapy . PCOS was present in 10(6.5 % ) , hirsutism was present in 11 ( 7.1 % ) , and acne was present in 19 ( 12.3 % ) of the 154 women . Our results demonstrate a 6.5 % prevalence of PCOS , as defined , in a minimally biased population of Caucasian women from Spain . The polycystic ovary syndrome , hirsutism , and acne are common endocrine disorders in women 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 We assessed the prevalence of mood disturbance among women with prospect ively documented polycystic ovary syndrome ( PCOS ) . METHODS Thirty-two women with PCOS completed the Center for Epidemiological Studies -Depression Rating Scale ( CES-D ) . Clinical and biochemical characteristics were assessed . RESULTS Sixteen women had CES-D scores indicative of depression . Depression was associated with greater insulin resistance ( P=0.02 ) and higher body mass index ( P=0.05 ) . Women receiving oral contraceptives  for the treatment of PCOS were less depressed than patients not receiving treatment ( P=0.03 ) . LIMITATIONS Possible selection bias , use of a screening tool alone without further diagnostic evaluation of depression , small sample s size and lack of direct comparison with an age matched control group , should be considered in interpretation of these results . CONCLUSION Findings suggest a high prevalence of depression among women with PCOS , and an association between depression and PCOS markers BACKGROUND To evaluate the effects of long-term acipimox administration on glucose-induced insulin secretion and peripheral insulin sensitivity in polycystic ovarian syndrome ( PCOS ) , 20 PCOS subjects ( eight lean and 12 obese ) and 14 body mass index-matched controls ( seven lean and seven obese ) were investigated . METHODS Fasting blood sample s were collected for basal hormone and lipoprotein assays , after which patients underwent an oral glucose tolerance test ( OGTT ) . The following day a euglycaemic-hyperinsulinaemic clamp was performed . After 4 - 6 weeks of treatment with acipimox at a dose of 250 mg given orally three times a day , the patients repeated the study protocol . RESULTS No significant differences were found in the glucose , insulin or C-peptide responses to OGTT before and after anti-lipolytic drug administration in any group , nor was there any effect on insulin sensitivity . Concerning the lipid profile , acipimox administration led to a significant decrease of cholesterol and low-density lipoprotein levels in obese PCOS patients as well as in obese and lean controls . Lower triglycerides were found after the drug administration in both obese groups . Post-treatment free fatty acid levels were not significantly different when compared with basal values . CONCLUSIONS Acipimox does not appear to be an effective insulin-lowering drug in PCOS , even if it can be used in obese women with PCOS as an additional therapeutic agent to ameliorate the atherogenic lipid profile of the syndrome Objective To investigate trends in obesity prevalence in recent years and to predict the obesity prevalence in 2015 in European population s. Methods Data of 97 942 participants from seven cohorts involved in the European Prospect i ve Investigation into Cancer and Nutrition ( EPIC ) study participating in the Diogenes project ( named as “ Diogenes cohort ” in the following ) with weight measurements at baseline and follow-up were used to predict future obesity prevalence with logistic linear and non-linear ( leveling off ) regression models . In addition , linear and leveling off models were fitted to the EPIC-Potsdam data set with five weight measures during the observation period to find out which of these two models might provide the more realistic prediction . Results During a mean follow-up period of 6 years , the obesity prevalence in the Diogenes cohort increased from 13 % to 17 % . The linear prediction model predicted an overall obesity prevalence of about 30 % in 2015 , whereas the leveling off model predicted a prevalence of about 20 % . In the EPIC-Potsdam cohort , the shape of obesity trend favors a leveling off model among men ( R2 = 0.98 ) , and a linear model among women ( R2 = 0.99 ) . Conclusion Our data show an increase in obesity prevalence since the 1990ies , and predictions by 2015 suggests a sizeable further increase in European population s. However , the estimates from the leveling off model were considerably lower OBJECTIVE To measure the prevalence of obesity in Australian adults and to examine the associations of obesity with socioeconomic and lifestyle factors . DESIGN AusDiab , a cross-sectional study conducted between May 1999 and December 2000 , involved participants from 42 r and omly selected districts throughout Australia . PARTICIPANTS Of 20,347 eligible people aged > or = 25 years who completed a household interview , 11,247 attended the physical examination at local survey sites  ( response rate , 55 % ) . MAIN OUTCOME MEASURES Overweight and obesity defined by body mass index ( BMI ; kg/m(2 ) ) and waist circumference ( cm ) ; sociodemographic factors ( including smoking , physical activity and television viewing time ) . RESULTS The prevalence of overweight and obesity ( BMI > or = 25.0 kg/m(2 ) ; waist circumference > 80.0 cm [ women ] or > or = 94.0 cm [ men ] ) in both sexes was almost 60 % , defined by either BMI or waist circumference . The prevalence of obesity was 2.5 times higher than in 1980 . Using waist circumference , the prevalence of obesity was higher in women than men ( 34.1 % v 26.8 % ; P < 0.01 ) . Lower educational status , higher  television viewing time and lower physical activity time were each strongly associated with obesity , with television viewing time showing a stronger relationship than physical activity time . CONCLUSIONS The prevalence of obesity in Australia has more than doubled in the past 20 years . Strong positive associations between obesity and each of television viewing time and lower physical activity time confirm the influence of sedentary lifestyles on obesity , and underline the potential benefits of reducing sedentary behaviour , as well as increasing physical activity , to curb the obesity epidemic OBJECTIVE Although prospect i ve studies indicate that insulin resistance and insulin secretory dysfunction predict type 2 diabetes , they provide limited information on the relative contributions of both abnormalities to worsening glucose tolerance at different developmental stages of the disease . We therefore assessed the predictive effect of insulin resistance and insulin secretory dysfunction separately for the progression from normal glucose tolerance ( NGT ) to impaired glucose tolerance ( IGT ) and from IGT to diabetes . RESEARCH DESIGN AND METHODS  Insulin-stimulated glucose disposal ( M ) ( hyperinsulinemic clamp ) , acute insulin secretory response ( AIR ) ( 25-g intravenous glucose tolerance test ) , and body composition  ( hydrodensitometry or dual-energy X-ray absorptiometry ) were measured in 254 Pima Indians with NGT and in 145 Pima Indians with IGT , who were then followed for 0.5 - 13 years . RESULTS After follow-ups of 4.4 + /- 3.1 and 5.5 + /- 3.4 years , 79 ( 31 % ) of the subjects with initial NGT had developed IGT , and 64 ( 44 % ) of the subjects with initial IGT had developed diabetes . In proportional-hazards analyses with adjustment for age , sex , and percent body fat , low M and low AIR were independent predictors of both the progression from NGT to IGT ( relative hazards [ 95 % CI ] for 10th vs. 90th percentile : M 2.4 [ 1.2 - 4.7 ] , P < 0.02 ; AIR 2.1 [ 1.1 - 4.1 ] , P < 0.04 ) and from IGT to diabetes ( M 2.5 [ 1.3 - 5.0 ] , P < 0.01 ; AIR 1.8 [ 0.99 - 3.3 ] , P = 0.055 ) . CONCLUSIONS During each stage of the development of type 2 diabetes , insulin resistance and insulin secretory dysfunction are independent predictors of worsening glucose tolerance and are , therefore , both targets for the primary prevention of the disease OBJECTIVE --To assess the validity of the 1990 US weight guidelines for women that support a substantial gain in weight at approximately 35 years of age and recommend a range of body mass index ( 
    Output:
    