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: OBJECTIVE To study whether there is an increased risk of glucose intolerance and hypertensive complications during pregnancy in women with polycystic ovarian syndrome ( PCOS ) who conceived after laparoscopic ovarian drilling  and to investigate if there is an adverse pregnancy outcome . METHODS This prospect i ve study took place at Salmaniya Medical Complex in Bahrain , between June 1996 and June 2003 . We compared the pregnancy and neonatal outcomes of 134 patients with PCOS who were treated with laparoscopic ovarian drilling with 479 pregnant women without PCOS ( controls ) . We used the multiple logistic regression analysis to assess the risk of PCOS on impaired glucose tolerance ( IGT ) , gestational diabetes mellitus ( GDM ) , hypertensive disorders in pregnancy ( HDP ) and premature delivery . RESULTS Subjects with PCOS had a significantly greater  prepregnancy body mass index , prevalence of obesity and nulliparity  as compared with controls . The incidence of IGT ( p=0.007 ) , GDM ( p=0.01 ) and HDP ( p=0.001 ) were significantly higher in pregnant PCOS compared with the control group . There were no significant differences in the neonatal outcomes and prevalence of premature delivery between the 2 study groups . When non-obese PCOS patients were compared with non-obese controls , the incidence of GDM ( p=0.04 ) and HDP ( p=0.004 ) were still significantly higher in the former . The prevalence of pregnancy complications were not significantly different when obese PCOS were compared with obese control patients . The PCOS was demonstrated as a risk factor for IGT ( p=0.05 ) , GDM ( p=0.03 ) and HDP ( p=0.03 ) , but not for premature delivery . CONCLUSION Women with PCOS who conceived after the drilling were at higher risk of IGT , GDM and HDP , and this risk seemed to be independent of maternal obesity 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 BACKGROUND / AIMS Insulin resistance is a common feature of both nonalcoholic fatty liver disease ( NAFLD ) and polycystic ovary syndrome ( PCOS ) , therefore , we hypothesize that PCOS and NAFLD may coexist . The aim of the present study was to determine the frequency and characteristics of NAFLD in women with PCOS . METHODS A prospect i ve study of patients with PCOS and no current pharmacological treatment was conducted . NAFLD was diagnosed by abdominal ultrasound following exclusion of alcohol consumption , viral , or autoimmune liver disease . Anthropometric variables , serum levels of glucose , insulin , lipids and aminotransferases , and HOMA index were determined . RESULTS Forty-one PCOS patients ( mean age : 24.6+/-7.2yr , mean body mass index [ BMI ] : 30.3+/-7.0kg/m(2 ) ) were included ; 26 of 41 PCOS patients ( 63.4 % ) had insulin resistance and 17 ( 41.5 % ) had NAFLD . Nine of the NAFLD patients ( 64 % ) also had abnormal aminotransferases .  Women with NAFLD and PCOS had a higher HOMA index and a higher waist-hip ratio than those with normal ultrasound . Patients with PCOS showed a higher frequency of NAFLD ( 41 % vs. 19 % ) and insulin resistance ( 63 % vs. 35.5 % ) than a control group . CONCLUSIONS NAFLD is frequent in patients with PCOS confirming a relevant clinical association between these two conditions . Women with PCOS should be screened for liver disease CONTEXT Insulin resistance , impaired glucose tolerance , and type 2 diabetes are common in women with polycystic ovary syndrome ( PCOS ) .  Obstructive sleep apnea ( OSA ) has been linked to metabolic dysfunction . We studied women with and without PCOS to determine the extent to which OSA is responsible for insulin resistance and glucose intolerance in PCOS . METHODS In a prospect i ve design , 52 women with PCOS and 21 women without PCOS of similar age and body mass index had an overnight polysomnogram and a 75-g oral glucose tolerance test . RESULTS Twenty-nine women ( 56 % ) with PCOS had OSA compared with four controls ( 19 % ) ( adjusted odds ratio 7.1 ; 95 % confidence interval , 1.7 - 45.7 ; P = 0.01 ) . PCOS women with OSA were more insulin resistant than those without OSA [ homeostasis model assessment ( HOMA ) index 5.7 + /- 0.4 vs. 3.5 + /- 0.4 ; P = 0.006 ] after controlling for age , body mass index , and ethnicity . Impaired glucose tolerance was found in 16 of 29 ( 55 % ) PCOS women with OSA and only six of 23 ( 26 % ) of those without OSA ( unadjusted P = 0.049 ) . Insulin resistance and glucose intolerance were highly correlated with the presence and severity of OSA . Among PCOS women with normal glucose tolerance , the presence of OSA was associated with a nearly 2-fold higher fasting insulin level and HOMA index . The severity of OSA was a highly significant predictor of the fasting concentrations of glucose and insulin as well as the 2-h glucose concentration and HOMA index . CONCLUSIONS OSA is a highly prevalent and important determinant of insulin resistance , glucose intolerance , and type 2 diabetes in PCOS BACKGROUND Cross-sectional studies have shown a high frequency of impaired glucose tolerance ( IGT ) and non-insulin dependent diabetes mellitus ( NIDDM ) in women with polycystic ovarian syndrome ( PCOS ) . However , little is known about the change in glucose tolerance that occurs over a period of several years in women with PCOS . METHODS Sixty-seven women with PCOS received a 75 g glucose tolerance test and measurement of lipids at baseline and at follow-up after an average time of 6.2 years . All women followed prospect ively had normal glucose tolerance ( n = 54 ) or IGT ( n = 13 ) at the start of the study . RESULTS Change in glycaemic control from baseline was frequent , with 5/54 ( 9 % ) of normoglycaemic women at baseline developing IGT and a further 4/54 ( 8 % ) moving directly from normoglycaemic to NIDDM . For women with IGT at baseline , 7/13 ( 54 % ) had NIDDM at follow-up . Body mass index ( BMI ) at baseline was an independent significant predictor of adverse change in glycaemic control . CONCLUSIONS Women with PCOS , particularly those with a high BMI , should be review ed regularly with respect to IGT or NIDDM , as the frequency of impaired glycaemic control is high , and that the rate of conversion from normal glucose tolerance to IGT or NIDDM , or from IGT to NIDDM is substantial 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 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 ch 
    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: OBJECTIVE To study whether there is an increased risk of glucose intolerance and hypertensive complications during pregnancy in women with polycystic ovarian syndrome ( PCOS ) who conceived after laparoscopic ovarian drilling  and to investigate if there is an adverse pregnancy outcome . METHODS This prospect i ve study took place at Salmaniya Medical Complex in Bahrain , between June 1996 and June 2003 . We compared the pregnancy and neonatal outcomes of 134 patients with PCOS who were treated with laparoscopic ovarian drilling with 479 pregnant women without PCOS ( controls ) . We used the multiple logistic regression analysis to assess the risk of PCOS on impaired glucose tolerance ( IGT ) , gestational diabetes mellitus ( GDM ) , hypertensive disorders in pregnancy ( HDP ) and premature delivery . RESULTS Subjects with PCOS had a significantly greater  prepregnancy body mass index , prevalence of obesity and nulliparity  as compared with controls . The incidence of IGT ( p=0.007 ) , GDM ( p=0.01 ) and HDP ( p=0.001 ) were significantly higher in pregnant PCOS compared with the control group . There were no significant differences in the neonatal outcomes and prevalence of premature delivery between the 2 study groups . When non-obese PCOS patients were compared with non-obese controls , the incidence of GDM ( p=0.04 ) and HDP ( p=0.004 ) were still significantly higher in the former . The prevalence of pregnancy complications were not significantly different when obese PCOS were compared with obese control patients . The PCOS was demonstrated as a risk factor for IGT ( p=0.05 ) , GDM ( p=0.03 ) and HDP ( p=0.03 ) , but not for premature delivery . CONCLUSION Women with PCOS who conceived after the drilling were at higher risk of IGT , GDM and HDP , and this risk seemed to be independent of maternal obesity 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 BACKGROUND / AIMS Insulin resistance is a common feature of both nonalcoholic fatty liver disease ( NAFLD ) and polycystic ovary syndrome ( PCOS ) , therefore , we hypothesize that PCOS and NAFLD may coexist . The aim of the present study was to determine the frequency and characteristics of NAFLD in women with PCOS . METHODS A prospect i ve study of patients with PCOS and no current pharmacological treatment was conducted . NAFLD was diagnosed by abdominal ultrasound following exclusion of alcohol consumption , viral , or autoimmune liver disease . Anthropometric variables , serum levels of glucose , insulin , lipids and aminotransferases , and HOMA index were determined . RESULTS Forty-one PCOS patients ( mean age : 24.6+/-7.2yr , mean body mass index [ BMI ] : 30.3+/-7.0kg/m(2 ) ) were included ; 26 of 41 PCOS patients ( 63.4 % ) had insulin resistance and 17 ( 41.5 % ) had NAFLD . Nine of the NAFLD patients ( 64 % ) also had abnormal aminotransferases .  Women with NAFLD and PCOS had a higher HOMA index and a higher waist-hip ratio than those with normal ultrasound . Patients with PCOS showed a higher frequency of NAFLD ( 41 % vs. 19 % ) and insulin resistance ( 63 % vs. 35.5 % ) than a control group . CONCLUSIONS NAFLD is frequent in patients with PCOS confirming a relevant clinical association between these two conditions . Women with PCOS should be screened for liver disease CONTEXT Insulin resistance , impaired glucose tolerance , and type 2 diabetes are common in women with polycystic ovary syndrome ( PCOS ) .  Obstructive sleep apnea ( OSA ) has been linked to metabolic dysfunction . We studied women with and without PCOS to determine the extent to which OSA is responsible for insulin resistance and glucose intolerance in PCOS . METHODS In a prospect i ve design , 52 women with PCOS and 21 women without PCOS of similar age and body mass index had an overnight polysomnogram and a 75-g oral glucose tolerance test . RESULTS Twenty-nine women ( 56 % ) with PCOS had OSA compared with four controls ( 19 % ) ( adjusted odds ratio 7.1 ; 95 % confidence interval , 1.7 - 45.7 ; P = 0.01 ) . PCOS women with OSA were more insulin resistant than those without OSA [ homeostasis model assessment ( HOMA ) index 5.7 + /- 0.4 vs. 3.5 + /- 0.4 ; P = 0.006 ] after controlling for age , body mass index , and ethnicity . Impaired glucose tolerance was found in 16 of 29 ( 55 % ) PCOS women with OSA and only six of 23 ( 26 % ) of those without OSA ( unadjusted P = 0.049 ) . Insulin resistance and glucose intolerance were highly correlated with the presence and severity of OSA . Among PCOS women with normal glucose tolerance , the presence of OSA was associated with a nearly 2-fold higher fasting insulin level and HOMA index . The severity of OSA was a highly significant predictor of the fasting concentrations of glucose and insulin as well as the 2-h glucose concentration and HOMA index . CONCLUSIONS OSA is a highly prevalent and important determinant of insulin resistance , glucose intolerance , and type 2 diabetes in PCOS BACKGROUND Cross-sectional studies have shown a high frequency of impaired glucose tolerance ( IGT ) and non-insulin dependent diabetes mellitus ( NIDDM ) in women with polycystic ovarian syndrome ( PCOS ) . However , little is known about the change in glucose tolerance that occurs over a period of several years in women with PCOS . METHODS Sixty-seven women with PCOS received a 75 g glucose tolerance test and measurement of lipids at baseline and at follow-up after an average time of 6.2 years . All women followed prospect ively had normal glucose tolerance ( n = 54 ) or IGT ( n = 13 ) at the start of the study . RESULTS Change in glycaemic control from baseline was frequent , with 5/54 ( 9 % ) of normoglycaemic women at baseline developing IGT and a further 4/54 ( 8 % ) moving directly from normoglycaemic to NIDDM . For women with IGT at baseline , 7/13 ( 54 % ) had NIDDM at follow-up . Body mass index ( BMI ) at baseline was an independent significant predictor of adverse change in glycaemic control . CONCLUSIONS Women with PCOS , particularly those with a high BMI , should be review ed regularly with respect to IGT or NIDDM , as the frequency of impaired glycaemic control is high , and that the rate of conversion from normal glucose tolerance to IGT or NIDDM , or from IGT to NIDDM is substantial 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 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 ch 
    Output:
    