Are progranulin levels associated with polycystic ovary syndrome and its possible metabolic effects in adolescents and young women?

Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management

Diagnosing polycystic ovary syndrome (PCOS) during adolescence is challenging since normal pubertal development overlap typical features of this syndrome. The authors aim to summarize the existing evidence concerning PCOS in adolescence, particularly its diagnostic criteria and therapeutic options. A search throughout medical databases such as PubMed and MedScape was performed. Diagnostic criteria include irregular menstrual cycles according to time postmenarche and evidence of clinical hyperandrogenism and/or biochemical hyperandrogenism, provided other causes have been excluded. Polycystic ovarian morphology ought not to be used as a diagnostic criterion. Treatment should target manifestations and/or comorbidities, even in the absence of a definite diagnosis. Lifestyle interventions are the first-line treatment. Combined oral contraceptives, metformin or antiandrogens may also be considered as adjuvants. Screening for PCOS in adolescence is crucial as it allows an early intervention on the symptoms and comorbidities presented leading to better long-term reproductive and metabolic outcomes.

Levels of Trace Elements in Erythrocytes as Endocrine Disruptors in Obese and Nonobese Women with Polycystic Ovary Syndrome

Introduction: Polycystic ovary syndrome (PCOS) is one of the most commonly recognized endocrinopathies in women. The literature lacks clear data that allow any meaningful conclusions to be drawn about the influence of trace elements in erythrocytes on the biochemical parameters of PCOS. Materials and methods: This study was conducted among 47 women meeting the Rotterdam criteria for the diagnosis of polycystic ovary syndrome. The research groups included women with PCOS with different BMI values (body mass index): obese women with PCOS (PCOS with BMI ≥ 30, mean BMI index 35.4 ± 4.4 kg/m²), nonobese PCOS women (PCOS with BMI < 30, mean BMI index 25.2 ± 2.8 kg/m²), and healthy control group (CG) with a mean BMI of 23.57 ± 0.9 kg/m². The contents of trace elements in erythrocytes were determined with an inductively coupled plasma atomic emission spectrometer. Results: The only trace element showing significant differences in concentration between the studied groups was nickel (Ni). The level of nickel in the obese women with PCOS (BMI ≥ 30) was significantly higher than in nonobese women (BMI < 30). The content of other trace elements in erythrocytes did not differ significantly between the studied groups. Several significant correlations were found within each of the studied PCOS groups: in the group of obese women, the content of zinc (Zn) in erythrocytes positively correlated with prolactin, the content of magnesium (Mg) positively correlated with testosterone, and the content of manganese (Mn) negatively correlated with thyroid-stimulating hormone. In the group of nonobese women, Zn content correlated positively with testosterone, Ni with luteinizing hormone (LH) and estradiol, and Mg negatively correlated with estradiol. Conclusions: The relationship between the level of trace elements and the level of hormones suggests that, in obese women with PCOS, nickel may play a role in inhibiting the processes of folliculogenesis and ovulation. Research on trace elements and their relationship to ovulatory cycles and the development of PCOS may contribute to reducing the consequences of PCOS and, therefore, should be extended.

Progranulin and tumor necrosis factor-alpha in lean polycystic ovary syndrome patients

OBJECTIVE

In this study, levels of progranulin (PGRN) and tumor necrosis factor-alpha (TNF-α) were measured to detect the presence of inflammation in lean polycystic ovary (PCOS) patients.

METHODS

40 lean PCOS patients were assessed by Rotterdam criteria. Forty healthy women with regular menstrual cycles and without biochemical and clinical hyperandrogenism were involved in our study. Blood samples were taken from the patient and control groups for the measurement of progranulin (PGRN), tumor necrosis factor-alpha (TNF-α), lipid parameters, glucose, insulin, and other hormones.

RESULTS

Serum PGRN and TNF-α levels were significantly higher in patients with lean PCOS, compared with the control group (p = .037, p = .041). PGRN levels were positively correlated with TNF-α levels in lean PCOS patients.

CONCLUSION

PGRN is known as a ligand for the TNF-α receptor. PGRN level increase in lean PCOS patients may be due to inhibiting the inflammatory effects of TNF-α. To observe the PGRN and TNF-α connection in obesity, further study is needed in obese PCOS patients and obese control groups.

Serum Progranulin As a Risk Predictor in Patients with Acute Myocardial Infarction

BACKGROUND Although progranulin was recently proposed as an adipokine that may be involved in glucose metabolic and inflammatory diseases, the role of serum progranulin in cardiovascular disease is elusive and remains disputed. The aim of our research was to determine the concentration of serum progranulin in Chinese patients with cardiovascular disease, notably in acute myocardial infarction (AMI), and its relationship to other cardiometabolic risk factors. MATERIAL AND METHODS This prospective observational study included 342 Chinese AMI patients and 255 healthy control subjects. Serum progranulin concentrations and various cardiometabolic risk factor levels were investigated. We assessed the relationship between progranulin and other cardiometabolic risk factors. Logistic regression analysis was applied to evaluate risk factors in patients with AMI. RESULTS Progranulin levels were obviously elevated in AMI patients compared to control subjects (P=0.0001). Correlation analysis showed that progranulin levels were positively associated with coronary artery disease severity (r=0.380, P=0.0001), glucose (r=0.195, P=0.015), and myeloperoxidase (r=0.198, P=0.014). In logistic regression analysis, serum progranulin (Exp(B)=1.104, 95% CI=1.043-1.168, P=0.001), myeloperoxidase (Exp(B)=1.006, 95% CI=1.003-1.008, P=0.0001), and uric acid (Exp(B)=1.020, 95% CI=1.009-1.032, P=0.0001) were independent risk factors in AMI patients. CONCLUSIONS Patients with AMI had significantly higher serum progranulin concentrations than control subjects. This study suggests that serum progranulin is an independent risk predictor in Chinese patients with AMI.

Progranulin is increased in human and murine lipodystrophy

AIMS

Lipodystrophies (LD) are genetic or acquired disorders sharing the symptom of partial or complete adipose tissue deficiency and a dysregulation of adipokines including leptin and adiponectin. Progranulin, an adipokine with proinflammatory and insulin resistance-inducing characteristics, has not been investigated in LD so far.

METHODS

Circulating progranulin was determined in LD patients (N=37) and in age-, gender-, and body mass index-matched healthy control subjects (N=37). Additionally, we investigated progranulin expression in an LD mouse model as compared to wild-type mice. Moreover, we elucidated circulating progranulin before and during metreleptin supplementation in 10 patients with LD.

RESULTS

Median [interquartile range] circulating progranulin was increased in patients with LD (82.9 [25.9] μg/l) as compared to controls (73.6 [22.8] μg/l) (p=0.005). C-reactive protein (CRP) remained an independent and positive predictor of progranulin in multivariate analysis. Progranulin mRNA was significantly upregulated in all adipose tissue depots, i.e. visceral, subcutaneous, and brown adipose tissue, and in muscle of LD animals versus wild-type mice. Progranulin levels did not significantly change during metreleptin supplementation.

CONCLUSIONS

Progranulin serum concentration is increased in patients with LD, and shows an independent and positive correlation with CRP. Different adipose tissue depots and muscle might be potential origins of elevated progranulin.