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Profili NI, Castelli R, Gidaro A, Manetti R, Maioli M, Petrillo M, Capobianco G, Delitala AP. Possible Effect of Polycystic Ovary Syndrome (PCOS) on Cardiovascular Disease (CVD): An Update. J Clin Med 2024; 13:698. [PMID: 38337390 PMCID: PMC10856325 DOI: 10.3390/jcm13030698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women during the fertile period. Women with PCOS have an increased risk of developing major cardiovascular risk factors during the fertile period: obesity, impaired glucose tolerance, diabetes mellitus, dyslipidemia, and metabolic syndrome. The possible effect of PCOS on cardiovascular disease (CVD) has been reported in different studies, but the results are not clear for several reasons. Indeed, most of the studies analyzed a cohort of fertile women who, given their relatively young age, have a low frequency of cardiovascular diseases. In addition, longitudinal studies have a short follow-up period, insufficient to draw firm conclusions on this topic. Finally, pharmacological treatment is limited by the lack of specific drugs available to specifically treat PCOS. In this review, we report on studies that analyzed the possible effect of PCOS on the most common CVD (hypertension, arterial stiffness, atherosclerosis, and cardiovascular event) and available drugs used to reduce CVD in PCOS women.
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Affiliation(s)
- Nicia I. Profili
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (N.I.P.); (R.C.); (R.M.); (M.P.); (G.C.)
| | - Roberto Castelli
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (N.I.P.); (R.C.); (R.M.); (M.P.); (G.C.)
| | - Antonio Gidaro
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Luigi Sacco Hospital, 20122 Milan, Italy;
| | - Roberto Manetti
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (N.I.P.); (R.C.); (R.M.); (M.P.); (G.C.)
| | - Margherita Maioli
- Department of Biochemical Science, University of Sassari, 07100 Sassari, Italy;
| | - Marco Petrillo
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (N.I.P.); (R.C.); (R.M.); (M.P.); (G.C.)
| | - Giampiero Capobianco
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (N.I.P.); (R.C.); (R.M.); (M.P.); (G.C.)
| | - Alessandro P. Delitala
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (N.I.P.); (R.C.); (R.M.); (M.P.); (G.C.)
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Chen Y, Chen J, Li Y, Wu Y, Wu X, Zhang H, Zhang Z. Insulin-like peptide 5 is associated with insulin resistance in women with polycystic ovary syndrome. J Diabetes Complications 2023; 37:108493. [PMID: 37207506 DOI: 10.1016/j.jdiacomp.2023.108493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 04/06/2023] [Accepted: 04/24/2023] [Indexed: 05/21/2023]
Abstract
AIMS Insulin-like peptide 5 (INSL5) plays an important part in metabolic processes in vitro and in vivo. We hypothesized that INSL5 levels are associated with the presence of polycystic ovary syndrome (PCOS) and insulin resistance (IR). METHODS Circulating INSL5 levels were measured by an enzyme-linked immunosorbent assay in the PCOS group (n = 101) and control (n = 78) groups. The relationship between INSL5 and IR was evaluated by using regression models. RESULTS The levels of circulating INSL5 were elevated in the individuals with PCOS (P < 0.001) and significantly associated with homeostasis model assessment of insulin resistance (HOMA-IR, r = 0.434, P < 0.001; HOMA-IS, r = 0.432, P < 0.001; QUICKI, r = -0.504, P < 0.001). The subjects in the highest tertile of INSL5 levels were more likely to have PCOS (odds ratio: 12.591, 95 % confidence interval 2.616-60.605) as compared with the lowest tertile after adjustment for potential confounders. Furthermore, the multiple linear regression analyses after adjustment for confounders showed an independent association between INSL5 levels and HOMA-IR (β = 0.024, P < 0.001). CONCLUSIONS Circulating INSL5 concentration is linked to PCOS, possibly through increased insulin resistance.
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Affiliation(s)
- Yijie Chen
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310000, China.
| | - Jun Chen
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310000, China.
| | - Yiyi Li
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310000, China
| | - Yi Wu
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310000, China
| | - Xiaoyu Wu
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310000, China
| | - Hongyan Zhang
- Department of the Reproductive Endocrinology Division, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, Zhejiang 310008, China.
| | - Zhifen Zhang
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310000, China; Department of the Reproductive Endocrinology Division, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, Zhejiang 310008, China.
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Chen Y, Deng M, Chen Z, Han S, Chen J, Zhang H, Wang Q, Jin X, Liu W, Zhang Z. Insulin-like peptide 5 (INSL5) positively correlates with anti-Müllerian hormone (AMH) in women with the polycystic ovary syndrome: a case-control study. J Ovarian Res 2022; 15:118. [PMID: 36303231 PMCID: PMC9615208 DOI: 10.1186/s13048-022-01052-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 10/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Insulin-like peptide 5 (INSL5) is involved in both reproductive and metabolic processes in polycystic ovary syndrome (PCOS). This study aimed to evaluate the relationship between INSL5 and anti-Müllerian hormone (AMH). METHODS A retrospective case-control study was conducted in a university-based reproductive centre between December 2019 and January 2021. We included 117 women with PCOS and 100 healthy subjects from Zhejiang Province. All subjects were divided into four groups (1st-4th) based on quartiles of serum INSL5 levels. Serum INSL5 concentration was assayed using an enzyme-linked immunosorbent assay. RESULTS A significant direct association was observed between serum INSL5 and AMH levels in women with PCOS. The mean AMH level in the 1st-4th INSL5 level quartiles were 4.64, 5.20, 6.46, and 9.48 ng/ml, respectively (P < 0.001). After adjusting for age, body mass index, metabolic indices, and serum levels of oestradiol and total testosterone, AMH levels remained positively and significantly associated with INSL5 levels (P for trend < 0.001). The diagnostic value of AMH was better than that of INSL5. CONCLUSIONS INSL5 and AMH levels were significantly correlated and elevated in women with PCOS. INSL5 and AMH might be associated with increased androgen secretion and chronic anovulation in PCOS.
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Affiliation(s)
- Yijie Chen
- The Fourth School of Clinical Medicine, Hangzhou Women's Hospital, Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, 310008, Hangzhou, China.,Department of the Reproductive Endocrinology Division, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), No. 369 kunpeng Road, Shangcheng District, Hangzhou, 310008, Zhejiang, China
| | - Miao Deng
- The Fourth School of Clinical Medicine, Hangzhou Women's Hospital, Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, 310008, Hangzhou, China
| | - Zhaojing Chen
- Department of Epidemiology and Health Statistics, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China
| | - Shuyang Han
- Department of the Reproductive Endocrinology Division, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), No. 369 kunpeng Road, Shangcheng District, Hangzhou, 310008, Zhejiang, China
| | - Jun Chen
- The Fourth School of Clinical Medicine, Hangzhou Women's Hospital, Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, 310008, Hangzhou, China
| | - Hongyan Zhang
- The Fourth School of Clinical Medicine, Hangzhou Women's Hospital, Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, 310008, Hangzhou, China
| | - Qianwen Wang
- Department of Obstetrics and Gynecology, Nanjing Medical University, Nanjing, 210000, China
| | - Xuejing Jin
- The Fourth School of Clinical Medicine, Hangzhou Women's Hospital, Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, 310008, Hangzhou, China
| | - Wenhua Liu
- Department of the Reproductive Endocrinology Division, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), No. 369 kunpeng Road, Shangcheng District, Hangzhou, 310008, Zhejiang, China
| | - Zhifen Zhang
- The Fourth School of Clinical Medicine, Hangzhou Women's Hospital, Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, 310008, Hangzhou, China. .,Department of the Reproductive Endocrinology Division, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), No. 369 kunpeng Road, Shangcheng District, Hangzhou, 310008, Zhejiang, China. .,Department of Obstetrics and Gynecology, Nanjing Medical University, Nanjing, 210000, China. .,Department of fourth Clinical Medical College, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang, China.
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Liu R, Li M, Wang P, Yu M, Wang Z, Zhang GZ. Preventive online and offline health management intervention in polycystic ovary syndrome. World J Clin Cases 2022; 10:3060-3068. [PMID: 35647126 PMCID: PMC9082701 DOI: 10.12998/wjcc.v10.i10.3060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/24/2022] [Accepted: 02/20/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, hyperinsulinemia, ovarian polycystic changes, and irregular ovulation, often occurring in women of childbearing age for whom it can be a cause of infertility. Hypothalamus-pituitary-ovarian axis dysregulation is important in the pathogenesis of PCOS and the associated chronic excess of sex hormones can lead to cardiovascular and cerebrovascular diseases, diabetes, and malignancies such as endometrial cancer, and breast cancer. At present, most scholars agree that lifestyle interventions in conjunction with drug treatment can help PCOS patients achieve their goals of successful pregnancy and childbirth.
AIM To investigate the clinical effect of an online and offline (O2O) preventive health management model on PCOS with kidney deficiency and phlegm dampness.
METHODS A total of 82 patients with PCOS of the kidney deficiency and phlegm dampness type who were admitted to Beijing Luhe Hospital Affiliated to Capital Medical University from April 2019 to June 2020 were randomly divided into two groups. The treatment group was treated with oral Diane-35 for 3 mo and received preventive O2O medical health management for 6 mo (including eating and living, exercise, drug management). The control group was treated with oral Diane-35 for 3 mo and completed outpatient health education. The traditional Chinese medicine (TCM) syndrome score, acne score, hair score, sex hormone level and clinical effects were compared between the two groups before and after the intervention.
RESULTS After treatment, the TCM syndrome score, acne score, and serum luteinizing hormone/follicle stimulating hormone level were significantly lower in the treatment group than in the control group (P < 0.05). After 3 mo of treatment, the TCM syndrome curative effect index in the treatment group was 97.30% compared to 54.05% in the control group (P < 0.05), whereas the total treatment effect in the treatment group was 91.89%, compared to 54.05% in the control group (P < 0.05).
CONCLUSION An integrated therapeutic approach incorporating medication, TCM methods and social media is more effective than standard treatment for PCOS.
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Affiliation(s)
- Rui Liu
- Dermatological Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 101100, China
- Chinese Medicine Department, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China
| | - Min Li
- Chinese Medicine Department, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China
| | - Pei Wang
- Chinese Medicine Department, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China
| | - Man Yu
- Chinese Medicine Department, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China
| | - Zheng Wang
- Chinese Medicine Department, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China
| | - Guang-Zhong Zhang
- Dermatological Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 101100, China
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Alexandraki KI, Kandaraki EA, Poulia KA, Piperi C, Papadimitriou E, Papaioannou TG. Assessment of Early Markers of Cardiovascular Risk in Polycystic Ovary Syndrome. TOUCHREVIEWS IN ENDOCRINOLOGY 2021; 17:37-53. [PMID: 35118445 DOI: 10.17925/ee.2021.17.1.37] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/22/2020] [Indexed: 11/24/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a heterogeneous syndrome, with long-term sequelae from birth to senescence. The long-term effects of PCOS are attributed to several metabolic aberrations ensuing the syndrome. In a systematic review of literature regarding the cardiovascular risk factors that accompany PCOS, we found that macrovascular function has been assessed by flow-mediated dilatation (FMD), microvascular function by venous occlusion plethysmography (VOP), and arterial structure by ultrasonographic assessment of intima-media thickness (IMT) usually of the carotid artery. Contradictory results have been reported; however, in most studies, endothelial dysfunction, an early marker of atherosclerosis assessed either by haemodynamic methods such as FMD or by biochemical methods such as endothelin-1 levels, was found to be impaired. VOP is a less-studied method, with few indices altered. IMT was found to be altered in most of the included studies, but the population was more heterogeneous. Inflammatory markers, including C-reactive protein, were also found to be altered in most studies. On the other hand, a number of interventions have been shown beneficial for the markers of cardiovascular risk, in the context of insulin-sensitizers. However, other interventions such as oral contraceptive pills or statins did not consistently show a similar beneficial effect. In summary, the early identification and eventual treatment of cardiovascular clinical and biochemical risk factors may be used in clinical practice to prevent potential 'silent' triggers of cardiovascular disease.
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Affiliation(s)
- Krystallenia I Alexandraki
- Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Eleitho Practice, Athens, Greece
| | - Eleni A Kandaraki
- Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Department of Endocrinology & Diabetes Mellitus, HYGEIA Hospital, Athens, Greece
| | | | - Christina Piperi
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Theodoros G Papaioannou
- First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Alexandraki KI, Kandaraki EA, Poulia KA, Piperi C, Papadimitriou E, Papaioannou TG. Assessment of Early Markers of Cardiovascular Risk in Polycystic Ovary Syndrome. EUROPEAN ENDOCRINOLOGY 2021. [DOI: 10.17925/ee.2021.1.1.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Vahkal B, Yegorov S, Onyilagha C, Donner J, Reddick D, Shrivastav A, Uzonna J, Good SV. Immune System Effects of Insulin-Like Peptide 5 in a Mouse Model. Front Endocrinol (Lausanne) 2020; 11:610672. [PMID: 33519716 PMCID: PMC7841425 DOI: 10.3389/fendo.2020.610672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 11/16/2020] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Insulin-like peptide 5 (INSL5) is a peptide hormone with proposed actions in glucose homeostasis and appetite regulation via its cognate receptor, relaxin family peptide receptor 4 (RXFP4). Here, we look for evidence for their involvement in the immune system using a mouse model. METHODS In silico analyses: we queried public databases for evidence of expression of INSL5-RXFP4 in immune system tissues/cells (NCBI's SRA and GeoProfiles) and disorders (EMBO-EBI) and performed phylogenetic footprinting to look for evidence that they are regulated by immune-associated transcription factors (TFs). Experimental analyses: We characterized the expression and correlation of INSL5/RXFP4 and other immune system markers in central and peripheral immune organs from C57/bl6 mice in seven cohorts. We tested whether fluctuations in circulating INSL5 induce an immune response, by injecting mice with 30 μg/kg of INSL5 peptide in the peritoneum, and examining levels of immune markers and metabolic peptides in plasma. Lastly, we quantified the expression of Rxfp4 in T-cells, dendritic cells and cell lines derived from human and mouse and tested the hypothesis that co-incubation of ANA-1 cells in INSL5 and LPS alters cytokine expression. RESULTS We find Insl5 expression only in thymus (in addition to colon) where its expression was highly correlated with Il-7, a marker of thymocyte development. This result is consistent with our in silico findings that Insl5 is highly expressed in thymic DP, DN thymocytes and cortical TEC's, and with evidence that it is regulated by thymocyte-associated TF's. We find Rxfp4 expression in all immune organs, and moderately high levels in DCs, particularly splenic DCs, and evidence that it is regulated by immune-associated TF's, such as STAT's and GATA. Systemic effects: We observed significantly elevated concentrations of blood GLP-1, GIP, GCG and PYY following intraperitoneal injection of INSL5, and significantly altered expression of cytokines IL-5, IL-7, M-CSF, IL-15, IL-27 and MIP-2. Immune cell effects: Incubation of ANA-1 cells with INSL5 impeded cell growth and led to a transient elevation of IL-15 and sustained reduction in IL-1β, IL-6 and TNFα. CONCLUSION We propose that INSL5-RXFP4 play a novel role in both central and peripheral immune cell signaling.
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Affiliation(s)
- Brett Vahkal
- Department of Biology, University of Winnipeg, Winnipeg, MB, Canada
- *Correspondence: Brett Vahkal, ; Sara V. Good,
| | - Sergey Yegorov
- Department of Biology, University of Winnipeg, Winnipeg, MB, Canada
| | | | | | - Dean Reddick
- Department of Biology, University of Winnipeg, Winnipeg, MB, Canada
| | | | - Jude Uzonna
- Department of Immunology, University of Manitoba, Winnipeg, MB, Canada
| | - Sara V. Good
- Department of Biology, University of Winnipeg, Winnipeg, MB, Canada
- *Correspondence: Brett Vahkal, ; Sara V. Good,
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