Correlation of Serum Visfatin Level in Non-obese Women with Polycystic Ovary Syndrome and Matched Control

A Complete Overview of the Polycystic Ovarian Syndrome with Recent Advancement in Clinical Trial

Background:

Polycystic ovarian syndrome (PCOS) has emerged as one of the most common endocrine and metabolic disorders seen in women of childbearing age throughout the whole world. The complex pathophysiology, different diagnostic criteria, and various manifestations attached to several environmental factors, including lifestyle influences, have made it one of the most difficult disorders to treat in recent times. In addition, inadequate knowledge among patients and a lack of dedicated approved medications have only enhanced the difficulties in treating such a heterogeneous disorder.

Objective:

The main objective of this review-type paper is to provide a detailed overview of PCOS along with the current concept of a clinical stance in this complex multigenic disorder.

Method:

The following databases were used for literature searches: PubMed, Frontiers, Science Direct, Springer, Wiley, and MDPI. For the purpose of finding pertinent articles and contents, the keywords “PCOS; hirsutism; psychological burden; obesity” and others of a similar nature were utilized.

Conclusion:

PCOS is a complicated hormonal, metabolic, and psychological condition with many different clinical manifestations. It is among the most prevalent causes of infertility. Before considering any medication choices, lifestyle modifications should be considered the primary therapeutic prescription for PCOS-related infertility. According to recent studies, PCOS does not affect the risk of ovarian or breast cancer, but it does raise the risk of endometrial cancer in women of all ages. These results suggest that PCOS may increase the risk of gynaecological cancer morbidity. The following stage is ovulation stimulation, which is best accomplished with letrozole and is followed by clomiphene citrate. Women who had not responded to the first-line oral ovulatory medicine were given gonadotropins as a backup. Early detection of girls with a high propensity to develop PCOS will be made possible by a comprehensive knowledge of the condition's etiology. Adolescent PCOS will be better managed overall, related comorbidities will be prevented, and quality of life will increase with customized therapeutic approaches.

Asprosin is a Reliable Predictor of Osteoporosis in Type 2 Diabetic Postmenopausal Women: A Case-Control Study

The study evaluates Asprosin's value in diabetic postmenopausal women, examining its reliability as a predictor for osteoporosis (OP) in the second type of diabetes (T2D) women. A case-control study recruited 255 postmenopausal women attending the geriatric department of the University Hospital. They were grouped into controls (non-OP non-T2D), and study cases. The latter were subdivided into: non-OP T2D, and OP T2D postmenopausal women (85/255) for each. Serum Asprosin level showed a significant increase in postmenopausal T2D women with OP (42.51 ± 2.97 ng/mL, P < 0.001) compared with postmenopausal T2D women without OP and controls. Additionally, there is a significant interrelationship between OP radiological indicators and bone-forming hormone in T2D women, osteocalcin. Moreover, bone resorption and glycemic markers in T2D women correlated significantly and positively with Asprosin. The Receiver operator characteristic curve discriminates OP T2D postmenopausal women from non-OP T2D postmenopausal women by estimating cutoff value (> 39.3 ng/mL) at 90% sensitivity, 63.3% specificity, and P < 0.001.

The Value IRS-1 rs1801278G > A Polymorphism Testing in Evaluating Infertile Women with Polycystic Ovarian Syndrome: A Case-control Study

Background:

Polycystic ovary syndrome (PCOS) is a leading cause of infertility. Insulin resistance is a key element in pathogenesis. The insulin receptor causes phosphorylation of the insulin receptor substrate (IRS); IRS-1 rs1801278G > A polymorphism variant is the most common genetic variant associated with IR and PCOS.

Objective:

We aimed to examine the frequency of IRS-1 rs1801278G > A polymorphism variant and test its value in evaluating infertile PCOS women.

Methods:

A case-control study recruited 140 age and body-mass-matched participants in the university hospital, subdivided according to Rotterdam criteria into PCOS cases (70/140) and healthy controls (70/140). We collected demographic data, ultrasonic [antral follicles and endometrial thickness], hormonal [FSH, LH, AMH, E2], and genetic data by polymerase chain reaction for analysis.

Result:

Wild GG SNP rs1801278 G was meaningfully higher among controls (58.57%, P<0.0001). Mutant AA SNP rs1801278 was significantly higher in PCOS women (37.14%, P-value =0.0001, an odds ratio of 20.50, 95% CI (9.42-28.63) to develop PCOS. Heterogenous GA gene SNP rs1801278 showed a trend of higher frequency in PCOS patients with 44.29%; OR of 3.91, 95% CI (1.37–7.55); P = 0.422. Upon correlating infertility parameters to SNP rs1801278 G>A polymorphism, statistical differences were found with AFC, LH/FSH ratio, and serum testosterone. As for the AMH, E2, and endometrial thickness, they failed to have a statistical value.

Conclusion:

The significant correlation of genetic polymorphism to infertility parameters among PCOS women opens a new therapeutic and prognostic avenue that helps gynecologists tailor manganate for a better and safer outcome.

Can follicular fluid 8-oxo-2'-deoxyguanosine predict the clinical outcomes in ICSI cycle among couples with normospermia male?

OBJECTIVE

Oxidative stress (OS) occurs when excess free radicals damage the DNA. Moreover, 8-oxo-2'-deoxyguanosine (8-OHdG) is a well-known biomarker for OS linked to cellular damage and gene instability. However, its role in female subfertility has not been properly assessed. We aimed to examine the level of OS represented by 8-OHdG based on the cause of subfertility and to test its correlation with reproductive hormones, intracytoplasmic sperm injection (ICSI) parameters, and outcomes.

METHODS

A cross-sectional study examined 108 subfertile couples with endometriosis, polycystic ovary syndrome (PCOS), tubal factors, and unexplained infertility undergoing ICSI treatment with two different stimulation programs. We included couples whose partners had normal sperm parameters. Levels of follicular fluid (FF) 8-OHdG were correlated with the causes of subfertility and fertilization rates and compared between pregnant and non-pregnant cases.

RESULTS

Based on the causes of subfertility, FF 8-OHdG was the highest among endometriosis cases, followed by PCOS cases. Furthermore, FF 8-OHdG was higher in non-pregnant (2.37±0.75 ng/mL) vs. pregnant (1.58±0.39 ng/mL), P<0.001. A two-way analysis of variance showed that only subfertility affected ICSI outcomes, whereas the stimulation program did not. FF 8-OHdG correlated positively with female age and inversely with estradiol and good-quality embryos. The receiver operating characteristic estimated 8-OHdG cutoff value of 1.8 ng/mL predicted clinical pregnancies with 86.7% sensitivity and 74.4% specificity (P<0.001).

CONCLUSION

Higher FF 8-OHdG levels negatively impacted ICSI outcomes. FF 8-OHdG discriminated between cases of clinical pregnancy with good specificity and sensitivity. Because OS can be measured and treated, this opens up a therapeutic and prognostic avenue for improving ICSI outcomes.

The Reliability of Serum Neuregulin-4 as a Marker of Polycystic Ovarian Syndrome with Respect to Adiposity Parameters

Background: Polycystic ovarian syndrome (PCOS) is a chronic endocrinopathy of unexplained etiology linked to obesity. Neuregulin 4 (NG-4) is an adipokine synthesized primarily by brown adipose tissue; that keeps glucose and lipids in hemostasis. Earlier research tested serum NG-4 correlation with metabolic parameters in PCOS; herein, we aimed to examine serum NG-4 validity as a marker for PCOS with respect to obesity parameters and the influence of obesity on NG-4 concentrations. Methods: A cross-sectional study recruited 120 women into two groups; PCOS cases (60/120) and healthy controls (60/120). For every participant, three sets of data were recorded; anthropometric data (age, height, and weight for calculation of body mass index (BMI), waist/hip ratio, and systolic and diastolic blood pressure) hormonal levels, including serum (luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratio, prolactin, anti-Mullerian hormone (AMH), testosterone, and insulin) and biochemical biomarkers (fasting blood sugar, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), high and low-density lipoproteins (HDL and LDL), and NG-). Results: Serum NG-4 levels were significantly higher among PCOS vs. healthy controls. The univariant analysis confirmed a significant correlation of NG-4 to BMI, hormonal, and metabolic parameters. None of the obesity parameters were correlated with serum NG-4; only PCOS had an effect on serum NG-4 with p < 0.001 in multivariate analysis. At a cutoff value of 32 (ng/mL), NG-4 showed the highest sensitivity and specificity in discriminating PCOS cases with an area under the curve (AUC) of 0.97, p < 0.001. Conclusions: Serum NG-4’s strong relation to hormonal and biochemical parameters that define PCOS independent of BMI and waist-to-hip ratio makes it a reliable biomarker in diagnosing and following up PCOS cases.

Vaginal microbes confounders and implications on women's health

The vagina has diverse vaginal microbes (Vm). A disturbance in the delicate balance maintained in Vm is linked to women's obstetrical and reproductive tract problems. Vaginal microbes play an essential role in protecting the health of the female reproductive tract by alleviating gynecological infection. However, Vm profiling has many confounders that need to be addressed during sampling, including age, race, pregnancy, medical illness, and smoking. Vm profiling improves reproduction odds, may serve as a marker for genital malignancies and have a therapeutic application in menopausal women and women with cervical cancers.

The Complex Roles of Adipokines in Polycystic Ovary Syndrome and Endometriosis

Polycystic ovary syndrome (PCOS) and endometriosis are frequent diseases of the female reproductive tract causing high morbidity as they can significantly affect fertility and quality of life. Adipokines are pleiotropic signaling molecules secreted by white or brown adipose tissues with a central role in energy metabolism. More recently, their involvement in PCOS and endometriosis has been demonstrated. In this review article, we provide an update on the role of adipokines in both diseases and summarize previous findings. We also address the results of multi-omics approaches in adipokine research to examine the role of single nucleotide polymorphisms (SNPs) in genes coding for adipokines and their receptors, the secretome of adipocytes and to identify epigenetic alterations of adipokine genes that might be conferred from mother to child. Finally, we address novel data on the role of brown adipose tissue (BAT), which seems to have notable effects on PCOS. For this review, original research articles on adipokine actions in PCOS and endometriosis are considered, which are listed in the PubMed database.