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Saei Ghare Naz M, Mousavi M, Firouzi F, Momenan A, Azizi F, Ramezani Tehrani F. Association Between Insulin Resistance Indices and Liver Function Parameters Among Women With Polycystic Ovary Syndrome. Endocrinol Diabetes Metab 2024; 7:e490. [PMID: 38769719 PMCID: PMC11106557 DOI: 10.1002/edm2.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/21/2024] [Accepted: 04/27/2024] [Indexed: 05/22/2024] Open
Abstract
OBJECTIVE This study aimed to investigate whether polycystic ovary syndrome (PCOS) status changes the association between insulin resistance (IR) indices and liver function parameters among women. METHODS This is a cross-sectional, population-based study. We selected 1101 subjects aged ≥20 years from participants of Tehran Lipid and Glucose Study (TLGS). All of them had known the status of PCOS, and all variables were related to the IR indices and liver function parameters. The main outcome measures were TG/HDL-C and triglyceride-glucose (TyG) and liver function parameters (hepatic steatosis index [HSI], alanine transaminase [ALT] and aspartate transaminase [AST]). RESULT In the present study, there was no significant difference between the PCOS and the non-PCOS regarding the presence of liver function abnormalities. A model adjusted by age and BMI showed that the upper tertile of TyG index was positively associated with high AST (OR = 3.04 [95% CI: 1.20-7.68], p < 0.05), high ALT (4.76 [3.07-7.36], p < 0.05) and high HSI (8.44 [1.82-39.17], p < 0.05). Although the history of diabetes had a positive impact on elevated AST (1.66 [1.15, 2.40], p < 0.05), the third tertile of TG/HDL-C was associated with increased odds of elevated ALT (3.35 [2.21-5.06]) and HSI (6.55 [1.17-36.46]), whereas the second tertile of TG/HDL-C (OR = 2.65, CI 95%: 1.74-4.03) was also positively associated with elevated ALT. PCOS had no significant association with elevated liver function tests. CONCLUSION The highest tertile of TyG index and the TG/HDL-C ratio as a surrogate of IR might play a role in detecting abnormalities of liver function parameters among women. However, PCOS status cannot change the association between IR and liver dysfunction.
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Affiliation(s)
- Marzieh Saei Ghare Naz
- Reproductive Endocrinology Research CenterResearch Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesTehranIran
| | - Maryam Mousavi
- Reproductive Endocrinology Research CenterResearch Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesTehranIran
| | - Faezeh Firouzi
- Department of Pathology, School of MedicineShahid Beheshti University of Medical SciencesTehranIran
| | - Amir Abbas Momenan
- Prevention of Metabolic Disorders Research CenterResearch Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesTehranIran
| | - Fereidoun Azizi
- Endocrine Research CenterResearch Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesTehranIran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research CenterResearch Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesTehranIran
- The Foundation for Research & Education ExcellenceVestaria HillsAIUSA
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Kong FS, Huang P, Chen JH, Ma Y. The Novel Insight of Gut Microbiota from Mouse Model to Clinical Patients and the Role of NF-κB Pathway in Polycystic Ovary Syndrome. Reprod Sci 2024:10.1007/s43032-024-01562-3. [PMID: 38653859 DOI: 10.1007/s43032-024-01562-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
Polycystic Ovary Syndrome (PCOS) is a metabolic disorder characterized by hyperandrogenism and related symptoms in women of reproductive age. Emerging evidence suggests that chronic low-grade inflammation plays a significant role in the development of PCOS. The gut microbiota, a complex bacterial ecosystem, has been extensively studied for various diseases, including PCOS, while the underlying mechanisms are not fully understood. This review comprehensively summarizes the changes in gut microbiota and metabolites observed in PCOS and their potential association with the condition. Additionally, we discuss the role of abnormal nuclear factor κB signaling in the pathogenesis of PCOS. These findings offer valuable insights into the mechanisms of PCOS and may pave the way for the development of control and therapeutic strategies for this condition in clinical practice. By bridging the gap between mouse models and clinical patients, this review contributes to a better understanding of the interplay between gut microbiota and inflammation in PCOS, thus paving new ways for future investigations and interventions.
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Affiliation(s)
- Fan-Sheng Kong
- Department of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, 214122, Jiangsu, China
- Laboratory of Genomic and Precision Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Panwang Huang
- Department of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, 214122, Jiangsu, China
- Laboratory of Genomic and Precision Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Jian-Huan Chen
- Laboratory of Genomic and Precision Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China.
- Joint Primate Research Center for Chronic Diseases, Institute of Zoology of Guangdong Academy of Science, Jiangnan University, Wuxi, Jiangsu, China.
- Jiangnan University Brain Institute, Wuxi, Jiangsu, China.
| | - Yaping Ma
- Department of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, 214122, Jiangsu, China.
- Laboratory of Genomic and Precision Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China.
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Han W, Zhang M, Wang H, Yang Y, Wang L. Lipid accumulation product is an effective predictor of metabolic syndrome in non-obese women with polycystic ovary syndrome. Front Endocrinol (Lausanne) 2024; 14:1279978. [PMID: 38269246 PMCID: PMC10807289 DOI: 10.3389/fendo.2023.1279978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 12/06/2023] [Indexed: 01/26/2024] Open
Abstract
Objective To explore the correlation of lipid accumulation product (LAP) with metabolic syndrome (MS) and to assess the predictive value of LAP for MS risk in polycystic ovary syndrome (PCOS) with different body mass index (BMI). Methods A total of 242 PCOS patients and 150 controls were recruited and divided into normal-weight, overweight, and obese groups, then further divided into MS and without MS subgroups. Clinical and anthropometric variables and laboratory results were recorded. LAP was calculated from waist circumference (WC) and triglyceride using sex-specific formulae. Logistic regression analysis and receiver operating characteristic (ROC) curve were applied to determine and analyze the predictive value of LAP for MS. Results The prevalence of MS among PCOS patients was 45.04%, which was significantly higher than that of the controls (10%). Stratified by BMI, the incidence of MS in the normal-weight, overweight, and obese PCOS groups were 15.58%, 41.43%, and 71.58%, respectively. Logistic regression analysis indicated that LAP was an independent risk factor for MS in both normal-weight and overweight groups; however, the results were not significant in the obese group. ROC curve analysis showed that LAP had an outstanding discrimination index for MS in normal-weight (AUC=0.960, cut-off value=42.5) and overweight (AUC=0.937, cut-off value=47.93) PCOS patients, with a sensitivity of 0.917/0.931 (normal-weight/overweight) and a specificity of 0.969/0.854 (normal-weight/overweight), respectively. Conclusion Normal-weight and overweight PCOS patients also have a fairly high incidence of MS and should receive as much attention as obese patients. Compared to applying multiple clinical indicators, LAP is more convenient and facilitates acquiring early and accurate diagnoses of MS among non-obese PCOS patients using fewer MS markers.
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Affiliation(s)
- Wenju Han
- Department of Reproductive Center, Dalian Women and Children’s Medical Group, Dalian, China
- School of Public Health, China Medical University, Shenyang, China
| | - Meiwei Zhang
- Department of Reproductive Center, Dalian Women and Children’s Medical Group, Dalian, China
| | - Haiyan Wang
- Department of Reproductive Center, Dalian Women and Children’s Medical Group, Dalian, China
| | - Yitian Yang
- Department of Reproductive Center, Dalian Women and Children’s Medical Group, Dalian, China
| | - Lei Wang
- Department of Reproductive Center, Dalian Women and Children’s Medical Group, Dalian, China
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Tsinopoulou VR, Kotanidou EP, Athanasiadis N, Sapountzi E, Bacopoulou F, Ntzani E, Galli-Tsinopoulou A, Christoforidis A. The Role of the Gut Microbiome in Youth with Polycystic Ovary Syndrome: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1872. [PMID: 38136074 PMCID: PMC10741487 DOI: 10.3390/children10121872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects women of reproductive age and female adolescents. The diagnosis of PCOS is difficult during puberty due to overlapping of the criteria with normal variations of menstruation during this age period. There are insufficient data on the gut microbiome and PCOS and potential mechanisms linking the two. The present systematic review aimed to detect dysbiosis patterns in youth with PCOS, compared with healthy controls. METHODS One hundred seventy-eight studies were identified by a databases search and sixty-eight by a full-text assessment for eligibility; four were included in the systematic review and underwent quality control. RESULTS The results of the study were controversial in accordance to findings from the literature. A change in gut microbiome α diversity was found in PCOS adolescents, with no significant alterations in β diversity. Almost all studies found Firmicutes, Bacteroidetes, and Actinobacteria in abundance in both groups, with changes in family composition and fluctuations at the phylum level. A statistically significant association between these changes and clinical or biochemical features of the syndrome was described. CONCLUSIONS This systematic review confirmed gut microbiota dysbiosis in youth with PCOS. However, further data are needed to clarify these changes and to build a strategy to prevent the syndrome.
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Affiliation(s)
- Vasiliki-Rengina Tsinopoulou
- Program of Postgraduate Studies “Adolescent Medicine and Adolescent Health Care”, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.P.K.); (A.G.-T.); (A.C.)
- 2nd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA University General Hospital, Stilponos Kyriakidi 1, 54636 Thessaloniki, Greece
| | - Eleni P. Kotanidou
- Program of Postgraduate Studies “Adolescent Medicine and Adolescent Health Care”, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.P.K.); (A.G.-T.); (A.C.)
- 2nd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA University General Hospital, Stilponos Kyriakidi 1, 54636 Thessaloniki, Greece
| | - Nikolaos Athanasiadis
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Ippokration General Hospital, 54642 Thessaloniki, Greece
| | - Evdoxia Sapountzi
- 2nd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA University General Hospital, Stilponos Kyriakidi 1, 54636 Thessaloniki, Greece
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, 1st Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital Athens, 11527 Athens, Greece;
| | - Evangelia Ntzani
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, 45500 Ioannina, Greece;
| | - Assimina Galli-Tsinopoulou
- Program of Postgraduate Studies “Adolescent Medicine and Adolescent Health Care”, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.P.K.); (A.G.-T.); (A.C.)
- 2nd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA University General Hospital, Stilponos Kyriakidi 1, 54636 Thessaloniki, Greece
| | - Athanasios Christoforidis
- Program of Postgraduate Studies “Adolescent Medicine and Adolescent Health Care”, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (E.P.K.); (A.G.-T.); (A.C.)
- 1st Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Ippokration General Hospital, 54636 Thessaloniki, Greece
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Hussain L, Rana S, Abbas G, Alshammari A, Alasmari AF, Alharbi M, Zahid MT, Irfan M. Pharmacological Potential of Hippophae rhamnoides L. Nano-Emulsion for Management of Polycystic Ovarian Syndrome in Animals' Model: In Vitro and In Vivo Studies. ACS OMEGA 2023; 8:32977-32989. [PMID: 37720770 PMCID: PMC10500670 DOI: 10.1021/acsomega.3c04720] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 08/15/2023] [Indexed: 09/19/2023]
Abstract
The most common female endocrinopathy, polycystic ovarian syndrome (PCOS), generally affects women of childbearing age. Hippophae rhamnoides L. has been traditionally used to improve menstrual cyclicity. Gas chromatography by flame ionization detection analysis showed that it contained various phytoconstituents such as omega-3 fatty acid, phytosterols, palmitic acid, oleic acid, and linoleic acid. H. rhamnoides L. (HR) nano-emulsion was also formulated. HR and its encapsulated nano-emulsion (HRNE) were evaluated for the treatment of PCOS. Thirty-five healthy female adult albino rats were acquired and divided into seven groups (n = 5). Letrozole (1 mg/kg) was used for 5 weeks to induce the disease. To confirm disease (PCOS) induction, the animals were weighed weekly and their vaginal smears were analyzed daily under a microscope. After PCOS induction, animals were treated with metformin, HR, and HRNE with two different doses (0.5/kg and 1 g/kg, p.o.) for 5 weeks. At the end of the treatment, animals were euthanized, and blood was collected for hormonal assessment, lipid profiling, and liver functioning test assessment. Both the ovaries were preserved for histopathology and liver for the purpose of assessment of antioxidant potential. The results revealed that HR and HRNE at both doses improved the hormonal imbalance; follicle-stimulating hormone, estrogen, and progesterone levels are increased, while luteinizing hormone surge and testosterone level are controlled. Insulin sensitivity is improved. Ovarian histopathology showed that normal ovarian echotexture is restored with corpus luteum and mature and developing follicles. HR and HRNE also improved the lipid profile and decreased lipid peroxidation (MDA) with improved antioxidant markers (SOD, CAT, and GSH). Results were statistically analyzed by one-way analysis of variance and were considered significant only if p < 0.05. In conclusion, it can be postulated that H. rhamnoides L. proved effective in the management of PCOS and its nano-emulsion effects were statistically more significant, which might be due to better bioavailability.
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Affiliation(s)
- Liaqat Hussain
- Department
of Pharmacology, Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad 38040, Pakistan
| | - Saba Rana
- Department
of Pharmacology, Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad 38040, Pakistan
| | - Ghulam Abbas
- Department
of Pharmaceutics, Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad 38040, Pakistan
| | - Abdulrahman Alshammari
- Department
of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Post Box 2455, Riyadh 11451, Saudi Arabia
| | - Abdullah F. Alasmari
- Department
of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Post Box 2455, Riyadh 11451, Saudi Arabia
| | - Metab Alharbi
- Department
of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Post Box 2455, Riyadh 11451, Saudi Arabia
| | - Muhammad Toseef Zahid
- College
of Pharmaceutical Sciences, China Pharmaceutical
University, Nanjing 210009, China
| | - Muhammad Irfan
- Department
of Pharmaceutics, Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad 38040, Pakistan
- College
of Pharmacy, Freie Universitaet Berlin, Berlin 14195, Germany
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Zhao T, Xiao X, Li L, Tao X, He W, Zhang Q, Wu X, Yuan T. Role of kisspeptin in polycystic ovarian syndrome: A metabolomics study. Clin Endocrinol (Oxf) 2023. [PMID: 36843187 DOI: 10.1111/cen.14899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/18/2023] [Accepted: 02/23/2023] [Indexed: 02/28/2023]
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS) is a pathophysiological disease affecting reproductive and metabolic indicators. Research has shown that kisspeptin might be involved in the regulation of pituitary hormone secretion and energy metabolism. The aim of this study was to investigate the relationship between serum kisspeptin levels and abnormal metabolism in PCOS. METHODS Fifty patients with PCOS and 50 control patients were recruited for this study. Serum kisspeptin levels were measured via ELISA. High-performance liquid chromatography-tandem mass spectrometry metabolomics was used to study the changes in serum metabolism between the PCOS and control groups. RESULTS Serum kisspeptin levels were significantly elevated in individuals with PCOS compared with those in healthy controls (p = 0.011) and positively correlated with LH, T, FFA, BA, and LEP levels (p < 0.05). Significantly dysregulated expression of several metabolites was observed in the intergroup comparisons of the high-kisspeptin PCOS, low-kisspeptin PCOS, and healthy control groups. These primarily consisted of lipid, amino acid, and carbohydrate metabolites, among which palmitic acid and N-formylkynurenine levels were lower in the high-kisspeptin group than in controls. Metabolite set enrichment analysis was also performed based on metabolites in the KEGG database. The results showed that owing to the differences in kisspeptin concentrations in individuals with PCOS, there was a significant difference in amino acid and pyruvate metabolism. CONCLUSIONS Kisspeptin could be a potential biomarker for the diagnosis of PCOS and plays an important role in metabolic regulation in individuals with PCOS. In addition, metabolomics provides a promising method for the study of metabolic abnormalities in individuals with PCOS, which might contribute to our understanding of its mechanisms.
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Affiliation(s)
- Ting Zhao
- Department of Gynacologist, The First People's Hospital of Yunnan Province, Kunming, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Xiao Xiao
- Department of Gynacologist, The First People's Hospital of Yunnan Province, Kunming, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Lingchuan Li
- Department of Gynacologist, The First People's Hospital of Yunnan Province, Kunming, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Xinghua Tao
- Department of Gynacologist, The First People's Hospital of Yunnan Province, Kunming, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Wenli He
- Department of Gynacologist, The First People's Hospital of Yunnan Province, Kunming, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Qiong Zhang
- Department of Gynacologist, The First People's Hospital of Yunnan Province, Kunming, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Xiaomei Wu
- Department of Gynacologist, The First People's Hospital of Yunnan Province, Kunming, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Tao Yuan
- Department of Gynacologist, The First People's Hospital of Yunnan Province, Kunming, China
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
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Olaniyi KS, Areloegbe SE, Oyeleke MB. Acetate restores hypothalamic-adipose kisspeptin status in a rat model of PCOS by suppression of NLRP3 immunoreactivity. Endocrine 2022; 78:628-640. [PMID: 36114434 DOI: 10.1007/s12020-022-03191-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/02/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Polycystic ovary syndrome (PCOS) is a complex reproductive event that is delineated by endocrine/metabolic disorders. Alteration of kisspeptin status in the hypothalamus and adipose tissue is critical to increased endocrine/metabolic derangements in PCOS individuals, aggravating the clinical manifestation of PCOS and its complications. Short chain fatty acids (SCFAs) are crucial modulators of metabolic homeostasis. However, the role of SCFAs, particularly acetate on hypothalamic-adipose kisspeptin status (HAKS) in PCOS model is unknown. The present study hypothesized acetate as a key player in restoration of deranged HAKS, associated with experimental PCOS model. METHODS Three groups (n = 6/group) of female Wistar rats (120-150 g) were used. The groups were treated (po) for 21 days with vehicle, letrozole (1 mg/kg) with/without acetate (200 mg/kg) respectively. RESULTS Letrozole-treated animals had impaired glucose homeostasis, elevated testosterone, leptin and LH/FSH ratio and decreased GnRH and adiponectin with ovarian tissues revealing degenerated follicles and disrupted morphology. These animals also showed increased concentration of hypothalamic triglyceride (TG)/total cholesterol (TC), free fatty acid (FFA), and decreased concentration of TG/TC/FFA in visceral adipose tissue (VAT) with an increase in hypothalamic and VAT malondialdehyde, NF-κB/TNF-α and decreased glutathione/G6PD and hypothalamic but not VAT kisspeptin. Immunohistochemical analysis revealed the expression of NLRP3 inflammasome in the hypothalamus and VAT and all these changes were attenuated by acetate. CONCLUSIONS Altogether, the present results demonstrate that PCOS is characterized with hypothalamic-adipose inflammation, associated with immunohistochemical expression of NLRP3 with significant alteration of hypothalamic but not adipose kisspeptin. The results suggest that acetate restores kisspeptin status in PCOS animals. This beneficial effect is accompanied by repressed NLRP3 immunoreactivity.
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Affiliation(s)
- Kehinde S Olaniyi
- Cardio/Repro-metabolic and Microbiome Research Unit, Department of Physiology, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, 360101, Nigeria.
| | - Stephanie E Areloegbe
- Cardio/Repro-metabolic and Microbiome Research Unit, Department of Physiology, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, 360101, Nigeria
| | - Mosunmola B Oyeleke
- Cardio/Repro-metabolic and Microbiome Research Unit, Department of Physiology, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, 360101, Nigeria
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Jie HY, Zhou X, Zhao MP, Hu M, Mai QY, Zhou CQ. Pregnancy outcomes in patients with polycystic ovary syndrome who conceived after single thawed blastocyst transfer: a propensity score-matched study. BMC Pregnancy Childbirth 2022; 22:718. [PMID: 36127673 PMCID: PMC9487057 DOI: 10.1186/s12884-022-05011-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background It remains unclear whether polycystic ovary syndrome (PCOS) is an independent risk factor for pregnancy complications in women undergoing assisted reproductive technology (ART) treatment. For the integrative treatment of PCOS patients, it is still important to investigate the pregnancy outcomes of PCOS patients after adjusting for potential biases, such as body mass index, embryo quality and endometrial preparation method. Methods This retrospective cohort study ultimately included a total of 336 PCOS patients who conceived after single thawed blastocyst transfer in the PCOS group and 2,325 patients in the control group from January 2018 to December 2020. A propensity score matching (PSM) model was used, and 336 PCOS patients were matched with 336 patients in the control group. Results Before PSM, no differences in the miscarriage rate, pregnancy complication rate, preterm birth rate, or live birth rate were found between the PCOS group and the control group. After PSM, the late miscarriage rate of the PCOS group was significantly higher than that of the control group (3.3% vs. 0.6%, P = 0.040), although the early miscarriage rates were similar (14.0% vs. 13.7%). The rates of pregnancy complications, preterm birth and live birth in the PCOS group were comparable to those in the matched control group (P = 0.080, P = 0.105, P = 0.109, respectively). The neonatal weights of male infants and female infants were similar between the two groups (P = 0.219, P = 0.169). Subgroup analysis showed that PCOS patients with homeostasis model assessment of insulin resistance (HOMA-IR) levels ≥ 2.49 had a significantly increased risk of preterm birth compared with those with HOMA-IR levels < 1.26 and 1.26 ≤ HOMA-IR levels < 2.49 (26.0% vs. 6.0% vs. 9.8%, P = 0.005). PCOS patients with total testosterone levels ≥ 0.7 ng/ml had a higher early miscarriage rate but a lower late miscarriage rate than those with total testosterone levels < 0.7 ng/ml (29.4% vs. 12.3%, 0% vs. 3.6%, respectively, P = 0.032). Conclusions PCOS is an independent risk factor for late miscarriage in patients conceived after a single thawed blastocyst transfer, even after adjusting for biases. Among PCOS patients, insulin resistance and hyperandrogenism are associated with a higher risk of preterm birth and early miscarriage, respectively. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-05011-4.
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Affiliation(s)
- Hui-Ying Jie
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Xiu Zhou
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Ming-Peng Zhao
- Department of Reproductive Medicine, Department of Obstetrics and Gynaecology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Min Hu
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Qing-Yun Mai
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Can-Quan Zhou
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China.
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Mohd Shukri MF, Norhayati MN, Badrin S, Abdul Kadir A. Effects of L-carnitine supplementation for women with polycystic ovary syndrome: a systematic review and meta-analysis. PeerJ 2022; 10:e13992. [PMID: 36132218 PMCID: PMC9484467 DOI: 10.7717/peerj.13992] [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: 03/28/2022] [Accepted: 08/11/2022] [Indexed: 01/19/2023] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is a disorder in reproductive age women and is characterized by hyperandrogenic anovulation and oligo-amenorrhea, which leads to infertility. Anovulation in PCOS is associated with low follicle-stimulating hormone levels and the arrest of antral follicle development in the final stages of maturation. L-carnitine (LC) plays a role in fatty acid metabolism, which is found to be lacking in PCOS patients. This systematic review and meta-analysis aimed to determine the effectiveness of LC supplementation for patients with PCOS. Methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychological Information Database (PsycINFO), and the World Health Organization International Clinical Trials Registry Platform for all randomized control trials, comparing LC alone or in combination with other standard treatments for the treatment of PCOS from inception till June 2021. We independently screened titles and abstracts to identify available trials, and complete texts of the trials were checked for eligibility. Data on the methods, interventions, outcomes, and risk of bias from the included trials were independently extracted by the authors. The estimation of risk ratios and mean differences with a 95 percent confidence interval (CI) was performed using a random-effects model. Results Nine studies with 995 participants were included in this review. Five comparison groups were involved. In one comparison group, LC reduced the fasting plasma glucose (FPG) (mean differences (MD) -5.10, 95% CI [-6.25 to -3.95]; P = 0.00001), serum low-density lipoprotein (LDL) (MD -25.00, 95% CI [-27.93 to -22.07]; P = 0.00001), serum total cholesterol (MD -21.00, 95% CI [-24.14 to -17.86]; P = 0.00001), and serum triglyceride (TG) (MD -9.00, 95% CI [-11.46 to -6.54]; P = 0.00001) with moderate certainty of evidence. Another comparison group demonstrated that LC lowers the LDL (MD -12.00, 95% CI [-15.80 to -8.20]; P = 0.00001), serum total cholesterol (MD -24.00, 95% CI [-27.61 to -20.39]; P = 0.00001), and serum TG (MD -19.00, 95% CI [-22.79 to -15.21]; P = 0.00001) with moderate certainty of evidence. Conclusion There was low to moderate certainty of evidence that LC improves Body Mass Index (BMI) and serum LDL, TG, and total cholesterol levels in women with PCOS.
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Affiliation(s)
| | - Mohd Noor Norhayati
- Department of Family Medicine, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Salziyan Badrin
- Department of Family Medicine, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Azidah Abdul Kadir
- Department of Family Medicine, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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10
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Dev D, Dutta P. A novel approach to treat polycystic ovarian syndrome (PCOS) patients. Biomedicine (Taipei) 2022. [DOI: 10.51248/.v42i4.1503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The precise underlying pathophysiology for the progression of Polycystic Ovary Syndrome (PCOS) remains unclear. Eminent scientists and clinicians normally target the given clinical symptoms to curtail the syndrome in a given period. For years, multiple varied techniques have been developed and followed to treat this disorder. A novel non-invasive, pain-free treatment ‘Neurotherapy’ has been highlighted in this article that can be considered as a boon in the field of treatment and healing. This study aimed to evaluate the effectiveness of Neurotherapy in a patient with PCOS. A regular case of PCOS with ultrasonography denoting bilateral ovarian cysts is hereby discussed. Post the therapy, ultrasound reports have shown no trace of cysts in both the ovaries thereby concluding that this novel therapy can be very fruitful in treating one of the most common gynaecology related female problems, without any side effects or after-effects.
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11
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Yu Y, Tan P, Zhuang Z, Wang Z, Zhu L, Qiu R, Xu H. Untargeted metabolomic approach to study the serum metabolites in women with polycystic ovary syndrome. BMC Med Genomics 2021; 14:206. [PMID: 34416878 PMCID: PMC8379735 DOI: 10.1186/s12920-021-01058-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 08/11/2021] [Indexed: 12/30/2022] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is not only a kind of common endocrine syndrome but also a metabolic disorder, which harms the reproductive system and the whole body metabolism of the PCOS patients worldwide. In this study, we aimed to investigate the differences in serum metabolic profiles of the patients with PCOS compared to the healthy controls. Material and methods 31 PCOS patients and 31 matched healthy female controls were recruited in this study, the clinical characteristics data were recorded, the laboratory biochemical data were detected. Then, we utilized the metabolomics approach by UPLC-HRMS technology to study the serum metabolic changes between PCOS and controls. Results The metabolomics analysis showed that there were 68 downregulated and 78 upregulated metabolites in PCOS patients serum compared to those in the controls. These metabolites mainly belong to triacylglycerols, glycerophosphocholines, acylcarnitines, diacylglycerols, peptides, amino acids, glycerophosphoethanolamines and fatty acid. Pathway analysis showed that these metabolites were enriched in pathways including glycerophospholipid metabolism, fatty acid degradation, fatty acid biosynthesis, ether lipid metabolism, etc. Diagnosis value assessed by ROC analysis showed that the changed metabolites, including Leu–Ala/Ile–Ala, 3-(4-Hydroxyphenyl) propionic acid, Ile–Val/Leu–Val, Gly–Val/Val–Gly, aspartic acid, DG(34:2)_DG(16:0/18:2), DG(34:1)_DG(16:0/18:1), Phe–Trp, DG(36:1)_DG(18:0/18:1), Leu–Leu/Leu–Ile, had higher AUC values, indicated a significant role in PCOS. Conclusion The present study characterized the difference of serum metabolites and related pathway profiles in PCOS patients, this finding hopes to provide potential metabolic markers for the prognosis and diagnosis of this disease.
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Affiliation(s)
- Ying Yu
- Institute of Laboratory Medicine, Jiangsu Key Laboratory of Laboratory Medicine, Jiangsu University, Zhenjiang, 210013, Jiangsu, People's Republic of China.,Department of Laboratory Medicine, Chinese Medicine Hospital of Zhejiang, Hangzhou, 310006, Zhejiang, People's Republic of China
| | - Panli Tan
- Department of Laboratory Medicine, Chinese Medicine Hospital of Zhejiang, Hangzhou, 310006, Zhejiang, People's Republic of China
| | - Zhenchao Zhuang
- Department of Laboratory Medicine, Chinese Medicine Hospital of Zhejiang, Hangzhou, 310006, Zhejiang, People's Republic of China
| | - Zhejiong Wang
- Department of Laboratory Medicine, Chinese Medicine Hospital of Zhejiang, Hangzhou, 310006, Zhejiang, People's Republic of China
| | - Linchao Zhu
- Department of Laboratory Medicine, Chinese Medicine Hospital of Zhejiang, Hangzhou, 310006, Zhejiang, People's Republic of China
| | - Ruyi Qiu
- Department of Laboratory Medicine, Chinese Medicine Hospital of Zhejiang, Hangzhou, 310006, Zhejiang, People's Republic of China
| | - Huaxi Xu
- Institute of Laboratory Medicine, Jiangsu Key Laboratory of Laboratory Medicine, Jiangsu University, Zhenjiang, 210013, Jiangsu, People's Republic of China.
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12
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Liu J, Wu Q, Hao Y, Jiao M, Wang X, Jiang S, Han L. Measuring the global disease burden of polycystic ovary syndrome in 194 countries: Global Burden of Disease Study 2017. Hum Reprod 2021; 36:1108-1119. [PMID: 33501984 PMCID: PMC7970729 DOI: 10.1093/humrep/deaa371] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 12/10/2020] [Indexed: 12/15/2022] Open
Abstract
STUDY QUESTION What is the current burden of polycystic ovary syndrome (PCOS) at the global, regional, and country-specific levels in 194 countries and territories according to age and socio-demographic index (SDI)? SUMMARY ANSWER Slight increases in age-standardized incidence of PCOS and associated disability-adjusted life-years (DALYs) were evidenced among women of reproductive age (15–49 years) from 2007 to 2017 at the global level, and in most regions and countries. WHAT IS KNOWN ALREADY No detailed quantitative estimates of the PCOS incidence and DALYs by age and SDI in these 194 countries and territories have been published previously. STUDY DESIGN, SIZE, DURATION An age- and SDI-stratified systematic analysis of the PCOS incidence and DALYs across 194 countries and territories has been performed. PARTICIPANTS/MATERIALS, SETTING, METHODS We used data from the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2017 to estimate the total and age-standard PCOS incidence rates and DALYs rates among women of reproductive age in both 2007 and 2017, and the trends in these parameters from 2007 to 2017. MAIN RESULTS AND THE ROLE OF CHANCE Globally, women of reproductive age accounted for 1.55 million (95% uncertainty intervals (UIs): 1.19–2.08) incident cases of PCOS and 0.43 million (0.19–0.82) associated DALYs. The global age-standardized PCOS incidence rate among women of reproductive age increased to 82.44 (64.65–100.24) per 100 000 population in 2017, representing an increase of 1.45% (1.43–1.47%) from 2007 to 2017. The rate of age-standardized DALYs increased to 21.96 (12.78–31.15) per 100 000 population in 2017, representing an increase of 1.91% (1.89–1.93%) from 2007 to 2017. Over the study period, the greatest increase in the age-standardized PCOS incidence and DALYs rates were observed in the middle-SDI and high-middle SDI regions, respectively. At the GBD regional level, the highest age-standardized incidence and DALY rates in 2017 were observed in Andean Latin America, whereas the largest percentage increases in both rates from 2007 to 2017 were observed in Tropical Latin America. At the national level, Ecuador, Peru, Bolivia, Japan, and Bermuda had the highest age-standardized incidence rates and DALYs rates in both 2007 and 2017. The highest increases in both the age-standardized incidence rates and DALYs rates from 2007 to 2017 were observed in Ethiopia, Brazil, and China. LIMITATIONS, REASONS FOR CAUTION Although the GBD (2017) study aimed to gather all published and unpublished data, the limited availability of data in some regions might have led to the estimation of wide UIs. Additionally, the PCOS phenotype is complicated and the diagnostic criteria are constantly changing. Consequently, the incidence of PCOS might have been underestimated. WIDER IMPLICATIONS OF THE FINDINGS Knowledge about the differences in the PCOS burden across various locations will be valuable for the allocation of resources and formulation of effective preventive strategies. STUDY FUNDING/COMPETING INTEREST(S) The study was supported by grants from the Innovative Talent Support Plan of the Medical and Health Technology Project in Zhejiang Province (2021422878), Ningbo Science and Technology Project (202002N3152), Ningbo Health Branding Subject Fund (PPXK2018-02), Sanming Project of Medicine in Shen-zhen (SZSM201803080), and National Social Science Foundation (19AZD013). No potential conflicts of interest relevant to this article were reported. TRIAL REGISTRATION NUMBER N/A
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Affiliation(s)
- Jingjing Liu
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China.,Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China.,Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang Province, PR China.,Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, PR China
| | - Qunhong Wu
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang Province, PR China.,Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, PR China
| | - Yanhua Hao
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang Province, PR China.,Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, PR China
| | - Mingli Jiao
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang Province, PR China.,Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, PR China
| | - Xing Wang
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang Province, PR China.,Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, PR China
| | - Shengchao Jiang
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang Province, PR China.,Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, PR China
| | - Liyuan Han
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China.,Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China
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13
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Barlampa D, Bompoula MS, Bargiota A, Kalantaridou S, Mastorakos G, Valsamakis G. Hypothalamic Inflammation as a Potential Pathophysiologic Basis for the Heterogeneity of Clinical, Hormonal, and Metabolic Presentation in PCOS. Nutrients 2021; 13:520. [PMID: 33562540 PMCID: PMC7915850 DOI: 10.3390/nu13020520] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 12/12/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age. It is a heterogeneous condition characterized by reproductive, endocrine, metabolic, and psychiatric abnormalities. More than one pathogenic mechanism is involved in its development. On the other hand, the hypothalamus plays a crucial role in many important functions of the body, including weight balance, food intake, and reproduction. A high-fat diet with a large amount of long-chain saturated fatty acids can induce inflammation in the hypothalamus. Hypothalamic neurons can sense extracellular glucose concentrations and participate, with a feedback mechanism, in the regulation of whole-body glucose homeostasis. When consumed nutrients are rich in fat and sugar, and these regulatory mechanisms can trigger inflammatory pathways resulting in hypothalamic inflammation. The latter has been correlated with metabolic diseases, obesity, and depression. In this review, we explore whether the pattern and the expansion of hypothalamic inflammation, as a result of a high-fat and -sugar diet, may contribute to the heterogeneity of the clinical, hormonal, and metabolic presentation in PCOS via pathophysiologic mechanisms affecting specific areas of the hypothalamus. These mechanisms could be potential targets for the development of effective therapies for the treatment of PCOS.
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Affiliation(s)
- Danai Barlampa
- Unit of Endocrinology, Aretaieion University Hospital, Medical School of Athens, Ethnikon and Kapodistriakon University of Athens, Athens, Vasilisis Sofia Avenue 76, 115 28 Athens, Greece; (D.B.); (G.V.)
| | - Maria Sotiria Bompoula
- Reproductive Endocrinology Unit, 3nd University Department of Obs & Gynae, Attikon University Hospital, Medical School of Athens, Ethnikon and Kapodistriakon University of Athens, 12462 Athens, Greece; (M.S.B.); (S.K.)
| | - Alexandra Bargiota
- Department of Endocrinology and Metabolic Disorders, University Hospital of Larissa, Medical School of Larissa, University of Thessaly, 41334 Larissa, Greece;
| | - Sophia Kalantaridou
- Reproductive Endocrinology Unit, 3nd University Department of Obs & Gynae, Attikon University Hospital, Medical School of Athens, Ethnikon and Kapodistriakon University of Athens, 12462 Athens, Greece; (M.S.B.); (S.K.)
| | - George Mastorakos
- Unit of Endocrinology, Aretaieion University Hospital, Medical School of Athens, Ethnikon and Kapodistriakon University of Athens, Athens, Vasilisis Sofia Avenue 76, 115 28 Athens, Greece; (D.B.); (G.V.)
| | - Georgios Valsamakis
- Unit of Endocrinology, Aretaieion University Hospital, Medical School of Athens, Ethnikon and Kapodistriakon University of Athens, Athens, Vasilisis Sofia Avenue 76, 115 28 Athens, Greece; (D.B.); (G.V.)
- Reproductive Endocrinology Unit, 3nd University Department of Obs & Gynae, Attikon University Hospital, Medical School of Athens, Ethnikon and Kapodistriakon University of Athens, 12462 Athens, Greece; (M.S.B.); (S.K.)
- Department of Endocrinology and Metabolic Disorders, University Hospital of Larissa, Medical School of Larissa, University of Thessaly, 41334 Larissa, Greece;
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Abstract
Mounting evidence suggests a role for mitochondrial dysfunction in the pathogenesis of many diseases, including type 2 diabetes, aging, and ovarian failure. Because of the central role of mitochondria in energy production, heme biosynthesis, calcium buffering, steroidogenesis, and apoptosis signaling within cells, understanding the molecular mechanisms behind mitochondrial dysregulation and its potential implications in disease is critical. This review will take a journey through the past and summarize what is known about mitochondrial dysfunction in various disorders, focusing on metabolic alterations and reproductive abnormalities. Evidence is presented from studies in different human populations, and rodents with genetic manipulations of pathways known to affect mitochondrial function.
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Affiliation(s)
- Manasi Das
- VA San Diego Healthcare System, San Diego, California
- Department of Medicine, Division of Endocrinology and Metabolism, University of California, San Diego, La Jolla, California
| | - Consuelo Sauceda
- VA San Diego Healthcare System, San Diego, California
- Department of Medicine, Division of Endocrinology and Metabolism, University of California, San Diego, La Jolla, California
| | - Nicholas J G Webster
- VA San Diego Healthcare System, San Diego, California
- Department of Medicine, Division of Endocrinology and Metabolism, University of California, San Diego, La Jolla, California
- Moores Cancer Center, University of California, San Diego, La Jolla, California
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15
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Tian W, Zhang H, Zhang Y, Wang Y, Zhang Y, Xue F, Song X, Zhang H. High level of visfatin and the activation of Akt and ERK1/2 signaling pathways are associated with endometrium malignant transformation in polycystic ovary syndrome. Gynecol Endocrinol 2020; 36:156-161. [PMID: 31452406 DOI: 10.1080/09513590.2019.1650340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This study aimed to assess the clinicopathological significance of serum levels and endometrium tissue expression of visfatin in polycystic ovary syndrome (PCOS) patients. A total of 80 PCOS patients and 80 matching controls were included in this study. We analyzed the relationship between the expression of visfatin in endometrium and clinicopathological characteristics in PCOS patients. The correlation between the expression of visfatin and p-Akt, Akt, p-ERK1/2, and ERK1/2 in PCOS tissues was evaluated as well. Visfatin expression in PCOS endometrial tissues were significantly higher than those in controls (p = .001). The expression of phosphorylation of Akt and ERK1/2 were significantly higher in PCOS endometrium tissues compared to controls (p < .05). Moreover, a high expression of tissue visfatin in PCOS tissues was positively correlated with the expression of p-Akt (p = .015), and p-ERK1/2 (p = .013). Western blotting revealed that protein expression of visfatin in PCOS patients with endometrial hyperplasia and cancer was higher than that in patients with normal endometrium tissues, and the difference was statistically significant (p = .027). The expression of p-Akt (p = .018) and p-ERK1/2 (p = .035) in PCOS patients with endometrial hyperplasia and cancer was significantly higher than that in patients with normal endometrium tissues. Visfatin may be a potential biomarker for endometrial malignant transformation in PCOS patients.
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Affiliation(s)
- Wenyan Tian
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Huixia Zhang
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Yan Zhang
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Yingmei Wang
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Yanfang Zhang
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Fengxia Xue
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Xueru Song
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Huiying Zhang
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
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16
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Deswal R, Nanda S, Dang AS. Single nucleotide polymorphisms in treatment of polycystic ovary syndrome: a systematic review. Drug Metab Rev 2019; 51:612-622. [PMID: 31549867 DOI: 10.1080/03602532.2019.1667380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
As 15-20% of reproductive aged females are suffering from polycystic ovary syndrome (PCOS), a large number of pharmacological preparations are frequently available in the market for the treatment of PCOS; however, they seem to be ineffective and cause undesirable side effects. This has emphasized the need to optimize dosage regimens for individualized treatment. The objective of this systematic review is to review single nucleotide polymorphisms (SNPs) associated with drugs used for the treatment of PCOS to understand pharmacogenetics variability of patients to drug response there by helping clinicians in designing tailored treatments and possibly reducing adverse drug reactions. A comprehensive electronic literature search was conducted to highlight some clinically relevant SNPs that act to influence PCOS and associated co-morbidities. A total of 16 studies were included in this review. These genetic variations can be used as a potential target for pharmacotherapy and pharmacogenetic clinical trials for better diagnosis, management, and treatment planning.
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Affiliation(s)
- Ritu Deswal
- Centre for Medical Biotechnology, Maharshi Dayanand University, Rohtak, India
| | - Smiti Nanda
- Department of Obstetrics and Gynecology, PG Institute of Medical Sciences, Rohtak, India
| | - Amita Suneja Dang
- Centre for Medical Biotechnology, Maharshi Dayanand University, Rohtak, India
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17
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Rasool SUA, Ashraf S, Nabi M, Rashid F, Fazili KM, Amin S. Elevated fasting insulin is associated with cardiovascular and metabolic risk in women with polycystic ovary syndrome. Diabetes Metab Syndr 2019; 13:2098-2105. [PMID: 31235143 DOI: 10.1016/j.dsx.2019.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 05/06/2019] [Indexed: 12/16/2022]
Abstract
AIMS PCOS is associated with various immediate and long term health complications. The aim of this study was to investigate the association of serum fasting insulin concentration with cardiovascular and metabolic risk factors in women with polycystic ovary syndrome. METHODS A total of 349 women, 249 women with polycystic ovary syndrome and 100 age-matched healthy controls, were recruited in this case-control study. Fasting insulin and various other biochemical, hormonal and clinical parameters were measured in all participants. The correlation of insulin with cardiometabolic risk factors was evaluated in PCOS women with normal and high serum insulin concentration. RESULTS Fasting Insulin, BMI, WHR, FAI, LH: FSH, HOMA, QUICKI were significantly higher in PCOS women compared with healthy controls (p < 0.01). Fasting insulin showed a positive correlation with more cardiovascular and metabolic risk factors in PCOS compared to controls. The BMI, BAI, LAP, HOMA IR, QUICKI and FAI were significantly higher (all p < 0.05) in PCOS patients with higher insulin levels than with PCOS women with normal levels. CONCLUSION Fasting insulin is an important determinant in the pathogenesis of obesity and hyperandrogenism in PCOS. It is associated with an increased risk of cardiovascular and metabolic disorders in women with PCOS.
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Affiliation(s)
| | - Sairish Ashraf
- Department of Biochemistry, University of Kashmir, India.
| | - Mudasar Nabi
- Department of Biochemistry, University of Kashmir, India.
| | - Fouzia Rashid
- Clinical Biochemistry, University of Kashmir, India.
| | | | - Shajrul Amin
- Department of Biochemistry, University of Kashmir, India.
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18
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Alterations of Sphingolipid Metabolism in Different Types of Polycystic Ovary Syndrome. Sci Rep 2019; 9:3204. [PMID: 30824725 PMCID: PMC6397209 DOI: 10.1038/s41598-019-38944-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 12/07/2018] [Indexed: 02/07/2023] Open
Abstract
The roles of sphingolipids in polycystic ovary syndrome (PCOS) are still unknown. This study aimed to investigate the sphingolipid characteristics for different types of PCOS using liquid chromatography-mass spectrometry (LC-MS). A total of 107 women with PCOS and 37 healthy women as normal controls were studied. PCOS patients were further classified into non-obesity with insulin resistance (IR) (NOIR), obesity with IR (OIR), and non-obesity and non-IR (NIR) subgroups. A total of 87 serum sphingolipids, including 9 sphingosines, 3 sphinganines, 1 sphingosine-1-phosphate (S1P), 19 ceramides (Cers), 1 ceramide-1-phosphate, 44 sphingomyelins (SMs), 4 hexosylceramides, and 6 lactosylceramides (LacCers) were analyzed using an improved sphingolipidomic approach based on LC-MS. Notable elevations in the levels of S1P, Cer, and SM were observed in PCOS patients when compared with healthy women, and SM species with long saturated acyl chains showed potential as novel biomarkers of PCOS. In addition, the level of LacCer was only elevated in NIR, and there was almost no change in NOIR and OIR. This study is the first to report the comprehensive sphingolipidomic profiling of different subgroups of PCOS with or without IR or obesity and suggests that serum sphingolipids might be useful as diagnostic biomarkers for different types of PCOS.
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19
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Urinary steroid profiling in women hints at a diagnostic signature of the polycystic ovary syndrome: A pilot study considering neglected steroid metabolites. PLoS One 2018; 13:e0203903. [PMID: 30308019 PMCID: PMC6181287 DOI: 10.1371/journal.pone.0203903] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 08/29/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Although the polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women with vast metabolic consequences, its etiology remains unknown and its diagnosis is still made by exclusion. This study aimed at characterizing a large number of urinary steroid hormone metabolites and enzyme activities in women with and without PCOS in order to test their value for diagnosing PCOS. METHODS Comparative steroid profiling of 24h urine collections using an established in-house gas-chromatography mass spectrometry method. Data were collected mostly prospectively. Patients were recruited in university hospitals in Switzerland. Participants were 41 women diagnosed with PCOS according to the current criteria of the Androgen Excess and PCOS Society Task Force and 66 healthy controls. Steroid profiles of women with PCOS were compared to healthy controls for absolute metabolite excretion and for substrate to product conversion ratios. The AUC for over 1.5 million combinations of metabolites was calculated in order to maximize the diagnostic accuracy in patients with PCOS. Sensitivity, specificity, PPV, and NPV were indicated for the best combinations containing 2, 3 or 4 steroid metabolites. RESULTS The best single discriminating steroid was androstanediol. The best combination to diagnose PCOS contained four of the forty measured metabolites, namely androstanediol, estriol, cortisol and 20βDHcortisone with AUC 0.961 (95% CI 0.926 to 0.995), sensitivity 90.2% (95% CI 76.9 to 97.3), specificity 90.8% (95% CI 81.0 to 96.5), PPV 86.0% (95% CI 72.1 to 94.7), and NPV 93.7% (95% CI 84.5 to 98.2). CONCLUSION PCOS shows a specific 24h urinary steroid profile, if neglected metabolites are included in the analysis and non-conventional data analysis applied. PCOS does not share a profile with hyperandrogenic forms of congenital adrenal hyperplasias due to single steroid enzyme deficiencies. Thus PCOS diagnosis by exclusion may no longer be warranted. Whether these findings also apply to spot urine and serum, remains to be tested as a next step towards routine clinical applicability.
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Sala Elpidio LN, de Alencar JB, Tsuneto PY, Alves HV, Trento Toretta M, It Taura SK, Laguila Visentainer JE, Sell AM. Killer-cell immunoglobulin-like receptors associated with polycystic ovary syndrome. J Reprod Immunol 2018; 130:1-6. [PMID: 30099219 DOI: 10.1016/j.jri.2018.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 07/12/2018] [Accepted: 08/02/2018] [Indexed: 01/12/2023]
Abstract
Polycystic ovary syndrome (PCOS) affects the endocrine system and is associated with low-grade inflammation. Natural killer (NK) cells are involved in the defense of the female reproductive tract, folliculogenesis, ovulation and the menstrual cycle. The killer-cell immunoglobulin-like receptors (KIR) on the surface of NK cells modulate the activation and function of these cells after interacting with human leukocyte antigen (HLA) class I ligands. The objective of this study was to evaluate the possible association of the KIR and their HLA ligands with polycystic ovary syndrome. METHODS Ninety-three patients with PCOS according to the Rotterdam criteria and 104 healthy controls were included in this study. The HLA class I and KIR genotypes were determined using a PCR-SSO technique, rSSO Luminex®. In order to assess whether the distribution of the HLA and KIR genotypes was in Hardy-Weinberg equilibrium, Arlequin 3.1 software was used. The frequency distributions in the two study groups were compared using the chi-squared statistic with Yates´s correction using Open Epi software. RESULTS The higher frequencies of KIR3DS1-Bw4 (41% vs. 19%, Pc = 0.002; OR = 2.90) and homozygotic KIR2DS4-del (54% vs. 26%, Pc = 0.0002; OR = 3.316) in patients compared with controls suggest they confer susceptibility to PCOS. A lower frequency of KIR2DS4-full was observed in patients (43% vs. 70%, Pc = 0.0004, OR = 0.320). CONCLUSION KIR and its HLA ligands were associated with the development of PCOS in the studied population.
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Affiliation(s)
- Laise Nayana Sala Elpidio
- Postgraduate Program in Biosciences and Physiopathology at the State University of Maringá, Paraná, Brazil
| | - Josiane Bazzo de Alencar
- Postgraduate Program in Biosciences and Physiopathology at the State University of Maringá, Paraná, Brazil
| | - Patrícia Yumeko Tsuneto
- Postgraduate Program in Biosciences and Physiopathology at the State University of Maringá, Paraná, Brazil
| | - Hugo Vicentin Alves
- Postgraduate Program in Biosciences and Physiopathology at the State University of Maringá, Paraná, Brazil
| | | | - Sérgio Ken It Taura
- Health Department of Maringá, Paraná, Brazil; The State University of Maringá, Brazil
| | - Jeane Eliete Laguila Visentainer
- Postgraduate Program in Biosciences and Physiopathology at the State University of Maringá, Paraná, Brazil; Laboratory of Immunogenetics, State University of Maringá, Paraná, Brazil
| | - Ana Maria Sell
- Postgraduate Program in Biosciences and Physiopathology at the State University of Maringá, Paraná, Brazil; Laboratory of Immunogenetics, State University of Maringá, Paraná, Brazil.
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Brakta S, Lizneva D, Mykhalchenko K, Imam A, Walker W, Diamond MP, Azziz R. Perspectives on Polycystic Ovary Syndrome: Is Polycystic Ovary Syndrome Research Underfunded? J Clin Endocrinol Metab 2017; 102:4421-4427. [PMID: 29092064 DOI: 10.1210/jc.2017-01415] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 09/14/2017] [Indexed: 11/19/2022]
Abstract
CONTEXT Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic abnormality with a worldwide prevalence of 4% to 21%, depending on diagnostic criteria. The National Institutes of Health (NIH) is the largest single funding agency in the world; it invests nearly $30.0 billion annually in biomedical research. EVIDENCE ACQUISITION Using the NIH Research Portfolio Online Reporting tool, we searched for all grants awarded by the NIH for PCOS and three other disorders with similar degrees of morbidity and similar or lower mortality and prevalence [rheumatoid arthritis (RA), tuberculosis (TB), and systemic lupus erythematosus (SLE)]. EVIDENCE SYNTHESIS We compared funding by the NIH for PCOS, RA, TB, and SLE research for the years 2006 to 2015, inclusive. CONCLUSION PCOS, compared with RA, TB, and SLE, was relatively less funded (total mean 10-year funding was $215.12 million vs $454.39 million, $773.77 million, and $609.52 million, respectively). Funding for PCOS was largely provided by one NIH Institute/Center (ICs) vs at least two ICs for SLE and RA; more individual Research Project Grants were awarded for RA, SLE, and TB than for PCOS, whereas PCOS funding was more likely to be through General Clinical Research Centers Program or Specialized Centers Program awards. Our data suggest that PCOS research may be underfunded considering its prevalence, economic burden, metabolic morbidity, and negative impact on quality of life. Greater education of NIH leaders, including those at the National Heart, Lung, and Blood Institute and National Institutes of Diabetes and Digestive and Kidney Diseases; other federal and state agency leads; elected leaders; and the general public by professional societies, the scientific community, and patient advocates regarding this disorder is needed.
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Affiliation(s)
- Soumia Brakta
- Department of OB/GYN, Medical College of Georgia, Augusta University
| | - Daria Lizneva
- Department of OB/GYN, Medical College of Georgia, Augusta University
| | | | | | - Walidah Walker
- Department of OB/GYN, Medical College of Georgia, Augusta University
| | - Michael P Diamond
- Department of OB/GYN, Medical College of Georgia, Augusta University
| | - Ricardo Azziz
- Department of OB/GYN, Medical College of Georgia, Augusta University
- Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany, State University of New York
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Atiomo W, Shafiee MN, Chapman C, Metzler VM, Abouzeid J, Latif A, Chadwick A, Kitson S, Sivalingam VN, Stratford IJ, Rutland CS, Persson JL, Ødum N, Fuentes‐Utrilla P, Jeyapalan JN, Heery DM, Crosbie EJ, Mongan NP. Expression of NAD(P)H quinone dehydrogenase 1 (NQO1) is increased in the endometrium of women with endometrial cancer and women with polycystic ovary syndrome. Clin Endocrinol (Oxf) 2017; 87:557-565. [PMID: 28748640 PMCID: PMC5697576 DOI: 10.1111/cen.13436] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 05/11/2017] [Accepted: 07/24/2017] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Women with a prior history of polycystic ovary syndrome (PCOS) have an increased risk of endometrial cancer (EC). AIM To investigate whether the endometrium of women with PCOS possesses gene expression changes similar to those found in EC. DESIGN AND METHODS Patients with EC, PCOS and control women unaffected by either PCOS or EC were recruited into a cross-sectional study at the Nottingham University Hospital, UK. For RNA sequencing, representative individual endometrial biopsies were obtained from women with EC, PCOS and a woman unaffected by PCOS or EC. Expression of a subset of differentially expressed genes identified by RNA sequencing, including NAD(P)H quinone dehydrogenase 1 (NQO1), was validated by quantitative reverse transcriptase PCR validation (n = 76) and in the cancer genome atlas UCEC (uterine corpus endometrioid carcinoma) RNA sequencing data set (n = 381). The expression of NQO1 was validated by immunohistochemistry in EC samples from a separate cohort (n = 91) comprised of consecutive patients who underwent hysterectomy at St Mary's Hospital, Manchester, between 2011 and 2013. A further 6 postmenopausal women with histologically normal endometrium who underwent hysterectomy for genital prolapse were also included. Informed consent and local ethics approval were obtained for the study. RESULTS We show for the first that NQO1 expression is significantly increased in the endometrium of women with PCOS and EC. Immunohistochemistry confirms significantly increased NQO1 protein expression in EC relative to nonmalignant endometrial tissue (P < .0001). CONCLUSIONS The results obtained here support a previously unrecognized molecular link between PCOS and EC involving NQO1.
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Affiliation(s)
- William Atiomo
- Faculty of Medicine and Health SciencesDivision of Obstetrics and Gynaecology and Child HealthSchool of MedicineQueen's Medical CentreNottingham University HospitalNottinghamUK
| | - Mohamad Nasir Shafiee
- Faculty of Medicine and Health SciencesDivision of Obstetrics and Gynaecology and Child HealthSchool of MedicineQueen's Medical CentreNottingham University HospitalNottinghamUK
- Faculty of MedicineDepartment Obstetrics and GynaecologyUKM Medical CentreCherasKuala LumpurMalaysia
| | - Caroline Chapman
- Faculty of Medicine and Health SciencesDivision of Obstetrics and Gynaecology and Child HealthSchool of MedicineQueen's Medical CentreNottingham University HospitalNottinghamUK
| | - Veronika M. Metzler
- Faculty of Medicine and Health SciencesSchool of Veterinary Medicine and ScienceUniversity of NottinghamNottinghamUK
| | - Jad Abouzeid
- Faculty of Medicine and Health SciencesSchool of Veterinary Medicine and ScienceUniversity of NottinghamNottinghamUK
| | - Ayşe Latif
- Faculty of Biology, Medicine and HealthDivision of Pharmacy and OptometrySchool of Health SciencesUniversity of ManchesterManchesterUK
| | - Amy Chadwick
- Faculty of BiologyDivision of Molecular & Clinical Cancer SciencesMedicine and HealthUniversity of ManchesterManchesterUK
| | - Sarah Kitson
- Faculty of BiologyDivision of Molecular & Clinical Cancer SciencesMedicine and HealthUniversity of ManchesterManchesterUK
- Department of Obstetrics and GynaecologyCentral Manchester University Hospitals NHS Foundation TrustManchester Academic Health Science CentreManchesterUK
- Manchester School of PharmacyUniversity of ManchesterManchesterUK
| | - Vanitha N. Sivalingam
- Faculty of BiologyDivision of Molecular & Clinical Cancer SciencesMedicine and HealthUniversity of ManchesterManchesterUK
- Department of Obstetrics and GynaecologyCentral Manchester University Hospitals NHS Foundation TrustManchester Academic Health Science CentreManchesterUK
- Manchester School of PharmacyUniversity of ManchesterManchesterUK
| | - Ian J. Stratford
- Faculty of Biology, Medicine and HealthDivision of Pharmacy and OptometrySchool of Health SciencesUniversity of ManchesterManchesterUK
| | - Catrin S. Rutland
- Faculty of Medicine and Health SciencesSchool of Veterinary Medicine and ScienceUniversity of NottinghamNottinghamUK
| | - Jenny L. Persson
- Clinical Research CenterLund UniversityMalmöSweden
- Department of Molecular BologyUmeå UniversityUmeåSweden
| | - Niels Ødum
- Department of Immunology and MicrobiologyUniversity of CopenhagenKobenhavnDenmark
| | | | - Jennie N. Jeyapalan
- Faculty of Medicine and Health SciencesSchool of Veterinary Medicine and ScienceUniversity of NottinghamNottinghamUK
| | | | - Emma J. Crosbie
- Faculty of BiologyDivision of Molecular & Clinical Cancer SciencesMedicine and HealthUniversity of ManchesterManchesterUK
- Department of Obstetrics and GynaecologyCentral Manchester University Hospitals NHS Foundation TrustManchester Academic Health Science CentreManchesterUK
- Manchester School of PharmacyUniversity of ManchesterManchesterUK
| | - Nigel P. Mongan
- Faculty of Medicine and Health SciencesSchool of Veterinary Medicine and ScienceUniversity of NottinghamNottinghamUK
- Department of PharmacologyWeill Cornell MedicineNew YorkNYUSA
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Diamandis EP, Stanczyk FZ, Wheeler S, Mathew A, Stengelin M, Nikolenko G, Glezer EN, Brown MD, Zheng Y, Chen YH, Wu HL, Azziz R. Serum complexed and free prostate-specific antigen (PSA) for the diagnosis of the polycystic ovarian syndrome (PCOS). Clin Chem Lab Med 2017; 55:1789-1797. [PMID: 28361781 DOI: 10.1515/cclm-2016-1124] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 02/21/2017] [Indexed: 01/25/2023]
Abstract
BACKGROUND Polycystic ovarian syndrome (PCOS) is a common cause of reproductive and metabolic dysfunction. We hypothesized that serum prostate-specific antigen (PSA) may constitute a new biomarker for hyperandrogenism in PCOS. METHODS We conducted a cross-sectional study of 45 women with PCOS and 40 controls. Serum from these women was analyzed for androgenic steroids and for complexed PSA (cPSA) and free PSA (fPSA) with a novel fifth- generation assay with a sensitivity of ~10 fg/mL for cPSA and 140 fg/mL for fPSA. RESULTS cPSA and fPSA levels were about three times higher in PCOS compared to controls. However, in PCOS, cPSA and fPSA did not differ according to waist-to-hip ratio, Ferriman-Gallwey score, or degree of hyperandrogenemia or oligo-ovulation. In PCOS and control women, serum cPSA and fPSA levels were highly correlated with each other, and with free and total testosterone levels, but not with other hormones. Adjusting for age, body mass index (BMI) and race, cPSA was significantly associated with PCOS, with an odds ratio (OR) of 5.67 (95% confidence interval [CI]: 1.86, 22.0). The OR of PCOS for fPSA was 7.04 (95% CI: 1.65, 40.4). A multivariate model that included age, BMI, race and cPSA yielded an area-under-the-receiver-operating-characteristic curve of 0.89. CONCLUSIONS Serum cPSA and fPSA are novel biomarkers for hyperandrogenism in PCOS and may have value for disease diagnosis.
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Kumar DRN, Seshadri KG, Pandurangi M. Effect of Metformin-sustained Release Therapy on Low-density Lipoprotein Size and Adiponectin in the South Indian Women with Polycystic Ovary Syndrome. Indian J Endocrinol Metab 2017; 21:679-683. [PMID: 28989873 PMCID: PMC5628535 DOI: 10.4103/ijem.ijem_154_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The aim of the study is to compare surrogate markers of cardiovascular disease (CVD) risk, such as adiponectin (APN) levels and low-density lipoprotein (LDL) size, before and after sustained release metformin (Met-SR) therapy in women with polycystic ovarian syndrome (PCOS). METHODS Sixty women with PCOS and sixty age-matched controls in the age group 18-45 years were recruited after obtaining informed consent. Women with PCOS were initiated on Met-SR 1 g orally, which was increased to 1.5 g after 2 weeks and continued up to 24 weeks. Demographic data along with family history of type 2 diabetes mellitus, PCOS, and CVD were collected. Lipid profile plasma APN levels and LDL size were measured before and after therapy in the PCOS group. Data analysis was performed using the GraphPad Prism-5 software. RESULTS Women with PCOS had greater dyslipidemia, lower APN level and LDL size, and increased lipid accumulating product index as compared to controls. After 6 months of Met-SR therapy, women with PCOS demonstrated significant increase in plasma APN levels and LDL size and significant decrease in weight, waist-hip ratio (WHR), waist circumference (WC), and blood pressure (BP). A significant decrease was observed in body mass index (BMI) in the overweight and obese PCOS subgroups. CONCLUSION Met-SR increases LDL size, APN concentration and decreases weight, WC, WHR, and BP in patients with PCOS. Met-SR may have salutary effects on LDL particle size through effects on APN levels in women with PCOS.
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Affiliation(s)
- D. Rama Nagendra Kumar
- Department of Endocrinology, Diabetes and Metabolism, Sri Ramachandra Medical College, Porur, Chennai, Tamil Nadu, India
| | - Krishna G. Seshadri
- Department of Endocrinology and Medical Education, Sri Balaji Vidyapeeth, Puducherry, Tamil Nadu, India
| | - Monna Pandurangi
- Department of Reproductive Medicine, Sri Ramachandra Medical College, Porur, Chennai, Tamil Nadu, India
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Qi X, Pang Y, Qiao J. The role of anti-Müllerian hormone in the pathogenesis and pathophysiological characteristics of polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol 2016; 199:82-7. [DOI: 10.1016/j.ejogrb.2016.01.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 01/05/2016] [Accepted: 01/29/2016] [Indexed: 02/01/2023]
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Yang YM, Choi EJ. Efficacy and safety of metformin or oral contraceptives, or both in polycystic ovary syndrome. Ther Clin Risk Manag 2015; 11:1345-53. [PMID: 26366087 PMCID: PMC4562722 DOI: 10.2147/tcrm.s89737] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is an endocrinopathy that affects approximately 10% of reproductive-aged women throughout their lives. Women with PCOS present with heterogeneous symptoms including ovulatory dysfunction, hyperandrogenism, and polycystic ovaries. Therefore, lifelong individualized management should be considered. Pharmacological agents commonly used to manage the symptoms are metformin and oral contraceptive pills. Although these medications have been beneficial in treating PCOS symptoms, their efficacy and safety are still not entirely elucidated. This study aimed to report the efficacy and safety of metformin, oral contraceptives, or their combination in the treatment of PCOS and to define their specific individual roles. Methods A literature search of original studies published in PubMed and Scopus was conducted to identify studies comparing metformin with oral contraceptives or evaluating the combination of both in PCOS. Results Eight clinical trials involving 313 patients were examined in the review. The intervention dosage of metformin ranged from 1,000 to 2,000 mg/d and that of oral contraceptives was ethinylestradiol 35 µg and cyproterone acetate 2 mg. Lower body mass index was observed with regimens including metformin, but increased body mass index was observed in monotherapy with oral contraceptives. Administration of metformin or oral contraceptives, especially as monotherapy, had a negative effect on lipid profiles. In addition, there are still uncertainties surrounding the effects of metformin or oral contraceptives in the management of insulin level, although they improved total testosterone and sex hormone-binding globulin levels. In the included studies, significant side effects due to metformin or oral contraceptives were not reported. Conclusion The clinical trials suggest that metformin or oral contraceptives are at least patient convenient, efficacious, and safe for the treatment of PCOS. However, well-designed, prospective, long-term, large-scale, randomized clinical trials are necessary to elucidate the efficacy and safety of metformin, oral contraceptives, or both in the treatment of PCOS, and to elucidate their individual roles in the treatment of this condition.
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Affiliation(s)
- Young-Mo Yang
- College of Pharmacy, Chosun University, Gwangju, South Korea
| | - Eun Joo Choi
- College of Pharmacy, Chosun University, Gwangju, South Korea
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Zhao PL, Zhang QF, Yan LY, Huang S, Chen Y, Qiao J. Functional investigation on aromatase in endometrial hyperplasia in polycystic ovary syndrome cases. Asian Pac J Cancer Prev 2015; 15:8975-9. [PMID: 25374239 DOI: 10.7314/apjcp.2014.15.20.8975] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To explore the possible significance of aromatase P450 in endometrial hyperplasia with a background of polycystic ovary syndrome (PCOS). METHODS Immunohistochemistry was used to determine the expression of aromatase P450 in endometrium of PCOS patients. Semiquantitative analysis of aromatase P450 expression of mRNA and protein level wasalso carried out by real-time quantitative RT-PCR method. After endometrial cells were stimulated by testosterone and letrozole in vitro, the estradiol (E2) level was determined, and the expression of cell aromatase P450 mRNA was assessed. RESULTS The aromatase P450 mRNA level was increased in endometria of PCOS patients. When endometrial cells were cultured with 10-6 M testosterone, the E2 level in the culture medium increased. An inhibitory effect on E2 generation and expression of aromatase P450 mRNA was observed when the endometrial cells were treated with 10(-5) M letrozole. CONCLUSIONS There is an increased expression of aromatase P450 in PCOS patient endometrium. Androgen stimulation could enhance the synthesis of aromatase P450 mRNA and the production of E2 in endometrial cells in vitro while letrozole could do the reverse.
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Affiliation(s)
- Pan-Lin Zhao
- Reproductive Center, Peking University Third Hospital, Beijing, China E-mail :
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