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Andlib N, Sajad M, Thakur SC. Association of diabetes mellitus with risk of reproductive impairment in females: A comprehensive review. Acta Histochem 2024; 126:152173. [PMID: 39004007 DOI: 10.1016/j.acthis.2024.152173] [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: 02/20/2024] [Revised: 05/31/2024] [Accepted: 07/04/2024] [Indexed: 07/16/2024]
Abstract
Reproductive impairment is the most prevalent yet most ignored complication of diabetes mellitus. In diabetes, the problem associated with reproductive health is comprehensive in both males and females. Diabetic females have problems like delayed menarche, irregular menstrual cycle, subfertility, complications in pregnancy and early menopause. This may decrease reproductive age in diabetic females as the menarche is delayed and menopause is early in them. Like diabetic males, diabetic females also have the negative effect of oxidative stress on the reproductive system. This may lead to dysfunction of the ovary. It affects the physiological cycle like the ovary's maturation, embryo development and pregnancy. These complications also affect the offspring, and they may also become diabetic. This review aims to concentrate on the effect of diabetes on the reproductive system of females and the impairment caused by it. We will also discuss in detail the role of the hypothalamus-pituitary ovary axis, diabetes impact on different reproductive phases of females, and the sexual disorders that occur in them.
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Affiliation(s)
- Nida Andlib
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi 110025, India
| | - Mohd Sajad
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi 110025, India
| | - Sonu Chand Thakur
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi 110025, India..
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Wu H, Zhao B, Yao Q, Kang J. Dehydroepiandrosterone-induced polycystic ovary syndrome mouse model requires continous treatments to maintain reproductive phenotypes. J Ovarian Res 2023; 16:207. [PMID: 37880784 PMCID: PMC10599050 DOI: 10.1186/s13048-023-01299-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 10/16/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the most common endocrinopathy associated with infertility and metabolic disorder in women of reproductive age. Animal models have been developed and used as tools to unravel the pathogenesis of PCOS, among which most postnatal models employ continuing experimental manipulations. However, the persistence and stability of these animals after modeling is unknown. Dehydroepiandrosterone (DHEA)-induced PCOS mouse model is commonly used in PCOS studies. Thus the aim of the present study was to investigate the reproductive features of DHEA-induced PCOS mice fed a normal chow or an high-fat diet (HFD) with treatment withdrawal or consecutive treatments after PCOS mouse models were established. METHODS Prepubertal C57BL/6 J mice (age 25 days) were injected (s.c.) daily with DHEA on a normal chow or a 60% HFD for 20 consecutive days to induce PCOS mouse models. Mice injected with the vehicle sesame oil were used as controls. After 20 days, mice were divided into 2 groups, namely "Continue dosing group" and "Stop dosing group". The animals were consecutively treated with DHEA or DHEA + HFD, or housed without any treatment for 2 or 4 weeks. Estrous cycles were evaluated during this period. At the end of the experiment, serum testosterone (T) levels were measured and the morphology of ovaries was evaluated. RESULTS The mice in Continue dosing groups maintained reproductive phenotypes of PCOS mouse models. In contrast, 2 or 4 weeks after PCOS models were established, the mice with treatment withdrawal in Stop dosing groups exhibited normal serum testosterone levels, regular estrous cycle, and relatively normal ovarian morphology. In addition, even with consecutive treatments, there was no marked difference in body weight between DHEA mice on the normal chow or an HFD in Continue dosing groups and the control animals 3 weeks after modeling. CONCLUSIONS After PCOS mice were induced with DHEA or DHEA + HFD, the mice still need consecutive treatments to maintain reproductive phenotypes to be regarded as PCOS mice that meet the diagnostic criteria of PCOS defined by the 2003 Rotterdam criteria.
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Affiliation(s)
- Haowen Wu
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Bining Zhao
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Qiyang Yao
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Jihong Kang
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University Health Science Center, No.38 Xueyuan Rd, Haidian District, Beijing, 100191, China.
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Unlu C, Guney G, Tugrul Ersak D, Kosem A, Tarlan N, Tokmak A. Evaluation of serum telomerase activity in normal-weight young girls with polycystic ovary syndrome and its relation to metabolic parameters. J Pediatr Endocrinol Metab 2023; 36:283-289. [PMID: 36656544 DOI: 10.1515/jpem-2022-0455] [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: 09/08/2022] [Accepted: 12/30/2022] [Indexed: 01/20/2023]
Abstract
OBJECTIVES This study investigated the discriminative value of serum telomerase levels in polycystic ovary syndrome (PCOS) and its relation to metabolic parameters. METHODS Patients aged 16-23 years old who visited an adolescent outpatient clinic were included in the study. Our study consisted of 45 non-obese girls with polycystic ovary syndrome (PCOS), while our control group consisted of 45 healthy girls with normal menstrual cycles and no signs of hyperandrogenism. During the early follicular phase, all individuals were analyzed for serum telomerase levels, blood cell count, biochemical parameters, basal hormone levels, lipid profile and homeostatic model assessment of insulin resistance (HOMA-IR) index. RESULTS Serum telomerase levels in PCOS patients were considerably lower (80.0 ± 52.8 IU/mL) than in the controls (113.1 ± 54.9 IU/mL) (p=0.004). We observed that blood telomerase levels less than 108.6 distinguished PCOS group from healthy controls with a sensitivity of 73.33% and a specificity of 57.78%. Low-density lipoprotein cholesterol, HOMA-IR index, Ferriman-Gallwey score and dehydroepiandrosterone sulfate values were higher in the study group. Moreover, serum telomerase levels were inversely correlated with body mass index (r=-0.339, p=0.023) and triglycerides (r=-0.511, p=0.002) in this group. Telomerase levels were also considerably lower in patients with metabolic syndrome (p=0.005). CONCLUSIONS Serum telomerase activity is lower in PCOS patients than in healthy controls. Furthermore, decreased serum telomerase levels may correlate well with the metabolic complications of PCOS.
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Affiliation(s)
- Cemal Unlu
- Department of Reproductive Endocrinology and Infertility, Zekai Tahir Burak Women's Health Research and Education Hospital, University of Health Sciences, Ankara, Türkiye
| | - Gurhan Guney
- Department of Reproductive Endocrinology and Infertility, Faculty of Medicine, Balikesir University, Balikesir, Türkiye
| | - Duygu Tugrul Ersak
- Department of Reproductive Endocrinology and Infertility, Zekai Tahir Burak Women's Health Research and Education Hospital, University of Health Sciences, Ankara, Türkiye
| | - Arzu Kosem
- Department of Clinical Biochemistry, Ankara City Hospital, University of Health Sciences, Ankara, Türkiye
| | - Nurten Tarlan
- Department of Reproductive Endocrinology and Infertility, Zekai Tahir Burak Women's Health Research and Education Hospital, University of Health Sciences, Ankara, Türkiye
| | - Aytekin Tokmak
- Department of Reproductive Endocrinology and Infertility, Zekai Tahir Burak Women's Health Research and Education Hospital, University of Health Sciences, Ankara, Türkiye
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Wang Y, Yang J, Wang Y, Chen Y, Wang Y, Kuang H, Feng X. Upregulation of TXNIP contributes to granulosa cell dysfunction in polycystic ovary syndrome via activation of the NLRP3 inflammasome. Mol Cell Endocrinol 2023; 561:111824. [PMID: 36450326 DOI: 10.1016/j.mce.2022.111824] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a complex endocrine disease. Thioredoxin-interacting protein (TXNIP) promotes oxidative stress and triggers inflammation. Herein, we investigated the role and potential mechanism of TXNIP in PCOS. In a mouse model of dehydroepiandrosterone (DHEA)-induced PCOS, we found that TXNIP was upregulated in the ovaries, especially in granulosa cells (GCs). TXNIP was also upregulated in testosterone (T)-treated GCs in vitro. Knockdown of TXNIP by lentivirus-constructed shRNA attenuated T-induced GC injury and oxidative stress, as well as inflammation and the NLRP3 inflammasome. The mechanism by which TXNIP promotes inflammation may involve TXNIP dissociation from the TXNIP-TRX complex and binding to NLRP3 to form the inflammasome. Additionally, we verified that knockdown of TXNIP ameliorated ovarian injury and inflammation in mice with DHEA-induced PCOS in vivo. Collectively, we demonstrated that TXNIP is involved in GC inflammation by promoting NLRP3 inflammasome activation in PCOS.
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Affiliation(s)
- Ying Wang
- The Second Department of Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jiyu Yang
- Graduate School, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yu Wang
- Graduate School, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yao Chen
- Graduate School, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yiran Wang
- School of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Hongying Kuang
- The Second Department of Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China.
| | - Xiaoling Feng
- The Second Department of Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China.
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Ranathunga I, Athukorala TG, Sumanatilleke MR, Somasundaram NP. Evaluation of socio-demographic and clinical characteristics of PCOS patients attending a tertiary care institute in Colombo. BMC Endocr Disord 2022; 22:289. [PMID: 36411444 PMCID: PMC9677619 DOI: 10.1186/s12902-022-01206-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 11/09/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Polycystic ovary syndrome (PCOS) is a common endocrine disorder with heterogeneous aetiology. It is characterized by irregular menses and or oligo/anovulation, hyper-androgenism, and polycystic ovaries. The prevalence and diagnosis of PCOS changes depending on which clinical criteria are utilized to confirm the diagnosis. The prevalence can be high as 8-13% when the Rotterdam criteria are used. However, there is significant inter-individual variation in presentation. We have studied the socio-demographic and clinical characteristics of PCOS patients attending the Endocrinology clinic in a tertiary care institute in Sri Lanka. METHODS A descriptive cross sectional study was conducted from September 2019 to September 2020 at the Endocrinology Unit of the National Hospital of Sri Lanka. All the patients who met the inclusion and exclusion criteria and who has a diagnosis of PCOS made according to Rotterdam criteria were recruited in to the study. After obtaining informed written consent, the data was collected using an interviewer administered questionnaire. HOMA-IR was calculated using the fasting insulin and blood glucose level. RESULTS The study enrolled sixty females. The mean age was 26.7 years (range 18-44). The mean weight was 64.8 (SD = 11.9) kg and BMI was 27.1 (SD = 4.8) kg/m-2. According to Asian BMI cut-offs, 1 (1.7%) patient was underweight and 13 (21.7%) had normal weight. Forty six (76.7%) had their weight in the overweight or obese category. Fifty four (90.0%) patients had clinical or biochemical evidence of hyperandrogenism while 24 (40%) had polycystic ovaries on trans-abdominal ultrasound scan and 50 (83.3%) had irregular menstrual cycles. According to the body fat percentage assessed by the whole body DEXA scan 4.1% normal body fat, while 50.0% and 45.8% had overweight and obesity respectively. HOMA-IR detected 61.1% to have high insulin resistance. Out of the patients who had USS of the abdomen 27.5% had co-existent non-alcoholic fatty liver. Fifty four percent of the patients had sub/infertility. CONCLUSIONS The majority of the population were overweight or obese and had higher prevalence of insulin resistance and non-alcoholic fatty liver. Out of the clinical characteristics used to make the diagnosis of PCOS, the presence of clinical or biochemical evidence of hyperandrogenism and irregular menstrual cycles are more common than the detection of polycystic ovaries on trans-vaginal USS. The higher prevalence of overweight, obesity, insulin resistance and NAFLD associated with PCOS makes the diagnosis and management of the disease crucial to prevent long term consequences of the disease.
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Affiliation(s)
- I Ranathunga
- Diabetes and Endocrinology Unit, National Hospital of Sri Lanka, Colombo 10, Sri Lanka.
| | - T G Athukorala
- Diabetes and Endocrinology Unit, National Hospital of Sri Lanka, Colombo 10, Sri Lanka
| | - M R Sumanatilleke
- Diabetes and Endocrinology Unit, National Hospital of Sri Lanka, Colombo 10, Sri Lanka
| | - N P Somasundaram
- Diabetes and Endocrinology Unit, National Hospital of Sri Lanka, Colombo 10, Sri Lanka
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Hu L, Ma L, Xia X, Ying T, Zhou M, Zou S, Yu H, Yin J. Efficacy of Bariatric Surgery in the Treatment of Women With Obesity and Polycystic Ovary Syndrome. J Clin Endocrinol Metab 2022; 107:e3217-e3229. [PMID: 35554540 PMCID: PMC9282367 DOI: 10.1210/clinem/dgac294] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Indexed: 01/31/2023]
Abstract
CONTEXT The comparative effectiveness of drugs and surgical therapy for women with obesity and polycystic ovary syndrome (PCOS) has not been systematically compared. OBJECTIVE We aimed to determine the difference in efficacy between drug and bariatric surgery therapy for women with obesity and PCOS. METHODS This prospective nonrandomized trial enrolled 90 women aged 18 to 40 years with body mass index (BMI) ≥ 27.5 kg/m2 and waist circumference ≥ 85 cm and fulfilling the 2011 Chinese diagnostic criteria for PCOS; 81 subjects completed the study. In the drug group, patients were administered metformin and an oral contraceptive containing ethinyl-estradiol and cyproterone acetate for the first 6 months, and metformin alone for the second 6 months. In the surgical group, patients underwent laparoscopic sleeve gastrectomies. The follow-up period was 12 months. The main outcome was the complete remission of PCOS, requiring 6 consecutive regular menstruation cycles or spontaneous pregnancy. RESULTS Median BMI at endpoint was 30.1 kg/m2 in the drug group and 23.7 kg/m2 in the surgical group; complete remission rate was 15% and 78%, respectively. Except endpoint BMI, no difference was observed in free androgen index, ovarian morphology, homeostasis model assessment for insulin resistance, and total weight loss between remission and nonremission patients. Logistic regression analyses also revealed that the final BMI was the major factor influencing the remission of PCOS. The cutoff points for the final BMI were 27.5 kg/m2 for the drug group and 26 kg/m2 for the surgical group. Overall, nearly 95% of patients with an endpoint BMI below the cutoff values achieved complete remission. CONCLUSION Complete remission of PCOS in patients with obesity depends on the final BMI after weight loss. Thus, bariatric surgery should be prioritized for these patients.
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Affiliation(s)
| | | | | | - Tao Ying
- Department of Ultrasound in Medicine, Shanghai Institute of Ultrasound in Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People’s Hospital, Shanghai 200233, China
| | - Minzhi Zhou
- Department of Ultrasound in Medicine, Shanghai Institute of Ultrasound in Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People’s Hospital, Shanghai 200233, China
| | - Shuhua Zou
- International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Haoyong Yu
- Haoyong Yu, M.D., Department of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People’s Hospital, #600 Yishan Road, Shanghai 200233, China.
| | - Jun Yin
- Correspondence: Jun Yin, M.D., Ph.D., Department of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People’s Hospital, #600 Yishan Road, Shanghai 200233, China.
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Liu S, Hong L, Lian R, Xiao S, Li Y, Diao L, Zeng Y. Transcriptomic Analysis Reveals Endometrial Dynamics in Normoweight and Overweight/Obese Polycystic Ovary Syndrome Women. Front Genet 2022; 13:874487. [PMID: 35646061 PMCID: PMC9136323 DOI: 10.3389/fgene.2022.874487] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 04/07/2022] [Indexed: 01/14/2023] Open
Abstract
The aim of this work was to identify the transcriptomic characteristics of the endometrium in normoweight and overweight/obese polycystic ovary syndrome (PCOS) potentially underlying the pathogenesis. This study included 38 patients undergoing in vitro fertilization: 22 women with PCOS and 16 matched controls. Each of the groups was subdivided into normoweight (body mass index (BMI) < 25 kg/m2) and overweight/obese (BMI ≥25 kg/m2) subgroups. Endometrium samples were collected in the secretory phase from controls or in a modeled secretory phase using daily administration of progesterone from women with PCOS before in vitro fertilization treatment. Transcriptome profiles were assessed by high-throughput RNA sequencing to investigate distinct endometrial gene expression patterns in PCOS. Bioinformatics analyses revealed that the endometrium from PCOS expresses significantly different transcripts encoding endometrial receptivity, inflammatory response, angiogenesis, and energy metabolism. Additionally, our study demonstrated that the differentially expressed genes between normoweight and overweight/obese PCOS are involved in fatty acid metabolism, endometrial decidualization, and immune response. For the first time, we have described the transcriptome characteristics of normoweight and overweight/obese PCOS endometria. Our results indicate different endometrial gene expressions between different subtypes of PCOS and non-PCOS women, which might affect endometrial functions in PCOS patients.
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Affiliation(s)
| | | | | | | | | | - Lianghui Diao
- *Correspondence: Lianghui Diao, ; Yong Zeng, , orcid.org/0000-0002-6264-283X
| | - Yong Zeng
- *Correspondence: Lianghui Diao, ; Yong Zeng, , orcid.org/0000-0002-6264-283X
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Ribeiro VB, Pedroso DCC, Kogure GS, Lopes IP, Santana BA, Dutra de Souza HC, Ferriani RA, Calado RT, Furtado CLM, dos Reis RM. Short-Term Aerobic Exercise Did Not Change Telomere Length While It Reduced Testosterone Levels and Obesity Indexes in PCOS: A Randomized Controlled Clinical Trial Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111274. [PMID: 34769797 PMCID: PMC8582753 DOI: 10.3390/ijerph182111274] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/21/2021] [Accepted: 10/24/2021] [Indexed: 12/29/2022]
Abstract
Metabolic and hormonal outcomes of polycystic ovary syndrome (PCOS) have implications on telomere biology and physical activity may prevent telomere erosion. We sought to observe the effects of continuous (CAT) and intermittent (IAT) aerobic training on telomere length, inflammatory biomarkers, and its correlation with metabolic, hormonal, and anthropometric parameters of PCOS. This randomized controlled clinical trial study included 87 PCOS randomly stratified according to body mass index (BMI) in CAT (n = 28), IAT (n = 29) and non-training control group (CG, n = 30). The exercises were carried out on a treadmill, three times per week for 16 weeks. The participants' anthropometric characteristics and biochemical and hormonal concentrations were measured before and after aerobic training or observation period, as the telomere length that was evaluated using quantitative real-time PCR. Four months of aerobic exercises (CAT or IAT) did not alter telomere length and inflammatory biomarkers in PCOS women. Obesity index as BMI and waist circumference (WC), and inflammatory biomarkers negatively affect telomeres. The hyper-andro-genism measured by testosterone levels was reduced after both exercises (CAT, p ≤ 0.001; IAT, p = 0.019). In particular, the CAT reduced WC (p = 0.045), hip circumference (p = 0.032), serum cholesterol (p ≤ 0.001), and low-density lipoprotein (p = 0.030). Whereas, the IAT decreased WC (p = 0.014), waist-to-hip ratio (p = 0.012), free androgen index (FAI) (p = 0.037). WC (p = 0.049) and body fat (p = 0.015) increased in the non-training group while total cholesterol was reduced (p = 0.010). Booth exercises reduced obesity indices and hyperandrogenism on PCOS women without changes in telomere length or inflammatory biomarkers.
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Affiliation(s)
- Victor Barbosa Ribeiro
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo 14048-900, Brazil; (V.B.R.); (D.C.C.P.); (G.S.K.); (I.P.L.); (R.A.F.)
- Federal Institute of São Paulo, Jacareí, São Paulo 12322-030, Brazil
| | - Daiana Cristina Chielli Pedroso
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo 14048-900, Brazil; (V.B.R.); (D.C.C.P.); (G.S.K.); (I.P.L.); (R.A.F.)
| | - Gislaine Satyko Kogure
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo 14048-900, Brazil; (V.B.R.); (D.C.C.P.); (G.S.K.); (I.P.L.); (R.A.F.)
| | - Iris Palma Lopes
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo 14048-900, Brazil; (V.B.R.); (D.C.C.P.); (G.S.K.); (I.P.L.); (R.A.F.)
| | - Barbara Aparecida Santana
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo 14048-900, Brazil; (B.A.S.); (R.T.C.)
| | - Hugo Celso Dutra de Souza
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo 14048-900, Brazil;
| | - Rui Alberto Ferriani
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo 14048-900, Brazil; (V.B.R.); (D.C.C.P.); (G.S.K.); (I.P.L.); (R.A.F.)
| | - Rodrigo Tocantins Calado
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo 14048-900, Brazil; (B.A.S.); (R.T.C.)
| | - Cristiana Libardi Miranda Furtado
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo 14048-900, Brazil; (V.B.R.); (D.C.C.P.); (G.S.K.); (I.P.L.); (R.A.F.)
- Drug Research and Development Center, Postgraduate Program in Translational Medicine, Federal University of Ceará, Fortaleza, Ceará 60430-275, Brazil
- Correspondence: (C.L.M.F.); (R.M.d.R.); Tel.: +55-85-98185-4719 (C.L.M.F.); +55-16-99992-5722 (R.M.d.R.)
| | - Rosana Maria dos Reis
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo 14048-900, Brazil; (V.B.R.); (D.C.C.P.); (G.S.K.); (I.P.L.); (R.A.F.)
- Correspondence: (C.L.M.F.); (R.M.d.R.); Tel.: +55-85-98185-4719 (C.L.M.F.); +55-16-99992-5722 (R.M.d.R.)
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Li Y, Yao N, Gao Y, Wang Y, Bai L, Xu J, Wang H. MiR-1224-5p attenuates polycystic ovary syndrome through inhibiting NOD-like receptor protein 3 inflammasome activation via targeting Forkhead box O 1. Bioengineered 2021; 12:8555-8569. [PMID: 34637688 PMCID: PMC8806973 DOI: 10.1080/21655979.2021.1987125] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disorder that poses a great threat to women's health. MiR-1224-5p is downregulated in the follicular fluid of patients with PCOS, but its role remains largely unknown. In this study, mice were treated with dehydroepiandrosterone (DHEA) to establish an in vivo model of PCOS. We found that enhanced activation of NLRP3 inflammasome was accompanied by downregulation of miR-1224-5p in ovarian tissue of PCOS mice. The effect of miR-1224-5p was further explored in TNF-α-treated human granulosa-like tumor (KGN) cells. Upregulation of miR-1224-5p suppressed TNF-α-induced secretion of DHEA and testosterone. MiR-1224-5p attenuated TNF-α-induced inflammation by inhibiting NLRP3 inflammasome activation, IL-1β synthesis, and nuclear factor kappa B (NF-κB) p65 nuclear translocation. Notably, miR-1224-5p decreased the expression of Forkhead box O 1 (FOXO1) and its downstream gene thioredoxin interaction protein (TXNIP). Luciferase reporter assay confirmed FOXO1 as a target of miR-1224-5p. Upregulation of FOXO1 abolished miR-1224-5p-induced activation of NLRP3 inflammasome, demonstrating that miR-1224-5p might inhibit NLRP3 inflammasome activation through regulating FOXO1. This study provided novel insights into the pathogenesis of PCOS and suggested that miR-1224-5p might be a promising target for treating PCOS.
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Affiliation(s)
- Yan Li
- Department of Obstetrics and Gynecology, The Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Nianling Yao
- Department of Obstetrics and Gynecology, The Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Yan Gao
- Department of Obstetrics and Gynecology, The Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Yunping Wang
- Department of Obstetrics and Gynecology, The Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Lu Bai
- Department of Obstetrics and Gynecology, The Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Jia Xu
- Department of Obstetrics and Gynecology, The Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Haixu Wang
- Department of Obstetrics and Gynecology, The Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
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Zhang Z, Sang M, Liu S, Shao J, Cai Y. Differential expression of long non-coding RNA Regulator of reprogramming and its molecular mechanisms in polycystic ovary syndrome. J Ovarian Res 2021; 14:79. [PMID: 34148561 PMCID: PMC8215827 DOI: 10.1186/s13048-021-00829-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/21/2021] [Indexed: 12/13/2022] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is a common endocrine disease in women of reproductive age. Multiple studies have shown that long non-coding RNAs (lncRNA) and microRNAs (miRNA) play a role in PCOS. This study aimed to explore the role and molecular mechanism of lncRNA -Regulator of reprogramming (lncROR) in PCOS. Results Expression level of lncROR in PCOS patients was up-regulated, while level of miR-206 was down-regulated in comparison with control group (P < 0.001). Logistics regression analysis showed that lncROR and miR-206 were independent predictors of PCOS. The ROC curve showed that lncROR had a high diagnostic value for PCOS with an AUC value of 0.893. Pearson correlation coefficient indicated that the expression level of miR-206 was negatively correlated with the level of lncROR. CCK-8 assay and apoptosis assay revealed that downregulation of lncROR up-regulated the expression of miR-206, thereby inhibiting cell proliferation and promoting cell apoptosis. However, silencing the expression of miR-206 reversed the above effects caused by down-regulation of lncROR expression. Luciferase reporter gene assay suggested that there was a target relationship between lncROR and miR-206. VEGF was proved to be the target gene of miR-206. Conclusions Highly expressed lncROR indirectly up-regulated the expression of VEGF by down-regulating the expression of miR-206, thereby promoting the proliferation of KGN cells and inhibiting apoptosis, and further promoting the development of PCOS.
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Affiliation(s)
- Zhihong Zhang
- Department of Obstetrics and Gynecology, General Hospital of Daqing Oilfield, Daqing, 163000, Heilongjiang, China
| | - Min Sang
- Gynecology Clinic, The First Hospital of Harbin, No.151 Diduan Street, Heilongjiang, 150010, Harbin, China.
| | - Siqin Liu
- Laboratory Department, General Hospital of Daqing Oilfield, Daqing, 163000, Heilongjiang, China
| | - Jing Shao
- Department of Obstetrics and Gynecology, General Hospital of Daqing Oilfield, Daqing, 163000, Heilongjiang, China
| | - Yunjiang Cai
- Department of Psychology, Harbin Medical Univercity (Daqing), Daqing, 163319, Heilongjiang, China
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11
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Eiras MC, Pinheiro DP, Romcy KAM, Ferriani RA, Reis RMD, Furtado CLM. Polycystic Ovary Syndrome: the Epigenetics Behind the Disease. Reprod Sci 2021; 29:680-694. [PMID: 33826098 DOI: 10.1007/s43032-021-00516-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 02/21/2021] [Indexed: 10/21/2022]
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders, affecting approximately 5-20% of women of reproductive age. PCOS is a multifactorial, complex, and heterogeneous disease, characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovaries, which may lead to impaired fertility. Besides the reproductive outcomes, multiple comorbidities, such as metabolic disturbances, insulin resistance, obesity, diabetes, and cardiovascular disease, are associated with PCOS. In addition to the clear genetic basis, epigenetic alterations may also play a central role in PCOS outcomes, as environmental and hormonal alterations directly affect clinical manifestations and PCOS development. Here, we highlighted the epigenetic modifications in the multiplicity of clinical manifestations, as well as environmental epigenetic disruptors, as intrauterine hormonal and metabolic alterations affecting embryo development and the adulthood lifestyle, which may contribute to PCOS development. Additionally, we also discussed the new approaches for future studies and potential epigenetic biomarkers for the treatment of associated comorbidities and improvement in quality of life of women with PCOS.
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Affiliation(s)
- Matheus Credendio Eiras
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo, Av Bandeirantes, 3900, Ribeirão Preto, São Paulo, 14049-900, SP, Brazil
| | - Daniel Pascoalino Pinheiro
- Drug Research and Development Center, Department of Physiology and Pharmacology, Federal University of Ceara, Coronel Nunes de Melo, 1000, Rodolfo Teófilo, Fortaleza, 60430-275, CE, Brazil
| | - Kalil Andrade Mubarac Romcy
- Drug Research and Development Center, Postgraduate Program in Medical and Surgical Sciences, Federal University of Ceara, Coronel Nunes de Melo, 1000, Rodolfo Teófilo, Fortaleza, CE, 60430-275, Brazil
| | - Rui Alberto Ferriani
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo, Av Bandeirantes, 3900, Ribeirão Preto, São Paulo, 14049-900, SP, Brazil
| | - Rosana Maria Dos Reis
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo, Av Bandeirantes, 3900, Ribeirão Preto, São Paulo, 14049-900, SP, Brazil.
| | - Cristiana Libardi Miranda Furtado
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo, Av Bandeirantes, 3900, Ribeirão Preto, São Paulo, 14049-900, SP, Brazil. .,Drug Research and Development Center, Postgraduate Program in Medical and Surgical Sciences, Federal University of Ceara, Coronel Nunes de Melo, 1000, Rodolfo Teófilo, Fortaleza, CE, 60430-275, Brazil.
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12
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Liu S, Hong L, Mo M, Xiao S, Chen C, Li Y, Lian R, Wang X, Cai S, Diao L, Zeng Y. Evaluation of endometrial immune status of polycystic ovary syndrome. J Reprod Immunol 2021; 144:103282. [PMID: 33607547 DOI: 10.1016/j.jri.2021.103282] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/24/2020] [Accepted: 01/26/2021] [Indexed: 01/23/2023]
Abstract
Polycystic ovary syndrome (PCOS) is described as a low-grade chronic inflammatory state. However, there are limited studies on the specific endometrial immune status of PCOS patients. Whether this endometrial immune cell pattern is intrinsic to PCOS or the consequence of PCOS-associated obesity is a subject of debate. This study retrospectively included one hundred women diagnosed with PCOS and ninety-five normal fertile controls, which further divided into four groups (normoweight PCOS; overweight PCOS; normoweight control; overweight control) based on body mass index. The percentages of endometrial CD68+ macrophages (1.97 % vs. 1.17 %; P < 0.001), CD163+ M2 macrophages (2.30 % vs. 1.83 %; P = 0.001), CD1a+ iDCs (0.044 % vs. 0.029 %; P = 0.002), CD83+ mDCs (1.72 % vs. 1.07 %; P < 0.001) and CD8+ T cells (2.82 % vs. 1.95 %; P < 0.001) were significantly higher in normoweight PCOS women than normoweight controls. The percentage of CD68+ macrophages (2.09 % vs. 1.15 %; P < 0.001) was significantly higher in overweight PCOS women compared with overweight controls. In multivariant linear regression analysis, participants' PCOS status was the main predictors of endometrial CD68+ macrophages, CD163+ M2 macrophages, CD1a+ iDCs, CD83+ mDCs and CD8+ T cells in the whole study population. Additionally, in PCOS group, positive correlations were found between endometrial CD56+ NK, CD163+ M2 macrophages and QUICKI, indicating there was an association between endometrial immune cells and insulin resistance in PCOS women. Our study suggests that women with PCOS have altered endometrial immune cells, which may reflect a state of chronic low grade inflammation. The chronic inflammation, independent of obesity, may help understand the pathophysiologic mechanisms of intrinsic PCOS.
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Affiliation(s)
- Su Liu
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Ling Hong
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Meilan Mo
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Shan Xiao
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Cong Chen
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Yuye Li
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Ruochun Lian
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Xuejin Wang
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Songchen Cai
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Lianghui Diao
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, China
| | - Yong Zeng
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, China.
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13
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Helvaci N, Karabulut E, Demir AU, Yildiz BO. Polycystic ovary syndrome and the risk of obstructive sleep apnea: a meta-analysis and review of the literature. Endocr Connect 2017; 6:437-445. [PMID: 28739562 PMCID: PMC5574283 DOI: 10.1530/ec-17-0129] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 07/24/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND OBJECTIVE Polycystic ovary syndrome (PCOS) has been reported to be associated with the development of obstructive sleep apnea (OSA). The objective of this meta-analysis is to assess the relationship between PCOS and OSA. METHODS A literature search was conducted to identify studies linking PCOS with the risk of OSA. Studies in which the presence of OSA was confirmed with overnight polysomnography were included. Random effects models were used to calculate pooled relative risks. RESULTS Eight studies conducted in adults and five studies conducted in adolescents were identified. The pooled OSA prevalence was 0.22 (95% confidence interval (CI): 0.08-0.40) in PCOS patients. The pooled prevalence of OSA was higher in adults (0.32, 95% CI: 0.13-0.55) than adolescents (0.08, 95% CI: 0.00-0.30). Risk of OSA was significantly increased in adult patients with PCOS (odds ratio (OR) 9.74, 95% CI: 2.76-34.41). Risk of OSA was not significantly increased in adolescents (OR: 4.54, 95% CI:0.56-36.43). CONCLUSIONS These findings demonstrate a significant association between PCOS and OSA in adult patients. Considering the increased risk for long-term cardiometabolic disorders associated with both PCOS and OSA, it is important to diagnose and treat OSA in patients with PCOS.
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Affiliation(s)
- Nafiye Helvaci
- Department of Internal MedicineDivision of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey
| | - Erdem Karabulut
- Department of BiostatisticsHacettepe University School of Medicine, Ankara, Turkey
| | - Ahmet Ugur Demir
- Department of Chest DiseasesHacettepe University School of Medicine, Ankara, Turkey
| | - Bulent Okan Yildiz
- Department of Internal MedicineDivision of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey
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14
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Sun HY, Li Q, Liu YY, Wei XH, Pan CS, Fan JY, Han JY. Xiao-Yao-San, a Chinese Medicine Formula, Ameliorates Chronic Unpredictable Mild Stress Induced Polycystic Ovary in Rat. Front Physiol 2017; 8:729. [PMID: 29018356 PMCID: PMC5614964 DOI: 10.3389/fphys.2017.00729] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 09/07/2017] [Indexed: 12/16/2022] Open
Abstract
Chronic stress induces endocrine disturbance, which contributes to the development of polycystic ovary syndrome (PCOS), a condition that remains a challenge for clinicians to cope with. The present study investigated the effect of Xiao-Yao-San (XYS), a traditional Chinese medicine formula used for treatment of gynecological disease, on the chronic stress-induced polycystic ovary and its underlying mechanism. Female Sprague-Dwaley rats underwent a 3 weeks chronic unpredictable mild stress (CUMS) procedure to establish the PCOS model, followed by 4 weeks treatment with XYS (0.505 g/kg or 1.01 g/kg) by gavage. Granulosa cells were exposed to noradrenaline (1 mM) in vitro for 24 h, followed by incubation with or without XYS-treated rat serum for 24 h. Post-treatment with XYS ameliorated CUMS-induced irregular estrous cycles and follicles development abnormalities, decrease of estradiol and progesterone level as well as increase of luteinizing hormone in serum, reduced cystic follicles formation and the apoptosis and autophagy of granulosa cells, attenuated the increase in dopamine beta hydroxylase and c-fos level in locus coeruleus, the noradrenaline level in serum and ovarian tissue, and the expression of beta 2 adrenergic receptor in ovarian tissue. Besides, XYS alleviated the reduction of phosphorylation of ribosomal protein S6 kinase polypeptide I and protein kinase B, as well as the increase of microtubule-associated protein light chain 3-I to microtubule-associated protein light chain 3-II conversion both in vivo and in vitro. This study demonstrated XYS as a potential strategy for CUMS induced polycystic ovary, and suggested that the beneficial role of XYS was correlated with the regulation of the sympathetic nerve activity.
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Affiliation(s)
- Hao-Yu Sun
- Department of Integration of Chinese and Western Medicine, School of Basic Medical Sciences, Peking UniversityBeijing, China.,Tasly Microcirculation Research Center, Peking University Health Science CenterBeijing, China.,Key Laboratory of Microcirculation, State Administration of Traditional Chinese Medicine of the People's Republic of ChinaBeijing, China.,Key Laboratory of Stasis and Phlegm, State Administration of Traditional Chinese Medicine of the People's Republic of ChinaBeijing, China
| | - Quan Li
- Tasly Microcirculation Research Center, Peking University Health Science CenterBeijing, China.,Key Laboratory of Microcirculation, State Administration of Traditional Chinese Medicine of the People's Republic of ChinaBeijing, China.,Key Laboratory of Stasis and Phlegm, State Administration of Traditional Chinese Medicine of the People's Republic of ChinaBeijing, China.,State Key Laboratory of Core Technology in Innovative Chinese MedicineBeijing, China
| | - Yu-Ying Liu
- Tasly Microcirculation Research Center, Peking University Health Science CenterBeijing, China.,Key Laboratory of Microcirculation, State Administration of Traditional Chinese Medicine of the People's Republic of ChinaBeijing, China.,Key Laboratory of Stasis and Phlegm, State Administration of Traditional Chinese Medicine of the People's Republic of ChinaBeijing, China.,State Key Laboratory of Core Technology in Innovative Chinese MedicineBeijing, China
| | - Xiao-Hong Wei
- Tasly Microcirculation Research Center, Peking University Health Science CenterBeijing, China.,Key Laboratory of Microcirculation, State Administration of Traditional Chinese Medicine of the People's Republic of ChinaBeijing, China.,Key Laboratory of Stasis and Phlegm, State Administration of Traditional Chinese Medicine of the People's Republic of ChinaBeijing, China.,State Key Laboratory of Core Technology in Innovative Chinese MedicineBeijing, China
| | - Chun-Shui Pan
- Tasly Microcirculation Research Center, Peking University Health Science CenterBeijing, China.,Key Laboratory of Microcirculation, State Administration of Traditional Chinese Medicine of the People's Republic of ChinaBeijing, China.,Key Laboratory of Stasis and Phlegm, State Administration of Traditional Chinese Medicine of the People's Republic of ChinaBeijing, China.,State Key Laboratory of Core Technology in Innovative Chinese MedicineBeijing, China
| | - Jing-Yu Fan
- Tasly Microcirculation Research Center, Peking University Health Science CenterBeijing, China.,Key Laboratory of Microcirculation, State Administration of Traditional Chinese Medicine of the People's Republic of ChinaBeijing, China.,Key Laboratory of Stasis and Phlegm, State Administration of Traditional Chinese Medicine of the People's Republic of ChinaBeijing, China.,State Key Laboratory of Core Technology in Innovative Chinese MedicineBeijing, China
| | - Jing-Yan Han
- Department of Integration of Chinese and Western Medicine, School of Basic Medical Sciences, Peking UniversityBeijing, China.,Tasly Microcirculation Research Center, Peking University Health Science CenterBeijing, China.,Key Laboratory of Microcirculation, State Administration of Traditional Chinese Medicine of the People's Republic of ChinaBeijing, China.,Key Laboratory of Stasis and Phlegm, State Administration of Traditional Chinese Medicine of the People's Republic of ChinaBeijing, China.,State Key Laboratory of Core Technology in Innovative Chinese MedicineBeijing, China
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15
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Li S, Chu Q, Ma J, Sun Y, Tao T, Huang R, Liao Y, Yue J, Zheng J, Wang L, Xue X, Zhu M, Kang X, Yin H, Liu W. Discovery of Novel Lipid Profiles in PCOS: Do Insulin and Androgen Oppositely Regulate Bioactive Lipid Production? J Clin Endocrinol Metab 2017; 102:810-821. [PMID: 27886515 PMCID: PMC5477809 DOI: 10.1210/jc.2016-2692] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 11/23/2016] [Indexed: 11/20/2022]
Abstract
CONTEXT Polycystic ovary syndrome (PCOS) is a complex syndrome showing clinical features of an endocrine/metabolic disorder, including hyperinsulinemia and hyperandrogenism. Polyunsaturated fatty acids (PUFAs) and their derivatives, both tightly linked to PCOS and obesity, play important roles in inflammation and reproduction. OBJECTIVE This study aimed to investigate serum lipid profiles in newly diagnosed patients with PCOS using lipidomics and correlate these features with the hyperinsulinemia and hyperandrogenism associated with PCOS and obesity. DESIGN AND SETTING Thirty-two newly diagnosed women with PCOS and 34 controls were divided into obese and lean subgroups. A PCOS rat model was used to validate results of the human studies. MAIN OUTCOME MEASURES Serum lipid profiles, including phospholipids, free fatty acids (FFAs), and bioactive lipids, were analyzed using gas chromatography-mass spectrometry (MS) and liquid chromatography-MS. RESULTS Elevation in phosphatidylcholine and a concomitant decrease in lysophospholipid were found in obese patients with PCOS vs lean controls. Obese patients with PCOS had decreased PUFA levels and increased levels of long-chain saturated fatty acids vs lean controls. Serum bioactive lipids downstream of arachidonic acid were increased in obese controls, but reduced in both obese and lean patients with PCOS vs their respective controls. CONCLUSIONS Patients with PCOS showed abnormal levels of phosphatidylcholine, FFAs, and PUFA metabolites. Circulating insulin and androgens may have opposing effects on lipid profiles in patients with PCOS, particularly on the bioactive lipid metabolites derived from PUFAs. These clinical observations warrant further studies of the molecular mechanisms and clinical implications of PCOS and obesity.
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Affiliation(s)
| | | | - Jing Ma
- Department of Endocrinology and
| | - Yun Sun
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Center for Reproductive Medicine and
| | - Tao Tao
- Department of Endocrinology and
| | | | - Yu Liao
- Department of Endocrinology and
| | | | | | | | - Xinli Xue
- Key Laboratory of Food Safety Research and
- University of the Chinese Academy of Sciences, Shanghai 200031, China; and
| | | | - Xiaonan Kang
- Department of Biobank, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Huiyong Yin
- Key Laboratory of Food Safety Research and
- School of Life Science and Technology, ShanghaiTech University, Shanghai 200031, China
| | - Wei Liu
- Department of Endocrinology and
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16
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Mioni R, Cà AD, Turra J, Azzolini S, Xamin N, Bleve L, Maffei P, Vettor R, Fallo F. Hyperinsulinemia and obese phenotype differently influence blood pressure in young normotensive patients with polycystic ovary syndrome. Endocrine 2017; 55:625-634. [PMID: 27142411 DOI: 10.1007/s12020-016-0958-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 04/11/2016] [Indexed: 12/24/2022]
Abstract
To differentiate the impact of insulin levels/resistance per se from that of excess weight on blood pressure (BP) daily changes, we evaluated, using 24-h ambulatory blood pressure monitoring (ABPM), systolic blood pressure (SBP) and diastolic blood pressure (DBP) in a cohort of young normotensive patients affected by polycystic ovary syndrome (PCOS). A cross-sectional study was performed. Fifty-four patients were studied according to (a) insulinemic state: 32 hyperinsulinemic and/or insulin-resistant (h-INS) and 22 normoinsulinemic (n-INS) patients; and (b) body mass index (BMI): 22 obese (BMI > 30) and 32 lean (18.0 < BMI < 24.9) patients. Each subject's SBP and DBP and heart rate (HR) were measured by ABPM. Supine and upright plasma renin activity (PRA), and aldosterone levels were also assayed. Patients in the h-INS group showed higher 24-h, daytime, and nighttime diastolic blood pressure (DBP), higher nighttime systolic blood pressure (SBP) levels, as well as an increased 24-h, daytime and nighttime HR, compared to both obese and lean patients in the n-INS group. In relation to BMI, only 24-h, daytime, and nighttime DBP were higher in obese than in lean patients. At variance, when both h-INS and obesity were considered, 24-h SBP and DBP were higher in h-INS obese subjects than in the other groups. In multivariate analysis, insulin (max peak), area under the curve of insulin and insulin sensitivity index was independently associated with SBP. (1) Within a normotensive range, hyperinsulinemia and/or insulin resistance influence daily BP variation more than obesity does, suggesting a pivotal role of insulin on BP control in PCOS; (2) altered insulinemic state and ABPM-derived higher nighttime BP and HR may represent early markers to identify PCOS subjects prone to high cardiovascular risk.
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Affiliation(s)
- Roberto Mioni
- Clinica Medica 3 - Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, 35128, Padua, Italy.
| | - Anna Dalla Cà
- Clinica Medica 3 - Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Jenni Turra
- Clinica Medica 3 - Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Sara Azzolini
- Pediatric Endocrinology Unit - Department of Woman's and Child's Health, University of Padua, Padua, Italy
| | - Nadia Xamin
- Internal Medicine Unit - Civic Hospital, Bassano del Grappa (VI), Italy
| | - Luigi Bleve
- Clinica Medica 3 - Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Pietro Maffei
- Clinica Medica 3 - Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Roberto Vettor
- Clinica Medica 3 - Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Francesco Fallo
- Clinica Medica 3 - Department of Medicine (DIMED), University of Padua, Via Giustiniani 2, 35128, Padua, Italy
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17
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Foroozanfard F, Soleimani A, Arbab E, Samimi M, Tamadon MR. Relationship between IL-17 serum level and ambulatory blood pressure in women with polycystic ovary syndrome. J Nephropathol 2016; 6:15-24. [PMID: 28042549 PMCID: PMC5106878 DOI: 10.15171/jnp.2017.04] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 07/20/2016] [Indexed: 11/09/2022] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders with an inflammatory basis. It is associated with hyperandrogenism in women and can be also associated with increased activity of the renin-angiotensin system (RAS). Approximately 5% to 10% of women of reproductive age are affected by this disease. This syndrome is the main cause of infertility. Blood pressure may be one of the complications of the syndrome.
Objectives In this study, we sought to assess the role of the IL-17 inflammatory cytokine in increasing blood pressure in patients with PCOS.
Patients and Methods In this cross-sectional study, after obtaining informed consent, we evaluated 85 patients with PCOS. IL-17 serum level was measured after separating the serum via ELISA method. The results obtained for the two groups of patients with high blood pressure and normal blood pressure were compared with each other.
Results The daytime blood pressure was abnormal in eight patients, while it was normal in 72 patients. The blood pressure during the day had a direct correlation with the IL-17serum level; as a result, the mean IL-17 serum level in patients with high blood pressure was 77.10 ± 17.94 ρ g/ml while in those with normal blood pressure it was 55.20 ± 13.71 ρ g/ml (P = 0.001). High blood pressure during the night also showed a direct relation with theIL-17 serum level (P = 0.001). In addition, increasing of ambulatory 24-hourblood pressure was significantly related with IL-17 serum level, in such a way that the IL-17 serum level of people with high blood pressure rose by almost 22 ρg/ml during 24 hours (P = 0.001).
Conclusions Our results showed an association between PCO syndrome and inflammatory factors. The IL-17 serum level was directly associated with the increase in blood pressure.
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Affiliation(s)
- Fatemeh Foroozanfard
- Department of Gynecology and Obstetrics, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Soleimani
- Department of Internal Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Elham Arbab
- Department of Gynecology and Obstetrics, Kashan University of Medical Sciences, Kashan, Iran
| | - Mansooreh Samimi
- Department of Gynecology and Obstetrics, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Reza Tamadon
- Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran
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18
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Ozdemir O, Sari ME, Kalkan D, Koc EM, Ozdemir S, Atalay CR. Comprasion of ovarian stromal blood flow measured by color Doppler ultrasonography in polycystic ovary syndrome patients and healthy women with ultrasonographic evidence of polycystic. Gynecol Endocrinol 2015; 31:322-6. [PMID: 25558942 DOI: 10.3109/09513590.2014.995617] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To compare ovarian stromal artery blood flows measured by Doppler ultrasonography of polycystic ovary syndrome (PCOS) patients and healthy women with polycystic ovarian image in ultrasonography. METHODS Forty-two patients diagnosed with PCOS according to the criteria of 2003 Rotterdam Concencus Conferance on PCOS and 38 healthy volunteers with polycystic ovarian image in ultrasonography were included in the study. Ovarian volumes and ovarian stromal artery blood flows were measured by 3-dimensional (3-D) ultrasonography and Doppler ultrasonography in all patients. RESULTS In patients with PCOS, ovarian stromal artery pulsatility index (PI) and resistivity index (RI) were found significantly different from healthy women with polycystic ovarian image in ultrasonography (p < 0.05). 3-D ovarian volumes were found significantly higher in patients with PCOS (p < 0.05), and a negative correlation was also obtained between ovarian volumes and ovarian stromal artery resistivity indices. CONCLUSION Ovarian stromal artery Doppler examination could have an importance to explain the pathophysiology of PCOS, but there are few publications in the literature about PCOS and the details of ovarian stromal artery Doppler parameters in patients with polycystic ovarian image only. We conclude that Doppler ultrasonography findings of PCOS patients might be helpful in understanding the clinical follow-up and etiology of the disease.
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Affiliation(s)
- Ozhan Ozdemir
- Department of Obstetrics and Gynecology, Ankara Numune Education and Research Hospital , Ankara , Turkey
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Asemi Z, Esmaillzadeh A. DASH diet, insulin resistance, and serum hs-CRP in polycystic ovary syndrome: a randomized controlled clinical trial. Horm Metab Res 2015; 47:232-8. [PMID: 24956415 DOI: 10.1055/s-0034-1376990] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
UNLABELLED This study was designed to assess the effects of Dietary Approaches to Stop Hypertension (DASH) eating plan on insulin resistance and serum hs-CRP in overweight and obese women with PCOS. This randomized controlled clinical trial was done on 48 women diagnosed with PCOS. Subjects were randomly assigned to consume either the control (n=24) or the DASH eating pattern (n=24) for 8 weeks. The DASH diet consisted of 52% carbohydrates, 18% proteins, and 30% total fats. It was designed to be rich in fruits, vegetables, whole grains, and low-fat dairy products and low in saturated fats, cholesterol, refined grains, and sweets. Sodium content of the DASH diet was designed to be less than 2 400 mg/day. The control diet was also designed to contain 52% carbohydrates, 18% protein, and 30% total fat. Fasting blood samples were taken at baseline and after 8 weeks intervention to measure -insulin resistance and serum hs-CRP levels. -Adherence to the DASH eating pattern, compared to the -control diet, resulted in a significant reduction of serum insulin levels (-1.88 vs. 2.89 μIU/ml, p=0.03), HOMA-IR score (-0.45 vs. 0.80; p=0.01), and serum hs-CRP levels (-763.29 vs. 665.95 ng/ml, p=0.009). Additionally, a significant reduction in waist (-5.2 vs. -2.1 cm; p=0.003) and hip circumference (-5.9 vs. -1 cm; p<0.0001) was also seen in the DASH group compared with the control group. In conclusion, consumption of the DASH eating pattern for 8 weeks in overweight and obese women with PCOS resulted in the improvement of insulin resistance, serum hs-CRP levels, and abdominal fat accumulation. CLINICAL TRIAL REGISTRATION NUMBER www.irct.ir: IRCT201304235623N6.
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Affiliation(s)
- Z Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - A Esmaillzadeh
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Pedroso DCC, Miranda-Furtado CL, Kogure GS, Meola J, Okuka M, Silva C, Calado RT, Ferriani RA, Keefe DL, dos Reis RM. Inflammatory biomarkers and telomere length in women with polycystic ovary syndrome. Fertil Steril 2014; 103:542-7.e2. [PMID: 25467041 DOI: 10.1016/j.fertnstert.2014.10.035] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 10/17/2014] [Accepted: 10/20/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To analyze whether leukocyte telomere length (LTL) is impaired in women with polycystic ovary syndrome (PCOS). DESIGN Case-control study. SETTING Hospital. PATIENT(S) A total of 274 women, including 150 patients with PCOS and 124 controls. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Body mass index (BMI), waist circumference, systemic arterial pressure, lipid profile, E(2), LH, T, androstenedione, PRL, TSH, sex hormone-binding globulin, C-reactive protein (CRP), homocysteine, free androgen index, and the homeostatic model of insulin sensitivity (HOMA-IR) index were analyzed. The LTL evaluation was measured by quantitative polymerase chain reaction. RESULT(S) The PCOS group had higher values for weight, BMI, waist circumference, systolic arterial pressure, triglycerides, LH, T, insulin, CRP, free androgen index, and HOMA-IR compared with the control group. Sex hormone-binding globulin and E(2) levels were lower in the PCOS group than in the control group. The LTL did not differ between groups. Age, BMI, and HOMA-IR had no significant effect on LTL. The inflammatory biomarkers CRP and homocysteine were negatively correlated with LTL in patients with PCOS. CONCLUSION(S) Our results showed no differences in LTL between patients with PCOS and controls, but CRP and homocysteine biomarkers negatively correlated with LTL in the PCOS group.
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Affiliation(s)
- Daiana Cristina Chielli Pedroso
- Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | | | - Gislaine Satyko Kogure
- Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Juliana Meola
- Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Maja Okuka
- Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida
| | - Celso Silva
- Center for Reproductive Medicine, Orlando, Florida
| | - Rodrigo T Calado
- Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Rui Alberto Ferriani
- Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - David L Keefe
- Department of Obstetrics and Gynecology, New York University Langone Medical Center, New York, New York
| | - Rosana Maria dos Reis
- Department of Obstetrics and Gynecology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil.
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Lai H, Jia X, Yu Q, Zhang C, Qiao J, Guan Y, Kang J. High-fat diet induces significant metabolic disorders in a mouse model of polycystic ovary syndrome. Biol Reprod 2014; 91:127. [PMID: 25100714 DOI: 10.1095/biolreprod.114.120063] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common female endocrinopathy associated with both reproductive and metabolic disorders. Dehydroepiandrosterone (DHEA) is currently used to induce a PCOS mouse model. High-fat diet (HFD) has been shown to cause obesity and infertility in female mice. The possible effect of an HFD on the phenotype of DHEA-induced PCOS mice is unknown. The aim of the present study was to investigate both reproductive and metabolic features of DHEA-induced PCOS mice fed a normal chow or a 60% HFD. Prepubertal C57BL/6 mice (age 25 days) on the normal chow or an HFD were injected (s.c.) daily with the vehicle sesame oil or DHEA for 20 consecutive days. At the end of the experiment, both reproductive and metabolic characteristics were assessed. Our data show that an HFD did not affect the reproductive phenotype of DHEA-treated mice. The treatment of HFD, however, caused significant metabolic alterations in DHEA-treated mice, including obesity, glucose intolerance, dyslipidemia, and pronounced liver steatosis. These findings suggest that HFD induces distinct metabolic features in DHEA-induced PCOS mice. The combined DHEA and HFD treatment may thus serve as a means of studying the mechanisms involved in metabolic derangements of this syndrome, particularly in the high prevalence of hepatic steatosis in women with PCOS.
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Affiliation(s)
- Hao Lai
- Department of Physiology and Pathophysiology, Peking University Health Science Center, Beijing, China
| | - Xiao Jia
- Department of Physiology and Pathophysiology, Peking University Health Science Center, Beijing, China
| | - Qiuxiao Yu
- Department of Physiology and Pathophysiology, Peking University Health Science Center, Beijing, China
| | - Chenglu Zhang
- Department of Physiology and Pathophysiology, Peking University Health Science Center, Beijing, China
| | - Jie Qiao
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, China
| | - Youfei Guan
- Department of Physiology and Pathophysiology, Peking University Health Science Center, Beijing, China
| | - Jihong Kang
- Department of Physiology and Pathophysiology, Peking University Health Science Center, Beijing, China
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Abstract
Polycystic ovary syndrome (PCOS), a heterogeneous and chronic condition, today affects about 5% of women of reproductive age. PCOS is strongly associated with states of insulin resistance and hyperinsulinemia. Risk factors include genetics, metabolic profiles, and the in utero environment. Long-term consequences of PCOS include metabolic complications such as diabetes, obesity, and cardiovascular disease. Dysregulation of insulin action is closely linked to the pathogenesis of PCOS. However, whether insulin resistance is the causative factor in the development of PCOS remains to be ascertained. Moreover, the mechanism by which insulin resistance may lead to reproductive dysfunction requires further elucidation.
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Affiliation(s)
- Anindita Nandi
- Division of Endocrinology and Metabolism, Beth Israel Medical Center, Albert Einstein College of Medicine, New York, NY 10003, USA
| | - Zijian Chen
- Division of Endocrinology and Metabolism, Beth Israel Medical Center, Albert Einstein College of Medicine, New York, NY 10003, USA
| | - Ronak Patel
- Division of Endocrinology and Metabolism, Beth Israel Medical Center, Albert Einstein College of Medicine, New York, NY 10003, USA
| | - Leonid Poretsky
- Division of Endocrinology and Metabolism, Department of Medicine, Gerald J. Friedman Diabetes Institute, Beth Israel Medical Center, Albert Einstein College of Medicine, 317 East 17th Street, 7th Floor, New York, NY 10003, USA.
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Abstract
The insulin/insulin-like growth factor (IGF) pathways and glucose metabolism act as mediators of human ovarian function and female fertility. In normal insulin action, insulin binds to its own receptors in the ovary to mediate steroidogenesis and act as a co-gonadotropin. Insulin with other factors may influence ovarian growth and cyst formation. The IGF pathway also seems to influence normal ovarian function. Insulin signaling affects reproductive function. Dysregulation of this pathway leads to altered puberty, ovulation, and fertility. Better understanding of the normal physiology and pathophysiology of insulin, IGF, and glucose effects on the human reproductive system will allow for better outcomes.
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Affiliation(s)
- Anindita Nandi
- Division of Endocrinology and Metabolism, Beth Israel Medical Center, Albert Einstein College of Medicine, 317 East 17th Street, 7th Floor, New York, NY 10003, USA
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Ságodi L, Lombay B, Vámosi I, Barkai L. [Obesity, hormonal and metabolic abnormalities in adolescent girls with polycystic ovary syndrome]. Orv Hetil 2013; 154:1226-34. [PMID: 23895991 DOI: 10.1556/oh.2013.29669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Polycystic ovary syndrome is associated with metabolic abnormalities, such as dyslipidemia, obesity, glucose intolerance, which are also components of the metabolic syndrome. Central obesity and insulin resistance appear to play an important role in the pathogenesis of polycystic ovary syndrome, perhaps via subsequent steroidogenic dysregulation. AIM The aim of the authors was to assess metabolic and hormonal abnormalities in adolescent girls with polycystic ovary syndrome. METHOD The study included 52 adolescents diagnosed with polycystic ovary syndrome based on the Rotterdam criteria. Anthropometric, hormonal and metabolic parameters were evaluated among all subjects. 20 healthy, age-matched, non-obese, regularly menstruating girls were used as controls. Of the 52 patients, 15 patients were born with low-birth-weight and 37 patients were born with normal birth weight. Oral glucose tolerance test was performed in all patients and controls. The age of patients was 16.8±3.1 years, and the age of controls was 16.95±2.1 years. RESULTS Among patients with polycystic ovary syndrome the prevalence of overweight and obesity was 35% (n = 18), while impaired fasting glucose occurred in one patient, impaired glucose tolerance in 8 patients, insulin resistance in 25 patients and metabolic syndrome in 12 patients. Serum triglyceride levels in patients and controls were 1.4±0.8 and 0.9±0.3 mmol/l, respectively (p<0.05), while fasting blood glucose, total cholesterol, HDL and LDL cholesterol were not different in the two groups. Metabolic abnormalities and obesity were more severe and more frequent in patients with low-birth-weight compared to those born with normal weight. There was a negative correlation between birth weight and body mass index SDS values and a positive correlation between fasting insulin levels and body mass index SDS (r = 0.37) in patients born with low-birth-weight. CONCLUSIONS Abnormal glucose metabolism is frequently present in adolescents with polycystic ovary syndrome. It is possible that early diagnosis of polycystic ovary syndrome in adolescence may prevent some of the long-term complications associated with this syndrome.
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Affiliation(s)
- László Ságodi
- Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház Csecsemő- és Gyermekosztály Miskolc.
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25
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Gunebakmaz O, Kaya MG, Duran M. PCOS must be kept in mind in young females especially those without traditional risk factors but suffered from coronary events. Int J Cardiol 2013; 163:e16. [DOI: 10.1016/j.ijcard.2012.08.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 08/23/2012] [Indexed: 11/27/2022]
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Kral JG. Preventing and Treating Obesity in Girls and Young Women to Curb the Epidemic. ACTA ACUST UNITED AC 2012; 12:1539-46. [PMID: 15536217 DOI: 10.1038/oby.2004.193] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Obesity and its serious comorbidities, type 2 diabetes, coronary heart disease, hypertension, and dyslipidemia, have reached epidemic proportions in adults and children. Female obesity is more prevalent and, thus, has greater epidemiological importance: mothers transmit the disease epigenetically and genetically. Maternal obesity affects maternal health, pregnancy outcome, and fetal, neonatal, childhood, and ultimately adult morbidity and mortality. Obesity is easy to diagnose, as are most of its risk factors, yet very little progress has been made in preventing the disease. During a brief period of rapid early growth, there is imprinting of antecedents of adult obesity and obesity-related disease. Because of the rapidity of this early growth and the relative brevity of the critical period, early recognition and prompt intervention are necessary and possibly sufficient to prevent the development of obesity. Identification of inappropriate rapid weight gain through frequent weighing should trigger immediate adjustment of energy intake, a simple intervention in bottle-fed infants, the ones at greatest risk for becoming obese. This review presents a step-care strategy with fail-safe action levels starting with maternal education and diet, exercise, and behavior modification for mother and child and progressing to drug treatment and, in selected cases, laparoscopic surgery for young women of childbearing age in whom other measures have failed. This approach is predicated on the assumption that careful monitoring and responsive supplementation of potential deficiencies is easier to achieve, more cost-effective, and safer than effectively treating manifest obesity and its comorbidities in adults.
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Affiliation(s)
- John G Kral
- Department of Surgery, Box 40, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.
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Wang X, Smith GI, Patterson BW, Reeds DN, Kampelman J, Magkos F, Mittendorfer B. Testosterone increases the muscle protein synthesis rate but does not affect very-low-density lipoprotein metabolism in obese premenopausal women. Am J Physiol Endocrinol Metab 2012; 302:E740-6. [PMID: 22252942 PMCID: PMC3311295 DOI: 10.1152/ajpendo.00533.2011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Men and women with hyperandrogenemia have a more proatherogenic plasma lipid profile [e.g., greater triglyceride (TG) and total and low-density lipoprotein-cholesterol and lower high-density lipoprotein-cholesterol concentrations] than healthy premenopausal women. Furthermore, castration of male rats markedly reduces testosterone availability below normal and decreases plasma TG concentration, and testosterone replacement reverses this effect. Testosterone is, therefore, thought to be an important regulator of plasma lipid homeostasis. However, little is known about the effect of testosterone on plasma TG concentration and kinetics. Furthermore, testosterone is a potent skeletal muscle protein anabolic agent in men, but its effect on muscle protein turnover in women is unknown. We measured plasma lipid concentrations, hepatic very low density lipoprotein (VLDL)-TG and VLDL-apolipoprotein B-100 secretion rates, and the muscle protein fractional synthesis rate in 10 obese women before and after trandermal testosterone (1.25 g of 1% AndroGel daily) treatment for 3 wk. Serum total and free testosterone concentrations increased (P < 0.05) by approximately sevenfold in response to testosterone treatment, reaching concentrations that are comparable to those in women with hyperandrogenemia, but lower than the normal range for eugonadal men. Except for a small (∼10%) decrease in plasma high-density lipoprotein particle and cholesterol concentrations (P < 0.04), testosterone therapy had no effect on plasma lipid concentrations, lipoprotein particle sizes, and hepatic VLDL-TG and VLDL-apolipoprotein B-100 secretion rates (all P > 0.05); the muscle protein fractional synthesis rate, however, increased by ∼45% (P < 0.001). We conclude that testosterone is a potent skeletal muscle protein anabolic agent, but not an important regulator of plasma lipid homeostasis in obese women.
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Affiliation(s)
- Xuewen Wang
- Washington Univ. School of Medicine, Division of Geriatrics & Nutritional Science, St. Louis, MO 63110, USA
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Gören K, Sağsöz N, Noyan V, Yücel A, Cağlayan O, Bostancı MS. Plasma apelin levels in patients with polycystic ovary syndrome. J Turk Ger Gynecol Assoc 2012; 13:27-31. [PMID: 24627671 DOI: 10.5152/jtgga.2011.74] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Accepted: 11/07/2011] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE The aim of the study was to evaluate plasma apelin levels in patients with polycystic ovary syndrome (PCOS) and healthy controls. MATERIAL AND METHODS Plasma apelin levels, serum lipid levels, serum hormone levels, and homeostasis model assessment-insulin resistance (HOMA-IR) values of 32 patients with PCOS and 31 healthy women forming the control group were checked. RESULTS Plasma apelin levels of the PCOS group (0.350±0.083 ng/ml) were significantly higher than those of the control group (0.246±0.045 ng/ml) (p<0.001). No significant correlation was detected between apelin levels and biochemical or clinical data in PCOS group. CONCLUSION Plasma apelin levels were significantly higher in PCOS patients.
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Affiliation(s)
- Kıvılcım Gören
- Department of Gynecology and Obstetrics, Haci Hidayet Dogruer State Hospital, Specialist of Obstetric and Gynecology, Kırıkkale, Turkey
| | - Nevin Sağsöz
- Department of Gynecology and Obstetrics, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey
| | - Volkan Noyan
- Department of Gynecology and Obstetrics, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey
| | - Aykan Yücel
- Department of Gynecology and Obstetrics, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey
| | - Osman Cağlayan
- Department of Biochemistry, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey
| | - Mehmet Sühha Bostancı
- Specialist of Obstetric and Gynecology, Sakarya Education and Research Hospital, Sakarya, Turkey
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Knebel B, Janssen OE, Hahn S, Jacob S, Nitzgen U, Haas J, Muller-Wieland D, Kotzka J. Genetic variations in SREBP-1 and LXRα are not directly associated to PCOS but contribute to the physiological specifics of the syndrome. Mol Biol Rep 2012; 39:6835-42. [DOI: 10.1007/s11033-012-1508-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 01/24/2012] [Indexed: 11/24/2022]
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Mokhlesi B, Scoccia B, Mazzone T, Sam S. Risk of obstructive sleep apnea in obese and nonobese women with polycystic ovary syndrome and healthy reproductively normal women. Fertil Steril 2012; 97:786-91. [PMID: 22264851 DOI: 10.1016/j.fertnstert.2011.12.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 11/14/2011] [Accepted: 12/14/2011] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To study the risk for obstructive sleep apnea (OSA) in a group of nonobese and obese polycystic ovary syndrome (PCOS) and control women. DESIGN Prospective study. SETTING Academic tertiary care medical center. PATIENT(S) Forty-four women with PCOS and 34 control women. INTERVENTION(S) All of the women completed the Berlin questionnaire for assessment of OSA risk. MAIN OUTCOME MEASURE(S) All of the women underwent fasting determination of androgens, glucose, and insulin. RESULT(S) Women with PCOS were more obese compared with control women. However, there were no differences in BMI once subjects were divided into nonobese (PCOS: n = 17; control: n = 26) and obese (PCOS: n = 27; control: n = 8) groups. Women with PCOS had higher prevalence of high-risk OSA compared with control women (47% vs. 15%). However, none of the nonobese PCOS and control women screened positively for high-risk OSA. Among the obese group, the risk did not differ between groups (77% vs. 63%). CONCLUSION(S) Our findings indicate that even though the risk for OSA in PCOS is high, it is related to the high prevalence of severe obesity. The risk for OSA among nonobese women with PCOS is very low. However, our findings are limited by lack of polysomnographic confirmation of OSA.
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Affiliation(s)
- Babak Mokhlesi
- Sleep Disorders Center, Section of Pulmonary and Critical Care, Department of Medicine, University of Chicago, Chicago, Illinois 60612, USA
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Huang J, Ni R, Chen X, Huang L, Mo Y, Yang D. Metabolic abnormalities in adolescents with polycystic ovary syndrome in south China. Reprod Biol Endocrinol 2010; 8:142. [PMID: 21083920 PMCID: PMC2994875 DOI: 10.1186/1477-7827-8-142] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Accepted: 11/17/2010] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Adults with polycystic ovary syndrome (PCOS) can have multiple metabolic abnormalities. However, studies in the adolescent population are still limited and these results seem to vary widely. This study was to investigate the metabolic abnormalities in adolescents with PCOS in South China and the potential risk factors contributed to these health risks. METHODS Anthropometric measurements and biochemical parameters were evaluated in 128 adolescents with PCOS and their age- and BMI-matched controls. RESULTS The prevalence of pre-diabetes, insulin resistance, hyperinsulinemia, dyslipidemia and metabolic syndrome in adolescents with PCOS was 11.7%, 46.9%, 29.7%, 22.7% and 4.7%, respectively. 16.3%, 74.4%, 67.4%, 39.5% and 14% of the PCOS subjects with BMI > 85th had pre-diabetes, insulin resistance, hyperinsulinemia, dyslipidemia and metabolic syndrome, whereas 9.4%, 32.9%, 10.6%, 14.1% and 0% of the PCOS subjects with BMI < 85th had such disturbances. CONCLUSIONS Adolescents with PCOS in South China had more metabolic abnormalities than their age- and BMI-matched non-PCOS counterparts. Obesity could worsen insulin resistance, hyperinsulinemia and metabolic syndrome in PCOS adolescents.
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Affiliation(s)
- Jia Huang
- Department of Obstetrics and Gynecology, Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Renmin Ni
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Kunming Medical College, Kunming, Yunnan, China
| | - Xiaoli Chen
- Department of Obstetrics and Gynecology, Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Lili Huang
- Department of Obstetrics and Gynecology, Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yaqin Mo
- Department of Obstetrics and Gynecology, Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Dongzi Yang
- Department of Obstetrics and Gynecology, Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
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Karaer A, Cavkaytar S, Mert I, Buyukkagnici U, Batioglu S. Cardiovascular risk factors in polycystic ovary syndrome. J OBSTET GYNAECOL 2010; 30:387-92. [PMID: 20455724 DOI: 10.3109/01443611003763408] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
A total of 31 women with polycystic ovary syndrome (PCOS) and 31 healthy age/body mass index matched controls were compared for serum hormones, basal and oral-glucose stimulated glucose, insulin, homocysteine, high sensitive C-reactive protein (hsCRP) and lipid levels. The women with PCOS had significantly higher serum fasting insulin, homocysteine, total cholesterol and LDL cholesterol level than controls, whereas no differences were detected in serum fasting or OGTT 60th- and 120th-minute glucose concentrations, hsCRP, HDL cholesterol, VLDL cholesterol and triglyceride levels between PCOS and control women. Insulin resistance was found in 54.8% (17/31) of PCOS patients by glucose: insulin (G/I) ratio, whereas only 29.0% (9/31) of control women (p = 0.04). Multivariate linear regression analysis revealed that only waist/hip ratio was independent determinants of G/I ratio. PCOS is associated with some biochemical and clinical risk factors for cardiovascular disease. Therefore, patients with PCOS should undergo comprehensive evaluation for recognised cardiovascular risk factors.
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Affiliation(s)
- A Karaer
- Department of Obstetrics and Gynecology, Dr Zekai Tahir Burak Woman Health Education and Research Hospital, Ankara, Turkey.
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Sakka SD, Loutradis D, Kanaka-Gantenbein C, Margeli A, Papastamataki M, Papassotiriou I, Chrousos GP. Absence of insulin resistance and low-grade inflammation despite early metabolic syndrome manifestations in children born after in vitro fertilization. Fertil Steril 2010; 94:1693-9. [PMID: 20045517 DOI: 10.1016/j.fertnstert.2009.09.049] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2009] [Revised: 08/22/2009] [Accepted: 09/23/2009] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To investigate the metabolic profile, traditional adipokines, and indices of insulin resistance and low-grade inflammation in children born as a result of IVF compared with spontaneously conceived controls. DESIGN Cross-sectional, case-control study. SETTING IVF Section of the First Department of Obstetrics and Gynecology and the First Department of Pediatrics of the University of Athens. PATIENT(S) One hundred six children conceived after classic IVF and 68 age-matched spontaneously conceived controls, aged 4-14 years. INTERVENTION(S) Children underwent physical examination and morning fasting samples were collected. MAIN OUTCOME MEASURE(S) Lipid profile, circulating fasting glucose, insulin, leptin, adiponectin, high-sensitivity interleukin-6, and high-sensitivity C-reactive protein were determined and the fasting glucose-to-insulin ratio was calculated. RESULT(S) Children born as a result of classic IVF had significantly higher systolic and diastolic blood pressures (BP) and triglycerides than controls. These BP differences remained significant even after correction for birth size and multiple births. No significant differences in biochemical indices of insulin resistance, circulating adipokines, and inflammatory markers were detected before or after these same corrections. CONCLUSION(S) Despite an increase of BP, children born as a result of IVF have no biochemical evidence of insulin resistance, including fasting glucose-to-insulin ratio and circulating adipokines, or low-grade chronic inflammation. However, the long-term impact of periconceptual manipulations should be closely monitored.
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Affiliation(s)
- Sophia D Sakka
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Aghia Sophia Children's Hospital, Athens University Medical School, Athens, Greece
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Kanaka-Gantenbein C, Sakka S, Chrousos GP. Assisted reproduction and its neuroendocrine impact on the offspring. PROGRESS IN BRAIN RESEARCH 2010; 182:161-74. [PMID: 20541664 DOI: 10.1016/s0079-6123(10)82006-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Assisted reproductive technologies (ARTs) have been widely used during the last three decades and progressively more children are born with the help of such methods. There is now evidence that ARTs may be associated with slight epigenetic modifications in the expression of several genes that could have a long-term impact on the health of the offspring. Also, a clear association between such techniques and genomic imprinting abnormalities has been reported. The neuroendocrine impact of ART on the offspring includes slight elevations of systolic blood pressure (SBP) and diastolic blood pressure (DBP), as well as increased circulating triglyceride concentrations, in children born after ART, especially in those with rapid catch-up growth in weight during early childhood. However, the postnatal growth of most children after ART is normal and no increased incidence of the full metabolic syndrome has been observed in these children and adolescents. Moreover, the pace and timing of puberty of such children is normal and no increased incidence of premature adrenarche could be discerned in ART children in the absence of restricted fetal growth. Finally, a slight modification of the set point of thyroid stimulating hormone sensitivity was observed in ART children, without an apparent impact on thyroid hormone secretion. This has been attributed to epigenetic changes. Questions remain to be answered regarding the future reproductive capacity of children born after ART, as well as their cardiovascular risk in later adult life. Long-term prospective studies should be performed to provide robust evidence.
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Affiliation(s)
- Christina Kanaka-Gantenbein
- Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, University of Athens, Agia Sophia Children's Hospital, Goudi, Athens, Greece.
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Farshchi H, Rane A, Love A, Kennedy RL. Diet and nutrition in polycystic ovary syndrome (PCOS): Pointers for nutritional management. J OBSTET GYNAECOL 2009; 27:762-73. [DOI: 10.1080/01443610701667338] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
Polycystic ovarian syndrome (PCOS) is the most frequent endocrine disorder and most common cause of anovulation in women of reproductive age. It is a heterogeneous disorder, characterized by excess androgen, ovulatory dysfunction and/or polycystic ovaries. The syndrome is known for its association with several reproductive problems, including infertility and obstetric adverse effects. In addition, significant long-term health problems have been strongly linked to PCOS, with women suffering from the disorder having a significantly higher risk of diabetes, cardiovascular risk and some types of cancer, such as endometrial cancer. Although its etiology is unknown, insulin resistance is believed to play a pivotal role in its pathophysiology, with insulin sensitizers found to provide an exciting option in managing health problems associated with PCOS. Almost a decade ago, we proposed a non-insulin-sensitizing mechanism of action for insulin sensitizers through their effect on steroidogenesis. Accumulating evidence supported such an assumption, with solid evidence for a modulating effect on steroidogenesis by metformin and glitazones in the ovaries, adrenal glands and fat cells. Furthermore, other exciting positive roles for insulin sensitizers, in particular glitazones, have been reported at the level of endothelial function. Studying the value of insulin sensitizers in preventing long-term health problems in women with PCOS is still in the stage of infancy.
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Affiliation(s)
- Ahmed F Galal
- a Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, MN 55454, USA
| | - Mohamed F Mitwally
- b Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, 606 24th Avenue South, Suite 402, Minneapolis, MN 55454, USA.
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Kenigsberg S, Bentov Y, Chalifa-Caspi V, Potashnik G, Ofir R, Birk OS. Gene expression microarray profiles of cumulus cells in lean and overweight-obese polycystic ovary syndrome patients. Mol Hum Reprod 2009; 15:89-103. [PMID: 19141487 DOI: 10.1093/molehr/gan082] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The aim of this work was to study gene expression patterns of cultured cumulus cells from lean and overweight-obese polycystic ovary syndrome (PCOS) patients using genome-wide oligonucleotide microarray. The study included 25 patients undergoing in vitro fertilization and intra-cytoplasmic sperm injection: 12 diagnosed with PCOS and 13 matching controls. Each of the groups was subdivided into lean (body mass index (BMI) < 24) and overweight (BMI > 27) subgroups. The following comparisons of gene expression data were made: lean PCOS versus lean controls, lean PCOS versus overweight PCOS, all PCOS versus all controls, overweight PCOS versus overweight controls, overweight controls versus lean controls and all overweight versus all lean. The largest number of differentially expressed genes (DEGs), with fold change (FC) |FC| >or= 1.5 and P-value < 0.01, was found in the lean PCOS versus lean controls comparison (487) with most of these genes being down-regulated in PCOS. The second largest group of DEGs originated from the comparison of lean PCOS versus overweight PCOS (305). The other comparisons resulted in a much smaller number of DEGs (174, 109, 125 and 12, respectively). In the comparison of lean PCOS with lean controls, most DEGs were transcription factors and components of the extracellular matrix and two pathways, Wnt/beta-catenin and mitogen-activated protein kinase. When comparing overweight PCOS with overweight controls, most DEGs were of pathways related to insulin signaling, metabolism and energy production. The finding of unique gene expression patterns in cumulus cells from the two PCOS subtypes is in agreement with other studies that have found the two to be separate entities with potentially different pathophysiologies.
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Affiliation(s)
- Shlomit Kenigsberg
- The Morris Kahn Laboratory of Human Genetics, National Institute for Biotechnology in the Negev, Ben-Gurion University, Beer-Sheva, Israel
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Ciaraldi TP, Aroda V, Mudaliar S, Chang RJ, Henry RR. Polycystic ovary syndrome is associated with tissue-specific differences in insulin resistance. J Clin Endocrinol Metab 2009; 94:157-63. [PMID: 18854391 PMCID: PMC2630871 DOI: 10.1210/jc.2008-1492] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2008] [Accepted: 10/06/2008] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The potential differential contributions of skeletal muscle and adipose tissue to whole body insulin resistance were evaluated in subjects with polycystic ovary syndrome (PCOS). RESEARCH DESIGN AND METHODS Forty-two PCOS subjects and 15 body mass index-matched control subjects were studied. Insulin action was evaluated by the hyperinsulinemic/euglycemic clamp procedure. Isolated adipocytes and cultured muscle cells were analyzed for glucose transport activity; adipocytes, muscle tissue, and myotubes were analyzed for the expression and phosphorylation of insulin-signaling proteins. RESULTS Fifty-seven per cent of the PCOS subjects had impaired glucose tolerance and the lowest rate of maximal insulin-stimulated whole body glucose disposal compared to controls (P < 0.01). PCOS subjects with normal glucose tolerance had intermediate reduction in glucose disposal rate (P < 0.05 vs. both control and impaired glucose tolerance subjects). However, rates of maximal insulin-stimulated glucose transport (insulin responsiveness) into isolated adipocytes were comparable between all three groups, whereas PCOS subjects displayed impaired insulin sensitivity. In contrast, myotubes from PCOS subjects displayed reduced insulin responsiveness for glucose uptake and normal sensitivity. There were no differences between groups in the expression of glucose transporter 4 or insulin-signaling proteins or maximal insulin stimulation of phosphorylation of Akt in skeletal muscle, myotubes, or adipocytes. CONCLUSIONS Individuals with PCOS display impaired insulin responsiveness in skeletal muscle and myotubes, whereas isolated adipocytes display impaired insulin sensitivity but normal responsiveness. Skeletal muscle and adipose tissue contribute differently to insulin resistance in PCOS. Insulin resistance in PCOS cannot be accounted for by differences in the expression of selected signaling molecules or maximal phosphorylation of Akt.
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Affiliation(s)
- Theodore P Ciaraldi
- Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive (111G), San Diego, California 92161, USA.
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Asagami T, Holmes TH, Reaven G. Differential effects of insulin sensitivity on androgens in obese women with polycystic ovary syndrome or normal ovulation. Metabolism 2008; 57:1355-60. [PMID: 18803938 PMCID: PMC2573867 DOI: 10.1016/j.metabol.2008.05.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2007] [Accepted: 05/13/2008] [Indexed: 11/18/2022]
Abstract
The differential effects of insulin sensitivity and adiposity on androgen concentrations in women with polycystic ovary syndrome (PCOS) are unclear. To address this issue, we divided 43 overweight women into 4 groups based on both their clinical classification (PCOS or normal) and whether they were insulin resistant (IR) or insulin sensitive (IS) by their steady-state plasma glucose concentrations. Total testosterone concentrations were significantly increased as a function of both clinical classification (PCOS vs normal, P < .0001) and steady-state plasma glucose concentration (IR vs IS, P = .002). Mean testosterone concentrations were higher in PCOS-IR compared with PCOS-IS, normal-IR, or normal-IS women (P < .005). In addition, there was a statistically significant interaction (P = .03) between clinical classification (PCOS vs normal) and insulin sensitivity (IR vs IS) for testosterone concentrations. In contrast, androstenedione concentrations were higher in women with PCOS (P = .001), irrespective of whether they were IR or IS (P = .31); and no interaction between clinical classification and insulin sensitivity was discerned (P = .34). These results indicate that both PCOS and insulin resistance independently contributed to increased total testosterone concentrations within a group of overweight/obese women. These findings are consistent with the hypothesis that the ovaries of women with PCOS are hypersensitive to the ability of insulin to increase testosterone production and that the more insulin resistant the patient, the higher the testosterone concentration. In contrast, androstenedione concentrations seem to be independent of differences in insulin resistance. Our findings emphasize the need to increase understanding of the factors that modulate ovarian androgen secretion.
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Affiliation(s)
- Tomoko Asagami
- FALK Cardiovascular Research Center, Division of Cardiovascular Medicine, Stanford University, Stanford, CA. USA
| | - Tyson H. Holmes
- Department of Health Research and Policy, Division of Biostatistics, Stanford University, Stanford, CA.USA
| | - Gerald Reaven
- FALK Cardiovascular Research Center, Division of Cardiovascular Medicine, Stanford University, Stanford, CA. USA
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Sivabalan S, Renuka S, Menon VP. Fat feeding potentiates the diabetogenic effect of dexamethasone in Wistar rats. Int Arch Med 2008; 1:7. [PMID: 18500989 PMCID: PMC2414485 DOI: 10.1186/1755-7682-1-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2007] [Accepted: 05/23/2008] [Indexed: 01/15/2023] Open
Abstract
Background The role of cortisol and its increased action/availability is implicated in the pathogenesis of insulin resistance associated with obesity and metabolic syndrome but the mechanism of increased action/availability is not known. Availability of several other lipophilic hormones, drugs and pollutants are also reported to be increased in obesity. Increased lipids in the circulation are reported to alter the fluidity and permeability of membranes. Hyperlipidemia is also reported to alter the pharmacokinetics and pharmacodynamics of lipophilic molecules and also membrane fluidity and permeability. In this context we assumed that the hyperlipidemia associated with human obesity might play a role in the altered action/availability of cortisol and this in turn might have initiated the metabolic complications. To evaluate our assumption we have administered dexamethasone [low [50 μg/kg/day] or high [250 μg/kg/day] dose] to high-fat [coconut oil & vanaspati] fed rats and the results were compared with rats administered with either dexamethasone or high-fat. Results and Discussion Within two weeks, the rats co-administered with high-fat and dexamethasone developed severe hyperglycemia, hyperlipidemia and insulin resistance compared to rats treated either of them alone. High-fat fed rats treated with higher dose of dexamethasone were presented with severe hyperglycemia, insulin resistance and also severe glycosuria. The hyperlipidemia caused by high-fat feeding might have altered the transport and distribution of dexamethasone, probably by altering the physical state of membranes and transport proteins. Conclusion From the results obtained, it can be speculated that the altered lipid and cortisol metabolism could affect one another, forming a vicious cycle.
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Affiliation(s)
- Shanmugam Sivabalan
- Department of Biochemistry & Biotechnology, Faculty of Science, Annamalai University, Annamalainagar - 608002, Tamilnadu, India.
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Jones MR, Wilson SG, Mullin BH, Mead R, Dudbridge F, Watts GF, Stuckey BGA. Polymorphism in postinsulin receptor signaling pathway is not associated with polycystic ovary syndrome. Fertil Steril 2008; 90:2298-303. [PMID: 18249389 DOI: 10.1016/j.fertnstert.2007.10.079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2007] [Revised: 10/23/2007] [Accepted: 10/30/2007] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate polymorphisms in postinsulin receptor signaling. To investigate PIK3R1, SLC2A4, SLC2A4RG, and MEF2A to determine whether these genes are associated with susceptibility to polycystic ovary syndrome (PCOS) or key phenotypic features of insulin resistance in subjects with PCOS. DESIGN Case-control study. SETTING Participants with PCOS were recruited from a clinical practice database, and controls from the general community. PATIENT(S) One hundred seventy-three patients with PCOS conforming to the National Institutes of Health (NIH) diagnostic criteria, all of Caucasian descent; 107 normally ovulating women of white descent from the general community. INTERVENTION(S) Drawing of blood for DNA extraction. MAIN OUTCOME MEASURE(S) Frequency of PIK3R1, SLC2A4, SLC2A4RG, and MEF2A polymorphisms in case and control subjects. RESULT(S) No significant difference between the frequency of the polymorphisms in case and control women was identified. No single nucleotide polymorphism studied in any of these four genes was associated with the PCOS phenotype. CONCLUSION(S) Polymorphisms in the PIK3R1, SLC2A4, SLC2A4RG, and MEF2A genes are not associated with key PCOS phenotypes.
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Affiliation(s)
- Michelle R Jones
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, University of Western Australia, Nedlands, , Australia
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Bloom MS, Schisterman EF, Hediger ML. The use and misuse of matching in case-control studies: the example of polycystic ovary syndrome. Fertil Steril 2007; 88:707-10. [PMID: 17433314 PMCID: PMC2040105 DOI: 10.1016/j.fertnstert.2006.11.125] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2006] [Revised: 10/25/2006] [Accepted: 11/21/2006] [Indexed: 11/15/2022]
Abstract
Matching control selection strategies are often used in polycystic ovary syndrome case-control studies; however, they are infrequently used in an appropriate fashion. When properly applied, matching may offer improved study precision, but this is highly contingent on the causal pathway under consideration, strength of the associations between the matching variable and both the risk factor of interest and polycystic ovary syndrome, and the use of an appropriate stratified data analysis.
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Affiliation(s)
- Michael S. Bloom
- Postdoctoral Research Fellow, Epidemiology Branch, Division of Epidemiology Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, U.S. Dept. of Health and Human Services, 6100 Executive Blvd., Rm. 7B03, MSC 7510, Bethesda, MD 20892, Phone (301) 496-5581, Fax (301) 402-2084,
| | - Enrique F. Schisterman
- Investigator, Epidemiology Branch, Division of Epidemiology Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, U.S. Dept. of Health and Human Services, 6100 Executive Blvd., Rm. 7B03, MSC 7510 Bethesda, MD 20892, Phone (301) 435-6893, Fax (301) 402-2084,
| | - Mary L. Hediger
- Investigator, Epidemiology Branch, Division of Epidemiology Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, U.S. Dept. of Health and Human Services, 6100 Executive Blvd., Rm. 7B03, MSC 7510, Bethesda, MD 20892, Phone (301) 435-6897, Fax (301) 402-2084,
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Askelöf M, Halldin Stenlid M, Edlund B. Eating behaviour and body image in overweight adolescent girls with or without hyperandrogenicity. Eat Weight Disord 2007; 12:41-7. [PMID: 17384529 DOI: 10.1007/bf03327771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
UNLABELLED We addressed the question of whether a combination of obesity and hyperandrogenicity has a more severe influence on psychosocial behaviours, as reflected by eating behaviour and body image, compared to obesity alone. AIM To study eating behaviour and body image in age-, pubertal- and BMI-matched overweight adolescent girls with and without hyperandrogenicity, and to compare the data with those from a control group of normal weight girls. METHODS Overweight adolescent girls in late puberty with (n=10) and without hyperandrogenicity (n=8) and a control group of normal weight girls (n=9) were studied. The Eating Disorder Inventory for children (EDI-C) questionnaire was used to obtain information on eating behaviours and psychological characteristics, and silhouettes were used to evaluate body image. RESULTS The girls with overweight but without hyperandrogenicity showed more disturbed eating behaviour and more psychological problems than did the girls with both overweight and hyperandrogenicity as compared to the healthy controls. The overweight group also had more feelings of ineffectiveness than the hyperandrogenic group. Both the overweight and the hyperandrogenic girls estimated themselves as being significantly larger and their ideal shape as being significantly smaller than their current shape. However, all overweight girls considered their current shape to be significantly smaller than it was objectively. CONCLUSIONS The girl with overweight alone seemed to have more disturbed eating behaviour and more psychological problems than girls with combined overweight and hyperandrogenicity. This could indicate that different therapeutic interventions might be needed in attempts to reduce weight in the two groups.
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Affiliation(s)
- M Askelöf
- Department of Woman's and Children's Health, Uppsala University, University Hospital in Uppsala, Uppsala, Sweden.
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Krentz AJ, von Mühlen D, Barrett-Connor E. Searching for polycystic ovary syndrome in postmenopausal women: evidence of a dose-effect association with prevalent cardiovascular disease. Menopause 2007; 14:284-92. [PMID: 17245231 PMCID: PMC2642654 DOI: 10.1097/gme.0b013e31802cc7ab] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To test the hypothesis that polycystic ovary syndrome (PCOS) is associated with an increased risk of atherosclerotic cardiovascular disease (CVD) in older postmenopausal women. DESIGN Cross-sectional study of community-dwelling non-estrogen-using postmenopausal-white women (N=713; mean+/-SD age, 73.8+/-7.9 years; mean body mass index, 24.0+/-3.5 kg/m) participating in the Rancho Bernardo Study. A putative PCOS phenotype was defined as the presence of three or more of the following features: (1) recalled history of irregular menses, (2) symptomatic premenopausal hyperandrogenism or biochemical evidence of current biochemical hyperandrogenism, (3) history of infertility or miscarriage, (4) central obesity, or (5) insulin resistance. Atherosclerotic CVD was determined from clinical history, electrocardiography, and structured interviews using validated techniques. The analysis was stratified by diabetes status, ascertained from medical history or 75-g oral glucose tolerance tests. RESULTS The PCOS phenotype was present in 9.3% of the entire cohort and 5.8% of nondiabetic women. The prevalence of CVD was similar between women with the phenotype and unaffected women (27.3% vs 24.4%). Among women with intact ovaries and no diabetes, there was a stepwise graded association between an increasing number of features of the PCOS phenotype (ie, none to three or more) and prevalent CVD (P=0.02). A similar association was also observed for coronary heart disease alone (P=0.03). CONCLUSIONS Among nondiabetic postmenopausal women with intact ovaries, prevalent atherosclerotic CVD is associated with features of a putative PCOS phenotype. This finding supports the thesis that PCOS increases the risk of atherosclerotic CVD after menopause.
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Affiliation(s)
- Andrew J Krentz
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla 92093-0607, USA
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Diamanti-Kandarakis E, Katsikis I, Piperi C, Alexandraki K, Panidis D. Effect of long-term orlistat treatment on serum levels of advanced glycation end-products in women with polycystic ovary syndrome. Clin Endocrinol (Oxf) 2007; 66:103-9. [PMID: 17201808 DOI: 10.1111/j.1365-2265.2006.02693.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
UNLABELLED BACKGROUND Women with polycystic ovary syndrome (PCOS) exhibit elevated serum advanced glycation end-products (AGE) compared with healthy subjects. Short-term administration of orlistat has been shown to reduce the postmeal increase in serum AGE levels in women with PCOS and in controls. OBJECTIVE To evaluate the long-term effect of orlistat and a low-calorie diet on serum AGE levels, and on the hormonal and metabolic profile of obese PCOS and normal women. DESIGN A clinical trial of 6 months of orlistat administration with an energy-restricted diet [basic metabolic rate (BMR) 600 kcal/day] in all subjects. SUBJECTS Twenty-nine women with PCOS [aged 27.52 +/- 5.77 years; body mass index (BMI) 35.43 +/- 5.31 kg/m(2)] and 18 controls (aged 32.06 +/- 5.64 years; BMI 36.39 +/- 6.47 kg/m(2)). MEASUREMENTS Serum AGE levels (U/ml), hormonal and metabolic profile. RESULTS PCOS and controls did not differ in BMI (P = 0.58), waist-to-hip ratio (WHR) (P = 0.44), fasting insulin concentration (P = 0.45) and glucose-to-insulin ratio (GIR) (P = 0.34). PCOS women exhibited statistically higher AGE (P < 0.001) and testosterone levels (P < 0.001) compared with controls. After 6 months of orlistat treatment, AGE levels showed a statistically significant decrease in both groups (PCOS: baseline 9.08 +/- 1.84, post-orlistat 8.56 +/- 1.95, P = 0.001; controls: baseline 5.02 +/- 0.62, post-orlistat 4.91 +/- 0.69, P = 0.03), independently of the BMI reduction in the PCOS group. A significant reduction was observed in BMI (PCOS: P < 0.001; controls: P < 0.001), WHR (PCOS: P = 0.002; controls: P = 0.04), fasting insulin (PCOS: P < 0.001; controls: P = 0.008), and testosterone concentrations in PCOS (P < 0.001). SHBG concentration (PCOS: P = 0.004; controls: P = 0.008) and GIR (PCOS: P < 0.001; controls: P = 0.03) were significantly increased. A significant improvement was also observed in insulin resistance indices post-treatment in both groups. CONCLUSIONS Our data suggest that orlistat has a beneficial effect in reducing elevated AGE levels and improving the hormonal and metabolic profile in women with PCOS after 6 months of treatment, independently of BMI changes.
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Affiliation(s)
- Evanthia Diamanti-Kandarakis
- Laiko Hospital, Medical School, University of Athens, Endocrine Section, First Department of Medicine, Athens, Greece.
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El-Halawaty S, Rizk A, Kamal M, AboulHassan M, Al-Sawah H, Noah O, Al-Inany H. Clinical significance of serum concentration of anti-Müllerian hormone in obese women with polycystic ovary syndrome. Reprod Biomed Online 2007; 15:495-9. [DOI: 10.1016/s1472-6483(10)60379-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Weiping L, Qingfeng C, Shikun M, Xiurong L, Hua Q, Xiaoshu B, Suhua Z, Qifu L. Elevated serum RBP4 is associated with insulin resistance in women with polycystic ovary syndrome. Endocrine 2006; 30:283-7. [PMID: 17526940 DOI: 10.1007/s12020-006-0006-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2006] [Revised: 10/26/2006] [Accepted: 11/27/2006] [Indexed: 01/28/2023]
Abstract
Retinol binding protein 4 (RBP4) is a novel adipocyte-secreted protein that contributes to systemic insulin resistance. Experiments in mice suggest that elevated RBP4 causes insulin resistance. In the present study, we determined serum RBP4 concentration and evaluated its association with insulin resistance in women with polycystic ovarian syndrome (PCOS); 39 PCOS women and 45 healthy control subjects were enrolled in this study. Serum RBP4, fasting plasma glucose (FPG) and fasting serum insulin (FINS) were measured in all subjects. Furthermore, oral glucose tolerance test (OGTT), Botnia clamp (an intravenous glucose tolerance test followed by an euglycemic hyperinsulinemic clamp), and measurements of sex hormones were performed in 13 control subjects and all the PCOS women. The levels of serum RBP4 were elevated in PCOS women compared with the control (11.69 +/- 6.72 versus 7.75 +/- 5.96 microg/mL, p = 0.006). RBP4 levels were positively correlated with WHR (r = 0.216, p = 0.048), and intravenous glucose tolerance test beta cell index (IVGTT-beta index) which reflected beta cell function (r = 0.309, p = 0.028), but were inversely correlated with M value during Botnia clamp, which represented insulin sensitivity (r = -0.362, p = 0.008). No correlation was found between RBP4 and age, BMI, blood pressure, FPG, FINS, 2-h postprandial glucose, 2-h postprandial insulin, free testosterone, total testosterone, follicle-stimulating hormone (FSH), or luteinizing hormone (LH). In a linear stepwise regression analysis with a model including age, BMI, WHR, free testosterone, IVGTT-beta index, and M value as independent variables, only M value showed significant correlation with serum RBP4 levels (r2 = 0.105, f = 6.640, p = 0.012). In conclusion, serum RBP4 levels are significantly increased in PCOS women and associated with insulin resistance, which indicates that RBP4 may be a contributing factor linking adipose tissue with insulin resistance in PCOS.
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Affiliation(s)
- Li Weiping
- Department of Endocrinology, First Affiliated Hospital, Chongqing Medical University, 1 Youyi Road, 400016, Chongqing, P. R. China
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Poretsky L. Commentary: Polycystic ovary syndrome--increased or preserved ovarian sensitivity to insulin? J Clin Endocrinol Metab 2006; 91:2859-60. [PMID: 16684824 DOI: 10.1210/jc.2006-0317] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- Leonid Poretsky
- Beth Israel Medical Center, 317 East 17th Street, New York, NY 10003, USA.
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Sarwer DB, Allison KC, Gibbons LM, Markowitz JT, Nelson DB. Pregnancy and Obesity: A Review and Agenda for Future Research. J Womens Health (Larchmt) 2006; 15:720-33. [PMID: 16910904 DOI: 10.1089/jwh.2006.15.720] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
At present, more than 60% of American women of childbearing age are either overweight or obese. As the obesity epidemic in the United States and many other countries continues to grow unchecked, there is greater interest in the relationship between obesity and other major health issues. This paper reviews the literature on the relationship between obesity and pregnancy. We begin with a discussion of the relationship between excess body weight and fertility and then turn to the relationship between maternal body weight and pregnancy-related complications. The role of pregnancy as a possible risk factor for the development of obesity is noted. The studies investigating the efficacy of behavioral interventions to control excessive weight gain during pregnancy or help women lose weight after childbirth are then reviewed. The paper concludes with an agenda for future research examining the relationship between obesity and pregnancy.
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Affiliation(s)
- David B Sarwer
- Department of Psychiatry, Weight and Eating Disorders Program, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
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Zhang YF, Yang YS, Hong J, Gu WQ, Shen CF, Xu M, Du PF, Li XY, Ning G. Elevated serum levels of interleukin-18 are associated with insulin resistance in women with polycystic ovary syndrome. Endocrine 2006; 29:419-23. [PMID: 16943580 DOI: 10.1385/endo:29:3:419] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2005] [Revised: 01/08/2006] [Accepted: 02/02/2006] [Indexed: 11/11/2022]
Abstract
Overproduction of proinflammatory factors is associated with obesity and diabetes. Interleukin (IL)-18 as a member of IL-1 cytokine family is increased in obese, in diabetic, and even in polycystic ovary syndrome (PCOS) patients. In the present study we evaluated the association of serum IL-18 levels with insulin resistance in PCOS women. Forty-two PCOS women and 38 control subjects were enrolled in this study and matched with respect to age and body mass index (BMI). Serum IL-18 levels and hormones were measured for all subjects. Furthermore, euglycemic hyperinsulinemic clamp test was performed in selected 30 PCOS women and 11 control subjects. Serum IL-18 levels were elevated in PCOS women compared with the control (p = 0.033). IL-18 levels were positively correlated with homeostasis model assessment index (HOMA) beta index, which assesses beta cell function (p = 0.035), but were inversely correlated with clamp indices, which best represent insulin resistance status: M, Clamp ISI*100, and MCRg values (p = 0.006, 0.010, and 0.009 respectively). No correlation was found between IL-18 and age, BMI, waist-to-hip ratio (WHR), lipid profile, dehydroepiandrosterone-sulfate (DHEAS), sex hormone- binding globulin (SHBG), or fasting insulin levels. In conclusion, in the present study, serum IL-18 levels were significantly increased in PCOS women and firmly associated with insulin resistance displayed by euglycemic hyperinsulinemic clamp test. It indicates that IL-18 may be a contributing factor linking inflammation and insulin resistance in PCOS women.
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Affiliation(s)
- Yi-fei Zhang
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University Medical School, 197 Ruijin 2nd Road, 200025, Shanghai, P R China
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