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Baba T, Endo T, Mariya T, Kuno Y, Honnma H, Kanaya M, Saito T. Endocrinological and Metabolic Heterogeneity Is Low in Japanese Women With Polycystic Ovary Syndrome. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2024; 46:102217. [PMID: 37709141 DOI: 10.1016/j.jogc.2023.102217] [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: 05/25/2023] [Revised: 08/30/2023] [Accepted: 09/01/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVES This study aims to evaluate the endocrine differences among polycystic ovary syndrome (PCOS) phenotypes in Japanese women. METHODS 118 Japanese women that we diagnosed with PCOS agreed to be included in the study. The study group was classified into the following 4 phenotypes: (A) hyperandrogenism (HA); ovulatory disorder (OvD) and polycystic ovary morphology (PCOM); (B) HA and OvD; (C) HA and PCOM; and (D) OvD and PCOM. We also recruited 66 healthy Japanese women to the study as control participants. Age, body mass index, androgens, luteinizing hormone, follicle-stimulating hormone, and insulin resistance (IR) index were evaluated and compared. RESULTS The proportions of phenotypes A, B, C, and D were 57/120 (47.5%), 4/120 (3.3%), 13/120 (10.8%), and 46/120 (38.3%), respectively. The proportion of phenotype B was too small; therefore, phenotypes A and B were grouped as classical PCOS for intergroup comparisons. The luteinizing hormone/follicle-stimulating hormone ratio in the classical PCOS group was higher than that in the phenotype D group (P < 0.001). Androgen concentrations in the phenotype D group were significantly lower than those in the other groups (P < 0.01). Phenotype D was more common in lean women with PCOS. The surrogate marker of IR (homeostasis model assessment of IR) was not different irrespective of PCOS and its phenotypes. CONCLUSIONS Except for androgens, endocrine differences by PCOS phenotype are not evident, suggesting that diversity among patients with PCOS is relatively low in Japanese women.
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Affiliation(s)
- Tsuyoshi Baba
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan.
| | - Toshiaki Endo
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Tasuku Mariya
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Yoshika Kuno
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | | | | | - Tsuyoshi Saito
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
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Thaller M, Homer V, Sassani M, Mollan SP, Sinclair AJ. Longitudinal prospective cohort study evaluating prognosis in idiopathic intracranial hypertension patients with and without comorbid polycystic ovarian syndrome. Eye (Lond) 2023; 37:3621-3628. [PMID: 37225826 PMCID: PMC10686374 DOI: 10.1038/s41433-023-02569-x] [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: 09/20/2022] [Revised: 04/06/2023] [Accepted: 04/26/2023] [Indexed: 05/26/2023] Open
Abstract
INTRODUCTION Idiopathic intracranial hypertension (IIH) and polycystic ovary syndrome (PCOS) are hyperandrogenic metabolic disorders that affect women of reproductive age living with obesity. The previously reported prevalence of comorbid PCOS in IIH patients is highly variable and the longitudinal impact on visual and headache outcomes are unknown. METHODS In this prospective longitudinal cohort study patients were identified from the IIH: Life database over a nine-year period (2012-2021). Data collected included demographics and PCOS questionnaire data. Key visual and detailed headache outcomes were recorded. We analysed the key variables for influential outcomes of vision and headache. Logistical regression methods were used to model long term visual and headache outcomes. RESULTS Overall 398 women with IIH and documented PCOS questionnaires were followed up for a median of 10 months (range 0-87). Prevalence of PCOS in IIH was 20% (78/398) diagnosed by the Rotterdam criteria. Patients with IIH and comorbid PCOS reported higher self-reported fertility problems (3.2-fold increased risk) and increased need for medical help in becoming pregnant (4.4-fold increased risk). Comorbid PCOS in IIH patients does not adversely impact long-term vision or headache outcomes. The headache burden was high in both cohorts studied. CONCLUSIONS The study demonstrated that comorbid PCOS in IIH is common (20%). Diagnosing comorbid PCOS is important as it can impact on fertility and is known to have long-term adverse cardiovascular risks. Our data suggest that a diagnosis of PCOS in those with IIH does not significantly exacerbate long-term vision or headache prognosis.
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Affiliation(s)
- Mark Thaller
- Translational Brain Science, Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- Department of Neurology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, B15 2TH, UK
| | - Victoria Homer
- Cancer Research (UK) Clinical Trials Unit, University of Birmingham, Birmingham, B15 2TT, UK
| | - Matilde Sassani
- Translational Brain Science, Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, B15 2TH, UK
| | - Susan P Mollan
- Translational Brain Science, Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- Birmingham Neuro-Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK
| | - Alexandra J Sinclair
- Translational Brain Science, Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
- Department of Neurology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK.
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, B15 2TH, UK.
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Iwasa T, Noguchi H, Tanano R, Yamanaka E, Takeda A, Tamura K, Aoki H, Sugimoto T, Sasada H, Maeda T, Minato S, Yamamoto S, Inui H, Kagawa T, Yoshida A, Mineda A, Nii M, Kinouchi R, Yoshida K, Yamamoto Y, Kaji T. Age-Dependent Changes in the Effects of Androgens on Female Metabolic and Body Weight Regulation Systems in Humans and Laboratory Animals. Int J Mol Sci 2023; 24:16567. [PMID: 38068890 PMCID: PMC10706411 DOI: 10.3390/ijms242316567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/17/2023] [Accepted: 11/19/2023] [Indexed: 12/18/2023] Open
Abstract
In recent years, the effects of androgens on metabolic and body weight regulation systems and their underlying mechanisms have been gradually revealed in females. In women and experimental animals of reproductive age, androgen excess can adversely affect metabolic functioning, appetite, and body weight regulation. In addition, excess androgens can increase the risk of metabolic disorders, such as obesity, insulin resistance, and diabetes. These unfavorable effects of androgens are induced by alterations in the actions of hypothalamic appetite-regulatory factors, reductions in energy expenditure, insulin resistance in skeletal muscle, and β-cell dysfunction. Interestingly, these unfavorable effects of androgens on metabolic and body-weight regulation systems are neither observed nor evident in ovariectomized animals and post-menopausal women, indicating that the adverse effects of androgens might be dependent on the estrogen milieu. Recent findings may provide novel sex- and age-specific strategies for treating metabolic diseases.
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Affiliation(s)
- Takeshi Iwasa
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Hiroki Noguchi
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Risa Tanano
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Erika Yamanaka
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Asuka Takeda
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Kou Tamura
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Hidenori Aoki
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Tatsuro Sugimoto
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Hikari Sasada
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Takaaki Maeda
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Saki Minato
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Shota Yamamoto
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
- Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo 060-0808, Japan
| | - Hiroaki Inui
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Tomohiro Kagawa
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Atsuko Yoshida
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Ayuka Mineda
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Mari Nii
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Riyo Kinouchi
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Kanako Yoshida
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Yuri Yamamoto
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
| | - Takashi Kaji
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-Cho, Tokushima 770-8503, Japan; (H.N.); (R.T.); (E.Y.); (A.T.); (K.T.); (H.A.); (T.S.); (H.S.); (T.M.); (S.M.); (S.Y.); (H.I.); (T.K.); (A.Y.); (A.M.); (M.N.); (R.K.); (K.Y.); (Y.Y.); (T.K.)
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Boldis BV, Grünberger I, Cederström A, Björk J, Nilsson A, Helgertz J. Early Life Factors and Polycystic Ovary Syndrome in a Swedish Birth Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7083. [PMID: 37998314 PMCID: PMC10671095 DOI: 10.3390/ijerph20227083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/02/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a medical condition with important consequences for women's well-being and reproductive outcomes. Although the etiology of PCOS is not fully understood, there is increasing evidence of both genetic and environmental determinants, including development in early life. We studied a population of 977,637 singleton women born in in Sweden between 1973 and 1995, followed sometime between the age 15 and 40. The incidence of PCOS was measured using hospital register data during 2001-2012, complemented with information about the women's, parents' and sisters' health and social characteristics from population and health care registers. Cox regression was used to study how PCOS is associated with intergenerational factors, and a range of early life characteristics. 11,594 women in the study sample were diagnosed with PCOS during the follow-up period. The hazard rate for PCOS was increased 3-fold (HR 2.98, 95% CI 2.43-3.64) if the index woman's mother had been diagnosed with PCOS, and with 1.5-fold (HR 1.51, 95% CI 1.39-1.63) if their mother had diabetes mellitus. We found associations of PCOS with lower (<7) one-minute Apgar score (HR 1.19, 95% CI 1.09-1.29) and with post-term birth (HR 1.19, 95% CI 1.13-1.26). Furthermore, heavy (10+ cigarettes/day) maternal smoking (HR 1.30, 95% CI 1.18-1.44) and maternal obesity (HR 1.90, 95% CI 1.62-2.36) were strongly associated with PCOS. This study finds support for the heritability and fetal origins of PCOS. Risk of PCOS could be reduced by further emphasizing the importance of maternal and early life health.
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Affiliation(s)
- Beata Vivien Boldis
- Department of Public Health Sciences, Stockholm University, 10691 Stockholm, Sweden; (I.G.); (A.C.)
- Epidemiology, Population Studies and Infrastructures (EPI@LUND), Department of Laboratory Medicine, Lund University, 22100 Lund, Sweden; (J.B.); (A.N.)
- Centre for Economic Demography, School of Economics and Management, Lund University, 22100 Lund, Sweden;
| | - Ilona Grünberger
- Department of Public Health Sciences, Stockholm University, 10691 Stockholm, Sweden; (I.G.); (A.C.)
| | - Agneta Cederström
- Department of Public Health Sciences, Stockholm University, 10691 Stockholm, Sweden; (I.G.); (A.C.)
| | - Jonas Björk
- Epidemiology, Population Studies and Infrastructures (EPI@LUND), Department of Laboratory Medicine, Lund University, 22100 Lund, Sweden; (J.B.); (A.N.)
| | - Anton Nilsson
- Epidemiology, Population Studies and Infrastructures (EPI@LUND), Department of Laboratory Medicine, Lund University, 22100 Lund, Sweden; (J.B.); (A.N.)
- Centre for Economic Demography, School of Economics and Management, Lund University, 22100 Lund, Sweden;
| | - Jonas Helgertz
- Centre for Economic Demography, School of Economics and Management, Lund University, 22100 Lund, Sweden;
- Department of Economic History, Lund University, 22100 Lund, Sweden
- Institute for Social Research and Data Innovation, Minnesota Population Center, University of Minnesota, Minneapolis, MN 55455, USA
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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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Moursi MO, Salem H, Ibrahim AR, Marzouk S, Al-Meraghi S, Al-Ajmi M, Al-Naimi A, Alansari L. The role of anti-Mullerian hormone and other correlates in patients with polycystic ovary syndrome. Gynecol Endocrinol 2023; 39:2247098. [PMID: 37573873 DOI: 10.1080/09513590.2023.2247098] [Citation(s) in RCA: 1] [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: 05/01/2023] [Revised: 07/26/2023] [Accepted: 08/06/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Anti-Müllerian hormone (AMH) has recently emerged as a promising biomarker for the detection of polycystic ovarian morphology. In polycystic ovary syndrome (PCOS), an elevated level of AMH has been suggested to add value to the Rotterdam criteria in cases of diagnostic uncertainty. In this study, we evaluated the correlation between AMH and PCOS, and the potential role of AMH in PCOS diagnosis. METHODS A case-control study was performed on a total of 200 females, 100 of which were diagnosed with PCOS as per Rotterdam revised criteria (2003) and 100 as the control (non-PCOS group). Patient medical records were therefore retrieved for clinical, biochemical and ultrasound markers for PCOS diagnosis. Sensitivity, specificity, area under receiver operating characteristic (AUROC) curve, and multivariate linear regression models were applied to analyze our data. RESULTS Mean serum levels of LH and AMH, and LH/FSH ratio were significantly different between compared groups. In the PCOS group, the mean serum AMH level was 6.78 ng/mL and LH/FSH ratio was 1.53 while those of controls were 2.73 ng/mL and 0.53, respectively (p < .001). The most suitable compromise between 81% specificity and 79% sensitivity was obtained with a cutoff value of 3.75 ng/mL (26.78 pmol/L) serum AMH concentration for PCOS prediction, with an AUROC curve of 0.9691. CONCLUSION Serum AMH cutoff level of 3.75 ng/mL was identified as a convenient gauge for the prediction of PCOS and an adjuvant to the Rotterdam criteria.
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Affiliation(s)
- Moaz O Moursi
- Department of Internal Medicine, Hamad General Hospital, Doha, Qatar
| | - Haya Salem
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Ayman R Ibrahim
- Department of Internal Medicine, Hamad General Hospital, Doha, Qatar
| | - Sandy Marzouk
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Sara Al-Meraghi
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Maha Al-Ajmi
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Alreem Al-Naimi
- Department of Medical Education, Hamad Medical Corporation, Doha, Qatar
| | - Lolwa Alansari
- Department of Obstetrics and Gynecology, Al-Wakra Hospital, Al-Wakrah,Qatar
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Piltonen TT, Komsi E, Morin-Papunen LC, Korhonen E, Franks S, Järvelin MR, Arffman RK, Ollila MM. AMH as part of the diagnostic PCOS workup in large epidemiological studies. Eur J Endocrinol 2023; 188:547-554. [PMID: 37294941 DOI: 10.1093/ejendo/lvad065] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/06/2023] [Accepted: 06/08/2023] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Previous studies have shown good correlation between polycystic ovarian morphology (PCOM) and serum anti-Müllerian hormone (AMH) levels. We evaluated the utility of AMH as a surrogate for PCOM as a part of the polycystic ovary syndrome (PCOS) diagnosis by describing how the use of different AMH cut-off values would change the prevalence of PCOS. METHODS A general population-based birth cohort study. Anti-Müllerian hormone concentrations were measured from serum samples taken at age 31 years (n = 2917) using the electrochemiluminescence immunoassay (Elecsys). Anti-Müllerian hormone data were combined with data on oligo/amenorrhoea and hyperandrogenism to identify women with PCOS. RESULTS The addition of AMH as a surrogate marker for PCOM increased the number of women fulfilling at least two PCOS features in accordance with the Rotterdam criteria. The prevalence of PCOS was 5.9% when using the AMH cut-off based on the 97.5% quartile (10.35 ng/mL) and 13.6% when using the recently proposed cut-off of 3.2 ng/mL. When using the latter cut-off value, the distribution of PCOS phenotypes A, B, C, and D was 23.9%, 4.7%, 36.6%, and 34.8%, respectively. Compared with the controls, all PCOS groups with different AMH concentration cut-offs showed significantly elevated testosterone (T), free androgen index (FAI), luteinizing hormone (LH), LH/follicle-stimulating hormone (FSH) ratio, body mass index (BMI), waist circumference, and homoeostatic model assessment of insulin resistance (HOMA-IR) values, as well as significantly decreased sex hormone-binding globulin (SHBG) values. CONCLUSIONS Anti-Müllerian hormone could be useful surrogate for PCOM in large data sets, where transvaginal ultrasound is not feasible, to aid the capturing of women with typical PCOS characteristics. Anti-Müllerian hormone measurement from archived samples enables retrospective PCOS diagnosis when combined with oligo/amenorrhoea or hyperandrogenism.
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Affiliation(s)
- Terhi T Piltonen
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, FI-90029, Oulu, Finland
| | - Elina Komsi
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, FI-90029, Oulu, Finland
| | - Laure C Morin-Papunen
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, FI-90029, Oulu, Finland
| | - Elisa Korhonen
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, FI-90029, Oulu, Finland
| | - Stephen Franks
- Institute of Reproductive and Developmental Biology, Imperial College London, W12 0NN, London, United Kingdom
| | - Marjo-Riitta Järvelin
- Faculty of Medicine, Center for Life Course Health Research, University of Oulu, FI-90014, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, FI-90220, Oulu, Finland
- Department of Epidemiology and Biostatistics, School of Public Health, MRC Centre for Environment and Health, Imperial College London, W2 1PG, London, United Kingdom
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, UB8 3PH, London, United Kingdom
| | - Riikka K Arffman
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, FI-90029, Oulu, Finland
| | - Meri-Maija Ollila
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, FI-90029, Oulu, Finland
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8
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Yi W, Zhang M, Yuan X, Shi L, Yuan X, Sun M, Liu J, Cai H, Lv Z. A model combining testosterone, Androstenedione and free testosterone index improved the diagnostic efficiency of polycystic ovary syndrome. Endocr Pract 2023:S1530-891X(23)00414-7. [PMID: 37225042 DOI: 10.1016/j.eprac.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 05/10/2023] [Accepted: 05/16/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Hyperandrogenism is frequently observed in patients with polycystic ovary (PCOS). The purpose of this study was to develop an easy-to-use tool for predicting polycystic ovary syndrome (PCOS) and to evaluate and compare the value of androstenedione (Andro) and other hormone indicators in the diagnosis of patients with hyperandrogenic PCOS. METHODS This study included 139 women diagnosed with hyperandrogenic PCOS according to the Rotterdam criteria and 74 healthy control women from Shanghai Tenth People's Hospital. The serum hormone levels of the patients and controls were measured using a chemiluminescence immunoassay (CLIA) and incorporated for further analysis. RESULTS Total testosterone (TT), Andro, Dehydroepiandrosterone sulfate (DHEAS), and Free androgen index (FAI) were significantly higher in the PCOS group than the control group. Further, Andro, FSH, LH, TT, FAI and LH/FSH in the hyper-androstenedione (HA) group were higher than the normal Andro (NA) group. The Youden index was the highest for Andro (0.65), with 81.82% sensitivity and 83.16% specificity. Correlation analysis showed that FSH, LH, TT, FAI, Insulin Sensitivity Index (ISI), and LH/FSH were positively correlated with Andro, while Fasting blood glucose (FPG) and two-hour postprandial blood glucose (2h PG) were negatively correlated with Andro. CONCLUSIONS The model using Andro, TT, FAI may help to identifying women with undiagnosed PCOS. Serum Andro is a meaningful biomarker for hyperandrogenism in PCOS patients and may further aid disease diagnosis.
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Affiliation(s)
- Wanwan Yi
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Mengyu Zhang
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - XueYu Yuan
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Lishuai Shi
- School of Medicine, Tongji University, Shanghai, 200060, China
| | - Xie Yuan
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Ming Sun
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Jin Liu
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
| | - Haidong Cai
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
| | - Zhongwei Lv
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
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Jozkowiak M, Piotrowska-Kempisty H, Kobylarek D, Gorska N, Mozdziak P, Kempisty B, Rachon D, Spaczynski RZ. Endocrine Disrupting Chemicals in Polycystic Ovary Syndrome: The Relevant Role of the Theca and Granulosa Cells in the Pathogenesis of the Ovarian Dysfunction. Cells 2022; 12:cells12010174. [PMID: 36611967 PMCID: PMC9818374 DOI: 10.3390/cells12010174] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common heterogeneous endocrine disorder among women of reproductive age. The pathogenesis of PCOS remains elusive; however, there is evidence suggesting the potential contribution of genetic interactions or predispositions combined with environmental factors. Among these, endocrine disrupting chemicals (EDCs) have been proposed to potentially contribute to the etiology of PCOS. Granulosa and theca cells are known to cooperate to maintain ovarian function, and any disturbance can lead to endocrine disorders, such as PCOS. This article provides a review of the recent knowledge on PCOS pathophysiology, the role of granulosa and theca cells in PCOS pathogenesis, and the evidence linking exposure to EDCs with reproductive disorders such as PCOS.
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Affiliation(s)
- Malgorzata Jozkowiak
- Department of Toxicology, Poznan University of Medical Sciences, Dojazd 30, 60-631 Poznan, Poland
- Doctoral School, Poznan University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland
| | - Hanna Piotrowska-Kempisty
- Department of Toxicology, Poznan University of Medical Sciences, Dojazd 30, 60-631 Poznan, Poland
- Department of Basic and Preclinical Sciences, Institute of Veterinary Medicine, Nicolaus Copernicus University in Torun, Gagarina 7, 87-100 Torun, Poland
- Correspondence: ; Tel.: +48-61847-0721
| | - Dominik Kobylarek
- Department of Toxicology, Poznan University of Medical Sciences, Dojazd 30, 60-631 Poznan, Poland
| | - Natalia Gorska
- Department of Toxicology, Poznan University of Medical Sciences, Dojazd 30, 60-631 Poznan, Poland
| | - Paul Mozdziak
- Physiology Graduate Program, North Carolina State University, Raleigh, NC 27695, USA
- Prestage Department of Poultry Sciences, North Carolina State University, Raleigh, NC 27695, USA
| | - Bartosz Kempisty
- Prestage Department of Poultry Sciences, North Carolina State University, Raleigh, NC 27695, USA
- Division of Anatomy, Department of Human Morphology and Embryology, Wroclaw Medical University, Chalubinskiego 6a, 50-368 Wroclaw, Poland
- Department of Veterinary Surgery, Institute of Veterinary Medicine, Nicolaus Copernicus University in Torun, Gagarina 7, 87-100 Torun, Poland
| | - Dominik Rachon
- Department of Clinical and Experimental Endocrinology, Medical University of Gdansk, Debinki 7, 80-211 Gdansk, Poland
| | - Robert Z. Spaczynski
- Center for Gynecology, Obstetrics and Infertility Treatment Pastelova, Pastelowa 8, 60-198 Poznan, Poland
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10
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Wang W, Zeng W, Chen X, Tu L, Xu J, Yin X. Parameter study on characteristic pulse diagram of polycystic ovary syndrome based on logistic regression analysis. J OBSTET GYNAECOL 2022; 42:3712-3719. [PMID: 36562187 DOI: 10.1080/01443615.2022.2158317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study aimed to explore the parameters of the independent predictive characteristic pulse diagram of polycystic ovary syndrome (PCOS) by analysing the pulse characteristics between healthy women and the PCOS group. A total of 278 women were recruited for this study. Pulse wave parameters were collected by the pulse spectrum analyser. The single-factor analysis of the pulse diagram parameters was used to identify significant indicators, and the logistic regression analysis was carried out on the above indicators with statistical differences to obtain independent predictors. According to the single-factor and multi-factor analyses, h1, h5, h3/h1, t, t1 and t5 were independent predictors of PCOS diagnosis. The results showed that PCOS patients had a faster heart rate, decreased left ventricular systolic function and decreased aortic compliance compared to healthy individuals. These findings suggested that the characteristic pulse parameters screened out are valuable for the diagnosis of PCOS.IMPACT STATEMENTWhat is already known on this subject? Polycystic ovary syndrome (PCOS) is a common gynecological reproductive endocrine and metabolic disease, which is significant for screening and early intervention in the disease. However, due to the lack of pulse's diagnostic evidence of PCOS, there is still an unknown area in the research on the correlation between PCOS and pulse diagram parameters.What do the results of this study add? This study fills the gap between the research on PCOS and pulse wave. The study also shows that the pulse characteristic parameters h1, h5, h3/h1, t, t1, and t5 are independent predictors of PCOS, suggesting that the patients have a higher heart rate, lower ventricular systolic function, and aortic compliance than healthy individuals.What are the implications of these findings for clinical practice and/or further research? Prominent risk factors for pulse parameters associated with the occurrence of PCOS facilitate early screening and diagnosis of the disease. The objectification of pulse diagnosis helps to establish a health management model, which can be used for the accurate assessment and treatment of PCOS by traditional Chinese medicine (TCM). It provides a clinical reference for the study of pulse diagnosis objectification.
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Affiliation(s)
- Weiying Wang
- Department of Gynecology and Obstetrics, Shuguang Hospital Affiliated to the Shanghai University of Chinese Medicine, Shanghai, PR China
| | - Weiwei Zeng
- Department of Gynecology and Obstetrics, Shuguang Hospital Affiliated to the Shanghai University of Chinese Medicine, Shanghai, PR China
| | - Xinmin Chen
- Department of Gynecology and Obstetrics, Shuguang Hospital Affiliated to the Shanghai University of Chinese Medicine, Shanghai, PR China
| | - Liping Tu
- Basic Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, PR China
| | - Jiatuo Xu
- Basic Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, PR China
| | - Xiuqi Yin
- Department of Gynecology and Obstetrics, Shuguang Hospital Affiliated to the Shanghai University of Chinese Medicine, Shanghai, PR China
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11
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Martinez AI, Mezitis N. Diabetes insipidus in a patient with PCOS treated with Depo-Provera. Endocrinol Diabetes Metab Case Rep 2022; 2022:22-0289. [PMID: 36511443 PMCID: PMC9782430 DOI: 10.1530/edm-22-0289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022] Open
Abstract
Summary Depot medroxyprogesterone acetate, also known as Depo-Provera, is a progesterone-only contraceptive that is administered by injection to patients every three months. We describe the case of a 19-year-old female who was diagnosed with central diabetes insipidus following the administration of the contraceptive injection Depo-Provera. The patient was diagnosed with polycystic ovarian syndrome at age 16 and was originally prescribed oral contraceptives to restore menstrual regularity. Three years later, Depo-Provera was substituted for convenience, and symptoms of polyuria and polydipsia appeared one month after initiating the progesterone-only regimen. We are proposing that central diabetes insipidus may be a possible adverse effect of Depo-Provera in women with polycystic ovarian syndrome who receive the progesterone-only contraception, due to the interference of their arginine vasopressin mechanism through the alteration of estrogen levels. We review potential mechanisms through the presentation of previously completed research in polycystic ovarian syndrome. Learning points We propose that although rare, the decrease in estrogen that is experienced during the administration of Depo-Provera can interfere with arginine vasopressin release in patients with polycystic ovarian syndrome (PCOS). Increased awareness of possible lasting adverse effects on fluid balance with unopposed progesterone administration in PCOS is important, as this case of the development of diabetes insipidus suggests. Discussion of such potential side effects is important when considering contraceptive options for the regulation of menses in patients with PCOS.
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Affiliation(s)
- Amanda I Martinez
- Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio, USA
| | - Nicholas Mezitis
- Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio, USA
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12
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Dapas M, Dunaif A. Deconstructing a Syndrome: Genomic Insights Into PCOS Causal Mechanisms and Classification. Endocr Rev 2022; 43:927-965. [PMID: 35026001 PMCID: PMC9695127 DOI: 10.1210/endrev/bnac001] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Indexed: 01/16/2023]
Abstract
Polycystic ovary syndrome (PCOS) is among the most common disorders in women of reproductive age, affecting up to 15% worldwide, depending on the diagnostic criteria. PCOS is characterized by a constellation of interrelated reproductive abnormalities, including disordered gonadotropin secretion, increased androgen production, chronic anovulation, and polycystic ovarian morphology. It is frequently associated with insulin resistance and obesity. These reproductive and metabolic derangements cause major morbidities across the lifespan, including anovulatory infertility and type 2 diabetes (T2D). Despite decades of investigative effort, the etiology of PCOS remains unknown. Familial clustering of PCOS cases has indicated a genetic contribution to PCOS. There are rare Mendelian forms of PCOS associated with extreme phenotypes, but PCOS typically follows a non-Mendelian pattern of inheritance consistent with a complex genetic architecture, analogous to T2D and obesity, that reflects the interaction of susceptibility genes and environmental factors. Genomic studies of PCOS have provided important insights into disease pathways and have indicated that current diagnostic criteria do not capture underlying differences in biology associated with different forms of PCOS. We provide a state-of-the-science review of genetic analyses of PCOS, including an overview of genomic methodologies aimed at a general audience of non-geneticists and clinicians. Applications in PCOS will be discussed, including strengths and limitations of each study. The contributions of environmental factors, including developmental origins, will be reviewed. Insights into the pathogenesis and genetic architecture of PCOS will be summarized. Future directions for PCOS genetic studies will be outlined.
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Affiliation(s)
- Matthew Dapas
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Andrea Dunaif
- Division of Endocrinology, Diabetes and Bone Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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13
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Bahadori F, Jahanian Sadatmahalleh S, Montazeri A, Nasiri M. Sexuality and psychological well-being in different polycystic ovary syndrome phenotypes compared with healthy controls: a cross-sectional study. BMC Womens Health 2022; 22:390. [PMID: 36155624 PMCID: PMC9509607 DOI: 10.1186/s12905-022-01983-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 09/21/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. The present study aimed to compare the women with different PCOS phenotypes with the healty group in terms of sexual function, depression, anxiety and quality of life scale.
Materials and methods
The present cross-sectional study was carried out on 192 women with PCOS (classified on the basis of Rotterdam criteria into four categories) and 50 healthy controls. All participants were asked to fill out the valid and reliable questionnaires of FSFI (Female Sexual Function Index), HADS (Hospital Depression and Anxiety Scale) and SF-12.
Results
In the HADS questionnaire, phenotype B achieved the highest mean score in anxiety and depression domains, whereas, phenotype B had the lowest mean score in the FSFI and SF-12 quassionnaires. Furthermore, there was a significant difference between the women with PCOS phenotypes and the control grroup in arousal, lubrication, pain, and mean total score of FSFI (P < 0.05). In regression logistic analysis, age, infertility and depression were predictors of sexual dysfunction (P < 0.05).
Conclusion
The results indicated significant differences in terms of sexual dysfunction, depression, anxiety and quality of life in the women suffering from different phenotypes of PCOS compared with the healthy group. These results provide evidence that care and recommendations for improving women’s QoL and sexual function should be considered according to the relevant PCOS phenotypes.
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14
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Chhour I, Blackshaw L, Moran LJ, Boyle JA, Robinson T, Lim SS. Barriers and facilitators to the implementation of lifestyle management in polycystic ovary syndrome: Endocrinologists' and obstetricians and gynaecologists' perspectives. PATIENT EDUCATION AND COUNSELING 2022; 105:2292-2298. [PMID: 34980547 DOI: 10.1016/j.pec.2021.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 12/18/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To study the barriers and facilitators to lifestyle management in PCOS from the perspectives of endocrinologists and obstetricians and gynecologists (Ob/Gyns) to inform the translation and implementation of the international evidence-based guideline on lifestyle management in PCOS. METHODS 11 endocrinologists and ten Ob/Gyns participated in semi-structured interviews and transcripts were thematically analyzed on NVIVO software. RESULTS Both endocrinologists and Ob/Gyns supported lifestyle as key to PCOS management but faced systemic barriers of lack of access to allied health services and had limited capacity for in-depth lifestyle discussions. They suggested team-based approach to address these barriers. Endocrinologists reported lifestyle could be a less effective treatment option and most of their patients had challenges with past failed lifestyle attempts while Ob/Gyns perceived the desire to conceive among patients a facilitator. The importance of credible, individualised and PCOS-specific lifestyle advice was highlighted. CONCLUSION Endocrinologists and Ob/Gyns perceived lifestyle management as integral to PCOS management but experience barriers to lifestyle management related to specialist care. PRACTICE IMPLICATIONS Resources that provide credible, individualized and PCOS-specific lifestyle advice, team care approach and professional development on motivating patients for lifestyle modification may address these barriers.
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Affiliation(s)
- Irene Chhour
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lucinda Blackshaw
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jacqueline A Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Tracy Robinson
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Siew S Lim
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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15
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Altuntaş SÇ, Güneş M. Investigation of the Relationship Between Autoimmune and Nodular Goiter in Patients with Euthyroid Polycystic Ovary Syndrome and Their Phenotypes. Horm Metab Res 2022; 54:396-406. [PMID: 35419775 DOI: 10.1055/a-1825-0316] [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: 11/04/2022]
Abstract
Polycystic ovary syndrome (PCOS) is an endocrine disorder that frequently affects women of reproductive age. In PCOS, the incidence of thyroid diseases has increased in addition to reproductive and metabolic problems. To compare thyroid nodule, volume, autoimmunity, and thyroid function tests of euthyroid PCOS and its phenotypes. The files of 178 patients with PCOS aged 18-45 years and 92 patients with no disease who were matched for body mass index were retrospectively scanned. Women with PCOS were divided into four phenotypes, ABCD. Anti-TPO titer and prevalence, fT3, and thyroid volume were higher in the PCOS group compared with the control group in terms of anti-Tg levels, presence of nodules, and the number of nodules. There was no statistical difference between the PCOS group and the healthy controls. The number of nodules of 1 cm and above was found to be higher only in patients with PCOS compared with the control group. When the phenotypes were examined, thyroid dysfunction features were found in phenotype A, which was the most prominent. Thyroid autoimmunity, thyroid volume, and the number of nodules larger than 1 cm increased in patients with PCOS compared with controls. This situation is thought to be caused by the reproductive and metabolic properties of PCOS because thyroid dysfunction was detected more in phenotype A, which is called the full phenotype. Therefore, all patients with PCOS, especially phenotype A, should be evaluated for the presence of nodules with autoimmunity using USG, even if there are no symptoms, and thyroid functions.
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Affiliation(s)
- Seher Çetinkaya Altuntaş
- Division of Endocrinology, Bursa Yuksek Ihtisas Education and Training Hospital, University of Health Sciences, Bursa, Turkey
| | - Mutlu Güneş
- Department of Endocrinology and Metabolism, Bursa Yuksek Ihtisas Education and Training Hospital, University of Health Sciences, Bursa, Turkey
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16
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Rhamnocitrin Attenuates Ovarian Fibrosis in Rats with Letrozole-Induced Experimental Polycystic Ovary Syndrome. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:5558599. [PMID: 35663203 PMCID: PMC9162838 DOI: 10.1155/2022/5558599] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/04/2022] [Accepted: 04/23/2022] [Indexed: 12/12/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine-related cause of infertility in women and has an unknown etiology. Studies have shown that rhamnocitrin (Rha) exhibits positive effects on the reproductive system. This study investigated Rha's antifibrotic effects on PCOS rats and revealed its underlying mechanisms. Female SD rats were randomized into 4 groups (n = 8, each); the control group received tea oil by intraperitoneal injection and 1% w/v CMC by oral gavage; the PCOS group received letrozole (1 mg/kg); the PCOS+Rha group received letrozole and Rha (5 mg/kg); the PCOS+Met group received letrozole and Met (265 mg/kg) for 21 days. At the study end, Rha treatment restored letrozole-induced alterations in the relative ovarian weights, body weight, and relative weights of uterine and visceral adipose tissues. Histological observation showed that Rha ameliorates ovarian structure and fibrosis in PCOS. Administration of Rha reduced letrozole-induced metabolic dysfunction by ameliorating the levels of TC, TG, and HDL-C in the PCOS rats. Rha treatment also modulated the serum levels of sex hormones, which decreased T, E2, and LH and increased FSH in PCOS rats. In addition, Rha treatment modulated insulin resistance and increased gene expression of antioxidant enzymes (Cat, Sod2, Gpx3, Mgst1, Prdx3, Gsta4, Gsr, and Sod1) in the ovaries of the PCOS rats. Finally, Rha treatment appeared to increase the activity of PPAR-γ and inhibit the TGF-β1/Smad pathway in the ovaries of the PCOS rats. Our findings suggest that Rha significantly ameliorated metabolic disturbances and ovarian fibrosis in the PCOS rats. Rha perhaps is an effective compound for preventing ovarian fibrosis in the future.
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Powell MJ, Fuller S, Gunderson EP, Benz CC. Reduced cardiovascular risks in women with endometriosis or polycystic ovary syndrome carrying a common functional IGF1R variant. Hum Reprod 2022; 37:1083-1094. [PMID: 35362533 PMCID: PMC9071223 DOI: 10.1093/humrep/deac059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 03/03/2022] [Indexed: 11/28/2022] Open
Abstract
STUDY QUESTION Is the increased future cardiovascular risk seen in women with endometriosis or polycystic ovary syndrome (PCOS) mitigated by functional insulin-like growth factor-1 receptor (IGF1R) single-nucleotide polymorphism (SNP) rs2016347 as previously shown in women with hypertensive disorders of pregnancy? SUMMARY ANSWER This cohort study found that women with endometriosis or PCOS who carry a T allele of IGF1R SNP rs2016347 had a reduced future risk of developing cardiovascular disease (CVD) and associated risk factors, with risk reduction dependent on cohort era. WHAT IS KNOWN ALREADY Women with endometriosis or PCOS have been shown to have an increased future risk of CVD and associated risk factors with limited predictive ability. STUDY DESIGN, SIZE, DURATION This retrospective cohort study took place in the Nurses' Health Study 2 (NHS2), which enrolled 116 430 participants in 1989 who were followed through 2015. The study population was analyzed in its entirety, and subdivided into entry (pre-1989) and after entry (post-1989) exposure cohorts. All NHS2 participants were eligible for inclusion in the study, 9599 (8.2%) were excluded for missing covariates. PARTICIPANTS/MATERIALS, SETTING, METHODS The NHS2 enrolled female registered nurses from 14 different states who ranged in age from 25 to 42 years at study entry. Data were collected from entry and biennial questionnaires, and analysis conducted from November 2020 to June 2021. Cox proportional hazard models were used to assess risk of CVD, hypertension (HTN), hypercholesterolemia (HC) and type 2 diabetes, both with and without genotyping for rs2016347. MAIN RESULTS AND THE ROLE OF CHANCE While women without endometriosis or PCOS, as a whole, demonstrated no impact of genotype on risk in either cohort, women with endometriosis carrying a T allele had a lower risk of CVD (hazard ratio (HR), 0.48; 95% CI, 0.27-0.86, P = 0.02) and HTN (HR, 0.80; 95% CI, 0.66-0.97, P = 0.03) in the pre-1989 cohort, while those in the post-1989 cohort had a decrease in risk for HC (HR, 0.76; 95% CI, 0.62-0.94, P = 0.01). Women with PCOS in the post-1989 cohort showed a significant protective impact of the T allele on HTN (HR, 0.44; 95% CI, 0.27-0.73, P = 0.002) and HC (HR, 0.62; 95% CI, 0.40-0.95, P = 0.03). LIMITATIONS, REASONS FOR CAUTION Data on specific endometriosis lesion locations or disease stage, as well as on PCOS phenotypes were lacking. In addition, data on systemic medical treatments beyond the use of oral contraceptives were missing, and these treatments may have confounded the results. WIDER IMPLICATIONS OF THE FINDINGS These findings implicate systemic dysregulation of the insulin-like growth factor-1 axis in the development of HTN, HC and clinical CVD in endometriosis and PCOS, suggesting a common underlying pathogenetic mechanism. STUDY FUNDING/COMPETING INTEREST(S) The NHS2 infrastructure for questionnaire data collection was supported by National Institute of Health (NIH) grant U01CA176726. This work was also supported in part by NIH and National Cancer Institute grant U24CA210990; as well, research effort and publication costs were supported by the Elizabeth MA Stevens donor funds provided to the Buck Institute for Research on Aging. The authors declare they have no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Mark J Powell
- Buck Institute for Research on Aging, Novato, CA, USA
| | - Sophia Fuller
- Graduate Group in Biostatistics, University of California, Berkeley, School of Public Health, Berkeley, CA, USA
| | - Erica P Gunderson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
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Sangaraju SL, Yepez D, Grandes XA, Talanki Manjunatha R, Habib S. Cardio-Metabolic Disease and Polycystic Ovarian Syndrome (PCOS): A Narrative Review. Cureus 2022; 14:e25076. [PMID: 35719759 PMCID: PMC9203254 DOI: 10.7759/cureus.25076] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 12/24/2022] Open
Abstract
Polycystic ovarian syndrome (PCOS) is considered the most common endocrine disorder affecting females in today's world. Although it has been primarily studied and discussed in terms of its reproductive symptoms such as infertility, amenorrhea or oligomenorrhea, acne, hirsutism, and mood disorders, there is yet another unexplored and under-diagnosed category in the PCOS spectrum of diseases: its cardio-metabolic consequences. PCOS patients are prone to these abnormalities from a very young age, increasing their morbidity and mortality rates compared to their regular counterparts. The usual pathogenesis of PCOS is a culmination of several genetic and environmental factors. Regarding its cardio-metabolic aspects, insulin resistance (IR) is said to be the single most important cause of a variety of metabolic risk factors, including type 2 diabetes mellitus (T2DM), metabolic syndrome (MetS), dyslipidemia, obesity, and hypertension (HTN), whereas a few other non-traditional factors such as C-reactive protein (CRP), carotid intima-media thickness (IMT), coronary artery calcification (CAC), and endothelial dysfunction are also said to be increased in PCOS patients, further increasing their risk of complications due to cardiovascular diseases (CVD). A timely diagnosis and adequate treatment of these risk factors by using lifestyle interventions, diet, and/or medications are essential to reduce the burden of PCOS in today's world. This article has highlighted an array of traditional and non-traditional cardio-metabolic consequences PCOS patients are prone to and their systematic pathogenesis. In addition, an outline of recommendations has been given in the pharmacological and non-pharmacological sections of this article, which may benefit doctors in managing this challenging condition.
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Affiliation(s)
| | - Daniela Yepez
- General Medicine, Universidad Catolica de Santiago de Guayaquil, Guayaquil, ECU
| | - Xavier A Grandes
- General Physician, Universidad Catolica de Santiago de Guayaquil, Guayaquil, ECU
| | | | - Salma Habib
- Medicine and Surgery, Institute of Applied Health Sciences (IAHS), Chittagong, BGD
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19
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Ghazeeri G, Ibrahim N, Khalifeh F, Beyrouthy C, El-Taha L, Bizri M. Character strengths of women with polycystic ovary syndrome in a single center. PLoS One 2022; 17:e0266398. [PMID: 35363827 PMCID: PMC8975165 DOI: 10.1371/journal.pone.0266398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/18/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the difference in character strengths (CSs) between patients with and without polycystic ovary syndrome (PCOS) and the association between biological (i.e., testosterone levels) and psychological factors (i.e., character strengths). Patients and methods A total of 99 women divided into PCOS (49) and non-PCOS (50) groups who presented to the gynecological clinics at the women’s center in the American University of Beirut Medical Center in 2017 were included. Women were assessed for testosterone bioavailable levels and completed a questionnaire that included Hospital Anxiety and Depression Scale and Values in Action Survey-72. Univariate and multivariable analyses were performed to examine the association of CSs between the two groups and its predictors. Results The scores of hope, judgement, perspective, and transcendence of the PCOS group were significantly higher in comparison with healthy participants. An increase in free androgen index was negatively correlated to the score of judgement only. Conclusion Women with PCOS have their own profile of character strengths and virtues that constitute judgement, hope, perspective, and transcendence. This in turn can be utilized to reinforce those personality strengths and thus decrease the psychological distress and mood disorders accompanied with this disease.
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Affiliation(s)
- Ghina Ghazeeri
- Department of Obstetrics and Gynecology, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nour Ibrahim
- Department of Psychiatry, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fatin Khalifeh
- Department of Obstetrics and Gynecology, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Christine Beyrouthy
- Department of Obstetrics and Gynecology, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Lina El-Taha
- Department of Obstetrics and Gynecology, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maya Bizri
- Department of Psychiatry, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- * E-mail:
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20
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Long Z, Huang L, Lyu J, Xia Y, Chen Y, Li R, Wang Y, Li S. Trends of central obesity and associations with nutrients intake and daily behaviors among women of childbearing age in China. BMC Womens Health 2022; 22:12. [PMID: 35016648 PMCID: PMC8753840 DOI: 10.1186/s12905-022-01600-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 01/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background Obesity among women of childbearing age has becoming an important public health concern. We aimed to describe the trends of central obesity among Chinese women of childbearing age from 2004 to 2011 and to examine its associations with nutrients intake and daily behaviors. Methods Longitudinal data were derived from the China Health and Nutrition Survey. Participants consisted of 2481 women aged 15–44 years old. WC (Waist circumference) and WHtR (Waist to height ratio) were adopted as indicators of central obesity. Generalized linear mixed model was performed to analyze the associations of nutrients intake and daily behaviors with central obesity. Results From 2004 to 2011, the prevalence of central obesity among Chinese women of childbearing age increased from 21.6 to 30.7% (WC as indice) or from 22.8 to 32.6% (WHtR as indice) (both p < 0.001). Protein intake above the AMDR (Acceptable macronutrient distribution range) (OR = 1.21, 95% CI 1.05–1.39, p < 0.01) and non-participation in LTPA (Leisure time physical activity) (OR = 1.45, 95% CI 1.17–1.80, p < 0.001) were risk factors for high WC, and the latter was also associated with high WHtR (OR = 1.36, 95% CI 1.10–1.67, p < 0.01). For those women who had high WC & high WHtR, the impacts of protein intake and LTPA became stronger, especial LTPA (OR = 1.53, 95% CI 1.21–1.94, p < 0.001). Age-stratified analyses found that non-participation in LTPA was key factor for central obesity in 15–34 age group, while protein intake above the AMDR was pronounced in the 35–44 age group. Conclusions Non-participation in LTPA and protein intake above the AMDR were significant contributors of central obesity, which could be intervention targets to deal with the growing trend of central obesity among women of childbearing age. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01600-9.
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Affiliation(s)
- Zichong Long
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu District, 200025, Shanghai, China
| | - Lili Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu District, 200025, Shanghai, China
| | - Jiajun Lyu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu District, 200025, Shanghai, China
| | - Yuanqing Xia
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu District, 200025, Shanghai, China
| | - Yiting Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu District, 200025, Shanghai, China
| | - Rong Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu District, 200025, Shanghai, China
| | - Yanlin Wang
- Prenatal Diagnosis Department, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, 910 Hengshan Road, Xuhui District, 200030, Shanghai, China.
| | - Shenghui Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu District, 200025, Shanghai, China. .,MOE - Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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21
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Zhang H, Wang W, Zhao J, Jiao P, Zeng L, Zhang H, Zhao Y, Shi L, Hu H, Luo L, Fukuzawa I, Li D, Li R, Qiao J. Relationship between body composition, insulin resistance, and hormonal profiles in women with polycystic ovary syndrome. Front Endocrinol (Lausanne) 2022; 13:1085656. [PMID: 36699018 PMCID: PMC9869160 DOI: 10.3389/fendo.2022.1085656] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/20/2022] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To investigate how body fat influences glucose metabolism and hormone profiles in women with polycystic ovary syndrome (PCOS), compared to women without PCOS. METHODS We conducted a cross-sectional study of 166 women with PCOS and 139 age-matched control women at Peking University Third Hospital (Beijing, China) from March 2016 to December 2021. All participants underwent bioimpedance rate assessment of clinical, anthropometric, hormonal, and metabolic features. In particular, body composition parameters were assessed, based on the methods used in a previous study. Homeostasis model assessment-insulin resistance (HOMA-IR) and other indices calculated from fasting glucose and insulin were used to measure insulin resistance. The hormonal profiles [follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen (E2), prolactin (PRL), total testosterone (T), and androstenedione (A2)] were assessed by using biochemical methods. Two subgroup analyses were conducted according to waist-to-hip ratio (WHR; < 0.85, non-central obesity and ≥ 0.85, central obesity) and body fat percentage (BFP; < 35% for lean and ≥35% for obesity). The indices above were analyzed using a two-sided t-test or Wilcoxon rank sum test. Linear regression was used to investigate the effects of body composition on metabolism and sex hormones in the PCOS and control groups. RESULTS Compared to women without PCOS, women with PCOS and central obesity (P=0.021), PCOS and noncentral obesity (P<0.001), PCOS and high BFP (P<0.001), and PCOS and low BFP (P<0.001) had more severe glucose metabolism evaluated with HOMA-IR. Women with PCOS experienced greater insulin sensitivity impairment than did the normal population for every equal increase in BFP. LH, LH/FSH, total testosterone, and androstenedione were significantly higher in patients with PCOS than in healthy controls, regardless of WHR and BFP stratification. However, negative correlations existed between body fat indices (i.e., BFP and body mass index) and hormone indices (i.e., LH and androstenedione) in the PCOS group, but were absent in the control group. CONCLUSIONS Obese and non-obese women with PCOS have more severe insulin resistance and sex-hormone disorders than women without PCOS. The effect of body fat on sex-hormone disorders is only exist in women with PCOS. These findings suggested that PCOS clinical guidelines should be more specific to body fat. CLINICAL TRIAL REGISTRATION https://clinicaltrials.gov/, Registration No. NCT04264832.
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Affiliation(s)
- Haolin Zhang
- Department of Traditional Chinese Medicine (TCM), Peking University Third Hospital, Beijing, China
| | - Wei Wang
- Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China
| | - Jiaming Zhao
- School of Basic Medical Sciences, Peking University, Beijing, China
| | - Peijie Jiao
- School of Basic Medical Sciences, Peking University, Beijing, China
| | - Lin Zeng
- Research Centre of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Hua Zhang
- Research Centre of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Yue Zhao
- Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China
| | - Li Shi
- Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China
| | - Hangqi Hu
- Department of Traditional Chinese Medicine (TCM), Peking University Third Hospital, Beijing, China
| | - Liyan Luo
- Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China
| | - Ii Fukuzawa
- Department of Traditional Chinese Medicine (TCM), Peking University Third Hospital, Beijing, China
| | - Dong Li
- Department of Traditional Chinese Medicine (TCM), Peking University Third Hospital, Beijing, China
- *Correspondence: Dong Li, ; Rong Li,
| | - Rong Li
- Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China
- Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China
- *Correspondence: Dong Li, ; Rong Li,
| | - Jie Qiao
- Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China
- Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China
- Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Chinese Academy of Medical Sciences, Beijing, China
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Srinivas S, Khurana A, Swamy MV, Mitra S, Nagaraja N. Prevalence of polycystic ovarian syndrome, phenotypes and their ovulation response to sequential letrozole dose escalation among infertile women at a tertiary care centre in Southern India. J Hum Reprod Sci 2022; 15:42-50. [PMID: 35494195 PMCID: PMC9053339 DOI: 10.4103/jhrs.jhrs_141_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 11/05/2022] Open
Abstract
Background: Women with polycystic ovarian syndrome (PCOS) often have anovulatory infertility requiring ovulation induction with letrozole. Aims: This study aimed to determine the prevalence and phenotypic categorisation of infertile PCOS women and to assess ovulatory response and pregnancy rates of PCOS phenotypes with sequential letrozole dose escalation. Study Setting and Design: This was a prospective observational study. Materials and Methods: One hundred seventy-five infertile PCOS women were enrolled. One hundred fifty-six women received ovulation induction as per the protocol with sequential letrozole dose escalation in each subsequent cycle (2.5 mg, 5 mg and 7.5 mg). Responses were assessed by ovulation and/or pregnancy. Statistical Analysis Used: Descriptive statistics were elaborated by means, medians, frequencies and percentages. Group comparisons and linear correlation between two continuous variables were done using appropriate statistical tests. Results: Eighty-seven (49.7%) women were Phenotype A; 11 (6.3%) were Phenotype B; 20 (11.4%) were Phenotype C and 57 (32.6%) were Phenotype D in our study. After excluding the lost to follow up participants in each induction cycle, 33.3% (2.5 mg dose); 62.8% (5 mg dose) and 78.9% (7.5 mg dose) women responded to letrozole. A significant increase in ovulation to escalating letrozole doses was noted (Phenotype A: 35.1% to 2.5 mg, 53.7% to 5 mg and 72.7% to 7.5 mg; Phenotype B: 30% to 2.5 mg and 80% to 5 mg; Phenotype C: 35.3% to 2.5 mg and 87.5% to 5 mg and Phenotype D: 30.8% to 2.5 mg, 65.6% to 5 mg and 87.5% to 7.5 mg). Fifty-six of 156 (35.9%) infertile PCOS women achieved pregnancy; increase in pregnancy rates with escalated doses of letrozole was noted. Conclusion: All PCOS phenotypes show a similar response to escalating doses of letrozole. The role of phenotypic sub-categorisation for variable response to letrozole as an ovulation-inducing agent is uncertain.
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Adiponectin Gene Polymorphism (rs17300539) Has No Influence on the Occurrence of Metabolic Syndrome in Women with Polycystic Ovary Syndrome. Genes (Basel) 2021; 12:genes12121902. [PMID: 34946852 PMCID: PMC8701950 DOI: 10.3390/genes12121902] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/21/2021] [Accepted: 11/25/2021] [Indexed: 01/04/2023] Open
Abstract
Adiponectin (rs17300539) is implicated in the pathogenesis of metabolic syndrome (MS), a common comorbidity of polycystic ovarian syndrome (PCOS). The aim of this study was to analyze the association between adiponectin gene polymorphism and incidence of MS in patients with PCOS. The study included 201 women (age 18 to 35 years), among them 81 patients with PCOS without concomitant MS, 70 subjects with PCOS and concomitant, and 50 regularly menstruating controls. Adiponectin gene polymorphism (11391 G/A, rs17300539) was determined by means of a real-time PCR. The study groups did not differ significantly in terms of their age and frequencies of various genotypes of the adiponectin gene polymorphism. The largest proportion in the whole group was Caucasian women (n = 178, 88.56%), who carried the GG genotype of the polymorphism; frequencies of GA and AA genotypes in the whole study group were 10.94% (n = 22) and 0.5% (n = 1), respectively. The presence of G or A allele of the rs17300539 adiponectin gene polymorphism was not associated with a greater likelihood of PCOS with/without concomitant MS. The hereby presented findings imply that MS is a common comorbidity in women with PCOS. However, the incidence of concomitant MS does not seem to be associated with adiponectin gene polymorphism.
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Iwasa T, Yamamoto Y, Shinya A, Minato S, Yanagihara R, Kamada S, Imaizumi J, Kagawa T, Shirakawa A, Noguchi H, Nakagawa T, Taniguchi M, Kadota Y, Kawakita T, Yoshida K, Kato T, Yasui T, Irahara M. The effects of androgens on metabolic functions in females. THE JOURNAL OF MEDICAL INVESTIGATION 2021; 68:228-231. [PMID: 34759135 DOI: 10.2152/jmi.68.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The metabolic effects of androgens and their underlying mechanisms in females have been revealed by recent studies. An excess of androgens can have adverse effects on feeding behavior and metabolic functions and induce metabolic disorders / diseases, such as obesity, insulin resistance, and diabetes, in women and experimental animals of reproductive age. Interestingly, these effects of androgens are not observed in ovariectomized animals, indicating that their effects might be dependent on the estrogen milieu. Central and peripheral mechanisms, such as alterations in the activity of hypothalamic factors, reductions in energy expenditure, skeletal muscle insulin resistance, and β-cell dysfunction, might be related to these androgens' effects. J. Med. Invest. 68 : 228-231, August, 2021.
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Affiliation(s)
- Takeshi Iwasa
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yuri Yamamoto
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Akari Shinya
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Saki Minato
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Rie Yanagihara
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Shuhei Kamada
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Junki Imaizumi
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Tomohiro Kagawa
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Aya Shirakawa
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Hiroki Noguchi
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Tomotaka Nakagawa
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Miyu Taniguchi
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yuri Kadota
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Takako Kawakita
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | | | - Takeshi Kato
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Toshiyuki Yasui
- Department of Reproductive and Menopausal Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Minoru Irahara
- Department of Obstetrics and Gynecology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
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Nejati A, Shahri MPK, Farahvash T. Astragalus hamosus Acts as an Insulin Sensitizer Through the Treatment of Polycystic Ovary Syndrome Rat Models by Affecting IRS1 Expression. Endocr Metab Immune Disord Drug Targets 2021; 22:348-356. [PMID: 34758721 DOI: 10.2174/1871530321666211110123931] [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: 03/04/2021] [Revised: 05/31/2021] [Accepted: 08/24/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the most common endocrine abnormality among women of reproductive age. Insulin resistance is known as the hallmark of PCOS that leads to hyperinsulinemia and type 2 diabetes in PCOS patients. OBJECTIVE This study aimed to evaluate the expression pattern of IRS1 as a candidate gene in insulin resistance development in the PCOS Rat models. METHODS In this study, estradiol valerate was used for PCOS induction. Then, all of the rats were divided into five experimental groups and treated with Astragalus hamosus extract. Ethanol was used for extraction by Soxhlet, and extracts were analyzed by GC-MS. Ovarian morphology was analyzed using histological experiments. Finally, the expression of IRS1 and hormonal titration of testosterone and insulin were evaluated using qRT-PCR and ELISA assays, respectively. RESULTS Induction of PCOS led to an increase in body weight, which decreased after treatment with the extract. Histological assessment declared an increased number of corpus luteums in treated groups and reduced cystic follicles compared with the PCOS group. Astragalus hamosus extract-treated groups exhibited decreased levels of insulin and testosterone compared to the PCOS group. qRT-PCR results showed an increase in the expression levels of IRS1 in the treated groups compared to the PCOS group. CONCLUSIONS This study indicated the impact of Astragalus hamosus extract on PCOS by clarifying the increased levels of IRS1 expression in the treated groups compared to the PCOS group.
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Affiliation(s)
- Amir Nejati
- Department of Biology, Urmia Branch, Islamic Azad University, Urmia. Iran
| | | | - Tarlan Farahvash
- Department of Animal Science and Veterinary, Shabestar Branch, Islamic Azad University, Shabestar. Iran
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Butler AE, Moin ASM, Sathyapalan T, Atkin SL. Vitamin D association with the renin angiotensin system in polycystic ovary syndrome. J Steroid Biochem Mol Biol 2021; 214:105965. [PMID: 34619249 DOI: 10.1016/j.jsbmb.2021.105965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/08/2021] [Accepted: 08/10/2021] [Indexed: 12/12/2022]
Abstract
Vitamin D deficiency is a negative endocrine renin-angiotensin system (RAS) modulator and PCOS women are often vitamin D deficient, leading to RAS overactivation in PCOS. A cross-sectional study was performed in 99 PCOS and 68 control women who presented sequentially. Circulating plasma levels of RAS proteins (Angiotensin-converting enzyme 2 (ACE2), renin and angiotensinogen) were measured by Slow Off-rate Modified Aptamer (SOMA)-scan and 25-hydroxyvitamin D [25(OH)D] was measured by tandem mass spectroscopy. The RAS system was found to be overactivated in the PCOS women compared to non-PCOS control women with increased renin and decreased angiotensinogen (p < 0.05); 25-hydroxyvitamin D was also significantly lower in the PCOS group (p < 0.0001). In PCOS women, plasma renin was increased in vitamin D deficient and insufficient groups compared with the vitamin D sufficient group (p < 0.005), but did not differ across non-PCOS control subgroups. In non-PCOS controls, plasma ACE2 decreased from vitamin D insufficiency to deficiency (p < 0.05). Angiotensinogen was not different across the vitamin D sufficiency, insufficiency and deficiency strata for either PCOS or non-PCOS controls. These data show that RAS activation through increased plasma renin levels was seen in vitamin D insufficient and deficient PCOS subjects compared to non-PCOS control women. In addition, decreased plasma ACE2 levels were seen in vitamin D deficiency in non-PCOS controls, which may predispose these vitamin D deficient subjects to increased cardiovascular risk and susceptibility to infectious agents such as COVID-19 where this is a risk factor.
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Affiliation(s)
| | | | - Thozhukat Sathyapalan
- Academic Endocrinology, Diabetes and Metabolism, Hull York Medical School, Hull, UK.
| | - Stephen L Atkin
- Royal College of Surgeons in Ireland Bahrain, Adliya, Bahrain.
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Xing C, Lv B, Zhao H, Wang D, Li X, He B. Metformin and exenatide upregulate hepatocyte nuclear factor-4α, sex hormone binding globulin levels and improve hepatic triglyceride deposition in polycystic ovary syndrome with insulin resistance rats. J Steroid Biochem Mol Biol 2021; 214:105992. [PMID: 34478829 DOI: 10.1016/j.jsbmb.2021.105992] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/18/2021] [Accepted: 08/29/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To explore the efficacy and underlying mechanisms of metformin and exenatide in reversing reproductive and metabolic disturbances in letrozole combined with high-fat diet-induced polycystic ovary syndrome (PCOS) rats. METHODS Rats with PCOS and insulin resistance (IR) were induced by intra-gastric instillation of letrozole combined with a high-fat diet and verified by histological screening of vaginal exfoliated cells. After metformin and exenatide supplementation, body weight, chow intake and ovarian morphology were observed. Serum biochemical profiles were analyzed using ELISA, while the levels of key anabolism-related proteins, including sex hormone binding globulin (SHBG), hepatocyte nuclear factor-4α (HNF-4α), PI3K, and AKT, were determined using western blotting. RESULTS The estrus cycle and ovarian morphology of rats with PCOS and IR were significantly recovered following metformin and exenatide treatment, with decreased body weight and chow intake. Furthermore, PCOS-induced changes in metabolic disorders including IR and hepatic triglyceride (TG) deposition, and hyperandrogenemia were reversed by treatment with both drugs. Specifically, the levels of HNF-4α and SHBG in liver tissue of rats with PCOS and IR were upregulated significantly. CONCLUSIONS Both metformin and exenatide could recover the estrous cycle and ovarian morphology, reduce body weight and high-fat chow intake, and improve glycolipid metabolism disorders and hyperandrogenemia in PCOS with IR rat models. Interestingly, our findings also highlight the potential of both therapeutic agents for improving IR by regulating the liver PI3K/AKT pathway, reducing the deposition of hepatic TG, as well as upregulating the levels of SHBG and HNF-4α in PCOS with IR rat liver tissue.
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Affiliation(s)
- Chuan Xing
- Department of Endocrinology, Shengjing Hospital of China Medical University, 110004, Shenyang, China
| | - Bo Lv
- Department of Endocrinology, Dalian Third People's Hospital, 116000, Dalian, China
| | - Han Zhao
- Department of Endocrinology, Shengjing Hospital of China Medical University, 110004, Shenyang, China
| | - Dongxu Wang
- Department of General Internal Medicine, Shengjing Hospital of China Medical University, 110004, Shenyang, China
| | - Xuesong Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, 110004, Shenyang, China
| | - Bing He
- Department of Endocrinology, Shengjing Hospital of China Medical University, 110004, Shenyang, China.
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Wu W, Duan C, Lv H, Song J, Cai W, Fu K, Xu J. MiR-let-7d-3p inhibits granulosa cell proliferation by targeting TLR4 in polycystic ovary syndrome. Reprod Toxicol 2021; 106:61-68. [PMID: 34655744 DOI: 10.1016/j.reprotox.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/17/2021] [Accepted: 10/05/2021] [Indexed: 10/20/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a typical reproductive and endocrinological disorder of women at child-bearing age. In this study, we used miRNA sequencing technology and verified miR-let-7d-3p as a vital miRNA in PCOS. RT-qPCR confirmed miR-let-7d-3p was significantly increased in granulosa cells (GCs) of PCOS. Cell counting kit-8 (CCK-8) identified the suppression of miR-let-7d-3p mimic in KGN cell proliferation and PI3K/Akt signaling pathway. Dual luciferase reporter assay proved that Toll-like receptor 4 (TLR4) was a target of miR-let-7d-3p, and TLR4 was significantly down-regulated by miR-let-7d-3p. Furthermore, over-expression of TLR4 promoted KGN cell proliferation and rescued the inhibition of miR-let-7d-3p on KGN cells. In conclusion, miR-let-7d-3p was a crucial miRNA up-regulated in GCs of PCOS, and inhibited cell proliferation by targeting TLR4 gene.
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Affiliation(s)
- Wei Wu
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Cuicui Duan
- Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Houyi Lv
- Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianyuan Song
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Wangyu Cai
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Kaiyou Fu
- School of Medicine, Zhejiang University, Hangzhou, China
| | - Jian Xu
- The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China.
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Chudzicka-Strugała I, Kubiak A, Banaszewska B, Zwozdziak B, Siakowska M, Pawelczyk L, Duleba AJ. Effects of Synbiotic Supplementation and Lifestyle Modifications on Women With Polycystic Ovary Syndrome. J Clin Endocrinol Metab 2021; 106:2566-2573. [PMID: 34050763 DOI: 10.1210/clinem/dgab369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting women of reproductive age. OBJECTIVE This study was designed to evaluate effects of lifestyle modifications and synbiotic supplementation on PCOS. DESIGN A randomized (1:1) double-blind, placebo-controlled trial. SETTING Academic hospital. PATIENTS OR OTHER PARTICIPANTS Overweight and obese women with PCOS were identified according to the Rotterdam criteria. Evaluations were performed at baseline and repeated after 3 months of treatment. INTERVENTION Lifestyle modifications in combination with synbiotic supplementation or placebo. MAIN OUTCOME MEASURES Change in body mass index (BMI) and testosterone level. RESULTS In the placebo group, a 5% decrease in BMI was accompanied by significant decreases of the waist, hip, and thigh circumferences. The synbiotic group experienced an 8% decrease in BMI, which was significantly greater than that in the control group (P = 0.03) and was accompanied by decreases in the waist, hip, and thigh circumferences. Testosterone did not decrease significantly in the placebo group (decrease of 6%), whereas in the synbiotic group it decreased by 32% (P < 0.0001). The decrease of testosterone was significantly greater in the synbiotic group than in the placebo group (P = 0.016). CONCLUSIONS Synbiotic supplementation potentiated effects of lifestyle modifications on weight loss and led to significant reduction of serum testosterone.
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Affiliation(s)
| | - Anna Kubiak
- Division of Infertility and Reproductive Endocrinology, Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, Poznan,Poland
| | - Beata Banaszewska
- Division of Infertility and Reproductive Endocrinology, Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, Poznan,Poland
| | - Barbara Zwozdziak
- Department of Medical Microbiology, Poznan University of Medical Sciences, Poznan,Poland
| | - Martyna Siakowska
- Division of Infertility and Reproductive Endocrinology, Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, Poznan,Poland
| | - Leszek Pawelczyk
- Division of Infertility and Reproductive Endocrinology, Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, Poznan,Poland
| | - Antoni J Duleba
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
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Sarahian N, Sarvazad H, Sajadi E, Rahnejat N, Eskandari Roozbahani N. Investigation of common risk factors between polycystic ovary syndrome and Alzheimer's disease: a narrative review. Reprod Health 2021; 18:156. [PMID: 34311759 PMCID: PMC8314638 DOI: 10.1186/s12978-021-01203-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/13/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The most common endocrine and metabolic disorders in premenopausal women is polycystic ovary syndrome (PCOS), characterized by hyperandrogenism, chronic anovulation, and/or ultrasound evidence of small ovarian cysts. Obesity and insulin resistance are also the main factors influencing the clinical manifestations of this syndrome. Alzheimer's disease (AD) is the most typical progressive neurodegenerative disorder of the brain, and recent studies suggest a relationship between endocrinal dysregulation and neuronal loss during AD pathology. AIM This study aimed to evaluate the common risk factors for Alzheimer's and PCOS based on previous studies. Knowing the common risk factors and eliminating them may prevent neurodegenerative Alzheimer's disease in the future. METHOD In this narrative review, international databases, including Google Scholar, Scopus, PubMed, and the Web of Science, were searched to retrieve the relevant studies. The relevant studies' summaries were categorized to discuss the possible pathways that may explain the association between Alzheimer's and PCOS signs/symptoms and complications. RESULTS According to our research, the factors involved in Alzheimer's and PCOS disorders may share some common risk factors. In patients with PCOS, increased LH to FSH ratio, decreased vitamin D, insulin resistance, and obesity are some of the most important factors that may increase the risk of Alzheimer's disease.
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Affiliation(s)
- Nahid Sarahian
- Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hosna Sarvazad
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Elham Sajadi
- Department of Basic Science, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Nasrin Rahnejat
- Faculty of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Narges Eskandari Roozbahani
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Cao CH, Wei Y, Liu R, Lin XR, Luo JQ, Zhang QJ, Lin SR, Geng L, Ye SK, Shi Y, Xia X. Three-Dimensional Genome Interactions Identify Potential Adipocyte Metabolism-Associated Gene STON1 and Immune-Correlated Gene FSHR at the rs13405728 Locus in Polycystic Ovary Syndrome. Front Endocrinol (Lausanne) 2021; 12:686054. [PMID: 34248847 PMCID: PMC8264658 DOI: 10.3389/fendo.2021.686054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/03/2021] [Indexed: 12/03/2022] Open
Abstract
Background rs13405728 was identified as one of the most prevalent susceptibility loci for polycystic ovary syndrome (PCOS) in Han Chinese and Caucasian women. However, the target genes and potential mechanisms of the rs13405728 locus remain to be determined. Methods Three-dimensional (3D) genome interactions from the ovary tissue were characterized via high-through chromosome conformation capture (Hi-C) and Capture Hi-C technologies to identify putative targets at the rs13405728 locus. Combined analyses of eQTL, RNA-Seq, DNase-Seq, ChIP-Seq, and sing-cell sequencing were performed to explore the molecular roles of these target genes in PCOS. PCOS-like mice were applied to verify the expression patterns. Results Generally, STON1 and FSHR were identified as potential targets of the rs13405728 locus in 3D genomic interactions with epigenomic regulatory peaks, with STON1 (P=0.0423) and FSHR (P=0.0013) being highly expressed in PCOS patients. STON1 co-expressed genes were associated with metabolic processes (P=0.0008) in adipocytes (P=0.0001), which was validated in the fat tissue (P<0.0001) and ovary (P=0.0035) from fat-diet mice. The immune system process (GO:0002376) was enriched in FSHR co-expressed genes (P=0.0002) and PCOS patients (P=0.0002), with CD4 high expression in PCOS patients (P=0.0316) and PCOS-like models (P=0.0079). Meanwhile, FSHR expression was positively correlated with CD4 expression in PCOS patients (P=0.0252) and PCOS-like models (P=0.0178). Furthermore, androgen receptor (AR) was identified as the common transcription factor for STON1 and FSHR and positively correlated with the expression of STON1 (P=0.039) and FSHR (P=4e-06) in ovary tissues and PCOS-like mice. Conclusion Overall, we identified STON1 and FSHR as potential targets for the rs13405728 locus and their roles in the processes of adipocyte metabolism and CD4 immune expression in PCOS, which provides 3D genomic insight into the pathogenesis of PCOS.
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Affiliation(s)
- Can-hui Cao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
- Department of Gynecologic Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ye Wei
- Department of Gynecologic Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rang Liu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Xin-ran Lin
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Jia-qi Luo
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Qiu-ju Zhang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Shou-ren Lin
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Lan Geng
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Si-kang Ye
- Department of Critical Care Medicine, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Yu Shi
- Department of Ultrasonography, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Xi Xia
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
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Dietz de Loos ALP, Jiskoot G, Timman R, Beerthuizen A, Busschbach JJV, Laven JSE. Improvements in PCOS characteristics and phenotype severity during a randomized controlled lifestyle intervention. Reprod Biomed Online 2021; 43:298-309. [PMID: 34238659 DOI: 10.1016/j.rbmo.2021.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/26/2021] [Accepted: 05/06/2021] [Indexed: 11/30/2022]
Abstract
RESEARCH QUESTION What is the effect of weight loss through different interventions (three-component lifestyle intervention with short message service [SMS+] versus three-component lifestyle intervention without SMS [SMS-] versus care as usual [CAU]) on polycystic ovary syndrome (PCOS) characteristics (ovulatory dysfunction, hyperandrogenism, polycystic ovarian morphology [PCOM]) and phenotype distribution? DESIGN Analysis of secondary outcome measures of a randomized controlled trial. Women diagnosed with PCOS (n = 183), who wished to become pregnant, with a body mass index above 25 kg/m², were assigned to a 1-year three-component (cognitive behavioural therapy, diet, exercise) lifestyle intervention group, with or without SMS, or to CAU (advice to lose weight). RESULTS The prevalence of biochemical hyperandrogenism was 30.9% less in the SMS- group compared with CAU after 1 year (P = 0.027). Within-group analyses revealed significant improvements in ovulatory dysfunction (SMS+: -39.8%, P = 0.001; SMS-: -30.5%, P = 0.001; CAU: -32.1%, P < 0.001), biochemical hyperandrogenism (SMS-: -27.8%, P = 0.007) and PCOM (SMS-: -14.0%, P = 0.034). Weight loss had a significantly favourable effect on the chance of having ovulatory dysfunction (estimate 0.157 SE 0.030, P < 0.001) and hyperandrogenism (estimate 0.097 SE 0.027, P < 0.001). CONCLUSIONS All groups demonstrated improvements in PCOS characteristics, although these were more profound within the lifestyle intervention groups. Weight loss per se led to an amelioration of diagnostic characteristics and in the phenotype of PCOS. A three-component lifestyle intervention aimed at a 5-10% weight loss should be recommended for all women with PCOS before they become pregnant.
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Affiliation(s)
- Alexandra L P Dietz de Loos
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands.
| | - Geranne Jiskoot
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands; Department of Psychiatry, Section Medical Psychology and Psychotherapy Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands
| | - Reinier Timman
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands
| | - Annemerle Beerthuizen
- Department of Psychiatry, Section Medical Psychology and Psychotherapy Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands
| | - Joop S E Laven
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands
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Fatemeh B, Shahideh JS, Negin M. Health related quality of life and psychological parameters in different polycystic ovary syndrome phenotypes: a comparative cross-sectional study. J Ovarian Res 2021; 14:57. [PMID: 33894770 PMCID: PMC8070288 DOI: 10.1186/s13048-021-00811-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 04/13/2021] [Indexed: 11/24/2022] Open
Abstract
Background Polycystic Ovary Syndrome (PCOS) is associated with high levels of phsychological implications and detriments to Quality of Life (QoL). The aim of this study was to assess Health- Related Quality of Life (HRQoL), depression, and anxiety in Iranian women with different PCOS phenotypes. Methods The present observational, cross-sectional study was carried out on 239 PCOS women who were classified on the basis of Rotterdam criteria into four categories: A (n = 77), B (n = 38), C (n = 68), and D (n = 56). They asked to fill out three questionnaires, namely, HRQoL, SF-12, and HADS. Results No significant differences were observed between the four PCOS phenotypes for anxiety, depression and QoL, as well as HRQoL domains related to infertiliy, weight and emotional problems (P > 0.05). Phenotypes A and B had worse HRQoL related to hirsutism (13.98 ± 5.22, 14.13 ± 6.23, P < 0.001). In addition, no significant differences were observed between them for HRQoL domains. While the score of acne in phenotype D (19.60 ± 5.12, P = 0.003) and menstrual score in phenotype C were significantly higher comparing to the other PCOS groups (16.82 ± 3.87, P < 0.001). Conclusion Presenting similar psychological profiles in all phenotypes unveils the importance of pychological well-being screening, even in milder reproductive phenotypes.
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Affiliation(s)
- Bahadori Fatemeh
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Jalal Al-Ahmad Highway, Nasr Bridge, Tehran, Iran
| | - Jahanian Sadatmahalleh Shahideh
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Jalal Al-Ahmad Highway, Nasr Bridge, Tehran, Iran.
| | - Mirzaei Negin
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Jalal Al-Ahmad Highway, Nasr Bridge, Tehran, Iran
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GÜRBÜZ T, GÖKMEN O, DOKUZEYLÜL GÜNGÖR N. Polikistik over sendromu bulunan kadınlarda glikoz potasyum oranının tanısal değerinin insülin ile karşılaştırılması. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.782931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Wu Z, Fang L, Li Y, Yan Y, Thakur A, Cheng JC, Sun YP. Association of circulating monocyte chemoattractant protein-1 levels with polycystic ovary syndrome: A meta-analysis. Am J Reprod Immunol 2021; 86:e13407. [PMID: 33638245 DOI: 10.1111/aji.13407] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 02/09/2021] [Accepted: 02/22/2021] [Indexed: 12/15/2022] Open
Abstract
PROBLEM Polycystic ovary syndrome (PCOS) is a common hormonal disorder that has a huge impact on the human infertility. Increased levels of various circulating inflammatory cytokines have been observed in PCOS patients, which can contribute to the pathogenesis of PCOS. Monocyte chemoattractant protein-1 (MCP-1), a secretory chemokine, is a potent chemotactic factor that recruits monocytes/macrophages to inflammatory foci. Several previous studies comparing the circulating MCP-1 levels between non-PCOS and PCOS patients have yielded contradictory results. Therefore, the aim of this meta-analysis was to investigate whether circulating MCP-1 levels vary between non-PCOS and PCOS patients. METHODS Research articles published before November 11, 2020, were screened to identify eligible studies. Heterogeneity, sensitivity, and publication bias were analyzed using STATA software. Standardized mean difference (SMD) with a 95% confidence interval (CI) was calculated by the STATA software using a random-effects model. RESULTS 11 studies were included in this meta-analysis involving 897 individuals: 368 non-PCOS patient and 529 PCOS patients. Our pooled meta-analysis results show that circulating MCP-1 levels were significantly higher in PCOS patients than in non-PCOS patients (SMD = 0.84, 95% CI = [0.37, 1.31], Z = 3.50, p < 0.01). However, due to the limited number of studies included in this meta-analysis, subgroup analysis determined that circulating MCP-1 levels were not significantly varied between obese non-PCOS and obese PCOS patients (SMD = 0.42, 95% CI = [-0.65, 1.49], Z = 0.77, p = 0.442) as well as between non-PCOS and PCOS patients without obesity (SMD = 2.04, 95% CI = [-0.84, 4.93], Z = 1.39, p = 0.166). In addition, circulating MCP-1 levels were also not significantly different between obese and non-obese PCOS patients (SMD = -0.04, 95% CI = [-0.68, 0.60], Z = 0.11, p = 0.909). CONCLUSION Our findings reveal that circulating MCP-1 levels are upregulated in women with PCOS and are associated with an increased risk of PCOS.
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Affiliation(s)
- Ze Wu
- Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lanlan Fang
- Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuxi Li
- Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yang Yan
- Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Avinash Thakur
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.,Terry Fox Laboratory, BC Cancer Agency, Vancouver, British Columbia, Canada
| | - Jung-Chien Cheng
- Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ying-Pu Sun
- Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Bloom MS, Perkins NJ, Sjaarda LA, Mumford SL, Ye A, Kim K, Kuhr DL, Nobles CJ, Connell MT, Schisterman EF. Adiposity is associated with anovulation independent of serum free testosterone: A prospective cohort study. Paediatr Perinat Epidemiol 2021; 35:174-183. [PMID: 33107110 PMCID: PMC7878298 DOI: 10.1111/ppe.12726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/13/2020] [Accepted: 08/16/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Obesity, a body mass index (BMI) ≥30 kg/m2 , is linked to infertility, potentially through a greater risk of anovulation due to elevated androgens. Yet, previous studies have not directly assessed the impact of adiposity, or body fat, on anovulation in the absence of clinical infertility. OBJECTIVE To characterise the associations between adiposity and anovulation among women menstruating on a regular basis. METHODS Women from the EAGeR trial (n = 1200), a randomised controlled trial of low-dose aspirin and pregnancy loss among women trying to conceive, were used to estimate associations between adiposity and incident anovulation. Participants completed baseline questionnaires and anthropometry, and provided blood specimens. Women used fertility monitors for up to six consecutive menstrual cycles, with collection of daily first morning voids for hormone analysis in the first two menstrual cycles for prospective assessment of anovulation. Anovulation was assessed by urine pregnanediol glucuronide or luteinising hormone concentration or the fertility monitor. Weighted mixed-effects log-binomial regression was used to estimate associations between measures of adiposity and incident anovulation, adjusted for free (bioavailable) testosterone, anti-Mullerian hormone (AMH), serum lipids, and demographic and life style factors. RESULTS 343 (28.3%) women experienced at least one anovulatory cycle. Anovulation risk was higher per kg/m2 greater BMI (relative risk [RR] 1.03, 95% confidence interval (CI) 1.01, 1.04), cm waist circumference (RR 1.01, 95% CI 1.00, 1.02), mm subscapular skinfold (RR 1.02, 95% CI 1.01, 1.03), and mm middle upper arm circumference (RR 1.04, 95% CI 1.01, 1.06) adjusted for serum free testosterone, AMH, lipids, and other factors. CONCLUSIONS Adiposity may be associated with anovulation through pathways other than testosterone among regularly menstruating women. This may account in part for reported associations between greater adiposity and infertility among women having menstrual cycles regularly. Understanding the association between adiposity and anovulation might lead to targeted interventions for preventing infertility.
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Affiliation(s)
- Michael S. Bloom
- Departments of Environmental Health Sciences and Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY
- Department of Global and Community Health, George Mason University, Fairfax, VA (author’s current institution)
| | - Neil J. Perkins
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Lindsey A. Sjaarda
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Sunni L. Mumford
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Aijun Ye
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Keewan Kim
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Daniel L. Kuhr
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
- Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH (author’s current institution)
| | - Carrie J. Nobles
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Matthew T. Connell
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Enrique F. Schisterman
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
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Taylor FC, Dunstan DW, Fletcher E, Townsend MK, Larsen RN, Rickards K, Maniar N, Buman M, Dempsey PC, Joham AE, Cohen N, Owen N, Moran LJ, Green DJ. Interrupting Prolonged Sitting and Endothelial Function in Polycystic Ovary Syndrome. Med Sci Sports Exerc 2021; 53:479-486. [PMID: 32925494 DOI: 10.1249/mss.0000000000002513] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE In healthy adults, the impairment of vascular function associated with prolonged sitting can be mitigated with intermittent brief bouts of activity. It is unknown whether these benefits extend to women with polycystic ovary syndrome (PCOS), in whom vascular function is typically impaired and sitting time is high. We examined the acute effect of regularly interrupting sitting time with brief simple resistance activities (SRA) on vascular function in PCOS. METHODS In a randomized crossover trial, 13 physically inactive women with PCOS (18-45 yr) completed two 3.5-h conditions: 1) uninterrupted sitting (SIT) and 2) sitting interrupted by 3-min bouts of SRA every 30 min. Femoral artery flow-mediated dilation (FMD), resting shear rate, and resting blood flow were measured at 0, 1, and 3.5 h. RESULTS Mean resting femoral shear rate, averaged across the 3.5 h, significantly increased in the SRA condition relative to the SIT condition (40.1 ± 6.1 vs 62.8 ± 6.1 s-1, P < 0.0001). In addition, mean resting blood flow also significantly increased across the 3.5 h for SRA relative to SIT (45.0 ± 9.8 vs 72.8 ± 9.9 mL·min-1, P < 0.0001). There were no differences between conditions in the temporal change in femoral artery FMD across 3.5 h (Ptime-condition > 0.05 for all). CONCLUSION Frequently interrupting sitting with SRA acutely increased resting shear rate and blood flow in women with PCOS but did not alter FMD. With sedentary behavior increasing in prevalence, longer-term studies of similar interventions to reduce and break up sitting time are warranted.
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Affiliation(s)
| | | | - Elly Fletcher
- Baker Heart and Diabetes Institute, Melbourne, Victoria, AUSTRALIA
| | | | - Robyn N Larsen
- School of Agriculture and Food, The University of Melbourne, Melbourne, Victoria, AUSTRALIA
| | - Kym Rickards
- Baker Heart and Diabetes Institute, Melbourne, Victoria, AUSTRALIA
| | - Nirav Maniar
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, AUSTRALIA
| | - Matthew Buman
- College of Health Solutions, Arizona State University, Phoenix, AZ
| | | | - Anju E Joham
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, AUSTRALIA
| | - Neale Cohen
- Baker Heart and Diabetes Institute, Melbourne, Victoria, AUSTRALIA
| | | | - Lisa J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, AUSTRALIA
| | - Daniel J Green
- School of Human Sciences (Exercise and Sports Science), The University of Western Australia, Perth, Western Australia, AUSTRALIA
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Abstract
Polycystic ovarian syndrome (PCOS) is a common endocrinopathy with many clinical manifestations. The effects on women's lives start at puberty and can last throughout her lifetime. Women frequently experience anovulatory menstrual cycles, infertility, hirsutism, obesity and increased risk of diabetes mellitus, hypertension, lipid abnormalities, and metabolic syndrome. PCOS is a heterogenous disorder, and a diagnosis of exclusion. In general, women afflicted will have menstrual irregularities, ultrasound findings of abnormal ovarian size and morphology, and clinical or laboratory evidence of hyperandrogenism. This chapter reviews the current understanding of PCOS, associated metabolic abnormalities, and diagnosis in reproductive-aged women, as well as adolescents.
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Affiliation(s)
- Jessica A Lentscher
- Program of Reproductive Endocrinology and Infertility, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
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Dadachanji R, Patil A, Joshi B, Mukherjee S. Elucidating the impact of obesity on hormonal and metabolic perturbations in polycystic ovary syndrome phenotypes in Indian women. PLoS One 2021; 16:e0246862. [PMID: 33635862 PMCID: PMC7909663 DOI: 10.1371/journal.pone.0246862] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 01/27/2021] [Indexed: 12/23/2022] Open
Abstract
Polycystic ovary syndrome is a complex endocrinopathy with heterogeneous presentation and multifactorial etiology. We have undertaken this case-control study to compare metabolic and endocrine characteristics in different phenotypic subgroups of women with PCOS and the impact of obesity on them. Women with PCOS (n = 489) were classified into 4 phenotypes according to Rotterdam criteria. Comparisons of clinical, biochemical and hormonal parameters were performed across all phenotypic groups of PCOS and with controls (n = 270) by Welch’s ANOVA with subsequent Games-Howell post-hoc test. We found maximum prevalence of normoandrogenic phenotype D, which is milder form of PCOS in terms of insulin resistance, gonadotropin levels and dyslipidemia, followed by phenotype A, in our total study population. After classification of the study group into lean and obese groups, only few insulin and lipid-related traits showed marked differences between phenotypes. Further, we noted that obese women showed adverse metabolic but not androgenic traits compared to lean counterparts in the same phenotype. Metabolic syndrome frequency is increased in hyperandrogenic phenotypes with HDL-C and waist circumference being most predominant contributing factors in total, lean and obese groups. We demonstrate that in our study population there is greater occurrence of phenotype D of PCOS. Our study highlights the importance of clinicians concurrently employing Rotterdam criteria along with obesity status for ascertaining accurate PCOS status and formulating suitable therapeutic intervention.
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Affiliation(s)
- Roshan Dadachanji
- Department of Molecular Endocrinology, ICMR-National Institute for Research in Reproductive Health, Parel, Mumbai, India
| | - Anushree Patil
- Department of Clinical Research, ICMR-National Institute for Research in Reproductive Health, Parel, Mumbai, India
| | - Beena Joshi
- Department of Operational Research, ICMR-National Institute for Research in Reproductive Health, Parel, Mumbai, India
| | - Srabani Mukherjee
- Department of Molecular Endocrinology, ICMR-National Institute for Research in Reproductive Health, Parel, Mumbai, India
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Moin ASM, Sathyapalan T, Atkin SL, Butler AE. The relationship of soluble neuropilin-1 to severe COVID-19 risk factors in polycystic ovary syndrome. Metabol Open 2021; 9:100079. [PMID: 33521617 PMCID: PMC7834728 DOI: 10.1016/j.metop.2021.100079] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/05/2021] [Accepted: 01/09/2021] [Indexed: 12/12/2022] Open
Affiliation(s)
- Abu Saleh Md Moin
- Diabetes Research Center (DRC), Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), 34110, Doha, Qatar
| | | | - Stephen L Atkin
- Royal College of Surgeons in Ireland Bahrain, Adliya, Bahrain
| | - Alexandra E Butler
- Diabetes Research Center (DRC), Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), PO Box 34110, Doha, Qatar
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Association of metabolic and inflammatory markers with polycystic ovarian syndrome (PCOS): an update. Arch Gynecol Obstet 2021; 303:631-643. [PMID: 33439300 DOI: 10.1007/s00404-020-05951-2] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 12/26/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Polycystic ovarian syndrome (PCOS) is the most prevalent metabolic disorder in reproductive-age women. It is indeed a multifactorial condition evidenced by ovarian dysfunction, hyperandrogenaemia, infertility, hormonal imbalance and chronic anovulation. Experimental evidence infers that PCOS women are prone to cardiovascular problems and insulin resistance. PURPOSE To furnish the details about the association of inflammatory markers in PCOS. DESIGN An extensive literature search on PubMed, science direct and google scholar has been performed for articles about PCOS and inflammation in PCOS. A comprehensive analysis using original articles, reviews, systemic and meta-analysis was conducted for better understanding the relationship between inflammatory cytokines and PCOS. RESULTS The inflammatory markers perform a substantial part in managing the functions of the ovary. Any disturbances in their levels can lead to ovarian dysfunction. Inflammatory markers are associated with PCOS pathogenesis. The interplay between inflammatory cytokines in the PCOS ovary strongly implies that inflammation is one of the most potent risk factors of PCOS. CONCLUSION Inflammatory markers have a significant role in regulating the ovary. This manuscript highlights the significance of metabolic and inflammatory markers with PCOS. Since PCOS is always considered as a metabolic disorder, researchers can also consider focusing on the relationship between the inflammatory markers in PCOS to establish a new treatment or management of the disease and to improve women's health.
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Luo E, Zhang J, Song J, Feng D, Meng Y, Jiang H, Li D, Fang Y. Serum Anti-Müllerian Hormone Levels Were Negatively Associated With Body Fat Percentage in PCOS Patients. Front Endocrinol (Lausanne) 2021; 12:659717. [PMID: 34149614 PMCID: PMC8213015 DOI: 10.3389/fendo.2021.659717] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/13/2021] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Obesity is a state of excess body fat accumulation, and appears to be closely associated with polycystic ovary syndrome (PCOS). Notably, plausible biological pathways through which obesity can regulate anti-Müllerian hormone (AMH) production have been proposed, and women with PCOS characteristically have an increased AMH level. Body fat accumulation can be described by body fat percentage (BFP). However, the relationship between BFP and AMH still remains unclear. MATERIALS AND METHODS A total of 87 controls and 156 PCOS patients were divided into lean and overweight/obese groups, and the PCOS patients were further divided into hyper-AMH and normal-AMH subgroups. Univariate regression was used to assess the unadjusted relationship between AMH and outcome variables, multivariable regression analysis was performed to test whether and how serum AMH levels were associated with BFP after adjusting for other co-variables. Receiver-operating characteristic (ROC) curve analyses were used to test the utility of BFP for the diagnosis of PCOS. RESULTS BFP was higher in PCOS patients compared with controls, regardless of obesity. Serum AMH levels were negatively associated with BFP in the PCOS group (r = -0.371; P < 0.001) but not in the control group (r = -0.095; P = 0.385). Multivariable logistic regression analysis showed that elevated BFP was associated with a high risk of PCOS (odds ratio, 1.290; 95% confidence interval, 1.084-1.534, P = 0.004). Furthermore, the combination of BFP and serum AMH into a multivariate model gave an improved area under the curve (AUC) of 88.5%, with a sensitivity of 72.4% and specificity of 87.4%; the positive and negative predictive values were 91.2% and 63.9%, respectively. One limitation of this study is all the conclusion reported was based on small sample size. CONCLUSIONS Herein, we described the negative correlation between BFP and serum AMH levels for the first time, and the present results highlight the importance of further investigation into the role of BFP, especially in body fat-related AMH change as it relates to the underlying pathogenesis of PCOS.
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Zhao X, Wang M, Wen Z, Lu Z, Cui L, Fu C, Xue H, Liu Y, Zhang Y. GLP-1 Receptor Agonists: Beyond Their Pancreatic Effects. Front Endocrinol (Lausanne) 2021; 12:721135. [PMID: 34497589 PMCID: PMC8419463 DOI: 10.3389/fendo.2021.721135] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 08/05/2021] [Indexed: 12/13/2022] Open
Abstract
Glucagon like peptide-1 (GLP-1) is an incretin secretory molecule. GLP-1 receptor agonists (GLP-1RAs) are widely used in the treatment of type 2 diabetes (T2DM) due to their attributes such as body weight loss, protection of islet β cells, promotion of islet β cell proliferation and minimal side effects. Studies have found that GLP-1R is widely distributed on pancreatic and other tissues and has multiple biological effects, such as reducing neuroinflammation, promoting nerve growth, improving heart function, suppressing appetite, delaying gastric emptying, regulating blood lipid metabolism and reducing fat deposition. Moreover, GLP-1RAs have neuroprotective, anti-infectious, cardiovascular protective, and metabolic regulatory effects, exhibiting good application prospects. Growing attention has been paid to the relationship between GLP-1RAs and tumorigenesis, development and prognosis in patient with T2DM. Here, we reviewed the therapeutic effects and possible mechanisms of action of GLP-1RAs in the nervous, cardiovascular, and endocrine systems and their correlation with metabolism, tumours and other diseases.
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Affiliation(s)
- Xin Zhao
- Department of Pharmacology, Shanxi Medical University, Taiyuan, China
| | - Minghe Wang
- Department of Pharmacology, Shanxi Medical University, Taiyuan, China
| | - Zhitong Wen
- Department of Pharmacology, Shanxi Medical University, Taiyuan, China
| | - Zhihong Lu
- Department of Pharmacology, Shanxi Medical University, Taiyuan, China
| | - Lijuan Cui
- Department of Pharmacology, Shanxi Medical University, Taiyuan, China
| | - Chao Fu
- Department of Pharmacology, Shanxi Medical University, Taiyuan, China
| | - Huan Xue
- Department of Pharmacology, Shanxi Medical University, Taiyuan, China
| | - Yunfeng Liu
- Department of Endocrinology, First Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, China
- *Correspondence: Yi Zhang, ; Yunfeng Liu,
| | - Yi Zhang
- Department of Pharmacology, Shanxi Medical University, Taiyuan, China
- *Correspondence: Yi Zhang, ; Yunfeng Liu,
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Wang N, Zhu Q, Ma M, Liang Z, Tao Y, Wang Y, Kuang Y. Comparison of a progestin-primed ovarian stimulation protocol with a flexible GnRH antagonist protocol in patients with polycystic ovary syndrome who are participating in an IVF programme: study protocol for a randomised controlled trial. BMJ Open 2020; 10:e038153. [PMID: 33268401 PMCID: PMC7713223 DOI: 10.1136/bmjopen-2020-038153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Women with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization (IVF) protocols are typically characterised by an increased number of oocytes retrieved. The oocytes are often of poor quality, leading to lower pregnancy rates, higher miscarriage rates and an increased risk of developing ovarian hyperstimulation syndrome (OHSS). Since our previous preliminary study showed that a novel progestin-primed ovarian stimulation (PPOS) protocol blocked the luteinising hormone (LH) surge during IVF and achieved a higher pregnancy rate with a lower incidence of OHSS, we designed a prospective randomised controlled trial to compare the efficacy and safety of this PPOS protocol with the flexible gonadotropin-releasing hormone (GnRH) antagonist protocol in patients with PCOS who are undergoing IVF procedures. METHODS AND ANALYSIS Patients with PCOS will be randomised to one of two controlled ovarian stimulation regimens-GnRH antagonist or PPOS-using a computer-generated random number. A freeze-all strategy using embryo vitrification techniques and frozen embryo transfer will be performed in both groups. The primary outcome is the live-birth rate per transfer. Secondary outcomes include the incidence of premature LH surges, the duration and total dose of human menopausal gonadotropin stimulation, the number of oocytes retrieved, the incidence of moderate or severe OHSS, the number of embryos available for transfer, implantation rates, clinical pregnancy rates, pregnancy loss rates, ectopic pregnancy rates, pregnancy and neonatal complications, and congenital anomalies. The necessary sample size for this trial was estimated as 392 participants, with 196 participants in each group. Intention-to-treat analysis was used in processing our experimental data. ETHICS AND DISSEMINATION This study was approved by the Institutional Review Board of the hospital (2016-133-T82). The trial will be conducted according to the principles of the World Medical Association's Declaration of Helsinki and in accordance with Good Clinical Practice standards. The findings of this trial will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER ChiCTRIPR16009580.
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Affiliation(s)
- Ningling Wang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qianqian Zhu
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Meng Ma
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhou Liang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yu Tao
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yun Wang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yanping Kuang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Cai H, Mol BW, Gordts S, Wang H, Wang T, Li N, Shi J. Early and late pregnancy loss in women with polycystic ovary syndrome undergoing IVF/ICSI treatment: a retrospective cohort analysis of 21 820 pregnancies. BJOG 2020; 128:1160-1169. [PMID: 33142019 DOI: 10.1111/1471-0528.16590] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine early and late pregnancy loss in women with and without polycystic ovary syndrome (PCOS) undergoing IVF/ICSI transfers. DESIGN Retrospective cohort study. SETTING Reproductive medicine centre at a tertiary hospital. POPULATION We studied women with a positive β-human chorionic gonadotropin (β-hCG) after in vitro fertilisation/intra-cytoplasmic sperm injection (IVF/ICSI) treatment from May 2014 to April 2019. METHODS Odds ratios (OR) for early (≤13 weeks) and late (>13 weeks) pregnancy loss were calculated among women with and without PCOS for plurality of the pregnancy with adjustment for confounding factors. MAIN OUTCOME MEASURES Early pregnancy loss (EPL) and late pregnancy loss (LPL). RESULTS From 21 820 women identified with a positive β-hCG, 2357 (10.8%) women had PCOS, and 19 463 (89.2%) women did not. EPL occurred in 16.6% (391) of women with PCOS versus 18.3% (3565) in women with non-PCOS (OR 0.89, 95% CI 0.79-0.99, P = 0.04). After adjustment for age and other confounders, the rate of EPL was not statistically significantly associated with PCOS status (adjusted OR [aOR] 0.91, 95% CI 0.80-1.05). Women with PCOS demonstrated a higher rate of LPL (6.4% in PCOS versus 3.6% in non-PCOS, OR 1.81, 95% CI 1.48-2.21, P < 0.001). In multivariable analysis, the potential impact of PCOS was less strong (aOR 1.38, 95% CI 0.96-1.98), with BMI and maternal comorbidities also associated with LPL (aOR 1.08, 95% CI 1.04-1.1 and aOR 2.07, 95% CI 1.43-3.00, respectively). CONCLUSIONS Polycystic ovary syndrome was not independently associated with EPL. There was an increased risk of LPL but this difference was not statistically significant. TWEETABLE ABSTRACT Polycystic ovary syndrome women are at increased risk of late pregnancy loss, partly driven by elevated BMI and maternal comorbidities.
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Affiliation(s)
- He Cai
- Assisted Reproduction Centre, Northwest Women and Children's Hospital, Xi'an, China
| | - B W Mol
- Department of Obstetrics and Gynaecology, Monash Medical Centre, Monash University, Melbourne, Victoria, Australia
| | - S Gordts
- Leuven Institute for Fertility & Embryology, Leuven, Belgium
| | - H Wang
- Assisted Reproduction Centre, Northwest Women and Children's Hospital, Xi'an, China
| | - T Wang
- Assisted Reproduction Centre, Northwest Women and Children's Hospital, Xi'an, China
| | - N Li
- Assisted Reproduction Centre, Northwest Women and Children's Hospital, Xi'an, China
| | - J Shi
- Assisted Reproduction Centre, Northwest Women and Children's Hospital, Xi'an, China
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Butler AE, Abouseif A, Dargham SR, Sathyapalan T, Atkin SL. Metabolic comparison of polycystic ovarian syndrome and control women in Middle Eastern and UK Caucasian populations. Sci Rep 2020; 10:18895. [PMID: 33144665 PMCID: PMC7641235 DOI: 10.1038/s41598-020-75109-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/07/2020] [Indexed: 01/21/2023] Open
Abstract
To determine if metabolic characteristics differed in women with and without polycystic ovary syndrome (PCOS) between a Caucasian and Middle East population. Comparative cross-sectional analysis. Demographic and metabolic data from Middle Eastern women from Qatar Biobank (97 with PCOS, 622 controls) were compared to a Caucasian PCOS biobank in Hull UK (108 with PCOS, 69 controls). In both populations, PCOS women showed a worse cardiovascular risk profile of increased systolic and diastolic blood pressure, increased C-reactive protein (CRP), reduced HDL, insulin resistance as well as increased androgens compared to their respective controls without PCOS. UK women without PCOS had higher systolic and diastolic blood pressures, and increased testosterone results (p < 0.01) compared to Middle Eastern women without PCOS who had higher inflammatory markers (WBC and CRP), HDL and insulin resistance (p < 0.001). UK PCOS women had a higher body mass index, systolic and diastolic blood pressures, triglycerides (p < 0.01), whilst Middle Eastern PCOS women showed increased testosterone, free androgen index, HDL and CRP (P < 0.01). There was no difference in insulin or insulin resistance between the two PCOS cohorts. This study highlights ethnic population differences because, whilst cardiovascular risk indices were increased for both PCOS cohorts, this may be for different reasons: BMI, waist and hip measurements, systolic and diastolic blood pressure, and triglycerides were higher in the UK cohort whilst testosterone, HDL and CRP were higher in the Middle East population. Insulin resistance did not differ between the two PCOS populations despite differences in BMI.
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Affiliation(s)
- Alexandra E Butler
- Diabetes Research Center (DRC), Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), PO Box 34110, Doha, Qatar.
| | - Ahmed Abouseif
- Department of Obstetrics, Hamad Medical Corporation, Doha, Qatar
| | - Soha R Dargham
- Infectious Disease Epidemiology Group, Weill Cornell Medicine, PO Box 24144, Doha, Qatar
| | - Thozhukat Sathyapalan
- Department of Academic Diabetes, Endocrinology and Metabolism, University of Hull, Hull, UK
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Jarrett BY, Vanden Brink H, Oldfield AL, Lujan ME. Ultrasound Characterization of Disordered Antral Follicle Development in Women with Polycystic Ovary Syndrome. J Clin Endocrinol Metab 2020; 105:5891761. [PMID: 32785651 PMCID: PMC7473602 DOI: 10.1210/clinem/dgaa515] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 08/06/2020] [Indexed: 01/26/2023]
Abstract
CONTEXT The mechanism of oligo-anovulation in polycystic ovary syndrome (PCOS) is unknown. OBJECTIVES To evaluate follicular and endocrine characteristics of anovulatory and sporadic ovulatory cycles in women with PCOS. DESIGN Prospective, longitudinal study. SETTING Academic clinical research unit. PARTICIPANTS 26 reproductive-aged women (18-38 years) with PCOS, observed during natural anovulatory (PCOS-Anov; n = 12) and sporadic ovulatory cycles (PCOS-Ov; n = 14), and 12 controls. INTERVENTIONS Transvaginal ultrasonography and venipuncture were performed every other day for 4 to 6 weeks in women with PCOS or at 1 interovulatory interval in control subjects. MAIN OUTCOME MEASURES Follicle number and diameter (ie, ≥2 mm) were quantified at each visit. Individual growth profiles were assessed for all follicles that grew to ≥7 mm. Blood samples were assayed for follicle-stimulating hormone, luteinizing hormone, estradiol, and progesterone. RESULTS Follicular excess, or heightened follicle number versus controls, was observed across anovulatory and sporadic ovulatory cycles in PCOS. In PCOS-Anov, follicles emerged cyclically in some women (6/12; 50%) and continuously in others (6/12; 50%), then grew to a mean maximum diameter of 7.2 mm and regressed within 4.7 days. In PCOS-Ov, follicles mostly emerged cyclically as part of a cohort and dominant follicles showed normal growth to ovulation-albeit mean and maximum luteal progesterone concentrations were significantly lower versus controls. CONCLUSIONS Follicle growth and regression were detected on ultrasonography amidst perpetual follicular excess in PCOS. Documentation of continuous follicle recruitment and turnover, the absence of persistence, and altered luteal progesterone following sporadic ovulation, provide formative data on antral follicle development in PCOS.
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Affiliation(s)
| | | | - Alexis L Oldfield
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
| | - Marla E Lujan
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
- Correspondence and Reprint Requests: Marla E. Lujan, PhD, Associate Professor, Division of Nutritional Sciences, Cornell University, 216 Savage Hall, Ithaca, NY 14853, USA. E-mail:
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He S, Mao X, Lei H, Dong B, Guo D, Zheng B, Sun P. Peripheral Blood Inflammatory-Immune Cells as a Predictor of Infertility in Women with Polycystic Ovary Syndrome. J Inflamm Res 2020; 13:441-450. [PMID: 32884325 PMCID: PMC7443446 DOI: 10.2147/jir.s260770] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/29/2020] [Indexed: 12/19/2022] Open
Abstract
Purpose This study aimed to investigate the inflammatory-immune cells in the peripheral blood of women with polycystic ovary syndrome (PCOS) and assessed the potential correlation between inflammatory-immune cells and infertility in PCOS women. Materials and Methods In this case-control study, the profiles of lymphocyte subsets were analyzed by flow cytometry. White blood cells (WBC), neutrophils (Neu), lymphocytes, Ferriman-Gallwey (F-G) score, testosterone, prolactin, follicle-stimulating hormone, luteinizing hormone, fasting blood glucose, and fasting plasma insulin were measured, together with body mass index. Association between inflammatory-immune cells and PCOS was evaluated. Moreover, inflammatory-immune cells of the PCOS women with infertility were evaluated, and the relative operating characteristic (ROC) curve and cutoff values were calculated. Results The number of WBC, Neu, and lymphocytes was higher in PCOS women than controls (P<0.05). The percentages of total T lymphocytes, CD4+T, and NK were significantly increased in the PCOS group (P<0.001). The CD4/CD8 ratio was obviously elevated for increasing CD4+T (P<0.05). Consequently, T%, CD4+T%, and NK% were found to be the independent risk factors of PCOS by ROC curve and multivariate logistic regression analysis. Furthermore, only NK% was significantly higher in PCOS women with infertility than those who had PCOS without infertility (P<0.001). To diagnose infertility in PCOS, the cutoff value of NK% was calculated as 16.43%. Conclusion These findings suggest that the pathogenesis of PCOS is related to immune cells including T, CD4+T, and NK cells. NK cells are likely to be a potential predictive factor for PCOS women with infertility.
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Affiliation(s)
- ShuQiong He
- Department of Prenatal Diagnosis, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350001, People's Republic of China
| | - XiaoDan Mao
- Laboratory of Gynecologic Oncology, Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350001, People's Republic of China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, 350001, People's Republic of China
| | - HuiFang Lei
- Laboratory of Gynecologic Oncology, Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350001, People's Republic of China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, 350001, People's Republic of China
| | - BinHua Dong
- Laboratory of Gynecologic Oncology, Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350001, People's Republic of China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, 350001, People's Republic of China
| | - DanHua Guo
- Department of Prenatal Diagnosis, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350001, People's Republic of China
| | - BeiHong Zheng
- Department of Reproduction, Fujian, Affiliated Hospital of Fujian Medical University, Fuzhou, 350001, People's Republic of China
| | - PengMing Sun
- Laboratory of Gynecologic Oncology, Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350001, People's Republic of China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, 350001, People's Republic of China
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Mandal S, Pradhan RR, Mols Kowalczewski B. Atypical Presentation of Myocardial Infarction in a Young Patient With Polycystic Ovarian Syndrome. Cureus 2020; 12:e9494. [PMID: 32879818 PMCID: PMC7458705 DOI: 10.7759/cureus.9494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Polycystic ovarian syndrome (PCOS) is one of the common endocrinopathy noted in women of childbearing age groups. Patients with PCOS have increased cardiovascular risk factors compared with age-matched control; hence, these patients are believed to be at an increased risk for cardiovascular events. Here, we report a case of a young female with PCOS, who presented with atypical back pain in the thoracic region. Initially, her electrocardiogram (EKG) and troponin were normal; hence, it was thought to be a muscle spasm but the back pain continued; repeat EKG and troponin came abnormal suggestive of myocardial infarction (MI). The patient underwent primary percutaneous coronary intervention and was discharged on dual antiplatelet therapy. MI is common in patients with PCOS. MI is the most important differential diagnosis in any patients of PCOS presenting with chest pain or back pain. Early diagnosis and prompt treatment of MI in patients with PCOS prevent adverse outcomes.
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Affiliation(s)
- Shobha Mandal
- Internal Medicine, Guthrie Robert Packer Hospital, Sayre, USA
| | - Ravi R Pradhan
- Internal Medicine, Tribhuvan University Institute of Medicine, Kathmandu, NPL
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Peng Y, Guo L, Gu A, Shi B, Ren Y, Cong J, Yang X. Electroacupuncture alleviates polycystic ovary syndrome-like symptoms through improving insulin resistance, mitochondrial dysfunction, and endoplasmic reticulum stress via enhancing autophagy in rats. Mol Med 2020; 26:73. [PMID: 32698821 PMCID: PMC7374902 DOI: 10.1186/s10020-020-00198-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/13/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Electroacupuncture (EA), a treatment derived from traditional Chinese medicine, can effectively improve hyperandrogenism and insulin resistance in patients with polycystic ovary syndrome (PCOS), however, its underlying mechanisms remain obscure. This study aimed to investigate whether EA could mitigate PCOS-like symptoms in rats by regulating autophagy. METHODS A rat model of PCOS-like symptoms was established by subcutaneous injection with dehydroepiandrosterone (DHEA), and then EA treatment at acupoints (ST29 and SP6) was carried out for 5 weeks. To inhibit autophagy in rats, intraperitoneal injection with 0.5 mg/kg 3-MA (an autophagy inhibitor) was performed at 30 min before each EA treatment. RESULTS EA intervention alleviated PCOS-like symptoms in rats, which was partly counteracted by the combination with 3-MA. Moreover, DHEA-exposure-induced deficient autophagy in skeletal muscle was improved by EA treatment. EA-mediated improvements in insulin resistance, mitochondrial dysfunction, and endoplasmic reticulum (ER) stress in PCOS-like rats were counteracted by 3-MA pretreatment. Mechanically, EA attenuated autophagy deficiency-mediated insulin resistance in PCOS-like rats via inactivating mTOR/4E-BP1 signaling pathway. CONCLUSIONS Taken together, our findings indicate that EA treatment ameliorates insulin resistance, mitochondrial dysfunction, and ER stress through enhancing autophagy in a PCOS-like rat model. Our study provides novel insight into the mechanisms underlying the treatment of EA in PCOS, which offers more theoretic foundation for its clinical application.
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Affiliation(s)
- Yan Peng
- Disease Prevention Center, The First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, People's Republic of China
| | - Liyuan Guo
- Department of Gynecological Oncology, Cancer Hospital of Harbin Medical University, Harbin, 150081, People's Republic of China
| | - Anxin Gu
- Department of Radiation oncology, Cancer Hospital of Harbin Medical University, Harbin, 150081, People's Republic of China
| | - Beibei Shi
- Graduate School, Heilongjiang University of Chinese Medicine, Harbin, 150040, People's Republic of China
| | - Yukun Ren
- Graduate School, Heilongjiang University of Chinese Medicine, Harbin, 150040, People's Republic of China
| | - Jing Cong
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, People's Republic of China
| | - Xinming Yang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, People's Republic of China.
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