Assessment the Correlations of Hormones, Lipid Profiles, Oxidative Stress, and Zinc Concentration in Iraqi Women with Polycystic Ovary Syndrome

Association of Serum Anti-Mullerian Hormone and Free Testosterone with Different Phenotypes of Polycystic Ovary Syndrome

Background

Anti-Müllerian hormone (AMH) has lately been connected to polycystic ovary syndrome (PCOS) in a growing body of research, even though hyperandrogenism is one of the primary symptoms of PCOS.Evaluate the association of serum anti-Müllerian hormone and free testosterone with different phenotypes of polycystic ovary syndrome.

Methods

This is cross-sectional study was carried out at Department of Biochemistry, College of Medicine, University of Baghdad, during the period from November 2023 to March 2024. It included 111 women, 91 of these women, age range (18-40 year) were diagnosed with polycystic ovary syndrome according to 2003 Rotterdam Consensus criteria, and 20 women were apparently healthy women. The PCOS women were sub-grouped into four phenotype groups (A, B, C and D). Investigations included serum measurements of free testosterone and anti-müllerian hormone by using enzyme linked immunosorbent assay (ELISA) technique in all included women.

Results

The results revealed that phenotype A is the predominant one of PCOS, while the B phenotype is the rare one. The mean (±SEM) values of free testosterone levels of phenotypes A, B, and C were significantly higher those of phenotype D and controls (p=0.001). The mean (±SEM) value of serum anti-Mullerian hormone levels was significantly increased in phenotypes A (p=0.04) and D (p=0.01) than C phenotype.

Conclusions

Phenotype A is the predominant one of PCOS phenotypes and is associated with highest serum AMH, free testosterone and obesity. Both free testosterone and AMH are helpful in differentiation of different phenotypes of PCOS.

A review of nitric oxide and oxidative stress in typical ovulatory women and in the pathogenesis of ovulatory dysfunction in PCOS

Polycystic ovary syndrome (PCOS) is a heterogeneous functional endocrine disorder associated with a low-grade, chronic inflammatory state. Patients with PCOS present an increased risk of metabolic comorbidities and often menstrual dysregulation and infertility due to anovulation and/or poor oocyte quality. Multiple mechanisms including oxidative stress and low-grade inflammation are believed to be responsible for oocyte deterioration; however, the influence of nitric oxide (NO) insufficiency in oocyte quality and ovulatory dysfunction in PCOS is still a matter for debate. Higher production of superoxide (O2•-) mediated DNA damage and impaired antioxidant defense have been implicated as contributory factors for the development of PCOS, with reported alteration in superoxide dismutase (SOD) function, an imbalanced zinc/copper ratio, and increased catalase activity. These events may result in decreased hydrogen peroxide (H2O2) accumulation with increased lipid peroxidation events. A decrease in NO, potentially due to increased activity of NO synthase (NOS) inhibitors such as asymmetric dimethylarginine (ADMA), and imbalance in the distribution of reactive oxygen species (ROS), such as decreased H2O2 and increased O2•-, may offset the physiological processes surrounding follicular development, oocyte maturation, and ovulation contributing to the reproductive dysfunction in patients with PCOS. Thus, this proposal aims to evaluate the specific roles of NO, oxidative stress, ROS, and enzymatic and nonenzymatic elements in the pathogenesis of PCOS ovarian dysfunction, including oligo- anovulation and oocyte quality, with the intent to inspire better application of therapeutic options. The authors believe more consideration into the specific roles of oxidative stress, ROS, and enzymatic and nonenzymatic elements may allow for a more thorough understanding of PCOS. Future efforts elaborating on the role of NO in the preoptic nucleus to determine its influence on GnRH firing and follicle-stimulating hormone/Luteinizing hormone (FSH/LH) production with ovulation would be of benefit in PCOS. Consequently, treatment with an ADMA inhibitor or NO donor may prove beneficial to PCOS patients experiencing reproductive dysfunction and infertility.

Neuregulin 4 in Polycystic Ovarian Syndrome (PCOS) Phenotypes: A Key Role or Standby

Background

Neuregulin_4 (NRG4) is one of the adipokines members that synthesize adipose tissues. It has an activating effect on epidermal growth factor receptors (ErbB receptors). NRG4 has indirect effects on the hormonal environment through its interaction to ErbB receptors. Increased insulin resistance and chronic low-grade inflammation may be present when NRG4 levels are high in PCOS. Obesity and polycystic ovarian syndrome have recently gained a lot of attention. However, the literature on the connection between NRG4 and the PCOS phenotype is limited. Thus, this research aimed to identify neuregulin_4's function as a biomarker for insulin resistance in PCOS phenotypes.

Methods

A case-control study and included 140 female cases effect by different phenotypes of PCOS. Patients samples were collected at the reproductive fertility consultant of the Teaching Hospital for Obstetrics and Gynecology, Kerbala health directorate, Iraq. The outpatient clinic serum hormonal levels and insulin concentration were determined by the electrochemiluminescence immunoassay "ECLIA" system. Elisa system was used for the detection of Neuregulin-4 protein level.

Results

At the early age of participant NRG4 was increased significantly in all phenotypes of PCOS compared to control with a P< 0.05. interestingly, phenotype A was shown high level of NRG4 following phenotype C than phenotype D and phenotype B. Receiver Operator Characteristic Curves (ROC) analysis for NRG4 was performed and showed good diagnostic performers to word phenotype A.

Conclusions

Females with phenotype A have a higher level of NRG4 than other phenotypes, which could be attributable to the more pronounced metabolic abnormalities in this phenotype.

Investigation of Zinc Supplement Impact on the Serum Biochemical Parameters in Pulmonary Tuberculosis: A Double Blinded Placebo Control Trial

BACKGROUND

Zinc (Zn) is nutritionally essential trace element, and thus deficiency may severely affect human health. The results of cross-sectional studies indicate that micronutrient deficiencies are common in patients with tuberculosis. Our goal is to investigate whether Zn supplementation can increase the effects of anti-TB treatment or not.

METHODS

Patients with newly diagnosed tuberculosis were divided in to 2 groups. One group (n= 37) received capsule contains 50 mg of elemental zinc (as zinc sulfate) for 6 months every other day (micronutrient group) and Group II (n= 37) received placebo. Both groups received the same anti-tuberculosis treatment recommended by the WHO. Clinical examination, BMI, chest X-ray, direct sputum examination, assessment of serum zinc levels (by atomic absorption spectrophotometry), and biochemical markers serum concentration (by using an RA1000 AutoAnalyzer) were carried out before and after 2- and 6-months anti-tuberculosis treatment.

RESULTS

Plasma zinc concentrations in the micronutrient group was higher than placebo group After treatment. In the placebo group increasing in SGOT and SGPT concentrations were significantly higher than micronutrient group after 2 months of treatment (p< 0.05). The significant changes (p< 0.05) were observed on the serum levels of total protein, albumin. Alkaline phosphatase (ALP) levels, serum creatinine, uric acid and urea in groups were not significantly different.

CONCLUSION

Zinc supplementation results in earlier sputum smear conversion in the micronutrient group during the first 6 weeks. Increased body weight and serum zinc and serum albumin and decrease in total protein was observed in the micronutrient group.