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Azmy Nabeh O, Amr A, Faoosa AM, Esmat E, Osama A, Khedr AS, Amin B, Saud AI, Elmorsy SA. Emerging Perspectives on the Impact of Diabetes Mellitus and Anti-Diabetic Drugs on Premenstrual Syndrome. A Narrative Review. Diabetes Ther 2024; 15:1279-1299. [PMID: 38668996 PMCID: PMC11096298 DOI: 10.1007/s13300-024-01585-8] [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: 03/15/2024] [Accepted: 04/08/2024] [Indexed: 05/16/2024] Open
Abstract
Diabetes mellitus (DM) and premenstrual syndrome (PMS) are global health challenges. Both disorders are often linked to a range of physical and psychological symptoms that significantly impact the quality of life of many women. Yet, the exact relation between DM and PMS is not clear, and the management of both conditions poses a considerable challenge. In this review, we aimed to investigate the interplay between DM, anti-diabetic drugs, and the different theories and symptoms of PMS. Female sex hormones are implicated in the pathophysiology of PMS and can also impair blood glucose control. In addition, patients with diabetes face a higher susceptibility to anxiety and depression disorders, with a significant number of patients experiencing symptoms such as fatigue and difficulty concentrating, which are reported in patients with PMS as well. Complications related to diabetic medications, such as hypoglycemia (with sulfonylurea) and fluid retention (with thiazolidinediones) may also mediate PMS-like symptoms. DM can, in addition, disturb the normal gut microbiota (GM), with a consequent loss of beneficial GM metabolites that guard against PMS, particularly the short-chain fatty acids and serotonin. Among the several available anti-diabetic drugs, those (1) with an anti-inflammatory potential, (2) that can preserve the beneficial GM, and (3) possessing a lower risk for hypoglycemia, might have a favorable outcome in PMS women. Yet, well-designed clinical trials are needed to investigate the anti-diabetic drug(s) of choice for patients with diabetes and PMS.
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Affiliation(s)
- Omnia Azmy Nabeh
- Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Alaa Amr
- Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Eshraka Esmat
- Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Alaa Osama
- Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Basma Amin
- Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Alaa I Saud
- Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
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Schieren A, Koch S, Pecht T, Simon MC. Impact of Physiological Fluctuations of Sex Hormones During the Menstrual Cycle on Glucose Metabolism and the Gut Microbiota. Exp Clin Endocrinol Diabetes 2024; 132:267-278. [PMID: 38382644 DOI: 10.1055/a-2273-5602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Diabetes mellitus is one of the most prevalent chronic diseases. Previous studies have shown differences in glucose metabolism between males and females. Moreover, difficulties in medication adherence have been reported in females with type 2 diabetes. These observations are believed to be caused by fluctuations in sex hormone concentrations during the menstrual cycle. Furthermore, gut microbiota is linked to female host metabolism and sex hormone production. Understanding the interactions between fluctuating hormone concentrations during the menstrual cycle, gut microbiota, and glucose metabolism in humans is significant because of the increasing prevalence of diabetes and the consequent need to expand preventive efforts. A literature search was performed to determine and summarize the existing evidence, deduce future research needs to maintain female health, and investigate the relationship between the physiological menstrual cycle and glucose metabolism. Studies from 1967 to 2020 have already examined the relationship between variations during the menstrual cycle and glucose metabolism in healthy female subjects using an oral-glucose tolerance test or intravenous glucose tolerance test. However, the overall number of studies is rather small and the results are contradictory, as some studies detected differences in glucose concentrations depending on the different cycle phases, whereas others did not. Some studies reported lower glucose levels in the follicular phase than in the luteal phase, whereas another study detected the opposite. Data on gut microbiota in relation to the menstrual cycle are limited. Conflicting results exist when examining the effect of hormonal contraceptives on the gut microbiota and changes in the course of the menstrual cycle. The results indicate that the menstrual cycle, especially fluctuating sex hormones, might impact the gut microbiota composition.The menstrual cycle may affect the gut microbiota composition and glucose metabolism. These results indicate that glucose tolerance may be the greatest in the follicular phase; however, further well-conducted studies are needed to support this assumption.
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Affiliation(s)
- Alina Schieren
- University of Bonn, Institute of Nutrition and Food Sciences, Nutrition and Microbiota, Bonn, Germany
| | - Sandra Koch
- University of Bonn, Institute of Nutrition and Food Sciences, Nutrition and Microbiota, Bonn, Germany
| | - Tal Pecht
- University of Bonn, Life & Medical Sciences (LIMES) Institute, Department for Genomics and Immunoregulation, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Systems Medicine, Bonn, Germany
| | - Marie-Christine Simon
- University of Bonn, Institute of Nutrition and Food Sciences, Nutrition and Microbiota, Bonn, Germany
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Shi X, Chen M, Pan Q, Zhou J, Liu Y, Jiang T, Lin Y, Huang J, Shen X, Lu D, Li Y. Association between dietary patterns and premenstrual disorders: a cross-sectional analysis of 1382 college students in China. Food Funct 2024; 15:4170-4179. [PMID: 38482855 DOI: 10.1039/d3fo05782h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Premenstrual disorders (PMDs) are common among young women and have been linked to metabolic dysfunction. Limited evidence exists regarding the associations between dietary patterns and PMDs. This cross-sectional study involved young female adults recruited from the Care of Premenstrual Emotion (COPE) cohort study in China to examine the relationship between dietary patterns and PMDs in young adulthood. PMDs were assessed using the Calendar of Premenstrual Experiences, and the consumption frequency of 12 common food groups was evaluated using a Food Frequency Questionnaire. We used principal component analysis to identify the dietary patterns and employed logistic regression to investigate the association between dietary pattern adherence and PMDs. The study included 1382 participants, of whom 337 (24.4%) reported having PMDs. Three dietary patterns were identified and named based on regional food preferences: the Traditional North China Diet (TNCD), the Traditional South China Diet (TSCD), and the Lacto-ovo Vegetarian Diet (LVD). The TSCD, characterized by high consumption of rice, red meat, and poultry, showed a significant inverse association with PMDs. This pattern held good for both premenstrual syndrome and premenstrual dysphoric disorder. These findings suggest that targeted dietary modifications could serve as a localized strategy for PMDs prevention.
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Affiliation(s)
- Xinyi Shi
- Health Management Center, General Practice Medical Center, Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, China.
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
| | - Min Chen
- Health Management Center, General Practice Medical Center, Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, China.
| | - Qing Pan
- Health Management Center, General Practice Medical Center, Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, China.
| | - Jing Zhou
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Yuqing Liu
- Health Management Center, General Practice Medical Center, Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, China.
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
| | - Tingting Jiang
- Youth League Committee (Youth Work Department, Medical and Social Work Office), West China Hospital, Sichuan University, Chengdu, China
| | - Yifei Lin
- Health Management Center, General Practice Medical Center, Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, China.
| | - Jin Huang
- Health Management Center, General Practice Medical Center, Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, China.
| | - Xi Shen
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Donghao Lu
- Health Management Center, General Practice Medical Center, Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu, China.
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Yuchen Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
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MacGregor KA, Ho FK, Celis-Morales CA, Pell JP, Gallagher IJ, Moran CN. Association between menstrual cycle phase and metabolites in healthy, regularly menstruating women in UK Biobank, and effect modification by inflammatory markers and risk factors for metabolic disease. BMC Med 2023; 21:488. [PMID: 38066548 PMCID: PMC10709933 DOI: 10.1186/s12916-023-03195-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Preliminary evidence demonstrates some parameters of metabolic control, including glycaemic control, lipid control and insulin resistance, vary across the menstrual cycle. However, the literature is inconsistent, and the underlying mechanisms remain uncertain. This study aimed to investigate the association between the menstrual cycle phase and metabolites and to explore potential mediators and moderators of these associations. METHODS We undertook a cross-sectional cohort study using UK Biobank. The outcome variables were glucose; triglyceride; triglyceride to glucose index (TyG index); total, HDL and LDL cholesterol; and total to HDL cholesterol ratio. Generalised additive models (GAM) were used to investigate non-linear associations between the menstrual cycle phase and outcome variables. Anthropometric, lifestyle, fitness and inflammatory markers were explored as potential mediators and moderators of the associations between the menstrual cycle phase and outcome variables. RESULTS Data from 8694 regularly menstruating women in UK Biobank were analysed. Non-linear associations were observed between the menstrual cycle phase and total (p < 0.001), HDL (p < 0.001), LDL (p = 0.012) and total to HDL cholesterol (p < 0.001), but not glucose (p = 0.072), triglyceride (p = 0.066) or TyG index (p = 0.100). Neither anthropometric, physical fitness, physical activity, nor inflammatory markers mediated the associations between the menstrual cycle phase and metabolites. Moderator analysis demonstrated a greater magnitude of variation for all metabolites across the menstrual cycle in the highest and lowest two quartiles of fat mass and physical activity, respectively. CONCLUSIONS Cholesterol profiles exhibit a non-linear relationship with the menstrual cycle phase. Physical activity, anthropometric and fitness variables moderate the associations between the menstrual cycle phase and metabolite concentration. These findings indicate the potential importance of physical activity and fat mass as modifiable risk factors of the intra-individual variation in metabolic control across the menstrual cycle in pre-menopausal women.
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Affiliation(s)
- Kirstin A MacGregor
- Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, Scotland, UK
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | - Carlos A Celis-Morales
- School Cardiovascular and Metabolic Health, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, Scotland, UK
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Jill P Pell
- Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile
| | - Iain J Gallagher
- Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, Scotland, UK
- Centre for Biomedicine and Global Health, School of Applied Sciences, Edinburgh Napier University, Sighthill Campus, Sighthill Court, Edinburgh, UK
| | - Colin N Moran
- Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, Scotland, UK.
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Saito M, Okada Y, Torimoto K, Tanaka Y. [A Case of Reactive Hypoglycemia Exacerbated Before Menstruation Improved by the Use of Continuous Glucose Monitoring]. J UOEH 2022; 44:301-306. [PMID: 36089349 DOI: 10.7888/juoeh.44.301] [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] [Indexed: 06/15/2023]
Abstract
A 40-year-old female patient was referred to our department with a complaint of postprandial hypoglycemia. We performed a 75g oral glucose tolerance test, and the patient was diagnosed as having impaired glucose tolerance with a 1-hour blood glucose of 245 mg/dl and a 2-hour blood glucose of 196 mg/dl. The patient also showed hypoglycemia with a 6-hour blood glucose of 46 mg/dl, and delayed hypersecretion of insulin, which was diagnosed as reactive hypoglycemia. The patient was diagnosed as having reactive hypoglycemia with delayed hypersecretion of insulin. She was given dietary guidance to avoid simple carbohydrates, and voglibose 0.6 mg was started for glucose intolerance and reactive hypoglycemia. The frequency of hypoglycemic symptoms decreased for a while, but gradually increased again. An interview revealed that the frequency of hypoglycemia was high at 2-3 days before menstruation, and Flash Glucose Monitoring (FGM) was applied to check the blood glucose fluctuation before and after menstruation. Her postprandial hyperglycemia worsened with FGM, and reactive hypoglycemia appeared 3 days before menstruation, while postprandial hyperglycemia improved and reactive hypoglycemia disappeared 4 days after menstruation. The frequency of hypoglycemia was reduced by instructing the patient to take voglibose before menses and to eat a supplementary meal after lunch a few days before menses. There have been no reports on the evaluation of reactive hypoglycemia exacerbated before menstruation by FGM. The menstrual cycle should be considered in the diagnosis, evaluation, and treatment of reactive hypoglycemia.
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Affiliation(s)
- Momo Saito
- First Department of Internal Medicine, School of Medicine, University of Occupational and Enviromental Health, Japan
| | - Yosuke Okada
- First Department of Internal Medicine, School of Medicine, University of Occupational and Enviromental Health, Japan
| | - Keiichi Torimoto
- First Department of Internal Medicine, School of Medicine, University of Occupational and Enviromental Health, Japan
| | - Yoshiya Tanaka
- First Department of Internal Medicine, School of Medicine, University of Occupational and Enviromental Health, Japan
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Shiota A, Shime C, Nakai K, Kageyama M. "Kambakutaisoto" and Emotional Instability Associated With Premenstrual Syndrome. Front Nutr 2021; 8:760958. [PMID: 34760911 PMCID: PMC8573044 DOI: 10.3389/fnut.2021.760958] [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: 08/19/2021] [Accepted: 09/27/2021] [Indexed: 12/02/2022] Open
Abstract
Many women suffer from premenstrual syndrome (PMS), which can be considered a modern illness in this busy society; mental symptoms, such as irritability, often affect the surroundings and result in loss of self-confidence. The symptoms of PMS are diverse, and it is often difficult to treat psychiatric and social symptoms with low-dose estrogen progestin combination drug (LEP) alone. Selective serotonin reuptake inhibitors (SSRIs) are also effective; however, many are unable to take them owing to their side effects. “Kambakutaisoto” is a Kampo medicine consisting of “jujube,” “licorice,” and “wheat,” which is often described as “food”; however, it is highly effective in treating emotional instability attributed to PMS in sensitive young women. There are many reports on the effects of kambakutaisoto; the molecular nutritional findings of kambakutaisoto, which has dramatic effects despite its mild composition of crude drugs, have also been reported, suggesting an association with premenstrual exacerbation of functional hypoglycemia. A narrative review of its clinical effects on PMS and the results of molecular nutrition studies was performed.
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Affiliation(s)
- Atsuko Shiota
- Department of Health Sciences, Faculty of Medicine, Kagawa University, Kitagun, Japan
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MacGregor KA, Gallagher IJ, Moran CN. Relationship Between Insulin Sensitivity and Menstrual Cycle Is Modified by BMI, Fitness, and Physical Activity in NHANES. J Clin Endocrinol Metab 2021; 106:2979-2990. [PMID: 34111293 PMCID: PMC8475204 DOI: 10.1210/clinem/dgab415] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Indexed: 11/25/2022]
Abstract
CONTEXT There is evidence demonstrating variation in insulin sensitivity across the menstrual cycle. However, to date, research has yielded inconsistent results. OBJECTIVE This study investigated variation in insulin sensitivity across the menstrual cycle and associations with body mass index (BMI), physical activity, and cardiorespiratory fitness (CRF). METHODS Data from 1906 premenopausal women in NHANES cycles 1999 to 2006 were analyzed. Menstrual cycle day was assessed using questionnaire responses recording days since last period. Rhythmic variation of plasma glucose, triglycerides, and insulin, homeostatic model of insulin resistance (HOMA-IR), and adipose tissue insulin resistance index (ADIPO-IR) across the menstrual cycle were analyzed using cosinor rhythmometry. Participants were assigned low or high categories of BMI, physical activity, and CRF, and category membership included in cosinor models as covariates. RESULTS Rhythmicity was demonstrated by a significant cosine fit for glucose (P = .014) but not triglycerides (P = .369), insulin (P = .470), HOMA-IR (P = .461), and ADIPO-IR (P = .335). When covariates were included, rhythmicity was observed when adjusting for: 1) BMI: glucose (P < .001), triglycerides (P < .001), insulin (P < .001), HOMA-IR (P < .001), and ADIPO-IR (P < .001); 2) physical activity: glucose (P < .001), triglycerides (P = .006), and ADIPO-IR (P = .038); and 3) CRF: triglycerides (P = .041), insulin (P = .002), HOMA-IR (P = .004), and ADIPO-IR (P = .004). Triglyceride amplitude, but not acrophase, was greater in the high physical activity category compared to low (P = .018). CONCLUSION Rhythmicity in insulin sensitivity and associated metabolites across the menstrual cycle are modified by BMI, physical activity, and CRF.
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Affiliation(s)
- Kirstin A MacGregor
- Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, Stirlingshire, Scotland FK9 4LA, UK
| | - Iain J Gallagher
- Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, Stirlingshire, Scotland FK9 4LA, UK
| | - Colin N Moran
- Physiology, Exercise and Nutrition Research Group, University of Stirling, Stirling, Stirlingshire, Scotland FK9 4LA, UK
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Grüneis V, Schweiger K, Galassi C, Karl CM, Treml J, Ley JP, König J, Krammer GE, Somoza V, Lieder B. Sweetness Perception is not Involved in the Regulation of Blood Glucose after Oral Application of Sucrose and Glucose Solutions in Healthy Male Subjects. Mol Nutr Food Res 2021; 65:e2000472. [PMID: 33249735 PMCID: PMC7900990 DOI: 10.1002/mnfr.202000472] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 09/07/2020] [Indexed: 01/01/2023]
Abstract
SCOPE This study investigates the effect of the sweetness of a sucrose versus an isocaloric glucose solution in dietary concentrations on blood glucose regulation by adjusting the sweetness level using the sweet taste inhibitor lactisole. METHODS AND RESULTS A total of 27 healthy males participated in this randomized, crossover study with four treatments: 10% glucose, 10% sucrose, 10% sucrose + 60 ppm lactisole, and 10% glucose + 60 ppm lactisole. Plasma glucose, insulin, glucagon-like peptide 1, and glucagon levels are measured at baseline and 15, 30, 60, 90, and 120 min after beverage consumption. Test subjects rated the sucrose solution to be sweeter than the isocaloric glucose solution, whereas no difference in sweetness is reported after addition of lactisole to the sucrose solution. Administration of the less sweet glucose solution versus sucrose led to higher blood glucose levels after 30 min, as reflected by a lower ΔAUC for sucrose (1072 ± 136) than for glucose (1567 ± 231). Application of lactisole leads to no differences in glucose, insulin, or glucagon responses induced by sucrose or glucose. CONCLUSION The results indicate that the structure of the carbohydrate has a stronger impact on the regulation of blood glucose levels than the perceived sweetness.
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Affiliation(s)
- Verena Grüneis
- Christian Doppler Laboratory for Taste ResearchFaculty of ChemistryUniversity of ViennaAlthanstrasse 14Vienna1090Austria
| | - Kerstin Schweiger
- Department of Physiological ChemistryFaculty of ChemistryUniversity of ViennaAlthanstrasse 14Vienna1090Austria
| | - Claudia Galassi
- Christian Doppler Laboratory for Taste ResearchFaculty of ChemistryUniversity of ViennaAlthanstrasse 14Vienna1090Austria
| | - Corinna M. Karl
- Christian Doppler Laboratory for Taste ResearchFaculty of ChemistryUniversity of ViennaAlthanstrasse 14Vienna1090Austria
| | - Julia Treml
- Christian Doppler Laboratory for Taste ResearchFaculty of ChemistryUniversity of ViennaAlthanstrasse 14Vienna1090Austria
| | - Jakob P. Ley
- Symrise AGMuehlenfeldstrasse 1Holzminden37603Germany
| | - Jürgen König
- Department of Nutritional ScienceFaculty of Life SciencesUniversity of ViennaAlthanstrasse 14Vienna1090Austria
| | | | - Veronika Somoza
- Department of Physiological ChemistryFaculty of ChemistryUniversity of ViennaAlthanstrasse 14Vienna1090Austria
| | - Barbara Lieder
- Christian Doppler Laboratory for Taste ResearchFaculty of ChemistryUniversity of ViennaAlthanstrasse 14Vienna1090Austria
- Department of Physiological ChemistryFaculty of ChemistryUniversity of ViennaAlthanstrasse 14Vienna1090Austria
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Miragem AA, Homem de Bittencourt PI. Nitric oxide-heat shock protein axis in menopausal hot flushes: neglected metabolic issues of chronic inflammatory diseases associated with deranged heat shock response. Hum Reprod Update 2018; 23:600-628. [PMID: 28903474 DOI: 10.1093/humupd/dmx020] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 06/28/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Although some unequivocal underlying mechanisms of menopausal hot flushes have been demonstrated in animal models, the paucity of similar approaches in humans impedes further mechanistic outcomes. Human studies might show some as yet unexpected physiological mechanisms of metabolic adaptation that permeate the phase of decreased oestrogen levels in both symptomatic and asymptomatic women. This is particularly relevant because both the severity and time span of hot flushes are associated with increased risk of chronic inflammatory disease. On the other hand, oestrogen induces the expression of heat shock proteins of the 70 kDa family (HSP70), which are anti-inflammatory and cytoprotective protein chaperones, whose expression is modulated by different types of physiologically stressful situations, including heat stress and exercise. Therefore, lower HSP70 expression secondary to oestrogen deficiency increases cardiovascular risk and predisposes the patient to senescence-associated secretory phenotype (SASP) that culminates in chronic inflammatory diseases, such as obesities, type 2 diabetes, neuromuscular and neurodegenerative diseases. OBJECTIVE AND RATIONALE This review focuses on HSP70 and its accompanying heat shock response (HSR), which is an anti-inflammatory and antisenescent pathway whose intracellular triggering is also oestrogen-dependent via nitric oxide (NO) production. The main goal of the manuscript was to show that the vasomotor symptoms that accompany hot flushes may be a disguised clue for important neuroendocrine alterations linking oestrogen deficiency to the anti-inflammatory HSR. SEARCH METHODS Results from our own group and recent evidence on hypothalamic control of central temperature guided a search on PubMed and Google Scholar websites. OUTCOMES Oestrogen elicits rapid production of the vasodilatory gas NO, a powerful activator of HSP70 expression. Whence, part of the protective effects of oestrogen over cardiovascular and neuroendocrine systems is tied to its capacity of inducing the NO-elicited HSR. The hypothalamic areas involved in thermoregulation (infundibular nucleus in humans and arcuate nucleus in other mammals) and whose neurons are known to have their function altered after long-term oestrogen ablation, particularly kisspeptin-neurokinin B-dynorphin neurons, (KNDy) are the same that drive neuroprotective expression of HSP70 and, in many cases, this response is via NO even in the absence of oestrogen. From thence, it is not illogical that hot flushes might be related to an evolutionary adaptation to re-equip the NO-HSP70 axis during the downfall of circulating oestrogen. WIDER IMPLICATIONS Understanding of HSR could shed light on yet uncovered mechanisms of menopause-associated diseases as well as on possible manipulation of HSR in menopausal women through physiological, pharmacological, nutraceutical and prebiotic interventions. Moreover, decreased HSR indices (that can be clinically determined with ease) in perimenopause could be of prognostic value in predicting the moment and appropriateness of starting a HRT.
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Affiliation(s)
- Antônio Azambuja Miragem
- Laboratory of Cellular Physiology, Department of Physiology, Federal University of Rio Grande do Sul, Rua Sarmento Leite 500, ICBS, 2nd Floor, Suite 350, Porto Alegre, RS 90050-170, Brazil.,Federal Institute of Education, Science and Technology 'Farroupilha', Rua Uruguai 1675, Santa Rosa, RS 98900-000, Brazil
| | - Paulo Ivo Homem de Bittencourt
- Laboratory of Cellular Physiology, Department of Physiology, Federal University of Rio Grande do Sul, Rua Sarmento Leite 500, ICBS, 2nd Floor, Suite 350, Porto Alegre, RS 90050-170, Brazil
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Hashemi S, Ramezani Tehrani F, Mohammadi N, Rostami Dovom M, Torkestani F, Simbar M, Azizi F. Comparison of Metabolic and Hormonal Profiles of Women With and Without Premenstrual Syndrome: A Community Based Cross-Sectional Study. Int J Endocrinol Metab 2016; 14:e28422. [PMID: 27679647 PMCID: PMC5035673 DOI: 10.5812/ijem.28422] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 11/16/2015] [Accepted: 11/17/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Premenstrual syndrome (PMS) is reported by up to 85% of women of reproductive age. Although several studies have focused on the hormone and lipid profiles of females with PMS, the results are controversial. OBJECTIVES This study was designed to investigate the association of hormonal and metabolic factors with PMS among Iranian women of reproductive age. MATERIALS AND METHODS This study was a community based cross-sectional study. Anthropometric measurements, biochemical parameters, and metabolic disorders were compared between 354 women with PMS and 302 healthy controls selected from among 1126 women of reproductive age who participated in the Iranian PCOS prevalence study. P values < 0.05 were considered significant. RESULTS Prolactin (PRL) and triglycerides (TG) were significantly elevated in women with PMS, whereas their testosterone (TES), high density lipoprotein (HDL) and 17-hydroxyprogesterone (17-OHP) levels were significantly less than they were in women without the syndrome (P < 0.05). After adjusting for age and body mass index (BMI), linear regression analysis demonstrated that for every one unit increase in PMS score there was 12% rise in the probability of having metabolic syndrome (P = 0.033). CONCLUSIONS There was a significant association between PMS scores and the prevalence of metabolic syndrome. Further studies are needed to confirm and validate the relationships between lipid profile abnormalities and metabolic disorders with PMS.
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Affiliation(s)
- Somayeh Hashemi
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Fahimeh Ramezani Tehrani, Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P. O. Box: 193954763, Tehran, IR Iran. Tel: +98-2122409309, Fax: +98-2122402463, E-mail:
| | - Nader Mohammadi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Marzieh Rostami Dovom
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | | | - Masumeh Simbar
- Department of Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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Incebiyik A, Camuzcuoglu A, Hilali NG, Ulas T, Vural M, Camuzcuoglu H, Aksoy N. Serum oxidative stress, visfatin and apelin in healthy women and those with premenstrual syndrome. J OBSTET GYNAECOL 2014; 35:188-92. [PMID: 25110962 DOI: 10.3109/01443615.2014.948399] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The aim of this study was to investigate whether there is a relationship between premenstrual syndrome and oxidative stress, visfatin and apelin. The study included 40 women with premenstrual syndrome and 40 healthy women. In all subjects, serum visfatin, apelin and oxidative stress parameters were studied in venous blood samples. The oxidative stress parameters were higher in the premenstrual syndrome group than among the controls, but this difference did not reach statistical significance (p > 0.05). It was found that total antioxidant capacity was similar in both groups. For the insulin-serotonin cycle markers, no significant difference was found between groups in terms of visfatin level (p = 0.893), although apelin was found to be significantly higher in the premenstrual syndrome group when compared with the controls (p < 0.001). According to our results, apelin can be used as an ancillary laboratory test in the diagnosis of premenstrual syndrome.
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Affiliation(s)
- A Incebiyik
- Department of Obstetrics and Gynecology, Faculty of Medicine, Harran University , Sanliurfa , Turkey
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12
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Deveci EO, Incebiyik A, Selek S, Camuzcuoglu A, Hilali NG, Camuzcuoglu H, Erdal ME, Vural M. Is catechol-o-methyltransferase gene polymorphism a risk factor in the development of premenstrual syndrome? Clin Exp Reprod Med 2014; 41:62-7. [PMID: 25045629 PMCID: PMC4102691 DOI: 10.5653/cerm.2014.41.2.62] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 05/20/2014] [Accepted: 05/21/2014] [Indexed: 11/23/2022] Open
Abstract
Objective The objective of this study was to investigate whether there was a correlation between catechol-o-methyltransferase (COMT) gene polymorphism, which is believed to play a role in the etiology of psychotic disorders, and premenstrual syndrome (PMS). Methods Fifty-three women with regular menstrual cycles, aged between 18 and 46 years and diagnosed with PMS according to the American Congress of Obstetrics and Gynecology criteria were included in this study as the study group, and 53 healthy women having no health problems were selected as the controls. Venous blood was collected from all patients included in the study and kept at -18℃ prior to analysis. Results There was no significant difference between the groups in terms of demographic features such as age, body mass index, number of pregnancies, parity, and number of children. No statistically significant difference was observed in terms of COMT gene polymorphism (p=0.61) between women in the PMS and the control groups. However, a significant difference was found between arthralgia, which is an indicator of PMS, and low-enzyme activity COMT gene (Met/Met) polymorphism (p=0.04). Conclusion These results suggested that there was no significant relationship between PMS and COMT gene polymorphism. Since we could not find a direct correlation between the COMT gene polymorphism and PMS, further studies including alternative neurotransmitter pathways are needed to find an effective treatment for this disease.
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Affiliation(s)
- Esma Ozturk Deveci
- Department of Gynecology and Obstetrics, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Adnan Incebiyik
- Department of Gynecology and Obstetrics, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Salih Selek
- Psychiatry Department, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Aysun Camuzcuoglu
- Department of Gynecology and Obstetrics, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Nese Gul Hilali
- Department of Gynecology and Obstetrics, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Hakan Camuzcuoglu
- Department of Gynecology and Obstetrics, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Mehmet Emin Erdal
- Medical Faculty, Department of Medical Biology and Genetics, Mersin University, Mersin, Turkey
| | - Mehmet Vural
- Department of Gynecology and Obstetrics, Faculty of Medicine, Harran University, Sanliurfa, Turkey
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