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Rashid R, Shah IA, Asrar MM, Godha M, Ganai BA, Ganie MA. Family history of menstrual irregularity or diabetes mellitus enhances the susceptibility to polycystic ovary syndrome among subjects harboring rs7903146 genetic variant of TCF7L2. J Diabetes Metab Disord 2022; 21:769-776. [PMID: 35673429 DOI: 10.1007/s40200-022-01050-y] [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: 03/14/2022] [Accepted: 04/24/2022] [Indexed: 01/07/2023]
Abstract
Purpose TCF7L2 mediated Wnt signaling cascade regulates glucose homeostasis by orchestrating expression, processing, and hepatic clearance of insulin. Type 2 diabetes mellitus (T2DM) and polycystic ovary syndrome (PCOS) significantly overlap in pathophysiological features with insulin resistance as a central driver. While TCF7L2 is the most potent T2DM locus, studies on the association of TCF7L2 with PCOS are limited and inconclusive. Therefore, in addition to expression profiling, the association of TCF7L2 polymorphic variant rs7903146 with PCOS was evaluated. Methods Using Rotterdam-2003 criteria for the diagnosis, 120 PCOS cases, and 120 age-matched controls were recruited. Subjects underwent clinical, biochemical, and hormonal assessment, followed by genotyping for rs7903146, carried out by PCR-RFLP and TCFL2 expression profiling by qRT-PCR. Genotype-phenotype correlation analysis was performed to evaluate any such associations. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were computed by conditional logistic regression. Results Higher odds of developing PCOS were observed in the women having a family history (FH) of either T2DM (OR = 3.86, 95% CI:1.90 - 7.83), hirsutism (OR = 4.74. 95%CI: 1.91 - 17.21) or menstrual irregularities (MI) (OR = 3.07, 95%CI: 1.61 - 8.54). The genotypes of rs7903146 did not confer any risk for developing PCOS (OR = 0.46;95%CI: 0.15 - 2.03). However, the elevated risk was seen in the subjects who harbored the variant allele and had FH of either T2DM (OR = 6.71; 95%CI: 1.89 - 23.78) or MI (OR = 9.71; 95% CI:1.89 - 23.78). Conclusion TCF7L2 polymorphic variant rs7903146 is not independently linked to PCOS risk, but modulates the risk in the subjects having a family history of either T2DM or MI. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-022-01050-y.
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Affiliation(s)
- Rabiya Rashid
- Department of Life Sciences, Jaipur National University, Jaipur, India
- Multidisciplinary Research Unit, Department of Clinical Research, SKIMS, Srinagar, India
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Idrees A Shah
- Multidisciplinary Research Unit, Department of Clinical Research, SKIMS, Srinagar, India
| | - Mir M Asrar
- Multidisciplinary Research Unit, Department of Clinical Research, SKIMS, Srinagar, India
| | - Meena Godha
- Department of Life Sciences, Jaipur National University, Jaipur, India
| | - Bashir A Ganai
- Centre for Research and Development, University of Kashmir, Srinagar, India
| | - Mohd Ashraf Ganie
- Multidisciplinary Research Unit, Department of Clinical Research, SKIMS, Srinagar, India
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
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Ganie MA, Chowdhury S, Suri V, Joshi B, Bhattacharya PK, Agrawal S, Malhotra N, Sahay R, Rozati R, Jabbar PK, Sreenivas V, Sriwastva M, Wani IA, Singh S, Sharma RS. Evaluation of the Prevalence, Regional Phenotypic Variation, Comorbidities, Risk Factors, and Variations in Response to Different Therapeutic Modalities Among Indian Women: Proposal for the Indian Council of Medical Research-Polycystic Ovary Syndrome (ICMR-PCOS) Study. JMIR Res Protoc 2021; 10:e23437. [PMID: 34448720 PMCID: PMC8433859 DOI: 10.2196/23437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/30/2020] [Accepted: 01/06/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND There is scanty data in India on polycystic ovary syndrome (PCOS) from several small, undersized, convenience-based studies employing differing diagnostic criteria and reporting varied regional prevalence. It is difficult to draw clear-cut conclusions from these studies; therefore, the present multicentric, well-designed, large-scale representative countrywide epidemiological study on PCOS across India was conceived with the aim to generate the actual prevalence rates of PCOS in India with a total sample size of approximately 9000 individuals. OBJECTIVE The primary objectives of the study are to estimate the national prevalence of PCOS in India and the burden of comorbidities and to compare the variation in efficacy of standard therapeutic modalities for metabolic dysfunction in women with PCOS. METHODS This multicentric umbrella study consists of three different substudies. Substudy 1 will involve recruitment of women aged 18-40 years using a multistage sampling technique from randomly selected polling booths across urban and rural areas to estimate national prevalence, phenotypic variation, and risk factors among regions. Substudy 2 involves recruitment of subjects from the community pool of substudy 1 and the institutional pool for quantitation of comorbidities among women with PCOS. Substudy 3, an interventional part of the study, aims for comparison of variation in efficacies of common treatment modalities and will be conducted only at 2 centers. The eligible consenting women will be randomized in a 1:1 ratio into 2 arms through a blinding procedure. All these women will undergo clinical, biochemical, and hormonal assessment at baseline and at 3 and 6 months. The data generated will be analyzed using the reliable statistical software SPSS (version 26). RESULTS The study is ongoing and is likely to be completed by April 2022. The data will be compiled and analyzed, and the results of the study will be disseminated through publications. CONCLUSIONS The Indian Council of Medical Research-PCOS study is the first of its kind attempting to provide accurate and comprehensive data on prevalence of PCOS in India. TRIAL REGISTRATION Clinical Trials Registry-India CTRI/2018/11/016252; ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=26366. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/23437.
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Affiliation(s)
- Mohd Ashraf Ganie
- Department of Endocrinology & Clinical Research, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Subhankar Chowdhury
- Department of Endocrinology & Metabolism, Institute of Postgraduate Medical Education & Research, Kolkata, India
| | - Vanita Suri
- Department of Obstetrics & Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Beena Joshi
- Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Mumbai, India
| | - Prasanta Kumar Bhattacharya
- Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India
| | - Sarita Agrawal
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, Raipur, India
| | - Neena Malhotra
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Sahay
- Department of Endocrinology, Osmania Medical College, Hyderabad, India
| | - Roya Rozati
- Department of Obstetrics & Gynaecology, Maternal Health & Research Trust, Hyderabad, India
| | | | | | - Mukesh Sriwastva
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Imtiyaz Ahmad Wani
- Department of Endocrinology & Clinical Research, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Shalini Singh
- Reproductive Biology and Maternal Health, Child Health, Indian Council of Medical Research, New Delhi, India
| | - Radhey Shyam Sharma
- Reproductive Biology and Maternal Health, Child Health, Indian Council of Medical Research, New Delhi, India
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Ganie MA, Vasudevan V, Wani IA, Baba MS, Arif T, Rashid A. Epidemiology, pathogenesis, genetics & management of polycystic ovary syndrome in India. Indian J Med Res 2020; 150:333-344. [PMID: 31823915 PMCID: PMC6902362 DOI: 10.4103/ijmr.ijmr_1937_17] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disorder predominantly affecting women of reproductive age. Clinical manifestations are diverse including hyperandrogenism, anovulation, infertility and increased risk of metabolic diseases besides psychosocial dysfunction. This review provides information on the problem of PCOS in India, its pathophysiology, genetics and an overview of current management options to instigate further research in this field. Prevalence of PCOS in India ranges from 3.7 to 22.5 per cent depending on the population studied and the criteria used for diagnosis. Abnormalities in leptin-adiponectin (adipocyte biology), oxidative stress and autoimmunity are among the mechanisms studied regarding pathogenesis of PCOS. Many candidate gene studies have shown associations with PCOS in various studies. Studies have consistently demonstrated the relationship between the well-known manifestation of hyperandrogenism among Indian PCOS women and the metabolic morbidities including insulin resistance, glucose intolerance and cardiovascular risk. Management of individual components of PCOS can be achieved by medications or surgical methods, though further clarification regarding pathogenesis of PCOS is needed to sharpen our therapeutic armamentarium.
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Affiliation(s)
- Mohammad Ashraf Ganie
- Department of Endocrinology & Metabolism, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Vishnu Vasudevan
- Department of Endocrinology & Metabolism, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Imtiyaz Ahmad Wani
- Department of Endocrinology & Metabolism, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Mohammad Salem Baba
- Department of Endocrinology & Metabolism, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Tasleem Arif
- Department of Endocrinology & Metabolism, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Aafia Rashid
- Department of Endocrinology & Metabolism, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
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Jeelani H, Ganie MA, Amin S, Fatima Q, Kawa IA, Manzoor S, Parvez T, Ahmad DN, Rashid F. Effect of Paraoxonase1 (PON1) gene polymorphisms on PON1 activity, HDL, LDL and MDA levels in women with polycystic ovary syndrome (PCOS): A case-control study. Meta Gene 2019. [DOI: 10.1016/j.mgene.2019.100552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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