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Are epigenetic mechanisms and nutrition effective in male and female infertility? J Nutr Sci 2023; 12:e103. [PMID: 37771507 PMCID: PMC10523291 DOI: 10.1017/jns.2023.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 09/30/2023] Open
Abstract
This review discusses epigenetic mechanisms and the relationship of infertility in men and women in relation to parameters pertaining to nutrition. The prevalence of infertility worldwide is 8-12 %, and one out of every eight couples receives medical treatment. Epigenetic mechanisms, aging, environmental factors, dietary energy and nutrients and non-nutrient compounds; more or less energy intake, and methionine come into play in the occurrence of infertility. It also interacts with vitamins B12, D and B6, biotin, choline, selenium, zinc, folic acid, resveratrol, quercetin and similar factors. To understand the molecular mechanisms regulating the expression of genes that affect infertility, the environment, the role of genotype, age, health, nutrition and changes in the individual's epigenotype must first be considered. This will pave the way for the identification of the unknown causes of infertility. Insufficient or excessive intake of energy and certain macro and micronutrients may contribute to the occurrence of infertility as well. In addition, it is reported that 5-10 % of body weight loss, moderate physical activity and nutritional interventions for improvement in insulin sensitivity contribute to the development of fertility. Processes that pertain to epigenetics carry alterations which are inherited yet not encoded via the DNA sequence. Nutrition is believed to have an impact over the epigenetic mechanisms which are effective in the pathogenesis of several diseases like infertility. Epigenetic mechanisms of individuals with infertility are different from healthy individuals. Infertility is associated with epigenetic mechanisms, nutrients, bioactive components and numerous other factors.
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Key Words
- 5mc, 5-methylcytosine
- AMH, anti-Müllerian hormone
- ART, assisted reproductive technique
- Aging
- CoQ10, coenzyme Q10
- CpG dinucleotides, context of guanine
- DMR, distinct methylated region
- DNMT, DNA methyltransferase
- Epigenetic
- FSH, follicle stimulating hormone
- Female
- H2A, H2B, H3 and H4, nucleosomal core histones
- HOXA10, HomeoboxA10
- HPR, histone-protamine ratio
- ICMART, International Committee for Monitoring Assisted Reproductive Technologies
- ICR, imprinted control region
- ICSI, intracytoplasmic sperm injection
- IL-6, interleukin-6
- IVF, in vitro fertilisation
- Infertility
- MAR, matrix attachment region
- MTHFR, methylenetetrahydrofolate reductase
- Male
- NIFT, non-IVF fertility treatment
- NTD, neural tube defect
- Nutrition
- OAT, oligo-astheno-teratozoospermia
- P1, P2, potamine 1, potamine 2
- PCOS, polycystic ovary syndrome
- ROS, reactive oxygen species
- SAM, S-adenosylmethionine
- SHBG, sex hormone-binding globulin
- SNP, single nucleotide polymorphism
- SNRPN, small nuclear ribonucleoprotein polypeptide N
- TP1, TP2, transition proteins
- UMI, unexplained male infertility
- VDR, vitamin D receptor
- lncRNA, long non-coding RNA
- mRNA, coding RNA
- miRNA, micro-RNA
- ncRNA, non-coding RNA
- piRNA, piwi-interacting RNA
- siRNA, small interfering RNA
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Quantitative approaches in clinical reproductive endocrinology. CURRENT OPINION IN ENDOCRINE AND METABOLIC RESEARCH 2022; 27:100421. [PMID: 36643692 PMCID: PMC9831018 DOI: 10.1016/j.coemr.2022.100421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Understanding the human hypothalamic-pituitary-gonadal (HPG) axis presents a major challenge for medical science. Dysregulation of the HPG axis is linked to infertility and a thorough understanding of its dynamic behaviour is necessary to both aid diagnosis and to identify the most appropriate hormonal interventions. Here, we review how quantitative models are being used in the context of clinical reproductive endocrinology to: 1. analyse the secretory patterns of reproductive hormones; 2. evaluate the effect of drugs in fertility treatment; 3. aid in the personalization of assisted reproductive technology (ART). In this review, we demonstrate that quantitative models are indispensable tools enabling us to describe the complex dynamic behaviour of the reproductive axis, refine the treatment of fertility disorders, and predict clinical intervention outcomes.
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Key Words
- AI, artificial intelligence
- AMH, anti-Müllerian hormone
- ART, assisted reproductive technology
- Artificial intelligence
- Assisted reproductive technology
- BSA, Bayesian Spectrum Analysis
- Clinical decision making
- E2, estradiol
- FSH, follicle-stimulating hormone
- GnRH, gonadotropin-releasing hormone
- HA, hypothalamic amenorrhea
- HPG, hypothalamic-pituitary gonadal
- IVF, in vitro fertilization
- In vitro fertilization
- LH, luteinizing hormone
- ML, machine learning
- Machine learning
- Mathematical modelling
- OHSS, ovarian hyperstimulation syndrome
- P4, progesterone
- PCOS, polycystic ovary syndrome
- Pulsatility analysis
- Quantitative modelling
- Reproductive endocrinology
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Effect of a pulse-based diet and aerobic exercise on bone measures and body composition in women with polycystic ovary syndrome: A randomized controlled trial. Bone Rep 2020; 12:100248. [PMID: 32071953 PMCID: PMC7016198 DOI: 10.1016/j.bonr.2020.100248] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/19/2019] [Accepted: 01/21/2020] [Indexed: 12/22/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, with clinical symptoms including menstrual dysfunction and hyperandrogenemia, as well as insulin resistance which is thought to be a key contributing factor to symptoms. Insulin is also thought to positively affect bone while oligo- and amenorrhea are known to negatively affect bone. Lifestyle modification is the first recommendation to treat symptoms of PCOS; however, little is known about the effect of lifestyle interventions on bone measures in this population. Pulses (e.g., chickpeas, beans, split peas, lentils) have been shown to lower fasting insulin, and the objective of this study was to determine the effect of a pulse-based diet compared to the therapeutic lifestyle changes (TLC) diet on bone measures and body composition in women with PCOS. Women aged 18-35 years with PCOS were randomized to either a pulse-based diet or the TLC diet for 16-weeks while following an aerobic exercise program. Thirty-one in the TLC group and 29 in the pulse group completed dual-energy X-ray absorptiometry analysis following the intervention. After 16-weeks, both groups had a lower BMI, whole body fat mass, and % fat (p < 0.005), with no difference in lean mass. In both groups, lumbar spine bone mineral content (BMC) and density were higher following the intervention (p < 0.05) while femoral neck bone mineral density (BMD) was lower (p < 0.05). Intertrochanteric section modulus improved in both groups while there was a group x time interaction in femoral shaft subperiosteal width which was more favorable in the pulse group (p < 0.05). This study demonstrates that the femoral neck may be compromised during a lifestyle intervention in women with PCOS. Research is warranted to preserve bone health during lifestyle change in women with PCOS.
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Key Words
- AUC, area under the curve
- BMC, bone mineral content
- BMD, bone mineral density
- BMI, body mass index
- Bone mineral density
- CSA, cross-sectional area
- CSMI, cross-sectional moment of inertia
- DXA, dual-energy X-ray absorptiometry
- FS, femoral shaft
- Hip geometry
- NN, narrow neck
- PCOS, polycystic ovary syndrome
- Polycystic ovary syndrome
- Randomized controlled trial
- SPW, subperiosteal width
- TLC, therapeutic lifestyle changes
- Z, section modulus
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Influence of peroxisome proliferator-activated receptor-γ exon 2 and exon 6 and insulin receptor substrate (IRS)-1 Gly972Arg polymorphisms on insulin resistance and beta-cell function in southern mediterranean women with polycystic ovary syndrome. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY 2018; 13:1-8. [PMID: 30013936 PMCID: PMC6022250 DOI: 10.1016/j.jcte.2018.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 05/21/2018] [Accepted: 05/23/2018] [Indexed: 11/28/2022]
Abstract
Background and objective The Pro12Ala (exon 2) and His447His (exon 6) polymorphisms of PPAR-γ, and Gly972Arg polymorphism of IRS-1 have been implicated in insulin resistance (IR) and adiposity. Our aim was to investigate the influence of these polymorphisms on metabolic features of polycystic ovary syndrome (PCOS). Methods Fifty-three PCOS women and 26 control women underwent a clinical and biochemical evaluation, including a 75-g oral glucose tolerance test. Insulin secretion and insulin sensitivity indices were calculated. Results Frequencies of PPAR-γ polymorphisms did not differ from those predicted by the Hardy-Weinberg equilibrium. Instead, the IRS-1 Gly972Arg allele was significantly more frequent in the PCOS group compared to controls. The most frequent allelic combinations were IRS1+/exon2-/exon6- (which prevailed in PCOS) and IRS-1-/exon2-/exon6- (which prevailed in controls). Among PCOS women, compared with the wild type patients, carriers of the Gly972Arg IRS-1 allele had lower E2 levels, while carriers of the Pro12Ala PPAR-γ (exon 2) allele had lower free testosterone levels. No other significant relationships were noted. When compared with the wild type, in PCOS group IR and beta-cell function were: (i) trendwise greater in carriers of the variant IRS-1 allele; (ii) trendwise lower in carriers of the variant PPAR-γ exon 6 allele; (iii) significantly lower in carriers of the variant PPAR-γ exon 2 allele. Conclusions Our data support the protective influence of PPAR-γ-exon 2 and exon 6 variants on IR and beta cell function, whereas IRS-1 polymorphism is associated with an unfavorable metabolic profile. However, these associations do not fully explain the high metabolic risk associated with PCOS.
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Key Words
- 17-OHP, 17-hydroxyprogesterone
- AE-PCOS, Androgen Excess and Polycystic Ovary Syndrome Society
- BMI, body mass index
- DI, disposition index
- E2, 17β-estradiol
- FSH, follicular stimulating hormone
- HDL, high-density lipoprotein
- HOMA-IR, homeostasis model assessment
- IGI, insulinogenic index
- IRS, insulin receptor substrate
- Insulin receptor substrate-1
- LDL, low-density lipoprotein
- LH, luteinizing hormone
- OGTT, oral glucose tolerance test
- PCOS, polycystic ovary syndrome
- PCR, polymerase chain reaction
- PPAR-γ, peroxisome proliferator activated receptor-γ
- Peroxisome proliferator-activated-receptor-gamma
- Polycystic ovary syndrome
- Polymorphisms
- SHBG, sex hormone binding globulin
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Circulating thyrotropin is upregulated by estradiol. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY 2018; 11:11-17. [PMID: 29725582 PMCID: PMC5928282 DOI: 10.1016/j.jcte.2018.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 01/30/2018] [Accepted: 02/12/2018] [Indexed: 01/26/2023]
Abstract
After encountering two women with serum thyrotropin (TSH) levels greater in periovulatory phase than in other days of the menstrual cycle, we hypothesized that TSH levels could be sensitive to changes in circulating estrogens in women. The objective of this study was to evaluate whether serum TSH increases after an induced acute increase of serum estradiol, and compare serum TSH increase with that of prolactin (PRL) which is a classic estradiol-upregulated pituitary hormone. In this retrospective study, we resorted to stored frozen sera from 55 women who had undergone the GnRH agonist (buserelin)-acute stimulation test of ovarian steroidogenesis. This test, that is preceded by dexamethasone administration to suppress adrenal steroidogenesis, had been performed to show an increased buserelin-stimulated response of 17-hydroxyprogesterone, a response that is frequent in polycystic ovary syndrome. Fifty-five women had enough serum volume at pertinent times (first observation early in the follicular phase and all times of the test) to permit assay of serum estradiol, TSH and PRL. Before dexamethasone administration, estradiol averaged 26.4 ± 15.5 pg/ml (reference range 23–139, follicular phase), TSH 1.78 ± 0.86 mU/L (reference range 0.3–4.2) and PRL 409.4 ± 356 mU/L (reference range 70.8–556) (mean ± SD). Serum estradiol, TSH and PRL averaged 47.2 ± 27 pg/ml, 0.77 ± 0.48 mU/L and 246.4 ± 206.8 mU/L just prior to the buserelin injection, but they peaked at 253.4 ± 113.5 pg/ml (nv 83–495, midcycle), 3.30 ± 1.65 mU/L and 540.3 ± 695.2 mU/L after injection. The responses to buserelin of estradiol, TSH and PRL were of wide magnitude. There was a significant correlation between TSH peak and serum estradiol peak, betweeen AUC0-24 h-TSH and AUC0-24 h-estradiol, or between PRL peak and estradiol peak and AUC0-24 h -PRL and AUC0-24 h-estradiol in only a subgroup of women. Therefore, women with estradiol-dependent increase in serum TSH do exist. Reference bands of serum TSH dependent on the phases of the menstrual cycle should be available.
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Key Words
- 17-OHPg, 17-hydroxyprogesterone
- AUC, area under the curve
- Buserelin
- E2, estradiol
- Estradiol
- FSH, follicle-stimulating hormone
- FT3, free T3
- GnRH, gonadotropin-releasing hormone
- LH, luteinizing hormone
- Menstrual cycle
- PCOS, polycystic ovary syndrome
- PRL, prolactin
- Polycystic ovary syndrome
- Prolactin
- T3, triiodothyronine
- T4, thyroxine
- TRH, TSH-releasing hormone
- TSH, thyrotropin
- Thyrotropin
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Metabolomic profiling identifies potential pathways involved in the interaction of iron homeostasis with glucose metabolism. Mol Metab 2016; 6:38-47. [PMID: 28123936 PMCID: PMC5220278 DOI: 10.1016/j.molmet.2016.10.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 10/17/2016] [Accepted: 10/24/2016] [Indexed: 02/06/2023] Open
Abstract
Objective Elevated serum ferritin has been linked to type 2 diabetes (T2D) and adverse health outcomes in subjects with the Metabolic Syndrome (MetS). As the mechanisms underlying the negative impact of excess iron have so far remained elusive, we aimed to identify potential links between iron homeostasis and metabolic pathways. Methods In a cross-sectional study, data were obtained from 163 patients, allocated to one of three groups: (1) lean, healthy controls (n = 53), (2) MetS without hyperferritinemia (n = 54) and (3) MetS with hyperferritinemia (n = 56). An additional phlebotomy study included 29 patients with biopsy-proven iron overload before and after iron removal. A detailed clinical and biochemical characterization was obtained and metabolomic profiling was performed via a targeted metabolomics approach. Results Subjects with MetS and elevated ferritin had higher fasting glucose (p < 0.001), HbA1c (p = 0.035) and 1 h glucose in oral glucose tolerance test (p = 0.002) compared to MetS subjects without iron overload, whereas other clinical and biochemical features of the MetS were not different. The metabolomic study revealed significant differences between MetS with high and low ferritin in the serum concentrations of sarcosine, citrulline and particularly long-chain phosphatidylcholines. Methionine, glutamate, and long-chain phosphatidylcholines were significantly different before and after phlebotomy (p < 0.05 for all metabolites). Conclusions Our data suggest that high serum ferritin concentrations are linked to impaired glucose homeostasis in subjects with the MetS. Iron excess is associated to distinct changes in the serum concentrations of phosphatidylcholine subsets. A pathway involving sarcosine and citrulline also may be involved in iron-induced impairment of glucose metabolism. This metabolomic study focuses on pathways linking iron status to insulin resistance. Metabolomic differences in Metabolic Syndrome with/without iron overload are shown. Phlebotomy changes methionine, glutamate and long-chain phosphatidylcholines levels. Phosphatidylcholines are involved in the interaction of iron and glucose homeostasis.
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Key Words
- +Fe, with iron overload
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- Akt/PKB, Akt/protein kinase B
- BMI, body mass index
- CDP, Cytidinediphosphat
- CRP, C-reactive protein
- DIOS, dysmetabolic iron overload syndrome
- FoxO1, forkhead transcription factor O1
- GGT, gamma-glutamyl transpeptidase
- GLUT1, glucose transporter 1
- GNMT, glycine N-methyltransferase
- GSK3β, glycogen synthase kinase 3β
- Glucose
- HDL, high density lipoproteins
- HIF1α, hypoxia-inducible factor 1α
- HOMA-IR, homeostatic model assessment-insulin resistance
- Hyperferritinemia
- IL, interleukin
- IR, insulin resistance
- Iron overload
- LDL, low density lipoproteins
- MRI, magnet resonance imaging
- MetS, metabolic syndrome
- Metabolic syndrome
- Metabolomics
- NAFLD, non-alcoholic fatty liver disease
- PC, phosphatidylcholine
- PCOS, polycystic ovary syndrome
- PC_E, plasmalogens
- PEMT, phosphatidylethanolamine N-methyltransferase
- RBC, red blood count
- T2D, type 2 diabetes mellitus
- TNF, tumor necrosis factor
- VLDL, very low-densitylipoproteins
- WHO, World Health Organization
- WHR, waist hip ratio
- oGTT, oral glucose tolerance test
- −Fe, without iron overload
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Normal menstrual cycle steroid hormones variation does not affect the blood levels of total adiponectin and its multimer forms. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY 2015; 2:61-65. [PMID: 29159111 PMCID: PMC5685044 DOI: 10.1016/j.jcte.2015.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 03/05/2015] [Accepted: 03/10/2015] [Indexed: 01/15/2023]
Abstract
Objective Plasma total adiponectin reveals a sexual dimorphism indicating that gonadal steroids may be involved in its secretion and/or metabolism. However, results from previous reports are conflicting and data regarding the influence of ovarian steroids on adiponectin's multimer forms are scarce. The objective of the study was to assess if total adiponectin and its isoforms are affected by the changes of estradiol and progesterone during the normal menstrual cycle and the association of total adiponectin and its isoforms with the gonadal steroid levels. Materials/methods Quantitative determination of plasma adiponectin and its multimers was conducted in the three phases of an ovulatory cycle in 13 premenopausal women, in the follicular phase of 10 more premenopausal women, in 20 postmenopausal women and in 21 men. Moreover, serum levels of FSH, LH, prolactin, estradiol, progesterone, and testosterone, sex hormone binding globulin, glucose, and insulin were measured. Results The circulating levels of total adiponectin and its multimers were not affected by the normal variation of estradiol and progesterone across the ovulatory menstrual cycle. In the whole number of participants, the total adiponectin and high molecular weight adiponectin levels were significantly different between genders and associated positively with age and sex hormone binding globulin levels, and negatively with testosterone and progesterone levels and the waist/hip ratio. In the multiple logistic regression analysis, after adjustment for age, gender, and sex hormone binding globulin and progesterone levels, significant predictors of total adiponectin levels were the waist/hip ratio and testosterone levels, and of high molecular weight adiponectin the testosterone levels. Conclusions Normal menstrual cycle ovarian steroids are not involved directly in the regulation of secretion and/or metabolism of total adiponectin and its multimers. Testosterone seems to be responsible for the adiponectin's sexual dimorphism. Adiponectin and its multimers were assessed in the three-step hormonal model of normal menstrual cycle. Estrogens may not be involved directly in the regulation of adiponectin's secretion and/or metabolism. Androgens appear to be responsible for the sexual dimorphism of adiponectin.
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Key Words
- Adiponectin multimers
- Androgens
- BMI, body mass index
- Bio-T, bioavailable testosterone
- CRP, C reactive protein
- E2, estradiol
- Estradiol
- FAI, free androgen index
- FSH, follicle stimulating hormone
- FT, free testosterone
- FT4, free thyroxine
- Gonadal steroids
- HMW, high molecular weight
- HOMA-R, homeostasis model assessment of insulin resistance
- LH, luteinizing hormone
- LMW, low molecular weight
- MBP, mean blood pressure
- MMW, mean molecular weight
- Menstrual cycle
- PCOS, polycystic ovary syndrome
- SHBG, sex hormone binding globulin
- TA, total adiponectin
- TSH, Thyroid stimulating hormone
- TT, total testosterone
- Testosterone
- WC, waist circumference
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