1
|
Rakic D, Jakovljevic V, Jovic N, Bicanin Ilic M, Dimitrijevic A, Vulovic T, Arsenijevic P, Sretenovic J, Nikolic M, Petrovich Fisenko V, Bolevich S, Zarkovic G, Joksimovic Jovic J. The Potential of SGLT-2 Inhibitors in the Treatment of Polycystic Ovary Syndrome: The Current Status and Future Perspectives. Biomedicines 2023; 11:biomedicines11040998. [PMID: 37189616 DOI: 10.3390/biomedicines11040998] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/14/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most frequent endocrinopathy during women’s reproductive age. PCOS is a heterogeneous disorder featuring specific cardiometabolic properties. The association between the presence of metabolic disorders and PCOS supports the claim that the regulation of glycemic status is very important in these patients. There is a wide range of therapeutic options (including those treating diabetes mellitus type 2) with potential advantages available for the management of PCOS. Sodium–glucose cotransporter type 2 inhibitors (SGLT-2is) improve glucose metabolism, reduce fat tissue, lower blood pressure, reduce oxidative stress and inflammation, and protect the cardiovascular system. Currently, the use of SGLT-2is is not widespread in PCOS therapy, although these drugs represent a promising new therapeutic approach. Therefore, it is necessary to initiate further study in order to determine more effective therapies for PCOS and investigate the effect of SGLT-2is, both as a monotherapy and in combination with other drugs. It is necessary to understand the mechanisms underlying SGLT-2is in PCOS and their effects on long-term complications, especially since the gold standard treatment for PCOS, such as metformin and oral contraceptives, do not have long-term cardioprotective effects. The effects of SGLT-2is seem to involve cardiac protection, while diminishing endocrine and reproductive abnormalities in PCOS. In the current narrative review, we examine the most recent clinical evidence and discuss the potential applications of SGLT-2is for PCOS therapy.
Collapse
|
2
|
Jensterle M, Herman R, Janež A. Therapeutic Potential of Glucagon-like Peptide-1 Agonists in Polycystic Ovary Syndrome: From Current Clinical Evidence to Future Perspectives. Biomedicines 2022; 10:biomedicines10081989. [PMID: 36009535 PMCID: PMC9405922 DOI: 10.3390/biomedicines10081989] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/30/2022] [Accepted: 08/14/2022] [Indexed: 11/16/2022] Open
Abstract
Despite the continuous effort to understand the pathophysiology and determine potential therapeutic targets, PCOS treatment largely depends on lifestyle intervention and symptomatic management of individual signs and symptoms. International guidelines recognize the importance of weight reduction as a cornerstone for the achievement of better metabolic, reproductive, and cardiovascular outcomes in PCOS women who are overweight or obese. With its profound weight loss potential in patients with or without diabetes, the administration of GLP-1 receptor agonists has been investigated in overweight/obese women with PCOS in several single-center randomized control trials with considerable variation in the dosing regimen, follow-up duration, and outcome measurements over recent years. Most trials reported superior weight loss effects of GLP-1 receptor agonists compared to lifestyle changes or metformin, with additional metabolic, reproductive, and cardiovascular benefits in this population. However, their use is currently not widely accepted by the clinical community that treats this population. The major concern is how to balance the reproductive and metabolic treatment strategies since the use of GLP-1 receptor agonists requires effective contraception while on therapy and a washout period before pregnancy. Both approaches are not mutually exclusive, yet the best choice requires a careful assessment of the clinical context. Knowing a patient’s individual circumstances, precise clinical sub-phenotyping, and regular monitoring are crucial components for the safe and effective use of these new tools. In the present narrative review, we explore the current clinical evidence and provide the future perspectives and challenges for their implementation in PCOS management.
Collapse
Affiliation(s)
- Mojca Jensterle
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia
- Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Rok Herman
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia
- Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Andrej Janež
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia
- Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Correspondence: ; Tel.: +386-1-522-35-64
| |
Collapse
|
3
|
Abstract
Increasing evidence has demonstrated that obesity impairs female fertility and negatively affects human reproductive outcome following medically assisted reproduction (MAR) treatment. In the United States, 36.5% of women of reproductive age are obese. Obesity results not only in metabolic disorders including type II diabetes and cardiovascular disease, but might also be responsible for chronic inflammation and oxidative stress. Several studies have demonstrated that inflammation and reactive oxygen species (ROS) in the ovary modify steroidogenesis and might induce anovulation, as well as affecting oocyte meiotic maturation, leading to impaired oocyte quality and embryo developmental competence. Although the adverse effect of female obesity on human reproduction has been an object of debate in the past, there is growing evidence showing a link between female obesity and increased risk of infertility. However, further studies need to clarify some gaps in knowledge. We reviewed the recent evidence on the association between female obesity and infertility. In particular, we highlight the association between fat distribution and reproductive outcome, and how the inflammation and oxidative stress mechanisms might reduce ovarian function and oocyte quality. Finally, we evaluate the connection between female obesity and endometrial receptivity.
Collapse
|
4
|
Rondanelli M, Riva A, Petrangolini G, Allegrini P, Giacosa A, Fazia T, Bernardinelli L, Gasparri C, Peroni G, Perna S. Berberine Phospholipid Is an Effective Insulin Sensitizer and Improves Metabolic and Hormonal Disorders in Women with Polycystic Ovary Syndrome: A One-Group Pretest-Post-Test Explanatory Study. Nutrients 2021; 13:3665. [PMID: 34684666 PMCID: PMC8538182 DOI: 10.3390/nu13103665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/15/2021] [Accepted: 10/15/2021] [Indexed: 12/22/2022] Open
Abstract
Polycystic Ovary Syndrome (PCOS) is the most frequent endocrine disease in females of reproductive age and is characterized by multifactorial unhealthy conditions related to hormonal unbalance and also to dysmetabolism and inflammation. Recently, increasing evidence has shown that natural plant-based products may play a role in PCOS management. The aim of this one-group pretest-post-test explanatory study was to evaluate, in normal-overweight PCOS women with normal menses, the effectiveness of berberine on: Insulin resistance (IR) by Homeostasis Model Assessment (HOMA); Inflammation by C-Reactive Protein (CRP), Tumor Necrosis Factor α (TNF-α); Lipid metabolism; Sex hormone profile and symptoms correlated to hyperandrogenism, such as acne, by Global Acne Grading System (GAGS) and Cardiff Acne Disability Index (CADI); Body composition by DXA. Finally, adverse effects were assessed by liver and kidney functions and creatine phosphokinase (CPK). All these parameters were collected at baseline and 60 days after supplementation with a new bioavailable and safe berberine formulation. Twelve females (aged 26.6 ± 4.9, BMI 25.3 ± 3.6) were supplied for 60 days with two tablets/day (550 mg/table) of the bioavailable berberine. Results showed a statistically significant decrease in HOMA, CRP, TNF-α, Triglycerides, testosterone, Body Mass Index (BMI), Visceral Adipose Tissue (VAT), fat mass, GAGS and CADI scores, and a statistically significant increase in sex hormone-binding globulin (SHBG). Liver and kidney functions and CPK are not statistically significantly different. Therefore, berberine can represent a safe novel dietary supplement, helpful in treatment strategy for PCOS.
Collapse
Affiliation(s)
- Mariangela Rondanelli
- IRCCS Mondino Foundation, 27100 Pavia, Italy;
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Antonella Riva
- Research and Development Department, Indena SpA, 20139 Milan, Italy; (A.R.); (G.P.); (P.A.)
| | - Giovanna Petrangolini
- Research and Development Department, Indena SpA, 20139 Milan, Italy; (A.R.); (G.P.); (P.A.)
| | - Pietro Allegrini
- Research and Development Department, Indena SpA, 20139 Milan, Italy; (A.R.); (G.P.); (P.A.)
| | - Attilio Giacosa
- Department of Gastroenterology and Clinical Nutrition, Policlinico di Monza, Via Amati 111, 20900 Monza, Italy;
| | - Teresa Fazia
- Department of Brain and Behavioral Science, University of Pavia, 27100 Pavia, Italy; (T.F.); (L.B.)
| | - Luisa Bernardinelli
- Department of Brain and Behavioral Science, University of Pavia, 27100 Pavia, Italy; (T.F.); (L.B.)
| | - Clara Gasparri
- Endocrinology and Nutrition Unit, Azienda di Servizi Alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, 27100 Pavia, Italy;
| | - Gabriella Peroni
- Endocrinology and Nutrition Unit, Azienda di Servizi Alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, 27100 Pavia, Italy;
| | - Simone Perna
- Department of Biology, College of Science, Sakhir Campus, University of Bahrain, Zallaq 32038, Bahrain;
| |
Collapse
|
5
|
Douglas CC, Jones R, Green R, Brown K, Yount G, Williams R. University Students with PCOS Demonstrate Limited Nutrition Knowledge. AMERICAN JOURNAL OF HEALTH EDUCATION 2021. [DOI: 10.1080/19325037.2021.1877218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
6
|
Han QW, Wu JP, Pang Y, Wu LX, Yang LN. Efficacy of clomifene citrate for the treatment of patients with polycystic ovary syndrome: A protocol of systematic review. Medicine (Baltimore) 2020; 99:e20590. [PMID: 32569186 PMCID: PMC7310963 DOI: 10.1097/md.0000000000020590] [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] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This study aims to assess the efficacy and safety of clomifene citrate (CC) for the treatment of patients with polycystic ovary syndrome (PCOS). METHODS In this study, we will comprehensively search MEDLINE, EMBASE, The Cochrane Library, Web of Science, CINAHL, ACMD, PsycINFO, and China National Knowledge Infrastructure for original articles published from their inceptions to the January 1, 2020 without language restrictions. All studies will undergo relevance and a design selecting process. Data from qualified studies will be collected by 2 independent authors. Additionally, we will conduct a risk of bias evaluation using a Cochrane risk of bias tool. We will undertake statistical analysis utilizing RevMan 5.3 software. RESULTS This study will summarize the up-to-date evidence to investigate the efficacy and safety of CC for the treatment of patients with PCOS. CONCLUSION The findings of this study will provide helpful evidence of CC for the treatment of patients with PCOS, as well as may help develop treatment guidelines. PROSPERO REGISTRATION NUMBER PROSPERO CRD42020162818.
Collapse
Affiliation(s)
- Qin-wei Han
- Department of Obstetrics and Gynecology, 521 Hospital of Norinco Group
- Department of Obstetrics and Gynecology, Institute for Hygiene of Ordnance Industry, Xi’an, Shaanxi, China
| | - Jin-ping Wu
- Department of Obstetrics and Gynecology, 521 Hospital of Norinco Group
- Department of Obstetrics and Gynecology, Institute for Hygiene of Ordnance Industry, Xi’an, Shaanxi, China
| | - Ying Pang
- Department of Obstetrics and Gynecology, 521 Hospital of Norinco Group
- Department of Obstetrics and Gynecology, Institute for Hygiene of Ordnance Industry, Xi’an, Shaanxi, China
| | - Li-xia Wu
- Department of Obstetrics and Gynecology, 521 Hospital of Norinco Group
- Department of Obstetrics and Gynecology, Institute for Hygiene of Ordnance Industry, Xi’an, Shaanxi, China
| | - Li-na Yang
- Department of Obstetrics and Gynecology, 521 Hospital of Norinco Group
- Department of Obstetrics and Gynecology, Institute for Hygiene of Ordnance Industry, Xi’an, Shaanxi, China
| |
Collapse
|
7
|
Rondanelli M, Infantino V, Riva A, Petrangolini G, Faliva MA, Peroni G, Naso M, Nichetti M, Spadaccini D, Gasparri C, Perna S. Polycystic ovary syndrome management: a review of the possible amazing role of berberine. Arch Gynecol Obstet 2020; 301:53-60. [PMID: 32060683 PMCID: PMC7028834 DOI: 10.1007/s00404-020-05450-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 01/23/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE The therapy of polycystic ovary syndrome (PCOS) is based on synthetic hormones associated with lifestyle changes, but these therapies cannot be taken continuously, especially by women who would like to become pregnant. Thus, nutraceutical compounds were investigated as possible agents for treatment of PCOS. Berberine is shown to be effective against insulin resistance and obesity, particularly against visceral adipose tissue (VAT). Because of these properties, researchers theorized that berberine could be effective in PCOS treatment. METHODS The aim of this narrative review was to assess the state of the art about the use of berberine in PCOS management. RESULTS This review included 5 eligible studies. Despite the number of studies considered being low, the number of women studied is high (1078) and the results are interesting. Two authors find out that berberine induced a redistribution of adipose tissue, reducing VAT in the absence of weight loss and improved insulin sensitivity, quite like metformin. One author demonstrated that berberine improved the lipid pattern. Moreover, three authors demonstrated that berberine improved insulin resistance in theca cells with an improvement of the ovulation rate per cycle, so berberine is also effective on fertility and live birth rates. CONCLUSIONS Finally, berberine is safe to use in premenopausal women who want to get pregnant and showed few side effects in all the cited studies. In conclusion, the use of berberine for PCOS is safe and promising, even if more studies are needed to create a consensus about the dosage of berberine useful for long-term therapy.
Collapse
Affiliation(s)
- M. Rondanelli
- IRCCS Mondino Foundation, 27100 Pavia, Italy
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Vittoria Infantino
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, 70121 Bari, Italy
| | - A. Riva
- Research and Development Unit, Indena, 20146 Milan, Italy
| | | | - M. A. Faliva
- Endocrinology and Nutrition Unit, Azienda Di Servizi Alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, 27100 Pavia, Italy
| | - G. Peroni
- Endocrinology and Nutrition Unit, Azienda Di Servizi Alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, 27100 Pavia, Italy
| | - M. Naso
- Endocrinology and Nutrition Unit, Azienda Di Servizi Alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, 27100 Pavia, Italy
| | - M. Nichetti
- Endocrinology and Nutrition Unit, Azienda Di Servizi Alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, 27100 Pavia, Italy
| | - D. Spadaccini
- Endocrinology and Nutrition Unit, Azienda Di Servizi Alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, 27100 Pavia, Italy
| | - C. Gasparri
- Endocrinology and Nutrition Unit, Azienda Di Servizi Alla Persona ‘‘Istituto Santa Margherita’’, University of Pavia, 27100 Pavia, Italy
| | - S. Perna
- Department of Biology, College of Science, University of Bahrain, Sakhir Campus, P. O. Box 32038, Zallaq, Kingdom of Bahrain
| |
Collapse
|
8
|
Piotrowska A, Pilch W, Czerwińska-Ledwig O, Zuziak R, Siwek A, Wolak M, Nowak G. The Possibilities of Using Chromium Salts as an Agent Supporting Treatment of Polycystic Ovary Syndrome. Biol Trace Elem Res 2019; 192:91-97. [PMID: 30715682 PMCID: PMC6820608 DOI: 10.1007/s12011-019-1654-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 01/24/2019] [Indexed: 02/07/2023]
Abstract
The polycystic ovary syndrome (PCOS) is the most frequent endocrinopathy in women in reproductive age with the so far undetermined causes of development. In the etiopathogenesis of PCOS, the role of insulin resistance is emphasised, which was an indication for the attempts at using chromium III salts (Cr) in augmenting pharmacotherapy applied in patients. The analysis of the usefulness and efficacy of this approach was the direct goal of this thesis. Animal tests confirmed the efficacy of chromium in maintaining the appropriate level of glycaemia and insulinaemia, normalisation of plasma concentrations of microelements and also a correlation between the Cr level, insulin and dehydroepiandrosterone (DHEA) was found. A decrease in the expression of 3β-hydroxysteroid dehydrogenase and 17β-hydroxysteroid dehydrogenase was identified in adipose tissue. Clinical studies, although sparse, show that the supplementation with chromium can improve BMI and the parameters evaluating the control of glycaemia and increase the chances for ovulation and regular menstruation. However, the small number and a variability in study protocols makes comparing them very difficult. A completely new subject that has not been yet studied is the possibility of using chromium in levelling mood disorders in patients with PCOS. Currently, there are still no sufficient proofs for introducing chromium as a standard in treating and preventing insulin resistance in patients with PCOS. However, this direction remains open, and treating insulin resistance is an important challenge in clinical practice.
Collapse
Affiliation(s)
- Anna Piotrowska
- Department of Biochemistry and Basics of Cosmetology, University of Physical Education, Kraków, Poland.
| | - Wanda Pilch
- Department of Biochemistry and Basics of Cosmetology, University of Physical Education, Kraków, Poland
| | - Olga Czerwińska-Ledwig
- Department of Biochemistry and Basics of Cosmetology, University of Physical Education, Kraków, Poland
| | - Roxana Zuziak
- Department of Biochemistry and Basics of Cosmetology, University of Physical Education, Kraków, Poland
| | - Agata Siwek
- Department of Pharmacobiology, Jagiellonian University Medical College, Kraków, Poland
| | - Małgorzata Wolak
- Department of Pharmacobiology, Jagiellonian University Medical College, Kraków, Poland
| | - Gabriel Nowak
- Department of Pharmacobiology, Jagiellonian University Medical College, Kraków, Poland
- Department of Neurobiology, Laboratory of Trace Elements Neurobiology, Institute of Pharmacology PAS, Kraków, Poland
| |
Collapse
|
9
|
Salek M, Clark CCT, Taghizadeh M, Jafarnejad S. N-3 fatty acids as preventive and therapeutic agents in attenuating PCOS complications. EXCLI JOURNAL 2019; 18:558-575. [PMID: 31611740 PMCID: PMC6785778 DOI: 10.17179/excli2019-1534] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 07/23/2019] [Indexed: 12/20/2022]
Abstract
To our knowledge, in spite of several trials exploring the beneficial effect of n-3 polyunsaturated fatty acids (PUFA) on polycystic ovary syndrome (PCOS), no comprehensive evidence has investigated the effects of n-3 PUFA consumption on PCOS complications. Therefore, our aim was to conduct a review to investigate the possible effect and related mechanisms. A comprehensive systematic search was conducted in Embase, MEDLINE/PubMed, Google Scholar, and SCOPUS, to identify studies investigating n-3 fatty acids as a preventative or therapeutic agent for the attenuation of PCOS complications. Subsequently, the impact of omega-3 on PCOS, omega-3 and inflammation, omega-3 and insulin resistance, omega-3 and adipokines, omega-3 and lipid metabolism, omega-3 and endothelial function and omega-3 and hormonal factors were discussed. There are multiple mechanisms by which n-3 PUFAs may exert their beneficial effects on PCOS, including anti-obesity, glycemic and hormonal hemostasis, anti-inflammatory, regulation of adipokine production and enhancement of endothelial function.N-3 PUFAs are a promising agent in relieving complications associated with PCOS. Although most of the studies in patients with PCOS reported an improvement in most complications after administration of omega-3 supplements, there is a distinct dearth of studies investigating the dietary intake of these types of fatty acids. Moreover, favorable effects regarding the improvement of dyslipidemia, regulation of adipokines, regulation of hormonal factors and enhancement of endothelial function are limited. Therefore, more trials are warranted to investigate palatable mechanisms for clarifying the metabolic and hormonal effects of these agents in PCOS.
Collapse
Affiliation(s)
- Mina Salek
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Cain C T Clark
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Mohsen Taghizadeh
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Sadegh Jafarnejad
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
| |
Collapse
|
10
|
Hadjadj L, Pál É, Monori-Kiss A, Sziva RE, Korsós-Novák Á, Mária Horváth E, Benkő R, Magyar A, Magyar P, Benyó Z, Nádasy GL, Várbíró S. Vitamin D deficiency and androgen excess result eutrophic remodeling and reduced myogenic adaptation in small cerebral arterioles in female rats. Gynecol Endocrinol 2019; 35:529-534. [PMID: 30623742 DOI: 10.1080/09513590.2018.1554037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Vitamin D (vitD) insufficiency affects 1 billion people worldwide. Androgen excess (AE) occurs in 8% of fertile females. There are few data about the combined effect of vitD deficiency and AE on the early biomechanical changes of cerebral arterioles in fertile-aged female. Forty-six adolescent female Wistar rats (21-28 day-old, weighing 90-110 g) were grouped randomly in four groups: vitD supplemented groups with and without transdermal testosterone (T) treatment, as well as vitD deficient groups also with and without transdermal T (n = 11 or 12, in all cases). After 8 weeks of treatment, anterior cerebral arterioles (in vivo diameter of 90-130 µm) were obtained and cylindrical segments were examined by pressure arteriography. Myogenic tone, tangential stress and incremental elastic moduli were computed and statistically analyzed. Elastic density was studied on resorcin-fuchsin-stained histological section. VitD deficiency with T treatment resulted in significantly lower inner radii and higher wall thickness values with reduced tangential stress and increased elastic fiber density. VitD deficiency reduced myogenic tone at higher intraluminar pressures (>110 mmHg). Our conclusion is that plasma vitD level is an important factor in the control of myogenic tone in cerebral resistance arteries. AE and vitD deficiency acting parallel induce remodeling of their wall.
Collapse
Affiliation(s)
- Leila Hadjadj
- a Faculty of Medicine , Institute of Human Physiology and Clinical Experimental Research, Semmelweis University , Budapest , Hungary
| | - Éva Pál
- a Faculty of Medicine , Institute of Human Physiology and Clinical Experimental Research, Semmelweis University , Budapest , Hungary
| | - Anna Monori-Kiss
- a Faculty of Medicine , Institute of Human Physiology and Clinical Experimental Research, Semmelweis University , Budapest , Hungary
| | - Réka Eszter Sziva
- b 2nd Department of Obstetrics and Gynecology, Faculty of Medicine , Semmelweis University , Budapest , Hungary
| | - Ágnes Korsós-Novák
- c Department of Pathology , Jász-Nagykun-Szolnok Megyei Hetényi Géza Regional Hospital , Szolnok , Hungary
| | - Eszter Mária Horváth
- d Department of Physiology, Faculty of Medicine, Semmelweis University , Budapest , Hungary
| | - Rita Benkő
- d Department of Physiology, Faculty of Medicine, Semmelweis University , Budapest , Hungary
| | - Attila Magyar
- e Department of Anatomy, Histology and Embryology , Semmelweis University , Faculty of Medicine , Budapest , Hungary
| | - Péter Magyar
- f Department of Radiology , Semmelweis University , Faculty of Medicine , Budapest , Hungary
| | - Zoltán Benyó
- a Faculty of Medicine , Institute of Human Physiology and Clinical Experimental Research, Semmelweis University , Budapest , Hungary
| | - György L Nádasy
- d Department of Physiology, Faculty of Medicine, Semmelweis University , Budapest , Hungary
| | - Szabolcs Várbíró
- b 2nd Department of Obstetrics and Gynecology, Faculty of Medicine , Semmelweis University , Budapest , Hungary
| |
Collapse
|
11
|
Cunha NBD, Ribeiro CT, Silva CM, Rosa-E-Silva ACJDS, De-Souza DA. Dietary intake, body composition and metabolic parameters in women with polycystic ovary syndrome. Clin Nutr 2018; 38:2342-2348. [PMID: 30449604 DOI: 10.1016/j.clnu.2018.10.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 07/30/2018] [Accepted: 10/18/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND & AIMS Overweight polycystic ovary syndrome (PCOS) patients present exacerbation of clinical symptoms and increased risk for chronic diseases. The effects of inadequate dietary intake have been investigated in body weight gain in PCOS women. The aim of this study was to evaluate the dietary pattern and to analyze possible associations with the metabolism and body composition in PCOS women. METHODS A case-control study was performed with thirty-nine women diagnosed with PCOS and thirty-five control women, matched by age and body mass index. A body composition assessment was performed by Dual-energy X-ray absorptiometry (DXA) and food intake was assessed using the seven-day food record. The metabolic parameters evaluated were fasting glucose, insulin, Homeostasis Model Assessment-estimated Insulin Resistance (HOMA-IR) index and oral glucose tolerance test (OGTT). RESULTS No significant differences were observed in dietary intake of women with or without PCOS. In the analysis of the associations between dietary intake, metabolic parameters and body composition, PCOS women showed an inverse correlation between dietetic fiber intake and HOMA-IR index (r = -0.365; p = 0.024). Also in PCOS group, dietary fiber intake presented an inverse correlation with total body fat (r = -0.401; p = 0.011), trunk fat (r = -0.388; p = 0.015), and android fat (r = -0.431; p = 0.006). PCOS women group had higher glucose 120', compared to those without PCOS (p = 0.015). CONCLUSION These results provide evidence that the adequate intake of dietary fiber contributes to more appropriate body composition and glucose metabolism in PCOS women and possibly toward the prevention of chronic non-communicable diseases.
Collapse
Affiliation(s)
- Nayara Bernardes da Cunha
- Multidisciplinary Residency Program in Clinical Nutrition, Multidisciplinary Residency in Health, Faculty of Medicine, Federal University of Uberlândia, Av. Pará, 1720, Bloco 2H, Uberlândia, MG, CEP-38405-320, Brazil.
| | - Camila Toffoli Ribeiro
- Department of Gynecology and Obstetrics, Faculty of Medicine, Federal University of Uberlândia, Av. Pará, 1720, Bloco 2H, Uberlândia, MG, CEP-38405-320, Brazil.
| | - Catarina Mendes Silva
- Multidisciplinary Residency Program in Clinical Nutrition, Multidisciplinary Residency in Health, Faculty of Medicine, Federal University of Uberlândia, Av. Pará, 1720, Bloco 2H, Uberlândia, MG, CEP-38405-320, Brazil.
| | - Ana Carolina Japur de Sá Rosa-E-Silva
- Department of Gynecology and Obstetrics, School of Medicine of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes, 3900, Ribeirão Preto, SP, CEP 14049-900, Brazil.
| | - Daurea Abadia De-Souza
- Department of Internal Medicine, Faculty of Medicine, Federal University of Uberlândia, Av. Pará, 1720, Bloco 2H, Sala 1, Uberlândia, MG, CEP-38405-320, Brazil.
| |
Collapse
|
12
|
Bizzarri M, Fuso A, Dinicola S, Cucina A, Bevilacqua A. Pharmacodynamics and pharmacokinetics of inositol(s) in health and disease. Expert Opin Drug Metab Toxicol 2016; 12:1181-96. [PMID: 27351907 DOI: 10.1080/17425255.2016.1206887] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Inositol and its derivatives comprise a huge field of biology. Myo-inositol is not only a prominent component of membrane-incorporated phosphatidylinositol, but participates in its free form, with its isomers or its phosphate derivatives, to a multitude of cellular processes, including ion channel permeability, metabolic homeostasis, mRNA export and translation, cytoskeleton remodeling, stress response. AREAS COVERED Bioavailability, safety, uptake and metabolism of inositol is discussed emphasizing the complexity of interconnected pathways leading to phosphoinositides, inositol phosphates and more complex molecules, like glycosyl-phosphatidylinositols. EXPERT OPINION Besides being a structural element, myo-inositol exerts unexpected functions, mostly unknown. However, several reports indicate that inositol plays a key role during phenotypic transitions and developmental phases. Furthermore, dysfunctions in the regulation of inositol metabolism have been implicated in several chronic diseases. Clinical trials using inositol in pharmacological doses provide amazing results in the management of gynecological diseases, respiratory stress syndrome, Alzheimer's disease, metabolic syndrome, and cancer, for which conventional treatments are disappointing. However, despite the widespread studies carried out to identify inositol-based effects, no comprehensive understanding of inositol-based mechanisms has been achieved. An integrated metabolomics-genomic study to identify the cellular fate of therapeutically administered myo-inositol and its genomic/enzymatic targets is urgently warranted.
Collapse
Affiliation(s)
- Mariano Bizzarri
- a Department of Experimental Medicine , Sapienza University of Rome , Rome , Italy.,b Systems Biology Group Lab , Sapienza University of Rome , Rome , Italy
| | - Andrea Fuso
- b Systems Biology Group Lab , Sapienza University of Rome , Rome , Italy.,c European Center for Brain Research (CERC)/IRCCS Santa Lucia Foundation , Rome , Italy
| | - Simona Dinicola
- d Department of Clinical and Molecular Medicine , Sapienza Universityof Rome , Rome , Italy.,e Department of Surgery 'Pietro Valdoni' , Sapienza University of Rome , Rome , Italy
| | - Alessandra Cucina
- e Department of Surgery 'Pietro Valdoni' , Sapienza University of Rome , Rome , Italy.,f Azienda Policlinico Umberto I , Rome , Italy
| | - Arturo Bevilacqua
- g Department of Psychology, Section of Neuroscience , Sapienza University of Rome , Rome , Italy
| |
Collapse
|
13
|
Noventa M, Vitagliano A, Quaranta M, Borgato S, Abdulrahim B, Gizzo S. Preventive and Therapeutic Role of Dietary Inositol Supplementation in Periconceptional Period and During Pregnancy. Reprod Sci 2015; 23:278-88. [DOI: 10.1177/1933719115594018] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Marco Noventa
- Department of Woman and Child Health, University of Padua, Padua, Italy
| | | | - Michela Quaranta
- Department of Obstetrics and Gynaecology, University of Verona, Verona, Italy
| | - Shara Borgato
- Department of Woman and Child Health, University of Padua, Padua, Italy
| | - Baydaa Abdulrahim
- Department of Obstetrics and Gynecology, NHS Trust, Northampton General Hospital, Northampton, United Kingdom
| | - Salvatore Gizzo
- Department of Woman and Child Health, University of Padua, Padua, Italy
- Department of Obstetrics and Gynecology, NHS Trust, Northampton General Hospital, Northampton, United Kingdom
| |
Collapse
|
14
|
Newell-Fugate AE, Taibl JN, Alloosh M, Sturek M, Bahr JM, Nowak RA, Krisher RL. Effects of Obesity and Metabolic Syndrome on Steroidogenesis and Folliculogenesis in the Female Ossabaw Mini-Pig. PLoS One 2015; 10:e0128749. [PMID: 26046837 PMCID: PMC4457902 DOI: 10.1371/journal.pone.0128749] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 05/01/2015] [Indexed: 11/25/2022] Open
Abstract
The discrete effects of obesity on infertility in females remain undefined to date. To investigate obesity-induced ovarian dysfunction, we characterized metabolic parameters, steroidogenesis, and folliculogenesis in obese and lean female Ossabaw mini-pigs. Nineteen nulliparous, sexually mature female Ossabaw pigs were fed a high fat/cholesterol/fructose diet (n=10) or a control diet (n=9) for eight months. After a three-month diet-induction period, pigs remained on their respective diets and had ovarian ultrasound and blood collection conducted during a five-month study period after which ovaries were collected for histology, cell culture, and gene transcript level analysis. Blood was assayed for steroid and protein hormones. Obese pigs developed abdominal obesity and metabolic syndrome, including hyperglycemia, hypertension, insulin resistance and dyslipidemia. Obese pigs had elongated estrous cycles and hyperandrogenemia with decreased LH, increased FSH and luteal phase progesterone, and increased numbers of medium, ovulatory, and cystic follicles. Theca cells of obese, compared to control, pigs displayed androstenedione hypersecretion in response to in vitro treatment with LH, and up-regulated 3-beta-hydroxysteroid dehydrogenase 1 and 17-beta-hydroxysteroid dehydrogenase 4 transcript levels in response to in vitro treatment with LH or LH + insulin. Granulosa cells of obese pigs had increased 3-beta-hydroxysteroid dehydrogenase 1 transcript levels. In summary, obese Ossabaw pigs have increased transcript levels and function of ovarian enzymes in the delta 4 steroidogenic pathway. Alterations in LH, FSH, and progesterone, coupled with theca cell dysfunction, contribute to the hyperandrogenemia and disrupted folliculogenesis patterns observed in obese pigs. The obese Ossabaw mini-pig is a useful animal model in which to study the effects of obesity and metabolic syndrome on ovarian function and steroidogenesis. Ultimately, this animal model may be useful toward the development of therapies to improve fertility in obese and/or hyperandrogenemic females or in which to examine the effects of obesity on the maternal-fetal environment and offspring health.
Collapse
Affiliation(s)
- Annie E. Newell-Fugate
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, United States of America
- * E-mail:
| | - Jessica N. Taibl
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, United States of America
| | - Mouhamad Alloosh
- Department of Cellular & Integrative Physiology, Indiana University School of Medicine, Indianapolis, Indiana 46202–5120, United States of America
| | - Michael Sturek
- Department of Cellular & Integrative Physiology, Indiana University School of Medicine, Indianapolis, Indiana 46202–5120, United States of America
| | - Janice M. Bahr
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, United States of America
| | - Romana A. Nowak
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, United States of America
| | - Rebecca L. Krisher
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, United States of America
| |
Collapse
|
15
|
Vitagliano A, Quaranta M, Noventa M, Gizzo S. "Empiric" inositol supplementation in normal-weight non insulin resistant women with polycystic ovarian disease: from the absence of benefit to the potential adverse effects. Arch Gynecol Obstet 2015; 291:955-7. [PMID: 25687659 DOI: 10.1007/s00404-015-3662-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 02/10/2015] [Indexed: 01/21/2023]
|
16
|
Spritzer PM, Lecke SB, Satler F, Morsch DM. Adipose tissue dysfunction, adipokines, and low-grade chronic inflammation in polycystic ovary syndrome. Reproduction 2015; 149:R219-27. [PMID: 25628442 DOI: 10.1530/rep-14-0435] [Citation(s) in RCA: 189] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Polycystic ovary syndrome (PCOS), a complex condition that affects women of reproductive age, is characterized by ovulatory dysfunction and androgen excess. Women with PCOS present higher prevalence of obesity, central adiposity, and dyslipidemia, and face increased risk of type 2 diabetes. PCOS is closely linked to functional derangements in adipose tissue. Adipocytes seem to be prone to hypertrophy when exposed to androgen excess, as experienced by women with PCOS, and both adipose tissue hypertrophy and hyperandrogenism are related to insulin resistance. Hypertrophic adipocytes are more susceptible to inflammation, apoptosis, fibrosis, and release of free fatty acids. Disturbed secretion of adipokines may also impact the pathophysiology of PCOS through their influence on metabolism and on sex steroid secretion. Chronic low-grade inflammation in PCOS is also related to hyperandrogenism and to the hypertrophy of adipocytes, causing compression phenomena in the stromal vessels, leading to adipose tissue hypoperfusion and altered secretion of cytokines. Lifestyle changes are the first-line intervention for reducing metabolic risks in PCOS and the addition of an insulin-sensitizing drug might be required. Nevertheless, there is not sufficient evidence in favor of any specific pharmacologic therapies to directly oppose inflammation. Further studies are warranted to identify an adipokine that could serve as an indirect marker of adipocyte production in PCOS, representing a reliable sign of metabolic alteration in this syndrome.
Collapse
Affiliation(s)
- Poli Mara Spritzer
- Gynecological Endocrinology UnitDivision of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, Rio Grande do Sul, BrazilLaboratory of Molecular EndocrinologyDepartment of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, 90035-003 Porto Alegre, BrazilDepartment of Diagnostic MethodsUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, 90050-170 Porto Alegre, Brazil Gynecological Endocrinology UnitDivision of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, Rio Grande do Sul, BrazilLaboratory of Molecular EndocrinologyDepartment of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, 90035-003 Porto Alegre, BrazilDepartment of Diagnostic MethodsUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, 90050-170 Porto Alegre, Brazil
| | - Sheila B Lecke
- Gynecological Endocrinology UnitDivision of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, Rio Grande do Sul, BrazilLaboratory of Molecular EndocrinologyDepartment of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, 90035-003 Porto Alegre, BrazilDepartment of Diagnostic MethodsUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, 90050-170 Porto Alegre, Brazil Gynecological Endocrinology UnitDivision of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, Rio Grande do Sul, BrazilLaboratory of Molecular EndocrinologyDepartment of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, 90035-003 Porto Alegre, BrazilDepartment of Diagnostic MethodsUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, 90050-170 Porto Alegre, Brazil
| | - Fabíola Satler
- Gynecological Endocrinology UnitDivision of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, Rio Grande do Sul, BrazilLaboratory of Molecular EndocrinologyDepartment of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, 90035-003 Porto Alegre, BrazilDepartment of Diagnostic MethodsUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, 90050-170 Porto Alegre, Brazil
| | - Debora M Morsch
- Gynecological Endocrinology UnitDivision of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, Rio Grande do Sul, BrazilLaboratory of Molecular EndocrinologyDepartment of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, 90035-003 Porto Alegre, BrazilDepartment of Diagnostic MethodsUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, 90050-170 Porto Alegre, Brazil
| |
Collapse
|