1
|
Rezq S, Huffman AM, Basnet J, Alsemeh AE, do Carmo JM, Yanes Cardozo LL, Romero DG. MicroRNA-21 modulates brown adipose tissue adipogenesis and thermogenesis in a mouse model of polycystic ovary syndrome. Biol Sex Differ 2024; 15:53. [PMID: 38987854 PMCID: PMC11238487 DOI: 10.1186/s13293-024-00630-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 06/26/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS), the most common endocrine disorder in premenopausal women, is associated with increased obesity, hyperandrogenism, and altered brown adipose tissue (BAT) thermogenesis. MicroRNAs play critical functions in brown adipocyte differentiation and maintenance. We aim to study the role of microRNA-21 (miR-21) in altered energy homeostasis and BAT thermogenesis in a PCOS mouse model of peripubertal androgen exposure. METHODS Three-week-old miR-21 knockout (miR21KO) or wild-type (WT) female mice were treated with dihydrotestosterone (DHT) or vehicle for 90 days. Body composition was determined by EchoMRI. Energy expenditure (EE), oxygen consumption (VO2), carbon dioxide production (VCO2), and respiratory exchange ratio (RER) were measured by indirect calorimetry. Androgen receptor (AR), and markers of adipogenesis, de novo lipogenesis, angiogenesis, extracellular matrix remodeling, and thermogenesis were quantified by RT-qPCR and/or Western-blot. RESULTS MiR-21 ablation attenuated DHT-mediated increase in body weight while having no effect on fat or BAT mass. MiR-21 ablation attenuated DHT-mediated BAT AR upregulation. MiR-21 ablation did not alter EE; however, miR21KO DHT-treated mice have reduced VO2, VCO2, and RER. MiR-21 ablation reversed DHT-mediated decrease in food intake and increase in sleep time. MiR-21 ablation decreased some adipogenesis (Adipoq, Pparγ, and Cebpβ) and extracellular matrix remodeling (Mmp-9 and Timp-1) markers expression in DHT-treated mice. MiR-21 ablation abolished DHT-mediated increases in thermogenesis markers Cpt1a and Cpt1b, while decreasing CIDE-A expression. CONCLUSIONS Our findings suggest that BAT miR-21 may play a role in regulating DHT-mediated thermogenic dysfunction in PCOS. Modulation of BAT miR-21 levels could be a novel therapeutic approach for the treatment of PCOS-associated metabolic derangements.
Collapse
Affiliation(s)
- Samar Rezq
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA.
- Women's Health Research Center, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA.
- Cardiovascular-Renal Research Center, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA.
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA.
| | - Alexandra M Huffman
- Women's Health Research Center, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA
- Cardiovascular-Renal Research Center, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA
| | - Jelina Basnet
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA
- Women's Health Research Center, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA
- Cardiovascular-Renal Research Center, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA
| | - Amira E Alsemeh
- Department of Anatomy, Histology, and Embryology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Jussara M do Carmo
- Department of Physiology and Biophysics, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA
- Cardiorenal and Metabolic Diseases Research Center, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA
| | - Licy L Yanes Cardozo
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA
- Department of Medicine, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA
- Women's Health Research Center, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA
- Cardiovascular-Renal Research Center, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA
| | - Damian G Romero
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA.
- Women's Health Research Center, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA.
- Cardiovascular-Renal Research Center, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA.
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS, 39216, USA.
| |
Collapse
|
2
|
Cooney LG, Sammel MD, Lee I, Clapp MA, Goldsammler M, Scott E, Bjorkman S, Fisher BT, Dokras A. The details matter: personalized prediction of live birth after in vitro fertilization in women with polycystic ovary syndrome. Fertil Steril 2024; 121:1010-1019. [PMID: 38307452 DOI: 10.1016/j.fertnstert.2024.01.033] [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] [Received: 12/15/2022] [Revised: 01/17/2024] [Accepted: 01/25/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVE To derive and internally validate a clinical prediction model for live birth (LB) in women with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization (IVF). DESIGN Retrospective cohort study. SETTING Four academic reproductive endocrinology clinics. PATIENTS A total of 207 women with PCOS confirmed using Rotterdam criteria undergoing their first fresh IVF cycle. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE The primary outcome was cumulative LB per IVF cycle start. This included any LB that resulted from either fresh embryo transfer or any subsequent frozen embryo transfer from embryos obtained at the index oocyte retrieval. A prediction model was derived using multivariable logistic regression. Covariates considered for inclusion in the prediction model included demographic characteristics, medical history, and prior fertility treatment. Predicted probabilities for LB were calculated using the prediction model which included the 90% shrinkage factor for each adjusted odds ratio. RESULTS The final model, on the basis of maximization of the area under the receiver operating characteristic curve, included age < 35 years, White race, presence of polycystic ovaries on ultrasound (polycystic ovary morphology), normal body mass index (<25 kg/m2), being metabolically healthy (no metabolic risk factors), and being a nonresponder to ovulation induction agents including letrozole and clomiphene citrate. The area under the receiver operating characteristic curve score for the model was 0.68 (95% confidence interval [CI]: 0.60, 0.77). Predicted probabilities of LB ranged from 8.1% (95% CI: 2.8, 21.5) for a woman who had no favorable predictors to 74.2% (95% CI: 59.5, 84.9) for a woman who had all favorable predictors. CONCLUSION Our study demonstrated that, in addition to anovulation, the underlying pathophysiology and associated comorbidities alter the likelihood of a successful pregnancy in women with PCOS undergoing IVF. Further validation of this model is needed before it can serve as a tool to personalize prediction estimates for the probability of LB in women with PCOS.
Collapse
Affiliation(s)
- Laura G Cooney
- Department of Obstetrics and Gynecology, University of Wisconsin, Middleton, Wisconsin; Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Mary D Sammel
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Biostatistics, Epidemiology and Informatics, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Iris Lee
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - M Alexa Clapp
- Department of Obstetrics and Gynecology, Montefiore's Institute for Reproductive Medicine and Health, Hartsdale, New York
| | - Michelle Goldsammler
- Department of Obstetrics and Gynecology, Montefiore's Institute for Reproductive Medicine and Health, Hartsdale, New York
| | - Erin Scott
- Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York
| | - Sarah Bjorkman
- Department of Obstetrics and Gynecology, Yale School of Medicine, New Haven, Connecticut
| | - Brian T Fisher
- Department of Biostatistics, Epidemiology and Informatics, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anuja Dokras
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
3
|
Stener-Victorin E, Teede H, Norman RJ, Legro R, Goodarzi MO, Dokras A, Laven J, Hoeger K, Piltonen TT. Polycystic ovary syndrome. Nat Rev Dis Primers 2024; 10:27. [PMID: 38637590 DOI: 10.1038/s41572-024-00511-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/20/2024]
Abstract
Despite affecting ~11-13% of women globally, polycystic ovary syndrome (PCOS) is a substantially understudied condition. PCOS, possibly extending to men's health, imposes a considerable health and economic burden worldwide. Diagnosis in adults follows the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome, requiring two out of three criteria - clinical or biochemical hyperandrogenism, ovulatory dysfunction, and/or specific ovarian morphological characteristics or elevated anti-Müllerian hormone. However, diagnosing adolescents omits ovarian morphology and anti-Müllerian hormone considerations. PCOS, marked by insulin resistance and hyperandrogenism, strongly contributes to early-onset type 2 diabetes, with increased odds for cardiovascular diseases. Reproduction-related implications include irregular menstrual cycles, anovulatory infertility, heightened risks of pregnancy complications and endometrial cancer. Beyond physiological manifestations, PCOS is associated with anxiety, depression, eating disorders, psychosexual dysfunction and negative body image, collectively contributing to diminished health-related quality of life in patients. Despite its high prevalence persisting into menopause, diagnosing PCOS often involves extended timelines and multiple health-care visits. Treatment remains ad hoc owing to limited understanding of underlying mechanisms, highlighting the need for research delineating the aetiology and pathophysiology of the syndrome. Identifying factors contributing to PCOS will pave the way for personalized medicine approaches. Additionally, exploring novel biomarkers, refining diagnostic criteria and advancing treatment modalities will be crucial in enhancing the precision and efficacy of interventions that will positively impact the lives of patients.
Collapse
Affiliation(s)
| | - Helena Teede
- Monash Centre for Health Research and Implementation, Monash Health and Monash University, Melbourne, Victoria, Australia
| | - Robert J Norman
- Robinson Research Institute, Adelaide Medical School, Adelaide, South Australia, Australia
| | - Richard Legro
- Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA, USA
- Department of Public Health Science, Penn State College of Medicine, Hershey, PA, USA
| | - Mark O Goodarzi
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Anuja Dokras
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA
| | - Joop Laven
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics and Gynecology, Erasmus MC, Rotterdam, Netherlands
| | - Kathleen Hoeger
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Terhi T Piltonen
- Department of Obstetrics and Gynecology, Research Unit of Clinical Medicine, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
| |
Collapse
|
4
|
Piao C, Li J, Liang C, Zhang J, Li X, Zhao Z, Wang K. Effect of vitamin D on pregnancy in women with polycystic ovary syndrome: retrospective and prospective studies. Reprod Biomed Online 2024; 49:103909. [PMID: 38776748 DOI: 10.1016/j.rbmo.2024.103909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 01/12/2024] [Accepted: 02/06/2024] [Indexed: 05/25/2024]
Abstract
RESEARCH QUESTION Does vitamin D affect the pregnancy rate of patients with polycystic ovary syndrome (PCOS) receiving ovulation-induction therapy? DESIGN The retrospective study included 200 patients with PCOS and 200 healthy women. The prospective study included 160 patients with PCOS receiving vitamin D or placebo supplementation. Pregnancy rates were assessed after a maximum of three cycles of ovulation induction. Serum concentrations of 25-hydroxycalciferol [25-(OH)D3], LH, FSH, progesterone, oestradiol, testosterone and fasting insulin; LH/FSH ratio; and body mass index were evaluated. RESULTS In the retrospective study, patients with PCOS had lower 25-(OH)D3 concentrations than healthy women, pregnant patients with PCOS had higher 25-(OH)D3 concentrations than non-pregnant patients with PCOS (both P = 0.000), and the pregnancy rate was lower in the vitamin-D-deficient group compared with the non-vitamin-D-deficient group (P = 0.022). In the prospective study, compared with placebo supplementation, vitamin D supplementation increased the serum concentration of 25-(OH)D3 (P = 0.000), and reduced the LH/FSH ratio, and concentrations of LH and testosterone significantly (all P ≤ 0.049). After the intervention, it was found that the LH/FSH ratio, and concentrations of LH and testosterone were significantly lower in both groups compared with pre-intervention (P = 0.000). After ovulation induction, the pregnancy rate was higher in patients in the vitamin D supplementation group compared with the placebo supplementation group (P = 0.049). CONCLUSIONS Vitamin D deficiency is common in patients with PCOS, and vitamin-D-deficient patients with PCOS have lower pregnancy rates after ovulation induction compared with non-vitamin-D-deficient patients with PCOS. Vitamin D supplementation can improve the pregnancy rate and mitigate basic hormone disorders. Therefore, monitoring vitamin D supplementation and checking vitamin D concentrations before and during interventions are essential for patients with PCOS.
Collapse
Affiliation(s)
- Chunmei Piao
- Department of Obstetrics and Gynaecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; Key Laboratory of Remodelling-Related Research Centre for Cardiovascular Diseases, Ministry of Education, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China
| | - Jia Li
- Department of Obstetrics and Gynaecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; Department of Obstetrics and Gynaecology, The Second Affiliated Hospital of Shandong First Medical University, Shandong, China
| | - Chao Liang
- Department of Obstetrics and Gynaecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; Department of Obstetrics, Qingdao Women and Children's Hospital, Qingdao, China
| | - Jun Zhang
- Department of Obstetrics and Gynaecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xin Li
- Department of Obstetrics and Gynaecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhihong Zhao
- Department of Obstetrics and Gynaecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Kefang Wang
- Department of Obstetrics and Gynaecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
| |
Collapse
|
5
|
Macruz CF, Lima SMRR. Polycystic ovary syndrome and abdominal fat: is there a relationship? REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230874. [PMID: 37909624 PMCID: PMC10610750 DOI: 10.1590/1806-9282.20230874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 07/27/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE The aim of this study was to compare the distribution of fat tissue in non-obese women with polycystic ovary syndrome and those without the syndrome using dual-energy radiological densitometry. METHODS This was a case-control study in which we enrolled women aged 14-39 years with polycystic ovary syndrome according to the Rotterdam criteria with a body mass index between 18.5 and 30 kg/m2. The control group comprised women with the same profile, but without polycystic ovary syndrome. Patients were treated at the Endocrinological Gynecology Outpatient Clinic of the Department of Obstetrics and Gynecology of the Irmandade da Santa Casa de Misericórdia de São Paulo between 2019 and 2022. Anthropometric measurements were taken and the assessment of body composition was performed using dual-energy radiological densitometry. RESULTS The sample comprised 57 women: 37 in the polycystic ovary syndrome group and 20 in the control group. The mean age of the polycystic ovary syndrome group was 24.9 years (±6.9) with a mean body mass index of 60.8 kg/m2 (±8.5), and for the control group, it was 24.2 years (±6.9) with a mean body mass index of 58 kg/m2 (±8.4). Body composition was evaluated using dual-energy radiological densitometry and showed a higher value of trunk fat in the polycystic ovary syndrome group (44.1%, ±9.0) compared to the control group (35.2%, ±11.4), which was statistically significant (p=0.002). CONCLUSION Our study showed that non-obese polycystic ovary syndrome patients have a higher concentration of abdominal fat, which is a risk factor for increased cardiovascular risk and insulin resistance.ClinicalTrials.gov ID: NCT02467751.
Collapse
Affiliation(s)
- Carolina Furtado Macruz
- Irmandade da Santa Casa de Misericórdia de São Paulo, Department of Obstetrics and Gynecology – São Paulo (SP), Brazil
| | - Sônia Maria Rolim Rosa Lima
- Irmandade da Santa Casa de Misericórdia de São Paulo, Department of Obstetrics and Gynecology – São Paulo (SP), Brazil
| |
Collapse
|
6
|
Krysiak R, Kowalcze K, Okopień B. Impact of Lisinopril on Cardiometabolic Risk Factors in Sisters of Women With Polycystic Ovary Syndrome. J Clin Pharmacol 2023; 63:1045-1052. [PMID: 37173821 DOI: 10.1002/jcph.2268] [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] [Received: 03/07/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023]
Abstract
Women with polycystic ovary syndrome (PCOS), the most common endocrinopathy in reproductive age, are characterized by increased cardiometabolic risk. Similar hormonal and metabolic changes were found in their siblings. The purpose of our study was to compare blood pressure-lowering and pleiotropic effects of lisinopril between sisters of women with PCOS and their unrelated peers. The study included two age-, body mass index-, and blood pressure-matched groups of women with grade 1 hypertension: 26 sisters of PCOS probands (Group 1) and 26 individuals without a family history of PCOS (Group 2), receiving 10-40 mg of lisinopril daily. Blood pressure, glucose homeostasis markers, plasma levels of lipids (androgens, estradiol, high-sensitivity C-reactive protein (hsCRP), homocysteine, fibrinogen, and uric acid), and urinary albumin-to-creatinine ratio (UACR) were measured before lisinopril treatment and 6 months later. At baseline, the study groups differed in insulin sensitivity, testosterone, free androgen index (FAI), hsCRP, homocysteine, and UACR. Blood pressure-lowering properties of lisinopril did not differ between the groups. The decrease in homocysteine and UACR, although observed in both groups, was stronger in Group 2 than in Group 1. Only in women without a family history of PCOS lisinopril improved insulin sensitivity and reduce hsCRP, fibrinogen, and uric acid. The remaining markers did not change throughout the study. Cardiometabolic effects of lisinopril correlated with testosterone, free androgen index, and changes in insulin sensitivity. The obtained results suggest that cardiometabolic effects of lisinopril may be slightly less pronounced in sisters of women with PCOS than in women without a family history of this disorder.
Collapse
Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
| | - Karolina Kowalcze
- Department of Pediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
| |
Collapse
|
7
|
Feyzioglu BS, Güven CM, Avul Z. Eight-Hour Time-Restricted Feeding: A Strong Candidate Diet Protocol for First-Line Therapy in Polycystic Ovary Syndrome. Nutrients 2023; 15:nu15102260. [PMID: 37242145 DOI: 10.3390/nu15102260] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/24/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
We aimed to investigate the effects of a 6-week program of 8 h time-restricted feeding (TRF) diet in polycystic ovary syndrome (PCOS), as determined by anthropometric, hormonal, metabolic profiles, and fecal calprotectin level. Thirty women diagnosed with PCOS underwent a 6-week 8 h TRF diet intervention. Age, anthropometric features (body mass index (BMI), waist-to-hip ratio (WHR)) and biochemical results were recorded. Free androgen index (FAI, defining hyperandrogenism) and the homeostatic model assessment-insulin resistance (HOMA-IR) were calculated. Baseline (pre-diet) and 6-week post-diet findings were compared. Mean age was 25.57 ± 2.67 years. BMI (p < 0.001) and WHR (p = 0.001) were found to have significantly decreased after the diet, as well as the percentage of patients defined to have hyperandrogenism (p = 0.016). Reproductive hormone levels, FAI (p < 0.001) and HOMA-IR (p < 0.001) were improved significantly. Metabolic parameters associated with glucose and lipid profiles were also significantly improved after the diet. Additionally, fecal calprotectin levels demonstrated a significant decrease from pre-diet to post-diet (p < 0.001). In conclusion, a 6-week diet intervention with 8 h TRF may be a suitable and effective intermittent fasting protocol that can be used as a first-line option in PCOS.
Collapse
Affiliation(s)
- Bihter Senem Feyzioglu
- Department of Obstetrics and Gynecology, Private Erciyes-Kartal Hospital, 38020 Kayseri, Turkey
| | - Cenk Mustafa Güven
- Department of Obstetrics and Gynecology, Izmir Private Can Hospital, 35630 Izmir, Turkey
| | - Zerrin Avul
- Department of Obstetrics and Gynecology, Private Erciyes-Kartal Hospital, 38020 Kayseri, Turkey
| |
Collapse
|
8
|
Le Hello C. Do polycystic ovary syndrome and endometriosis increase risk of venous thrombo-embolic disease? JOURNAL DE MEDECINE VASCULAIRE 2022; 47:218-219. [PMID: 36464415 DOI: 10.1016/j.jdmv.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
- C Le Hello
- Inserm, département de médecine vasculaire, U1059-SAINBIOSE, université Jean-Monnet, Mines Saint-Étienne, campus santé et innovations, 42000 Saint-Étienne, France.
| |
Collapse
|
9
|
Liao D, Liu X, Yuan X, Feng P, Ouyang Z, Liu Y, Li C. Clinical evidence of the effects of carnitine supplementation on body weight, glycemic control and serum lipids in women with polycystic ovary syndrome: a systematic review and meta-analysis. Gynecol Endocrinol 2022; 38:110-115. [PMID: 34633275 DOI: 10.1080/09513590.2021.1988559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. Several clinical trials have investigated the influence of carnitine on metabolic variables in PCOS, but have yielded conflicting results. This study aimed to summarize the clinical evidence of the effects of carnitine on weight management, glycemic and serum lipids controls in women with PCOS by conducting a meta-analysis of randomized control trials (RCTs). PubMed, Embase, Web of Sciences, Scopus, and the CENTRAL database were searched from inception to March 2021 for eligible articles. Study selection and assessment of quality were conducted independently by two investigators. Effect sizes for each outcome were reported with the weighted mean differences (WMDs) and 95% confidence intervals (CIs). The statistical heterogeneity of the included clinical trials was tested using the I2 statistic. Six studies with 672 PCOS participants were included for meta-analysis. Our results revealed that carnitine supplements significantly decreased total cholesterol, low-density lipoprotein-cholesterol, triglycerides, body weight, body mass index, hip circumference, and waist circumference (All p < .05). In addition, carnitine intervention also improved the levels of high-density lipoprotein cholesterol. However, no significant changes were seen in glucose homeostasis parameters. These results were stable after sensitivity analysis, and no significant publication biases were detected. Based on current evidence, carnitine supplementation in women with PCOS had beneficial effects on weight loss and lipid profiles. Further large-scale, well-designed RCTs are required to confirm these results.
Collapse
Affiliation(s)
- Dan Liao
- Department of Gynaecology, SSL Central Hospital of Dongguan, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, Guangdong, China
| | - Xiaomei Liu
- Department of Gynaecology, SSL Central Hospital of Dongguan, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, Guangdong, China
| | - Xiuying Yuan
- Department of Gynaecology, SSL Central Hospital of Dongguan, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, Guangdong, China
| | - Poling Feng
- Department of Gynaecology, SSL Central Hospital of Dongguan, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, Guangdong, China
| | - Zhiwei Ouyang
- Department of Gynaecology, SSL Central Hospital of Dongguan, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, Guangdong, China
| | - Yanyan Liu
- Department of Gynaecology, SSL Central Hospital of Dongguan, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, Guangdong, China
| | - Cuifen Li
- Department of Gynaecology, SSL Central Hospital of Dongguan, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, Guangdong, China
| |
Collapse
|
10
|
Chen J, Huang C, Zhang T, Gong W, Deng X, Liu H, Liu J, Guo Y. The effects of statins on hyperandrogenism in women with polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. Reprod Biol Endocrinol 2021; 19:189. [PMID: 34930305 PMCID: PMC8686603 DOI: 10.1186/s12958-021-00863-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/21/2021] [Indexed: 01/14/2023] Open
Abstract
Several clinical studies showed that statins were potential to treat polycystic ovary syndrome (PCOS). Through comprehensive search PubMed, EMBASE, the Web of Science, BIOSIS, the ClinialTrails.gov, and the Cochrane Library database up to 14 Feb 2020, we identified the randomized controlled trials about the treatment of statins on hyperandrogenism in PCOS women, and performed a systematic review and meta-analysis. The quality of the included studies was assessed by the Cochrane risk of bias tool and the Jadda score. Subgroup analysis and sensitivity analysis were conducted to analyze the pooled results. Nine trials included 682 PCOS patients were identified. Statins showed a significant potential to reduce testosterone (SMD = -0.47; 95% CI, - 0.76-- 0.18; P = 0.002) and dehydroepiandrosterone (SMD = -0.51; 95% CI, - 0.97-- 0.05; P = 0.03) levels, compared to the control treatments. The cutaneous symptoms hirsutism (SMD = -0.61; 95% CI, - 1.13-- 0.10; P = 0.02) and acne (SMD = -0.92; 95% CI, - 1.49-- 0.34; P = 0.002) were significantly improved by statins in PCOS women. Subgroup analysis showed that the two types of statins, and the different control treatments as well, presented no significantly different effect on testosterone and dehydroepiandrosterone. Sensitivity analysis confirmed the stability of the findings from the meta-analysis. In conclusion, statin treatment could significantly reduce androgen levels and improve cutaneous manifestations of hyperandrogenism of PCOS.
Collapse
Affiliation(s)
- Jianguo Chen
- Department of Medical Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
- Department of Clinical Laboratory, Qingbaijiang District People's Hospital of Chengdu, Chengdu, Sichuan, 610300, China
| | - Chaoran Huang
- Department of Medical Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
- Department of Clinical Laboratory, Qingbaijiang District People's Hospital of Chengdu, Chengdu, Sichuan, 610300, China
| | - Tongtong Zhang
- Medical Research Center, The Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, Sichuan, 610031, China
| | - Wuqing Gong
- Department of Clinical Laboratory, Qingbaijiang District People's Hospital of Chengdu, Chengdu, Sichuan, 610300, China
| | - Xiaofeng Deng
- Department of Gynecology and Obstetrics, Qingbaijiang District People's Hospital of Chengdu, Chengdu, Sichuan, 610300, China
| | - Hua Liu
- Neurology Department, The Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, Sichuan, 610031, China
| | - Jinbo Liu
- Department of Medical Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
| | - Yuanbiao Guo
- Department of Medical Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China.
- Medical Research Center, The Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, Sichuan, 610031, China.
| |
Collapse
|
11
|
Romero DG, Yanes Cardozo LL. Cardiovascular Events in Polycystic Ovary Syndrome: Is the Debate Settled for Good? J Clin Endocrinol Metab 2021; 106:e5258-e5259. [PMID: 34245281 DOI: 10.1210/clinem/dgab509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Damian G Romero
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Mississippi Center of Excellence in Perinatal Research, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Women's Health Research Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Cardio Renal Research Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Licy L Yanes Cardozo
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Mississippi Center of Excellence in Perinatal Research, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Women's Health Research Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Cardio Renal Research Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
| |
Collapse
|
12
|
Kuliczkowska-Płaksej J, Jończyk M, Jawiarczyk-Przybyłowska A, Stachowska B, Zembska A, Grzegrzółka J, Bolanowski M. The frequency of TLR2 (rs3804099, rs3804100, and rs5743708) and TLR4 (rs4986790 and rs4986791) polymorphisms in women with polycystic ovary syndrome - preliminary study. Gynecol Endocrinol 2021; 37:1027-1034. [PMID: 34279173 DOI: 10.1080/09513590.2021.1952975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Low-grade chronic inflammation may participate in PCOS etiology. Toll-like receptors (TLRs) may play a pivotal role in the initiation and progression of inflammatory process. We examined TLR2 and TLR4 gene polymorphisms in women with PCOS and their associations with metabolic/hormonal parameters. MATERIAL AND METHODS Sixty-eight women qualified for the study. PCOS was diagnosed in 40 women. The control group consisted of 28 women. All patients underwent anamnesis, physical examination, anthropometric measurements, and biochemical/hormonal assessments. The TLRs gene polymorphism was tested using PCR and the minisequencing method. RESULTS The frequency of TLR2 gene polymorphisms genotypes (rs3804099, rs3804100, and rs5743708) did not differ significantly between the groups. The difference in frequency of genotypes of TLR4 gene polymorphisms (rs4986790 and rs4986791) was close to the statistical significance level. No significant correlations between TLR2/TLR4 polymorphisms and anthropometric/metabolic parameters in PCOS group were observed. However, the relationship between HDL concentration and TLR2 S450S (rs3804100) polymorphism was close to the statistical significance level. Positive correlations between the two TLR4 polymorphisms (rs4986790 and rs4986791) were found, as well as between the TLR2 S450S (rs3804100) gene polymorphism and FSH concentration. CONCLUSIONS The TLR4 gene polymorphism may play a role in the PCOS etiopathogenesis but this observation needs further investigation.
Collapse
Affiliation(s)
| | - Maja Jończyk
- Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland
| | | | - Barbara Stachowska
- Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland
| | - Agnieszka Zembska
- Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland
| | - Jędrzej Grzegrzółka
- Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland
| | - Marek Bolanowski
- Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland
| |
Collapse
|
13
|
Rezq S, Huffman AM, Basnet J, Yanes Cardozo LL, Romero DG. Cardiac and Renal SARS-CoV-2 Viral Entry Protein Regulation by Androgens and Diet: Implications for Polycystic Ovary Syndrome and COVID-19. Int J Mol Sci 2021; 22:ijms22189746. [PMID: 34575910 PMCID: PMC8470275 DOI: 10.3390/ijms22189746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 12/31/2022] Open
Abstract
The susceptibility and the severity of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are associated with hyperandrogenism, obesity, and preexisting pulmonary, metabolic, renal, and cardiac conditions. Polycystic ovary syndrome (PCOS), the most common endocrine disorder in premenopausal women, is associated with obesity, hyperandrogenism, and cardiometabolic dysregulations. We analyzed cardiac, renal, circulatory, and urinary SARS-CoV-2 viral entry proteins (ACE2, TMPRSS2, TMPRSS4, furin, cathepsin L, and ADAM17) and androgen receptor (AR) expression, in a peripubertal androgen exposure model of PCOS. Peripubertal female mice were treated with dihydrotestosterone (DHT) and low (LFD) or high (HFD) fat diet for 90 days. HFD exacerbated DHT-induced increase in body weight, fat mass, and cardiac and renal hypertrophy. In the heart, DHT upregulated AR protein in both LFD and HFD, ACE2 in HFD, and ADAM17 in LFD. In the kidney, AR protein expression was upregulated by both DHT and HFD. Moreover, ACE2 and ADAM17 were upregulated by DHT in both diets. Renal TMPRSS2, furin, and cathepsin L were upregulated by DHT and differentially modulated by the diet. DHT upregulated urinary ACE2 in both diets, while neither treatment modified serum ACE2. Renal AR mRNA expression positively correlated with Ace2, Tmprss2, furin, cathepsin L, and ADAM17. Our findings suggest that women with PCOS could be a population with a high risk of COVID-19-associated cardiac and renal complications. Furthermore, our study suggests that weight loss by lifestyle modifications (i.e., diet) could potentially mitigate COVID-19-associated deleterious cardiorenal outcomes in women with PCOS.
Collapse
Affiliation(s)
- Samar Rezq
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA; (S.R.); (A.M.H.); (J.B.); (L.L.Y.C.)
- Mississippi Center of Excellence in Perinatal Research, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA
- Women’s Health Research Center, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA
- Cardio Renal Research Center, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt
| | - Alexandra M. Huffman
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA; (S.R.); (A.M.H.); (J.B.); (L.L.Y.C.)
- Mississippi Center of Excellence in Perinatal Research, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA
- Women’s Health Research Center, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA
- Cardio Renal Research Center, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA
| | - Jelina Basnet
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA; (S.R.); (A.M.H.); (J.B.); (L.L.Y.C.)
- Mississippi Center of Excellence in Perinatal Research, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA
- Women’s Health Research Center, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA
- Cardio Renal Research Center, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA
| | - Licy L. Yanes Cardozo
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA; (S.R.); (A.M.H.); (J.B.); (L.L.Y.C.)
- Mississippi Center of Excellence in Perinatal Research, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA
- Women’s Health Research Center, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA
- Cardio Renal Research Center, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA
- Department of Medicine, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA
| | - Damian G. Romero
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA; (S.R.); (A.M.H.); (J.B.); (L.L.Y.C.)
- Mississippi Center of Excellence in Perinatal Research, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA
- Women’s Health Research Center, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA
- Cardio Renal Research Center, University of Mississippi Medical Center, 2500 N, State Street, Jackson, MS 39216, USA
- Correspondence: ; Tel.: +1-601-984-1523; Fax: +1-601-984-1501
| |
Collapse
|
14
|
Guarnotta V, Lucchese S, Mineo MI, Mangione D, Venezia R, Almasio PL, Giordano C. Predictive factors of polycystic ovary syndrome in girls with precocious pubarche. Endocr Connect 2021; 10:796-804. [PMID: 34138747 PMCID: PMC8346197 DOI: 10.1530/ec-21-0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/17/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The aim of this study is to clarify, in girls with premature pubarche (PP), the influence of premature androgenization on the prevalence of polycystic ovary syndrome (PCOS). DESIGN AND PATIENTS Ninety-nine PP girls, 63 who developed PCOS and 36 who did not develop PCOS, were retrospectively included. Clinical, anthropometric, and metabolic parameters were evaluated at the time of diagnosis of PP and after 10 years from menarche to find predictive factors of PCOS. RESULTS Young females with PP showed a PCOS prevalence of 64% and showed a higher prevalence of familial history of diabetes (P = 0.004) and a lower prevalence of underweight (P = 0.025) than PP-NO-PCOS. In addition, girls with PP-PCOS showed higher BMI (P < 0.001), waist circumference (P < 0.001), total testosterone (P = 0.026), visceral adiposity index (VAI) (P = 0.013), total cholesterol (P < 0.001), LDL-cholesterol (P < 0.001), non-HDL cholesterol (P < 0.001) and lower age of menarche (P = 0.015), ISI-Matsuda (P < 0.001), DIo (P = 0.002), HDL cholesterol (P = 0.026) than PP-NO-PCOS. Multivariate analysis showed that WC (P = 0.049), ISI-Matsuda (P < 0.001), oral disposition index (DIo) (P < 0.001), VAI (P < 0.001), total testosterone (P < 0.001) and LDL-cholesterol (P < 0.001) are independent predictive factors for PCOS in girls with PP. CONCLUSIONS Our study established a strong association between multiple risk factors and development of PCOS in PP girls. These risk factors are predominantly related to the regulation of glucose, lipid, and androgen metabolism. Among these factors, WC, ISI-Matsuda, DIo, VAI, total testosterone, and LDL-cholesterol predict PCOS.
Collapse
Affiliation(s)
- Valentina Guarnotta
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy
| | - Silvia Lucchese
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy
| | - Mariagrazia Irene Mineo
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy
| | - Donatella Mangione
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Ostetricia e Ginecologia, Università di Palermo, Palermo, Italy
| | - Renato Venezia
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Ostetricia e Ginecologia, Università di Palermo, Palermo, Italy
| | - Piero Luigi Almasio
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Gastroenterologia ed Epatologia, Università di Palermo, Palermo, Italy
| | - Carla Giordano
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy
| |
Collapse
|
15
|
Marchesan LB, Ramos RB, Spritzer PM. Metabolic Features of Women With Polycystic Ovary Syndrome in Latin America: A Systematic Review. Front Endocrinol (Lausanne) 2021; 12:759835. [PMID: 34737723 PMCID: PMC8562723 DOI: 10.3389/fendo.2021.759835] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/04/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is an endocrine disorder that commonly affects women of childbearing age and has been associated with metabolic and reproductive abnormalities. Only a few studies have investigated metabolic traits in women with PCOS in Latin America. Therefore, we conducted a systematic review to provide an overview of the available evidence on the metabolic profile of Latin American women with PCOS. METHODS We searched PubMed, Cochrane Central Register of Controlled Trials, and Embase databases for cross-sectional, case-control, or cohort studies focusing on populations of countries in South and Central America and Mexico, published until October 31, 2019. We selected studies that reported the diagnostic criteria for PCOS. In the absence of a control group, we included studies if they reported relevant metabolic data. RESULTS The initial search yielded 4878 records, of which 41 studies were included in the systematic review. Sample sizes ranged from 10 to 288 in PCOS groups and from 10 to 1500 in control groups. The prevalence of phenotypes A and B (classic PCOS) ranged from 65.8% to 87.5% as reported in studies from Argentina, Brazil, and Chile. Metabolic syndrome ranged from 33.3% to 44.0% for phenotype A, from 15.0% to 58.0% for phenotype B, from 11.9% to 36.0% for phenotype C, and from 14.2% to 66.0% for phenotype D. Women with PCOS had higher body mass index, waist circumference, blood pressure, glucose, and homeostasis model assessment index as well as a more adverse lipid profile than those without PCOS. CONCLUSIONS Evidence from the present systematic review suggests that anthropometric and metabolic profiles are worse in women with PCOS who live in different Latin American countries than in women without PCOS living in the same region. Additional studies assessing metabolic comorbidities, such as diabetes, and distinct PCOS phenotypes in different Latin American countries are warranted and may produce invaluable information for primary and secondary prevention of PCOS in the region. This systematic review was registered with PROSPERO under number CRD42016038537. SYSTEMATIC REVIEW REGISTRATION PROSPERO, identifier CRD42016038537.
Collapse
Affiliation(s)
- Lucas Bandeira Marchesan
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Post-graduate Program in Endocrinology, Medicine School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Ramon Bossardi Ramos
- Post-graduate Program in Endocrinology, Medicine School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Poli Mara Spritzer
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Post-graduate Program in Endocrinology, Medicine School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Physiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- *Correspondence: Poli Mara Spritzer,
| |
Collapse
|