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Xing C, Zhao H, Zhang J, He B. The Association of CYP17A1, CYP19A1, and SHBG Gene Polymorphisms in Polycystic Ovary Syndrome Susceptibility: A Systematic Review and Meta-Analysis. Front Physiol 2022; 13:741285. [PMID: 35615684 PMCID: PMC9124751 DOI: 10.3389/fphys.2022.741285] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 03/18/2022] [Indexed: 12/04/2022] Open
Abstract
Objective: To elucidate the relationship between CYP17A1/CYP19A1/SHBG gene polymorphisms and PCOS susceptibility. Methods: We searched multiple databases from inception to December 2020 and meta analysis was conducted to elucidate the relationship between gene polymorphisms and PCOS risk. Results: 26 studies were included, comprising 4860 PCOS and 4043 controls. CYP17A1 rs743572 polymorphisms were found to be negatively associated with PCOS risk under dominant model (p = 0.017, OR = 0.83, 95%CI 0.72–0.97, I2 = 74.80%, Pheterogeneity = 0.000) in the general population while neither CYP19A1 rs2414096 polymorphisms (p = 0.578, OR = 0.87, 95%CI 0.54–1.41, I2 = 95.90%, Pheterogeneity = 0.000) nor SHBG rs6529 polymorphisms (p = 0.752, OR = 0.99, 95%CI 0.94–1.05, I2 = 60.90%, Pheterogeneity = 0.012) was associated with PCOS susceptibility under dominant model in the general population. Conclusion: CYP17A1 rs7435721 polymorphisms might be protective factors against PCOS in general populations. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/#myprospero, identifier CRD4202122640.
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A Review on CYP11A1, CYP17A1, and CYP19A1 Polymorphism Studies: Candidate Susceptibility Genes for Polycystic Ovary Syndrome (PCOS) and Infertility. Genes (Basel) 2022; 13:genes13020302. [PMID: 35205347 PMCID: PMC8871850 DOI: 10.3390/genes13020302] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/23/2022] [Accepted: 01/25/2022] [Indexed: 11/17/2022] Open
Abstract
Polycystic ovary syndrome is a multifactorial condition associated with reproductive and endocrine organs and might cause infertility and metabolic abnormalities in childbearing age. PCOS seems to be a multifactorial disorder resulting from the combination of several genetic and environmental factors. Little research has been conducted to date on the impact of polymorphisms in infertility. We aim to review the appearance of polymorphisms in females of diverse ethnicities and their effect on infertility in the population with polycystic ovary syndrome. There have been numerous reports of the importance of the steroidogenesis pathway and genetic variants in PCOS pathogenesis. The most important genes that play a role in the aetiology of PCOS are CYP11A1, CYP17A1, and CYP19A1. We evaluated the occurrence of polymorphisms in various ethnicities in the CYP11A1, CYP17A1, and CYP19A1 genes and their efficacy on increasing PCOS risk with infertility. Our findings revealed that polymorphisms in various ethnicities are associated with the risk of PCOS with infertility. Although conflicting results regarding CYP11A1, CYP17A1, and CYP19A1 polymorphisms and their influence on PCOS with infertility have been reported in a small number of papers, the authors feel this may be attributable to the sample size and ethnic composition of the examined populations. In conclusion, our study strongly suggests that the CYP11A1, CYP17A1, and CYP19A1 genes might significantly enhance the probability of developing PCOS with infertility.
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Ali R, Shkurat T, Alexandrova A, Bugrimova E, Lomteva S, Ammar M. Association of CYP17 gene polymorphism (rs743572) with polycystic ovary syndrome. Meta Gene 2022. [DOI: 10.1016/j.mgene.2021.100996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Liu X, Xu M, Qian M, Yang L. CYP17 T/C (rs74357) gene polymorphism contributes to polycystic ovary syndrome susceptibility: evidence from a meta-analysis. Endocr Connect 2021; 10:R305-R316. [PMID: 34788226 PMCID: PMC8679930 DOI: 10.1530/ec-21-0327] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/17/2021] [Indexed: 12/23/2022]
Abstract
The cytochrome P450 family 17 (CYP17) is associated with hyperandrogenism in women, and the association between CYP17 gene polymorphism and the risk of polycystic ovary syndrome (PCOS) is not definitive. In order to determine whether the CYP17 T/C (rs74357) gene polymorphism is an exposure risk for PCOS, a comprehensive meta-analysis summarizing 19 studies was performed. The pooled odds ratio (OR) and the corresponding 95% CI were measured under five genetic models, and the stratified analyses by ethnicity, Hardy-Weinberg equilibrium, testosterone levels and BMI in controls were carried out to identify the causes of substantial heterogeneity. The overall results validated that the CYP17 T/C (rs74357) gene polymorphism was significantly associated with PCOS risk in four genetic models. Moreover, the outcomes of subgroup analysis by ethnicity indicated that the frequencies of the C allele of CYP17 T/C (rs74357) polymorphism were markedly higher in women from Asia than in Caucasians (T vs C: OR 0.85, 95% CI = 0.74-0.99, P < 0.05). Therefore, these findings suggested that the CYP17 T/C (rs74357) gene polymorphism played an indispensable part in increasing the susceptibility of PCOS when carrying the C allele, which proposed that the polymorphism of the CYP17 gene may be a predictive factor for the risk of PCOS or an important pathway in PCOS-associated metabolic and hormonal dysregulation.
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Affiliation(s)
- Xingyan Liu
- Department of Obstetrics & Gynecology, General Hospital of PLA Eastern Theater (Nanjing General Hospital of Nanjing Military Command), Command, Nanjing, China
| | - Mei Xu
- Department of Obstetrics & Gynecology, General Hospital of PLA Eastern Theater (Nanjing General Hospital of Nanjing Military Command), Command, Nanjing, China
| | - Min Qian
- Department of Obstetrics & Gynecology, General Hospital of PLA Eastern Theater (Nanjing General Hospital of Nanjing Military Command), Command, Nanjing, China
| | - Lindong Yang
- Department of Obstetrics & Gynecology, General Hospital of PLA Eastern Theater (Nanjing General Hospital of Nanjing Military Command), Command, Nanjing, China
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Xu X, Hu K, Shi H, Yu Y, Xu J, Sun Y. The single-nucleotide polymorphism rs743572 of CYP17A1 shows significant association with polycystic ovary syndrome: a meta-analysis. Reprod Biomed Online 2021; 43:941-951. [PMID: 34538754 DOI: 10.1016/j.rbmo.2021.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/11/2021] [Accepted: 06/14/2021] [Indexed: 11/18/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a multifactorial reproductive and endocrine disease, believed to be caused by aberrant steroid biosynthesis pathways involving cytochrome P450, 17α-hydroxylase (CYP17A1). This meta-analysis aimed to evaluate the association between CYP17A1 polymorphism rs743572 and PCOS risk. Studies on the CYP17A1 gene were retrieved by searching PubMed, Embase and Web of Science and statistical analyses were performed by STATA software. Fifteen eligible studies were included, dated from January 1994 to 19 November 2020, involving 2277 patients with PCOS and 1913 control individuals. Overall, the results showed that the rs743572 T>C mutation was most likely to be associated with PCOS risk under the recessive model, which was further confirmed by heterogeneity analysis and publication bias detection (CC versus CT + TT, odds ratio [OR] 1.24, 95% confidence interval [CI] 1.02-1.50, P = 0.028, I² = 35.9%). Moreover, subgroup analysis by ethnicity demonstrated that Caucasian but not Asian women carrying the CC genotype of rs743572 had an elevated risk of PCOS (CC versus CT + TT, OR 1.45, 95% CI 1.03-2.06, P = 0.035, I² = 15.10%, six studies). In conclusion, rs743572 is highly likely to be a risk factor for PCOS, and the mutant genotype CC may increase susceptibility to PCOS in Caucasians rather than Asians.
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Affiliation(s)
- Xiqiao Xu
- Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Kaiyue Hu
- Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hao Shi
- Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yiping Yu
- Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jiawei Xu
- Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Yingpu Sun
- Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Ashraf S, Rasool SUA, Nabi M, Ganie MA, Jabeen F, Rashid F, Amin S. CYP17 gene polymorphic sequence variation is associated with hyperandrogenism in Kashmiri women with polycystic ovarian syndrome. Gynecol Endocrinol 2021; 37:230-234. [PMID: 32456493 DOI: 10.1080/09513590.2020.1770724] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE Polycystic ovarian syndrome is a complex reproductive as well as endocrinological disorder characterized by anovulatory dysfunction, androgen excess and polycystic ovarian morphology. Hyperandrogenism is regarded as a cardinal feature of the disease. It is believed that the excess androgens are produced due to abnormality in steroid biosynthesis pathway wherein cytochrome P450, 17α-hydroxylase (CYP17) plays an imperative role. Therefore the objective of the present study was to analyze the T/C polymorphism in 5'UTR of CYP17 gene for its association with PCOS and hyperandrogenism in Kashmiri population. METHOD A total of 700 subjects which included 394 PCOS patients and 306 healthy controls were recruited for the study. Their anthropometric, biochemical and hormonal parameters were analyzed. DNA was extracted followed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) to analyze the relationship of CYP17 gene polymorphism with PCOS and hyperandrogenism in PCOS. RESULTS AND CONCLUSION The allelic as well as genotypic distribution did not show any significant difference between the cases and controls. However, PCOS patients with mutant genotype had significantly higher level of total testosterone and clinical features like FG score, alopecia than those of wild and heterozygous genotype, indicating association with hyperandrogenism in our Kashmiri population.
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Affiliation(s)
- Sairish Ashraf
- Department of Biochemistry, University of Kashmir, Srinagar, India
| | | | - Mudasar Nabi
- Department of Biochemistry, University of Kashmir, Srinagar, India
| | - Mohd Ashraf Ganie
- Department of Endocrinology, Sher-e-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Farhat Jabeen
- Department of Obstetrics and Gynecology, LD Hospital, Government Medical College, Srinagar, India
| | - Fouzia Rashid
- Department of Clinical Biochemistry, University of Kashmir, Srinagar, India
| | - Shajrul Amin
- Department of Biochemistry, University of Kashmir, Srinagar, India
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Wen L, Liu Q, Xu J, Liu X, Shi C, Yang Z, Zhang Y, Xu H, Liu J, Yang H, Huang H, Qiao J, Tang F, Chen ZJ. Recent advances in mammalian reproductive biology. SCIENCE CHINA. LIFE SCIENCES 2020; 63:18-58. [PMID: 31813094 DOI: 10.1007/s11427-019-1572-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/22/2019] [Indexed: 01/05/2023]
Abstract
Reproductive biology is a uniquely important topic since it is about germ cells, which are central for transmitting genetic information from generation to generation. In this review, we discuss recent advances in mammalian germ cell development, including preimplantation development, fetal germ cell development and postnatal development of oocytes and sperm. We also discuss the etiologies of female and male infertility and describe the emerging technologies for studying reproductive biology such as gene editing and single-cell technologies.
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Affiliation(s)
- Lu Wen
- Beijing Advanced Innovation Center for Genomics, Department of Obstetrics and Gynecology Third Hospital, College of Life Sciences, Peking University, Beijing, 100871, China
| | - Qiang Liu
- Beijing Advanced Innovation Center for Genomics, Department of Obstetrics and Gynecology Third Hospital, College of Life Sciences, Peking University, Beijing, 100871, China
| | - Jingjing Xu
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China
| | - Xixi Liu
- Beijing Advanced Innovation Center for Genomics, Department of Obstetrics and Gynecology Third Hospital, College of Life Sciences, Peking University, Beijing, 100871, China
| | - Chaoyi Shi
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China
| | - Zuwei Yang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China
| | - Yili Zhang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China
| | - Hong Xu
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China
| | - Jiang Liu
- CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing, 100101, China.
| | - Hui Yang
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai Research Center for Brain Science and Brain-Inspired Intelligence, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, 200031, China.
| | - Hefeng Huang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China.
| | - Jie Qiao
- Beijing Advanced Innovation Center for Genomics, Department of Obstetrics and Gynecology Third Hospital, College of Life Sciences, Peking University, Beijing, 100871, China.
| | - Fuchou Tang
- Beijing Advanced Innovation Center for Genomics, Department of Obstetrics and Gynecology Third Hospital, College of Life Sciences, Peking University, Beijing, 100871, China.
| | - Zi-Jiang Chen
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, 250021, China.
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Ashraf S, Nabi M, Rasool SUA, Rashid F, Amin S. Hyperandrogenism in polycystic ovarian syndrome and role of CYP gene variants: a review. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2019. [DOI: 10.1186/s43042-019-0031-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Abstract
Background
Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder characterized by anovulation, hyperandrogenism, and polycystic ovarian morphology. The pathophysiology of PCOS is not clear; however, disturbance in hypothalamic-pituitary-ovarian axis and abnormal steroidogenesis along with genetic and environmental factors act as main contributors to this disorder.
Main text
Hyperandrogenism, the hallmark feature of PCOS, is clinically manifested as hirsutism, acne, and alopecia. Excessive androgen production by ovaries as well as from adrenals contributes to hyperandrogenism. Abnormalities in the neuroendocrine system like increased pulse frequency of gonadotropin-releasing hormone, stimulating the pituitary for excessive production of luteinizing hormone than that of follicle-stimulating hormone is seen in PCOS women. Excess LH stimulates ovarian androgen production, whereas a relative deficit in FSH impairs follicular development. The imbalance in LH: FSH causes proliferation of ovarian theca cells leading to increased steroidogenesis, and ultimately leading to hyperandrogenism in PCOS women. Various genetic factors have been shown to be associated with abnormal steroidogenesis. CYP genes involved in steroidogenesis play an important role in androgen production and are considered as key players in hyperandrogenism in PCOS.
Conclusion
Polymorphisms in CYP genes can aggravate the hyperandrogenic phenotype in women with PCOS by either upregulating or downregulating their expression, thus increasing androgens further. However, this hypothesis needs to be validated by further studies.
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Kaur R, Kaur T, Kaur A. Genetic association study from North India to analyze association of CYP19A1 and CYP17A1 with polycystic ovary syndrome. J Assist Reprod Genet 2018; 35:1123-1129. [PMID: 29564739 DOI: 10.1007/s10815-018-1162-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 03/14/2018] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Polycystic ovary syndrome (PCOS) is a complex multifactorial endocrine disorder affecting approximately 5-10% of women of reproductive age. Affected women have menstrual disturbances due to anovulation, infertility, and hyperandrogenism. Ovarian androgen overproduction is the key physiopathologic feature of PCOS. A number of genes encoding major enzymes of the androgen metabolic pathways, such as HSD17B6, CYP19A1, CYP11A1, CYP17A1, and INSR, have been examined. Very few studies have been done in North India. There is an increasing prevalence of PCOS in women in Punjab and it is the leading cause of female infertility. In view of the strong evidence implicating the importance of CYP19A1 and CYP17A1 in androgen metabolic pathways, we investigated the association of rs700519, rs2414096, and rs743572 (- 34T>C) polymorphisms on susceptibility of developing PCOS, in North India. METHODS A total of 500 subjects (women of reproductive age) including 250 PCOS cases and 250 healthy age-matched controls were included in the present study. DNA was extracted from venous blood for all samples, and association analysis for rs2414096, rs700519, and rs743572 was done by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Lipid profile was done using a biochemical analyzer and body mass index (BMI) was measured for all cases. Statistical analysis was performed. RESULTS Significant association of - 34T>C polymorphism of CYP17A1 was found with PCOS (p = 0.0005). BMI was statistically different between PCOS cases and controls (p = 0.000). Triglycerides were high in PCOS women. Variations of CYP19A1 were not statistically significant with PCOS. CONCLUSIONS These data suggest that - 34T>C polymorphism in CYP17A1 is associated with PCOS in North India. No polymorphism of CYP19A1 was found to be associated.
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Affiliation(s)
- Ratneev Kaur
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, 143005, India
| | - Tajinder Kaur
- Hartej Hospital, Ranjit Avenue, Amritsar, Punjab, 143001, India
| | - Anupam Kaur
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, 143005, India.
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Dadachanji R, Shaikh N, Mukherjee S. Genetic Variants Associated with Hyperandrogenemia in PCOS Pathophysiology. GENETICS RESEARCH INTERNATIONAL 2018; 2018:7624932. [PMID: 29670770 PMCID: PMC5835258 DOI: 10.1155/2018/7624932] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 01/18/2018] [Indexed: 12/18/2022]
Abstract
Polycystic ovary syndrome is a multifactorial endocrine disorder whose pathophysiology baffles many researchers till today. This syndrome is typically characterized by anovulatory cycles and infertility, altered gonadotropin levels, obesity, and bulky multifollicular ovaries on ultrasound. Hyperandrogenism and insulin resistance are hallmark features of its complex pathophysiology. Hyperandrogenemia is a salient feature of PCOS and a major contributor to cosmetic anomalies including hirsutism, acne, and male pattern alopecia in affected women. Increased androgen levels may be intrinsic or aggravated by preexisting insulin resistance in women with PCOS. Studies have reported augmented ovarian steroidogenesis patterns attributed mainly to theca cell hypertrophy and altered expression of key enzymes in the steroidogenic pathway. Candidate gene studies have been performed in order to delineate the association of polymorphisms in genes, which encode enzymes in the intricate cascade of steroidogenesis or modulate the levels and action of circulating androgens, with risk of PCOS development and its related traits. However, inconsistent findings have impacted the emergence of a unanimously accepted genetic marker for PCOS susceptibility. In the current review, we have summarized the influence of polymorphisms in important androgen related genes in governing genetic predisposition to PCOS and its related metabolic and reproductive traits.
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Affiliation(s)
- Roshan Dadachanji
- Department of Molecular Endocrinology, National Institute for Research in Reproductive Health, J.M. Street, Parel, Mumbai 400012, India
| | - Nuzhat Shaikh
- Department of Molecular Endocrinology, National Institute for Research in Reproductive Health, J.M. Street, Parel, Mumbai 400012, India
| | - Srabani Mukherjee
- Department of Molecular Endocrinology, National Institute for Research in Reproductive Health, J.M. Street, Parel, Mumbai 400012, India
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Gourgari E, Lodish M, Keil M, Sinaii N, Turkbey E, Lyssikatos C, Nesterova M, de la Luz Sierra M, Xekouki P, Khurana D, Ten S, Dobs A, Stratakis CA. Bilateral Adrenal Hyperplasia as a Possible Mechanism for Hyperandrogenism in Women With Polycystic Ovary Syndrome. J Clin Endocrinol Metab 2016; 101:3353-60. [PMID: 27336356 PMCID: PMC5010568 DOI: 10.1210/jc.2015-4019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
CONTEXT Androgen excess may be adrenal and/or ovarian in origin; we hypothesized that a subgroup of patients with polycystic ovarian syndrome (PCOS) may have some degree of abnormal adrenocortical function. OBJECTIVE The objective of the study was to evaluate the pituitary adrenal axis with an oral low- and high-dose dexamethasone-suppression test (Liddle's test) in women with PCOS. DESIGN This was a case-control study. SETTING The study was conducted at the National Institutes of Health Clinical Center. PARTICIPANTS A total of 38 women with PCOS and 20 healthy volunteers (HV) aged 16-29 years participated in the study. MAIN OUTCOME MEASURES Urinary free cortisol (UFC) and 17-hydroxysteroids (17OHS) before and after low- and high-dose dexamethasone and assessment of adrenal volume by computed tomography scan were measured. RESULTS Twenty-four-hour urinary 17OHS and UFC were measured during day 1 to day 6 of the Liddle's test. Baseline UFC levels were not different between PCOS and HVs; on the day after the completion of high-dose dexamethasone administration (d 6), UFC was higher in the PCOS group (2.0 ± 0.7 μg/m(2)·d) than the HV group (1.5 ± 0.5) (P = .038). On day 5, 17OHS and UFC were negatively correlated with adrenal volumes (left side, rp = -0.47, P = .009, and rp = -0.61, P < .001, respectively). PCOS patients above the 75th percentile for UFC and/or 17OHS after high-dose dexamethasone (n = 15) had a significantly smaller total adrenal volume (6.9 ± 1.9 cm(3) vs 9.2 ± 1.8 cm(3), P = .003) when compared with the remaining PCOS patients (n = 22), but they did not have worse insulin resistance or hyperandrogenism. CONCLUSIONS In a subset of young women with PCOS, we detected a pattern of glucocorticoid secretion that mimicked that of patients with micronodular adrenocortical hyperplasia: they had smaller adrenal volumes and higher steroid hormone secretion after dexamethasone compared with the group of PCOS with appropriate response to dexamethasone.
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Affiliation(s)
- Evgenia Gourgari
- Section on Endocrinology and Genetics (E.G., M.L., M.K., C.L., M.N., M.S., P.X., C.A.S.), and Pediatric Endocrinology Inter-Institute Training Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Department of Radiology (E.T.), Clinical Center, National Institutes of Health, Bethesda, Maryland 20892; Division of Pediatric Endocrinology (E.G.), Georgetown University Medical Center, Washington, DC 20007; Biostatistics and Clinical Epidemiology Service (N.S.), National Institutes of Health Clinical Center, Bethesda, MD; Division of Pediatric Endocrinology (D.K., S.T.), Infants and Children's Hospital of Brooklyn at Maimonides and Children and Hospital at Downstate, State University of New York, Brooklyn, New York 11219. and Department of Endocrinology (A.D.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Maya Lodish
- Section on Endocrinology and Genetics (E.G., M.L., M.K., C.L., M.N., M.S., P.X., C.A.S.), and Pediatric Endocrinology Inter-Institute Training Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Department of Radiology (E.T.), Clinical Center, National Institutes of Health, Bethesda, Maryland 20892; Division of Pediatric Endocrinology (E.G.), Georgetown University Medical Center, Washington, DC 20007; Biostatistics and Clinical Epidemiology Service (N.S.), National Institutes of Health Clinical Center, Bethesda, MD; Division of Pediatric Endocrinology (D.K., S.T.), Infants and Children's Hospital of Brooklyn at Maimonides and Children and Hospital at Downstate, State University of New York, Brooklyn, New York 11219. and Department of Endocrinology (A.D.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Meg Keil
- Section on Endocrinology and Genetics (E.G., M.L., M.K., C.L., M.N., M.S., P.X., C.A.S.), and Pediatric Endocrinology Inter-Institute Training Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Department of Radiology (E.T.), Clinical Center, National Institutes of Health, Bethesda, Maryland 20892; Division of Pediatric Endocrinology (E.G.), Georgetown University Medical Center, Washington, DC 20007; Biostatistics and Clinical Epidemiology Service (N.S.), National Institutes of Health Clinical Center, Bethesda, MD; Division of Pediatric Endocrinology (D.K., S.T.), Infants and Children's Hospital of Brooklyn at Maimonides and Children and Hospital at Downstate, State University of New York, Brooklyn, New York 11219. and Department of Endocrinology (A.D.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Ninet Sinaii
- Section on Endocrinology and Genetics (E.G., M.L., M.K., C.L., M.N., M.S., P.X., C.A.S.), and Pediatric Endocrinology Inter-Institute Training Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Department of Radiology (E.T.), Clinical Center, National Institutes of Health, Bethesda, Maryland 20892; Division of Pediatric Endocrinology (E.G.), Georgetown University Medical Center, Washington, DC 20007; Biostatistics and Clinical Epidemiology Service (N.S.), National Institutes of Health Clinical Center, Bethesda, MD; Division of Pediatric Endocrinology (D.K., S.T.), Infants and Children's Hospital of Brooklyn at Maimonides and Children and Hospital at Downstate, State University of New York, Brooklyn, New York 11219. and Department of Endocrinology (A.D.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Evrim Turkbey
- Section on Endocrinology and Genetics (E.G., M.L., M.K., C.L., M.N., M.S., P.X., C.A.S.), and Pediatric Endocrinology Inter-Institute Training Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Department of Radiology (E.T.), Clinical Center, National Institutes of Health, Bethesda, Maryland 20892; Division of Pediatric Endocrinology (E.G.), Georgetown University Medical Center, Washington, DC 20007; Biostatistics and Clinical Epidemiology Service (N.S.), National Institutes of Health Clinical Center, Bethesda, MD; Division of Pediatric Endocrinology (D.K., S.T.), Infants and Children's Hospital of Brooklyn at Maimonides and Children and Hospital at Downstate, State University of New York, Brooklyn, New York 11219. and Department of Endocrinology (A.D.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Charalampos Lyssikatos
- Section on Endocrinology and Genetics (E.G., M.L., M.K., C.L., M.N., M.S., P.X., C.A.S.), and Pediatric Endocrinology Inter-Institute Training Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Department of Radiology (E.T.), Clinical Center, National Institutes of Health, Bethesda, Maryland 20892; Division of Pediatric Endocrinology (E.G.), Georgetown University Medical Center, Washington, DC 20007; Biostatistics and Clinical Epidemiology Service (N.S.), National Institutes of Health Clinical Center, Bethesda, MD; Division of Pediatric Endocrinology (D.K., S.T.), Infants and Children's Hospital of Brooklyn at Maimonides and Children and Hospital at Downstate, State University of New York, Brooklyn, New York 11219. and Department of Endocrinology (A.D.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Maria Nesterova
- Section on Endocrinology and Genetics (E.G., M.L., M.K., C.L., M.N., M.S., P.X., C.A.S.), and Pediatric Endocrinology Inter-Institute Training Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Department of Radiology (E.T.), Clinical Center, National Institutes of Health, Bethesda, Maryland 20892; Division of Pediatric Endocrinology (E.G.), Georgetown University Medical Center, Washington, DC 20007; Biostatistics and Clinical Epidemiology Service (N.S.), National Institutes of Health Clinical Center, Bethesda, MD; Division of Pediatric Endocrinology (D.K., S.T.), Infants and Children's Hospital of Brooklyn at Maimonides and Children and Hospital at Downstate, State University of New York, Brooklyn, New York 11219. and Department of Endocrinology (A.D.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Maria de la Luz Sierra
- Section on Endocrinology and Genetics (E.G., M.L., M.K., C.L., M.N., M.S., P.X., C.A.S.), and Pediatric Endocrinology Inter-Institute Training Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Department of Radiology (E.T.), Clinical Center, National Institutes of Health, Bethesda, Maryland 20892; Division of Pediatric Endocrinology (E.G.), Georgetown University Medical Center, Washington, DC 20007; Biostatistics and Clinical Epidemiology Service (N.S.), National Institutes of Health Clinical Center, Bethesda, MD; Division of Pediatric Endocrinology (D.K., S.T.), Infants and Children's Hospital of Brooklyn at Maimonides and Children and Hospital at Downstate, State University of New York, Brooklyn, New York 11219. and Department of Endocrinology (A.D.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Paraskevi Xekouki
- Section on Endocrinology and Genetics (E.G., M.L., M.K., C.L., M.N., M.S., P.X., C.A.S.), and Pediatric Endocrinology Inter-Institute Training Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Department of Radiology (E.T.), Clinical Center, National Institutes of Health, Bethesda, Maryland 20892; Division of Pediatric Endocrinology (E.G.), Georgetown University Medical Center, Washington, DC 20007; Biostatistics and Clinical Epidemiology Service (N.S.), National Institutes of Health Clinical Center, Bethesda, MD; Division of Pediatric Endocrinology (D.K., S.T.), Infants and Children's Hospital of Brooklyn at Maimonides and Children and Hospital at Downstate, State University of New York, Brooklyn, New York 11219. and Department of Endocrinology (A.D.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Divya Khurana
- Section on Endocrinology and Genetics (E.G., M.L., M.K., C.L., M.N., M.S., P.X., C.A.S.), and Pediatric Endocrinology Inter-Institute Training Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Department of Radiology (E.T.), Clinical Center, National Institutes of Health, Bethesda, Maryland 20892; Division of Pediatric Endocrinology (E.G.), Georgetown University Medical Center, Washington, DC 20007; Biostatistics and Clinical Epidemiology Service (N.S.), National Institutes of Health Clinical Center, Bethesda, MD; Division of Pediatric Endocrinology (D.K., S.T.), Infants and Children's Hospital of Brooklyn at Maimonides and Children and Hospital at Downstate, State University of New York, Brooklyn, New York 11219. and Department of Endocrinology (A.D.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Svetlana Ten
- Section on Endocrinology and Genetics (E.G., M.L., M.K., C.L., M.N., M.S., P.X., C.A.S.), and Pediatric Endocrinology Inter-Institute Training Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Department of Radiology (E.T.), Clinical Center, National Institutes of Health, Bethesda, Maryland 20892; Division of Pediatric Endocrinology (E.G.), Georgetown University Medical Center, Washington, DC 20007; Biostatistics and Clinical Epidemiology Service (N.S.), National Institutes of Health Clinical Center, Bethesda, MD; Division of Pediatric Endocrinology (D.K., S.T.), Infants and Children's Hospital of Brooklyn at Maimonides and Children and Hospital at Downstate, State University of New York, Brooklyn, New York 11219. and Department of Endocrinology (A.D.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Adrian Dobs
- Section on Endocrinology and Genetics (E.G., M.L., M.K., C.L., M.N., M.S., P.X., C.A.S.), and Pediatric Endocrinology Inter-Institute Training Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Department of Radiology (E.T.), Clinical Center, National Institutes of Health, Bethesda, Maryland 20892; Division of Pediatric Endocrinology (E.G.), Georgetown University Medical Center, Washington, DC 20007; Biostatistics and Clinical Epidemiology Service (N.S.), National Institutes of Health Clinical Center, Bethesda, MD; Division of Pediatric Endocrinology (D.K., S.T.), Infants and Children's Hospital of Brooklyn at Maimonides and Children and Hospital at Downstate, State University of New York, Brooklyn, New York 11219. and Department of Endocrinology (A.D.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - Constantine A Stratakis
- Section on Endocrinology and Genetics (E.G., M.L., M.K., C.L., M.N., M.S., P.X., C.A.S.), and Pediatric Endocrinology Inter-Institute Training Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Department of Radiology (E.T.), Clinical Center, National Institutes of Health, Bethesda, Maryland 20892; Division of Pediatric Endocrinology (E.G.), Georgetown University Medical Center, Washington, DC 20007; Biostatistics and Clinical Epidemiology Service (N.S.), National Institutes of Health Clinical Center, Bethesda, MD; Division of Pediatric Endocrinology (D.K., S.T.), Infants and Children's Hospital of Brooklyn at Maimonides and Children and Hospital at Downstate, State University of New York, Brooklyn, New York 11219. and Department of Endocrinology (A.D.), Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
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12
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Techatraisak K, Chayachinda C, Wongwananuruk T, Dangrat C, Indhavivadhana S, Rattanachaiyanont M, Thongnoppakhun W. No association between CYP17 -34T/C
polymorphism and insulin resistance in Thai polycystic ovary syndrome. J Obstet Gynaecol Res 2015; 41:1412-7. [DOI: 10.1111/jog.12733] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 02/26/2015] [Accepted: 03/18/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Kitirat Techatraisak
- Division of Gynaecologic Endocrinology Department of Obstetrics and Gynaecology; Faculty of Medicine Siriraj Hospital, Mahidol University; Bangkok Thailand
| | - Chenchit Chayachinda
- Division of Gynaecologic Endocrinology Department of Obstetrics and Gynaecology; Faculty of Medicine Siriraj Hospital, Mahidol University; Bangkok Thailand
| | - Thanyarat Wongwananuruk
- Division of Gynaecologic Endocrinology Department of Obstetrics and Gynaecology; Faculty of Medicine Siriraj Hospital, Mahidol University; Bangkok Thailand
| | - Chongdee Dangrat
- Division of Gynaecologic Endocrinology Department of Obstetrics and Gynaecology; Faculty of Medicine Siriraj Hospital, Mahidol University; Bangkok Thailand
| | - Suchada Indhavivadhana
- Division of Gynaecologic Endocrinology Department of Obstetrics and Gynaecology; Faculty of Medicine Siriraj Hospital, Mahidol University; Bangkok Thailand
| | - Manee Rattanachaiyanont
- Division of Gynaecologic Endocrinology Department of Obstetrics and Gynaecology; Faculty of Medicine Siriraj Hospital, Mahidol University; Bangkok Thailand
| | - Wanna Thongnoppakhun
- Division of Molecular Genetics, Department of Research and Development; Faculty of Medicine Siriraj Hospital, Mahidol University; Bangkok Thailand
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13
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Ivanova SA, Geers LM, Al Hadithy AFY, Pechlivanoglou P, Semke AV, Vyalova NM, Rudikov EV, Fedorenko OY, Wilffert B, Bokhan NA, Brouwers JRBJ, Loonen AJM. Dehydroepiandrosterone sulphate as a putative protective factor against tardive dyskinesia. Prog Neuropsychopharmacol Biol Psychiatry 2014; 50:172-7. [PMID: 24389397 DOI: 10.1016/j.pnpbp.2013.12.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 11/30/2013] [Accepted: 12/21/2013] [Indexed: 12/15/2022]
Abstract
BACKGROUND Tardive dyskinesia (TD) is a potentially irreversible consequence of long term treatment with antipsychotic drugs which is according to a well-known theory believed to be related to oxidative stress induced neurotoxicity. Dehydroepiandrosterone (DHEA) is an endogenous antioxidant with neuroprotective activity. The biosynthesis of DHEA depends upon the activity of cytochrome P450c17α (CYP17). The gene that encodes for CYP17 has a (T34C) single nucleotide polymorphism which enhances CYP17 transcription and expression. OBJECTIVE To test the hypothesis that carriership of a more active CYP17 variant would result in higher DHEA(S) levels and protect against neurotoxicity which results in orofaciolingual TD (TDof), limb-truncal TD (TDlt) or both (TDsum). METHOD Tardive dyskinesia was assessed cross-sectionally in 146 Caucasian psychiatric inpatients from Siberia. RESULTS Patients who are carriers of the Cyp17 genotype CC have less chance of developing TD compared to patients who are carriers of the Cyp17 genotypes TC or TT (p<0.05). However, these carriers have significant lower circulating DHEAS levels compared to carriers of the Cyp17 genotypes TC and TT (p<0.05). Conversely, carriers of the CYP17 T-allele have significant elevated DHEAS levels. After correcting for gender and age no significant relationship between Cyp17 genotype CC, the T-allelle and the C-allele and the DHEAS concentration of patients was observed. CONCLUSIONS Although an association between the CYP17 CC genotype and TD is indicated, our findings do not support the hypothesis that this is mediated through increased DHEA(S) levels. We believe that the relationship between this polymorphism and neuroprotective effects of steroids is more complex and cannot be elucidated without taking the posttranslational regulation of the enzyme into account.
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Affiliation(s)
- Svetlana A Ivanova
- Mental Health Research Institute, Tomsk, Russia; National Research Tomsk Polytechnic University, Tomsk, Russia
| | - Lisanne M Geers
- Department of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Asmar F Y Al Hadithy
- Department of Pharmacy, University of Groningen, Groningen, The Netherlands; Parnassia Group, Pharmacy Haaglanden, The Hague, The Netherlands
| | - Petros Pechlivanoglou
- Department of Pharmacy, University of Groningen, Groningen, The Netherlands; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | | | | | | | - Olga Y Fedorenko
- Mental Health Research Institute, Tomsk, Russia; National Research Tomsk Polytechnic University, Tomsk, Russia
| | - Bob Wilffert
- Department of Pharmacy, University of Groningen, Groningen, The Netherlands
| | | | | | - Anton J M Loonen
- Department of Pharmacy, University of Groningen, Groningen, The Netherlands; Mental Health Institute Westelijk Noord-Brabant, Halsteren, The Netherlands.
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14
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Lakkakula BVKS, Thangavelu M, Godla UR. Genetic variants associated with insulin signaling and glucose homeostasis in the pathogenesis of insulin resistance in polycystic ovary syndrome: a systematic review. J Assist Reprod Genet 2013; 30:883-95. [PMID: 23794114 DOI: 10.1007/s10815-013-0030-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Accepted: 05/31/2013] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome must be recognized as a serious issue due to its implication on long term health regardless of an individual's age. PCOS and insulin resistance are interlinked, as approximately 40 % of women with PCOS are insulin resistant. However, the detailed molecular basis for insulin resistance that is coupled with PCOS remains poorly understood. OBJECTIVE To review the published evidence that polymorphisms in genes that are involved in insulin secretion and action are associated with an increased risk of PCOS. METHODS We reviewed articles published through November 2012 which concerned polymorphisms of genes related to insulin signaling and glucose homeostasis as well as their associations with PCOS. The articles were identified via Medline searches. CONCLUSIONS No consistent evidence emerged of a strong association between the risk of PCOS and any known gene that is related to insulin signaling and glucose homeostasis. Moreover, recent genome-wide association studies are inconsistent in identifying the associations between PCOS and insulin metabolism genes. Many of the studies reviewed were limited by heterogeneity in the PCOS diagnosis and by not have having a sufficient number of study participants. Further studies are warranted to determine predisposing risk factors which could modify environmental factors and thus reduce the risk of PCOS. Large genome-wide association studies devoted solely to PCOS will be necessary to identify new candidate genes and proteins that are involved in PCOS risk.
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15
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Chua AK, Azziz R, Goodarzi MO. Association study of CYP17 and HSD11B1 in polycystic ovary syndrome utilizing comprehensive gene coverage. Mol Hum Reprod 2012; 18:320-4. [PMID: 22238371 DOI: 10.1093/molehr/gas002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Cytochrome P450-C17 enzyme (CYP17) is an important component of the androgen synthesis pathway, a pathway that is dysfunctional in polycystic ovary syndrome (PCOS). Variation in 11-beta hydroxysteroid dehydrogenase (HSD11B1) is associated with cortisone reductase deficiency, a condition with a phenotype similar to PCOS. Both CYP17 and HSD11B1 genes have been previously studied for their possible relationship with PCOS, yielding inconsistent results. In this study, we evaluated the association between variation in these genes and PCOS. Two-hundred and eighty-seven Caucasian PCOS women and 187 Caucasian controls were genotyped for single nucleotide polymorphisms (SNPs) that were specifically chosen to allow full coverage of CYP17 and HSD11B1, including four SNPs in CYP17 and eight SNPs in HSD11B1. SNP and haplotype association analyses were conducted. Our results indicate that variants in the two genes are not associated with PCOS, or with the quantitative traits characteristic of PCOS, suggesting that these genes are not major risk factors for the syndrome.
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Affiliation(s)
- Angela K Chua
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
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16
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Li Y, Liu F, Luo S, Hu H, Li XH, Li SW. Polymorphism T→C of gene CYP17 promoter and polycystic ovary syndrome risk: a meta-analysis. Gene 2012; 495:16-22. [PMID: 22237020 DOI: 10.1016/j.gene.2011.12.048] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2011] [Revised: 11/30/2011] [Accepted: 12/22/2011] [Indexed: 11/29/2022]
Abstract
The T→C polymorphism of CYP17 gene has been inconsistently associated with polycystic ovary syndrome (PCOS) risk. We examined the association by performing a meta-analysis. Two investigators independently searched the Medline, Embase, CNKI, and Chinese Biomedicine Databases. Summary odds ratios (ORs) and 95% confidence intervals (95% CIs) for CYP17 polymorphism and PCOS were calculated in a fixed-effects model and a random-effects model when appropriate. The pooled ORs were performed for co-dominant model (CC vs. TT, TC vs. TT), dominant model (CC+TC vs. TT), and recessive model (CC vs. TC+TT). Subgroup analyses were performed by ethnicity, country, Hardy-Weinberg equilibrium (HWE) in controls and study sample size. This meta-analysis included 10 case-control studies, which included 1321 PCOS cases and 1017 controls. Overall, the variant genotypes (CC and TC) were not associated with PCOS risk, compared with the wild-type TT homozygote. Similarly, no associations were found in the dominant and recessive models. Stratified analyses by ethnicity/country also detected no significant association. However, limiting the analysis to the studies within HWE, a significantly increased risk was observed (TC vs. TT, OR=1.44, 95% CI=1.10-1.88; dominant model, OR=1.41, 95% CI=1.10-1.81). Moreover, when stratifying by study sample size, a significantly elevated risk was found among small sample studies (≤200 subjects), but not among large sample studies (> 200 subjects). This meta-analysis suggests that the CYP17 T/C polymorphism may be not associated with PCOS risk, while the observed increase in risk of PCOS may be due to small-study bias.
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Affiliation(s)
- Ya Li
- Division of Reproductive Medical Center, West China Second University Hospital of Sichuan University, 3 Duan 20 Hao Ren Min Nan Lu, City of Chengdu, Sichuan 610041, China
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Unluturk U, Harmanci A, Kocaefe C, Yildiz BO. The Genetic Basis of the Polycystic Ovary Syndrome: A Literature Review Including Discussion of PPAR-gamma. PPAR Res 2011; 2007:49109. [PMID: 17389770 PMCID: PMC1820621 DOI: 10.1155/2007/49109] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2006] [Revised: 11/24/2006] [Accepted: 12/03/2006] [Indexed: 02/06/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of the women of reproductive age. Familial clustering of PCOS has been consistently reported suggesting that genetic factors play a role in the development of the syndrome although PCOS cases do not exhibit a clear pattern of Mendelian inheritance. It is now well established that PCOS represents a complex trait similar to type-2 diabetes and obesity, and that both inherited and environmental factors contribute to the PCOS pathogenesis. A large number of functional candidate genes have been tested for association or linkage with PCOS phenotypes with more negative than positive findings. Lack of universally accepted diagnostic criteria, difficulties in the assignment of male phenotype, obscurity in the mode of inheritance, and particularly small sample size of the study populations appear to be major limitations for the genetic studies of PCOS. In the near future, utilizing the genome-wide scan approach and the HapMap project will provide a stronger potential for the genetic analysis of the syndrome.
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Affiliation(s)
- Ugur Unluturk
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Hacettepe, 06100 Ankara, Turkey
| | - Ayla Harmanci
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Hacettepe, 06100 Ankara, Turkey
- Endocrinology and Metabolism Unit, Faculty of Medicine, Hacettepe University, Hacettepe, 06100 Ankara, Turkey
| | - Cetin Kocaefe
- Department of Medical Biology, Faculty of Medicine, Hacettepe University, Hacettepe, 06100 Ankara, Turkey
| | - Bulent O. Yildiz
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Hacettepe, 06100 Ankara, Turkey
- Endocrinology and Metabolism Unit, Faculty of Medicine, Hacettepe University, Hacettepe, 06100 Ankara, Turkey
- *Bulent O. Yildiz:
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18
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Jiang B, Kenna HA, Rasgon NL. Genetic overlap between polycystic ovary syndrome and bipolar disorder: The endophenotype hypothesis. Med Hypotheses 2009; 73:996-1004. [DOI: 10.1016/j.mehy.2008.12.056] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Revised: 12/03/2008] [Accepted: 12/07/2008] [Indexed: 12/13/2022]
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Vitzthum VJ. The ecology and evolutionary endocrinology of reproduction in the human female. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2009; 140 Suppl 49:95-136. [DOI: 10.1002/ajpa.21195] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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20
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Maliqueo M, Sir-Petermann T, Pérez V, Echiburú B, de Guevara AL, Gálvez C, Crisosto N, Azziz R. Adrenal function during childhood and puberty in daughters of women with polycystic ovary syndrome. J Clin Endocrinol Metab 2009; 94:3282-8. [PMID: 19567527 DOI: 10.1210/jc.2009-0427] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT In some patients, PCOS may develop as a consequence of an exaggerated adrenarche during pubertal development. OBJECTIVE The aim of the study was to assess adrenal function during childhood and pubertal development in daughters of women with PCOS (PCOSd). DESIGN We included 98 PCOSd [64 during childhood (ages 4-8 yr) and 34 during the peripubertal period (ages 9-13 yr)] and 51 daughters of control women (Cd) [30 during childhood and 21 during the peripubertal period]. In both groups, an acute ACTH-(1-24) stimulation test (0.25 mg) and an oral glucose tolerance test were performed. Bone age and serum concentrations of cortisol, androstenedione, 17-hydroxyprogesterone, dehydroepiandrosterone (DHEA), DHEA sulfate (DHEAS), glucose, and insulin were determined. RESULTS PCOSd and Cd were similar in age and body mass index. During the peripubertal period, basal and poststimulated DHEAS concentrations were higher in PCOSd compared to Cd. Among PCOSd, 12.5% of girls in childhood and 32.4% in peripuberty presented biochemical evidence of exaggerated adrenarche. Stimulated insulin was higher in PCOSd compared to Cd during childhood (P = 0.03) and peripuberty (P = 0.03). An advancement of 8 months between bone and chronological age was observed in peripubertal PCOSd compared to Cd. CONCLUSIONS In PCOSd, basal and stimulated DHEAS concentrations were higher during the onset of puberty. Around 30% of the PCOSd demonstrated an exacerbated adrenarche, which may reflect increased P450c17 activity. In addition, a modest advance in bone age was observed, probably secondary to the hyperinsulinemia and/or adrenal hyperandrogenism.
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Affiliation(s)
- Manuel Maliqueo
- Laboratory of Endocrinology, Department of Medicine, West Division, School of Medicine, Las Palmeras 299, Interior Quinta Normal, Casilla 33052, Correo 33, Santiago, Chile
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Metwally M, Amer S, Li TC, Ledger WL. An RCT of metformin versus orlistat for the management of obese anovulatory women. Hum Reprod 2008; 24:966-75. [PMID: 19095663 DOI: 10.1093/humrep/den454] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Treatment of obesity-related anovulation poses a significant clinical challenge. Occasionally, the use of antiobesity medications such as orlistat or insulin sensitizing agents such as metformin is sometimes indicated in these patients. This study aimed to compare the effects of metformin and orlistat for improving ovulation in obese anovulatory women. METHODS This was an open-label RCT. A total of 40 women were randomized to receive either metformin (n = 20) or orlistat (n = 20). BMI as well as the androgen profile and the ovulatory status were assessed at baseline and at four weekly intervals for 3 months. Different anthropometric and endocrine parameters were also assessed as possible predictors of ovulation. RESULTS There was no significant difference between the two study arms regarding the ovulation rate for metformin and orlistat [40% (n = 8/20) and 25% (n = 5/20), respectively, P = 0.31]. Both arms showed a significant drop in the BMI, testosterone and androstendione concentrations (P < 0.05), but there was no difference between the two arms. Patients who ovulated had significantly lower concentrations of baseline LH, androstendione, dehydroepiandrosterone and free androgen index (P < 0.05). Among these factors, a low baseline LH was found to be the only independent predictor of ovulation (area under curve, 0.85). CONCLUSIONS Both metformin and orlistat show a similar effect on weight loss, ovulation rates and androgen concentrations. However, the effects on ovulation rates need to be confirmed in larger studies. The presence of a low baseline serum LH was found to be the most important predictor of ovulation. The study was registered at clinicaltrials.gov. NCT00292799.
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Affiliation(s)
- M Metwally
- Sheffield University and Teaching Hospitals, The Jessop Wing, Tree Root Walk, Sheffield S10 4ED, UK.
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Abstract
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders characterized by androgen excess, oligo-ovulation and polycystic ovaries. Although ovaries are the main source of increased androgens in the syndrome, between 20 and 30% of patients with PCOS have adrenal androgen (AA) excess, detectable primarily by elevated dehydroepiandrosterone sulfate (DHEAS) levels. Patients with PCOS demonstrate a generalized hypersecretion of adrenocortical products, basally and in response to ACTH stimulation. The mechanisms of these abnormalities are unclear although AA excess in PCOS is likely a complex trait, modulated by both intrinsic and acquired factors. To date, no specific genetic defects have been identified. The production of AAs in response to ACTH appears to be closely related to altered factors regulating glucose-mediated glucose disposal, increased peripheral metabolism of cortisol, and to a less extent to the effects of extra-adrenal androgens, insulin resistance, hyperinsulinemia or obesity. Finally, DHEAS levels and the response of AAs to ACTH are relatively constant over time and are closely correlated between PCOS patients and their siblings suggesting that this abnormality is an inherited trait in PCOS.
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Affiliation(s)
- Bulent O Yildiz
- Department of Internal Medicine, Endocrinology and Metabolism Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Goodarzi MO, Antoine HJ, Azziz R. Genes for enzymes regulating dehydroepiandrosterone sulfonation are associated with levels of dehydroepiandrosterone sulfate in polycystic ovary syndrome. J Clin Endocrinol Metab 2007; 92:2659-64. [PMID: 17426092 DOI: 10.1210/jc.2006-2600] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT The adrenal androgen (AA) metabolite dehydroepiandrosterone sulfate (DHEAS) is often elevated in women with polycystic ovary syndrome (PCOS); AA excess in PCOS appears to be, in part, a heritable trait. Dehydroepiandrosterone (DHEA) sulfonation is controlled by the enzymes DHEA sulfotransferase (SULT2A1) and steroid sulfatase (STS). Polymorphisms in these genes have not been evaluated as modulators of DHEAS level in PCOS. OBJECTIVE The aim was to test the hypothesis that variants in the SULT2A1 and STS genes are associated with DHEAS levels in women with PCOS. DESIGN Women with and without PCOS were genotyped for seven single nucleotide polymorphisms (SNPs) in SULT2A1 and seven SNPs in STS. SNPs and haplotypes were determined and tested for association with DHEAS. SETTING Subjects were recruited from the reproductive endocrinology clinic at the University of Alabama at Birmingham; controls were recruited from the surrounding community. Genotyping took place at Cedars-Sinai Medical Center in Los Angeles. PARTICIPANTS A total of 287 white women with PCOS and 187 controls participated in the study. MAIN MEASUREMENTS SULT2A1 and STS genotype and DHEAS levels were measured. RESULTS In women with PCOS, SNP rs182420 in SULT2A1 was associated with DHEAS (P = 0.0035). Two haplotypes carrying the minor allele of rs182420 were also associated with DHEAS (P = 0.04 each). Variants within STS were not associated with DHEAS level. No associations were observed in control women. CONCLUSION This study presents genetic evidence suggesting a potential role of SULT2A1, but not STS, in the inherited AA excess of PCOS.
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Affiliation(s)
- Mark O Goodarzi
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Sinai Medical Center, Los Angeles, California 90048, USA
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Goodarzi MO, Guo X, Yildiz BO, Stanczyk FZ, Azziz R. Correlation of adrenocorticotropin steroid levels between women with polycystic ovary syndrome and their sisters. Am J Obstet Gynecol 2007; 196:398.e1-5; discussion 398.e5-6. [PMID: 17403434 DOI: 10.1016/j.ajog.2006.12.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2006] [Accepted: 12/11/2006] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the sibling correlation of adrenocorticotropic hormone-stimulated steroid hormone levels between probands with polycystic ovary syndrome and their sisters. STUDY DESIGN Twenty-seven women with polycystic ovary syndrome and 28 of their sisters underwent an adrenocorticotropic hormone stimulation test with measurement of the steroids dehydroepiandrosterone, androstenedione, and cortisol 60 minutes later. The 60-minute values were used to calculate sister-sister correlations by regression analyses. RESULTS The adrenocorticotropic hormone-stimulated (60-minute) log-transformed dehydroepiandrosterone and cortisol values were significantly correlated between siblings (r = 0.47, P = .01 and r = 0.57, P = .01, respectively); a similar trend was observed for the 60-minute A4 values (r = 0.29, P = .06). CONCLUSION Women with polycystic ovary syndrome and their sisters have significantly correlated levels of adrenocorticotropic hormone-stimulated steroids, supporting a genetic basis of the adrenal androgen excess observed in polycystic ovary syndrome.
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Affiliation(s)
- Mark O Goodarzi
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
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Olson SH, Bandera EV, Orlow I. Variants in estrogen biosynthesis genes, sex steroid hormone levels, and endometrial cancer: a HuGE review. Am J Epidemiol 2007; 165:235-45. [PMID: 17110639 DOI: 10.1093/aje/kwk015] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Variants in genes involved in estrogen biosynthesis are likely to be important in the etiology of endometrial cancer. This review summarizes data on variants in seven genes in the estrogen biosynthesis pathway and their relation to circulating levels of sex steroid hormones in women and to risk of endometrial cancer. Little or no association was found between genotypes of the cytochrome P-450 genes CYP11A1 (-528[TTTTA]n) or CYP17A1 (-34T/C) or the 17beta-hydroxysteroid dehydrogenase 1 gene HSD17B1 (Ser312Gly) and levels of progesterone, androgens, or estrogens. The position -34T/C variant in CYP17A1 appears to be associated with reduced risk of endometrial cancer, with those homozygous for the variant allele having about half the risk of those homozygous for the wild type. Linked variants in CYP19A1 (intron 4 [TTTA]n, intron 4 [TCT] insertion/deletion, exon 10 C/T) are related to some hormone levels and, based on two studies, to risk of endometrial cancer. For other genes (HSD3B1, HSD3B2, HSD17B2), no information is available on these associations. Results indicate the need to study other variants and haplotypes in these genes, particularly CYP17A1 and CYP19A1, as well as variants in other genes involved in hormone biosynthesis and metabolism pathways. Larger studies or combined studies that allow for investigation of gene-gene and gene-environment interactions are warranted.
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Affiliation(s)
- Sara H Olson
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
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Doi SAR, Al-Zaid M, Towers PA, Scott CJ, Al-Shoumer KAS. Steroidogenic alterations and adrenal androgen excess in PCOS. Steroids 2006; 71:751-9. [PMID: 16781743 DOI: 10.1016/j.steroids.2006.05.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2005] [Revised: 04/28/2006] [Accepted: 05/03/2006] [Indexed: 01/30/2023]
Abstract
BACKGROUND This cross-sectional study was undertaken to improve our understanding of the steroidogenic alterations leading to adrenal hyperandrogenism in polycystic ovarian syndrome (PCOS). METHODS Two-hundred and thirty-four women with clinical and biochemical features suggestive of PCOS underwent metabolic and hormonal evaluation. We used the androstenedione/DHEAS ratio as a surrogate for the level of ovarian 3betaHSD activity. We then selected the 90th percentile for the ratio in those with elevated DHEAS (>9 micromol/l) as the cut-off level beyond which excess DHEAS production will be minimized by excess ovarian 3betaHSD activity. This cut-off level was at a ratio of 1.5 and all PCOS women were then divided into two groups, the higher (>1.5) being the group with excess ovarian 3betaHSD activity. We hypothesized that women with a high ratio would be unlikely to have DHEAS excess due to the rapid conversion of DHEA to androstenedione. Those with a low ratio (concordant ovarian and adrenal steroidogenesis) could then either have high DHEAS or normal DHEAS, depending on whether CYP17 activity was higher or lower respectively. RESULTS Insulin resistance was found to be associated with decreased CYP17 activity while irregular cycles and neuroendocrine dysfunction were determined to be associated with higher ovarian 3betaHSD activity. CONCLUSION Adrenal androgen excess in PCOS seems to be related to insulin sensitivity as well as decreased activity of 3betaHSD, the latter being preferentially present in those women with regular cycles or without neuroendocrine dysfunction.
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Affiliation(s)
- Suhail A R Doi
- Division of Endocrinology, Mubarak Al-Kabeer Hospital & Department of Medicine, Faculty of Medicine, Kuwait University, P.O. Box 24923 Safat, 13110, Kuwait.
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