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Rizk J, Sahu R, Duteil D. An overview on androgen-mediated actions in skeletal muscle and adipose tissue. Steroids 2023; 199:109306. [PMID: 37634653 DOI: 10.1016/j.steroids.2023.109306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 08/29/2023]
Abstract
Androgens are a class of steroid hormones primarily associated with male sexual development and physiology, but exert pleiotropic effects in either sex. They have a crucial role in various physiological processes, including the regulation of skeletal muscle and adipose tissue homeostasis. The effects of androgens are mainly mediated through the androgen receptor (AR), a ligand-activated nuclear receptor expressed in both tissues. In skeletal muscle, androgens via AR exert a multitude of effects, ranging from increased muscle mass and strength, to the regulation of muscle fiber type composition, contraction and metabolic functions. In adipose tissue, androgens influence several processes including proliferation, fat distribution, and metabolism but they display depot-specific and organism-specific effects which differ in certain context. This review further explores the potential mechanisms underlying androgen-AR signaling in skeletal muscle and adipose tissue. Understanding the roles of androgens and their receptor in skeletal muscle and adipose tissue is essential for elucidating their contributions to physiological processes, disease conditions, and potential therapeutic interventions.
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Affiliation(s)
- Joe Rizk
- Université de Strasbourg, CNRS, Inserm, IGBMC UMR 7104- UMR-S 1258, F-67400 Illkirch, France
| | - Rajesh Sahu
- Université de Strasbourg, CNRS, Inserm, IGBMC UMR 7104- UMR-S 1258, F-67400 Illkirch, France
| | - Delphine Duteil
- Université de Strasbourg, CNRS, Inserm, IGBMC UMR 7104- UMR-S 1258, F-67400 Illkirch, France.
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Amiri M, Mahmoudieh L, Sheidaei A, Ramezani Tehrani F. Idiopathic hirsutism and dyslipidemia: A systematic review, meta-analysis, and meta-regressions. J Cosmet Dermatol 2023; 22:1449-1462. [PMID: 36718809 DOI: 10.1111/jocd.15608] [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: 07/21/2022] [Revised: 10/18/2022] [Accepted: 12/16/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Despite existing several kinds of studies on idiopathic hirsutism (IH) and its association with metabolic disturbances, a limited number of studies have assessed lipid profiles in patients with IH with conflicting and inconclusive results. This study aimed to evaluate the lipid profiles in women with IH, compared to those of polycystic ovary syndrome (PCOS) and healthy controls. MATERIALS AND METHODS For this systematic review and meta-analysis, PubMed, Scopus, and EMBASE databases were searched to obtain studies published from inception to July 2021 investigating the lipid parameters, including triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in women with IH, compared to control groups. A meta-regression and subgroup analysis were conducted to explore heterogeneity sources. Publication bias was assessed by the Egger test. RESULTS Of 209 studies retrieved through searching databases and other sources, a total of 12 studies including 3913 participants were included for the meta-analysis. This meta-analysis showed higher standardized mean difference (SMD) of TC (SMD: 0.09 mg/dl; 95% CI: 0.001, 0.18) and lower SMD of HDL-C (SMD: -0.10 mg/dl; 95% CI: -0.18, -0.02) in women with IH, compared to those of the healthy controls, whereas there were no significant differences in the SMDs of TG and LDL-C between the study groups. This study also revealed no difference in the levels of lipid profiles of women with IH in comparison with PCOS patients, except for TG (SMD: -0.24 mg/dl; 95% CI: -0.46, -0.02). The results of subgroup analysis based on the study design revealed no significant differences in the SMD of lipid parameters between women with IH and healthy controls. We also found no significant difference in the levels of lipid profiles of women with IH versus PCOS patients, except for HDL-C in the subgroup of case-control studies (SMD: 0.18 mg/dl; 95% CI: 0.01, 0.34). CONCLUSION This study demonstrated that the majority of lipid parameters were not significantly different in women with IH, compared to those of healthy and PCOS controls.
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Affiliation(s)
- Mina Amiri
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Mahmoudieh
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Mahmoudieh L, Amiri M, Rahmati M, Habibi Moeini AS, Sarvghadi F, Azizi F, Ramezani Tehrani F. Idiopathic Hirsutism and Metabolic Status: A Population-based Prospective Cohort Study. J Clin Endocrinol Metab 2022; 108:114-123. [PMID: 36125321 DOI: 10.1210/clinem/dgac538] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/10/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND A limited number of studies have investigated the impact of idiopathic hirsutism (IH) on cardiometabolic parameters with contradictory and inconclusive results. This study aimed to explore the effect of IH on metabolic outcomes. METHOD In this population-based prospective study, 334 women with IH and 1226 women as healthy controls were selected from Tehran Lipid and Glucose Study. The generalized estimation equations method was applied to investigate the secular longitudinal trends of metabolic indices, including fasting blood sugar (FBS), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL), non-HDL, triglyceride (TG), systolic blood pressure (SBP), diastolic blood pressure (DBP), and waist circumference (WC) in both groups. Unadjusted and adjusted Cox regression models were applied to assess the hazard ratios (HR) and 95% CIs for the association between IH and metabolic disorders. Potential confounding factors such as age, body mass index, smoking, physical activity, history of hypertension (HTN), and family history of diabetes were included in the adjusted model. RESULTS This study showed that compared with healthy controls, women with IH had lower SHBG and higher total testosterone (median [interquartile ratio; IQR]: 0.37 [0.16-0.70] vs 0.33 [0.14-0.58]; P = 0.01), free androgen index (median [IQR]: 0.85 [0.38-1.54] vs 0.54 [0.26-0.97]; P = 0.001), androstenedione (median [IQR]: 1.60 [1.00-2.25] vs 1.10 [0.90-1.70]; P = 0.001), and dehydroepiandrosterone sulfate (median [IQR]: 168.5 [91.1-227.8] vs 125.2 [66.3-181]; P = 0.001). Over time, mean changes of FBS, HDL-C, LDL-C, non-HDL-C, TG, SBP, DBP, and WC were not significantly different in women with IH, compared with healthy controls. According to the unadjusted Cox regression model, except for type 2 diabetes mellitus (T2DM) (HR [95% CI]: 1.45 [1.00-2.11]) P = 0.05; there was no statistically significant difference in hazard of metabolic disorders (ie, HTN, pre-HTN, pre-T2DM, and metabolic syndrome) in IH, compared with healthy controls. Besides, the adjusted Cox regression model showed no significant differences in the hazard of these outcomes. CONCLUSION This study showed no significant difference in overtime mean changes of metabolic risk factors and cardiometabolic outcomes in women with IH, compared with the healthy control group, except marginally significant difference on T2DM, which disappeared after further adjustment for potential confounders. Accordingly, routine screening of women for these metabolic outcomes should not recommend.
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Affiliation(s)
- Leila Mahmoudieh
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mina Amiri
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Rahmati
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Siamak Habibi Moeini
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh Sarvghadi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Amiri M, Mahmoudieh L, Sheidaei A, Fallahzadeh A, Ramezani Tehrani F. Insulin resistance and idiopathic hirsutism: A systematic review, meta-analysis, and meta-regression. J Cosmet Dermatol 2022; 21:5346-5359. [PMID: 35531788 DOI: 10.1111/jocd.15070] [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: 03/17/2022] [Revised: 04/17/2022] [Accepted: 05/05/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVES This study aimed to evaluate the Standardized Mean Difference (SMD) of insulin resistance parameters in women with IH, compared to healthy and polycystic ovary syndrome (PCOS) controls. MATERIALS AND METHODS PubMed, Scopus, Web of Sciences, and Embase were searched for retrieving studies published up to November 2021 investigating the insulin resistance parameters in women with IH, compared to control groups. Meta-regression and subgroup analysis were conducted to evaluate the effect of potential confounders, such as age, BMI, and study design. RESULTS A meta-analysis of 20 studies revealed that higher SMDs of fasting insulin (SMD: 0.58; 95% CI: 0.10, 1.06), HOMA-IR (SMD: 0.53; 95% CI: 0.09, 0.97), and FBS levels (SMD: 0.11; 95% CI: 0.03, 0.19) in women with IH than healthy. It also showed that the SMD of HOMA-IR was significantly lower in women with IH than PCOS patients (SMD: -0.49; 95% CI: -0.88, -0.09). A subgroup analysis of cross-sectional studies showed higher SMDs of fasting insulin (SMD: 0.86; 95% CI: 0.05, 1.68), HOMA-IR (SMD: 0.83; 95% CI: 0.01, 1.64), and FBS levels (SMD: 0.14; 95% CI: 0.00, 0.28) in women with IH than healthy, whereas there was no difference in the SMD of these metabolic parameters between IH and PCOS groups, except for SMD of HOMA-IR (SMD: -0.22; 95% CI: -0.42, -0.02). CONCLUSIONS The results of the study demonstrate that insulin resistance parameters are related to IH, although insulin resistance values in women with IH are not as high as in patients with PCOS. According to the results of the study, measuring these metabolic parameters can be beneficial to evaluate all hirsute women with IH.
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Affiliation(s)
- Mina Amiri
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Mahmoudieh
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,School of Public Health, Department of Epidemiology and biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Aida Fallahzadeh
- School of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Gomula A, Nowak-Szczepanska N, Chakraborty R, Koziel S. Relative Body Fat Distribution in Preadolescent Indian Children Exposed to a Natural Disaster during Early Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116356. [PMID: 35681941 PMCID: PMC9179979 DOI: 10.3390/ijerph19116356] [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: 04/19/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/16/2022]
Abstract
Fetal life and infancy are critical periods when adverse environmental conditions, such as natural disasters, may alter a developing organism, leading to life-lasting unfavorable health outcomes, such as central body fat distribution. Therefore, the aim of this study was to assess the effect of the exposure to cyclone Aila in utero or during infancy on the relative subcutaneous adiposity distribution in preadolescent Indian children. The study included children prenatally (N = 336) or postnatally (during infancy, N = 212) exposed to Aila and a non-affected group (N = 284). Anthropometric indices involved, i.e., subscapular, suprailiac, triceps, and biceps skinfolds. The relative adiposity distribution (PC1) and socioeconomic status (SES) were assessed using principal component analysis. An analysis of covariance and Tukey’s post hoc test for unequal samples were performed to assess the effect of exposure to a natural disaster on the PC1, controlling for age, sex, Z-BMI, and SES. Prenatally and postnatally Aila-exposed children revealed a significantly more central-oriented pattern of relative subcutaneous fat distribution compared to the controls (p < 0.05). Early-life exposure to a natural disaster was related to an adverse pattern of relative adipose tissue distribution in preadolescent children.
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Affiliation(s)
- Aleksandra Gomula
- Department of Anthropology, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wroclaw, Poland; (N.N.-S.); (S.K.)
- Correspondence:
| | - Natalia Nowak-Szczepanska
- Department of Anthropology, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wroclaw, Poland; (N.N.-S.); (S.K.)
| | - Raja Chakraborty
- Department of Anthropology and Tribal Studies, Sidho-Kanho-Birsha University, Purulia 723104, West Bengal, India;
- Department of Anthropology, Dinabandhu Mahavidyalaya, Bongaon 743235, West Bengal, India
| | - Slawomir Koziel
- Department of Anthropology, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wroclaw, Poland; (N.N.-S.); (S.K.)
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Chen Z, Cai Z. Effects of oral contraceptives plus orlistat in patients with polycystic ovary syndrome and overweight/obesity: A meta-analysis. J Obstet Gynaecol Res 2022; 48:1399-1408. [PMID: 35302695 DOI: 10.1111/jog.15211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/17/2022] [Accepted: 02/19/2022] [Indexed: 11/30/2022]
Abstract
AIM This meta-analysis was conducted to compare the effect and safety of oral contraceptive pills (OCP) plus orlistat with OCP alone in clinical, hormonal, and lipid metabolism outcomes in patients with polycystic ovary syndrome (PCOS) and overweight/obesity. METHODS Pubmed, Embase, Web of Science, Chinese National Knowledge Infrastructure (CNKI), and SinoMed were systematically reviewed. A random-effects or fixed-effects model was used to pool the estimate. RESULTS Eight studies were included in this meta-analysis. Significant reductions in BMI, WHR, and waist circumference were observed in combination group as compared with OCP alone group. Regarding the hormonal outcome, T, SHBG, FAI, LH, DHEAS, FSH, and E2 levels were significantly improved in combination group compared with OCP alone group. However, the TT and FT did not change significantly between the two groups. Regarding the lipid metabolism outcomes, TC, LDL-C, and TG levels were reduced and HDL-C level was increased in the combination group. Regarding the insulin metabolism outcomes, FINS and HOMA-IR levels were reduced in combination group than in OCP group. The ovulation rate, pregnancy rate, and overall effective rate were significantly higher in combination group than in OCP alone group. Fewer complications were observed in the combination group than in OCP group, and the difference between them was significant. CONCLUSION This combination treatment of OCP and orlistat was more effective than OCP alone in reducing the weight, hormonal, lipid, and insulin metabolism profiles, as well as improving the ovulation rate, pregnancy rate, and overall effective rate, as compared with OCP alone.
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Affiliation(s)
- Zhangming Chen
- Department of Reproductive Health and Infertility, Gaozhou Hospital of Traditional Chinese Medicine, Gaozhou City, Guangdong Province, China
| | - Zhaowei Cai
- Reproductive Center, SSL Central Hospital of Dongguan, Dongguan City, Guangdong Province, China
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Amisi CA. Markers of insulin resistance in Polycystic ovary syndrome women: An update. World J Diabetes 2022; 13:129-149. [PMID: 35432749 PMCID: PMC8984569 DOI: 10.4239/wjd.v13.i3.129] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 09/14/2021] [Accepted: 02/23/2022] [Indexed: 02/06/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders, affecting 5%-10% of women of reproductive age. The importance of this syndrome lies in the magnitude of associated comorbidities: infertility, metabolic dysfunction, cardiovascular disease (CVD), plus psychological and oncological complications. Insulin resistance (IR) is a prominent feature of PCOS with a prevalence of 35%-80%. Without adequate management, IR with compensatory hyperinsulinemia contributes directly to reproductive dysfunction in women with PCOS. Furthermore, epidemiological data shows compelling evidence that PCOS is associated with an increased risk of impaired glucose tolerance, gestational diabetes mellitus and type 2 diabetes. In addition, metabolic dysfunction leads to a risk for CVD that increases with aging in women with PCOS. Indeed, the severity of IR in women with PCOS is associated with the amount of abdominal obesity, even in lean women with PCOS. Given these drastic implications, it is important to diagnose and treat insulin resistance as early as possible. Many markers have been proposed. However, quantitative assessment of IR in clinical practice remains a major challenge. The gold standard method for assessing insulin sensitivity is the hyperinsulinemic euglycemic glucose clamp. However, it is not used routinely because of the complexity of its procedure. Consequently, there has been an urgent need for surrogate markers of IR that are more applicable in large population-based epidemiological investigations. Despite this, many of them are either difficult to apply in routine clinical practice or useless for women with PCOS. Considering this difficulty, there is still a need for an accurate marker for easy, early detection and assessment of IR in women with PCOS. This review highlights markers of IR already used in women with PCOS, including new markers recently reported in literature, and it establishes a new classification for these markers.
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Affiliation(s)
- Chantal Anifa Amisi
- Endocrinology and Diabetes Unit, Department of Medicine, Universita Campus Bio-medico di Rome, Rome 00128, Italy
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Gu H, Li L, Zhou B, Li M, Zhong W, Wei X, Zhong X. Single nucleotide polymorphisms in binding site of miRNA-135a and targeted gene IRS2 are correlated with multiple clinical features of PCOS: A study in Chinese women. Technol Health Care 2022; 30:71-80. [PMID: 35124585 PMCID: PMC9028752 DOI: 10.3233/thc-228007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND: The etiology of polycystic ovary syndrome (PCOS) remains unclear with highly heterogeneous clinical manifestations, recently growing evidence revealing genetic variants play a crucial part in its pathogenesis. OBJECTIVE: This study aimed to examine the correlation between SNPs in miRNA-135a’s binding site of targeted gene IRS2 and clinical manifestations of PCOS in Chinese females. METHOD: A total of 126 Chinese women with PCOS and 109 healthy women were enrolled, divided into 4 groups based on different clinical features of hyperandrogenemia (HA), insulin resistance (IR), polycystic ovary morphology (PCOM) and obesity. We analyzed 2 single nucleotide polymorphisms (SNPs) of the IRS2 gene (rs2289046 and rs1865434) and clinical features’ laboratory measurements such as sex hormone, fasting plasma glucose (FPG), fasting plasma insulin (FINS). RESULTS: Located in miRNA-135a binding site of IRS2 gene, the rs2289046’s triple genotypes distribution showed a significant difference between PCOS/control group and PCOM/non-PCOM group (P< 0.05) while the rs1865434’s triple genotype distribution showed a significant difference between obesity/non-obesity group (P< 0.05). CONCLUSION: The results revealed the two SNPs as rs2289046 and rs1865434 in the IRS-2 binding region of miRNA-135a have correlations with the clinical features of PCOS in Chinese population.
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Affiliation(s)
- Heng Gu
- NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Hospital, Guangzhou, Guangdong, China
- NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Hospital, Guangzhou, Guangdong, China
| | - Longyu Li
- Dongguan Institute of Reproduction and Genetics, Dongguan Maternal and Children Health Hospital, Dongguan, Guangdong, China
- NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Hospital, Guangzhou, Guangdong, China
| | - Bingyi Zhou
- NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Hospital, Guangzhou, Guangdong, China
| | - Mingzhen Li
- NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Hospital, Guangzhou, Guangdong, China
| | - Wenyao Zhong
- NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Hospital, Guangzhou, Guangdong, China
| | - Xiangcai Wei
- NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Hospital, Guangzhou, Guangdong, China
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Xingmin Zhong
- NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Hospital, Guangzhou, Guangdong, China
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
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Mawaddatina T, Budihastuti UR, Rahayu D. Waist circumference, hip circumference, arm span, and waist-to-hip ratio high risk of polycystic ovarian syndrome. Scott Med J 2021; 66:186-190. [PMID: 34661497 DOI: 10.1177/00369330211043206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS Polycystic ovarian syndrome is a reproductive problem of women with high prevalence cases accompanied by obesity conditions. Obesity condition can be seen from the size of waist circumference, hip circumference, arm span, and waist-to-hip ratio. This study aims to find out the risk factors between waist circumference size, hip circumference, arm span, and waist-to-hip ratio with polycystic ovarian syndrome. METHODS This research is an analytical observation using a case-control approach conducted at Sekar Fertility Clinic and Poly Obgyn Dr Moewardi General Hospital Surakarta. Subjects were 150 consisting of 75 polycystic ovarian syndrome women and 75 normal fertile women. Sampling techniques used in this study are purposive sampling, researchers doing anthropometric measurements in the form of waist circumference, hip circumference, arm span, and waist-to-hip ratio simultaneously. The results were analyzed using Statistic Product and Service Solution 25. RESULTS The results of the study obtained waist circumference with polycystic ovarian syndrome (b = 3.002; CI 95% = 3.41-123.5; p = 0.001), hip circumference (b = -2.671; CI 95% = 0.01-0.37; p = 0.002), arm span (b = 5.318; CI 95% = 32.23-129.58; p < 0.001) and waist-to-hip ratio (b = 1.761; CI 95% = 1.02-33.01; p = 0.047). CONCLUSION Waist circumference size, hip circumference, arm span, and waist-to-hip ratio correlate to a high risk of polycystic ovarian syndrome. Arm span is more dominant as an indicator of high risk to polycystic ovarian syndrome compared to waist circumference, hip circumference, and waist-to-hip ratio.
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Affiliation(s)
- Tazkia Mawaddatina
- Medical Faculty of Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia
| | - Uki Retno Budihastuti
- Medical Faculty of Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia.,Department of Obstetrics and Gynecology, 359613Moewardi General Hospital, Surakarta, Jawa Tengah, Indonesia
| | - Dwi Rahayu
- Medical Faculty of Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia
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Zhu S, Li Z, Hu C, Sun F, Wang C, Yuan H, Li Y. Imaging-Based Body Fat Distribution in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2021; 12:697223. [PMID: 34566888 PMCID: PMC8458943 DOI: 10.3389/fendo.2021.697223] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/19/2021] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Women with polycystic ovary syndrome (PCOS) are generally considered to be central obese and at higher risks of metabolic disturbances. Imaging methods are the golden standards for detecting body fat distribution. However, evidence based on magnetic resonance imaging (MRI) and computed tomography (CT) is conflicting. This study systematically reviewed the imaging-based body fat distribution in PCOS patients and quantitatively evaluated the difference in body fat distribution between PCOS and BMI-matched controls. METHODS PUBMED, EMBASE, and Web of Science were searched up to December 2019, and studies quantitatively compared body fat distribution by MRI, CT, ultrasound, or X-ray absorptiometry (DXA) between women with PCOS and their BMI-matched controls were included. Two researchers independently reviewed the articles, extract data and evaluated the study quality based on Newcastle-Ottawa Scale (NOS). RESULTS 47 studies were included in systematic review and 39 were eligible for meta-analysis. Compared to BMI-matched controls, higher accumulations of visceral fat (SMD 0.41; 95%CI: 0.23-0.59), abdominal subcutaneous fat (SMD 0.31; 95%CI: 0.20-0.41), total body fat (SMD 0.19; 95% CI: 0.06-0.32), trunk fat (SMD 0.47; 95% CI: 0.17-0.77), and android fat (SMD 0. 36; 95% CI: 0.06-0.66) were identified in PCOS group. However, no significant difference was identified in all the above outcomes in subgroups only including studies using golden standards MRI or CT to evaluate body fat distribution (SMD 0.19; 95%CI: -0.04-0.41 for visceral fat; SMD 0.15; 95%CI: -0.01-0.31 for abdominal subcutaneous fat). Moreover, meta-regression and subgroup analyses showed that young and non-obese patients were more likely to accumulate android fat. CONCLUSIONS PCOS women seem to have abdominal fat accumulation when compared with BMI-matched controls. However, MRI- and CT- assessed fat distribution was similar between PCOS and controls, suggesting central obesity may be independent of PCOS. These findings will help us reappraise the relationship between PCOS and abnormal fat deposition and develop specialized lifestyle interventions for PCOS patients. SYSTEMATIC REVIEW REGISTRATION PROSPERO, identifier CRD42018102983.
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Affiliation(s)
- Shiqin Zhu
- School of Medicine, Cheeloo College of Medicine, Shandong University, Ji’nan, China
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Ji’nan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Ji’nan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Ji’nan, China
| | - Zeyan Li
- School of Medicine, Cheeloo College of Medicine, Shandong University, Ji’nan, China
| | - Cuiping Hu
- School of Medicine, Cheeloo College of Medicine, Shandong University, Ji’nan, China
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Ji’nan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Ji’nan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Ji’nan, China
| | - Fengxuan Sun
- School of Medicine, Cheeloo College of Medicine, Shandong University, Ji’nan, China
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Ji’nan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Ji’nan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Ji’nan, China
| | - Chunling Wang
- Department of Anesthesiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Ji’nan, China
| | - Haitao Yuan
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ji’nan, China
- Department of Cardiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Ji’nan, China
- *Correspondence: Yan Li, ; Haitao Yuan,
| | - Yan Li
- School of Medicine, Cheeloo College of Medicine, Shandong University, Ji’nan, China
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Ji’nan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Ji’nan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Ji’nan, China
- Suzhou Research Institute, Shandong University, Suzhou, China
- *Correspondence: Yan Li, ; Haitao Yuan,
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11
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ACC/AHA 2017 definition of high blood pressure: implications for women with polycystic ovary syndrome. Fertil Steril 2019; 111:579-587.e1. [DOI: 10.1016/j.fertnstert.2018.11.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 11/21/2018] [Accepted: 11/21/2018] [Indexed: 01/22/2023]
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Wang FF, Wu Y, Zhu YH, Ding T, Batterham RL, Qu F, Hardiman PJ. Pharmacologic therapy to induce weight loss in women who have obesity/overweight with polycystic ovary syndrome: a systematic review and network meta-analysis. Obes Rev 2018; 19:1424-1445. [PMID: 30066361 DOI: 10.1111/obr.12720] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 04/29/2018] [Accepted: 05/22/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Women with polycystic ovary syndrome (PCOS) are almost three times more likely to be obese than those without PCOS. However, we have no specific interventions to induce weight loss so far and rely on drugs used to treat other symptoms of the syndrome or obesity in the general population. OBJECTIVE The objective of this study is to compare the effectiveness of metformin, inositol, liraglutide and orlistat to induce weight loss in women with PCOS and overweight/obesity. METHODS A search was conducted using the MEDLINE, EMBASE, PubMed and CENTRAL databases. Individually randomized, parallel group trials that evaluated the effects of these pharmacological treatments among adults or adolescents with PCOS and overweight/obesity, compared with a placebo or metformin group, were considered eligible. Registration number: PROSPERO CRD 42017076625. RESULTS Twenty-three trials reporting on 941 women were included in the network meta-analysis. The amount of weight lost differed significantly among the drugs (in descending order): liraglutide, orlistat and metformin. Liraglutide alone, liraglutide/metformin and metformin alone significantly reduced waist circumference, but no change was found with orlistat. Data for waist-to-hip ratio were only available for metformin, which had no significant effect. CONCLUSION Liraglutide appears superior to the other drugs in reducing weight and waist circumference.
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Affiliation(s)
- F-F Wang
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Institute of Women's Health, University College London (UCL), London, UK
| | - Y Wu
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Y-H Zhu
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - T Ding
- Department of Statistical Science, UCL, London, UK
| | - R L Batterham
- Center for Obesity Research, UCL, London, UK.,National Institute of Health Research, University College London Hospitals National Health Service (NHS) Foundation Trust (UCLH) Biomedical Research Centre, London, UK
| | - F Qu
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Institute of Women's Health, University College London (UCL), London, UK
| | - P J Hardiman
- Institute of Women's Health, University College London (UCL), London, UK
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13
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Seyyed Abootorabi M, Ayremlou P, Behroozi-Lak T, Nourisaeidlou S. The effect of vitamin D supplementation on insulin resistance, visceral fat and adiponectin in vitamin D deficient women with polycystic ovary syndrome: a randomized placebo-controlled trial. Gynecol Endocrinol 2018; 34:489-494. [PMID: 29271278 DOI: 10.1080/09513590.2017.1418311] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Low plasma 25-hydroxy-vitamin D (25OHD) is associated with polycystic ovary syndrome (PCOS). Vitamin D deficiency may contribute to the development of insulin resistance, visceral fat and low level of adiponectin which are common feature in PCOS women. This study aimed to evaluate the effect of vitamin D supplementation on insulin resistance, visceral fat, and adiponectin in hypovitaminosis D women with polycystic ovary syndrome. METHODS In this randomized, placebo-controlled clinical trial, 44 PCOS women aged 20-38 years with plasma 25OHD <20 ng/mL were randomized in the intervention or placebo groups and followed for 8 weeks. Participants received 50,000 IU of oral vitamin D3 once weekly in the intervention group or placebo. The visceral adipose tissue, Insulin resistance (HOMA-IR), HOMA-B, QUICKI, and circulating adiponectin were compared before and after the intervention within groups using paired tests and the mean changes were analyzed between two groups by independent t-test. RESULTS Of 44 eligible participates, 36 patients (81.8%) completed the study. After 8 week intervention, vitamin D supplementation compared to the placebo group significantly decreased fasting plasma glucose (FPG) (7.67 ± 7.66 versus 1.71 ± 7.50 mg/dL, p = .001) and significantly increased homeostasis model of assessment-estimated B cell function (HOMA-B) (129.76 ± 121.02 versus 48.32 ± 128.35, p = .014), Adiponectin (5.17 ± 8.09 versus -5.29 ± 8.64 mg/dL, p = .001), and serum vitamin D level (28.24 ± 6.47 versus 3.55 ± 4.25 ng/mL, p = .001). CONCLUSION Vitamin D supplementation in vitamin D deficient women with PCOS, improved the FPG, HOMA-B, Adiponectin, and serum vitamin D level.
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Affiliation(s)
- Maryam Seyyed Abootorabi
- a Department of Nutrition, School of Medicine , Urmia University of Medical Sciences , Urmia , The Islamic Republic of Iran
| | - Parvin Ayremlou
- b Clinical Research Development Unit of Imam Khomeini Hospital, Urmia University of Medical Sciences , Urmia , The Islamic Republic of Iran
| | - Tahereh Behroozi-Lak
- c Reproductive Health Research Center, Department of Infertility , Urmia University of Medical Sciences , Urmia , The Islamic Republic of Iran
| | - Sakineh Nourisaeidlou
- d Food and Beverages Safety Research Center , Urmia University of Medical Sciences , Urmia , The Islamic Republic of Iran
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14
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Santos BR, Lecke SB, Spritzer PM. Apa-I polymorphism in VDR gene is related to metabolic syndrome in polycystic ovary syndrome: a cross-sectional study. Reprod Biol Endocrinol 2018; 16:38. [PMID: 29669566 PMCID: PMC5907412 DOI: 10.1186/s12958-018-0355-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/06/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common endocrine disorder determined by polygenic traits as well as environmental factors. Lower vitamin D levels have been detected in PCOS women and related to hormone and metabolic disturbances. Vitamin D acts in tissues through the vitamin D receptor (VDR). VDR gene variants have been associated with worse metabolic profile in the general population. We investigated the genotype and haplotype distribution of the Bsm-I (rs1544410), Apa-I (rs7975232), and Taq-I (rs731236) VDR gene polymorphisms in PCOS and non-hirsute women from southern Brazil. We further investigated the associations of these gene variants and their haplotypes with PCOS, vitamin D levels, and metabolic abnormalities, including the metabolic syndrome (MetS). METHODS A group of 191 women with PCOS (Rotterdam criteria) and 100 non-hirsute controls with regular ovulatory cycles were genotyped for all polymorphisms by real-time PCR, with allelic discrimination assays. MetS and the cutoffs for its isolated components were defined in accordance with the Joint Scientific Statement. RESULTS Women with PCOS were younger and had significantly higher BMI and total testosterone levels than controls (p < 0.05). The frequency of MetS in PCOS and controls was 26.5% and 4.8% respectively. The CC genotype of Apa-I entailed higher risk of MetS in PCOS (OR: 2.133; 95% CI 1.020-4.464, p = 0.042), and was associated with higher systolic blood pressure (p = 0.009), total cholesterol (p = 0.040), and LDL-cholesterol (p = 0.038) in both PCOS and control groups (two-way ANOVA). The frequencies of VDR haplotypes were similar in PCOS and control women. CONCLUSIONS The present results suggest that the Apa-I variant in VDR gene may be associated with MetS in southern Brazilian women with PCOS, and with blood pressure, total cholesterol, and LDL-c in women with and without PCOS.
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Affiliation(s)
- Betânia Rodrigues Santos
- 0000 0001 0125 3761grid.414449.8Division of Endocrinology, Gynecological Endocrinology Unit, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-003 Brazil
- 0000 0001 2200 7498grid.8532.cDepartment of Physiology, Laboratory of Molecular Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Sheila Bunecker Lecke
- 0000 0001 0125 3761grid.414449.8Division of Endocrinology, Gynecological Endocrinology Unit, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-003 Brazil
- 0000 0004 0444 6202grid.412344.4Department of Diagnostic Methods, Universidade Federal de Ciências Médicas de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Poli Mara Spritzer
- 0000 0001 0125 3761grid.414449.8Division of Endocrinology, Gynecological Endocrinology Unit, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-003 Brazil
- 0000 0001 2200 7498grid.8532.cDepartment of Physiology, Laboratory of Molecular Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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15
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Santos BR, Lecke SB, Spritzer PM. Genetic variant in vitamin D-binding protein is associated with metabolic syndrome and lower 25-hydroxyvitamin D levels in polycystic ovary syndrome: A cross-sectional study. PLoS One 2017; 12:e0173695. [PMID: 28278285 PMCID: PMC5344505 DOI: 10.1371/journal.pone.0173695] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 02/26/2017] [Indexed: 12/22/2022] Open
Abstract
Vitamin D deficiency has been related to metabolic syndrome (MetS) in polycystic ovary syndrome (PCOS). The vitamin D-binding protein (DBP) is the main protein involved in vitamin D transport. Two single-nucleotide polymorphisms (SNPs) of the DBP gene, rs4588 and rs7041, have been associated with low circulating levels of 25-hydroxyvitamin D [25(OH)D] in various populations, but not in women with PCOS. Therefore, we determined the genotype and haplotype distribution of DBP gene polymorphisms and investigated the associations between these genetic variants and their haplotypes with PCOS, MetS, and 25(OH)D levels in women with PCOS and controls from the South of Brazil. The sample included 291 women (191 with PCOS and 100 controls). All participants were genotyped for polymorphisms rs2282679, rs4588, and rs7041. Serum 25(OH)D levels were determined in a subset of 102 participants. Women with PCOS were younger and had significantly higher body mass index, blood pressure, and insulin resistance than the control group (p<0.05). The prevalence of MetS in PCOS and controls was 26.5% and 4.8% respectively. Levels of 25(OH)D were lower in PCOS women with MetS, even after adjustment for age (p = 0.033). No associations were observed between PCOS and the polymorphisms or their haplotypes. A higher frequency of genotype TT of rs7041 was found in PCOS participants with MetS (OR: 2.21, 95%CI:1.08–4.52; p = 0.027). This same genotype was associated with lower 25(OH)D levels in both PCOS and control women (OR: 4.40, 95%CI:1.62–12.00; p = 0.002). In conclusion, these findings indicate that DBP gene polymorphisms and their haplotypes are not directly associated with PCOS. In contrast, the TT genotype of SNP rs7041 was associated with MetS in PCOS women, and with lower 25(OH)D levels in both PCOS and control groups.
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Affiliation(s)
- Betânia Rodrigues Santos
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- Laboratory of Molecular Endocrinology, Department of Physiology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Sheila Bünecker Lecke
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Diagnostic Methods, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Poli Mara Spritzer
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- Laboratory of Molecular Endocrinology, Department of Physiology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- * E-mail:
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Demir Ş, Temizkan Ş. Polikistik Over Sendromu Olan Kadınlarda Artan Lökosit Sayısının Hyperandrojenizm ve Vücut Kitle İndeksi ile İlişkisi. ANKARA MEDICAL JOURNAL 2016. [DOI: 10.17098/amj.40200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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17
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Cappy H, Giacobini P, Pigny P, Bruyneel A, Leroy-Billiard M, Dewailly D, Catteau-Jonard S. Low vitamin D3 and high anti-Müllerian hormone serum levels in the polycystic ovary syndrome (PCOS): Is there a link? ANNALES D'ENDOCRINOLOGIE 2016; 77:593-599. [PMID: 26997468 DOI: 10.1016/j.ando.2016.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 01/19/2016] [Accepted: 02/09/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Low vitamin D serum level has been reported in women with polycystic ovary syndrome (PCOS) compared to controls. A few in vitro studies showed that the bioactive form of vitamin D is able to modulate the expression of the anti-Müllerian hormone (AMH) gene. However, in vivo studies failed to demonstrate clearly whether low vitamin D3 serum level is involved in the AMH excess of PCOS. This prospective study evaluates serum vitamin D3 and AMH levels in women with PCOS and in controls, before and after vitamin D supplementation. MATERIALS AND METHODS Among vitamin D deficient patients, 23 patients with PCOS were compared to 27 women with normal ovarian reserve (NOR). The vitamin D deficient patients received a vitamin D supplementation according to the depth of their insufficiency. For the 23 patients with PCOS and the 27 controls, serum AMH assay and serum calciotropic hormone assays [25-hydroxyvitamin D (25[OH]D), 1,25 dihydroxyvitamin D (1,25[OH]2D) and parathyroid hormone (PTH)] were performed before and after supplementation. RESULTS Serum 25(OH)D levels before treatment were statistically lower in PCOS women than in NOR patients (P<0.05), even after adjustment for BMI, age and AMH level, but not after adjustment for waist circumference measurement. No difference in the serum AMH levels before and after treatment was observed neither in PCOS patients nor in NOR patients. In both groups, 25(OH)D serum levels were not related to serum AMH levels, serum 1,25(OH)2D and serum PTH levels, before and after treatment. CONCLUSION We found no evidence that serum calciotropic hormones are linked to circulating AMH levels, particularly in PCOS.
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Affiliation(s)
- Hélène Cappy
- Departments of Endocrine Gynaecology and Reproductive Medicine, Hôpital Jeanne-de-Flandre, CHRU de Lille, Faculty of Medicine, Université de Lille II, 59037 Lille, France
| | - Paolo Giacobini
- Inserm U1172 Team 2, JPARC, Université de Lille II, 59045 Lille, France
| | - Pascal Pigny
- Laboratory of Biochemistry and Hormonology, Biology Center, CHRU de Lille, 59037 Lille, France
| | - Aude Bruyneel
- Departments of Endocrine Gynaecology and Reproductive Medicine, Hôpital Jeanne-de-Flandre, CHRU de Lille, Faculty of Medicine, Université de Lille II, 59037 Lille, France
| | - Maryse Leroy-Billiard
- Departments of Endocrine Gynaecology and Reproductive Medicine, Hôpital Jeanne-de-Flandre, CHRU de Lille, Faculty of Medicine, Université de Lille II, 59037 Lille, France
| | - Didier Dewailly
- Departments of Endocrine Gynaecology and Reproductive Medicine, Hôpital Jeanne-de-Flandre, CHRU de Lille, Faculty of Medicine, Université de Lille II, 59037 Lille, France
| | - Sophie Catteau-Jonard
- Departments of Endocrine Gynaecology and Reproductive Medicine, Hôpital Jeanne-de-Flandre, CHRU de Lille, Faculty of Medicine, Université de Lille II, 59037 Lille, France; Inserm U1172 Team 2, JPARC, Université de Lille II, 59045 Lille, France.
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18
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Ramezani Tehrani F, Behboudi-Gandevani S, Simbar M, Azizi F. A population-based study of the relationship between idiopathic hirsutism and metabolic disturbances. J Endocrinol Invest 2015; 38:155-62. [PMID: 25200999 DOI: 10.1007/s40618-014-0164-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 08/13/2014] [Indexed: 12/26/2022]
Abstract
PURPOSE To evaluate the association of idiopathic hirsutism, insulin resistance and metabolic disorders. METHODS Participants of this study included 137 women with idiopathic hirsutism and 698 women as controls selected from two large population-based cross-sectional studies including 1,772 reproductive-aged women. Anthropometric and biochemical characteristics of the participants were measured and compared; for instance, insulin resistance was estimated through the homeostatic model assessment and the metabolic syndrome was detected using the Joint Interim Statement. RESULTS Mean age, body mass index and other anthropometric measures including waist and hip circumferences were statistically higher in women with idiopathic hirsutism. No differences were observed in blood pressure, glucose and lipid profiles, homeostatic model assessment or the prevalence of insulin resistance, obesity and metabolic syndrome in women with idiopathic hirsutism and controls after adjustment of age and body mass index. In the subgroup of women with metabolic syndrome, fasting glucose levels of those with idiopathic hirsutism were significantly higher than controls, after adjustment of age and body mass index as 114 ± 25.85 vs. 103.52 ± 41.90 mg/dL, P = 0.003. Furthermore, the age and body mass index-adjusted prevalence of impaired fasting glucose in women with idiopathic hirsutism were higher than controls as 16.8 vs. 4.6%, OR = 2.26, 95% CI 1.59-5.38. A threshold of 74.5 cm for waist circumference had the optimal combined sensitivity and specificity for prediction of insulin resistance in women with idiopathic hirsutism, though this value was 90.5 cm for controls. CONCLUSIONS Our data suggest that although the overall metabolic characteristics were similar in women with idiopathic hirsutism and controls, glycemic disturbances were more often seen in those suffered from metabolic syndrome and idiopathic hirsutism simultaneously.
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Affiliation(s)
- F Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 24, Parvaneh Street, Yaman Street, Velenjak, Tehran, 19395-4763, Iran.
| | - S Behboudi-Gandevani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 24, Parvaneh Street, Yaman Street, Velenjak, Tehran, 19395-4763, Iran.
| | - M Simbar
- Department of Reproductive Health, Faculty of Nursing and Midwifery, ShahidBeheshti University of Medical Science, Tehran, Iran.
| | - F Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, ShahidBeheshti University of Medical Sciences, Tehran, Iran.
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Spritzer PM, Lecke SB, Satler F, Morsch DM. Adipose tissue dysfunction, adipokines, and low-grade chronic inflammation in polycystic ovary syndrome. Reproduction 2015; 149:R219-27. [PMID: 25628442 DOI: 10.1530/rep-14-0435] [Citation(s) in RCA: 189] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Polycystic ovary syndrome (PCOS), a complex condition that affects women of reproductive age, is characterized by ovulatory dysfunction and androgen excess. Women with PCOS present higher prevalence of obesity, central adiposity, and dyslipidemia, and face increased risk of type 2 diabetes. PCOS is closely linked to functional derangements in adipose tissue. Adipocytes seem to be prone to hypertrophy when exposed to androgen excess, as experienced by women with PCOS, and both adipose tissue hypertrophy and hyperandrogenism are related to insulin resistance. Hypertrophic adipocytes are more susceptible to inflammation, apoptosis, fibrosis, and release of free fatty acids. Disturbed secretion of adipokines may also impact the pathophysiology of PCOS through their influence on metabolism and on sex steroid secretion. Chronic low-grade inflammation in PCOS is also related to hyperandrogenism and to the hypertrophy of adipocytes, causing compression phenomena in the stromal vessels, leading to adipose tissue hypoperfusion and altered secretion of cytokines. Lifestyle changes are the first-line intervention for reducing metabolic risks in PCOS and the addition of an insulin-sensitizing drug might be required. Nevertheless, there is not sufficient evidence in favor of any specific pharmacologic therapies to directly oppose inflammation. Further studies are warranted to identify an adipokine that could serve as an indirect marker of adipocyte production in PCOS, representing a reliable sign of metabolic alteration in this syndrome.
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Affiliation(s)
- Poli Mara Spritzer
- Gynecological Endocrinology UnitDivision of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, Rio Grande do Sul, BrazilLaboratory of Molecular EndocrinologyDepartment of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, 90035-003 Porto Alegre, BrazilDepartment of Diagnostic MethodsUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, 90050-170 Porto Alegre, Brazil Gynecological Endocrinology UnitDivision of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, Rio Grande do Sul, BrazilLaboratory of Molecular EndocrinologyDepartment of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, 90035-003 Porto Alegre, BrazilDepartment of Diagnostic MethodsUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, 90050-170 Porto Alegre, Brazil
| | - Sheila B Lecke
- Gynecological Endocrinology UnitDivision of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, Rio Grande do Sul, BrazilLaboratory of Molecular EndocrinologyDepartment of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, 90035-003 Porto Alegre, BrazilDepartment of Diagnostic MethodsUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, 90050-170 Porto Alegre, Brazil Gynecological Endocrinology UnitDivision of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, Rio Grande do Sul, BrazilLaboratory of Molecular EndocrinologyDepartment of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, 90035-003 Porto Alegre, BrazilDepartment of Diagnostic MethodsUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, 90050-170 Porto Alegre, Brazil
| | - Fabíola Satler
- Gynecological Endocrinology UnitDivision of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, Rio Grande do Sul, BrazilLaboratory of Molecular EndocrinologyDepartment of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, 90035-003 Porto Alegre, BrazilDepartment of Diagnostic MethodsUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, 90050-170 Porto Alegre, Brazil
| | - Debora M Morsch
- Gynecological Endocrinology UnitDivision of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, CEP 90035-003 Porto Alegre, Rio Grande do Sul, BrazilLaboratory of Molecular EndocrinologyDepartment of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, 90035-003 Porto Alegre, BrazilDepartment of Diagnostic MethodsUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, 90050-170 Porto Alegre, Brazil
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Ramos RB, Spritzer PM. FTO gene variants are not associated with polycystic ovary syndrome in women from Southern Brazil. Gene 2015; 560:25-9. [PMID: 25592819 DOI: 10.1016/j.gene.2015.01.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Revised: 01/01/2015] [Accepted: 01/05/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS Polycystic ovary syndrome (PCOS) is a common endocrine disorder, presenting polygenic traits as well as determined by environmental factors. Given the overlap between PCOS and obesity, we assessed the frequencies of SNPs rs9939609 and rs8050136 in intron 1 of the FTO gene and their haplotypes in women with PCOS and healthy controls with regular cycles from Southern Brazil and investigated their relationship with metabolic traits and endocrine parameters. SUBJECTS AND METHODS The sample comprised 298 women (199 with PCOS and 99 non-hirsute women with regular ovulatory cycles). FTO genotyping was done by real-time PCR. Haplotypes were constructed from the combination of both polymorphisms. Frequencies were inferred using PHASE 2.1.1 software. RESULTS The distribution of rs9939609 (PCOS: 32.6% TT, 45.9% TA, 21.5% AA; controls: 33.3% TT, 49.0% TA, 17.7% AA) and rs8050136 (PCOS: 21.7% AA, 43.3% AC, 35.0% CC; controls: 14.9% AA, 48.9% AC, 36.2% CC) was similar between groups. The mean age of participants was 22.7±7.1years. Women with PCOS had significantly higher BMI, waist circumference, total testosterone, and FAI vs. controls. In the PCOS group, no differences between genotypes and haplotypes were found for clinical variables. The presence of at least one risk allele for polymorphisms rs9939609 and rs8050136 was associated with higher fasting glucose levels. CONCLUSION Our findings indicate that neither the FTO rs9939609 and rs8050136 polymorphisms nor its haplotypes are related to PCOS, but suggest an association between the presence of risk alleles of SNPs rs9939609 and rs8050136 in FTO and glucose levels in women from Southern Brazil.
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Affiliation(s)
- Ramon B Ramos
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-003, Brazil
| | - Poli Mara Spritzer
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-003, Brazil; Laboratory of Molecular Endocrinology, Department of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-003, Brazil.
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Association between habitual physical activity and lower cardiovascular risk in premenopausal, perimenopausal, and postmenopausal women: a population-based study. Menopause 2014; 20:525-31. [PMID: 23615643 DOI: 10.1097/gme.0b013e318271b388] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Menopause is associated with an increased risk of cardiovascular disease. Habitual physical activity, defined as any form of body movement with energy expenditure above resting levels, may improve health parameters. We assessed the level of habitual physical activity and its effect on anthropometric measures and cardiovascular risk factors in a cohort of premenopausal, perimenopausal, and postmenopausal women. METHODS This cross-sectional study is nested on a longitudinal population-based study that was begun in 1995 in the city of Passo Fundo, Brazil. For the present analysis, 292 women were included. Anthropometric and metabolic profile was evaluated. Habitual physical activity was assessed by a digital pedometer for 7 days, and participants were stratified into active and inactive (≥6,000 and <6,000 steps/day, respectively). RESULTS The mean (SD) age was 57.1 (5.4) years. The average number of steps per day for the total sample was 5,250.7 (3,372.9): 3,472.4 (1,570.2) in the inactive group (61.8%) and 9,055.9 (3,033.4) in the active group (31.9%). A negative and statistically significant correlation was found between physical activity and smoking (P = -0.019), body mass index (P = -0.006), waist circumference (P = -0.013), and waist-to-hip ratio of 0.85 or higher (P = -0.043). Inactive women presented a higher risk of overweight/obesity (odds ratio [OR], 2.1; 95% CI, 1.233-3.622; P = 0.006) and waist circumference larger than 88 cm (OR, 1.7; 95% CI, 1.054-2.942; P = 0.03), even after adjustment for age, menopause status, smoking, and hormone therapy. Inactive women also had a higher risk of diabetes mellitus (OR, 2.7; 95% CI, 1.233-6.295; P = 0.014) and metabolic syndrome (OR, 2.5, 95% CI, 1.443-4.294; P = 0.001). CONCLUSIONS Habitual physical activity, specifically walking 6,000 or more steps daily, was associated with a decreased risk of cardiovascular disease and diabetes in middle-aged women, independently of menopause status.
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Ramos RB, Wiltgen D, Spritzer PM. Polymorphisms of TCF7L2 gene in South Brazilian women with polycystic ovary syndrome: a cross-sectional study. Eur J Endocrinol 2013; 169:569-76. [PMID: 23935130 DOI: 10.1530/eje-13-0105] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To assess whether TCF7L2 single nucleotide polymorphisms rs7903146 C/T and rs11196236 C/T are associated with polycystic ovary syndrome (PCOS) in South Brazilian women. DESIGN Cross-sectional study. METHODS Two hundred PCOS patients and 102 non-hirsute, ovulatory controls were genotyped by real-time PCR. Haplotypes were constructed from the combination of both polymorphisms. Frequencies were inferred using the PHASE 2.1.1 software. RESULTS AND CONCLUSIONS The distribution of rs7903146 (PCOS, 54.4% CC; 28.5% CT; 17.1% TT; controls, 51.0% CC; 37.0% CT; 12.0% TT) and rs11196236 (PCOS, 4.3% CC; 33.5% CT; 62.2% TT; controls, 3.2% CC; 35.5% CT; 61.3% TT) was similar between the groups. rs7903146 and rs11196236 were not in linkage disequilibrium (|D'|=0.34; r(2)=0.07). PCOS participants were younger, with higher age-adjusted BMI, waist circumference, blood pressure, triglycerides, insulin, homeostasis model assessment index to estimate insulin resistance and total testosterone, and lower HDL-C and sex hormone binding globulin vs controls. In PCOS, no differences between genotypes and haplotypes were found for clinical and metabolic variables. However, for each T (rs7903146) and T (rs11196236) allele added to the haplotypes, a variation of 5.87 cm in waist (P trend=0.01), 10.7 mg/dl in total cholesterol (P trend=0.03), and 10.3 mg/dl in LDL-C (P trend=0.01) was recorded. TCF7L2 variants are probably not implicated in PCOS development in South Brazilian women.
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Affiliation(s)
- Ramon Bossardi Ramos
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, 90035-003 Porto Alegre, RS, Brazil
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Silva TR, Alves BC, Maturana MA, Spritzer PM. Healthier Dietary Pattern and Lower Risk of Metabolic Syndrome in Physically Active Postmenopausal Women. J Am Coll Nutr 2013; 32:287-95. [DOI: 10.1080/07315724.2013.826111] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Sadat Hosseini M, Ramezani Tehrani F, Azizi F. The lack of association between idiopathic hirsutism and metabolic disturbances: Iranian PCOS Prevalence Study. Gynecol Endocrinol 2013; 29:821-5. [PMID: 23782000 DOI: 10.3109/09513590.2013.797399] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Idiopathic hirsutism (IH) is a condition diagnosed after other hirsutism related is ruled out. Its definition diagnosis had a dynamic process along with improving the understanding of the various androgen excess disorders. There is uncertainty regarding its health impact and its long-term metabolic consequences. We aimed to compare metabolic syndrome (Mets) and insulin resistance (IR) of Iranian women with IH and a group of healthy controls in a large community-based study. METHODS Anthropometric measurements, biochemical parameters, Mets (using Joint Interim Statement criteria) and IR (estimated by the homeostasis model assessment), were compared between 101 women with IH and 423 healthy controls recruited from among 1126 reproductive aged women. RESULTS There was a statistically significant difference between the BMI of women with IH in comparison to normal control (27.7 versus 26.7 kg/m(2), p = 0.02); however, the prevalence of android adiposity was similar (26.7% and 24.3%, respectively). The age and BMI adjusted prevalence of Mets and IR are similar in women with IH and controls (30% versus 23.9 and 25.7 % versus 22.5%, respectively). CONCLUSION There will be no need for additional cardiometabolic evaluations for women with IH, later in life.
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Affiliation(s)
- Mahboobeh Sadat Hosseini
- Endocrinology Department, School of Medicine, Baqiatallah University of Medical Sciences, Tehran, Iran
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Lecke SB, Morsch D, Spritzer PM. Circulating levels and subcutaneous adipose tissue gene expression of pigment epithelium-derived factor in polycystic ovary syndrome and normal women: a case control study. Reprod Biol Endocrinol 2013; 11:77. [PMID: 23941060 PMCID: PMC3751470 DOI: 10.1186/1477-7827-11-77] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 08/11/2013] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) has been recognized as a metabolic disorder, manifested by abdominal obesity, insulin resistance, dyslipidemia and hypertension. Pigment epithelium-derived factor (PEDF), a member of the serine protease inhibitor family, is a pleiotropic protein known for its antiangiogenic, antioxidant, and neuroprotective properties and has been shown to induce insulin resistance and play a role in glucose metabolism. Recent studies investigating circulating PEDF levels show elevated serum PEDF in association with insulin resistance in normal-weight women with PCOS, but not in obese PCOS patients. The aims of this study were 1) to assess PEDF gene expression in subcutaneous adipose tissue (scAT) from women with PCOS and nonhirsute, ovulatory controls, and 2) to determine the circulating levels of PEDF in these groups. METHODS Total RNA was extracted from adipose tissue biopsy samples and reverse-transcribed to cDNA. Real-time quantitative PCR was performed to determine relative gene expression levels. RESULTS The 22 women with PCOS and 14 non-PCOS controls included in the study had similar age, BMI, and fasting glucose, triglycerides, and HDL-cholesterol levels. Participants with PCOS exhibited higher 2 h oral glucose tolerance test levels (p = 0.006), total (p = 0.026) and LDL-cholesterol (p = 0.036), Ferriman-Gallwey score (p = 0.003) and total testosterone (p = 0.001) as compared to controls. BMI-adjusted PEDF serum levels and scAT gene expression were similar in the PCOS and control groups (p = 0.622 and p = 0.509, respectively). Circulating PEDF levels were not associated with scAT PEDF gene expression. Multiple regression analysis revealed that, in women with PCOS, insulin contributed positively and significantly to serum PEDF (p = 0.027), independently of testosterone. CONCLUSION Serum PEDF levels and scAT gene expression were associated with metabolic risk factors, but did not differ between women with PCOS and age- and BMI-matched controls. Circulating levels and scAT gene expression of PEDF were not associated in the study subjects, suggesting additional sources for PEDF in addition to or instead of fat tissue.
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Affiliation(s)
- Sheila B Lecke
- Division of Endocrinology, Gynecological Endocrinology Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Debora Morsch
- Division of Endocrinology, Gynecological Endocrinology Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Poli M Spritzer
- Division of Endocrinology, Gynecological Endocrinology Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Physiology, Laboratory of Molecular Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Dietary glycemic index is associated with less favorable anthropometric and metabolic profiles in polycystic ovary syndrome women with different phenotypes. Fertil Steril 2013; 100:1081-8. [PMID: 23830153 DOI: 10.1016/j.fertnstert.2013.06.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 06/03/2013] [Accepted: 06/03/2013] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To compare glycemic index (GI) in the usual diet of polycystic ovary syndrome (PCOS) and control women and to investigate whether dietary GI is associated with body composition and anthropometric and metabolic variables across PCOS phenotypes. DESIGN Cross-sectional study. SETTING University hospital outpatient clinic. PATIENT(S) Sixty-one women with PCOS and 44 nonhirsute women with ovulatory cycles. INTERVENTION(S) Metabolic work-up, biochemical and hormonal assays, assessment of body composition and rest metabolic rate, physical activity (pedometer), and food consumption (food frequency questionnaire). MAIN OUTCOME MEASURE(S) GI, glycemic load, dietary intake, and hormone and metabolic profile in PCOS versus control and in PCOS women stratified by tertiles of GI and PCOS phenotype. RESULT(S) Mean age was 23.7 ± 6.3 years. Participants with PCOS had higher body fat percentage, fasting insulin, insulin resistance, lipid accumulation product, and androgen levels compared with control women. PCOS and control women in the highest tertile of GI had higher body mass index and waist circumference than those in the lowest tertile. Dietary GI was higher in the classic PCOS group. Obesity and this more severe PCOS phenotype explained 28.3% of variance in dietary GI. CONCLUSION(S) Dietary GI is increased in the classic PCOS phenotype and associated with a less favorable anthropometric and metabolic profile. Obesity and classic PCOS phenotype are age-independent predictors of higher dietary GI.
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Radavelli-Bagatini S, de Oliveira IO, Ramos RB, Santos BR, Wagner MS, Lecke SB, Gigante DP, Horta BL, Spritzer PM. Haplotype TGTG from SNP 45T/G and 276G/T of the adiponectin gene contributes to risk of polycystic ovary syndrome. J Endocrinol Invest 2013; 36:497-502. [PMID: 23685884 DOI: 10.3275/8966] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Haplotypes of adiponectin gene single nucleotide polymorphisms (SNP) might be related to metabolic disorders. AIM To assess whether the prevalence of SNP 45T/G and 276G/T of the adiponectin gene and their haplotypes differ between polycystic ovary syndrome (PCOS) and non-hirsute cycling controls and to investigate the relationship between these haplotypes and risk factors for cardiovascular disease. SUBJECTS AND METHODS In this case-control study, 80 women with PCOS and 1500 non-hirsute controls with regular cycles underwent clinical and laboratory measurements. Genotype distribution was analyzed by conventional PCR-restriction fragment length polymorphism. RESULTS Compared to controls, PCOS women had greater body mass index (BMI) (31.0±7.9 kg/m² vs 23.4±4.6 kg/m²; p<0.001), waist circumference (92.2±18.8 cm vs 74.5±10.2 cm; p<0.001), and systolic and diastolic blood pressure (124.6±19.9 vs 111.5±13.0 mmHg and 79.2±12.5 vs 71.8±10.6 mmHg; p<0.025), as well as a worse lipid profile (p<0.007), even after adjustment for age and BMI. Genotype distribution was similar in PCOS and controls (45T/G: p=0.399; 276G/T: p=0.135). Six haplotypes were inferred and their frequencies differed significantly between the groups (p=0.001). The TGTG haplotype was more frequent in PCOS than controls (41.3 vs 18.9%). In PCOS, the GG genotype for SNP 276 (p=0.031) and the TGTG haplotype (p=0.023) were associated with higher systolic blood pressure vs other genotypes and haplotypes. Body composition, glucose, insulin, and lipid profile were similar across genotypes and haplotypes in both groups. CONCLUSIONS Haplotype TGTG from adiponectin gene variants 45T/G and 276G/T is related to susceptibility to PCOS, and might be associated with increased blood pressure in PCOS.
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Affiliation(s)
- S Radavelli-Bagatini
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, 90035-003, Porto Alegre, RS, Brazil
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The effects of drospirenone-ethinyl estradiol and drospirenone-ethinyl estradiol + metformin on ovarian ultrasonographic markers, body fat mass index, leptin, and ghrelin. Arch Gynecol Obstet 2013; 288:213-20. [DOI: 10.1007/s00404-013-2742-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 01/22/2013] [Indexed: 10/27/2022]
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Franz R, Maturana MA, Magalhães JA, Moraes RS, Spritzer PM. Central adiposity and decreased heart rate variability in postmenopause: a cross-sectional study. Climacteric 2012; 16:576-83. [PMID: 23234242 DOI: 10.3109/13697137.2012.745123] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate the impact of waist circumference (WC) on heart rate variability in 87 apparently healthy, postmenopausal women. METHODS In this cross-sectional study, time- and frequency-domain heart rate variability indices were determined at rest and during sympathetic stimulation with mental stress. Patients were stratified according to WC ≥ or < 88 cm. The mean (± standard deviation) age was 55 ± 5 years. The median time since menopause was 6 (range 1-22) years. Age and time since menopause were similar. RESULTS The mean body mass index was 27.12 ± 4.49 kg/m². Metabolic syndrome was diagnosed in 26 (29.5%) participants. Thirty-eight participants (43.6%) had hypertension. Women with WC ≥ 88 cm had higher body mass index, glucose and insulin (both fasting and after a 75-g oral glucose tolerance test), HOMA, triglycerides, and free androgen index (p < 0.05). The metabolic syndrome was more frequent in women with WC ≥ 88 cm (24.13% vs. 5.74%; p < 0.01). At rest, women with WC ≥ 88 cm presented lower vagal modulation, expressed by a reduction in the mean of all normal RR intervals (mean RR) (p < 0.01) and root mean square of successive differences of adjacent RR intervals (rMSSD) (p < 0.05) than women with WC < 88 cm. Mental stress significantly increased sympathetic modulation in both groups, expressed by reduction in high frequency (HF), increase in low frequency (LF) and LF/F ratio, and reduction in mean RR and rMSSD. CONCLUSIONS Less favorable metabolic profile and lower cardiac vagal modulation with preserved sympathetic responsiveness were found in participants with WC ≥ 88 cm, suggesting that central adiposity may be associated with decreased heart rate variability in apparently healthy, postmenopausal women.
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Affiliation(s)
- R Franz
- * Gynecological Endocrinology Unit, Division of Endocrinology
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Di Domenico K, Wiltgen D, Nickel FJ, Magalhães JA, Moraes RS, Spritzer PM. Cardiac autonomic modulation in polycystic ovary syndrome: does the phenotype matter? Fertil Steril 2012; 99:286-292. [PMID: 23025880 DOI: 10.1016/j.fertnstert.2012.08.049] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 08/19/2012] [Accepted: 08/22/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess whether heart rate variability (HRV) at rest and during sympathetic stimulation is disturbed in patients with different polycystic ovary syndrome (PCOS) phenotypes in comparison to healthy controls. DESIGN Cross-sectional study. SETTING University hospital. PATIENT(S) Thirty women with classic, anovulatory PCOS, 16 women with ovulatory PCOS, and 23 age-paired women with regular and proven ovulatory cycles. INTERVENTION(S) Anthropometric and hormonal evaluation and analysis of HRV (time and frequency domain HRV indices) at rest and after a mental stress test. MAIN OUTCOME MEASURE(S) Difference between HRV components during rest and stress. RESULT(S) Mean age was 22.80 ± 5.80 years in patients with classic PCOS, 19.81 ± 6.43 years in ovulatory PCOS, and 22.65 ± 5.89 years in controls. During mental stress, patients with classic PCOS showed lower HRV response when compared with the control group, even after adjustment for body mass index (BMI) and age. When patients with classic and ovulatory PCOS were considered together, total T levels were inversely associated with the low frequency component, low frequency/high frequency ratio, and the difference between high frequency response at rest and after the stress test. CONCLUSION(S) Young patients with the classic PCOS phenotype have an impaired autonomic modulation in response to sympathetic stimulation that is typical of considerably older women, or of advanced age.
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Affiliation(s)
- Kristhiane Di Domenico
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Denusa Wiltgen
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Fabian J Nickel
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Jose Antonio Magalhães
- Division of Gynecology and Obstetrics, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Ruy Silveira Moraes
- Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Poli Mara Spritzer
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Laboratory of Molecular Endocrinology, Department of Physiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Hormones and Women's Health, Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Porto Alegre, Brazil.
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Ramos RB, Casanova GK, Spritzer PM. Fat mass and obesity-associated gene polymorphisms do not affect metabolic response to hormone therapy in healthy postmenopausal women. Eur J Obstet Gynecol Reprod Biol 2012; 165:302-6. [PMID: 22901973 DOI: 10.1016/j.ejogrb.2012.07.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 07/06/2012] [Accepted: 07/26/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To determine whether fat mass and obesity-associated gene polymorphisms rs9939609 T>A and rs8050136 A>C or their haplotypes influence anthropometric and metabolic variables in recently postmenopausal women receiving hormone therapy. STUDY DESIGN In this randomized crossover study carried out in a university clinic, 86 postmenopausal women consulting for symptoms of estrogen deficiency were genotyped by real-time polymerase chain reaction for single nucleotide polymorphisms rs9939609 T>A and rs8050136 A>C of the fat mass and obesity-associated gene. Haplotypes were constructed from the combination of polymorphisms rs9939609 and rs8050136, and their frequencies were inferred using the PHASE 2.1.1 program. Participants were clinically evaluated before and after 6 months of hormone therapy to determine body mass index (current kg/m(2)) and waist circumference, blood pressure, lipid profile (total cholesterol, HDL cholesterol and triglycerides) plasma glucose (oral glucose tolerance test), and insulin. Blood samples were also drawn for ultra sensitive C reactive protein. The lipid accumulation product index was calculated as (waist [cm] - 58) × triglyceride concentration (mmol/L). Non-normally distributed parameters were log10 transformed before statistical analysis. Measurements at baseline and at follow-up were compared with ANOVA for repeated measures. Data were considered significant at P<0.05. RESULTS In women with the homozygous polymorphic AA genotype of the single nucleotide polymorphisms rs9939609 and the wild AA genotype of the single nucleotide polymorphisms rs8050136, lipid accumulation product index and ultra sensitive C reactive protein were higher before hormone therapy in comparison with women with other genotypes from the same single nucleotide polymorphisms group. There was no worsening of any of the anthropometric or metabolic variables, and lipid accumulation product index improved slightly after hormone therapy in SNP rs9939609 (P=0.03) and haplotype AAAA. No changes were observed after hormone therapy in SNP rs8050136. CONCLUSIONS The presence of fat mass and obesity-associated gene risk variants in healthy early postmenopausal women does not adversely affect their response to hormone therapy.
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Affiliation(s)
- Ramon B Ramos
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
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Maier PS, Spritzer PM. Aromatase gene polymorphism does not influence clinical phenotype and response to oral contraceptive pills in polycystic ovary syndrome women. Gynecol Obstet Invest 2012; 74:136-42. [PMID: 22889864 DOI: 10.1159/000339317] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 05/03/2012] [Indexed: 11/19/2022]
Abstract
AIMS To assess whether a single nucleotide polymorphism (SNP50) of the aromatase gene (CYP19) is associated with polycystic ovary syndrome (PCOS) phenotypes and to investigate the influence of this polymorphism on the response of PCOS to treatment with oral contraceptive pills (OCP). METHODS 162 hirsute women were stratified into a classic PCOS group (hyperandrogenism, ovulatory dysfunction, c-PCOS) and an ovulatory PCOS group (hyperandrogenism, ovulatory cycles, polycystic ovaries, ov-PCOS). 51 women completed a 6-month OCP trial (20 µg ethinyl estradiol + 75 µg gestodene, 21/28 days per cycle, plus 100 mg spironolactone in 32 women with moderate to severe hirsutism). We considered the presence of the polymorphic allele A (AG+AA) in comparison to the absence of the polymorphism (GG) to express results and to perform the comparisons regarding clinical variables. RESULTS Mean age was 23.3 ± 6.9 years. Hirsutism score was similar in c-PCOS and ov-PCOS (15 (11-20) vs. 13 (11-20)). The differences in hormone and metabolic variables between phenotypes were independent of the presence of allele A. In the OCP trial subsample, no differences were observed between genotypes after 6 months' treatment. CONCLUSION The differences between c-PCOS and ov-PCOS cannot be explained by the genetic variation at SNP50 in the CYP19 gene.
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Affiliation(s)
- Polyana S Maier
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Maier PS, Mattiello SS, Lages L, Spritzer PM. 17-Hydroxysteroid dehydrogenase type 5 gene polymorphism (-71A/G HSD17B5 SNP) and treatment with oral contraceptive pills in PCOS women without metabolic comorbidities. Gynecol Endocrinol 2012; 28:606-10. [PMID: 22329763 DOI: 10.3109/09513590.2011.650760] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We studied (1) the effects of oral contraceptive pills (OCPs) on hirsutism, hormonal and metabolic variables in 49 polycystic ovary syndrome patients without metabolic comorbidities and (2) the effect of 17-hydroxysteroid dehydrogenase type 5 gene polymorphism (-71A/G HSD17B5 SNP) on the response to OCP treatment. Mean age was 21.9 ± 6.5 years. Patients received monophasic OCP (20 μg ethinyl estradiol plus 75 μg gestodene), 21/28 days per cycle, during 6 months; 32 patients with severe hirsutism also received spironolactone 100 mg. The frequencies of HSD17B5 genotypes were: AA = 0.49 (55.1%), AG = 0.42 (30.6%) and GG = 0.09 (14.3%). After 6 months, body mass index and waist circumference remained unchanged regardless of the presence of allele G. A slight reduction (p < 0.05) was noted in systolic blood pressure (p < 0.05) and luteinizing hormone levels, whereas a slight increase (p < 0.05) was noted in lipids. Total testosterone and hirsutism score declined, while sex hormone binding globulin increased after OCP treatment (p < 0.05). None of these changes were associated with genotype. Insulin and homeostasis model assessment remained unchanged after treatment and did not vary according to the presence of allele G. OCP seems to ameliorate androgenic symptoms without compromising metabolic parameters. The -71A/G SNP of HSD17B5 gene did not contribute to the improvements observed.
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Affiliation(s)
- Polyana S Maier
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Brazil
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Graff SK, Alves BC, Toscani MK, Spritzer PM. Benefits of pedometer-measured habitual physical activity in healthy women. Appl Physiol Nutr Metab 2012; 37:149-56. [DOI: 10.1139/h11-145] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This cross-sectional study aimed at (i) characterizing pedometer-determined physical activity and (ii) examining its associations with dietary intake and anthropometric and metabolic profile in healthy women. Anthropometric and metabolic profile was evaluated in 68 healthy women of reproductive age. Habitual physical activity was assessed using a pedometer for 6 consecutive days, including weekends. Participants were stratified into active and inactive according to the mean steps·day–1(≥6000 and <6000, respectively). Food consumption was evaluated by 24-h recall in a subsample of 35 participants. Thirty-eight women were defined as active and had significantly lower body mass index (BMI), fat percentage, waist circumference, sum of skinfold thickness, insulin, and HOMA than the sedentary group. Mean BMI was 27 kg·m–2(overweight) in active participants and 31 kg·m–2(class I obesity) in inactive participants. Active women consumed more carbohydrates (55.5% ± 9.4% vs. 46.3% ± 7.6%) and calories (2138 ± 679 vs. 1664 ± 558 kcal), and less protein (15.4% ± 4.2% vs. 19.9% ± 5.8%) and lipids (29.0% ± 7.2% vs. 33.8% ± 6.2%) than inactive individuals (p < 0.05). Fiber, cholesterol, and fatty acid intake was similar in both groups. The number of steps was lower on Sunday than on weekdays for the overall group. Using a pedometer for 3 days was sufficient to determine habitual physical activity (sensitivity: 94%; specificity 91% vs. 6 days of pedometer use). In the present study, nonstructured physical activity was associated with more adequate dietary consumption and contributed toward a healthier anthropometric and metabolic profile in young women, despite the high prevalence of overweight.
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Affiliation(s)
- Scheila Karen Graff
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- National Institute of Hormones and Women’s Health, CNPq, Porto Alegre, Brazil
| | - Bruna Cherubini Alves
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Laboratory of Molecular Endocrinology, Department of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Mariana Kirjner Toscani
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- National Institute of Hormones and Women’s Health, CNPq, Porto Alegre, Brazil
| | - Poli Mara Spritzer
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- National Institute of Hormones and Women’s Health, CNPq, Porto Alegre, Brazil
- Laboratory of Molecular Endocrinology, Department of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Toscani MK, Mario FM, Radavelli-Bagatini S, Wiltgen D, Matos MC, Spritzer PM. Effect of high-protein or normal-protein diet on weight loss, body composition, hormone, and metabolic profile in southern Brazilian women with polycystic ovary syndrome: a randomized study. Gynecol Endocrinol 2011; 27:925-30. [PMID: 21627406 DOI: 10.3109/09513590.2011.564686] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of the present study was to assess the effects of a high protein (HP) and a normal protein (NP) diet on patients with polycystic ovary syndrome (PCOS) and body mass index-matched controls in a sample of southern Brazilian women. This 8-week randomized trial was carried out at a university gynecological endocrinology clinic and included 18 patients with PCOS and 22 controls. Changes in weight, body composition, hormone, and metabolic profile were analyzed in women randomized to receive HP (30% protein, 40% carbohydrate, and 30% lipid) or NP (15% protein, 55% carbohydrate, and 30% lipid). The energy content was estimated for each participant at 20-25 kcal/kg current weight/day. Physical activity, blood pressure, homeostasis model assessment (HOMA) index, and fasting and 2-h glucose and insulin remained stable during the intervention in PCOS and controls, even in the presence of weight loss. There were no changes in lipid profile in either group. In contrast, body weight, body mass index (BMI), waist circumference, percent of body fat, and sum of trunk skinfolds decreased significantly after both diets in both groups. Total testosterone also decreased in PCOS and controls regardless of diet. In conclusion, calorie reduction, rather than protein content, seemed to affect body composition and hormonal profile in this short-term study. These findings emphasize the role of non-pharmacological interventions to reduce weight and ameliorate the anthropometric and clinical phenotype in PCOS.
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Affiliation(s)
- Mariana K Toscani
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Lecke SB, Morsch DM, Spritzer PM. CYP19 gene expression in subcutaneous adipose tissue is associated with blood pressure in women with polycystic ovary syndrome. Steroids 2011; 76:1383-8. [PMID: 21807013 DOI: 10.1016/j.steroids.2011.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 06/14/2011] [Accepted: 07/16/2011] [Indexed: 12/29/2022]
Abstract
In polycystic ovary syndrome (PCOS), hypertension has been linked to androgen excess and insulin resistance. Aromatase, an enzyme encoded by the CYP19 gene, affects androgen metabolism and estrogen synthesis, influencing the androgen to estrogen balance. We characterized CYP19 gene expression in subcutaneous adipose tissue of women with PCOS and normal controls and evaluated the association between subcutaneous fat CYP19 mRNA, circulating hormone levels, and blood pressure. This case-control study was carried out with 31 PCOS patients and 27 BMI-matched normotensive non-hirsute women with regular cycles. Participants underwent anthropometric measurements, collection of blood samples, and adipose tissue biopsy (28 PCOS and 19 controls). Hypertension was defined as systolic blood pressure ≥ 130 mmHg and/or diastolic blood pressure ≥ 85 mmHg. PCOS patients were divided into normotensive and hypertensive. Main outcome measures were serum estrogen and androgen levels, estrogen-to-androgen ratio, and CYP19 gene expression in subcutaneous fat. Subcutaneous CYP19 mRNA was higher in hypertensive PCOS than in control and normotensive PCOS women (p = 0.014). Estrogen-to-androgen ratio was lower in hypertensive PCOS than controls (p < 0.003). Estrogen-to-androgen ratio ≤ 0.06 (median for the three groups) was observed in 91% of hypertensive PCOS women, vs. 37% and 61% in the control and normotensive PCOS groups (p = 0.011). CYP19 gene expression in subcutaneous fat of PCOS patient correlated positively with systolic (p = 0.006) and diastolic blood pressure (p = 0.009). Androgen excess and hyperinsulinemia may play a role in the molecular mechanisms that activate aromatase mRNA transcription in abdominal fat tissue.
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Affiliation(s)
- Sheila B Lecke
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre and National Institute of Hormones and Women's Health-CNPq, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-003, Brazil.
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Ramos RB, Casanova GK, Maturana MA, Spritzer PM. Variations in the fat mass and obesity-associated (FTO) gene are related to glucose levels and higher lipid accumulation product in postmenopausal women from southern Brazil. Fertil Steril 2011; 96:974-9. [PMID: 21868005 DOI: 10.1016/j.fertnstert.2011.07.1148] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2011] [Revised: 07/26/2011] [Accepted: 07/27/2011] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To test the association between polymorphisms rs9939609 T>A and rs8050136 A>C of the fat mass and obesity-associated (FTO) gene and metabolic and cardiovascular variables in postmenopause. DESIGN Cross-sectional study. SETTING University hospital. PATIENT(S) A total of 135 postmenopausal women (mean age 52 ± 4 years). INTERVENTION(S) Anthropometric measurements and collection of blood samples. MAIN OUTCOME MEASURE(S) Blood pressure, metabolic variables, and FTO genotype. RESULT(S) The frequency of polymorphism rs9939609 was 43.7% for the wild TT genotype, 43.0% for TA, and 13.3% for AA. The frequency of the rs8050136 polymorphism was 12.6% for the wild AA genotype, 39.3% for AC, and 48.1% for CC. The polymorphic AA genotype of the SNP rs9939609 was associated with higher glucose levels and lipid accumulation product (LAP) index, whereas the wild AA genotype of the SNP rs8050136 was associated with higher LAP. CONCLUSION(S) The rs9939609 polymorphism in the FTO gene is related to abnormal glucose levels and with LAP, a surrogate marker of diabetes and cardiovascular risk in postmenopause. Further studies are needed in different ethnic backgrounds to confirm the clinical relevance of these associations.
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Affiliation(s)
- Ramon Bossardi Ramos
- Gynecologic Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Lecke SB, Mattei F, Morsch DM, Spritzer PM. Abdominal subcutaneous fat gene expression and circulating levels of leptin and adiponectin in polycystic ovary syndrome. Fertil Steril 2011; 95:2044-9. [DOI: 10.1016/j.fertnstert.2011.02.041] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Revised: 02/18/2011] [Accepted: 02/21/2011] [Indexed: 12/15/2022]
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Toscani MK, Mario FM, Radavelli-Bagatini S, Spritzer PM. Insulin resistance is not strictly associated with energy intake or dietary macronutrient composition in women with polycystic ovary syndrome. Nutr Res 2011; 31:97-103. [DOI: 10.1016/j.nutres.2011.01.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 12/29/2010] [Accepted: 01/24/2011] [Indexed: 10/18/2022]
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Variation in metabolic and cardiovascular risk in women with different polycystic ovary syndrome phenotypes. Fertil Steril 2010; 94:2493-6. [DOI: 10.1016/j.fertnstert.2010.02.015] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2009] [Revised: 02/03/2010] [Accepted: 02/04/2010] [Indexed: 11/21/2022]
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Manu P, Tsang J, Napolitano BA, Lesser ML, Correll CU. Predictors of insulin resistance in the obese with metabolic syndrome. Eur J Intern Med 2010; 21:409-13. [PMID: 20816595 DOI: 10.1016/j.ejim.2010.05.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 04/28/2010] [Accepted: 05/02/2010] [Indexed: 01/22/2023]
Abstract
BACKGROUND In the obese, the metabolic syndrome (MetS) is assumed to reflect insulin resistance. OBJECTIVE To determine the predictors of insulin resistance in obese subjects with MetS. DESIGN We used the 90th percentile of the homeostasis model assessment (HOMA) to define insulin resistance in 4958 nondiabetic adults evaluated in the National Health and Nutrition Examination Surveys, 1999-2004, and compared the 373 obese subjects who were insulin-resistant (HOMA 9.52+/-5.73) to a control group of 373 obese who had the highest sensitivity to insulin (HOMA 1.79+/-0.44). MEASUREMENTS MetS was present in 312 (83.6%) obese with insulin resistance and in 156 (41.8%) obese from the insulin-sensitive control group. Demographic, metabolic, and lifestyle variables were analyzed with logistic regression. RESULTS In a logistic model of insulin resistance given the presence of MetS, the significant predictors were triglycerides (P=0.0021), body mass index (P=0.0096), HDL-cholesterol (P=0.0098), age (P=0.0242) and smoking (P=0.0366). LIMITATIONS Cross-sectional design prevents elucidation of causality for the association between insulin resistance and MetS. CONCLUSIONS Insulin resistance is not an obligatory correlate of MetS in the obese. Its likelihood can be predicted by cigarette smoking and by the severity of obesity and dyslipidemia.
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Affiliation(s)
- Peter Manu
- The Zucker Hillside Hospital, 59-75 263rd Street, Glen Oaks, NY 11004, USA.
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Influence of habitual physical activity on body composition, fat distribution and metabolic variables in early postmenopausal women receiving hormonal therapy. Eur J Obstet Gynecol Reprod Biol 2010; 150:52-6. [DOI: 10.1016/j.ejogrb.2010.02.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2009] [Revised: 12/24/2009] [Accepted: 02/02/2010] [Indexed: 11/21/2022]
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Maturana MA, Rubira MC, Consolim-Colombo F, Irigoyen MC, Spritzer PM. Androgenicity and venous endothelial function in post-menopausal women. J Endocrinol Invest 2010; 33:239-43. [PMID: 19820294 DOI: 10.1007/bf03345786] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Endothelial dysfunction is one of the early signs of cardiovascular damage. High androgen levels have been related to inflammatory endothelial markers in pre- and post-menopausal women. AIM This cross-sectional study aimed at investigating whether free androgen index (FAI) [estimated by dividing total testosterone (nmol/l) by SHBG (nmol/l) x 100] is related to endothelial function during post-menopause. SUBJECTS AND METHODS Twenty-six post-menopausal women were assessed with the dorsal hand vein compliance technique. Acetylcholine (Ach) and sodium nitroprusside (SNP) dose-response curves were constructed to test endothelium-dependent and independent relaxation, respectively. RESULTS Mean age was 54 yr (+/-4) and median time since menopause was 6 yr (interquartile range: 3-9). Patients were stratified according to FAI levels into two groups: FAI greater than or less than the group median of 2.5. Waist-to-hip ratio (WHR) was significantly higher in the group with FAI>2.5, as well as median dose of Ach for maximal vasodilation [720 (360-3600) ng/min with FAI>2.5 vs 36 (0.36-360) ng/min with FAI<or=2.5; p=0.005]. Maximal vasodilation with SNP was similar in both groups. Positive correlations were observed between Ach doses and maximal vasodilation and FAI (r=0.473, p=0.015), waist (r=0.510, p= 0.011), and WHR (r=0.479, p=0.021). SHBG was negatively correlated with Ach doses (rs=-0.400, p=0.043). CONCLUSIONS This study suggests that FAI, even within normal limits, is related to early changes in endothelial function in healthy post-menopausal women. Longitudinal studies are required to determine the clinical relevance of these findings.
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Affiliation(s)
- M A Maturana
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clinicas of Porto Alegre, CEP 90035-003, Porto Alegre, RS, Brazil
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Orsatti FL, Nahas EAP, Nahas-Neto J, Maesta N, Orsatti CL, Vespoli HDL, Traiman P. Association between anthropometric indicators of body fat and metabolic risk markers in post-menopausal women. Gynecol Endocrinol 2010; 26:16-22. [PMID: 19701839 DOI: 10.3109/09513590903184076] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE to evaluate anthropometric indicators of body fat and their association with metabolic risk markers in postmenopausal women. METHODS A cross-sectional study with 80 Brazilian women (40-70 years) was carried out. Body mass index (BMI = weight/height(2)), waist circumference (WC) and waist-to-hip ratio (WHR) were obtained for anthropometric evaluation. Trunk fat mass (TFM) was measured by dual-energy X-ray absorptiometry. The following metabolic variables were evaluated: total cholesterol (TC), HDL, LDL, triglycerides (TG), as well as glycemia and insulin to determine insulin resistance (HOMA-IR). RESULTS Overweight and obesity were observed in 81% of the women. Values of WC >88 cm were observed in 68.5% of the women. On average, TC, LDL and TG levels were above normal levels in 60, 50 and 42.5% of the women, respectively; and HDL was normal in 82.5%. IR was observed in 37.5% of the women. Positive correlations were found between anthropometric indicators and TFM (P < 0.05). WC was most correlated with TFM (r = 0.92), followed by BMI (r = 0.88) and by WHR (r = 0.48; P < 0.05). All anthropometric indicators and TFM showed significant negative correlations with HDL and significant positive correlations with HOMA-IR (P < 0.05). Only WHR was significantly associated with dysglycemia (R(2) = 12%), hypertriglyceridemia (R(2) = 17%) and decreased HDL (R(2) = 27%). WC was significantly associated with HOMA-IR (R(2) = 34%). CONCLUSION WC and WHR are anthropometric measures that showed strong correlation with TFM and with metabolic risk markers in postmenopausal women.
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Affiliation(s)
- Fabio Lera Orsatti
- Department of Gynecology and Obstetrics, Botucatu Medical School, UNESP, Sao Paulo State University, Botucatu, Sao Paulo, Brazil
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Sourris KC, Lyons JG, de Courten MP, Dougherty SL, Henstridge DC, Cooper ME, Hage M, Dart A, Kingwell BA, Forbes JM, de Courten B. c-Jun NH2-terminal kinase activity in subcutaneous adipose tissue but not nuclear factor-kappaB activity in peripheral blood mononuclear cells is an independent determinant of insulin resistance in healthy individuals. Diabetes 2009; 58:1259-65. [PMID: 19258436 PMCID: PMC2682665 DOI: 10.2337/db08-1725] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Chronic low-grade activation of the immune system (CLAIS) predicts type 2 diabetes via a decrease in insulin sensitivity. Our study investigated potential relationships between nuclear factor-kappaB (NF-kappaB) and c-Jun NH(2)-terminal kinase (JNK) pathways-two pathways proposed as the link between CLAIS and insulin resistance. RESEARCH DESIGN AND METHODS Adiposity (dual-energy X-ray absorptiometry), waist-to-hip ratio (WHR), and insulin sensitivity (M, hyperinsulinemic-euglycemic clamp) were measured in 22 healthy nondiabetic volunteers (aged 29 +/- 11 years, body fat 28 +/- 11%). NF-kappaB activity (DNA-binding assay) and JNK1/2 activity (phosphorylated JNK) were assessed in biopsies of the vastus lateralis muscle and subcutaneous adipose tissue and in peripheral blood mononuclear cell (PBMC) lysates. RESULTS NF-kappaB activities in PBMCs and muscle were positively associated with WHR after adjustment for age, sex, and percent body fat (both P < 0.05). NF-kappaB activity in PBMCs was inversely associated with M after adjustment for age, sex, percent body fat, and WHR (P = 0.02) and explained 16% of the variance of M. There were no significant relationships between NF-kappaB activity and M in muscle or adipose tissue (both NS). Adipose-derived JNK1/2 activity was not associated with obesity (all P> 0.1), although it was inversely related to M (r = -0.54, P < 0.05) and explained 29% of its variance. When both NF-kappaB and JNK1/2 were examined statistically, only JNK1/2 activity in adipose tissue was a significant determinant of insulin resistance (P = 0.02). CONCLUSIONS JNK1/2 activity in adipose tissue but not NF-kappaB activity in PBMCs is an independent determinant of insulin resistance in healthy individuals.
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Affiliation(s)
- Karly C. Sourris
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Jasmine G. Lyons
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | | | | | | | - Mark E. Cooper
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Michelle Hage
- Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Anthony Dart
- Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia
| | | | | | - Barbora de Courten
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Corresponding author: Barbora de Courten,
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Wiltgen D, Benedetto IG, Mastella LS, Spritzer PM. Lipid accumulation product index: a reliable marker of cardiovascular risk in polycystic ovary syndrome. Hum Reprod 2009; 24:1726-31. [PMID: 19329517 DOI: 10.1093/humrep/dep072] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Metabolic disturbances are common features of polycystic ovary syndrome (PCOS), which possibly enhance the risk of cardiovascular disease. The aim of this study was to assess the accuracy of lipid accumulation product (LAP) index as a marker of cardiovascular risk in PCOS patients. METHODS Case-control study including 51 PCOS patients aged between 14 and 35 years and 44 body mass index (BMI) and age-matched controls. Measures included the LAP index, homeostasis model assessment (HOMA) index, glucose tolerance and plasma hormones, cholesterols and triglycerides. RESULTS LAP index was positively correlated with HOMA index in all subjects (r = 0.70; P < 0.001). Waist circumference (WC) (P = 0.002), HOMA index (P < 0.001) and LAP index (P = 0.035) were higher in PCOS patients than controls. On receiver operating characteristic curve analysis, an LAP index of 34.5 (sensitivity: 84%; specificity 79%) showed a better performance than non-high-density lipoprotein cholesterol, WC or BMI to identify insulin resistance (IR) in all subjects. In PCOS patients, the positive and negative predictive values for LAP > or = 34.5 were 91 and 74%, respectively, compared with 73 and 61%, respectively, for WC > or =80 cm, and 43 and 20%, respectively, for WC > or =88 cm. CONCLUSIONS We have confirmed that IR is more common in PCOS than BMI-matched control women. Furthermore, the LAP index, an easily obtainable measure, is associated with HOMA index and an LAP > or = 34.5 is an additional risk factor for cardiovascular disease in PCOS patients.
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Affiliation(s)
- D Wiltgen
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Maturana MA, Breda V, Lhullier F, Spritzer PM. Relationship between endogenous testosterone and cardiovascular risk in early postmenopausal women. Metabolism 2008; 57:961-5. [PMID: 18555838 DOI: 10.1016/j.metabol.2008.02.012] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Accepted: 02/29/2008] [Indexed: 10/21/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of death among postmenopausal women. Changes in endothelial function play an important role in the pathophysiology of atherosclerosis, and evidence suggests that interventions to improve endothelial function could modify the rates of progression and the risk of cardiovascular events. In addition, a positive association between markers of endothelial dysfunction and androgenicity has been described in women with polycystic ovary syndrome, suggesting a correlation with the early-onset endothelial dysfunction found in these patients. We performed a cross-sectional study to verify whether endogenous testosterone levels are correlated with markers of inflammation and endothelial function and with anthropometric and metabolic profile in 53 postmenopausal women. Serum testosterone, sex hormone-binding globulin, C-reactive protein (CRP), fibrinogen, and plasma endothelin-1 (ET-1) were determined. Patients were stratified into 2 groups (higher or lower than the mean testosterone levels of the studied sample). Mean age was 55 years (+/-5), and median time since menopause was 5.5 years (interquartile range, 3-8 years). Body mass index and waist circumference were significantly higher in the group with testosterone levels >or=0.49 ng/mL. Median CRP levels were greater in the group with higher testosterone levels (1.17 [0.17-2.36] vs 0.17 [0.17-0.61] mg/L, P = .039). Median ET-1 levels were also higher in women with greater testosterone levels (0.84 [0.81-0.97] vs 0.81 [0.74-0.84] pg/mL, P = .023). An association of testosterone with CRP (r = 0.416, P = .004) and ET-1 (r = 0.323, P = .031) was observed. This association was dependent on homeostasis model assessment index for ET-1 but not CRP. Testosterone was also associated with waist circumference and blood pressure (P = .001). These data suggest that endogenous testosterone levels in recently postmenopausal women may be part of a proatherogenic profile. Longitudinal studies are needed to assess if androgenicity represents a risk factor for cardiovascular disease and the clinical relevance of its association with ET-1 and CRP in this population.
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Affiliation(s)
- Maria Augusta Maturana
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, 90050-170 Porto Alegre, RS, Brazil
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