Weight loss and vascular inflammatory markers in overweight women with and without polycystic ovary syndrome

Alcohol Drinks Induce Acute Lowering in Circulating l-Arginine in Obese and Type 2 Diabetic Subjects

Since low serum l-arginine (Arg) and high asymmetric dimethylarginine (ADMA) can predict microvascular complications in type 2 diabetes mellitus (T2DM), we tested whether Arg and ADMA are affected by diet and physical activity in overweight/obese and T2DM subjects. We tested the effects on serum Arg and ADMA of single loads of dextrose, protein, fat, or alcohol (∼300 calories each); one episode of physical exercise; and 12 weeks of standard lifestyle modification (dietary and physical activity counseling). Alcohol drink was followed by ∼30% lowering in Arg. Arg and ADMA increased after a protein load but remained stable after glucose or fat load or 30 min of treadmill walk. Following 12 weeks of lifestyle modification, ADMA declined only in subjects achieving weight loss >5%. In conclusion, alcohol is a previously unrecognized acute suppressor of serum Arg. Lifestyle modification lowers ADMA in subjects who achieve weight loss >5%. Clinical Trial Registration Number: NCT04406402.

The effects of empagliflozin vs metformin on endothelial microparticles in overweight/obese women with polycystic ovary syndrome

CONTEXT

Endothelial microparticles (EMPs) are novel, surrogate biomarkers of endothelial function and have been shown to be elevated in women with polycystic ovary syndrome (PCOS). It remains poorly understood how pharmacological options for managing PCOS affect EMP levels.

OBJECTIVE

To characterise and compare the effects of empagliflozin vs metformin on the circulating levels of EMPs in overweight/obese women with PCOS.

METHODS

This was a randomised, comparative, 12-week single-centre trial conducted at the Academic Diabetes, Endocrinology and Metabolism Research Centre, Hull, UK. This analysis includes data from 39 overweight/obese women with PCOS who completed the study and were randomised to empagliflozin (15 mg/day) (n = 19) or metformin (1500 mg/day) (n = 20). Blood samples were collected at baseline and 12 weeks after treatment and analysed for specific surface proteins (ICAM-1, VCAM-1, PECAM-1, E-selectin and endoglin) expressed by circulating EMPs using flow cytometry.

RESULTS

In the empagliflozin group, ICAM-1 (P = 0.006), E-selectin (P = 0.016) and VCAM-1 (P = 0.001) EMPs increased significantly following 12 weeks of treatment, but no changes were seen in PECAM-1 (P = 0.93) or endoglin (P = 0.13) EMPs. In the metformin group, VCAM-1 EMPs (P < 0.001) increased significantly after 12 weeks of treatment, whereas all other EMPs remained unchanged. When data were expressed as percentage change from baseline in each group, no significant differences were seen between groups for any biomarker (P-values from 0.22 to 0.80).

CONCLUSIONS

Short-term administration of empagliflozin and metformin in overweight/obese women with PCOS appear to increase EMPs expressed by endothelial cells during their activation.

Midlife women's health consequences associated with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is one of the most common female endocrinopathies. Its symptoms may appear as early as adolescence and may include irregular menstrual periods, amenorrhea, hirsutism and obesity. Regardless of their phenotypic appearance, women with PCOS are metabolically obese. PCOS is associated with metabolic syndrome, type 2 diabetes, depression, cardiovascular disease and gynecological cancers. The metabolic disorders in obese women with PCOS are invariably due to insulin resistance, while inflammation, oxidative stress and possible interaction with environmental factors are among the features linking women with PCOS alone to metabolic disorders. The current review aims to highlight the relationship between PCOS and midlife women's health complications.

Does a restricted energy low glycemic index diet have a different effect on overweight women with or without polycystic ovary syndrome?

BACKGROUND

Obese women with polycystic ovary syndrome (PCOS) may face additional barriers in achieving weight loss. We aimed to compare the effects of the hypocaloric low glycemic index (LGI) diet on anthropometric variables and insulin resistance in women with and without PCOS and investigate the effect of this diet on the clinical and hormonal features of PCOS women.

METHODS

This interventional study was carried out at the Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Of 108 women invited for the purpose of the present study, 62 participants (PCOS = 28, non-PCOS = 34) followed a 24-week energy restricted LGI diet. Anthropometric, biochemical, hormonal and clinical measurements were documented at baseline, 12 weeks and 24 weeks with intervention.

RESULTS

The percentages of weight loss achieved by both the PCOS and non-PCOS groups did not differ significantly (PCOS: -8.04% vs. non-PCOS: -8.09%). No significant difference in decrease of homeostatic model assessment of insulin resistance (HOMA-IR) was observed between the two groups (PCOS = - 0.83 ± 0.33, non PCOS = - 0.79 ± 0.28, P = 0.83). In PCOS women, significant reduction in total testosterone (- 0.91 ± 0.33 nmol/L, P = 0.006), FAI (- 4.47 ± 1.1, P < 0.001) and increase in SHBG (38.98 ± 11.02 nmol/L, P < 0.001) were observed. Menstrual irregularity was improved in 80% of women with PCOS and a significant decrease (32.1%) in occurrence of acne was reported.

CONCLUSIONS

This diet has equally beneficial effects on anthropometric and metabolic characteristics of overweight women with and without PCOS.

TRIAL REGISTRATION

This study is registered in the Iranian Randomized Clinical Trials Registry (IRCT, code: IRCT2016092129909N1 ).

Genome-wide DNA methylation and gene expression patterns provide insight into polycystic ovary syndrome development

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women. However, the epigenetic mechanism involved in PCOS progression remains largely unknown. Here, combining the DNA methylation profiling together with transcriptome analysis, we showed that (i) there were 7929 differentially methylated CpG sites (β > 0.1, P < 0.05) and 650 differential transcripts (fold change > 1.5, P < 0.005) in PCOS compared to normal ovaries; (ii) 54 genes were identified with methylated levels that were correlated with gene transcription in PCOS; and (iii) there were less hypermethylated sites, but many more hypomethylated sites residing in CpG islands and N_Shore in PCOS. Among these genes, we identified that several significant pathways, including the type I diabetes mellitus pathway, p53 signaling pathway and NOD-like receptor signaling pathway, and some immune and inflammatory diseases may be highly involved in PCOS development. These results suggested that differences in genome-wide DNA methylation and expression patterns exist between PCOS ovaries and normal ovaries; epigenetic mechanisms may in part be responsible for the different gene expression and PCOS phenotype. All of this may improve our understanding of the basic molecular mechanism underlying the development of PCOS.