1
|
Moretti C, Bonomi M, Dionese P, Federici S, Fulghesu AM, Giannelli J, Giordano R, Guccione L, Maseroli E, Moghetti P, Mioni R, Pivonello R, Sabbadin C, Scaroni C, Tonacchera M, Verde N, Vignozzi L, Gambineri A. Inositols and female reproduction disorders: a consensus statement from the working group of the Club of the Italian Society of Endocrinology (SIE)-Women's Endocrinology. J Endocrinol Invest 2024:10.1007/s40618-024-02363-w. [PMID: 39009925 DOI: 10.1007/s40618-024-02363-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 03/09/2024] [Indexed: 07/17/2024]
Abstract
PURPOSE To provide the latest scientific knowledge on the efficacy of inositols for improving reproductive disorders in women with and without polycystic ovary syndrome (PCOS) and to reach a consensus on their potential use through a Delphi-like process. METHODS A panel of 17 endocrinologists and 1 gynecologist discussed 4 key domains: menses irregularity and anovulation, fertility, pregnancy outcomes, and neonatal outcomes. RESULTS A total of eight consensus statements were drafted. Myo-inositol (Myo) supplementation can be used to improve menses irregularities and anovulation in PCOS. Myo supplementation can be used in subfertile women with or without PCOS to reduce the dose of r-FSH for ovarian stimulation during IVF, but it should not be used to increase the clinical pregnancy rate or live birth rate. Myo supplementation can be used in the primary prevention of gestational diabetes mellitus (GDM), but should not be used to improve pregnancy outcomes in women with GDM. Myo can be preconceptionally added to folic acid in women with a previous neural tube defects (NTD)-complicated pregnancy to reduce the risk of NTDs in newborns. Myo can be used during pregnancy to reduce the risk of macrosomia and neonatal hypoglycemia in mothers at risk of GDM. CONCLUSION This consensus statement provides recommendations aimed at guiding healthcare practitioners in the use of inositols for the treatment or prevention of female reproductive disorders. More evidence-based data are needed to definitively establish the usefulness of Myo, the appropriate dosage, and to support the use of D-chiro-inositol (DCI) or a definitive Myo/DCI ratio.
Collapse
Affiliation(s)
- Costanzo Moretti
- Department of Systems' Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marco Bonomi
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
- Department of Endocrine and Metabolic Diseases, IRCCS Instituto Auxologico Italiano, Milan, Italy
| | - Paola Dionese
- Division of Endocrinology and Diabetes Prevention and Care, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
| | - Silvia Federici
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
- Department of Endocrine and Metabolic Diseases, IRCCS Instituto Auxologico Italiano, Milan, Italy
| | - Anna Maria Fulghesu
- Department of Surgical Science, Duilio Casula Hospital, University of Cagliari, Monserrato, Cagliari, Italy
| | - Jacopo Giannelli
- Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Roberta Giordano
- Department of Biological and Clinical Sciences, University of Turin, Turin, Italy
| | - Laura Guccione
- Department of Systems' Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Elisa Maseroli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences, Mario Serio Careggi University Hospital, Florence, Italy
| | - Paolo Moghetti
- Unit of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Verona, Italy
| | - Roberto Mioni
- Department of Medicine, Clinica Medica 3-Azienda Ospedaliera, University of Padua, Padua, Italy
| | - Rosario Pivonello
- Dipartimento di Medicina Clinica e Chirurgica, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy
| | - Chiara Sabbadin
- Endocrinology Unit, Department of Medicine (DIMED), University Hospital of Padua, Padua, Italy
| | - Carla Scaroni
- Endocrinology Unit, Department of Medicine (DIMED), University Hospital of Padua, Padua, Italy
| | - Massimo Tonacchera
- Department of Endocrinology, Pisa University Hospital of Cisanello, Azienda Ospedaliera Universitaria, Pisa, Italy
| | - Nunzia Verde
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Diabetologia, Andrologia e Nutrizione, Unità di Andrologia e Medicina della Riproduzione, Sessualità e Affermazione di Genere, Università Federico II di Napoli, Naples, Italy
| | - Linda Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences, Mario Serio Careggi University Hospital, Florence, Italy
| | - Alessandra Gambineri
- Division of Endocrinology and Diabetes Prevention and Care, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy.
| |
Collapse
|
2
|
Tian M, Yuan J, He P, Yu F, Long C, Zha Y. Lean-to-fat tissue ratio as a risk factor for cognitive impairment in patients undergoing maintenance hemodialysis. J Psychosom Res 2023; 174:111464. [PMID: 37757523 DOI: 10.1016/j.jpsychores.2023.111464] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/02/2023] [Accepted: 08/14/2023] [Indexed: 09/29/2023]
Abstract
OBJECTIVE The relationship between body mass index (BMI) and cognitive impairment (CI) remains controversial, and no research has been done to explore the effect of lean-to-fat (L/F) tissue ratio on the risk of CI in patients undergoing maintenance hemodialysis (MHD) so far. This study aimed to explore the effect of L/F tissue ratio on the risk of incident CI in patients undergoing MHD. METHODS In this observational cohort study, 3356 patients were recruited and followed up for a median of 2 years. Global cognitive function was measured using Mini-Mental State Examination score. Lean tissue mass (LTM) and fat tissue mass (FTM) were analyzed using body composition monitor based on bioimpedance spectroscopy (BCM-BIS), and L/F tissue ratio was calculated by LTM divided by FTM. Hazard ratios (HRs) for incident CI were determined by Cox regression. RESULTS The median age of the cohort was 55 years, and 68.7% patients were less educated. During the follow-up period, 1249 patients (37.2%) experienced incident CI. Patients with lower L/F tissue ratios had significantly higher risks of CI (HR 1.51, 95% confidence interval 1.24-1.84; p < 0.001) than those with higher L/F tissue ratios. The association between L/F tissue ratio and incident CI persisted in all subgroups stratified by sex, age, education status, especially in older and less educated participants. Both in all our patients and subgroups, BMI and CI occurrence were not independently relevant. CONCLUSION The L/F tissue ratio rather than BMI was an independent risk factor of incident cognitive impairment in patients undergoing MHD.
Collapse
Affiliation(s)
- Maolu Tian
- School of Medicine, Guizhou University, Guiyang, China; Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guiyang, China; NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People's Hospital, China
| | - Jing Yuan
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guiyang, China; NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People's Hospital, China
| | - Pinghong He
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guiyang, China
| | - Fangfang Yu
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guiyang, China
| | - Changzhu Long
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guiyang, China
| | - Yan Zha
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guiyang, China; NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People's Hospital, China.
| |
Collapse
|
3
|
Çakır Biçer N, Ermiş AA, Baş D. The Role of Different Methods in Defining Cardiometabolic Risk and Metabolic Syndrome in Women with Polycystic Ovary Syndrome. Life (Basel) 2023; 13:1959. [PMID: 37895341 PMCID: PMC10608420 DOI: 10.3390/life13101959] [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: 07/31/2023] [Revised: 08/31/2023] [Accepted: 09/02/2023] [Indexed: 10/29/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is one of the most frequent endocrine illnesses, often accompanied by visceral adiposity and metabolic syndrome (MetS). Visceral adiposity is an accurate predictor of MetS and cardiometabolic risk. This study aims to evaluate different anthropometric indices that can be used in PCOS and MetS risk assessment. A total of 66 women with PCOS (50%) and 66 controls (50%) were included, and clinical and biochemical parameters were evaluated. The body mass index (BMI), body shape index (ABSI), body roundness index (BRI), dysfunctional adiposity index (DAI), lipid accumulation (LAP) index, and visceral adiposity index (VAI) were calculated. The means of all indices were higher in the PCOS group (p < 0.05). The marker with the lowest discriminatory ability for PCOS and MetS was ABSI (AUC = 0.762 and AUC = 0.714, respectively, p = 0.000). According to the multivariate logistic regression model, the VAI and WC are strong predictors of PCOS (AUC, 98%; accuracy, 92%; sensitivity, 92%; and specificity, 91%), and WC, LAP index, and BRI are strong predictors of MetS (AUC, 0.95%; accuracy, 86%; sensitivity, 83%; and specificity, 88%). The use of different anthropometric indices in the detection of PCOS and MetS may allow for early diagnosis and treatment, and are simple and cost-effective.
Collapse
Affiliation(s)
- Nihan Çakır Biçer
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Acıbadem Mehmet Ali Aydınlar University, Icerenkoy Mah., Kayisdagi Cad. No. 32, 34752 Atasehir, Istanbul, Türkiye;
| | - Asime Aleyna Ermiş
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Acıbadem Mehmet Ali Aydınlar University, Icerenkoy Mah., Kayisdagi Cad. No. 32, 34752 Atasehir, Istanbul, Türkiye;
| | - Dilşat Baş
- Department of Nutrition and Dietetics, Faculty of Health Sciences, İstanbul Galata University, Evliya Çelebi Mah., Meşrutiyet Cad. No. 62, Tepebaşı, 34425 Beyoğlu, Istanbul, Türkiye;
| |
Collapse
|
4
|
Santos WLL, da Silva Pinheiro C, de Oliveira Santos R, da Silva ACA, Severo JS, Mendes PHM, de Sousa LC, de Sousa OMC, Dos Santos BLB, de Oliveira KBV, Freitas AK, Torres-Leal FL, Dos Santos AA, da Silva MTB. Physical exercise alleviates oxidative stress in brown adipose tissue and causes changes in body composition and nutritional behavior in rats with polycystic ovary syndrome. Life Sci 2023; 325:121754. [PMID: 37156395 DOI: 10.1016/j.lfs.2023.121754] [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: 03/06/2023] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 05/10/2023]
Abstract
AIM Polycystic Ovary Syndrome (PCOS) is a very common endocrine disorder in women. We investigate the effect of physical exercise on body composition, nutritional parameters, and oxidative stress in rats with PCOS. METHODS Female rats were into three groups: Control, PCOS, and PCOS + Exercise. PCOS was induced by letrozole (1 mg/kg via p.o.) for 21 days consecutively. Physical exercise was swimming, for 21 consecutive days, 1 h/day with 5 % load. In all groups, we assessed the nutritional and murinometric parameters, body composition, thermography, and oxidative stress in brown adipose tissue (BAT) and peri-ovarian adipose tissue (POAT). KEY FINDINGS In PCOS we observed an increase (P < 0.05) in body weight vs. the Control group. But, the PCOS + Exercise group prevent this weight gain (P < 0.05). The temperature in BAT, decrease (P < 0.05) in the PCOS group vs. Control group. PCOS + Exercise prevented this reduction (P < 0.05) in BAT temperature vs. PCOS groups. We observed decreases (P < 0.05) in Lee Index and BMI in POS + Exercise vs. PCOS group. In PCOS rats, we observed an increase (P < 0.05) in murinometric (SRWG, EI, and FE) and body composition parameters (TWB, ECF, ICF, and FFM) vs. the Control group. The PCOS + Exercise prevents (P < 0.05) these changes in all groups, compared with PCOS. Regarding the BAT, we observe an increase (P < 0.05) in MPO and MDA levels in the PCOS vs. Control group. PCOS + Exercise prevents (P < 0.05) these increases vs. the PCOS group. SIGNIFICANCE PCOS modifies body composition, and nutritional parameters, and induces changes in oxidative stress in BAT. Physical exercise prevented these alterations.
Collapse
Affiliation(s)
- Wenna Lúcia Lima Santos
- Graduate Program in Food and Nutrition, Federal University of Piaui, Teresina, PI, Brazil; Laboratory of Exercise and Gastrointestinal Tract - Department of Physical Education, Federal University of Piaui, Teresina, PI, Brazil
| | - Clailson da Silva Pinheiro
- Laboratory of Exercise and Gastrointestinal Tract - Department of Physical Education, Federal University of Piaui, Teresina, PI, Brazil; Graduate Program in Pharmacology, Federal University of Piaui, Teresina, PI, Brazil
| | | | - Alda Cassia Alves da Silva
- Laboratory of Exercise and Gastrointestinal Tract - Department of Physical Education, Federal University of Piaui, Teresina, PI, Brazil; Graduate Program in Pharmacology, Federal University of Piaui, Teresina, PI, Brazil
| | - Juliana Soares Severo
- Graduate Program in Food and Nutrition, Federal University of Piaui, Teresina, PI, Brazil; Laboratory of Exercise and Gastrointestinal Tract - Department of Physical Education, Federal University of Piaui, Teresina, PI, Brazil
| | - Pedro Henrique Moraes Mendes
- Laboratory of Exercise and Gastrointestinal Tract - Department of Physical Education, Federal University of Piaui, Teresina, PI, Brazil
| | - Luiza Carolinda de Sousa
- Laboratory of Exercise and Gastrointestinal Tract - Department of Physical Education, Federal University of Piaui, Teresina, PI, Brazil
| | - Olga Maria Castro de Sousa
- Laboratory of Exercise and Gastrointestinal Tract - Department of Physical Education, Federal University of Piaui, Teresina, PI, Brazil
| | | | | | - António Klingem Freitas
- Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, CE, Brazil
| | | | | | - Moises Tolentino Bento da Silva
- Graduate Program in Food and Nutrition, Federal University of Piaui, Teresina, PI, Brazil; Laboratory of Exercise and Gastrointestinal Tract - Department of Physical Education, Federal University of Piaui, Teresina, PI, Brazil; Graduate Program in Pharmacology, Federal University of Piaui, Teresina, PI, Brazil; Laboratory of Physiology. Department of Immuno-Physiology and Pharmacology. Institute of the Biomedical Science Abel Salazar - ICBAS, Center for Drug Discovery and Innovative Medicines (MedInUP), University of Porto, Porto, Portugal.
| |
Collapse
|
5
|
Interaction between gut microbiota and sex hormones and their relation to sexual dimorphism in metabolic diseases. Biol Sex Differ 2023; 14:4. [PMID: 36750874 PMCID: PMC9903633 DOI: 10.1186/s13293-023-00490-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/30/2023] [Indexed: 02/09/2023] Open
Abstract
Metabolic diseases, such as obesity, metabolic syndrome (MetS) and type 2 diabetes (T2D), are now a widespread pandemic in the developed world. These pathologies show sex differences in their development and prevalence, and sex steroids, mainly estrogen and testosterone, are thought to play a prominent role in this sexual dimorphism. The influence of sex hormones on these pathologies is not only reflected in differences between men and women, but also between women themselves, depending on the hormonal changes associated with the menopause. The observed sex differences in gut microbiota composition have led to multiple studies highlighting the interaction between steroid hormones and the gut microbiota and its influence on metabolic diseases, ultimately pointing to a new therapy for these diseases based on the manipulation of the gut microbiota. This review aims to shed light on the role of sexual hormones in sex differences in the development and prevalence of metabolic diseases, focusing on obesity, MetS and T2D. We focus also the interaction between sex hormones and the gut microbiota, and in particular the role of microbiota in aspects such as gut barrier integrity, inflammatory status, and the gut-brain axis, given the relevance of these factors in the development of metabolic diseases.
Collapse
|
6
|
Lemaitre M, Christin-Maitre S, Kerlan V. Polycystic ovary syndrome and adipose tissue. ANNALES D'ENDOCRINOLOGIE 2023; 84:308-315. [PMID: 36623807 DOI: 10.1016/j.ando.2022.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 11/30/2022] [Indexed: 01/09/2023]
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine metabolic disorder in women of reproductive age. Typically, it is associated with ovulatory dysfunction: dysovulation or anovulation, and symptoms of hyperandrogenism. It incurs risk of metabolic disorders such as diabetes, dyslipidemia and fatty liver. As a key endocrine organ in metabolic homeostasis, adipose tissue is often implicated in these complications. Studies of white adipose tissue (WAT) in PCOS have focused on the mechanism of insulin resistance in this tissue. Clinically, abnormalities in WAT distribution are seen, with decreased waist-to-hip ratio and increased ratio of adipose to lean mass. Such abnormalities are greater when total circulating androgens are elevated. At tissue level, white adipocyte hyperplasia occurs, along with infiltration of macrophages. Secretion of adipokines, cytokines and chemo-attractant proteins is increased in a pro-inflammatory manner, leading to reduced insulin sensitivity via alteration of glucose transporters, and hence decreased glucose uptake. The kinetics of non-esterified fatty acids (or free fatty acids) is also altered, leading to lipotoxicity. In recent years, brown adipose tissue (BAT) has been studied in women with PCOS. Although abundance is low in the body, BAT appears to play a significant role in energy expenditure and metabolic parameters. Both supra-clavicular skin temperature, which reflects BAT activity, and BAT mass are reduced in women with PCOS. Moreover, BAT mass and body mass index (BMI) are inversely correlated in patients. In the adipocyte, increased total circulating androgen levels reduce expression of uncoupling protein 1 (UCP1), a key protein in the brown adipocyte, leading to reduced biogenesis and mitochondrial respiration and hence a reduction in post-prandial thermogenesis. BAT is currently being investigated as a possible new therapeutic application.
Collapse
Affiliation(s)
- Madleen Lemaitre
- CHU Lille, Department of Diabetology, Endocrinology, Metabolism and Nutrition, Lille University Hospital, 59000 Lille, France.
| | - Sophie Christin-Maitre
- Center for rare endocrine diseases of growth and development, ERN-HCP, Sorbonne University, Endocrinology, Diabetology and Reproductive Medicine, Saint-Antoine Hospital, AP-HP, 75012 Paris, France
| | - Véronique Kerlan
- CHU Brest, Department of Diabetology and Endocrinology, Brest University Hospital, 29200 Brest, France
| |
Collapse
|
7
|
The Efficacy of Chinese Herbal Medicine in Animal Models of Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:4892215. [PMID: 35996403 PMCID: PMC9392647 DOI: 10.1155/2022/4892215] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/20/2022] [Accepted: 07/22/2022] [Indexed: 12/30/2022]
Abstract
Objective This study aimed to evaluate the efficacy of Chinese herbal medicine (CHM) on ovarian mass, weight, sex hormone disorders, and insulin resistance in animal models of polycystic ovary syndrome (PCOS). Methods This systematic review and meta-analysis was conducted through a comprehensive search in three databases to find studies testing CHM in animal models of PCOS. Two researchers independently reviewed the retrieval, extraction, and quality assessment of the dataset. The pooled effects were calculated using random-effect models; heterogeneity was explored through subgroup analysis; and stability was assessed through sensitivity analysis. In addition, publication bias was assessed using the Egger's bias test. Results Fifteen studies with twelve mice and 463 rats published from 2016 to 2021 met the inclusion criteria. The results of primary outcomes revealed that CHM therapy was significantly different with control animals in ovarian mass and testosterone (SMD, −1.01 (95% CI, −1.58, −1.45); SMD, −1.62 (95% CI, −2.07, −1.16), respectively). The secondary outcomes as well showed an overall positive effect of CHM compared with control animals in weight (SMD, −1.02 (95% CI, −1.39, −0.65)), follicle-stimulating hormone (FSH) (SMD, 0.58 (95% CI, 0.19, 0.97)), luteinizing hormone (LH) (SMD, −0.94 [95% CI, −1.25, −0.64)), homeostasis model assessment-insulin resistance (HOMA-IR) (SMD, −1.24 (95% CI, −1.57, −0.92)). Subgroup analyses indicated that PCOS induction drug, formula composition, random allocation, and assessment of model establishment were relevant factors that influenced the effects of interventions. The stability of the meta-analysis was showed robust through sensitivity analysis. The publication bias was substantial. Conclusions Administration with CHM revealed a statistically positive effect on ovarian mass, weight, sex hormone disorders, and insulin resistance. Moreover, these data call for further high-quality studies investigating the underlying mechanism in more depth.
Collapse
|
8
|
Lim JY, Wee BS, Mohamad M, Mhd Jalil AM, Shahril MR, Lua PL. Fat-to-lean mass ratio as a new anthropometric indicator in predicting metabolic syndrome among Malay adolescents in Terengganu, Malaysia. PROCEEDINGS OF SINGAPORE HEALTHCARE 2022. [DOI: 10.1177/20101058221106283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Metabolic syndrome (MetS) is defined as a cluster of risk factors for predicting type 2 diabetes mellitus and cardiovascular disease. Objectives This cross-sectional study aimed to develop a cut-off value for fat versus lean mass ratio (FLMR) in predicting MetS and to investigate the association between this indicator with MetS and its components. Methods Subjects comprised 238 Malay adolescents (79% female) aged 18–19 years old. Anthropometric assessment comprised weight, height and waist circumference (WC). Body composition was measured using bioelectrical impedance analysis techniques while blood pressure was measured using a blood pressure monitor. Fasting blood glucose, total cholesterol , triglycerides, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol were determined from an overnight fasting blood sample. MetS was determined based on International Diabetes Federation (2007) definition for adolescents aged 16-year-old and above. Results The prevalence of MetS was 2.1%. Receiver Operating Characteristics curve analysis revealed that the optimal cut-off value for FLMR was 0.441 with an Area Under the Curve of 0.874 (95% CI: 0.825, 0.913); with sensitivity of 80.0% and specificity of 71.0%. FLMR cut-off of 0.441 was associated with high WC ( p < .001), low HDL-c ( p < .001) and MetS ( p < .05). Binary Logistic Regression analysis revealed that adolescents with high WC, low HDL-c and MetS had higher odds of developing increased FLMR than the cut-off value with an odds ratio (OR) of 43.4 (95% CI: 9.7,193.9), 4.7 (95% CI: 2.3,9.8) and 13.3 (95% CI: 1.5,121.2), respectively. Conclusion FLMR possesses fair discriminatory ability in identifying MetS among adolescents and significant association exists between FLMR and MetS and some of its components.
Collapse
Affiliation(s)
- Jing Ying Lim
- School of Nutrition & Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
- Dietetics Program & Centre of Healthy Aging & Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Bee Suan Wee
- School of Nutrition & Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
| | - Marhazlina Mohamad
- School of Nutrition & Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
| | - Abbe Maleyki Mhd Jalil
- School of Nutrition & Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
| | - Mohd Razif Shahril
- Nutritional Sciences Program & Centre of Healthy Aging & Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Pei Lin Lua
- Faculty of Pharmacy, Universiti Sultan Zainal Abidin, Besut, Malaysia
| |
Collapse
|
9
|
Medeiros SFD, Barbosa BB, Medeiros MASD, Yamamoto AKLW, Yamamoto MMW. Adrenal Androgen Predictive Effects on Clinical and Metabolic Abnormalities of Polycystic Ovary Syndrome. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:142-153. [PMID: 35213912 PMCID: PMC9948267 DOI: 10.1055/s-0041-1741030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To examine the possible effects of adrenal prohormones in the prediction of clinical and metabolic abnormalities in women with polycystic ovary syndrome (PCOS). METHODS The present study enrolled 299 normal cycling non-PCOS, 156 normoandrogenemic, and 474 hyperandrogenemic women with PCOS. Baseline characteristics were compared using a chi-squared test or analysis of variance (ANOVA) as appropriate. The roles of adrenal prohormones and their ratios with total testosterone in predicting co-occurring morbidities in women PCOS were evaluated using univariate and multivariate logistic regression analyses. RESULTS Adrenal hyperandrogenism per dehydroepiandrosterone sulfate (DHEAS) levels were found in 32% of women with PCOS. In non-PCOS women, dehydroepiandrosterone (DHEA) and its sulfate had no predictive role concerning clinical, anthropometric, and metabolic parameters. In PCOS women, mainly in the hyperandrogenemic group, DHEA showed to be a significant predictor against most anthropometric-metabolic index abnormalities (odds ratio [OR] = 0.36-0.97; p < 0.05), and an increase in triglycerides (TG) levels (OR = 0.76; p = 0.006). Dehydroepiandrosterone sulfate presented a few predictive effects regarding PCOS-associated disorders. In controls, DHEAS predicted against the increase in estimated average glucose (OR= 0.38; p = 0.036). In the normoandrogenic group, it predicted against elevation in the waist/hip ratio (WHR) (OR= 0.59; p = 0.042), and in hyperandrogenemic PCOS women, it predicted against abnormality in the conicity index (CI) (OR = 0.31; p = 0.028). CONCLUSION Dehydroepiandrosterone was shown to be a better predictor of abnormal anthropometric and biochemical parameters in women with PCOS than DHEAS. Thus, regarding adrenal prohormones, DHEA measurement, instead of DHEAS, should be preferred in PCOS management. The effects of androgen prohormones on the prediction of PCOS abnormalities are weak.
Collapse
Affiliation(s)
- Sebastião Freitas de Medeiros
- Department of Gynecology and Obstetrics, Medical School, Universidade Federal do Mato Grosso, Cuiabá, MT, Brazil.,Instituto Tropical de Medicina Reprodutiva, Cuiabá, MT, Brazil
| | | | | | | | | |
Collapse
|
10
|
Hypertension Predisposition and Thermoregulation Delays in Adolescents with Polycystic Ovary Syndrome: A Pilot Study. CHILDREN 2022; 9:children9030316. [PMID: 35327688 PMCID: PMC8946960 DOI: 10.3390/children9030316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/10/2022] [Accepted: 02/17/2022] [Indexed: 11/28/2022]
Abstract
Background: Polycystic ovary syndrome (PCOS) is a heterogeneous disorder in which clinical, sonographic, and endophenotypic features have been underinvestigated or inconclusive, especially in the early stages of the disease (adolescence/young adulthood). Objective: This prospective pilot study focused on the differences of multiple physiological functions between Greek adolescent/young adult females suffering from PCOS and age- and body mass index (BMI)- matched healthy controls. Study design: Nineteen PCOS patients and eighteen healthy controls (aged 13 to 23 years) were studied for: (i) biochemical and hormonal dysfunction by measuring circulating glucose, insulin, and androgen levels; (ii) arterial stiffness with pulse wave analysis (PWA) by Sphygmocord; (iii) intima-media thickness (IMT) by ultrasound; (iv) heart rate variability (HRV) by Task Force Monitor; and (v) QT, QRS, QT, P, QRSD by electrocardiogram (ECG). Statistical analysis included Hedge’s g correction for small samples bias, and the results are shown using the Hedge’s g effect size and 95% CI, in line with precision medicine prerequisites. Results: Significant differences in pulse wave velocity (PWV) (g = 0.964 [0.296, 1.632]), subendocardial viability ratio (SEVR) carotid (g = −0.679 [−1.329, −0.030]), pulse pressure (PP) carotid (g = 0.942 [0.275, 1.608]), systolic pressure (SP) carotid (g = 0.785 [0.129, 1.440]), free-testosterone (g = 0.677 [0.042, 0.312]), and Delta4-androstenedione (g = 0.735 [0.097, 0.373]) were observed between PCOS patients and controls. No differences were detected in the remaining endocrine and PWA or ECG biomarkers. Conclusions: Our multidisciplinary approach showed early onset of vascular dysfunction, predisposition to hypertension, thermoregulation delays, and metabolic syndrome changes in adolescent/young adult PCOS.
Collapse
|
11
|
Ezeh U, Pisarska MD, Azziz R. Association of severity of menstrual dysfunction with hyperinsulinemia and dysglycemia in polycystic ovary syndrome. Hum Reprod 2022; 37:553-564. [PMID: 35048126 PMCID: PMC8888996 DOI: 10.1093/humrep/deac001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/15/2021] [Indexed: 01/22/2023] Open
Abstract
STUDY QUESTION Is the severity of menstrual cyclicity related to hyperinsulinemia and dysglycemia in women with hyperandrogenic polycystic ovary syndrome (PCOS)? SUMMARY ANSWER Hyperandrogenic PCOS women with amenorrhea, compared to those with oligomenorrhea or eumenorrhea, had a greater risk of post-challenge hyperinsulinemia, which may explain their higher prevalence of dysglycemia. WHAT IS KNOWN ALREADY PCOS is associated with metabolic dysregulation including insulin resistance (IR) and hyperinsulinemia, risk factors for type 2 diabetes mellitus (T2DM) and other vascular-metabolic morbidities. Although the severity of menstrual cyclicity is associated with IR in PCOS, it is unclear whether, and to what extent, it is related to hyperinsulinemia and glycemic abnormalities. STUDY DESIGN, SIZE, DURATION We prospectively compared the degree of menstrual cyclicity with the presence of dysglycemia (elevated 1-h plasma glucose ≥155 mg/dl; abnormal glucose tolerance [AGT], including prediabetes and T2DM; and AUC for glucose [G-AUC]) or dynamic state hyperinsulinemia (peak insulin levels either at 1 or 2 h of the oral glucose tolerance test (oGTT) and AUC for insulin [I-AUC]) in 333 hyperandrogenic PCOS women. PARTICIPANTS/MATERIALS, SETTING, METHODS In a tertiary care setting, hyperandrogenic PCOS participants with ovulatory eumenorrhea (Ov-Eumeno, n = 25), anovulatory eumenorrhea (Anov-Eumeno, n = 33), oligomenorrhea (Oligo, n = 150) and amenorrhea (Ameno, n = 125) underwent comprehensive phenotyping and a 2-h 75 g oGTT. MAIN RESULTS AND THE ROLE OF CHANCE Mean BMI was greater among Ameno women than among Oligo, Anov-Eumeno or Ov-Eumeno women. Adjusting for BMI, the Ameno group demonstrated higher mean 1- and 2-h insulin and glucose, peak insulin and I-AUC and G-AUC, and either had a higher, or tended toward having a higher, prevalence of elevated 1-h glucose level and prevalence of AGT than the Oligo, Anov-Eumeno or Ov-Eumeno groups. In logistic regression, adjusting for BMI, Ameno women were more likely to have: AGT than Oligo women (odds ratio [OR]: 2.3; 95% CI: 1.3 to 4.2); elevated 1-h glucose (OR: 10.2; CI: 1.3-79.7) than those with Ov-Eumeno; and both AGT (OR: 1.7; CI: 1.1-2.6) and elevated 1-h glucose (OR: 1.8; CI: 1.1-2.8) than those with Anov-Eumeno or Ov-Eumeno when combined. Race/ethnicity, age, waist-to-hip ratio, fasting insulin and glucose, and biochemical or clinical measures of hyperandrogenism were similar across the four menstrual categories. LIMITATIONS, REASONS FOR CAUTION Our study was limited by its cross-sectional nature and by studying women affected by PCOS as defined by the Androgen Excess & PCOS Society criteria (i.e. Rotterdam Phenotypes A, B and C) who were identified in the clinical setting. Consequently, extrapolation of the present data to other PCOS phenotypes (e.g. PCOS Phenotype D) should be made with caution. WIDER IMPLICATIONS OF THE FINDINGS In hyperandrogenic PCOS phenotypes, a history of amenorrhea, compared to oligomenorrhea or eumenorrhea, suggests a more severe cardiometabolic risk, including a higher degree of hyperinsulinemia and greater prevalence of glycemic abnormalities. These findings may assist in refining the treatment and screening guidelines for glycemic abnormalities in PCOS. STUDY FUNDING/COMPETING INTEREST(S) This work was supported in part by grants R01-DK073632 and R01-HD29364 from the NIH and an endowment of the Helping Hand of Los Angeles, Inc. (to R.A.). M.D.P. has no competing interests to declare. U.E. is an investor in Concentric Analgesics, Inc. R.A. serves as a consultant for Spruce Biosciences and Fortress Biotech and an advisor for Aurora Forge. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- U Ezeh
- Department Obstetrics & Gynecology, Alta Bates Summit Medical Center/Sutter Health, Berkeley, CA, USA
- Department of Obstetrics & Gynecology, Medical College of Georgia, Augusta University, Augusta, GA, USA
- Department of Obstetrics & Gynecology, and Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - M D Pisarska
- Department of Obstetrics & Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Obstetrics & Gynecology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - R Azziz
- Department of Obstetrics & Gynecology, and Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Health Policy, Management and Behavior, School of Public Health, University at Albany, SUNY, Albany, NY, USA
- Department of Healthcare Organization & Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
- Correspondence address. Womens, Infant & Children, Ste. 10390, 1700 6th Ave, South, Birmingham, AL 35249-7333, USA. Tel: +1-205-934-1030; E-mail:
| |
Collapse
|
12
|
Evaluation of the relationship between serum ferritin and insulin resistance and visceral adiposity index (VAI) in women with polycystic ovary syndrome. Eat Weight Disord 2021; 26:1581-1593. [PMID: 32772321 DOI: 10.1007/s40519-020-00980-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 07/30/2020] [Indexed: 01/08/2023] Open
Abstract
PURPOSE There is a relationship between polycystic ovary syndrome (PCOS) and adipose tissue dysfunction (ADD), but this relationship is not clear. It has been recently shown that iron accumulation in adipose tissue is among the causes of adipose tissue dysfunction. Data on adipose tissue dysfunction in women with PCOS are insufficient. In this study, we aimed to evaluate the relationship between serum ferritin levels (iron accumulation biomarker) and visceral adiposity index (an indicator of adipose tissue dysfunction). METHODS The study is a case-control study. Women with diagnosed PCOS with 2003 Rotterdam Diagnostic Criteria (n = 40) were compared with non-PCOS group (n = 40). In this study, the cholesterol ratios, the homeostatic model evaluation index for insulin resistance (HOMA-IR) and the quantitative insulin sensitivity control index were calculated using biochemical parameters, and the visceral adiposity index (VAI) and the lipid accumulation product (LAP) were calculated using both anthropometric and biochemical parameters. In this study, insulin resistance was evaluated by HOMA-IR and adipose tissue dysfunction was evaluated by VAI index. RESULTS According to the results of this study, women with PCOS have a worse metabolic status than women without PCOS. However, this has been shown only in overweight and obese women, not in women with normal weight. CONCLUSION As a result, the presence of obesity in women with PCOS exacerbates metabolic status. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
Collapse
|
13
|
Westgate CS, Botfield HF, Alimajstorovic Z, Yiangou A, Walsh M, Smith G, Singhal R, Mitchell JL, Grech O, Markey KA, Hebenstreit D, Tennant DA, Tomlinson JW, Mollan SP, Ludwig C, Akerman I, Lavery GG, Sinclair AJ. Systemic and adipocyte transcriptional and metabolic dysregulation in idiopathic intracranial hypertension. JCI Insight 2021; 6:145346. [PMID: 33848268 PMCID: PMC8262372 DOI: 10.1172/jci.insight.145346] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 04/07/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Idiopathic intracranial hypertension (IIH) is a condition predominantly affecting obese women of reproductive age. Recent evidence suggests that IIH is a disease of metabolic dysregulation, androgen excess, and an increased risk of cardiovascular morbidity. Here we evaluate systemic and adipose specific metabolic determinants of the IIH phenotype. METHODS In fasted, matched IIH (n = 97) and control (n = 43) patients, we assessed glucose and insulin homeostasis and leptin levels. Body composition was assessed along with an interrogation of adipose tissue function via nuclear magnetic resonance metabolomics and RNA sequencing in paired omental and subcutaneous biopsies in a case-control study. RESULTS We demonstrate an insulin- and leptin-resistant phenotype in IIH in excess of that driven by obesity. Adiposity in IIH is preferentially centripetal and is associated with increased disease activity and insulin resistance. IIH adipocytes appear transcriptionally and metabolically primed toward depot-specific lipogenesis. CONCLUSION These data show that IIH is a metabolic disorder in which adipose tissue dysfunction is a feature of the disease. Managing IIH as a metabolic disease could reduce disease morbidity and improve cardiovascular outcomes. FUNDING This study was supported by the UK NIHR (NIHR-CS-011-028), the UK Medical Research Council (MR/K015184/1), Diabetes UK, Wellcome Trust (104612/Z/14/Z), the Sir Jules Thorn Award, and the Midlands Neuroscience Teaching and Research Fund.
Collapse
Affiliation(s)
- Connar Sj Westgate
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.,Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
| | - Hannah F Botfield
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Zerin Alimajstorovic
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.,Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
| | - Andreas Yiangou
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.,Department of Neurology, University Hospitals Birmingham National Health Service (NHS) Foundation Trust, Queen Elizabeth Hospital, Birmingham, United Kingdom
| | - Mark Walsh
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Gabrielle Smith
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.,Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
| | - Rishi Singhal
- Upper GI Unit and Minimally Invasive Unit, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham United Kingdom
| | - James L Mitchell
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.,Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
| | - Olivia Grech
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.,Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
| | - Keira A Markey
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.,Department of Neurology, University Hospitals Birmingham National Health Service (NHS) Foundation Trust, Queen Elizabeth Hospital, Birmingham, United Kingdom
| | - Daniel Hebenstreit
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Daniel A Tennant
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Jeremy W Tomlinson
- Oxford Centre for Diabetes, Endocrinology & Metabolism, National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, University of Oxford, Churchill Hospital, Headington, Oxford, United Kingdom
| | - Susan P Mollan
- Birmingham Neuro-Ophthalmology, Ophthalmology Department, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Christian Ludwig
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.,Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
| | - Ildem Akerman
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.,Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
| | - Gareth G Lavery
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.,Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
| | - Alexandra J Sinclair
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.,Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom.,Department of Neurology, University Hospitals Birmingham National Health Service (NHS) Foundation Trust, Queen Elizabeth Hospital, Birmingham, United Kingdom
| |
Collapse
|
14
|
Dietz de Loos ALP, Jiskoot G, Timman R, Beerthuizen A, Busschbach JJV, Laven JSE. Improvements in PCOS characteristics and phenotype severity during a randomized controlled lifestyle intervention. Reprod Biomed Online 2021; 43:298-309. [PMID: 34238659 DOI: 10.1016/j.rbmo.2021.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/26/2021] [Accepted: 05/06/2021] [Indexed: 11/30/2022]
Abstract
RESEARCH QUESTION What is the effect of weight loss through different interventions (three-component lifestyle intervention with short message service [SMS+] versus three-component lifestyle intervention without SMS [SMS-] versus care as usual [CAU]) on polycystic ovary syndrome (PCOS) characteristics (ovulatory dysfunction, hyperandrogenism, polycystic ovarian morphology [PCOM]) and phenotype distribution? DESIGN Analysis of secondary outcome measures of a randomized controlled trial. Women diagnosed with PCOS (n = 183), who wished to become pregnant, with a body mass index above 25 kg/m², were assigned to a 1-year three-component (cognitive behavioural therapy, diet, exercise) lifestyle intervention group, with or without SMS, or to CAU (advice to lose weight). RESULTS The prevalence of biochemical hyperandrogenism was 30.9% less in the SMS- group compared with CAU after 1 year (P = 0.027). Within-group analyses revealed significant improvements in ovulatory dysfunction (SMS+: -39.8%, P = 0.001; SMS-: -30.5%, P = 0.001; CAU: -32.1%, P < 0.001), biochemical hyperandrogenism (SMS-: -27.8%, P = 0.007) and PCOM (SMS-: -14.0%, P = 0.034). Weight loss had a significantly favourable effect on the chance of having ovulatory dysfunction (estimate 0.157 SE 0.030, P < 0.001) and hyperandrogenism (estimate 0.097 SE 0.027, P < 0.001). CONCLUSIONS All groups demonstrated improvements in PCOS characteristics, although these were more profound within the lifestyle intervention groups. Weight loss per se led to an amelioration of diagnostic characteristics and in the phenotype of PCOS. A three-component lifestyle intervention aimed at a 5-10% weight loss should be recommended for all women with PCOS before they become pregnant.
Collapse
Affiliation(s)
- Alexandra L P Dietz de Loos
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands.
| | - Geranne Jiskoot
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands; Department of Psychiatry, Section Medical Psychology and Psychotherapy Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands
| | - Reinier Timman
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands
| | - Annemerle Beerthuizen
- Department of Psychiatry, Section Medical Psychology and Psychotherapy Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands
| | - Joop S E Laven
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus MC, PO Box 2040, Rotterdam CA 3000, the Netherlands
| |
Collapse
|
15
|
de Medeiros SF, Rodgers RJ, Norman RJ. Adipocyte and steroidogenic cell cross-talk in polycystic ovary syndrome. Hum Reprod Update 2021; 27:771-796. [PMID: 33764457 DOI: 10.1093/humupd/dmab004] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 01/08/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Metabolic and endocrine alterations in women with polycystic ovary syndrome (PCOS) affect adipose tissue mass and distribution. PCOS is characterised by hyperandrogenism, obesity and adipocyte dysfunction. Hyperandrogenism in PCOS drives dysfunctional adipocyte secretion of potentially harmful adipocytokines. Glucocorticoids and sex-steroids modulate adipocyte development and function. For their part, adipocyte products interact with adrenal and ovarian steroidogenic cells. Currently, the relationship between adipocyte and steroidogenic cells is not clear, and for these reasons, it is important to elucidate the interrelationship between these cells in women with and without PCOS. OBJECTIVE AND RATIONALE This comprehensive review aims to assess current knowledge regarding the interrelationship between adipocytes and adrenal and ovarian steroidogenic cells in animal models and humans with or without PCOS. SEARCH METHODS We searched for articles published in English and Portuguese in PubMed. Keywords were as follows: polycystic ovary syndrome, steroidogenesis, adrenal glands, theca cells, granulosa cells, adipocytes, adipocytokines, obesity, enzyme activation, and cytochrome P450 enzymes. We expanded the search into the references from the retrieved articles. OUTCOMES Glucocorticoids and sex-steroids modulate adipocyte differentiation and function. Dysfunctional adipocyte products play important roles in the metabolic and endocrine pathways in animals and women with PCOS. Most adipokines participate in the regulation of the hypothalamic-pituitary-adrenal and ovarian axes. In animal models of PCOS, hyperinsulinemia and poor fertility are common; various adipokines modulate ovarian steroidogenesis, depending on the species. Women with PCOS secrete unbalanced levels of adipocyte products, characterised by higher levels of leptin and lower levels of adiponectin. Leptin expression positively correlates with body mass index, waist/hip ratio and levels of total cholesterol, triglyceride, luteinising hormone, oestradiol and androgens. Leptin inhibits the production of oestradiol and, in granulosa cells, may modulate 17-hydroxylase and aromatase enzyme activities. Adiponectin levels negatively correlate with fat mass, body mass index, waist-hip ratio, glucose, insulin and triglycerides, and decrease androgen production by altering expression of luteinising hormone receptor, steroidogenic acute regulatory protein, cholesterol-side-chain cleavage enzyme and 17-hydroxylase. Resistin expression positively correlates with body mass index and testosterone, and promotes the expression of 17-hydroxylase enzyme in theca cells. The potential benefits of adipokines in the treatment of women with PCOS require more investigation. WIDER IMPLICATIONS The current data regarding the relationship between adipocyte products and steroidogenic cells are conflicting in animals and humans. Polycystic ovary syndrome is an excellent model to investigate the interrelationship among adipocyte and steroidogenic cells. Women with PCOS manifest some pathological conditions associated with hyperandrogenism and adipocyte products. In animals, cross-talk between cells may vary according to species, and the current review suggests opportunities to test new medications to prevent or even reverse several harmful sequelae of PCOS in humans. Further studies are required to investigate the possible therapeutic application of adipokines in women with obese and non-obese PCOS. Meanwhile, when appropriate, metformin use alone, or associated with flutamide, may be considered for therapeutic purposes.
Collapse
Affiliation(s)
- Sebastião Freitas de Medeiros
- Department of Gynecology and Obstetrics, Medical School, Federal University of Mato Grosso; and Tropical Institute of Reproductive Medicine,Cuiabá, MT, Brazil
| | - Raymond Joseph Rodgers
- Paediatrics and Reproductive Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Robert John Norman
- Robinson Research Institute Adelaide Medical School, Adelaide, South Australia, Australia
| |
Collapse
|
16
|
Sánchez-Ferrer ML, De La Cruz-Sánchez E, Arense-Gonzalo JJ, Prieto-Sánchez MT, Bernabeu-González I, Carmona-Barnosi A, Mendiola J, Torres-Cantero AM. Body Composition and Characterization of Skinfold Thicknesses from Polycystic Ovary Syndrome Phenotypes. A Preliminar Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2977. [PMID: 33799425 PMCID: PMC8002058 DOI: 10.3390/ijerph18062977] [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: 02/02/2021] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 11/16/2022]
Abstract
To describe whether polycystic ovary syndrome (PCOS) phenotypes vary in their body composition and skinfold (SKF) thicknesses and if they differ from women without PCOS, a preiminar case-control study was performed. A total of 117 cases were diagnosed using the Rotterdam criteria. Gynecological examinations and transvaginal ultrasound were performed in all women (266 women). Anthropometric measurements including SKF thickness were taken according to the restricted profile protocol of the international standards for the anthropometric evaluation according to the International Society of the Advancement of Kinanthropometry (ISAK). Women with PCOS had higher body mass index and percentage of fat mass with respect to controls. The endomorphy component was also significantly higher in women with PCOS than in controls. Each PCOS phenotype displayed a different representation in the somatochart respect to the others phenotypes and also compared to controls. Women with PCOS had significantly higher ∑7 SKF (p = 0.013), ∑appendicular SKF (p = 0.017) and ∑arm SKF (p = 0.019) than controls. H-O-POM phenotype had higher 7∑ SKF (p = 0.003), ∑appendicular SKF (p = 0.01), ∑arm SKF (0.005), ∑leg SKF, and ∑trunk SKF (0.008) and also a higher fast mass percentage than controls (p = 0.011). In conclusion, body composition evaluated by ISAK protocol is different in women with PCOS, especially in the complete phenotype (H-O-POM). This could have relevant implications in terms of clinical evaluation and follow-up of these women, although more researches in this field are needed.
Collapse
Affiliation(s)
- María L. Sánchez-Ferrer
- Department of Obstetrics & Gynecology, “Virgen de la Arrixaca” University Clinical Hospital, 30120 El Palmar, Spain; (M.L.S.-F.); (M.T.P.-S.); (I.B.-G.); (A.C.-B.)
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120 El Palmar, Spain;
| | - Ernesto De La Cruz-Sánchez
- Division of Preventive Medicine and Public Health, Department of Physical Activity, Faculty of Sport Sciences, University of Murcia, C/Santa Alicia, s/n, 30720 Santiago de la Ribera, Spain;
| | - Julián J. Arense-Gonzalo
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120 El Palmar, Spain;
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, 30100 Espinardo, Spain;
| | - María T. Prieto-Sánchez
- Department of Obstetrics & Gynecology, “Virgen de la Arrixaca” University Clinical Hospital, 30120 El Palmar, Spain; (M.L.S.-F.); (M.T.P.-S.); (I.B.-G.); (A.C.-B.)
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120 El Palmar, Spain;
| | - Itziar Bernabeu-González
- Department of Obstetrics & Gynecology, “Virgen de la Arrixaca” University Clinical Hospital, 30120 El Palmar, Spain; (M.L.S.-F.); (M.T.P.-S.); (I.B.-G.); (A.C.-B.)
| | - Ana Carmona-Barnosi
- Department of Obstetrics & Gynecology, “Virgen de la Arrixaca” University Clinical Hospital, 30120 El Palmar, Spain; (M.L.S.-F.); (M.T.P.-S.); (I.B.-G.); (A.C.-B.)
| | - Jaime Mendiola
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, 30100 Espinardo, Spain;
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Alberto M. Torres-Cantero
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120 El Palmar, Spain;
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, 30100 Espinardo, Spain;
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Preventive Medicine, “Virgen de la Arrixaca” University Clinical Hospital, 30120 El Palmar, Spain
| |
Collapse
|
17
|
Yin L, Luo M, Wang R, Ye J, Wang X. Mitochondria in Sex Hormone-Induced Disorder of Energy Metabolism in Males and Females. Front Endocrinol (Lausanne) 2021; 12:749451. [PMID: 34987473 PMCID: PMC8721233 DOI: 10.3389/fendo.2021.749451] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/24/2021] [Indexed: 01/01/2023] Open
Abstract
Androgens have a complex role in the regulation of insulin sensitivity in the pathogenesis of type 2 diabetes. In male subjects, a reduction in androgens increases the risk for insulin resistance, which is improved by androgen injections. However, in female subjects with polycystic ovary syndrome (PCOS), androgen excess becomes a risk factor for insulin resistance. The exact mechanism underlying the complex activities of androgens remains unknown. In this review, a hormone synergy-based view is proposed for understanding this complexity. Mitochondrial overactivation by substrate influx is a mechanism of insulin resistance in obesity. This concept may apply to the androgen-induced insulin resistance in PCOS. Androgens and estrogens both exhibit activities in the induction of mitochondrial oxidative phosphorylation. The two hormones may synergize in mitochondria to induce overproduction of ATP. ATP surplus in the pancreatic β-cells and α-cells causes excess secretion of insulin and glucagon, respectively, leading to peripheral insulin resistance in the early phase of type 2 diabetes. In the skeletal muscle and liver, the ATP surplus contributes to insulin resistance through suppression of AMPK and activation of mTOR. Consistent ATP surplus leads to mitochondrial dysfunction as a consequence of mitophagy inhibition, which provides a potential mechanism for mitochondrial dysfunction in β-cells and brown adipocytes in PCOS. The hormone synergy-based view provides a basis for the overactivation and dysfunction of mitochondria in PCOS-associated type 2 diabetes. The molecular mechanism for the synergy is discussed in this review with a focus on transcriptional regulation. This view suggests a unifying mechanism for the distinct metabolic roles of androgens in the control of insulin action in men with hypogonadism and women with PCOS.
Collapse
Affiliation(s)
- Lijun Yin
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Man Luo
- Metabolism Research Center, Zhengzhou University Affiliated Zhengzhou Central Hospital, Zhengzhou, China
| | - Ru Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Jianping Ye
- Metabolism Research Center, Zhengzhou University Affiliated Zhengzhou Central Hospital, Zhengzhou, China
- Center for Advanced Medicine, College of Medicine, Zhengzhou University, Zhengzhou, China
- Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Jianping Ye, ; Xiaohui Wang,
| | - Xiaohui Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
- *Correspondence: Jianping Ye, ; Xiaohui Wang,
| |
Collapse
|
18
|
Akhavan NS, Pourafshar S, Johnson SA, Foley EM, George KS, Munoz J, Siebert S, Clark EA, Basiri R, Hickner RC, Navaei N, Levenson CW, Panton LB, Daggy BP, Arjmandi BH. The Relationship between Protein Intake and Source on Factors Associated with Glycemic Control in Individuals with Prediabetes and Type 2 Diabetes. Nutrients 2020; 12:nu12072031. [PMID: 32650580 PMCID: PMC7400940 DOI: 10.3390/nu12072031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 06/23/2020] [Accepted: 07/03/2020] [Indexed: 11/17/2022] Open
Abstract
Type 2 diabetes (T2D) is a major contributor to morbidity and mortality largely due to increased cardiovascular disease risk. This study examined the relationships among protein consumption and sources on glycemic control and cardiovascular health in individuals with prediabetes and T2D. Sixty-two overweight or obese participants with prediabetes or T2D, aged 45–75 years were stratified into the following three groups based on protein intake: <0.8 g (gram)/kg (kilogram) body weight (bw), ≥0.8 but <1.0 g/kg bw, and ≥1.0 g/kg bw as below, meeting, and above the recommended levels of protein intake, respectively. Body mass, body mass index (BMI), hip circumference (HC), waist circumference (WC), lean mass, and fat mass (FM) were significantly higher in participants who consumed below the recommended level of protein intake as compared with other groups. Higher animal protein intake was associated with greater insulin secretion and lower triglycerides (TG). Total, low-density, and high-density cholesterol were significantly higher in participants who met the recommended protein intake as compared with the other groups. These data suggest that high protein consumption is associated with lower BMI, HC, WC, and FM, and can improve insulin resistance without affecting lipid profiles in this population. Furthermore, higher intake of animal protein can improve β-cell function and lower plasma TG.
Collapse
Affiliation(s)
- Neda S. Akhavan
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
| | - Shirin Pourafshar
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
- Department of Medicine, Division of Nephrology, University of Virginia, Charlottesville, VA 22903, USA
| | - Sarah A. Johnson
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO 80526, USA;
| | - Elizabeth M. Foley
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
| | - Kelli S. George
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
- Division of Animal and Nutritional Sciences, West Virginia University, Morgantown, WV 26506, USA
| | - Joseph Munoz
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
| | - Shalom Siebert
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
| | - Elizabeth A. Clark
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
| | - Raedeh Basiri
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
| | - Robert C. Hickner
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
| | - Negin Navaei
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
- Department of Nutrition, Life University, Marietta, GA 30060, USA
| | - Cathy W. Levenson
- Department of Biomedical Sciences and Program in Neuroscience, Florida State University, Tallahassee, FL 32304, USA;
| | - Lynn B. Panton
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
- Institute for Successful Longevity, Florida State University, Tallahassee, FL 32304, USA
| | - Bruce P. Daggy
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
| | - Bahram H. Arjmandi
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (N.S.A.); (E.M.F.); (J.M.); (S.S.); (E.A.C.); (R.B.); (R.C.H.); (L.B.P.); (B.P.D.)
- Center for Advancing Exercise and Nutrition Research on Aging, Florida State University, Tallahassee, FL 32304, USA; (S.P.); (K.S.G.); (N.N.)
- Institute for Successful Longevity, Florida State University, Tallahassee, FL 32304, USA
- Correspondence: ; Tel.: +1-850-645-1517
| |
Collapse
|
19
|
Ezeh U, Chen IYD, Chen YH, Azziz R. Adipocyte Insulin Resistance in PCOS: Relationship With GLUT-4 Expression and Whole-Body Glucose Disposal and β-Cell Function. J Clin Endocrinol Metab 2020; 105:5834379. [PMID: 32382742 PMCID: PMC7274487 DOI: 10.1210/clinem/dgaa235] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 04/29/2020] [Indexed: 01/16/2023]
Abstract
CONTEXT Impaired sensitivity to the antilipolytic action of insulin in adipose tissue (AT) may play a role in determining metabolic dysfunction in polycystic ovary syndrome (PCOS). OBJECTIVES To test the hypothesis that insulin resistance (IR) in AT is associated with whole-body insulin sensitivity and β-cell function in PCOS. RESEARCH DESIGN AND SETTING Prospective cross-sectional study. METHODS Eighteen participants with PCOS and 18-matched control participants underwent a modified frequently sampled intravenous glucose tolerance test (mFSIVGTT); subgroups underwent single-slice computed tomography scans determining AT distribution and adipocyte glucose transporter type 4 (GLUT-4) expression. MAIN OUTCOME MEASURES IR in AT in basal (by the adipose insulin resistance index [Adipo-IR]) and dynamic (mFSIVGTT-derived indices of insulin-mediated nonesterified fatty acids [NEFA] suppression [NEFAnadir, TIMEnadir, and %NEFAsupp]) states; whole-body insulin-mediated glucose uptake and insulin secretion in basal (by homeostatic model assessment [HOMA]-IR and HOMA-β%) and dynamic (mFSIVGTT-derived insulin sensitivity index [Si], acute insulin response to glucose [AIRg], and disposition index [Di]) states. RESULTS Participants with PCOS had higher HOMA-IR and HOMA-β%, lower Si and Di, higher longer TIMEnadir, higher Adipo-IR and NEFAnadir, and a trend toward lower GLUT-4, than the control group participants. Adipo-IR was associated with dynamic state IR in AT (NEFAnadir TIMEnadir, and %NEFAsupp), but only in PCOS, and with HOMA-IR and HOMA-β% in both groups. NEFAnadir and TIMEnadir were negatively and %NEFAsupp positively associated with Si only in PCOS, but not with AIRg and Di, or GLUT-4 expression. CONCLUSION Women with PCOS demonstrated increased IR in AT, which is closely associated with whole-body IR but not with dynamic state β-cell function or adipocyte GLUT-4 gene expression.
Collapse
Affiliation(s)
- Uche Ezeh
- Department of Obstetrics and Gynecology, Stanford Healthcare-ValleyCare Hospital, Pleasanton, California
- Department of Obstetrics & Gynecology and Center for Androgen-Related Disorders, Cedars-Sinai Medical Center, Los Angeles, California
- Department of Obstetrics & Gynecology, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Ida Y-D Chen
- Department of Obstetrics & Gynecology and Center for Androgen-Related Disorders, Cedars-Sinai Medical Center, Los Angeles, California
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California
| | - Yen-Hao Chen
- Department of Obstetrics & Gynecology and Center for Androgen-Related Disorders, Cedars-Sinai Medical Center, Los Angeles, California
- Department of Obstetrics & Gynecology, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Ricardo Azziz
- Department of Obstetrics & Gynecology and Center for Androgen-Related Disorders, Cedars-Sinai Medical Center, Los Angeles, California
- Department of Obstetrics & Gynecology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
- Department of Health Policy, Management and Behavior, School of Public Health, University at Albany, SUNY, Albany, New York
- Department of Obstetrics & Gynecology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Correspondence and Reprint Requests: Ricardo Azziz, American Society for Reproductive Medicine, 1209 Montgomery Hwy, Birmingham, AL. E-mail:
| |
Collapse
|
20
|
Armeni E, Lambrinoudaki I. Cardiovascular Risk in Postmenopausal Women with Polycystic Ovary Syndrome. Curr Vasc Pharmacol 2020; 17:579-590. [PMID: 30156159 DOI: 10.2174/1570161116666180828154006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 07/28/2018] [Accepted: 08/01/2018] [Indexed: 02/06/2023]
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies affecting women of reproductive age. The hormonal alterations of PCOS have been linked with a higher risk of metabolic disturbances in young, reproductively active women. However, it remains to be clarified whether the presence of PCOS increases the risk of cardiovascular disease (CVD) later in life. Aging ameliorates the clinical manifestations of PCOS; hyperandrogenaemia and metabolic abnormalities, however, persist beyond the menopause. On the other hand, aging and menopause increase CVD risk in the general female population. The results of the limited available studies in aging women with a previous diagnosis of PCOS demonstrate early atherosclerosis. However, studies addressing clinical CVD outcomes in women with PCOS report inconsistent findings. A possible explanation for this heterogeneity is the difficulty in diagnosing PCOS after the menopausal transition, due to the absence of validated diagnostic criteria for this population. Larger prospective studies of women diagnosed during their reproductive years will shed more light on the longer-term CVD implications of PCOS.
Collapse
Affiliation(s)
- Eleni Armeni
- Menopause Clinic, 2nd Department of Obstetrics and Gynaecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Irene Lambrinoudaki
- Menopause Clinic, 2nd Department of Obstetrics and Gynaecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
21
|
Seo Y, Song HJ, Song YR. Fat-to-muscle ratio as a predictor of insulin resistance and metabolic syndrome in Korean adults. J Cachexia Sarcopenia Muscle 2020; 11:710-725. [PMID: 32030917 PMCID: PMC7296262 DOI: 10.1002/jcsm.12548] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 07/31/2019] [Accepted: 01/07/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The present study evaluated the associations of the fat-to-muscle ratio (FMR) with metabolic syndrome (MetS) and insulin resistance (IR) in Korean adults using nationally representative survey data. METHODS A two-stage stratified sampling method was reflected in a cross-sectional study involving a total of 13 032 participants aged ≥ 19 years who participated in the fourth and fifth Korea National Health and Nutrition Examination Surveys. The homeostasis model assessment for IR (HOMA-IR) was used to evaluate IR and was calculated as follows: [fasting plasma glucose level (mg/dL) × fasting plasma insulin level (uIU/mL)]/405. MetS was defined using the 2006 International Diabetes Federation criteria, and FMR was measured using whole-body dual-energy X-ray absorptiometry and calculated as follows: total fat mass (kg) divided by total lean mass (kg). In addition, the optimal FMR cut-off values for detecting MetS and the odds ratios (ORs) for MetS risk were determined according to the FMR quartile and sex. RESULTS Among all participants, the proportion of women was 58.4%, and the mean age was 44.22 ± 0.26 years. The FMR significantly differed between men and women (0.30 ± 0.002 vs. 0.53 ± 0.003, respectively, P < 0.001), and the prevalence of MetS and IR gradually increased as FMR increased (P for trend: <0.001). The optimal FMR cut-off value for detecting MetS was higher in women than in men (0.555 vs. 0.336, respectively). The negative predictive value was the highest in normal-weight participants (0.9992 in women and 0.9986 in men), while the positive predictive value was the highest in obese participants (0.5994 in women and 0.5428 in men). Based on the derived cut-off FMR, a high FMR was associated with poor outcomes in terms of cardiometabolic risk markers (P < 0.001). The multivariable-adjusted ORs for MetS, abdominal obesity, and IR (HOMA-IR ≥ 3) were 5.35 [95% confidence interval (CI): 4.39-6.52], 7.67 (95% CI: 6.33-9.30), and 3.25 (95% CI: 2.70-3.92), respectively, in men and 5.59 (95% CI: 4.66-6.72), 7.48 (95% CI: 6.35-8.82), and 2.55 (95% CI: 2.17-3.00), respectively, in women. CONCLUSIONS In the present study, a high FMR was significantly associated with the prevalence of MetS and IR. The present findings also showed that FMR can be a novel indicator for detecting the absence or presence of MetS, particularly in metabolically healthy normal-weight individuals and metabolically obese obese-weight individuals.
Collapse
Affiliation(s)
- Young‐Gyun Seo
- Department of Family MedicineHallym University Sacred Heart HospitalAnyangGyeonggi‐doRepublic of Korea
| | - Hong Ji Song
- Department of Family MedicineHallym University Sacred Heart HospitalAnyangGyeonggi‐doRepublic of Korea
| | - Young Rim Song
- Department of Internal MedicineHallym University Sacred Heart HospitalDongan‐guAnyangGyeonggi‐doRepublic of Korea
| |
Collapse
|
22
|
Barrea L, Arnone A, Annunziata G, Muscogiuri G, Laudisio D, Salzano C, Pugliese G, Colao A, Savastano S. Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS). Nutrients 2019; 11:E2278. [PMID: 31547562 PMCID: PMC6836220 DOI: 10.3390/nu11102278] [Citation(s) in RCA: 140] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 09/13/2019] [Accepted: 09/18/2019] [Indexed: 02/07/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common female endocrine disorder and is characterized by chronic anovulation, hyperandrogenism, and polycystic ovaries. Obesity, low-grade chronic inflammatory status, and insulin-resistance (IR) often coexist in PCOS. The Mediterranean diet (MD) is an anti-inflammatory dietary pattern, which is rich in complex carbohydrates and fiber, and high in monounsaturated fat. There is a close association among obesity, low-grade chronic inflammation, IR, and hormonal derangements in PCOS. The main aim of the present study was to evaluate the adherence to MD, the dietary intake, and the body composition and their association with PCOS clinical severity in a cohort of treatment-naïve women with PCOS when compared with a control group of healthy women matched for age and body mass index (BMI). In this case-controlled, cross-sectional study, we enrolled 112 patients with PCOS and 112 controls. PREvención con DIetaMEDiterránea (PREDIMED) and seven-day food records were used to evaluate the degree of adherence to the MD and dietary pattern, respectively. Body composition was evaluated by bioelectrical impedance analysis (BIA) phase-sensitive system. Testosterone levels and Ferriman-Gallwey score assessed the clinical severity of PCOS. C-reactive protein (CRP) levels were determined with a nephelometric assay with CardioPhase high sensitivity. PCOS women showed higher testosterone levels, Ferriman-Gallwey score, fasting insulin and glucose levels, and Homeostatic Model Assessment (HoMA)-IR when compared with the control group (p < 0.001). In addition, we found that the PCOS women consumed less extra-virgin olive oil, legumes, fish/seafood, and nuts compared with control group. Despite no differences in energy intake between the two groups, the PCOS women consumed a lower quantity of complex carbohydrate, fiber, monounsaturated fatty acids (MUFA), and n-3 polyunsaturated fatty acid (PUFA), and higher quantity of simple carbohydrate, total fat, saturated fatty acid (SFA), PUFA and n-6 PUFA than the control group. The PCOS women have an adverse body composition when compared with controls, with the lowest values of phase angle (PhA) and fat-free mass (p < 0.001). Additionally, after adjusting for BMI and total energy intake, testosterone levels showed significant negative correlations with PREDIMED score (p < 0.001) and consumption of protein (p = 0.005), complex carbohydrate (p < 0.001), fiber (p < 0.001), MUFA (p < 0.001), n-3 PUFA (p = 0.001), and positive associations with CRP levels, simple carbohydrate, SFA, n-6 PUFA (p < 0.001, respectively), and PUFA (p = 0.002). The cut-off for PREDIMED score ≤ 6 (p < 0.001, area under the curve (AUC) 0.848, standard error 0.036, 95% confidence interval (CI) 0.768 to 0.909) could serve as a threshold for significantly increased risk of high value of testosterone levels. In conclusion, a novel direct association between the adherence to MD and the clinical severity of the disease was reported in women with PCOS. This association could support a therapeutic role of foods and nutrients of the Mediterranean dietary pattern in the PCOS pathogenesis likely involving their inflammatory status, IR, and hyperandrogenemia. In addition, we reported a different body composition that is characterized by lower PhA and fat-free mass than controls. These data suggested a role of PhA as a useful marker of the clinical severity of this syndrome and provided strong evidence regarding the strategic relevance of the nutritional assessment in the management of women with PCOS.
Collapse
Affiliation(s)
- Luigi Barrea
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Angela Arnone
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Giuseppe Annunziata
- Department of Pharmacy, University of Naples "Federico II", Via Domenico Montesano, 49, 80131 Naples, Italy.
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Daniela Laudisio
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Ciro Salzano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Gabriella Pugliese
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| |
Collapse
|
23
|
McBreairty LE, Chilibeck PD, Gordon JJ, Chizen DR, Zello GA. Polycystic ovary syndrome is a risk factor for sarcopenic obesity: a case control study. BMC Endocr Disord 2019; 19:70. [PMID: 31262307 PMCID: PMC6604177 DOI: 10.1186/s12902-019-0381-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 05/15/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in young women and increases risk of cardiovascular and metabolic disease, and infertility. Women with PCOS share many characteristics commonly associated with aging including chronic inflammation and insulin resistance, which may be associated with "sarcopenic obesity", a term used to describe low appendicular skeletal muscle mass relative to total body mass. The purpose of this work was to determine the prevalence of sarcopenic obesity in women with PCOS. We hypothesized there would be a high prevalence of sarcopenic obesity, and that % appendicular skeletal muscle mass and markers of inflammation and insulin resistance would be inversely correlated in this population. METHODS Dual energy X-ray absorptiometry was used to assess body composition in 68 women with PCOS aged 18-35y and 60 healthy age-matched women from the same geographic area. Sarcopenic obesity was defined as having % appendicular skeletal muscle mass 2 standard deviations below the mean for the healthy age-matched controls and a % body fat above 35%. Data were analyzed with Mann-Whitney U-tests and Spearman correlations. RESULTS 53% of women with PCOS were classified as sarcopenic obese. Women with PCOS had a median (interquartile range) appendicular skeletal muscle mass of 23.8 (22.3-25.8)% which was lower than the control median of 30.4 (28.6-32.4)% (p < 0.0001). Among women with PCOS, there were negative correlations between % appendicular skeletal muscle mass and the homeostasis model assessment insulin resistance index (r = - 0.409; p < 0.01), high sensitivity C-reactive protein (r = - 0.608; p < 0.0001) and glycosylated hemoglobin (r = - 0.430; p < 0.0001). Furthermore, % appendicular skeletal muscle mass correlated positively with vitamin D (r = 0.398; p < 0.0001) in women with PCOS, which is thought to positively affect skeletal muscle mass. CONCLUSIONS Women with PCOS have a high prevalence of sarcopenic obesity, which is correlated to insulin resistance and inflammation.
Collapse
Affiliation(s)
- Laura E. McBreairty
- College of Pharmacy and Nutrition, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4 Canada
| | - Philip D. Chilibeck
- College of Kinesiology, Physical Activity Complex, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK S7N 5B2 Canada
| | - Julianne J. Gordon
- College of Kinesiology, Physical Activity Complex, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK S7N 5B2 Canada
| | - Donna R. Chizen
- Obstetrics and Gynecology, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8 Canada
| | - Gordon A. Zello
- College of Pharmacy and Nutrition, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4 Canada
| |
Collapse
|
24
|
Chen YY, Fang WH, Wang CC, Kao TW, Yang HF, Wu CJ, Sun YS, Wang YC, Chen WL. Fat-to-muscle ratio is a useful index for cardiometabolic risks: A population-based observational study. PLoS One 2019; 14:e0214994. [PMID: 30964893 PMCID: PMC6456204 DOI: 10.1371/journal.pone.0214994] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 03/26/2019] [Indexed: 12/14/2022] Open
Abstract
Metabolic disorders are prevalent worldwide and have recently become public health problems recently. Previous studies have proposed different body composition indices for predicting future cardiovascular risks. We hypothesized an association among fat-to-muscle ratio (FMR), metabolic syndrome (MetS), hypertension (HTN), prediabetes, type 2 diabetes mellitus (DM), and cardiovascular risk in an adult population. A total of 66829 eligible subjects composed of 34182 males and 32647 females aged 20 years or older were obtained from health examinations in the Tri-Service General Hospital from 2011 to 2017. The body composition indices included fat and muscle mass measured by bioelectrical impedance analysis. A multivariable regression model was performed in a large population-based cross-sectional study. FMR was significantly associated with MetS, prediabetes, DM and HTN in all models of both genders. Based on quartile analysis, higher FMR had higher predictive ability for adverse health outcomes. The association between different definitions of MetS and the Framingham risk score was analyzed, and FMR-incorporated MetS was more useful for predicting higher Framingham risk scores than traditional definitions. FMR was a useful indicator for the presence of adverse cardiometabolic risks. Compared to traditional definition of MetS, FMR-incorporated MetS had a greater ability to predict incident cardiovascular risks. FMR seemed to be a simple and effective index for the early prevention and management of cardiometabolic events.
Collapse
Affiliation(s)
- Yuan-Yuei Chen
- Department of Internal Medicine, Tri-Service General Hospital Songshan Branch, Taipei, Taiwan, Republic of China
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wen-Hui Fang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chung-Ching Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Graduate Institute of Clinical Medical, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Hui-Fang Yang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chen-Jung Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Family Medicine, Department of Community Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, Republic of China
| | - Yu-Shan Sun
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Ying-Chuan Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
- * E-mail:
| |
Collapse
|
25
|
Ezeh U, Chen IYD, Chen YH, Azziz R. Adipocyte expression of glucose transporter 1 and 4 in PCOS: Relationship to insulin-mediated and non-insulin-mediated whole-body glucose uptake. Clin Endocrinol (Oxf) 2019; 90:542-552. [PMID: 30623452 DOI: 10.1111/cen.13931] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 12/23/2018] [Accepted: 01/04/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine-metabolic disorder associated with insulin resistance (IR). In IR states, non-insulin-mediated glucose uptake (NIMGU) may increase to compensate for declining insulin-mediated glucose uptake (IMGU), although this does not appear to be the case in PCOS. The underlying molecular mechanisms for this deficiency remain unclear. OBJECTIVES To compare adipocyte glucose transporter 1 and 4 (GLUT-1 and GLUT-4) gene expression in PCOS women and matched controls, and to determine whether changes in GLUT-1 and GLUT-4 are associated with concomitant alterations in whole-body glucose uptake. RESEARCH DESIGN AND METHODS In this prospective cross-sectional study, 23 women with PCOS (by NIH 1990 criteria) and 23 matched controls were studied for subcutaneous abdominal adipocyte GLUT-1 and GLUT-4 mRNA expression (by real-time PCR), and basal whole-body IR (by HOMA-IR) and insulin secretion (by HOMA-β%). A subset of six PCOS women and six matched controls also underwent a mFSIVGTT to determine dynamic state glucose uptake (by insulin sensitivity index [Si] and glucose effectiveness [Sg]) and insulin secretion (by the acute insulin response to glucose [AIRg] and the disposition index [Di]). RESULTS For similar adiposity (BMI and waist-hip ratio), PCOS women tended to have higher HOMA-IR and lower Di and Si, and higher HOMA-β% and lower GLUT-4 than controls, while GLUT-1 was similar. GLUT-1 was positively associated with Sg (reflecting NIMGU) and GLUT-4 positively with Si (reflecting IMGU). GLUT-4 was associated negatively with HOMA-IR and HOMA-β% and positively with Di for the entire cohort but not with AIRg. Both GLUT-1 and GLU-4 were negatively associated with BMI, but not with each other. CONCLUSION Our results suggest that IR secondary to a lower IMGU and enhanced insulin secretion in PCOS is in part attributable to a reduction in adipocyte GLUT-4 expression that is not accompanied by a compensatory increase in GLUT-1 expression.
Collapse
Affiliation(s)
- Uche Ezeh
- Department of Obstetrics and Gynecology, Stanford Healthcare-ValleyCare Hospital, Pleasanton, California
- Department of Obstetrics & Gynecology and Center for Androgen-Related Disorders, Cedars-Sinai Medical Center, Los Angeles, California
- Department of Obstetrics & Gynecology, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Ida Y-D Chen
- Department of Obstetrics & Gynecology and Center for Androgen-Related Disorders, Cedars-Sinai Medical Center, Los Angeles, California
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California
| | - Yen-Hao Chen
- Department of Obstetrics & Gynecology and Center for Androgen-Related Disorders, Cedars-Sinai Medical Center, Los Angeles, California
- Department of Obstetrics & Gynecology, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Ricardo Azziz
- Department of Obstetrics & Gynecology and Center for Androgen-Related Disorders, Cedars-Sinai Medical Center, Los Angeles, California
- Department of Obstetrics & Gynecology, Medical College of Georgia, Augusta University, Augusta, Georgia
- Department of Obstetrics & Gynecology, Albany Medical College, Albany, New York
- Department of Health Policy, Management & Behavior, School of Public Health, University at Albany, SUNY, Albany, New York
| |
Collapse
|
26
|
Panchal SK, Carnahan S, Brown L. Coconut Products Improve Signs of Diet-Induced Metabolic Syndrome in Rats. PLANT FOODS FOR HUMAN NUTRITION (DORDRECHT, NETHERLANDS) 2017; 72:418-424. [PMID: 29079969 DOI: 10.1007/s11130-017-0643-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Increasing prevalence of obesity and metabolic syndrome warrants identification of potential therapeutic options for intervention. This study tested commercially available Virgin Coconut Oil and Coconut Nourish, as coconuts are rich sources of lauric and myristic acids. Male Wistar rats were fed either corn starch diet (C); high-carbohydrate, high-fat diet (H); high-carbohydrate, high-virgin coconut oil diet (HV); or high-carbohydrate, high-coconut Nourish diet (HN) for 16 weeks. Metabolic, liver, and cardiovascular health parameters were measured during and at the end of the study. Virgin coconut oil lowered body weight (C 386±8g, H 516±13g, HV 459±10g), blood glucose concentrations (C 4.2±0.1 mmol/L, H 5.4±0.2 mmol/L, HV 4.6±0.2 mmol/L), systolic blood pressure (C 127±5mmHg, H 149±4mmHg, HV 133±3mmHg,) and diastolic stiffness (C 25.0±1.7, H 31.4±1.2, HV 25.2±2.3,) with improved structure and function of the heart and liver. Coconut Nourish increased total body lean mass (C 255±10g, H 270±16g, HN 303±15g) and lowered plasma total cholesterol concentrations (C 1.6±0.2 mmol/L, H 1.7±0.1 mmol/L, HN 1.0±0.0 mmol/L), systolic blood pressure (C 127±5mmHg, H 149±4mmHg, HN 130±3mmHg) and diastolic stiffness (C 25.0±1.7, H 31.4±1.2, HN 26.5±1.0), improved structure and function of the heart and liver but increased plasma concentrations of triglycerides (C 0.3±0.1 mmol/L, H 1.1±0.4 mmol/L, HN 1.8±0.2 mmol/L) and non-esterified fatty acids (C 1.2±0.3 mmol/L, H 3.3±0.8 mmol/L, HN 5.6±0.4 mmol/L). Thus, the fiber and protein in coconut Nourish and the medium-chain saturated fatty acids in virgin coconut oil may improve cardiovascular and liver complications in obesity.
Collapse
Affiliation(s)
- Sunil K Panchal
- Functional Foods Research Group, Institute for Agriculture and the Environment, University of Southern Queensland, QLD, Toowoomba, 4350, Australia.
| | - Sharyn Carnahan
- Functional Foods Research Group, Institute for Agriculture and the Environment, University of Southern Queensland, QLD, Toowoomba, 4350, Australia
- School of Health and Wellbeing, Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, 4350, Australia
| | - Lindsay Brown
- Functional Foods Research Group, Institute for Agriculture and the Environment, University of Southern Queensland, QLD, Toowoomba, 4350, Australia
- School of Health and Wellbeing, Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, 4350, Australia
| |
Collapse
|
27
|
Dinsdale NL, Crespi BJ. Revisiting the wandering womb: Oxytocin in endometriosis and bipolar disorder. Horm Behav 2017; 96:69-83. [PMID: 28919554 DOI: 10.1016/j.yhbeh.2017.09.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 09/07/2017] [Accepted: 09/09/2017] [Indexed: 12/23/2022]
Abstract
Hippocrates attributed women's high emotionality - hysteria - to a 'wandering womb'. Although hysteria diagnoses were abandoned along with the notion that displaced wombs cause emotional disturbance, recent research suggests that elevated levels of oxytocin occur in both bipolar disorder and endometriosis, a gynecological condition involving migration of endometrial tissue beyond the uterus. We propose and evaluate the hypothesis that elevated oxytocinergic system activity jointly contributes to bipolar disorder and endometriosis. First, we provide relevant background on endometriosis and bipolar disorder, and then we examine evidence for comorbidity between these conditions. We next: (1) review oxytocin's associations with personality traits, especially extraversion and openness, and how they overlap with bipolar spectrum traits; (2) describe evidence for higher oxytocinergic activity in both endometriosis and bipolar disorder; (3) examine altered hypothalamic-pituitary-gonadal axis functioning in both conditions; (4) describe data showing that medications that treat one condition can improve symptoms of the other; (5) discuss fitness-related impacts of endometriosis and bipolar disorder; and (6) review a pair of conditions, polycystic ovary syndrome and autism, that show evidence of involving reduced oxytocinergic activity, in direct contrast to endometriosis and bipolar disorder. Considered together, the bipolar spectrum and endometriosis appear to involve dysregulated high extremes of normally adaptive pleiotropy in the female oxytocin system, whereby elevated levels of oxytocinergic activity coordinate outgoing sociality with heightened fertility, apparently characterizing, overall, a faster life history. These findings should prompt a re-examination of how mind-body interactions, and the pleiotropic endocrine systems that underlie them, contribute to health and disease.
Collapse
Affiliation(s)
- Natalie L Dinsdale
- Department of Biological Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, BC, Canada; Department of Psychology, 9 Campus Drive, 154 Arts, University of Saskatchewan, Saskatoon S7N 5A5, SK, Canada.
| | - Bernard J Crespi
- Department of Biological Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, BC, Canada.
| |
Collapse
|
28
|
Schiffer L, Kempegowda P, Arlt W, O’Reilly MW. MECHANISMS IN ENDOCRINOLOGY: The sexually dimorphic role of androgens in human metabolic disease. Eur J Endocrinol 2017; 177:R125-R143. [PMID: 28566439 PMCID: PMC5510573 DOI: 10.1530/eje-17-0124] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 04/12/2017] [Accepted: 05/03/2017] [Indexed: 12/22/2022]
Abstract
Female androgen excess and male androgen deficiency manifest with an overlapping adverse metabolic phenotype, including abdominal obesity, insulin resistance, type 2 diabetes mellitus, non-alcoholic fatty liver disease and an increased risk of cardiovascular disease. Here, we review the impact of androgens on metabolic target tissues in an attempt to unravel the complex mechanistic links with metabolic dysfunction; we also evaluate clinical studies examining the associations between metabolic disease and disorders of androgen metabolism in men and women. We conceptualise that an equilibrium between androgen effects on adipose tissue and skeletal muscle underpins the metabolic phenotype observed in female androgen excess and male androgen deficiency. Androgens induce adipose tissue dysfunction, with effects on lipid metabolism, insulin resistance and fat mass expansion, while anabolic effects on skeletal muscle may confer metabolic benefits. We hypothesise that serum androgen concentrations observed in female androgen excess and male hypogonadism are metabolically disadvantageous, promoting adipose and liver lipid accumulation, central fat mass expansion and insulin resistance.
Collapse
Affiliation(s)
- Lina Schiffer
- Institute of Metabolism and Systems ResearchUniversity of Birmingham, Edgbaston, Birmingham, UK
| | - Punith Kempegowda
- Institute of Metabolism and Systems ResearchUniversity of Birmingham, Edgbaston, Birmingham, UK
| | - Wiebke Arlt
- Institute of Metabolism and Systems ResearchUniversity of Birmingham, Edgbaston, Birmingham, UK
- Centre for EndocrinologyDiabetes and Metabolism, Birmingham Health Partners, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK
| | - Michael W O’Reilly
- Institute of Metabolism and Systems ResearchUniversity of Birmingham, Edgbaston, Birmingham, UK
- Centre for EndocrinologyDiabetes and Metabolism, Birmingham Health Partners, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK
- Correspondence should be addressed to M W O’Reilly;
| |
Collapse
|
29
|
Bordoni L, Napolioni V, Marchegiani F, Amadio E, Gabbianelli R. Angiotensin-Converting Enzyme Ins/Del Polymorphism and Body Composition: The Intermediary Role of Hydration Status. JOURNAL OF NUTRIGENETICS AND NUTRIGENOMICS 2017; 10:1-8. [PMID: 28315876 DOI: 10.1159/000458154] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 01/26/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND The well-known insertion/deletion polymorphism (rs4646994) of the angiotensin-converting enzyme (ACE) gene has been previously associated with obesity, blood flow, muscular strength, and ACE enzyme activity. Despite the relevant role of ACE in homeostasis, few data are currently available on the relationship between rs4646994 and hydration status. Thus, we tested the association between the ACE Ins/Del polymorphism, body composition, and hydration status in a young Italian population. METHODS A total of 306 healthy children and adolescents who regularly practice sports were recruited. Anthropometric, bioimpedentiometric parameters, and urine samples were collected, while ACE rs4646994 genotyping was performed on DNA from buccal swabs. General linear models were used for association testing. RESULTS The ACE Ins/Del polymorphism was associated with body composition. Ins/Ins individuals had higher phase angle (PhA) and body cellular mass index (BCMI) values. A significant influence of the ACE rs4646994 according to hydration status on body composition was also identified. In particular, Ins/Ins individuals displayed higher PhA and BCMI values only if norm-hydrated, while they showed values similar to Del carriers if dehydrated. CONCLUSION Our results confirm the relationship between the ACE Ins/Del polymorphism and body composition and suggest a role for hydration status in modulating this relationship. These interesting preliminary results warrant further investigation to disentangle the genetic role of ACE on hydration homeostasis.
Collapse
Affiliation(s)
- Laura Bordoni
- School of Advanced Studies, University of Camerino, Camerino, Italy
| | | | | | | | | |
Collapse
|
30
|
Chitme HR, Al Azawi EAK, Al Abri AM, Al Busaidi BM, Salam ZKA, Al Taie MM, Al Harbo SK. Anthropometric and body composition analysis of infertile women with polycystic ovary syndrome. J Taibah Univ Med Sci 2017; 12:139-145. [PMID: 31435228 PMCID: PMC6694878 DOI: 10.1016/j.jtumed.2016.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 11/21/2016] [Accepted: 11/29/2016] [Indexed: 01/30/2023] Open
Abstract
Objectives To evaluate the body composition and anthropometric profile of infertile women who have been diagnosed with polycystic ovary syndrome (PCOS) and to investigate the incidence of PCOS and to examine body fat composition as a risk factor for this disease. Methods This hospital-based case controlled study was conducted on a cohort of 132 patients with and without PCOS. Bioelectrical impedance analysis was used to record body composition parameters, such as total body fat, visceral fat, subcutaneous fat, skeletal muscle composition and their distribution in the trunk, legs and arms, as well as blood pressure. Anthropometric profile parameters, including body mass index (BMI), ideal body weight (IBW), waist circumference, hip circumference and waist-to-hip ratio, were also recorded. Results The mean age of incidence of PCOS was 29.74 ± 3.32 years (OR 1.417), and most of the cohort exhibited high to very high visceral fat with significant correlation (p < 0.001). Total body fat distribution and whole, trunk, arm and leg subcutaneous fat were significantly higher in patients with PCOS (p < 0.001). The mean BMI, waist and hip circumference of the PCOS group were 28.2 ± 6.08, 97.44 ± 15.11 cm and 109.22 ± 17.39 cm, respectively. The results also indicated significant increases in DP and MAP (OR 1.528) in patients with PCOS compared to the control group (p < 0.001). Conclusion This study exhibits higher levels of BMI, body fat distribution, waist and hip circumference, diastolic and mean blood pressure, visceral fat, and a disproportionate increase in the level of global fat and its distribution.
Collapse
Affiliation(s)
- Havagiray R Chitme
- Department of Pharmacy, Oman Medical College, Bowshar Campus, Muscat, Oman
| | | | | | | | | | | | | |
Collapse
|
31
|
Geronikolou SA, Bacopoulou F, Cokkinos D. Bioimpedance Measurements in Adolescents with Polycystic Ovary Syndrome: A Pilot Study. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 987:291-299. [PMID: 28971467 DOI: 10.1007/978-3-319-57379-3_26] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Limited data are available on the body composition of adolescent women with polycystic ovary syndrome (PCOS). The aim of this study was to examine differences in body composition indices of metabolism, homeostasis and inflammation, between Greek adolescent females suffering from PCOS and age- and body mass index (BMI)-matched non-PCOS controls. Thirteen PCOS patients and nine non-PCOS controls, aged 13-24 years participated in this cross-sectional study. Study participants underwent assessment by a novel dual frequency bioimpedance device (BIA-ACC). The following body composition indices were measured in each adolescent: extra cellular water (ECW) as inflammation marker, total body water (TBW) as homeostasis marker, extracellular mass to body cell mass ratio (ECM/BCM), fat mass (FM), fat-free mass (FFM) and intracellular water (ICW) as markers of body mass composition and metabolism. Non-linear analysis showed no statistically significant differences in the body composition characteristics between PCOS patients and controls. Further studies with larger sample sizes are needed to confirm whether adolescents with PCOS actually have similar body composition profile with their non-PCOS peers.
Collapse
Affiliation(s)
- Styliani A Geronikolou
- Clinical, Translational and Experimental Surgery Research Centre, Biomedical Research Foundation of Academy of Athens, 4 Soranou Ephessiou Street, 11527, Athens, Greece.
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, 3 Thivon Street, 11527, Athens, Greece
| | - Dennis Cokkinos
- Clinical, Translational and Experimental Surgery Research Centre, Biomedical Research Foundation of Academy of Athens, 4 Soranou Ephessiou Street, 11527, Athens, Greece
| |
Collapse
|
32
|
Goyal M, Dawood AS. Debates Regarding Lean Patients with Polycystic Ovary Syndrome: A Narrative Review. J Hum Reprod Sci 2017; 10:154-161. [PMID: 29142442 PMCID: PMC5672719 DOI: 10.4103/jhrs.jhrs_77_17] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a complex syndrome showing the clinical features of an endocrine/metabolic disorder, including hyperinsulinemia and hyperandrogenism. Two phenotypes are present, either lean or obese, with different biochemical, hormonal, and metabolic profiles. Evidence suggests many treatment modalities that can be applied. However, many of these modalities were found to be not suitable for the lean phenotype of PCOS. Much contradictory research was found regarding lean patients with PCOS. The aim of this narrative review is to shed light on the debate prevailing regarding characteristics, as well as metabolic, hematological, and potential management modalities. Literature review was performed from January 1, 2000 to March 31, 2017 with specific word search such as lean PCOS, hormonal abnormalities in lean PCOS, and the management of lean PCOS. All retrieved articles were carefully assessed, and data were obtained. We could conclude that the debate is still prevailing regarding this specific lean population with PCOS, especially with regard to their characteristics and management modalities. Further studies are still required to resolve this debate on the presence of PCOS in lean women.
Collapse
Affiliation(s)
- Manu Goyal
- Department of Obstetrics and Gynecology, AIIMS, New Delhi, India
| | - Ayman S Dawood
- Department of Obstetrics and Gynecology, Tanta University, Tanta, Egypt
| |
Collapse
|
33
|
Hung SP, Chen CY, Guo FR, Chang CI, Jan CF. Combine body mass index and body fat percentage measures to improve the accuracy of obesity screening in young adults. Obes Res Clin Pract 2017; 11:11-18. [DOI: 10.1016/j.orcp.2016.02.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 01/22/2016] [Accepted: 02/12/2016] [Indexed: 12/16/2022]
|
34
|
Lizneva D, Gavrilova-Jordan L, Walker W, Azziz R. Androgen excess: Investigations and management. Best Pract Res Clin Obstet Gynaecol 2016; 37:98-118. [DOI: 10.1016/j.bpobgyn.2016.05.003] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 05/05/2016] [Indexed: 01/25/2023]
|
35
|
Glintborg D, Petersen MH, Ravn P, Hermann AP, Andersen M. Comparison of regional fat mass measurement by whole body DXA scans and anthropometric measures to predict insulin resistance in women with polycystic ovary syndrome and controls. Acta Obstet Gynecol Scand 2016; 95:1235-1243. [DOI: 10.1111/aogs.12964] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 08/10/2016] [Indexed: 01/21/2023]
Affiliation(s)
- Dorte Glintborg
- Department of Endocrinology and Metabolism; Odense University Hospital; Odense Denmark
| | | | - Pernille Ravn
- Department of Gynecology and Obstetrics; Odense University Hospital; Odense Denmark
| | - Anne Pernille Hermann
- Department of Endocrinology and Metabolism; Odense University Hospital; Odense Denmark
| | - Marianne Andersen
- Department of Endocrinology and Metabolism; Odense University Hospital; Odense Denmark
| |
Collapse
|
36
|
Ding L, Gao F, Zhang M, Yan W, Tang R, Zhang C, Chen ZJ. Higher PDCD4 expression is associated with obesity, insulin resistance, lipid metabolism disorders, and granulosa cell apoptosis in polycystic ovary syndrome. Fertil Steril 2016; 105:1330-1337.e3. [DOI: 10.1016/j.fertnstert.2016.01.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 12/31/2015] [Accepted: 01/18/2016] [Indexed: 12/16/2022]
|
37
|
Tang M, Huang C, Wang YF, Ren PG, Chen L, Xiao TX, Wang BB, Pan YF, Tsang BK, Zabel BA, Ma BH, Zhao HY, Zhang JV. CMKLR1 deficiency maintains ovarian steroid production in mice treated chronically with dihydrotestosterone. Sci Rep 2016; 6:21328. [PMID: 26893072 PMCID: PMC4759558 DOI: 10.1038/srep21328] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 12/22/2015] [Indexed: 01/03/2023] Open
Abstract
Elevated serum chemerin levels correlate with increased severity of polycystic ovary syndrome (PCOS). However, the role of CMKLR1 signaling in ovarian biology under conditions of excess DHT remains unclear. In this study we compared the effects of continuous 90-day high dose DHT exposure (83.3 □g/day) on wild type and CMKLR1-deficient mice. DHT induced PCOS-like clinical signs in wild type mice as well as significant changes in the expression of hormone receptors, steroid synthesis enzymes, and BMPs and their receptors. In contrast, CMKLR1-deficient mice significantly attenuated DHT-induced clinical signs of PCOS and alterations in ovarian gene expression. To determine whether the BMP4 signaling pathway was involved in the pathogenic effects of CMKLR1 signaling in DHT-induced ovarian steroidogenesis, antral follicles were isolated from wild type and CMKLR1 knockout (KO) mice and treated in vitro with combinations of hCG, DHT, and BMP4 inhibitors. BMP4 inhibition attenuated the induction effects of hCG and DHT on estrogen and progesterone secretion in CMKLR1 KO mice, but not in WT mice, implicating the BMP4 signaling pathway in the CMKLR1-dependent response to DHT. In conclusion, CMKLR1 gene deletion attenuates the effects of chronic DHT treatment on ovarian function in experimental PCOS, likely via BMP4 signaling.
Collapse
Affiliation(s)
- Mi Tang
- College of Veterinary Medicine, Northwest Sci-Tech University of A&F, Yangling, Shanxi, 712100, China.,Research Laboratory for Reproductive Health, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Chen Huang
- Research Laboratory for Reproductive Health, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Yu-Fei Wang
- Research Laboratory for Reproductive Health, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China.,University of Science and Technology of China, An-Hui, He-Fei, 230026, China
| | - Pei-Gen Ren
- Research Laboratory for Reproductive Health, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Li Chen
- Research Laboratory for Reproductive Health, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Tian-Xia Xiao
- Research Laboratory for Reproductive Health, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Bao-Bei Wang
- Research Laboratory for Reproductive Health, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Yan-Fei Pan
- Research Laboratory for Reproductive Health, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Benjamin K Tsang
- Department of Obstetrics &Gynaecology, University of Ottawa, Ottawa, Ontario K1H 8L6, Canada.,Chronic Disease Program, Ottawa Hospital Research Institute Ontario K1H 8L6, Canada.,Department of Cellular &Molecular Medicine, University of Ottawa; Ottawa, Ontario K1H 8L6, Canada.,Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario K1H 8L6, Canada
| | - Brian A Zabel
- Palo Alto Veterans Institute for Research, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Bao-Hua Ma
- College of Veterinary Medicine, Northwest Sci-Tech University of A&F, Yangling, Shanxi, 712100, China
| | - Hui-Ying Zhao
- College of Veterinary Medicine, Northwest Sci-Tech University of A&F, Yangling, Shanxi, 712100, China
| | - Jian V Zhang
- Research Laboratory for Reproductive Health, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| |
Collapse
|
38
|
Churchill SJ, Wang ET, Bhasin G, Alexander C, Bresee C, Pall M, Azziz R, Mathur R, Pisarska MD. Basal metabolic rate in women with PCOS compared to eumenorrheic controls. Clin Endocrinol (Oxf) 2015; 83:384-8. [PMID: 25660380 DOI: 10.1111/cen.12740] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 12/02/2014] [Accepted: 02/04/2015] [Indexed: 12/31/2022]
Abstract
OBJECTIVE PCOS is associated with obesity and insulin resistance. Efforts have focused on whether an abnormal energy homeostasis contributes to the development of obesity in these patients. There are conflicting results in the literature regarding whether women with PCOS have an altered basal metabolic rate (BMR), thereby leading to difficulties in weight loss. The objective of this study is to compare basal metabolic rate (BMR) in women with PCOS and controls. DESIGN Cross-sectional study. PATIENTS One hundred and twenty-eight PCOS patients diagnosed by original NIH consensus criteria and 72 eumenorrheic, non-hirsute controls were recruited from an academic medical centre. MEASUREMENTS Assessment of BMR using the InBody portable bioelectrical impedance analysis (BIA) device and insulin resistance by HOMA-IR indices. RESULTS PCOS women were younger than controls. As expected, PCOS subjects had higher body mass index (BMI), serum androgens and estimated insulin resistance. After adjusting for age and BMI, there was no significant difference in BMR between PCOS subjects (adjusted mean 5807 kJ/day, 95% CI 5715-5899) and controls (adjusted mean 5916 kJ/day, 95% CI 5786-6046) (P = 0·193). BMR was also comparable in a secondary analysis comparing PCOS women with and without insulin resistance. CONCLUSIONS After adjusting for age and BMI, there was no difference in BMR between PCOS women and controls.
Collapse
Affiliation(s)
- Sara J Churchill
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Erica T Wang
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, David Geffen School of Medicine, University of California, University of California at Los Angeles, Los Angeles, CA, USA
| | - Gaisu Bhasin
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Carolyn Alexander
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, David Geffen School of Medicine, University of California, University of California at Los Angeles, Los Angeles, CA, USA
| | - Catherine Bresee
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Marita Pall
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ricardo Azziz
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Departments of Obstetrics and Gynecology, and Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA
| | - Ruchi Mathur
- Department of Medicine, Division of Endocrinology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Margareta D Pisarska
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, David Geffen School of Medicine, University of California, University of California at Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
39
|
Liu W, Liu W, Fu Y, Wang Y, Zhang Y. Bak Foong pills combined with metformin in the treatment of a polycystic ovarian syndrome rat model. Oncol Lett 2015; 10:1819-1825. [PMID: 26622758 DOI: 10.3892/ol.2015.3466] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 04/14/2015] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to investigate the treatment effects and associated mechanism of Bak Foong pills (BFPs) combined with metformin in the treatment of polycystic ovarian syndrome (PCOS). BFPs and/or metformin were administrated to treat the PCOS rats, and the weights and morphologies of the ovary, uterus and adrenal gland were measured. The levels of fasting blood glucose (FBG), serum testosterone (T), luteinizing hormone, fasting insulin (FIN) and insulin-like growth factor-1 were also measured, and the homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. The expression level of androgen receptor (AR) in the ovarian tissue, and the cytochrome P450 cholesterol side-chain cleavage enzyme (P450scc) mRNA levels in the ovary and adrenal tissues were detected. The levels of T, FIN, FBG and HOMA-IR in the combination group were significantly reduced; the wet weights of the ovary and the adrenal gland were decreased significantly, while that of the uterus was increased, and the histological morphology benignly recovered. The rats of each treatment group all experienced restored ovulation. The AR expression level in the treatment group was reduced, and the P450scc mRNA levels in the ovary and the adrenal gland of the combined treatment group were decreased. BFPs combined with metformin significantly affected PCOS, and the possible mechanism involved in the treatment may have been through the reduction of P450scc generation. BFPs may reduce the androgen levels, thus allowing the ovary to restore ovulation.
Collapse
Affiliation(s)
- Wenhui Liu
- Center of Reproductive Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Wenpei Liu
- Translational Medicine Institute, Affiliated to The First People's Hospital of Chenzhou, University of South China, Chenzhou, Hunan 423000, P.R. China
| | - Yuling Fu
- Department of Obstetrics and Gynecology, The Second Hospital of Yinzhou, Ningbo, Zhejiang 315000, P.R. China
| | - Yan Wang
- Center of Reproductive Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Yuanzhen Zhang
- Center of Reproductive Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
| |
Collapse
|
40
|
Swaroop A, Jaipuriar AS, Gupta SK, Bagchi M, Kumar P, Preuss HG, Bagchi D. Efficacy of a Novel Fenugreek Seed Extract (Trigonella foenum-graecum, Furocyst) in Polycystic Ovary Syndrome (PCOS). Int J Med Sci 2015; 12:825-31. [PMID: 26516311 PMCID: PMC4615243 DOI: 10.7150/ijms.13024] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 09/02/2015] [Indexed: 01/16/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is one of the most prevalent hormonal disorders among women of reproductive age causing irregular menstrual cycles, excessive body or facial hair, miscarriage and infertility. The latter being a most common PCOS symptoms. Because the symptoms are seemingly unrelated to one another, PCOS is often overlooked and undiagnosed. The present study is an open label, one-arm, non-randomized, post-marketing surveillance study in 50 premenopausal women (18-45 years, BMI<42) diagnosed with PCOS using a novel Trigonella foenum-graecum seed extract (fenugreek seed extract, Furocyst, 2 capsules of 500 mg each/day) extract, enriched in approximately 40% furostanolic saponins, over a period of 90 consecutive days. The study was conducted to determine its efficacy on the reduction of ovarian volume and the number of ovarian cysts. Ethical committee approval was obtained for this study. Furocyst treatment caused significant reduction in ovary volume. Approximately 46% of study population showed reduction in cyst size, while 36% of subjects showed complete dissolution of cyst. It is important to mention that 71% of subjects reported the return of regular menstrual cycle on completion of the treatment and 12% of subjects subsequently became pregnant. Overall, 94% of patients benefitted from the regimen. Significant increases in luteinizing hormone (LH) and follicular stimulating hormone (FSH) levels were observed compared to the baseline values. Extensive blood chemistry, hematological and biochemical assays demonstrated the broad-spectrum safety. Furocyst caused significant decrease in both ovarian volume and the number of ovarian cysts. Serum ALT, BUN and CK were assessed to demonstrate the broad-spectrum safety of Furocyst. No significant adverse effects were observed. In summary, Furocyst was efficacious in ameliorating the symptoms of PCOS.
Collapse
Affiliation(s)
| | | | | | | | - Pawan Kumar
- 4. Chemical Resources, Panchkula, Haryana, India
| | - Harry G Preuss
- 5. Departments of Biochemistry, Medicine and Pathology, Georgetown University Medical Center, Washington, DC, USA
| | - Debasis Bagchi
- 1. Cepham Research Center, Piscataway, NJ, USA ; 6. Department of Pharmacological and Pharmaceutical Sciences, University of Houston College of Pharmacy, Houston, TX, USA
| |
Collapse
|