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Zheng X, Zhou C, Xu W, Jia J, Li B, Lv G, Chen S. Protective effect of Yunkang oral liquid via regulating androgen receptor in polycystic ovary syndrome rats. Gynecol Endocrinol 2024; 40:2368845. [PMID: 39058911 DOI: 10.1080/09513590.2024.2368845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 05/21/2024] [Accepted: 06/10/2024] [Indexed: 07/28/2024] Open
Abstract
Objectives: This study aimed to explore the effect and mechanism of Yunkang oral liquid (YK) on polycystic ovary syndrome (PCOS). Methods: PCOS model rats were prepared by injecting exogenous androgen dehydroepiandrosterone, and YK was administered simultaneously for 28 days during modeling. The morphology of ovaries and uterus was observed using H&E staining, and serum levels of testosterone (T), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were determined by radioimmunoassay. Additionally, serum lipids (TG, HDL-c), blood glucose (GLU), and aminotransferase (AST, ALT) levels were detected. The expression of androgen receptor (AR) protein was determined by Western blotting. Results: YK treatment resulted in reduced serum levels of T, LH and FSH, ameliorated ovarian polycystic-like pathological changes and uterine morphology in PCOS rats, and decreased serum TG, GLU, AST and ALT levels, elevated serum HDL-c levels, and improved abnormalities of glycolipid metabolism accompanying PCOS. Moreover, YK decreased the expression of ovarian AR in PCOS rats. Conclusions: This study indicates that YK may protect the ovaries by inhibiting the expression of AR, which could be a potential treatment for PCOS.
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Affiliation(s)
- Xiang Zheng
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, China
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chuanjie Zhou
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, China
| | - Wanfeng Xu
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, China
| | - Jiujie Jia
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, China
| | - Bo Li
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, China
| | - Guiyuan Lv
- College of Pharmaceutical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Suhong Chen
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, China
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Zhejiang Provincial Key Laboratory of TCM for Innovative R & D and Digital Intelligent Manufacturing of TCM Great Health Products, Hangzhou, Zhejiang, China
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Ma Y, Cai J, Liu LW, Wen T, Huang W, Hou W, Wei Z, Xu Y, Xu Y, Wang Y, Mai Q. Causal relationships exist between polycystic ovary syndrome and adverse pregnancy and perinatal outcomes: a Mendelian randomization study. Front Endocrinol (Lausanne) 2024; 15:1327849. [PMID: 39006363 PMCID: PMC11239544 DOI: 10.3389/fendo.2024.1327849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 05/21/2024] [Indexed: 07/16/2024] Open
Abstract
Introduction Previous observational studies have shown that polycystic ovary syndrome (PCOS) was associated with adverse pregnancy and perinatal outcomes. However, it remains controversial whether PCOS is an essential risk factor for these adverse pregnancy and perinatal outcomes. We aimed to use instrumental variables in a two-sample Mendelian randomization (MR) study to determine causality between PCOS and adverse pregnancy and perinatal outcomes. Materials and methods Summary statistics were extracted from a recent genome-wide association study (GWAS) meta-analysis conducted in PCOS, which included 10,074 cases and 103,164 controls of European ancestry. Data on Adverse pregnancy and perinatal outcomes were summarized from the FinnGen database of European ancestry, which included more than 180,000 samples. The inverse variance weighted (IVW) method of MR was applied for the main outcome. To assess heterogeneity and pleiotropy, we conducted sensitivity analyses, including leave-one-out analysis, weighted median, MR-PRESSO (Mendelian Randomization Pleiotropy RESidual Sum and Outlier), and MR-Egger regression. Results Two-sample MR analysis with the IVW method suggested that PCOS exerted causal effects on the risk of hypertensive disorders of pregnancy [odds ratio (OR) 1.170, 95% confidence interval (CI) 1.051-1.302, p = 0.004], in particular gestational hypertension (OR 1.083, 95% CI 1.007-1.164, p = 0.031), but not other pregnancy and perinatal diseases (all p > 0.05). Sensitivity analyses demonstrated pleiotropy only in pre-eclampsia or eclampsia (p = 0.0004), but not in other pregnancy and perinatal diseases (all p > 0.05). The results remained consistent after excluding two outliers (all p > 0.05). Conclusions We confirmed a causal relationship between PCOS and hypertensive disorders of pregnancy, in particular gestational hypertension, but no association with any other adverse pregnancy or perinatal outcome. Therefore, we suggest that women with PCOS who are pregnant should have their blood pressure closely monitored.
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Affiliation(s)
- Yuanlin Ma
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- The Key Laboratory for Reproductive Medicine of Guangdong Province, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for obstetrical and gynecological diseases, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jiahao Cai
- Department of Neurology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Lok-Wan Liu
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- The Key Laboratory for Reproductive Medicine of Guangdong Province, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for obstetrical and gynecological diseases, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Tianrui Wen
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- The Key Laboratory for Reproductive Medicine of Guangdong Province, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for obstetrical and gynecological diseases, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Weina Huang
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- The Key Laboratory for Reproductive Medicine of Guangdong Province, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for obstetrical and gynecological diseases, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wenhui Hou
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Reproductive Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zixin Wei
- Department of Pulmonary and Critical Care Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yan Xu
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- The Key Laboratory for Reproductive Medicine of Guangdong Province, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for obstetrical and gynecological diseases, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yanwen Xu
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- The Key Laboratory for Reproductive Medicine of Guangdong Province, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for obstetrical and gynecological diseases, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yizi Wang
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- The Key Laboratory for Reproductive Medicine of Guangdong Province, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for obstetrical and gynecological diseases, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qingyun Mai
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- The Key Laboratory for Reproductive Medicine of Guangdong Province, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for obstetrical and gynecological diseases, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
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Suturina L, Lizneva D, Lazareva L, Danusevich I, Nadeliaeva I, Belenkaya L, Atalyan A, Belskikh A, Bairova T, Sholokhov L, Rashidova M, Krusko O, Darzhaev Z, Rinchindorzhieva M, Malanova A, Alekseeva L, Sharifulin E, Kuzmin M, Igumnov I, Babaeva N, Tyumentseva D, Grebenkina L, Kurashova N, Darenskaya M, Belyaeva E, Belkova N, Egorova I, Salimova M, Damdinova L, Sambyalova A, Radnaeva E, Dyachenko O, Antsupova K, Trofimova T, Khomyakova A, Ievleva K, Stanczyk FZ, Legro RS, Yildiz BO, Azziz R. Ethnicity and the Prevalence of Polycystic Ovary Syndrome: The Eastern Siberia PCOS Epidemiology and Phenotype Study. J Clin Endocrinol Metab 2024:dgae424. [PMID: 38888252 DOI: 10.1210/clinem/dgae424] [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: 01/12/2024] [Revised: 06/12/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024]
Abstract
CONTEXT Previous studies have shown that the prevalence of polycystic ovary syndrome (PCOS) may vary according to race/ethnicity, although few studies have assessed women of different ethnicities who live in similar geographic and socio-economic conditions. OBJECTIVE To determine the prevalence of PCOS in an unselected multiethnic population of premenopausal women. DESIGN A multicenter prospective cross-sectional study. SETTINGS The main regional employers of Irkutsk Region and the Buryat Republic, Russia. PARTICIPANTS During 2016-19, 1398 premenopausal women underwent a history and physical exam, pelvic ultrasound, and testing during a mandatory annual employment-related health assessment. MAIN OUTCOME MEASURES PCOS prevalence, overall and by ethnicity in a large medically unbiased population, including Caucasian (White), Mongolic or Asian (Buryat), and mixed ethnicity individuals, living in similar geographic and socio-economic conditions for centuries. RESULTS PCOS was diagnosed in 165/1134 (14.5%) women who had a complete evaluation for PCOS. Based on the probabilities for PCOS by clinical presentation observed in the cohort of women who had a complete evaluation we also estimated the weight-adjusted prevalence of PCOS in 264 women with an incomplete evaluation: 46.2 or 17.5%. Consequently, the total prevalence of PCOS in the population was 15.1%, higher among Caucasians and women of Mixed ethnicity compared to Asians (16.0% and 21.8% vs. 10.8%, pz <0.05). CONCLUSIONS We observed a 15.1% prevalence of PCOS in our medically unbiased population of premenopausal women. In this population of Siberian premenopausal women of Caucasian, Asian and Mixed ethnicity living in similar geographic and socio-economic conditions, the prevalence was higher in Caucasian or Mixed than Asian women. These data highlight the need to assess carefully ethnic-dependent differences in the frequency and clinical manifestation of PCOS.
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Affiliation(s)
- Larisa Suturina
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Daria Lizneva
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ludmila Lazareva
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Irina Danusevich
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Iana Nadeliaeva
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Lilia Belenkaya
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Alina Atalyan
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Alexey Belskikh
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Tatyana Bairova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Leonid Sholokhov
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Maria Rashidova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Olga Krusko
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Zorikto Darzhaev
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Marina Rinchindorzhieva
- Republican Perinatal Center of the Ministry of Health of Republic of Buryatia, Ulan-Ude, Republic of Buryatia, Russian Federation
| | - Ayuna Malanova
- Republican Perinatal Center of the Ministry of Health of Republic of Buryatia, Ulan-Ude, Republic of Buryatia, Russian Federation
| | - Lilia Alekseeva
- Banzarov Buryat State University, Institute of Medicine, Ulan-Ude, Republic of Buryatia, Russian Federation
| | - Eldar Sharifulin
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Mikhail Kuzmin
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Ilia Igumnov
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Natalia Babaeva
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Daria Tyumentseva
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Ludmila Grebenkina
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Nadezhda Kurashova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Marina Darenskaya
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Elena Belyaeva
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Natalia Belkova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Irina Egorova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Madinabonu Salimova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Ludmila Damdinova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Alexandra Sambyalova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Elena Radnaeva
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Olesya Dyachenko
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Karina Antsupova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Tatyana Trofimova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Anastasia Khomyakova
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Kseniia Ievleva
- Scientific Center for Family Health and Human Reproduction Problems, Irkutsk, Russian Federation
| | - Frank Z Stanczyk
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Richard S Legro
- Penn State College of Medicine, Penn State University, Hershey, PA, USA
| | - Bulent O Yildiz
- Hacettepe University School of Medicine, Hacettepe, Ankara, Turkey
| | - Ricardo Azziz
- Heersink School of Medicine and School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
- School of Public Health, University at Albany, SUNY, Rensselaer, NY, USA
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Wang J, Li L, Zhou J, Pan X, Qi Q, Sun H, Wang L. Yishen Huatan Huoxue decoction and quercetin ameliorate decidualization dysfunction in polycystic ovary syndrome: A comprehensive investigation combining clinical trial and experimental studies. Drug Discov Ther 2024; 18:117-129. [PMID: 38644207 DOI: 10.5582/ddt.2024.01003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Polycystic ovary syndrome (PCOS) is a common gynecological endocrine disorder characterized by a complex pathogenesis and limited treatment options. Yishen Huatan and Huoxue decoction (YHHD), as a traditional Chinese Medicine formula, has shown effectiveness in treating PCOS. However, the specific mechanisms by which YHHD exerts its therapeutic effects remain unclear. In this study, we performed to investigate the therapeutic effects of YHHD and quercetin on dehydroepiandrosterone-induced PCOS mice, and examine the effect of quercetin on the decidualization of T-HESCs under hyperinsulinemic conditions. The results showed that YHHD could reduce early miscarriage rates in PCOS patients and significantly improved glucose metabolism disorders, sex hormone levels, and the estrous cycles in PCOS mice. Quercetin could alleviate effect of high insulin levels and restore the low expression of insulin receptor substrate1/2 (IRS1/2) and glucose transporte 4 (GLUT4) in T-HESCs, demonstrating its potential to mitigate hyperinsulin-induced decidualization dysfunction via the GLUT4 signaling pathway mediated by IRS1/2. This study provides valuable molecular insights of YHHD and highlight the therapeutic potential of quercetin in treating decidualization dysfunction in PCOS.
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Affiliation(s)
- Jing Wang
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- The Academy of Integrative Medicine of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Lisha Li
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- The Academy of Integrative Medicine of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Jing Zhou
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- The Academy of Integrative Medicine of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Xinyao Pan
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- The Academy of Integrative Medicine of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Qing Qi
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- The Academy of Integrative Medicine of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Hongmei Sun
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- The Academy of Integrative Medicine of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
| | - Ling Wang
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- The Academy of Integrative Medicine of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China
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5
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Al Wattar BH, Teh JJ, Clarke S, Abbara A, Morman R, Wilcox A, Talaulikar V. Healthcare and research priorities for women with polycystic ovary syndrome in the UK National Health Service: A modified Delphi method. Clin Endocrinol (Oxf) 2024; 100:459-465. [PMID: 38420872 DOI: 10.1111/cen.15038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS) is a chronic lifelong condition affecting up to 20% of women worldwide. There is limited input from affected women to guide the provision of healthcare services and future research needs. Our objective was to scope the healthcare and research priorities of women with PCOS in the United Kingdom. DESIGN A three-staged modified Delphi method, consisting of two questionnaires and a consensus meeting involving lay representatives and healthcare professionals. PATIENTS AND MEASUREMENTS Lay patient representatives of women with PCOS. Participants were asked to identify and rank healthcare and research priorities for their importance. RESULTS Six hundred and twenty-four lay participants took part in our Delphi method. Over 98% were diagnosed with PCOS (614/624, 98.4%). More than half experienced difficulties to receive a PCOS diagnosis (375/624, 60%), and the majority found it difficult to access specialised PCOS health services in the NHS (594/624, 95%). The top two healthcare priorities included better education for health professionals on the diagnosis and management of PCOS (238/273, 87.1%) and the need to set up specialist PCOS services (234/273, 85.7%). The top two research priorities focused on identifying better treatments for irregular periods (233/273, 85.3%) followed by better tests for early PCOS diagnosis (230/273, 84.2%). CONCLUSIONS We identified 13 healthcare and 14 research priorities that reflect the current health needs of women with PCOS in the United Kingdom. Adopting these priorities in future healthcare and research planning will help to optimise the health of women with PCOS and increase patient satisfaction.
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Affiliation(s)
- Bassel H Al Wattar
- Beginnings Assisted Conception Unit, Epsom and St Helier University Hospitals, London, UK
- Comprehensive Clinical Trials Unit, Institute for Clinical Trials and Methodology, University College London, London, UK
| | - Jhia Jiat Teh
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Sophie Clarke
- Reproductive Medicine Unit, University College London Hospitals, London, UK
| | - Ali Abbara
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Division of Diabetes and Endocrinology, Imperial College Healthcare NHS Trust, London, UK
| | | | | | - Vikram Talaulikar
- Reproductive Medicine Unit, University College London Hospitals, London, UK
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6
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Espinosa ME, Sánchez R, Otzen T, Bautista-Valarezo E, Aguiar S, Corrales-Gutierrez I, Leon-Larios F, Manterola C. Phenotypic Characterization of Patients with Polycystic Ovary Syndrome in a Population from the Ecuadorian Andes: A Cross-Sectional Study. J Clin Med 2024; 13:2376. [PMID: 38673649 PMCID: PMC11051537 DOI: 10.3390/jcm13082376] [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: 03/16/2024] [Revised: 04/08/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine-metabolic disorder in women of reproductive age. Diagnosis is based on the evidence-based international guideline 2018 and the Rotterdam Consensus to classify PCOS phenotypes. This study aims to characterize the biodemographic, clinical, metabolic, and reproductive variables and their relationship with PCOS phenotypes in a population from the Ecuadorian Andes. Methodology: A cross-sectional study was conducted with a non-random consecutive sample of 92 women who attended the outpatient gynecology and endocrinology clinic at the Hospital of the Technical University of Loja (UTPL)-Santa Inés, Loja, Ecuador, between January 2022 and July 2023. Descriptive statistics, mean calculations, standard deviation, parametric and nonparametric tests, odds ratios (OR), confidence intervals (CI), and p-values were employed. Results: The average age was 22 ± 3.4 years, with a predominantly mestizo, urban, single, highly educated, and medium-high socioeconomic level population. It was identified that phenotypes A + B are at a higher risk of developing oligomenorrhea and hypertriglyceridemia compared to phenotypes C + D, with statistically significant differences (p < 0.05). Furthermore, in terms of reproductive variables, phenotypes A + B exhibit a significantly higher frequency of elevated anti-Müllerian hormone (AMH) compared to phenotypes C + D, also with statistical significance (p < 0.05). Conclusions: The classical phenotypes A and B of PCOS are the most common in Ecuadorian Andean women and carry a higher risk of insulin resistance, anovulation, metabolic disorders, and elevated triglyceride levels compared to phenotypes C and D. Ethnic diversity and sociocultural habits influence the prevalence and clinical manifestations of these phenotypes.
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Affiliation(s)
- María Elena Espinosa
- PhD Program in Medical Sciences, Universidad de La Frontera, Temuco 4780000, Chile; (M.E.E.); (R.S.); (T.O.)
- Health Sciences Department, Universidad Técnica Particular de Loja, UTPL, San Cayetano alto s/n, Loja 1101608, Ecuador; (E.B.-V.); (S.A.)
| | - Raúl Sánchez
- PhD Program in Medical Sciences, Universidad de La Frontera, Temuco 4780000, Chile; (M.E.E.); (R.S.); (T.O.)
- Center of Excellence in Translational Medicine-Scientific and Technological Bioresource (CEMT-BIOREN), Temuco 4780000, Chile
| | - Tamara Otzen
- PhD Program in Medical Sciences, Universidad de La Frontera, Temuco 4780000, Chile; (M.E.E.); (R.S.); (T.O.)
- Millennium Nucleus on Sociomedicine, Santiago 7560908, Chile
| | - Estefanía Bautista-Valarezo
- Health Sciences Department, Universidad Técnica Particular de Loja, UTPL, San Cayetano alto s/n, Loja 1101608, Ecuador; (E.B.-V.); (S.A.)
| | - Stephanie Aguiar
- Health Sciences Department, Universidad Técnica Particular de Loja, UTPL, San Cayetano alto s/n, Loja 1101608, Ecuador; (E.B.-V.); (S.A.)
| | - Isabel Corrales-Gutierrez
- Foetal Medicine Unit, University Hospital Virgen Macarena, 41009 Seville, Spain;
- Department of Surgery, Faculty of Medicine, University of Seville, 41004 Seville, Spain
| | - Fatima Leon-Larios
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41004 Seville, Spain;
| | - Carlos Manterola
- PhD Program in Medical Sciences, Universidad de La Frontera, Temuco 4780000, Chile; (M.E.E.); (R.S.); (T.O.)
- Millennium Nucleus on Sociomedicine, Santiago 7560908, Chile
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7
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Stener-Victorin E, Teede H, Norman RJ, Legro R, Goodarzi MO, Dokras A, Laven J, Hoeger K, Piltonen TT. Polycystic ovary syndrome. Nat Rev Dis Primers 2024; 10:27. [PMID: 38637590 DOI: 10.1038/s41572-024-00511-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/20/2024]
Abstract
Despite affecting ~11-13% of women globally, polycystic ovary syndrome (PCOS) is a substantially understudied condition. PCOS, possibly extending to men's health, imposes a considerable health and economic burden worldwide. Diagnosis in adults follows the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome, requiring two out of three criteria - clinical or biochemical hyperandrogenism, ovulatory dysfunction, and/or specific ovarian morphological characteristics or elevated anti-Müllerian hormone. However, diagnosing adolescents omits ovarian morphology and anti-Müllerian hormone considerations. PCOS, marked by insulin resistance and hyperandrogenism, strongly contributes to early-onset type 2 diabetes, with increased odds for cardiovascular diseases. Reproduction-related implications include irregular menstrual cycles, anovulatory infertility, heightened risks of pregnancy complications and endometrial cancer. Beyond physiological manifestations, PCOS is associated with anxiety, depression, eating disorders, psychosexual dysfunction and negative body image, collectively contributing to diminished health-related quality of life in patients. Despite its high prevalence persisting into menopause, diagnosing PCOS often involves extended timelines and multiple health-care visits. Treatment remains ad hoc owing to limited understanding of underlying mechanisms, highlighting the need for research delineating the aetiology and pathophysiology of the syndrome. Identifying factors contributing to PCOS will pave the way for personalized medicine approaches. Additionally, exploring novel biomarkers, refining diagnostic criteria and advancing treatment modalities will be crucial in enhancing the precision and efficacy of interventions that will positively impact the lives of patients.
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Affiliation(s)
| | - Helena Teede
- Monash Centre for Health Research and Implementation, Monash Health and Monash University, Melbourne, Victoria, Australia
| | - Robert J Norman
- Robinson Research Institute, Adelaide Medical School, Adelaide, South Australia, Australia
| | - Richard Legro
- Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA, USA
- Department of Public Health Science, Penn State College of Medicine, Hershey, PA, USA
| | - Mark O Goodarzi
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Anuja Dokras
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA
| | - Joop Laven
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics and Gynecology, Erasmus MC, Rotterdam, Netherlands
| | - Kathleen Hoeger
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Terhi T Piltonen
- Department of Obstetrics and Gynecology, Research Unit of Clinical Medicine, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
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Xuan F, Ren Y, Lu J, Zhou W, Jin R, Chen A, Ye Y. CPEB1 induces autophagy and promotes apoptosis in ovarian granulosa cells of polycystic ovary syndrome. Mol Reprod Dev 2024; 91:e23741. [PMID: 38616716 DOI: 10.1002/mrd.23741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/07/2024] [Accepted: 03/18/2024] [Indexed: 04/16/2024]
Abstract
Inflammatory damage in ovarian granulosa cells (GCs) is a key mechanism in polycystic ovary syndrome (PCOS), cytoplasmic polyadenylation element binding protein-1 (CPEB1) is important in inflammatory regulation, however, its role in PCOS is unclear. We aim to research the mechanism of CPEB1 in ovarian GCs in PCOS using dehydroepiandrosterone (DHEA)-induced PCOS rat models and testosterone-incubated GC models. The pathophysiology in PCOS rats was analyzed. Quantitative-realtime-PCR, TUNEL, immunohistochemistry, and Western blot were applied for quantification. Additionally, cell counting kit-8, flow cytometry, immunofluorescence, Western blot, and Monodansylcadaverine staining were performed. We found that PCOS rat models exhibited a disrupted estrus cycle, elevated serum levels of testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH), increased LH/FSH ratio, and heightened ovarian index. Furthermore, reduced corpus luteum and increased follicular cysts were observed in ovarian tissue. In ovarian tissue, autophagy and apoptosis were activated and CPEB1 was overexpressed. In vitro, CPEB1 overexpression inhibited cell viability and sirtuin-1 (SIRT1), activated tumor necrosis factor-α, and interleukin-6 levels, as well as apoptosis and autophagy; however, CPEB1 knockdown had the opposite effect. In conclusion, overexpression of CPEB1 activated autophagy and apoptosis of ovarian GCs in PCOS.
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Affiliation(s)
- Feilan Xuan
- Department of Obstetrics and Gynecology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yuefang Ren
- Department of Gynecology, Huzhou Maternity & Child Health Care Hospital, Huzhou, Zhejiang, China
| | - Jiali Lu
- Department of Gynecology, Huzhou Maternity & Child Health Care Hospital, Huzhou, Zhejiang, China
| | - Weimei Zhou
- Department of Ultrasound, Jiaojiang Maternal and Child Health Hospital, Taizhou, Zhejiang, China
| | - Ruiying Jin
- Department of Gynecology, Jiaojiang Maternal and Child Health Hospital, Taizhou, Zhejiang, China
| | - Aixue Chen
- Department of Gynecology, Changxing People's Hospital of Chongming District, Shanghai, China
| | - Yongju Ye
- Department of Gynecology, Lishui Hospital of Traditional Chinese Medicine, Lishui, Zhejiang, China
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Oğuz SH, Boyraz BS, Ertürk B, Yıldız BO. The prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome in treatment-naïve transgender people assigned female at birth. Endocrine 2024; 84:287-292. [PMID: 38141060 DOI: 10.1007/s12020-023-03648-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023]
Abstract
PURPOSE Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age. We aimed to investigate the prevalence and phenotypic characteristics of PCOS in testosterone treatment-naïve transgender people assigned female at birth (AFAB), as well as to determine whether cardiometabolic risk factors vary based on the presence of PCOS and its components. METHODS Evaluation of 112 testosterone treatment-naïve transgender adults AFAB for PCOS and its individual components, including androgen excess, ovulatory dysfunction and polycystic ovarian morphology (PCOM). RESULTS In our cohort, 79.5% of transgender individuals AFAB had at least one component of PCOS. The prevalence of PCOS was 38.4% (43/112). Phenotype C was the most common phenotype (17.8%), followed by phenotype B (10.7%). Transgender individuals AFAB with at least one component of PCOS had higher blood pressure (BP) measurements and higher fasting plasma glucose levels compared to those with none. Sixty-one subjects (54%) had hyperandrogenism (HA), with 20 (17.9%) having HA without other components of PCOS. When compared to those without HA, transgender individuals AFAB with HA had higher body mass index (BMI), BP, triglyceride and lower HDL-cholesterol levels. CONCLUSION PCOS and androgen excess appear to be prevalent among transgender people AFAB. Transgender individuals AFAB with HA or PCOS may exhibit an unfavorable cardiometabolic risk profile compared to those without any PCOS component. Assessment of androgen excess and the specific components of PCOS at baseline could inform long-term management.
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Affiliation(s)
- Seda Hanife Oğuz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Beyza Seda Boyraz
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Banu Ertürk
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Bülent Okan Yıldız
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
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Tatarchuk T, Pedachenko N, Kosei N, Malysheva I, Snizhko T, Kozub T, Zolotarevska O, Kosianenko S, Tutchenko T. Distribution and anthropometric characteristics of Rotterdam criteria-based phenotypic forms of Polycystic ovaries syndrome in Ukraine. Eur J Obstet Gynecol Reprod Biol 2024; 295:104-110. [PMID: 38354601 DOI: 10.1016/j.ejogrb.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/30/2024] [Accepted: 02/07/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE To explore the distribution of Rotterdam-based PCOS phenotypes and their associations with anthropometric parameters predictive of cardiometabolic risks in Ukrainian referral PCOS women. STUDY DESIGN It was a cross-sectional study conducted by the Ukrainian Society of Gynecological Endocrinology between September 2021 and January 2022 involving 42 clinics in 10 regional centres representing the major geographical parts of Ukraine. Two hundred obstetrician-gynecologists whose practice facilities corresponded to study criteria were committed to entering records of their PCOS patients aged 20-45 years into the uniform data collection forms. The recorded parameters were: PCOS phenotype with the mandatory assessment of biochemical hyperandrogenism, age, BMI, waist circumference, and hyperandrogenism symptoms. RESULTS 5254 patients' records were completed. Phenotype A was the most prevalent - 47.7 %, phenotypes B, C, and D were almost equally distributed in the studied population: 17.6 %, 17.4 %, and 17.3 % respectively. The total prevalence of androgenic phenotypes based on the presence of biochemical hyperandrogenism was 82.7 %. The incidence of obesity and hyperandrogenism symptoms, and mean BMI values were higher in phenotypes A and B compared to C and D. At the same time, the presence of 34.1 % and 46.2 % of normal-weight subjects in phenotypes A and B respectively, supports the fact that the excessive BMI is not a universal characteristic of androgenic phenotypes. In younger age groups, phenotypes C and D demonstrated the predominance of normal weight, but in older subgroups, the situation changed: in the age group of 36-45 y.o. compared to 18-25 y.o., the percentage of overweight and obese subjects for the non-classic phenotypes increased more than for the classic ones: C (OR = 3.91, 95 % CI: 2.41-6.38), D (OR = 4.14, 95 % CI: 2.64-6.52), A (OR = 2.30, 95 % CI:1.72-2.08), and B (OR = 2.56, 95 % CI:1.69-3.89). CONCLUSIONS In thoroughly assessed Ukrainian referral PCOS population the classic phenotypes prevailed as in other clinical cohorts. The classic phenotypes were characterized by the higher rate of adiposity and severity of clinical hyperandrogenism. At the same time, obese, overweight, and normal-weight subjects were present in all phenotypes, and the risk of obesity in non-classic phenotypes was higher in older age groups.
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Affiliation(s)
- Tetiana Tatarchuk
- Endocrine Gynecology Department, Institute of Pediatrics, Obstetrics and Gynecology, Kyiv 04050, Ukraine; Reproductive Health, Centre of Innovative Medical Technologies, Kyiv 04053, Ukraine
| | - Natalia Pedachenko
- Obstetrics, Gynecology and Perinatology Department, Shupyk National Healthcare University, Kyiv 04112, Ukraine
| | - Nataliia Kosei
- Reproductive Health, Centre of Innovative Medical Technologies, Kyiv 04053, Ukraine
| | - Iryna Malysheva
- Clinic of Reproductive Technologies of Shupyk National Healthcare University, Kyiv 01004, Ukraine
| | - Tetiana Snizhko
- Obstetrics, Gynecology Department, National Medical University, 76018 Ivano-Frankivsk, Ukraine
| | - Tetiana Kozub
- Kharkiv City Student Hospital, 61000 Kharkiv, Ukraine
| | - Olga Zolotarevska
- Communal Non-profit Enterprise of the Kamian City Council Primary Healthcare Centre 3, Kamian, Ukraine
| | | | - Tetiana Tutchenko
- Endocrine Gynecology Department, Institute of Pediatrics, Obstetrics and Gynecology, Kyiv 04050, Ukraine; Reproductive Health, Centre of Innovative Medical Technologies, Kyiv 04053, Ukraine.
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Vine D, Ghosh M, Wang T, Bakal J. Increased Prevalence of Adverse Health Outcomes Across the Lifespan in Those Affected by Polycystic Ovary Syndrome: A Canadian Population Cohort. CJC Open 2024; 6:314-326. [PMID: 38487056 PMCID: PMC10935704 DOI: 10.1016/j.cjco.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/11/2023] [Indexed: 03/17/2024] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is the most common metabolic-endocrine disorder impacting the health and quality of life of women over the lifespan. Evidence-based data on the scope of adverse health outcomes in those affected by PCOS is critical to improve healthcare and quality of life in this population. The aim of this study was to determine the prevalence of adverse health outcomes in those with PCOS compared to age-matched controls. Methods We conducted a retrospective observational case-control study in those diagnosed with PCOS and age-matched controls using the Alberta Health Services Health Analytics database and the International Classification of Diseases, for the period from 2002-2018 in Alberta, Canada. Results The cohort consisted of n = 16,531 exposed PCOS cases and n = 49,335 age-matched un-exposed controls. The prevalences of hypertension, renal disease, gastrointestinal disease, eating disorders, mental illness, depression-anxiety, rheumatoid arthritis, respiratory infections, and all malignancies were 20%-40% (P < 0.0001) higher in those with PCOS, compared to controls. The prevalence of obesity, dyslipidemia, nonalcoholic fatty liver disease, and type 2 diabetes was 2-3 fold higher in those with PCOS (P < 0.001). Cardiovascular, cerebrovascular, and peripheral vascular disease were 30%-50% higher, and they occurred 3-4 years earlier in those with PCOS (P < 0.0001); a 2-fold higher prevalence of dementia occurred in those with PCOS, compared to controls. Conclusion These findings provide evidence that PCOS is associated with a higher prevalence of morbidities over the lifespan, and the potential scope of the healthcare burden in women affected by PCOS.
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Affiliation(s)
- Donna Vine
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Mahua Ghosh
- Division of Endocrinology and Metabolism, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Ting Wang
- Alberta Strategy for Patient Orientated Research, Provincial Research Data Services, Alberta Health Services, Edmonton, Alberta, Canada
| | - Jeffrey Bakal
- Alberta Strategy for Patient Orientated Research, Provincial Research Data Services, Alberta Health Services, Edmonton, Alberta, Canada
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Lei R, Chen S, Li W. Advances in the study of the correlation between insulin resistance and infertility. Front Endocrinol (Lausanne) 2024; 15:1288326. [PMID: 38348417 PMCID: PMC10860338 DOI: 10.3389/fendo.2024.1288326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/04/2024] [Indexed: 02/15/2024] Open
Abstract
This is a narrative review of the progress of research on the correlation between insulin resistance and infertility. Insulin resistance (IR) is not only involved in the development of various metabolic diseases, but also affects female reproductive function, and to some extent is closely related to female infertility. IR may increase the risk of female infertility by activating oxidative stress, interfering with energy metabolism, affecting oocyte development, embryo quality and endometrial tolerance, affecting hormone secretion and embryo implantation, as well as affecting assisted conception outcomes in infertile populations and reducing the success rate of assisted reproductive technology treatment in infertile populations. In addition, IR is closely associated with spontaneous abortion, gestational diabetes and other adverse pregnancies, and if not corrected in time, may increase the risk of obesity and metabolic diseases in the offspring in the long term. This article provides a review of the relationship between IR and infertility to provide new ideas for the treatment of infertility.
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Affiliation(s)
| | | | - Weihong Li
- Reproductive Medical Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Ganie MA, Rashid A, Baba MS, Zargar MA, Wani IA, Nisar S, Wani IA, Douhath S, Sriwastawa M, Geer MI, Asrar MM, Kutum R, Hassan S, Khan S, Rafi W, Bhat DA, Showkat W, Sahar T, Choh NA, Khurshid R, Mudassar S, Shah ZA, Shabir I, Sofi SA, Gupta N, Hafeez I, Sreenivas V. Pre-polycystic ovary syndrome and polymenorrhoea as new facets of polycystic ovary syndrome (PCOS): Evidences from a single centre data set. Clin Endocrinol (Oxf) 2023; 99:566-578. [PMID: 37656656 DOI: 10.1111/cen.14964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/22/2023] [Accepted: 08/08/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS) is a complex disorder with diverse metabolic implications. Diagnosis typically relies on oligo-amenorrhoea (OA), hyperandrogenism (HA), and polycystic ovarian morphology (PCOM). However, the role of polymenorrhoea in PCOS remains understudied. Additionally, limited information exists regarding metabolic disturbances in women with partial PCOS phenotypes that do not meet diagnostic criteria. This extensive database aims to provide substantial evidence on the metabolic implications of polymenorrhoea and partial PCOS phenotypes. DESIGN Prospective observational study. PATIENTS AND MEASUREMENTS In this single-centre study, 6463 women with PCOS-like characteristics and 3142 age-matched healthy women were included. The study compared clinical (anthropometry, modified Ferriman Gallwey [mFG] score), hormonal (serum testosterone), and metabolic (plasma glucose, serum lipids, insulin) characteristics between women diagnosed with PCOS, those with partial PCOS phenotypes, and the healthy control group RESULTS: In all, 5174 women met Rotterdam criteria for PCOS diagnosis, while 737 were classified as Pre-PCOS, including HA (n = 538), OA (n = 121), or PCOM (n = 78). Common clinical features included oligomenorrhoea (75.5%), hirsutism (82.9%), obesity (27.2%), hypertension (1.6%), metabolic syndrome (19.6%), and diabetes mellitus (5.6%). Women diagnosed with PCOS, HA only, and OA only exhibited higher average body mass index, plasma glucose levels (both fasting and 2 h after the oral glucose tolerance test), and lipid fractions in comparison to those with PCOM and the healthy controls. However, indices of insulin resistance were similar among women with PCOS, HA, PCOM, and OA, albeit higher than in the healthy controls. The polymenorrhoea subgroup (5.9%) had lower BMI and serum testosterone, but similar mFG score, plasma glucose, insulin, and lipid levels as the oligomenorrhoea subgroup. CONCLUSION The metabolic disturbances observed in Pre-PCOS women highlight the need to reassess diagnostic criteria. Including the polymenorrhoea subcategory in PCOS criteria is recommended due to similar metabolic dysfunctions as the oligomenorrhoea group.
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Affiliation(s)
- Mohd Ashraf Ganie
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
- Department of Clinical Research, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Aafia Rashid
- Department of Clinical Research, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Mohammad Salem Baba
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Mohd Afzal Zargar
- Department of Life Sciences, Central University of Kashmir, Ganderbal, India
| | - Imtiyaz Ahmad Wani
- Department of Clinical Research, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Sobia Nisar
- Department of Medicine, Government Medical College, Srinagar, India
| | - Ishfaq Ahmad Wani
- Department of Clinical Research, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Syed Douhath
- Department of Clinical Research, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Mukesh Sriwastawa
- Department of Microbiology and Immunology, University of Louisville, Louisville, Kentucky, USA
| | - Mohd Ishaq Geer
- Department of Pharmacology, University of Kashmir, Srinagar, India
| | - Mir Mohd Asrar
- Department of Clinical Research, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Rintu Kutum
- Department of Computer Science, Ashoka University, Sonepath, India
- Department of Computer Science, Trivedi School of Biosciences, Ashoka University, Sonepath, India
| | - Saqib Hassan
- Department of Biotechnology, School of Bio and Chemical Engineering, Sathyabama Institute of Science and Technology (Deemed University), Chennai, India
| | - Shahid Khan
- Department of Lab Medicine, AIIMS New Delhi, New Delhi, India
| | - Wajid Rafi
- Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
| | - Dil Afroz Bhat
- Department of Clinical Biochemistry, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Wasia Showkat
- Department of Clinical Research, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Tajali Sahar
- Department of Clinical Research, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Naseer Ahmad Choh
- Department of Radiodiagnosis and Imaging, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Rabia Khurshid
- Department of Obstetrics and Gynecology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Syed Mudassar
- Department of Clinical Biochemistry, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Zafar Amin Shah
- Department of Immunology and Molecular Medicine, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Iram Shabir
- Department of Biochemistry, Iowa State University, Ames, Iowa, USA
| | - Sanjeed Ahmad Sofi
- Department of Radiodiagnosis and Imaging, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Nandita Gupta
- Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
| | - Imran Hafeez
- Department of Cardiology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Vishnubatla Sreenivas
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
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Silva MSB, Decoster L, Delpouve G, Lhomme T, Ternier G, Prevot V, Giacobini P. Overactivation of GnRH neurons is sufficient to trigger polycystic ovary syndrome-like traits in female mice. EBioMedicine 2023; 97:104850. [PMID: 37898094 PMCID: PMC10630624 DOI: 10.1016/j.ebiom.2023.104850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/18/2023] [Accepted: 10/12/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the most common endocrine disorder leading to anovulatory infertility. Abnormalities in the central neuroendocrine system governed by gonadotropin-releasing hormone (GnRH) neurons might be related to ovarian dysfunction in PCOS, although the link in this disordered brain-to-ovary communication remains unclear. Here, we manipulated GnRH neurons using chemogenetics in adult female mice to unveil whether chronic overaction of these neurons would trigger PCOS-like hormonal and reproductive impairments. METHODS We used adult Gnrh1cre female mice to selectively target and express the designer receptors exclusively activated by designer drugs (DREADD)-based chemogenetic tool hM3D(Gq) in hypophysiotropic GnRH neurons. Chronic chemogenetic activation protocol was carried out with clozapine N-oxide (CNO) i.p. injections every 48 h over a month. We evaluated the reproductive and hormonal profile before, during, and two months after chemogenetic manipulations. FINDINGS We discovered that the overactivation of GnRH neurons was sufficient to disrupt reproductive cycles, promote hyperandrogenism, and induce ovarian dysfunction. These PCOS features were detected with a long-lasting neuroendocrine dysfunction through abnormally high luteinizing hormone (LH) pulse secretion. Additionally, the GnRH-R blockade prevented the establishment of long-term neuroendocrine dysfunction and androgen excess in these animals. INTERPRETATION Taken together, our results show that hyperactivity of hypothalamic GnRH neurons is a major driver of reproductive and hormonal impairments in PCOS and suggest that antagonizing the aberrant GnRH signaling could be an efficient therapeutic venue for the treatment of PCOS. FUNDING European Research Council (ERC) under the European Union's Horizon 2020 research and innovation program (grant agreement n◦ 725149).
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Affiliation(s)
- Mauro S B Silva
- Laboratory of Development and Plasticity of the Neuroendocrine Brain, FHU 1000 Days for Health, School of Medicine, Lille, France; Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, Lille, France
| | - Laurine Decoster
- Laboratory of Development and Plasticity of the Neuroendocrine Brain, FHU 1000 Days for Health, School of Medicine, Lille, France; Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, Lille, France
| | - Gaspard Delpouve
- Laboratory of Development and Plasticity of the Neuroendocrine Brain, FHU 1000 Days for Health, School of Medicine, Lille, France; Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, Lille, France
| | - Tori Lhomme
- Laboratory of Development and Plasticity of the Neuroendocrine Brain, FHU 1000 Days for Health, School of Medicine, Lille, France; Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, Lille, France
| | - Gaetan Ternier
- Laboratory of Development and Plasticity of the Neuroendocrine Brain, FHU 1000 Days for Health, School of Medicine, Lille, France; Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, Lille, France
| | - Vincent Prevot
- Laboratory of Development and Plasticity of the Neuroendocrine Brain, FHU 1000 Days for Health, School of Medicine, Lille, France; Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, Lille, France
| | - Paolo Giacobini
- Laboratory of Development and Plasticity of the Neuroendocrine Brain, FHU 1000 Days for Health, School of Medicine, Lille, France; Univ. Lille, Inserm, CHU Lille, Lille Neuroscience & Cognition, UMR-S 1172, Lille, France.
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Li W, Li G, Chi H, Wang H, Zeng L. Uptake of the core outcome set on polycystic ovary syndrome before and after its publication. Hum Reprod 2023; 38:1816-1824. [PMID: 37533286 PMCID: PMC10477939 DOI: 10.1093/humrep/dead149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/19/2023] [Indexed: 08/04/2023] Open
Abstract
STUDY QUESTION Does the core outcome set (COS) on polycystic ovary syndrome (PCOS) impact the selection of research outcomes? SUMMARY ANSWER Following the publication of the COS on PCOS, an increasing number of trials are reporting both the generic domain and body mass index; however, the uptake of this COS has not been as extensive as expected. WHAT IS KNOWN ALREADY The COS on PCOS included 33 core outcomes in the following seven domains: the generic (3), metabolic (8), reproductive (7), pregnancy (10), psychological (3), oncological (1), and long-term (1). This was done to improve consistency in outcome selection and definition. However, thus far, no studies have investigated the effectiveness of this COS in the above-mentioned tasks. STUDY DESIGN, SIZE, DURATION A methodological study based on the trial registries, including 395 eligible clinical trials registered between 1 January 2018 and 21 September 2022. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 1258 registered clinical studies on PCOS were retrieved from the World Health Organization International Clinical Trials Registry Platform. Of those, 395 were selected according to the inclusion and exclusion criteria, and divided into two groups based on the publication date of the COS on PCOS (4 February 2020): pre-publication and post-publication. The practical uptake of this COS was explored after data collation, assessment, comparison of the uptake of core outcomes or domains before and after the publication of this COS, and correlation analysis between the domains. MAIN RESULTS AND THE ROLE OF CHANCE There were 26 out of 33 core outcomes and five out of seven domains reported in the 395 trials. The highest uptake was observed for the reproductive domain and the reproductive hormonal profile (63.0% and 38.7%, respectively). After the publication of the COS on PCOS, the uptake of the generic domain and body mass index increased from 24.1% to 35.8% (P = 0.011) and 17.8% to 26.5% (P = 0.039), respectively. The total number of reported core outcomes in the generic domain met statistical significance (P = 0.012). Moreover, multivariable analyses still supported the above finding in the generic domain. Correlation analysis showed that most of the domains were positively correlated with each other. However, the pregnancy domain was negatively correlated with the metabolic domain. Reasons responsible for the unsatisfactory uptake may be the absence of specific definitions of core outcomes, as well as the lack of awareness among researchers regarding this COS. LIMITATIONS, REASONS FOR CAUTION Due to the lack of standardized definition of outcomes, it was difficult to avoid some subjectivity in the process of consistency assessment. WIDER IMPLICATIONS OF THE FINDINGS Two years after its publication, there was no substantial improvement in the uptake of the COS on PCOS. This suggests that this COS may require further revision, refinement, and promotion to improve the comparability of PCOS studies. STUDY FUNDING/COMPETING INTEREST(S) This work was funded by Beijing Municipal Health Science and Technology Achievements and Appropriate Technology Promotion Project (BHTPP2022069), and the special fund of Beijing Key Clinical Specialty Construction Project. The authors do not have conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Wenqiang Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, People’s Republic of China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, People’s Republic of China
| | - Guoliang Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, People’s Republic of China
- School of Basic Medical Sciences, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Hongbin Chi
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Haining Wang
- Department of Endocrinology and Metabolism, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Lin Zeng
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, People’s Republic of China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, People’s Republic of China
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16
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Lempesis IG, Apple SJ, Duarte G, Palaiodimos L, Kalaitzopoulos DR, Dalamaga M, Kokkinidis DG. Cardiometabolic effects of SGLT2 inhibitors on polycystic ovary syndrome. Diabetes Metab Res Rev 2023; 39:e3682. [PMID: 37392147 DOI: 10.1002/dmrr.3682] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 03/03/2023] [Accepted: 06/11/2023] [Indexed: 07/03/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a complex endocrinopathy affecting many women of reproductive age. Although its physiology is poorly understood, hyperandrogenemia and insulin resistance play a pivotal role in this complex syndrome, predisposing patients to a variety of cardiovascular and metabolic modalities. Current therapeutic options, including lifestyle modifications and medications, often do not satisfactorily improve clinical outcomes. SGLT2 inhibitors (SGLT-2i) are a novel option which can potentially improve many hormonal and metabolic parameters for patients with PCOS, though the net cardiovascular effects remain under investigation in this population of patients with PCOS. Overall, the use of SGLT-2i may be associated with beneficial somatometric, metabolic and hormonal outcomes of PCOS. To date, all available studies have recorded body mass index, waist and hip circumference, and fat mass reductions, improved insulin and androgen levels, and reduced blood pressure. The aim of the present review is to summarise PCOS-related manifestations and mechanisms leading to cardiovascular disease, to explore the cardiometabolic impact of SGLT2i on PCOS, and to critically analyse the cardiometabolic and hormonal outcomes of the recent studies on the use of SGLT2i in women with PCOS.
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Affiliation(s)
- Ioannis G Lempesis
- Department of Biologic Chemistry, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Samuel J Apple
- Department of Medicine, New York City Health + Hospitals/Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Gustavo Duarte
- Department of Medicine, New York City Health + Hospitals/Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Leonidas Palaiodimos
- Department of Medicine, New York City Health + Hospitals/Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Maria Dalamaga
- Department of Biologic Chemistry, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Damianos G Kokkinidis
- Section of Cardiovascular Medicine, Yale University/Yale New Haven Hospital, New Haven, Connecticut, USA
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17
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Dar MA, Maqbool M, Ara I. The PCOS puzzle: putting the pieces together for optimal care. Int J Adolesc Med Health 2023; 35:299-311. [PMID: 37596861 DOI: 10.1515/ijamh-2023-0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 07/30/2023] [Indexed: 08/20/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a multifaceted hormonal disorder that has significant ramifications for both women's reproductive and metabolic well-being. This analysis aims to offer a thorough comprehension of PCOS by investigating the various contributing factors that are crucial for its effective management. We delve into the topic of hormonal imbalances, such as elevated androgens and disrupted estrogen-progesterone dynamics, and their effects on reproductive and metabolic health. Furthermore, we explore the intricate connection between insulin resistance, hyperinsulinemia, and PCOS, highlighting their pivotal role in metabolic dysfunction. Additionally, we examine fertility challenges, irregular menstrual patterns, and metabolic complications while also reviewing current treatment methodologies. Moreover, we address the latest research concerning genetic, environmental, and epigenetic influences on PCOS. By piecing together these essential elements, healthcare professionals can attain a comprehensive understanding of PCOS and deliver optimal care for those affected by the condition.
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Affiliation(s)
- Mohd Altaf Dar
- Department of Pharmacology, CT Institute of Pharmaceutical Sciences, PTU, Jalandhar, Punjab, India
| | - Mudasir Maqbool
- Department of Pharmaceutical Sciences, University Of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Irfat Ara
- Regional Research Institute of Unani Medicine, Srinagar, Jammu and Kashmir, India
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18
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de Oliveira NM, Machado J, Lopes L, Criado MB. A Review on Acupuncture Efficiency in Human Polycystic Ovary/Ovarian Syndrome. J Pharmacopuncture 2023; 26:105-123. [PMID: 37405111 PMCID: PMC10315877 DOI: 10.3831/kpi.2023.26.2.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 03/14/2022] [Accepted: 02/28/2023] [Indexed: 07/06/2023] Open
Abstract
Objectives Human Polycystic Ovary/Ovarian Syndrome (PCOS), a frequent endocrine pathophysiology among women of fertile age, is associated with woman's lifespan endocrine, metabolic and psychological implications. Long-term usage side effects of allopathic strategies and their low efficacy made complementary medicine treatments a relevant subject for these patients. The main aim of this work is to review the efficiency of the acupuncture treatment reported in the latest studies on literature regarding PCOS patients. Methods A comprehensive literature search, in English language, about the use of acupuncture on the management of PCOS, was conducted in October 2020 using EBSCO, Cochrane, PubMed, Medline, Embase, databases for randomised and non-randomised controlled trials between 2015 and 2020 (09/2015-10/2020), following the PRISMA protocol. Results This research led us to an analysis, according to PICOS, of six final papers selected among 178 in total. The articles addressed distinct aspects of the PCOS condition, diverse acupuncture techniques and different main and secondary outcomes in agreement to the respective main objective. According to this review, acupuncture seems to be useful for the treatment of this debilitating and chronic health condition which affects millions of women worldwide, many of them part of the workforce in their community. Conclusion Despite of the display of these positive results addressing acupuncture treatments to manage PCOS major symptoms - whether they are reproductive, metabolic, or mental health features - more research is urgent. Randomized, double blinded controlled trials with improved quality design and following STRICTA and/or CONSORT recommendations are necessary to engage acupuncture as a standardized and scientific validated technique in PCOS condition.
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Affiliation(s)
- Natália M. de Oliveira
- ICBAS - Institute of Biomedical Sciences Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto-UP, Porto, Portugal
- CBSin, Center of BioSciences in Integrative Health, Porto, Portugal
| | - Jorge Machado
- ICBAS - Institute of Biomedical Sciences Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto-UP, Porto, Portugal
- CBSin, Center of BioSciences in Integrative Health, Porto, Portugal
- LABIOMEP – Porto Biomechanics Laboratory, University of Porto-UP, Porto, Portugal
| | - Lara Lopes
- ICBAS - Institute of Biomedical Sciences Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto-UP, Porto, Portugal
- CBSin, Center of BioSciences in Integrative Health, Porto, Portugal
| | - Maria Begoña Criado
- CBSin, Center of BioSciences in Integrative Health, Porto, Portugal
- TOXRUN – Toxicology Research Unit, University Institute of Health Sciences, CESPU, Gandra, Portugal
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19
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Kim C, Schreiner PJ, Siscovick D, Wang A, Wellons MF, Ebong I, Vu TH, Appiah D, Catov J, Schisterman EF, Yin Z, Lewis CE. Factors associated with self-report of polycystic ovary syndrome in the Coronary Artery Risk Development in Young Adults study (CARDIA). BMC Womens Health 2023; 23:248. [PMID: 37161406 PMCID: PMC10170674 DOI: 10.1186/s12905-023-02394-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/25/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is underdiagnosed, but factors associated with women's report of diagnosis are not well-understood, particularly social determinants of health. Therefore, in a population-based cohort, we compared the characteristics of women with self-reported PCOS vs. women who have unrecognized PCOS vs. women without PCOS. METHODS We performed a secondary data analysis of the Coronary Artery Risk Development in Young Adults (CARDIA) Study, a population-based, prospective cohort of Black and White women. Participants were women (n = 2028) who responded to the question, "Did a doctor or nurse ever tell you that you had polycystic ovarian syndrome or polycystic ovarian disease?" at the year 15 examination. Women who answered "yes" were defined as having self-reported PCOS. Women who answered "no or not sure" were defined as having unrecognized PCOS if they also had irregular menses and hyperandrogenemia between 20 and 30 years of age. Exposures of interest included social determinants of health, symptoms including irregular menses and hirsutism, and comorbid conditions. RESULTS Forty-three (2.1%) of women had self-reported PCOS, 135 (6.7%) had unrecognized PCOS, and 1850 (91%) women were without PCOS. In logistic regression models adjusting for age, race, and center, women with self-reported PCOS were more likely to have obesity (OR 1.83, 95% CI 1.22, 2.75) and diabetes (OR 2.37, 95% CI 1.05, 5.33) compared to women without PCOS. Women with unrecognized PCOS were more likely to have hypertension (OR 1.68, 95% CI 1.03, 2.74) and food insecurity (OR 1.94, 95% CI 1.25, 3.01) compared to women without PCOS. CONCLUSIONS Unrecognized PCOS is common. Self-report of PCOS is not associated with access to healthcare. Women who report PCOS are more often obese and comorbidities may contribute to recognition of PCOS.
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Affiliation(s)
- Catherine Kim
- Departments of Medicine, Obstetrics & Gynecology, and Epidemiology, University of Michigan, North Campus Research Center, 2800 Plymouth Road, Building 16, Room 405E, Ann Arbor, MI, 48109, USA.
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | | | - Ange Wang
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Melissa F Wellons
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Imo Ebong
- Department of Medicine, University of California, Davis, Sacramento, CA, USA
| | - Thanh-Huyen Vu
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Duke Appiah
- Department of Public Health, School of Public and Population Health, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Janet Catov
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Enrique F Schisterman
- Department of Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Zhe Yin
- Institute of Health Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Cora E Lewis
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
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20
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Temkin SM, Barr E, Moore H, Caviston JP, Regensteiner JG, Clayton JA. Chronic conditions in women: the development of a National Institutes of health framework. BMC Womens Health 2023; 23:162. [PMID: 37024841 PMCID: PMC10077654 DOI: 10.1186/s12905-023-02319-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 03/29/2023] [Indexed: 04/08/2023] Open
Abstract
Rising rates of chronic conditions were cited as one of the key public health concerns in the Fiscal Year (FY) 2021 U.S. Senate and House of Representatives appropriations bills, where a review of current National Institutes of Health (NIH) portfolios relevant to research on women's health was requested. Chronic conditions were last defined by the US Department of Health and Human Services (HHS) in 2010. However, existing definitions of chronic conditions do not incorporate sex or gender considerations. Sex and gender influence health, yet significant knowledge gaps exist in the evidence-base for prevention, diagnosis, and treatment of chronic diseases amongst women. The presentation, prevalence, and long-term effects of chronic conditions and multimorbidity differs in women from men. A clinical framework was developed to adequately assess the NIH investment in research related to chronic conditions in women. The public health needs and NIH investment related to conditions included in the framework were measured. By available measures, research within the NIH has not mapped to the burden of chronic conditions among women. Clinical research questions and endpoints centered around women can be developed and implemented; clinical trials networks with expanded or extended eligibility criteria can be created; and data science could be used to extrapolate the effects of overlapping or multiple morbidities on the health of women. Aligning NIH research priorities to address the specific needs of women with chronic diseases is critical to addressing women's health needs from a life course perspective.
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Affiliation(s)
- Sarah M Temkin
- Office of Research On Women's Health, National Institutes of Health, Bethesda, MD, USA.
| | - Elizabeth Barr
- Office of Research On Women's Health, National Institutes of Health, Bethesda, MD, USA
| | - Holly Moore
- National Institute On Drug Abuse National Institutes of Health, Bethesda, MD, USA
| | - Juliane P Caviston
- Office of Research On Women's Health, National Institutes of Health, Bethesda, MD, USA
| | - Judith G Regensteiner
- Department of Medicine, Ludeman Family Center for Women's Health Research, University of Colorado Anschutz School of Medicine, Aurora, CO, USA
| | - Janine A Clayton
- Office of Research On Women's Health, National Institutes of Health, Bethesda, MD, USA
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21
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The experience in the development and validation of method for testosterone measurement in blood serum of premenopausal women using HPLC-MS/MS. ACTA BIOMEDICA SCIENTIFICA 2022. [DOI: 10.29413/abs.2022-7.6.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Testosterone assessment is essential for detecting biochemical hyperandrogenism, one of the important diagnostic criteria of polycystic ovary syndrome (PCOS) both in clinical practice and in epidemiological studies. Currently, tandem liquid chromatography-mass spectrometry (LC-MS/MS) is the most preferred technique to measure testosterone level in women. Its validation is important to reproducibility of androgen tests results for clinical practice and for epidemiological studies of the prevalence PCOS.The aim of the study. To develop and validate a method for determining total testosterone in blood serum using highly efficient LC-MS/MS to assess androgenemia in the epidemiological study of the prevalence of PCOS and its phenotypes in Eastern Siberia (ESPEP STUDY).Materials and methods. We determined a total testosterone level in serum blood using triple quadrupole mass spectrometer LCMS-8060 (Shimadzu, Japan). The protocol of technique was developed using self-prepared purified human testosteronefree serum with a known concentration of analyzed compound. We used the serum samples of women of reproductive age to test the developed method.Results. Optimum chromatographic conditions were obtained with a Kromasil 100-2.5-C18 column (2.1 mm × 100 mm; AkzoNobel, Netherlands), and an isocratic elution mode using a mobile phase consisting of acetonitrile and 0.1 % aqueous solution of formic acid. The total flow rate was 0.35 ml/min. The lower limit of quantification was 5 ng/dl with an average accuracy of 100.2 %. During the approbation of the method in a test population sample of 1138 premenopausal women (mean age – 34.3 ± 6.3 years), the median testosterone concentration was 26.9 ng/dl.Conclusion. It was found that the proposed method for determining testosterone in blood serum has acceptable linearity and reproducibility and meets the requirements for bioanalytical methods under the regulatory documentation. This method can be used for clinical practice and epidemiological study of the prevalence of PCOS.
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22
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Suturina L, Lizneva D, Atalyan A, Lazareva L, Belskikh A, Bairova T, Sholokhov L, Rashidova M, Danusevich I, Nadeliaeva I, Belenkaya L, Darzhaev Z, Sharifulin E, Belkova N, Igumnov I, Trofimova T, Khomyakova A, Ievleva K, Babaeva N, Egorova I, Salimova M, Yildiz BO, Legro RS, Stanczyk FZ, Azziz R. Establishing Normative Values to Determine the Prevalence of Biochemical Hyperandrogenism in Premenopausal Women of Different Ethnicities from Eastern Siberia. Diagnostics (Basel) 2022; 13:diagnostics13010033. [PMID: 36611327 PMCID: PMC9818891 DOI: 10.3390/diagnostics13010033] [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: 11/16/2022] [Revised: 12/17/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
Androgen assessment is a key element for diagnosing polycystic ovary syndrome (PCOS), and defining a "normal" level of circulating androgens is critical for epidemiological studies. We determined the upper normal limits (UNLs) for androgens in a population-based group of premenopausal "healthy control" women, overall and by ethnicity (Caucasian and Asian), in the cross-sectional Eastern Siberia PCOS Epidemiology and Phenotype (ESPEP) Study (ClinicalTrials.gov ID: NCT05194384) conducted in 2016-2019. Overall, we identified a "healthy control" group consisting of 143 healthy premenopausal women without menstrual dysfunction, hirsutism, polycystic ovaries, or medical disorders. We analyzed serum total testosterone (TT) by using liquid chromatography with tandem mass spectrometry (LC-MS/MS), and DHEAS, sex-hormone-binding globulin (SHBG), TSH, prolactin, and 17-hydroxyprogesterone (17OHP) were assessed with an enzyme-linked immunosorbent assay (ELISA). The UNLs for the entire population for the TT, free androgen index (FAI), and DHEAS were determined as the 98th percentiles in healthy controls as follows: 67.3 (95% confidence interval (CI): 48.1, 76.5) ng/dl, 5.4 (3.5, 14.0), and 355 (289, 371) μg/dl, respectively. The study results demonstrated that the UNLs for TT and FAI varied by ethnicity, whereas the DHEAS UNLs were comparable in the ethnicities studied.
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Affiliation(s)
- Larisa Suturina
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
- Correspondence: ; Tel.: +7-902-5774-906
| | - Daria Lizneva
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
- Center of Excellence for Translational Medicine and Pharmacology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Alina Atalyan
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Ludmila Lazareva
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Aleksey Belskikh
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Tatyana Bairova
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Leonid Sholokhov
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Maria Rashidova
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Irina Danusevich
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Iana Nadeliaeva
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Lilia Belenkaya
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Zorikto Darzhaev
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Eldar Sharifulin
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Natalia Belkova
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Ilia Igumnov
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Tatyana Trofimova
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Anastasiya Khomyakova
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Kseniia Ievleva
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Natalia Babaeva
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Irina Egorova
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Madinabonu Salimova
- Federal State Public Institution “Scientific Center for Family Health and Human Reproduction Problems”, 16, Timiryazeva Str., 664003 Irkutsk, Russia
| | - Bulent O. Yildiz
- Division of Endocrinology and Metabolism, Hacettepe University School of Medicine, Hacettepe, 06100 Ankara, Turkey
| | - Richard S. Legro
- Hershey Medical Center, Penn State College of Medicine, 500 University Dr, Hershey, PA 17033, USA
| | - Frank Z. Stanczyk
- Keck School of Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033, USA
| | - Ricardo Azziz
- School of Medicine and Public Health, University of Alabama at Birmingham, 1700 6th Ave, South Birmingham, AL 35249, USA
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23
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Tay CT, Joham AE, Moran LJ, Teede H. Better care for women with polycystic ovary syndrome - a proposal for an international evidence based best practice framework to improve care. Curr Opin Endocrinol Diabetes Obes 2022; 29:514-520. [PMID: 36081355 DOI: 10.1097/med.0000000000000770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in reproductive-age women and has reproductive, pregnancy, metabolic, dermatologic, and psychologic complications. Here we summarize current challenges and gaps in PCOS care, and propose a pathway forward to implement high quality international guideline recommendations and resources, through development of a best practice framework and benchmarking for evidence-based, patient-centric models of care (MoC). RECENT FINDINGS The majority of women with PCOS are unsatisfied with their healthcare experience due to delayed diagnosis, inadequate information provision and inconsistent advice from diverse healthcare providers. The 2018 International Evidence-based PCOS Guideline recommended co-development of evidence-based, patient centric MoC. High-quality guidelines and resources are now available to help women understand and manage PCOS and to assist healthcare professionals to partner in their care. Leveraging these and developing a best practice framework for patient centric PCOS MoC is now a vital to optimise care and outcomes in this common and neglected condition. SUMMARY Collaborative interdisciplinary efforts from academic leads, healthcare professionals and consumers are now needed to co-develop a framework and benchmarking performance indicators to guide evidence-based, patient centric PCOS MOC to improve experience and outcomes.
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Affiliation(s)
- Chau Thien Tay
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University
- Department of Diabetes and Vascular Medicine, Monash Health, Victoria, Australia
| | - Anju E Joham
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University
- Department of Diabetes and Vascular Medicine, Monash Health, Victoria, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University
- Department of Diabetes and Vascular Medicine, Monash Health, Victoria, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University
- Department of Diabetes and Vascular Medicine, Monash Health, Victoria, Australia
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Gezer E, Piro B, Cantürk Z, Çetinarslan B, Sözen M, Selek A, Polat Işik A, Seal LJ. The Comparison of Gender Dysphoria, Body Image Satisfaction and Quality of Life Between Treatment-Naive Transgender Males With and Without Polycystic Ovary Syndrome. Transgend Health 2022; 7:514-520. [PMID: 36644121 PMCID: PMC9829140 DOI: 10.1089/trgh.2021.0061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The prevalence of polycystic ovary syndrome (PCOS) among trans men has been reported as higher than among the cisgender population, which varies between 14.4% and 58%. In this cross-sectional study, we aimed to evaluate the association of oligo-anovulation and/or features of hyperandrogenism with the scores on the Utrecht Gender Dysphoria Scale (UGDS), the Body Image Scale (BIS), and the Short Form-36 Health Survey (SF-36) in treatment-naive trans men with PCOS seeking help for gender transition. The study sample consisted of trans men who were diagnosed with gender dysphoria (GD) between December 2019 and November 2020. To assess body dissatisfaction and psychological functioning, the UGDS, BIS, and SF-36 were administered to all transgender individuals as part of the routine assessment procedure. A total of 49 treatment-naive trans men were included in our study; 38.8% (n=19) of the participants were diagnosed with PCOS using the Rotterdam 2003 criteria. The scores of UGDS and BIS were significantly lower in the PCOS group compared with the non-PCOS group (p<0.001 and p=0.003, respectively). Among the eight parameters within SF-36, general health, emotional role, and vitality scores were significantly higher in the PCOS group (p=0.031, p=0.015, and p=0.006, respectively). Our study is the first study that demonstrates significantly lower GD, higher body image satisfaction and quality of life in trans men with PCOS compared with those without PCOS. Our findings are promising for larger prospective cohort studies to develop a consensus on the management of PCOS in trans men.
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Affiliation(s)
- Emre Gezer
- Department of Endocrinology and Metabolism and Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Bejda Piro
- Department of Psychiatry, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Zeynep Cantürk
- Department of Endocrinology and Metabolism and Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Berrin Çetinarslan
- Department of Endocrinology and Metabolism and Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Mehmet Sözen
- Department of Endocrinology and Metabolism and Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Alev Selek
- Department of Endocrinology and Metabolism and Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Aslıhan Polat Işik
- Department of Psychiatry, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Leighton John Seal
- Department of Endocrinology, St George's Hospital Medical School, London, United Kingdom
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Wang W, Hao J, Shi Y. IL23 suppresses proliferation and promotes apoptosis of human granulosa-like tumor cell line KGN by targeting the androgen receptor signal pathway. Gynecol Endocrinol 2022; 38:965-970. [PMID: 36123810 DOI: 10.1080/09513590.2022.2123914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background: Polycystic ovary syndrome (PCOS) is associated with chronic low-grade inflammation. IL23 is a classic pro-inflammatory factor, which has been found that serum levels of IL23 were higher in patients with PCOS. However, the exact function of IL23 in regulating the pathogenesis of PCOS has not been elucidated. This study aimed to investigate the role of IL23 in the pathogenesis of PCOS and uncover the possible molecular mechanism. Methods: We investigated the role of IL23 in the proliferation, cell cycle progression and apoptosis of granulosa cells (GCs) using the human granulosa-like tumor cell line KGN. Results: IL23 suppressed the proliferation, arrested cell cycle progression, and increased apoptosis of KGN cells. We also found that IL23 decreases proliferation and promotes apoptosis in KGN cells is mediated by androgen receptor (AR) signaling. Conclusions: Our results demonstrated that IL23 suppressed cell proliferation and promoted apoptosis of KGN cells, which might provide new evidence for abnormal proliferation and apoptosis of GCs in PCOS.
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Affiliation(s)
- Wenqi Wang
- Center for Reproductive Medicine, Shandong University, Jinan, China
- Medical Integration and Practice Center, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Department of Obstetrics and Gynecology, Taian Central Hospital, Taian, Shandong
| | - Jing Hao
- Key Laboratory of The Ministry of Education for Experimental Teratology, Department of Histology and Embryology, School of Basic Medicine Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yuhua Shi
- Center for Reproductive Medicine, Shandong University, Jinan, China
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences
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Acupuncture in Women with Human Polycystic Ovary/Ovarian Syndrome: Protocol for a Randomized Controlled Trial. Healthcare (Basel) 2022; 10:healthcare10101999. [PMID: 36292446 PMCID: PMC9602079 DOI: 10.3390/healthcare10101999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/04/2022] [Accepted: 10/08/2022] [Indexed: 11/04/2022] Open
Abstract
(1) Background: Human polycystic ovary/ovarian syndrome (PCOS) is linked to endocrine, metabolic, and psychological complications. We propose a randomized controlled pilot study for an acupuncture protocol regarding the management of PCOS symptoms based on TCM diagnosis; (2) Methods: We will randomly allocate 120 women diagnosed with PCOS into two groups. The study group will be treated with acupuncture for points known to act upon the autonomous regulation of the hormonal, metabolic and emotional components. (3) Results and Conclusions: We expect to provide evidence of high methodological quality related to the effects and safety of an acupuncture protocol based on the perspective of a TCM diagnostic.
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De Nardo Maffazioli G, Baracat EC, Soares JM, Carvalho KC, Maciel GAR. Evaluation of circulating microRNA profiles in Brazilian women with polycystic ovary syndrome: A preliminary study. PLoS One 2022; 17:e0275031. [PMID: 36206272 PMCID: PMC9543946 DOI: 10.1371/journal.pone.0275031] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/08/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS) is a heterogeneous endocrinopathy, which etiology encompasses complex genetic traits associated with epigenetic factors, including differences in microRNA (miRNA) expression in a variety of tissues. The circulating form of these molecules is raising attention in the syndrome not only as potential biomarkers of PCOS but also as possible therapeutic targets. The aim of this study was to explore the circulating miRNA profiles present in a cohort of Brazilian women with and without PCOS and to evaluate the potential role of miRNAs in the pathophysiology of the syndrome. METHODS Cross-sectional study of 36 well-characterized PCOS women and 16 healthy controls. Clinical, hormone and metabolic data were recorded and evaluated. The expression profile of the 201 circulating miRNA selected were analyzed by taqman quantitative real time polymerase chain reactions (RT-PCR) using a customized Open Array platform. Statistical and bioinformatic analyzed were performed. RESULTS Circulating miR-21-5p, miR-23a-3p and miR-26a-5p were upregulated, and miR-103a-3p, miR-376a-3p, miR-19b-3p and miR-222-3p were downregulated in women with PCOS compared to healthy normo-ovulatory controls. miR-21-5p, miR-103a-3p and miR-376a-3p levels correlated positively with androgen levels. These miRNAs, in combination, were related to pathways involved in insulin signaling, steroids biosynthesis and endothelial regulation as well as in folliculogenesis. CONCLUSION In this study, we identified a specific circulating miRNA signature in Brazilian women with PCOS. According to our data, circulating miR-21-5p, miR-23a-3p, miR-26a-5p, miR-103a-3p, miR-376a-3p, miR-19b-3p and miR-222-3p may represent potential candidates for differential diagnosis of PCOS in the future.
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Affiliation(s)
- Giovana De Nardo Maffazioli
- Faculdade de Medicina de Sao Paulo, Departamento de Obstetrícia e Ginecologia, Disciplina de Ginecologia, Hospital das Clínicas HCFMUSP, Sao Paulo, SP, Brazil
- Laboratório de Ginecologia Estrutural e Molecular (LIM 58), Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Departamento de Obstetricia e Ginecologia, Disciplina de Ginecologia, São Paulo, Brazil
- * E-mail:
| | - Edmund Chada Baracat
- Faculdade de Medicina de Sao Paulo, Departamento de Obstetrícia e Ginecologia, Disciplina de Ginecologia, Hospital das Clínicas HCFMUSP, Sao Paulo, SP, Brazil
- Laboratório de Ginecologia Estrutural e Molecular (LIM 58), Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Departamento de Obstetricia e Ginecologia, Disciplina de Ginecologia, São Paulo, Brazil
| | - José Maria Soares
- Faculdade de Medicina de Sao Paulo, Departamento de Obstetrícia e Ginecologia, Disciplina de Ginecologia, Hospital das Clínicas HCFMUSP, Sao Paulo, SP, Brazil
| | - Kátia Cândido Carvalho
- Faculdade de Medicina de Sao Paulo, Departamento de Obstetrícia e Ginecologia, Disciplina de Ginecologia, Hospital das Clínicas HCFMUSP, Sao Paulo, SP, Brazil
- Laboratório de Ginecologia Estrutural e Molecular (LIM 58), Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Departamento de Obstetricia e Ginecologia, Disciplina de Ginecologia, São Paulo, Brazil
| | - Gustavo Arantes Rosa Maciel
- Faculdade de Medicina de Sao Paulo, Departamento de Obstetrícia e Ginecologia, Disciplina de Ginecologia, Hospital das Clínicas HCFMUSP, Sao Paulo, SP, Brazil
- Laboratório de Ginecologia Estrutural e Molecular (LIM 58), Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Departamento de Obstetricia e Ginecologia, Disciplina de Ginecologia, São Paulo, Brazil
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Impact of social isolation during COVID-19 pandemic on health behaviors and weight management in women with polycystic ovary syndrome. Eat Weight Disord 2022; 27:2407-2413. [PMID: 35195885 PMCID: PMC8865179 DOI: 10.1007/s40519-022-01369-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 01/18/2022] [Indexed: 11/25/2022] Open
Abstract
PURPOSE COVID-19 pandemic has far-reaching psychosocial implications for chronic health conditions. We aimed to investigate whether COVID-19 associated social isolation affects lifestyle and weight control in women with polycystic ovary syndrome (PCOS). METHODS We conducted an online survey involving 232 women with PCOS and 157 healthy controls on weight changes, physical activity, sleep and eating patterns using Three-Factor Eating Questionnaire (TFEQ-18), Pittsburgh Sleep Quality Index (PSQI), and International Physical Activity Questionnaire Short Form (IPAQ-SF). PCOS-related quality of life questionnaire (PCOSQ) was also completed by the patients. RESULTS While 48.5% of all participants gained weight, 13.9% maintained a stable weight, and 37.6% lost weight during the 14-week social isolation. The distribution of weight change was similar between groups (p = 0.44). All participants reported a decrease in physical activity (p < 0.001). While eating behavior showed no significant change in both groups, reduced sleep quality was found only in the PCOS group (p < 0.001). In women with weight gain, increase in BMI values was higher in patients (1.3 ± 1 kg/m2) than controls (1.0 ± 0.6 kg/m2; p = 0.01). Among those who gained weight, delta BMI values showed positive correlations with delta sleep induction time (r = 0.25, p = 0.001), delta PSQI (r = 0.24, p = 0.004) and delta TFEQ-18 scores (r = 0.25, p = 0.001). CONCLUSION Weight changes during social isolation are similar in women with PCOS and healthy women. However, within those who gain weight, increase in BMI is more pronounced in women with PCOS. Weight gain appears to be related to alterations in sleep quality and eating habits rather than reduced physical activity. LEVEL III Evidence obtained from cohort or case-control analytic studies.
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Soria-Contreras DC, Perng W, Rifas-Shiman SL, Hivert MF, Chavarro JE, Oken E. Menstrual cycle length and adverse pregnancy outcomes among women in Project Viva. Paediatr Perinat Epidemiol 2022; 36:347-355. [PMID: 35172020 PMCID: PMC9050743 DOI: 10.1111/ppe.12866] [Citation(s) in RCA: 4] [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: 08/24/2021] [Revised: 01/04/2022] [Accepted: 01/16/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND Retrospective studies suggest that menstrual cycle length may be a risk marker of adverse pregnancy outcomes, but this evidence is susceptible to recall bias. OBJECTIVE To evaluate the prospective association between menstrual cycle length and the risk of adverse pregnancy outcomes. METHODS Secondary analysis of 2046 women enrolled in Project Viva at ~10 weeks of gestation and followed through delivery. The exposure was menstrual cycle length. The outcomes included gestational glucose tolerance (gestational diabetes/impaired glucose tolerance [GDM/IGT] and isolated hyperglycaemia), hypertensive disorders of pregnancy (gestational hypertension/preeclampsia), gestational weight gain, birthweight-for-gestational age z-scores (BWZ) categorised in tertiles, preterm birth and birth outcome (live birth and pregnancy loss). We used modified Poisson and multinomial logistic regression adjusted for age, race/ethnicity, parity, age at menarche and pre-pregnancy body mass index. RESULTS Mean (SD) age at enrolment was 32.1 (4.9) years. Most women (74.3%) had a cycle length of 26-34 days (reference group), 16.2% reported short cycles (≤25 days), and 9.5% reported long/irregular cycles (≥35 days/too irregular to estimate). Compared with the reference group, women with short cycles had lower odds of GDM/IGT (odds ratio [OR] 0.50, 95% confidence interval [CI] 0.28, 0.89), whereas women with long/irregular cycles had higher odds (OR 1.72, 95% CI 1.04, 2.83). Additionally, women with short cycles had higher odds of having a newborn in the lowest tertile of BWZ (OR 1.45, 95% CI 1.06, 1.98). There was a U-shaped relation between cycle length and preterm birth with both short (relative risk [RR] 1.49, 95% CI 0.98, 2.27) and long/irregular (RR 2.04, 95% CI 1.30, 3.20) cycles, associated with a higher risk. CONCLUSIONS Variation in menstrual cycle length may be a risk marker of GDM/IGT, lower birth size and preterm birth and flag women who may benefit from targeted monitoring and care before and during pregnancy.
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Affiliation(s)
- Diana C. Soria-Contreras
- Center for Nutrition and Health Research, National
Institute of Public Health. Avenida Universidad No. 655, Santa Maria Ahuacatitlan,
Cuernavaca, Morelos 62100, Mexico
| | - Wei Perng
- Department of Epidemiology, Colorado School of Public
Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Place,
Aurora, CO 80045, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD)
Center, Department of Epidemiology, Colorado School of Public Health, University of
Colorado, Anschutz Medical Campus, 12474 East 19 Ave, Aurora, CO 80045,
USA
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse,
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health
Care Institute, 401 Park Drive, Suite 401 East, Boston, MA 02215, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse,
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health
Care Institute, 401 Park Drive, Suite 401 East, Boston, MA 02215, USA
- Diabetes Unit, Massachusetts General Hospital, 50 Staniford
Street, Boston, MA 02114
| | - Jorge E. Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public
Health, 677 Huntington Ave, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of
Medicine, Brigham and Women’s Hospital and Harvard Medical School, 75 Francis
St, Boston, MA 02115, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse,
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health
Care Institute, 401 Park Drive, Suite 401 East, Boston, MA 02215, USA
- Department of Nutrition, Harvard T.H. Chan School of Public
Health, 677 Huntington Ave, Boston, MA 02115, USA
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Schoretsanitis G, Gastaldon C, Kalaitzopoulos DR, Ochsenbein-Koelble N, Barbui C, Seifritz E. Polycystic ovary syndrome and postpartum depression: A systematic review and meta-analysis of observational studies. J Affect Disord 2022; 299:463-469. [PMID: 34952106 DOI: 10.1016/j.jad.2021.12.044] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/08/2021] [Accepted: 12/18/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To estimate the risk of postpartum depression (PPD) in women with polycystic ovary syndrome (PCOS) and assess related moderators. METHODS Observational studies reporting on PPD rates in women with vs. without PCOS were identified in Embase/Medline/PsychInfo/Cinhail in 03/2021 since data inception. Quality of studies was evaluated using the Newcastle-Ottawa-Scale. The primary outcome was the odds ratio (OR, 95% confidence intervals [95%CI]) of PPD in women with vs. without PCOS. Meta-regression analyses included the effects of age, body mass index, percent smokers, history of depression, preterm delivery, hypertension during pregnancy, gestational diabetes and cesarian section as well as subgroup analyses based on the assessment methods for PCOS and PPD. Sensitivity analyses after excluding poor quality studies and cross-sectional studies and sequentially excluding each study were performed. RESULTS One study was rated as good, two as fair and three as low-quality. In six studies (n = 934,922), 44,167 women with PCOS were at increased PPD risk compared to 890,755 women without PCOS (OR= 1.45, 95%CI= 1.18 to 1.79, p< 0.001). When excluding one study that underestimated PCOS prevalence, we estimated an OR of 1.59 (95%CI= 1.56 to 1.62, p< 0.001) with reduced heterogeneity (I2= 45.3%). Higher ORs of PPD in women with PCOS were moderated by lower percentage of preterm delivery (co-efficient -0.07, 95%CI= -0.1 to -0.04, p< 0.001). After excluding low-quality studies yielded an OR of 1.58 (95%CI= 1.56 to 1.59, p< 0.001) with heterogeneity dropping (I2= 14.0%). LIMITATIONS The methodological heterogeneity of available studies. CONCLUSIONS Women with PCOS are at elevated PPD risk with risk moderators requiring further research.
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Affiliation(s)
- Georgios Schoretsanitis
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland; Behavioral Health Pavilion, Department of Psychiatry, Northwell Health, The Zucker Hillside Hospital, 7559 263rd Street, Glen Oaks, NY 11004, USA and Department of Psychiatry, Zucker School of Medicine at Northwell/Hofstra, Hempstead, New York, USA.
| | - Chiara Gastaldon
- WHO Collaborating Center for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | | | - Nicole Ochsenbein-Koelble
- Department of Obstetrics, University Hospital of Zurich, Switzerland; University of Zürich, Zürich, Switzerland
| | - Corrado Barbui
- WHO Collaborating Center for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
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OUP accepted manuscript. Hum Reprod Update 2022; 28:501-517. [DOI: 10.1093/humupd/dmac011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 02/06/2022] [Indexed: 11/14/2022] Open
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Jin C, Zou K, Xu Y, Yang H, Pan J. Elevated plasma pentraxin-3 in polycystic ovary syndrome is associated with hyperandrogenism: a case-control study. BMC Endocr Disord 2021; 21:240. [PMID: 34856980 PMCID: PMC8641145 DOI: 10.1186/s12902-021-00886-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 10/25/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Pentraxin 3 (PTX3) - a crucial humoral innate immunity component - is related to obesity and cardiovascular complications in women who suffer from polycystic ovary syndrome (PCOS). However, the circulating PTX3 level in PCOS is still debated. In this study, we aimed to evaluate PTX3 plasma levels in PCOS women of childbearing age, and find possible endocrine/metabolic factors that could affect this level. METHODS A total of 360 women were enrolled: 120 PCOS women and 240 body mass index (BMI) matched normally ovulating women. Blood samples were collected on the third day of natural menstrual cycle or from the bleeding after progesterone withdrawal. The PTX3 concentration was measured by immunoassay. RESULTS The PTX3 plasma level was significantly higher in PCOS women compared to controls. There was a positive correlation between PTX3 plasma level and PCOS diagnosis, overweight, cycle length, serum LH to FSH ratio, estradiol, total testosterone (TT) on the third day of menstrual cycle, antral follicle count (AFC), as well as uric acid. Multivariant linear regression analysis indicated that participants' serum PTX3 levels were proportional to the circulating TT level, existence of PCOS, basal estradiol level and AFC. CONCLUSIONS Overall, the circulating PTX3 level was elevated in PCOS women and significantly associated with the presence of hyperandrogenism. This study provided the basis for further in-depth researches regarding PTX3 role in PCOS pathophysiology.
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Affiliation(s)
- Congcong Jin
- The First Affiliated Hospital of Wenzhou Medical University, 325000, Wenzhou, China
| | - Kexin Zou
- Obstetrics & Gynecology Hospital, Institute of Reproduction and Development, Fudan University, 200011, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, 200030, Shanghai, China
| | - Yue Xu
- Obstetrics & Gynecology Hospital, Institute of Reproduction and Development, Fudan University, 200011, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, 200030, Shanghai, China
- Shanghai Ji Ai Genetics and IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, 200011, Shanghai, China
| | - Haiyan Yang
- The First Affiliated Hospital of Wenzhou Medical University, 325000, Wenzhou, China
| | - Jiexue Pan
- Obstetrics & Gynecology Hospital, Institute of Reproduction and Development, Fudan University, 200011, Shanghai, China.
- Shanghai Key Laboratory of Embryo Original Diseases, 200030, Shanghai, China.
- Shanghai Ji Ai Genetics and IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, 200011, Shanghai, China.
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Kiconco S, Mousa A, Azziz R, Enticott J, Suturina LV, Zhao X, Gambineri A, Tehrani FR, Yildiz BO, Kim JJ, Teede HJ, Joham AE. PCOS Phenotype in Unselected Populations Study (P-PUP): Protocol for a Systematic Review and Defining PCOS Diagnostic Features with Pooled Individual Participant Data. Diagnostics (Basel) 2021; 11:diagnostics11111953. [PMID: 34829300 PMCID: PMC8618006 DOI: 10.3390/diagnostics11111953] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/11/2021] [Accepted: 10/17/2021] [Indexed: 11/24/2022] Open
Abstract
The diagnosis of polycystic ovary syndrome (PCOS) remains challenging due to limited data regarding normative cut-offs for the diagnostic features in different subpopulations. We aim to conduct a systematic review, build a comprehensive repository of de-identified individual participant data (IPD), and define normative ranges and diagnostic cut-offs for all PCOS diagnostic features. We will conduct a systematic search of MEDLINE and EMBASE databases for studies that assessed PCOS diagnostic features in unselected women. Two reviewers will assess eligibility and perform quality appraisal. Authors of included studies will be invited to contribute IPD. Primary variables include directly assessed modified Ferriman Gallwey (mFG) scores; menstrual cycle lengths; follicle number per ovary (FNPO), ovarian volume (OV), anti-Müllerian hormone (AMH); circulating androgens, including total testosterone (TT), free testosterone, bioavailable testosterone, free androgen index (FAI), androstenedione (A4), and dehydroepiandrosterone sulphate (DHEAS). Normative ranges and cut-offs will be defined using cluster analysis. Monash University Human Research Ethics Committee granted ethical approval (26938/0 1/12/2020), all IPD will be de-identified and primary studies have ethical approval from their institutional ethics committees. Findings will clarify distinction between PCOS and non-PCOS populations, and inform the update of the international evidence-based guidelines for the assessment and management of PCOS.
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Affiliation(s)
- Sylvia Kiconco
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC 3800, Australia; (S.K.); (J.E.); (H.J.T.)
| | - Aya Mousa
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC 3800, Australia; (S.K.); (J.E.); (H.J.T.)
- Correspondence: (A.M.); (A.E.J.)
| | - Ricardo Azziz
- Departments of Obstetrics, Gynaecology and Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
- Department of Healthcare Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Department of Health Policy, Management and Behaviour, School of Public Health, University at Albany, SUNY, Rensselaer, Albany, NY 12144, USA
| | - Joanne Enticott
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC 3800, Australia; (S.K.); (J.E.); (H.J.T.)
| | - Larisa V. Suturina
- Department of Reproductive Health Protection, Scientific Center for Family Health and Human Reproduction, 664003 Irkutsk, Russia;
| | - Xiaomiao Zhao
- Reproductive Endocrinology and Infertility Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Yanjiang Road 107, Guangzhou 510120, China;
| | - Alessandra Gambineri
- Department of Medical and Surgical Science, University of Bologna, 40138 Bologna, Italy;
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran P.O. Box 19395-4763, Iran;
| | - Bulent O. Yildiz
- Division of Endocrinology and Metabolism, Hacettepe University of Medicine, Ankara 06100, Turkey;
| | - Jin-Ju Kim
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul 03080, Korea;
| | - Helena J. Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC 3800, Australia; (S.K.); (J.E.); (H.J.T.)
- Department of Endocrinology and Diabetes, Monash Health, Clayton, VIC 3168, Australia
| | - Anju E. Joham
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC 3800, Australia; (S.K.); (J.E.); (H.J.T.)
- Department of Endocrinology and Diabetes, Monash Health, Clayton, VIC 3168, Australia
- Correspondence: (A.M.); (A.E.J.)
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Ramasamy VA, Garad RM, Boyle JA. A Comprehensive PCOS Research and Guideline Translation Program to Improve Practice. Semin Reprod Med 2021; 39:161-166. [PMID: 34530479 DOI: 10.1055/s-0041-1733916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a common and complex endocrinopathy affecting reproductive-age women with a reported prevalence of 8 to 13%. To address the knowledge, practice, consumer satisfaction, and research gaps, an international research collaboration was formed to develop the first "International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (2018)." This article describes an effective research translation program to disseminate the guideline internationally to women and health providers. To date, this had led to 75,197 views and almost 36,000 downloads of the PCOS guideline, and 43,000 views and 10,600 downloads of a suite of PCOS resources. AskPCOS app, the first freely accessible, evidence-based PCOS app, has 9,910 users (between 400 and 800 users per month), 23,447 sessions, and 87,801 screen viewings. Fifty-four percent of returning users are from across 137 countries, with the most users in Australia, the United States, the United Kingdom, the Netherlands, and India. Extensive global uptake of the PCOS guideline and compendium of resources was augmented by extensive formative consumer and health professional consultation, end-user engagement across the evidence-creation spectrum, co-design, and quality improvement.
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Affiliation(s)
- Vijayanand A Ramasamy
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Rhonda M Garad
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Jacqueline A Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
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Chin HB, Marsh EE, Hall JE, Baird DD. Prevalence of Hirsutism Among Reproductive-Aged African American Women. J Womens Health (Larchmt) 2021; 30:1580-1587. [PMID: 34520248 DOI: 10.1089/jwh.2021.0125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Hirsutism is the most common clinical symptom of hyperandrogenism, but racial and ethnic-specific thresholds have not been established. Our objective was to characterize hirsutism using self-report of hair growth in a large sample of African American women. Materials and Methods: The Study of Environment, Lifestyle, and Fibroids is a prospective community-based cohort study of African American women (23-34 at recruitment). A total of 1568 participants received the modified Ferriman-Gallwey (mFG) pictorial assessment and were asked if they were ever bothered by excess hair. We estimated the prevalence of hirsutism (mFG score ≥8) and associations of acne, polycystic ovary syndrome (PCOS), and menstrual cycle characteristics with hirsutism. We also explored hirsutism defined by the 95th percentile of scores in our cohort (mFG = 11) and a newly recommended criterion, mFG = 4. Results: We could determine hirsutism status in 1556 women. Thirty-seven percent reported being bothered by excess hair, and 10% met the mFG criterion for hirsutism. History of severe facial acne was positively associated with hirsutism (prevalence ratio: 1.90; 95% confidence interval [CI]: 1.30-2.76), as was physician-diagnosed PCOS (2.22, 95% CI: 1.30-3.81). Women with irregular menstrual cycles were also more likely to report hirsutism (1.78, 95% CI: 1.00-3.18). Results were similar using mFG ≥11 and attenuated using mFG ≥4. Conclusions: Hirsutism prevalence was 10% in this community sample of African American women and was associated with PCOS, severe acne, and irregular menstrual cycles suggesting this represented hirsutism caused by hyperandrogenism. Ethnically diverse, population-based studies assessing the association between mFG score and androgen levels are needed to better understand the hirsutism threshold as a clinical marker of hyperandrogenism.
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Affiliation(s)
- Helen B Chin
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA.,Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA
| | - Erica E Marsh
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Janet E Hall
- Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA
| | - Donna D Baird
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA
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Kiconco S, Teede HJ, Azziz R, Norman RJ, Joham AE. The Need to Reassess the Diagnosis of Polycystic Ovary Syndrome (PCOS): A Review of Diagnostic Recommendations from the International Evidence-Based Guideline for the Assessment and Management of PCOS. Semin Reprod Med 2021; 39:71-77. [PMID: 34404096 DOI: 10.1055/s-0041-1735259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disorder that is associated with negative metabolic, reproductive, endocrine, and psychological consequences among women of reproductive age. The diagnosis of PCOS remains challenging due to limited and conflicting evidence regarding definitions for each of the diagnostic features. This review of the recommended PCOS assessment criteria from the international evidence-based guideline highlights the crucial need to reassess, redefine, and optimize the diagnosis of PCOS. Notably, normal values and cut-offs need to be defined for each diagnostic feature across the lifespan and diverse ethnic groups. Understanding how these features cluster together and relate to short- and long-term health outcomes in PCOS is also vital. Ultimately, greater knowledge of the natural history of PCOS is needed through well-characterized, community-based longitudinal studies, which will inform future PCOS diagnosis guidelines and optimize women's health in reproductive life.
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Affiliation(s)
- Sylvia Kiconco
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Helena J Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.,Department of Diabetes and Vascular Medicine, Monash Health, Victoria, Australia
| | - Ricardo Azziz
- American Society for Reproductive Medicine, Birmingham, Alabama.,Department of Obstetrics and Gynaecology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.,Department of Health Policy, Management, and Behaviour; University at Albany School of Public Health, SUNY, Rensselaer, New York
| | - Robert J Norman
- Department of Obstetrics and Gynaecology, Robinson Research Institute, University of Adelaide, South Australia, Australia
| | - Anju E Joham
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.,Department of Diabetes and Vascular Medicine, Monash Health, Victoria, Australia
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Al Wattar BH, Fisher M, Bevington L, Talaulikar V, Davies M, Conway G, Yasmin E. Clinical Practice Guidelines on the Diagnosis and Management of Polycystic Ovary Syndrome: A Systematic Review and Quality Assessment Study. J Clin Endocrinol Metab 2021; 106:2436-2446. [PMID: 33839790 PMCID: PMC8830055 DOI: 10.1210/clinem/dgab232] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Clinical practice guidelines (CPGs) are key instruments to implement the practice of evidence-based medicine. We aimed to evaluate the methodological quality and variations in CPGs recommendations on the diagnosis and management of polycystic ovary syndrome (PCOS). EVIDENCE ACQUISITION We searched MEDLINE, EMBASE, and CENTRAL until December 2020 for all evidence-based CPGs and consensus statements on PCOS. We extracted data in duplicate to map clinical recommendations across prespecified disease domains and assessed CPGs methodological quality of using the Appraisal of Guidelines, Research & Evaluation II tool. EVIDENCE SYNTHESIS We included 13 PCOS CPGs published between 2007 and 2018. CPGs recommendations were mostly focused on screening for and managing metabolic disease (12/13, 92%), followed by cardiovascular risk assessment (10/13, 77%). Mental health (8/13, 62%) and diagnosis in adolescents (7/13, 54%) were the least reported domains. Most CPGs had a high quality for scope and purpose description (12/13, 92%) while stakeholder's involvement and applicability of recommendations to clinical practice were appropriate in only 2 CPGs (2/13, 15%). We identified inconsistency in recommendations on PCOS diagnosis in adolescents, optimal lifestyle interventions, hirsutism and acne treatments, interventions to reduce the risk of ovarian hyperstimulation syndrome, the frequency and screening criteria for metabolic and cardiovascular disease, and optimal screening tools for mental health illness in women with PCOS. CONCLUSION Current CPGs on the diagnosis and management of PCOS vary in their scope and methodological quality, which may hinder evidence translation into clinical practice. We identified disease domains with existing evidence gap to guide future research and guideline updates.
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Affiliation(s)
- Bassel H Al Wattar
- Warwick Medical School, University of Warwick, Coventry, UK
- Reproductive medicine unit, University College London Hospitals, London, UK
- Correspondence: Bassel H. Al Wattar. Reproductive Medicine Unit, University College London Hospitals, London, UK.
| | - Maria Fisher
- University Hospital Coventry & Warwickshire, Coventry, UK
| | | | - Vikram Talaulikar
- Reproductive medicine unit, University College London Hospitals, London, UK
- UCL Institute for Women’s Health, University College London, London, England
| | - Melanie Davies
- Reproductive medicine unit, University College London Hospitals, London, UK
- UCL Institute for Women’s Health, University College London, London, England
| | - Gerrad Conway
- Reproductive medicine unit, University College London Hospitals, London, UK
- UCL Institute for Women’s Health, University College London, London, England
| | - Ephia Yasmin
- Reproductive medicine unit, University College London Hospitals, London, UK
- UCL Institute for Women’s Health, University College London, London, England
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Xie L, Jiang X, Chen Y, Huang C, Chen Y, Liu G, Sun W, Zeng L, Lu R. 3 CpG methylation biomarkers for the diagnosis of polycystic ovary syndrome (PCOS) in blood. Comb Chem High Throughput Screen 2021; 25:1304-1313. [PMID: 34080962 DOI: 10.2174/1386207321666210602170054] [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: 11/11/2020] [Revised: 03/26/2021] [Accepted: 04/12/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common endocrine disease in women that seriously interferes with the patient's metabolic and reproductive functions. The current diagnostic criteria for PCOS are expert-based and still disputed. Previous studies have identified changes in DNA methylation in peripheral blood of women with PCOS, but their diagnostic potential for PCOS remains to be studied. OBJECTIVE The present study aimed to identify potential methylation biomarkers for the diagnosis of PCOS in blood. METHODS Methylation profiles of peripheral blood were downloaded from a public database, Gene Expression Omnibus (GEO), of 30 PCOS patients (diagnosed with the revised 2003 Rotterdam consensus criteria), and 30 age-matched healthy women were recruited from the Centre of Reproductive Medicine, Linyi People's Hospital, Shandong, China. Weighted gene co-expression network analysis (WGCNA) was utilized to identify PCOS-related co-methylation CpG sites (co-MPs). Functional enrichment analysis was performed on the localized genes of PCOS-related co-MPs. The least absolute shrinkage and selection operator (LASSO) regression was used to screen CpG methylation signatures for PCOS diagnosis and receiver operating characteristic (ROC) analysis was conducted to evaluate their diagnostic accuracy, respectively. To assess the accuracy of the combination of the investigated indicators, multivariate ROC analysis was performed on the predicted probability values obtained using binary logistic regression on the methylation levels of selected CpGs together. RESULTS Seven co-methylation modules were obtained, most relevant to PCOS of which was the turquoise module, containing 194 co-MPs. The genes that these co-MPs located in were mainly associated with the immune-related pathway. According to LASSO regression, three Co-MPs (cg23464743, cg06834912, cg00103771) were identified as potential diagnostic biomarkers of PCOS. ROC analysis showed an AUC (area under the curve) of 0.7556 (sensitivity 60.0%, specificity 83.3%) for cg23464743, 0.7822 (sensitivity 70.0%, specificity 80.0%) for cg06834912, and 0.7611 (sensitivity 63.3%, specificity 83.3%) for cg00103771. The diagnostic accuracy of the combination of these 3 indicators presented to be higher than any single one of them, with an AUC of 0.8378 (sensitivity 73.3%, specificity 93.3%). CONCLUSION The combination of 3 CpG methylation signatures in blood was identified with a good diagnostic accuracy for PCOS, which may bring new insight into the development of PCOS diagnostic markers in the future.
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Affiliation(s)
- Linling Xie
- Guangzhou University of Chinese Medicine, Guangzhou 515000, China
| | - Xiaotao Jiang
- Guangzhou University of Chinese Medicine, Guangzhou 515000, China
| | - Yi Chen
- Guangzhou University of Chinese Medicine, Guangzhou 515000, China
| | - Cihui Huang
- Guangzhou University of Chinese Medicine, Guangzhou 515000, China
| | - Yanfen Chen
- Guangzhou University of Chinese Medicine, Guangzhou 515000, China
| | - Guantong Liu
- Guangzhou University of Chinese Medicine, Guangzhou 515000, China
| | - Wenxi Sun
- Guangzhou University of Chinese Medicine, Guangzhou 515000, China
| | - Lei Zeng
- Guangzhou University of Chinese Medicine, Guangzhou 515000, China
| | - Ruling Lu
- Guangzhou University of Chinese Medicine, Guangzhou 515000, China
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Ilias I, Goulas S, Zabuliene L. Polycystic ovary syndrome: Pathways and mechanisms for possible increased susceptibility to COVID-19. World J Clin Cases 2021; 9:2711-2720. [PMID: 33969054 PMCID: PMC8058679 DOI: 10.12998/wjcc.v9.i12.2711] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/16/2021] [Accepted: 03/18/2021] [Indexed: 02/06/2023] Open
Abstract
In 75% of women with polycystic ovary syndrome (PCOS), insulin action is impaired. In obesity, visceral adipose tissue becomes dysfunctional: Chronic inflammation is favored over storage, contributing to the development of metabolic complications. PCOS, metabolic syndrome (MetSy) and non-alcoholic fatty liver disease (NAFLD) apparently share common pathogenic factors; these include abdominal adiposity, excess body weight and insulin resistance. Alterations in the gut microbiome have been noted in women with PCOS compared to controls; these may lead to deterioration of the intestinal barrier, increased gut mucosal permeability and immune system activation, hyperinsulinemia and glucose intolerance, which hamper normal ovarian function and follicular development (all being hallmarks of PCOS). It has been proposed that PCOS may entail higher susceptibility to coronavirus disease 2019 (COVID-19) via its associated comorbidities (NAFLD, obesity, MetSy and alterations in the gut microbiome). Studies have found an association between acute respiratory distress syndrome (seen in severe cases of COVID-19) and the intestinal microbiome. Furthermore, apparently, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can gain entry to the gastrointestinal tract via locally-expressed angiotensin converting enzyme type 2 receptors. Excess body weight is associated with more severe COVID-19 and increased mortality. Although robust links between SARS-CoV-2 infection and PCOS/NAFLD/gut microbiome/metabolic consequences are yet to be confirmed, it seems that strategies for adapting the intestinal microbiome could help reduce the severity of COVID-19 in women with PCOS with or without NAFLD, MetSy or obesity.
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Affiliation(s)
- Ioannis Ilias
- Department of Endocrinology, Elena Venizelou Hospital, Athens GR-11521, Greece
| | - Spyridon Goulas
- Department of Gastroenterology Unit, Elena Venizelou Hospital, Athens GR-11521, Greece
| | - Lina Zabuliene
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius LT-03101, Lithuania
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40
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Wu P, Zhang X, Zhou P, Zhang W, Li D, Lv M, Liao X. Assessment of Bidirectional Relationships Between Polycystic Ovary Syndrome and Periodontitis: Insights From a Mendelian Randomization Analysis. Front Genet 2021; 12:644101. [PMID: 33868379 PMCID: PMC8044848 DOI: 10.3389/fgene.2021.644101] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/10/2021] [Indexed: 02/01/2023] Open
Abstract
Background Observational studies have indicated an association between polycystic ovary syndrome (PCOS) and periodontitis, but it is unclear whether the association is cofounded or causal. We conducted a two-sample Mendelian randomization (MR) study to investigate the bidirectional relationship between genetically predicted PCOS and periodontitis. Methods From two genome-wide association studies we selected 13 and 7 single nucleotide polymorphisms associated with PCOS and periodontitis, respectively, as instrumental variables. We utilized publicly shared summary-level statistics from European-ancestry cohorts. To explore the causal effect of PCOS on periodontitis, 12,289 cases of periodontitis and 22,326 controls were incorporated, while 4,890 cases of PCOS and 20,405 controls in the reverse MR. Inverse-variance weighted method was employed in the primary MR analysis and multiple sensitivity analyses were implemented. Results Genetically determined PCOS was not causally associated with risk of periodontitis (odds ratio 0.97; 95% confidence interval 0.88-1.06; P = 0.50) per one-unit increase in the log-odds ratio of periodontitis. Similarly, no causal effect of periodontitis on PCOS was shown with the odds ratio for PCOS was 1.17 (95% confidence interval 0.91-1.49; P = 0.21) per one-unit increase in the log-odds ratio of periodontitis. Consistent results were yielded via additional MR methods. Sensitivity analyses demonstrated no presence of horizontal pleiotropy or heterogeneity. Conclusion The bidirectional MR study couldn't provide convincing evidence for the causal relationship between genetic liability to PCOS and periodontitis in the Europeans. Triangulating evidence across further observational and genetic-epidemiological studies is necessary.
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Affiliation(s)
- Pengfei Wu
- Hunan Key Laboratory of Animal Models for Human Diseases, Department of Laboratory Animals, Third Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Center for Medical Genetics, Central South University, Changsha, China
| | - Xinghao Zhang
- Department of Ultrasound, Third Xiangya Hospital, Central South University, Changsha, China
| | - Ping Zhou
- Department of Ultrasound, Third Xiangya Hospital, Central South University, Changsha, China
| | - Wan Zhang
- Department of Biology, College of Arts and Sciences, Boston University, Boston, MA, United States
| | - Danyang Li
- Department of Biology, College of Arts and Sciences, Boston University, Boston, MA, United States
| | - Mingming Lv
- Department of Oral Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xiaoyao Liao
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom
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The Complementary and Alternative Medicine for Polycystic Ovary Syndrome: A Review of Clinical Application and Mechanism. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5555315. [PMID: 33727939 PMCID: PMC7935573 DOI: 10.1155/2021/5555315] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/08/2021] [Accepted: 02/19/2021] [Indexed: 11/17/2022]
Abstract
As a reproductive endocrine disease, polycystic ovary syndrome (PCOS) has influenced billions of women during childbearing age worldwide. Owing to its complex etiology and ambiguous pathogenesis, there is still not a specific method to cure it. Clinical treatments, such as hormone therapy and surgical treatment, have side effects. Therefore, it is essential and urgent to seek alternative treatment to solve these problems. The satisfactory efficacy of complementary and alternative medicine (CAM), such as traditional Chinese medicine (TCM), immunotherapy, medicinal foods, vitamin therapy, diet therapy, psychotherapy, spa, and oxygen therapy, in treating PCOS, has aroused an increasing number of medical workers' concern and gradually become the mainstream. This paper reviews the application of CAM in the treatment of PCOS, especially from the perspective of TCM. Meanwhile, the limitations of the literature about CAM in the treatment of PCOS are mentioned and analyzed as well.
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Al Wattar BH, Bueno A, Martin MG, Ibáñez NC, Harasani K, Garad R, Franks S, Balen A, Bhide P, Piltonen T, Romualdi D, Laven J, Moss N, Andrews C, Hawkes R, Mol BW, Teede H, Thangaratinam S, Khan KS. Harmonizing research outcomes for polycystic ovary syndrome (HARP), a marathon not a sprint: current challenges and future research need. Hum Reprod 2021; 36:523-528. [PMID: 33332572 DOI: 10.1093/humrep/deaa331] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/14/2020] [Indexed: 10/04/2023] Open
Abstract
Investing in clinical research and evidence-based medicine has helped to improve the care for women with polycystic ovary syndrome (PCOS). However, several important questions remain unanswered on the optimal prevention and management strategies for PCOS. Addressing this uncertainty is often hindered by suboptimal research conduct leading to inefficient evidence synthesis and research wastage. PCOS research is often practised by varied specialized teams in silo leading to disharmonious and fragmented efforts neglecting the lifelong impact of PCOS on women's wellbeing. Poor engagement among key stakeholders and lay consumers continues to limit the impact and benefits of research to society. Selective reporting on surrogate outcomes with a 'significant' P-value is a common malpractice in PCOS outputs. Effective adoption of the harmonizing research outcomes for PCOS (HARP) core outcome set is needed to minimize heterogeneity in reporting and promote research excellence. Small single-centre studies offer limited value to assess the varied PCOS phenotypes. Efficient large scale data-sharing is needed to address complex research questions and glean the benefits of big data research. We propose a roadmap to address these challenges and remedy future research need by promoting patient and public involvement in PCOS research to guide research efforts and address real patients' needs; engaging all key stakeholder groups to promote a multi-disciplinary lifelong approach to new research; continuously refining research needs and priorities to revise the knowledge gap and allocate resources judiciously; standardizing outcomes definitions and measurement tools to harmonize reporting and promote excellence in research; and by investing in large data-sharing infrastructure to facilitate big data research and govern ethical data sharing.
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Affiliation(s)
- Bassel H Al Wattar
- Warwick Medical School, University of Warwick, Coventry, UK
- Reproductive Medicine Unit, Institute for Women's Health, University College London Hospitals, London, UK
| | - Aurora Bueno
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Inst Invest Biosanitaria Ibs GRANADA, Granada, Spain
| | - Miguel Garcia Martin
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Inst Invest Biosanitaria Ibs GRANADA, Granada, Spain
| | - Naomi Cano Ibáñez
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Inst Invest Biosanitaria Ibs GRANADA, Granada, Spain
| | - Klejda Harasani
- Department of Pharmacy, University of Medicine of Tirana, Tirana, Albania
| | - Rhonda Garad
- National Health and Medical Research Council Centre for Research Excellence in PCOS, Monash Centre for Health Research and Implementation, Monash University Melbourne, Melbourne, VIC, Australia
- Monash Centre for Health Research and Implementation, School Public Health, Monash University, Clayton, VIC, Australia
| | - Steve Franks
- Imperial College School of Medicine, Institute of Reproductive and Developmental Biology, Hammersmith Hospital, London, UK
| | - Adam Balen
- Leeds Fertility, Seacroft Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Priya Bhide
- Homerton University Hospital NHS Foundation Trust, London, UK
- Barts Research Centre for Women's Health (BARC), Women's Health Research Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Terhi Piltonen
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Centre, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Daniela Romualdi
- Department of Women's and Children's Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Woman and Child Health, Azienda Ospedaliera Card.Panico, Tricase, Italy
| | - Joop Laven
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Ngawai Moss
- Barts Research Centre for Women's Health (BARC), Women's Health Research Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | | | - Ben W Mol
- Department of Obstetrics and Gynaecology, University of Monash, Melbourne, Australia
- Aberdeen Centre for Women's Health Research, University of Aberdeen, Aberdeen, UK
| | - Helena Teede
- National Health and Medical Research Council Centre for Research Excellence in PCOS, Monash Centre for Health Research and Implementation, Monash University Melbourne, Melbourne, VIC, Australia
- Monash Centre for Health Research and Implementation, School Public Health, Monash University, Clayton, VIC, Australia
| | - Shakila Thangaratinam
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Khalid Saeed Khan
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
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43
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Azziz R. How polycystic ovary syndrome came into its own. F&S SCIENCE 2021; 2:2-10. [PMID: 35559761 DOI: 10.1016/j.xfss.2020.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 06/15/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a disorder whose definition and diagnosis have been evolving over the past 85 years since Stein and Leventhal made their original description of the triad of amenorrhea, polycystic ovaries, and hyperandrogenism in 1935. Although much progress in characterizing the disorder was accomplished from the late 1950s through the late 1980s, much confusion remained in the field, as there were no agreed-upon diagnostic criteria. This deficiency began to be addressed with a conference held at the National Institutes of Health (NIH) in April 1990, which, through a survey of meeting participants, defined what is today known as "classic" PCOS. Following the NIH 1990 conference, many of our European colleagues, who relied more exclusively on the ultrasound detection of polycystic ovaries for the diagnosis of PCOS, organized a second expert conference in Rotterdam in May 2003, where the diagnostic criteria were expanded. Finally, the Androgen Excess Society (now the Androgen Excess and PCOS Society) published its recommendations for diagnosis in November 2006, principally rooted in associating the criteria for PCOS with the risks of metabolic and other long-term morbidities. A breakthrough in our understanding of PCOS came when we realized that PCOS could be classified into 4 phenotypes (A-D) based on 3 features (clinical and/or biochemical hyperandrogenism, oligoanovulation, and polycystic ovaries) and that the Rotterdam 2003 and the Androgen Excess Society 2006 criteria were simply expansions of the NIH 1990 criteria. Having a clearer definition of PCOS has allowed us to establish PCOS as a globally prevalent disorder, affecting between 1 in 10 and 1 in 7 women, the most common endocrine disorder of women, and the most common cause of infertility, among other findings. However, it is critical that we understand that much of the work on the criteria and definition of PCOS has arisen through the process of scientific dialog, debate, and "consensus," although many would argue that "consensus science" is not science at all. Despite the significant progress made over the past 50 years, much remains to be studied and advocated for when it comes to the care of women with PCOS.
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Affiliation(s)
- Ricardo Azziz
- Department of Health Policy, Management and Behavior, School of Public Health, State University of New York at Albany, Albany, New York; Department of Obstetrics and Gynecology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
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Oliveira FR, Mamede M, Bizzi MF, Rocha ALL, Ferreira CN, Gomes KB, Cândido AL, Reis FM. Effects of Short Term Metformin Treatment on Brown Adipose Tissue Activity and Plasma Irisin Levels in Women with Polycystic Ovary Syndrome: A Randomized Controlled Trial. Horm Metab Res 2020; 52:718-723. [PMID: 32365398 DOI: 10.1055/a-1157-0615] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a chronic dysfunction associated with obesity and metabolic disorders that can be ameliorated by treatment with metformin. Brown adipose tissue (BAT) has been recently identified in adult humans, and irisin is a myokine that induces BAT formation. The aim of this randomized controlled trial was to evaluate whether a short term treatment with metformin alters BAT activity and plasma irisin levels in women with PCOS. The participants were randomly assigned to receive metformin (1500 mg/day, n=21) or placebo (n=24) during 60 days. BAT activity was assessed by 18F-FDG positron emission tomography-computed tomography (PET-CT) and plasma irisin levels were measured by enzyme immunoassay. The groups were similar in age, body measures, metabolic profile and PCOS phenotypes. BAT activity did not change significantly in the women treated with metformin (median Δ SUVmax=-0.06 g/ml, interquartile interval -2.81 to 0.24 g/ml, p=0.484, Wilcoxon's test) or placebo (median Δ SUVmax=0.98 g/ml, interquartile interval -2.94 to 4.60 g/ml, p=0.386). In addition, plasma irisin levels remained unchanged in the groups treated with metformin (median Δ=-98 ng/ml, interquartile interval -366 to 60 ng/ml, p=0.310) and placebo (median Δ=28 ng/ml, interquartile interval -1260 to 215 ng/ml, p=0.650). These results suggest that in PCOS women BAT activity and plasma irisin levels may not change after a brief treatment with metformin.
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Affiliation(s)
- Flávia R Oliveira
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Odete Valadares Maternity Hospital, Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Brazil
| | - Marcelo Mamede
- Department of Anatomy and Imaging, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mariana F Bizzi
- Department of Internal Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Luiza L Rocha
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Cláudia N Ferreira
- Technical College, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Karina B Gomes
- Clinical and Toxicological Analyses, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana L Cândido
- Department of Internal Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fernando M Reis
- Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Comim FV. Correlation between glucose metabolism and serum steroid hormones in patients with polycystic ovary syndrome. Clin Endocrinol (Oxf) 2020; 93:355. [PMID: 32026483 DOI: 10.1111/cen.14171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 02/04/2020] [Indexed: 11/29/2022]
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Butler AE, Ramachandran V, Sathyapalan T, David R, Gooderham NJ, Benurwar M, Dargham SR, Hayat S, Hani Najafi-Shoushtari S, Atkin SL. microRNA Expression in Women With and Without Polycystic Ovarian Syndrome Matched for Body Mass Index. Front Endocrinol (Lausanne) 2020; 11:206. [PMID: 32411089 PMCID: PMC7199502 DOI: 10.3389/fendo.2020.00206] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 03/24/2020] [Indexed: 12/22/2022] Open
Abstract
Background: Despite several authors who have hypothesized that alterations of small noncoding RNAs (miR) are implicated in the etiopathogenesis of polycystic ovarian syndrome (PCOS), contrasting findings have been reported so far. Discrepancies in body mass index (BMI) levels may account for these differences; therefore, the aim of the present study was to determine whether miR differed in serum samples collected from age- and BMI-matched control and PCOS women. Methods: In a cross-sectional study, miR were measured using quantitative polymerase chain reaction in 29 women with anovulatory PCOS women and 29 control women who were in the follicular phase of their menstrual cycle, from the local biobank. Results: One hundred seventy-six miR were detected, of which 15 miR passed the false discovery rate (FDR; p < 0.05) that differed between PCOS and control women. There was no association of the top 9 miR (p < 0.02) (miR-486-5p, miR-24-3p, miR-19b-3p, miR-22-3p, miR-19a-3p, miR-339-5p, miR-185-5p, miR-101-3p, miR-let-7i-5p) with BMI, androgen levels, insulin resistance, or antimullerian hormone (AMH) in either PCOS or normal women. Ingenuity pathway assessment showed the pathways were interrelated for abnormalities of the reproductive system. Conclusion: When the confounding influence of weight was accounted for, miR levels differed between anovulatory PCOS women and control women in the follicular phase of the menstrual cycle. Interestingly, the differing miR were associated with the pathways of reproductive abnormalities but did not associate with AMH or metabolic parameters.
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Affiliation(s)
- Alexandra E. Butler
- Diabetes Research Center (DRC), Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha, Qatar
- *Correspondence: Alexandra E. Butler ;
| | - Vimal Ramachandran
- Division of Research, Weill Cornell Medical College-Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Thozhukat Sathyapalan
- Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, United Kingdom
| | - Rhiannon David
- Department of Surgery & Cancer, Faculty of Medicine, Imperial College, London, United Kingdom
| | - Nigel J. Gooderham
- Department of Surgery & Cancer, Faculty of Medicine, Imperial College, London, United Kingdom
| | - Manasi Benurwar
- Division of Research, Weill Cornell Medical College-Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Soha R. Dargham
- Division of Research, Weill Cornell Medical College-Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - Shahina Hayat
- Division of Research, Weill Cornell Medical College-Qatar, Qatar Foundation, Education City, Doha, Qatar
| | - S. Hani Najafi-Shoushtari
- Division of Research, Weill Cornell Medical College-Qatar, Qatar Foundation, Education City, Doha, Qatar
- Department of Cell and Developmental Biology, Weill Cornell Medicine, New York, NY, United States
| | - Stephen L. Atkin
- Division of Research, Weill Cornell Medical College-Qatar, Qatar Foundation, Education City, Doha, Qatar
- Royal College of Surgeons Ireland, Busaiteen, Bahrain
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