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Yifu P. A review of antioxidant N-acetylcysteine in addressing polycystic ovary syndrome. Gynecol Endocrinol 2024; 40:2381498. [PMID: 39039898 DOI: 10.1080/09513590.2024.2381498] [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: 03/19/2024] [Accepted: 07/12/2024] [Indexed: 07/24/2024] Open
Abstract
N-acetylcysteine (NAC), a compound known for its cysteine and glutathione precursor properties, has been used in therapeutic applications for many years. Recently, there has been increasing interest in exploring the potential benefits of NAC in addressing polycystic ovary syndrome (PCOS). However, the exact mechanisms underlying NAC's therapeutic and clinical uses remain not fully understood. This review aims to specifically investigate how NAC offers protection against PCOS. This involved an extensive systematic review of the literature, and it made use of PubMed, Embase, and Web of Science databases. By analyzing key findings from over 100 research papers, the potential mechanisms through which NAC produces its effects were explored and summarized. Most studies suggest that NAC, whether used on its own or in combination with other medications, has the potential to counteract oxidative stress, utilize its anti-inflammatory and anti-apoptotic properties, and offer benefits in managing PCOS. Moreover, NAC might have the potential to influence specific signaling pathways in insulin target cells and β cells. Diverse biological effects of NAC indicate its potential usefulness as a supplementary or therapeutic approach for managing PCOS. As a result, additional research is required to explore its potential in addressing PCOS.
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Affiliation(s)
- Pu Yifu
- Laboratory of Genetic Disease and Perinatal Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
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2
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Harrison C, Tay CT, Busby MA, Mousa A, Teede H, Boivin J. Challenges experienced by those with polycystic ovary syndrome in healthcare interactions: a qualitative evidence synthesis. Reprod Biomed Online 2024; 49:104293. [PMID: 39067213 DOI: 10.1016/j.rbmo.2024.104293] [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: 02/01/2024] [Revised: 05/16/2024] [Accepted: 05/20/2024] [Indexed: 07/30/2024]
Abstract
Studies report interaction difficulties between patients with polycystic ovary syndrome (PCOS) and healthcare professionals (HCP). This systematic review and qualitative evidence synthesis aimed to collate and synthesize the existing peer-reviewed literature investigating challenges for people with PCOS when interacting with HCP. Medline, PsycInfo, EMBASE, All EBM and CINAHL were searched from 1990 to September 2022. Study risk of bias (RoB) was performed and all textual data relevant to challenging interactions between patients with PCOS and HCP were extracted and analysed using thematic synthesis. Of the 6353 studies identified, 28 were included. Two were appraised as high, four as moderate and 22 as low RoB. Four analytic themes were derived illustrating that interactions were challenging when: (i) medical information (PCOS, its management) was not shared in the best way; (ii) information provision and deliberation opportunities were insufficient to achieve outcomes that mattered to patients; (iii) interactions prompted but did not support patient activation; and (iv) health system-level barriers (e.g. policies and guidelines) were present or made worse by HCP behaviour. Future research should examine methods for the implementation and evaluation of established frameworks for sharing medical information and supporting patient agency in the context of PCOS care.
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Affiliation(s)
- China Harrison
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), Bristol, UK; National Institute for Health Research, Health Protection Research Unit (HBU) in Behavioural Science and Evaluation, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Chau Thien Tay
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, Clayton, Australia
| | | | - Aya Mousa
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, Clayton, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, Clayton, Australia
| | - Jacky Boivin
- Cardiff Fertility and Reproductive Research, School of Psychology, Cardiff University, Cardiff, Wales, UK..
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Talebi S, Shab-Bidar S, Moini A, Mohammadi H, Djafarian K. The effects of time-restricted eating alone or in combination with probiotic supplementation in comparison with a calorie-restricted diet on endocrine and metabolic profiles in women with polycystic ovary syndrome: A randomized clinical trial. Diabetes Obes Metab 2024; 26:4468-4479. [PMID: 39143654 DOI: 10.1111/dom.15801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 06/28/2024] [Accepted: 06/28/2024] [Indexed: 08/16/2024]
Abstract
AIM To assess the impact of intermittent fasting, with or without probiotic supplementation, versus a calorie-restricted diet on anthropometric measures, metabolic status and gonadal variables in women with polycystic ovary syndrome (PCOS). METHODS This is a randomized, placebo-controlled, parallel-arm clinical trial. The effects of the 14:10 early time-restricted eating (eTRE) strategy alone or combined with probiotics, on obese women with PCOS, were investigated. Participants were divided into three groups: eTRE plus probiotics (n = 30), eTRE plus placebo (n = 30) and a control group following a standard three-meal-per-day diet with daily calorie restriction (DCR) (n = 30). Over 8 weeks, various anthropometric, metabolic, menstrual and gonadal variables were assessed. RESULTS A total of 90 individuals were included in the study, with a mean body weight of 81.4 kg, and a mean age of 30 years. Mean (standard deviation) weight loss was not different between the groups at week 8 (TRE + probiotic: -2.2 [1.6] kg vs. TRE + placebo: -2.9 [2.7] kg vs. DCR: -2.5 [1.7] kg). Results revealed that, while all three regimes led to reductions in body weight, body mass index, vascular risk indicators, hirsutism and acne scores, there were no statistically significant differences between the eTRE groups and the control group in terms of weight loss, or improvements in metabolic, menstrual and gonadal variables (P > .05). Additionally, combining probiotics with eTRE did not benefit hormonal and cardiometabolic factors (P > .05). CONCLUSIONS The eTRE alone or eTRE plus probiotics did not result in significantly greater weight loss or improvements in metabolic, menstrual and gonadal variables compared with the standard three-meal DCR diet.
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Affiliation(s)
- Sepide Talebi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ashraf Moini
- Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran
- Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Tong X, Hu Z, Zhou H, Zhang Y, Zhang YL, Zhang S, Jin J. Testosterone-Induced H3K27 Deacetylation Participates in Granulosa Cell Proliferation Suppression and Pathogenesis of Polycystic Ovary Syndrome. THE AMERICAN JOURNAL OF PATHOLOGY 2024:S0002-9440(24)00331-6. [PMID: 39243944 DOI: 10.1016/j.ajpath.2024.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 07/19/2024] [Accepted: 08/16/2024] [Indexed: 09/09/2024]
Abstract
Polycystic ovary syndrome (PCOS) is the leading cause of infertility in reproductive-age women. Hyperandrogenism, polycystic ovaries, and chronic anovulation are its typical clinical features. However, the correlation between hyperandrogenism and ovarian follicle growth aberrations remains undisclosed. To advance our understanding of the molecular alterations in ovarian granulosa cells (GCs) with excessive androgen, epigenetic changes and affected gene expression in human granulosa-lutein cells and immortalized human GCs were evaluated. A PCOS mouse model induced by dihydrotestosterone was also established. This study found excessive testosterone significantly decreased the acetylation of lysine 27 on histone H3 (H3K27ac). H3K27ac chromatin immunoprecipitation- sequencing data showed down-regulated expression of cell cycle-related genes (CCND1/CCND3/PCNA), which was confirmed by real-time quantitative PCR and Western blot analysis. Testosterone application impeding cell proliferation was also proved by Ki-67 immunofluorescence and flow-cytometric analysis. Moreover, testosterone influenced CK2α nuclear translocation, which increased the phosphorylation level of histone deacetylase 2 (HDAC2). Inhibition of CK2α nuclear translocation or silenced HDAC2 expression efficiently retarded H3K27 acetylation. Meanwhile, PCOS mouse model experiments also demonstrated decreased H3K27ac and enhanced HDAC2 phosphorylation in GCs. Cell proliferation-related genes were also down-regulated in PCOS mouse GCs. In conclusion, hyperandrogenism in human and mouse GCs caused H3K27Ac aberrations, which are associated with CK2α nuclear translocation and HDAC2 phosphorylation, participating in abnormal follicle development in patients with PCOS.
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Affiliation(s)
- Xiaomei Tong
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, China
| | - Zhanhong Hu
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, China
| | - Hanjing Zhou
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, China
| | - Yingyi Zhang
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, China
| | - Yin-Li Zhang
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, China
| | - Songying Zhang
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, China
| | - Jiamin Jin
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, China.
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Hooshmandi H, Ghadiri-Anari A, Ranjbar AM, Fallahzadeh H, Hosseinzadeh M, Nadjarzadeh A. Effects of licorice extract in combination with a low-calorie diet on obesity indices, glycemic indices, and lipid profiles in overweight/obese women with polycystic ovary syndrome (PCOS): a randomized, double-blind, placebo-controlled trial. J Ovarian Res 2024; 17:157. [PMID: 39080737 PMCID: PMC11287987 DOI: 10.1186/s13048-024-01446-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/29/2024] [Indexed: 08/03/2024] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the most common ovarian dysfunction. Recent studies showed the effectiveness of licorice on metabolic profiles with inconsistent findings. So, we investigated the effect of licorice on obesity indices, glycemic indices, and lipid profiles in women with PCOS. METHODS This randomized, double-blind, placebo-controlled trial was performed on 66 overweight/obese women with PCOS. The participants were randomly assigned to receive either 1.5 gr/day licorice extract plus a low-calorie diet (n = 33) or placebo plus a low-calorie diet (n = 33) for 8 weeks. Participants' anthropometric indices and body composition were assessed using standard protocols. Fasting blood sugar (FBS), insulin levels, low-density lipoprotein-cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), and high-density lipoprotein-cholesterol (HDL-C) were measured using enzymatic kits. The homeostasis model assessment-insulin resistance (HOMA-IR) and HOMA of β-cell function (HOMA-B) were calculated using valid formulas. RESULTS Between-group comparisons demonstrated significant differences between the groups in terms of obesity indices (body weight, BMI, and body fat), lipid profiles (TG, TC, LDL-C, and HDL-C), FBS and insulin levels, HOMA-IR, and HOMA-B at the end of the study (P < 0.05). Supplementation with licorice plus a low-calorie diet was also more effective in improving all parameters than a low-calorie diet alone after adjusting for confounders (baseline values, age, weight changes, and physical activity changes) (P < 0.05). CONCLUSION The findings showed that licorice consumption leads to improvements in obesity indices, glucose homeostasis, and lipid profiles compared to placebo. Due to possible limitations of the study, further research is needed to confirm these findings.
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Affiliation(s)
- Hadis Hooshmandi
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Akram Ghadiri-Anari
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ali Mohammad Ranjbar
- Department of Pharmacognosy, Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Herbal Medicine Center, Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Fallahzadeh
- Department of Biostatistics and Epidemiology, Research Center of Prevention and Epidemiology of Non-Communicable Disease, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahdieh Hosseinzadeh
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Azadeh Nadjarzadeh
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Meliani-Rodríguez A, Cutillas-Tolín A, Mendiola J, Sánchez-Ferrer ML, De la Cruz-Sánchez E, Vioque J, Torres-Cantero AM. Association between Coffee Consumption and Polycystic Ovary Syndrome: An Exploratory Case-Control Study. Nutrients 2024; 16:2238. [PMID: 39064680 PMCID: PMC11279816 DOI: 10.3390/nu16142238] [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: 06/09/2024] [Revised: 07/05/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is a leading cause of infertility, with an estimated worldwide prevalence between 5% and 15%. We conducted a case-control study with 121 PCOS patients and 155 controls to assess the association between coffee intake and the presence of having a diagnosis of PCOS in women in Murcia, Spain. The PCOS diagnosis was determined following Rotterdam criteria (the presence of two of the following three conditions: hyperandrogenism, oligo-anovulation, and/or polycystic ovarian morphology). Coffee consumption was assessed using a validated food frequency questionnaire. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multiple logistic regression. Coffee consumption was categorized into never, less than one cup per day, one cup per day, and two or more cups per day. We found a significant inverse linear trend: the higher the coffee consumption, the lower the probability of having PCOS in multivariable analysis (p-trend = 0.034). Women who presented with PCOS were less likely to drink one cup of coffee compared to those who had never drunk coffee (OR = 0.313, 95% CI: 0.141-0.69). The consumption of at least one cup of coffee per day may be associated with a decrease in PCOS symptoms.
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Affiliation(s)
- Aïcha Meliani-Rodríguez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, El Palmar, 30120 Murcia, Spain; (A.M.-R.); (J.M.); (A.M.T.-C.)
| | - Ana Cutillas-Tolín
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, El Palmar, 30120 Murcia, Spain; (A.M.-R.); (J.M.); (A.M.T.-C.)
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar, 30120 Murcia, Spain; (M.L.S.-F.); (E.D.l.C.-S.)
| | - Jaime Mendiola
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, El Palmar, 30120 Murcia, Spain; (A.M.-R.); (J.M.); (A.M.T.-C.)
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar, 30120 Murcia, Spain; (M.L.S.-F.); (E.D.l.C.-S.)
| | - María Luisa Sánchez-Ferrer
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar, 30120 Murcia, Spain; (M.L.S.-F.); (E.D.l.C.-S.)
- Department of Obstetrics and Gynecology, Virgen de la Arrixaca University Clinical Hospital, El Palmar, 30120 Murcia, Spain
| | - Ernesto De la Cruz-Sánchez
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar, 30120 Murcia, Spain; (M.L.S.-F.); (E.D.l.C.-S.)
- Public Health and Epidemiology Research Group, San Javier Campus, University of Murcia, 30720 Murcia, Spain
| | - Jesús Vioque
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010 Alicante, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Alberto M. Torres-Cantero
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, El Palmar, 30120 Murcia, Spain; (A.M.-R.); (J.M.); (A.M.T.-C.)
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar, 30120 Murcia, Spain; (M.L.S.-F.); (E.D.l.C.-S.)
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Preventive Medicine, University Clinical Hospital Virgen de la Arrixaca, El Palmar, 30120 Murcia, Spain
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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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8
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Guan M, Li R, Wang B, He T, Luo L, Zhao J, Lei J. Healthcare professionals' perspectives on the challenges with managing polycystic ovary syndrome: A systematic review and meta-synthesis. PATIENT EDUCATION AND COUNSELING 2024; 123:108197. [PMID: 38377709 DOI: 10.1016/j.pec.2024.108197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 01/06/2024] [Accepted: 02/05/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE To provide an overview of healthcare professionals' experience of PCOS management and identify the relevant facilitators and barriers. METHODS A systematic search was conducted in MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane CENTRAL database from the earliest available date to April 2023. Qualitative and mixed methods studies that described healthcare professionals' experiences of PCOS management were included. RESULTS A total of 74 findings were extracted from the 8 included studies, which were categorized into facilitators and barriers. The barriers were meta-aggregated into four themes: the weakness of clinical evidence; women's low adherence to PCOS management; various obstacles that healthcare professionals face, and the influence of social environment and culture. The facilitators were meta-aggregated into three themes: chronic disease healthcare plan, communication techniques and healthcare professionals' ability and awareness. CONCLUSION The findings of this study have the potential to improve the care provided to women with PCOS. However, it is important for national health professionals and policy markers to consider the cultural context of their own country when implementing these findings. PRACTICAL IMPLICATIONS This study illustrated several challenges in managing the heterogeneous condition of PCOS and provide insights for the development of medical policies and future research directions.
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Affiliation(s)
- Minhui Guan
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University,138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan,China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Rong Li
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University,138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan,China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Binglu Wang
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University,138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan,China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Tan He
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University,138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan,China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Lan Luo
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University,138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan,China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Jinxin Zhao
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University,138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan,China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China.
| | - Jun Lei
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University,138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan,China.
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9
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Bracho GS, Acosta MV, Altamirano GA, Alcaraz MR, Montemurro M, Culzoni MJ, Rossetti MF, Kass L, Luque EH, Bosquiazzo VL. Uterine histopathology and steroid metabolism in a polycystic ovary syndrome rat model. Mol Cell Endocrinol 2024; 585:112198. [PMID: 38467370 DOI: 10.1016/j.mce.2024.112198] [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: 12/26/2023] [Revised: 02/23/2024] [Accepted: 03/04/2024] [Indexed: 03/13/2024]
Abstract
The aim of this study was to investigate uterine lesions, uterine endocrine status and expression of genes involved in uterine differentiation in a rat model of polycystic ovary syndrome (PCOS). The possible involvement of the androgen receptor (AR) was also investigated. PCOS rats showed an increased incidence of uterine epithelial and glandular lesions and elevated serum testosterone level, which was not detected in uterine tissue. Uterine 17β-estradiol, estrone and progesterone were detected in 100%, 75% and 50% of the animals, respectively. This was associated with a decrease in Star and an increase in Hsd17b2, Srd5a1 and Cyp19a1, suggesting that uterine steroids are not synthesized de novo in PCOS and that alterations in these enzymes may explain the absence of testosterone and low progesterone. In addition, ESR2 decreased and AR increased, suggesting possible steroid receptor crosstalk. Genes associated with uterine differentiation, PTEN and WNT5a, also showed reduced expression. PCOS rats treated with flutamide, an AR antagonist, were similar to PCOS rats in terms of uterine lesions, serum steroid levels, ESR2, PTEN and WNT5a expression. However, testosterone, AR and aromatase levels were similar to control rats, with decreased expression of ESR1 and HOXA10, suggesting that these expressions are AR dependent. Our results suggest that the primary cause of the observed uterine lesions in the PCOS rat model is the altered endocrine status and consequently changes in genes related to uterine differentiation.
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Affiliation(s)
- Gisela Soledad Bracho
- Instituto de Salud y Ambiente del Litoral (ISAL, UNL-CONICET), Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina; Departamento de Química General e Inorgánica, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina
| | - María Virginia Acosta
- Instituto de Salud y Ambiente del Litoral (ISAL, UNL-CONICET), Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina
| | - Gabriela Anahí Altamirano
- Instituto de Salud y Ambiente del Litoral (ISAL, UNL-CONICET), Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina; Cátedra de Patología Humana, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina
| | - Mirta Raquel Alcaraz
- Laboratorio de Desarrollo Analítico y Quimiometría (LADAQ), Cátedra de Química Analítica I, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina
| | - Milagros Montemurro
- Laboratorio de Desarrollo Analítico y Quimiometría (LADAQ), Cátedra de Química Analítica I, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina
| | - María Julia Culzoni
- Laboratorio de Desarrollo Analítico y Quimiometría (LADAQ), Cátedra de Química Analítica I, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina
| | - María Florencia Rossetti
- Instituto de Salud y Ambiente del Litoral (ISAL, UNL-CONICET), Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina; Departamento de Bioquímica Clínica y Cuantitativa, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina
| | - Laura Kass
- Instituto de Salud y Ambiente del Litoral (ISAL, UNL-CONICET), Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina; Cátedra de Patología Humana, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina
| | - Enrique Hugo Luque
- Instituto de Salud y Ambiente del Litoral (ISAL, UNL-CONICET), Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina
| | - Verónica Lis Bosquiazzo
- Instituto de Salud y Ambiente del Litoral (ISAL, UNL-CONICET), Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina; Departamento de Bioquímica Clínica y Cuantitativa, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina.
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10
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Kobayashi H, Shigetomi H, Matsubara S, Yoshimoto C, Imanaka S. Role of the mitophagy-apoptosis axis in the pathogenesis of polycystic ovarian syndrome. J Obstet Gynaecol Res 2024; 50:775-792. [PMID: 38417972 DOI: 10.1111/jog.15916] [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: 01/07/2024] [Accepted: 02/15/2024] [Indexed: 03/01/2024]
Abstract
AIM Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by menstrual irregularities, androgen excess, and polycystic ovarian morphology, but its pathogenesis remains largely unknown. This review focuses on how androgen excess influences the molecular basis of energy metabolism, mitochondrial function, and mitophagy in granulosa cells and oocytes, summarizes our current understanding of the pathogenesis of PCOS, and discuss perspectives on future research directions. METHODS A search of PubMed and Google Scholar databases were used to identify relevant studies for this narrative literature review. RESULTS Female offspring born of pregnant animals exposed to androgens recapitulates the PCOS phenotype. Abnormal mitochondrial morphology, altered expression of genes related to glycolysis, mitochondrial biogenesis, fission/fusion dynamics, and mitophagy have been identified in PCOS patients and androgenic animal models. Androgen excess causes uncoupling of the electron transport chain and depletion of the cellular adenosine 5'-triphosphate pool, indicating further impairment of mitochondrial function. A shift toward mitochondrial fission restores mitochondrial quality control mechanisms. However, prolonged mitochondrial fission disrupts autophagy/mitophagy induction due to loss of compensatory reserve for mitochondrial biogenesis. Disruption of compensatory mechanisms that mediate the quality control switch from mitophagy to apoptosis may cause a disease phenotype. Furthermore, genetic predisposition, altered expression of genes related to glycolysis and oxidative phosphorylation, or a combination of these factors may also contribute to the development of PCOS. CONCLUSION In conclusion, fetuses exposed to a hyperandrogenemic intrauterine environment may cause the PCOS phenotype possibly through disruption of the compensatory regulation of the mitophagy-apoptosis axis.
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Affiliation(s)
- Hiroshi Kobayashi
- Department of Gynecology and Reproductive Medicine, Ms.Clinic MayOne, Kashihara, Japan
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Japan
| | - Hiroshi Shigetomi
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Japan
- Department of Gynecology and Reproductive Medicine, Aska Ladies Clinic, Nara, Japan
| | - Sho Matsubara
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Japan
- Department of Medicine, Kei Oushin Clinic, Nishinomiya, Japan
| | - Chiharu Yoshimoto
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Japan
- Department of Obstetrics and Gynecology, Nara Prefecture General Medical Center, Nara, Japan
| | - Shogo Imanaka
- Department of Gynecology and Reproductive Medicine, Ms.Clinic MayOne, Kashihara, Japan
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Japan
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11
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Pérez-Prieto I, Rodríguez-Santisteban A, Altmäe S. Beyond the reproductive tract: gut microbiome and its influence on gynecological health. Curr Opin Obstet Gynecol 2024:00075197-990000000-00151. [PMID: 38598655 DOI: 10.1097/gco.0000000000000952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
PURPOSE OF REVIEW The analysis of microbiome in association with female health is today a "hot topic" with the main focus on microbes in the female reproductive tract. Nevertheless, recent studies are providing novel information of the possible influence of the gut microbiome on gynecological health outcomes, especially as we start to understand that the gut microbiome is an extended endocrine organ influencing female hormonal levels. This review summarizes the current knowledge of the gut microbes in association with gynecological health. RECENT FINDINGS The gut microbiome has been associated with endometriosis, polycystic ovary syndrome, gynecological cancers, and infertility, although there is a lack of consistency and consensus among studies due to different study designs and protocols used, and the studies in general are underpowered. SUMMARY The interconnection between the gut microbiome and reproductive health is complex and further research is warranted. The current knowledge in the field emphasizes the link between the microbiome and gynecological health outcomes, with high potential for novel diagnostic and treatment tools via modulation of the microenvironment.
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Affiliation(s)
- Inmaculada Pérez-Prieto
- Department of Biochemistry and Molecular Biology, Faculty of Sciences, University of Granada
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | | | - Signe Altmäe
- Department of Biochemistry and Molecular Biology, Faculty of Sciences, University of Granada
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
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12
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Eng PC, Phylactou M, Qayum A, Woods C, Lee H, Aziz S, Moore B, Miras AD, Comninos AN, Tan T, Franks S, Dhillo WS, Abbara A. Obesity-Related Hypogonadism in Women. Endocr Rev 2024; 45:171-189. [PMID: 37559411 PMCID: PMC10911953 DOI: 10.1210/endrev/bnad027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 06/02/2023] [Accepted: 08/07/2023] [Indexed: 08/11/2023]
Abstract
Obesity-related hypogonadotropic hypogonadism is a well-characterized condition in men (termed male obesity-related secondary hypogonadism; MOSH); however, an equivalent condition has not been as clearly described in women. The prevalence of polycystic ovary syndrome (PCOS) is known to increase with obesity, but PCOS is more typically characterized by increased gonadotropin-releasing hormone (GnRH) (and by proxy luteinizing hormone; LH) pulsatility, rather than by the reduced gonadotropin levels observed in MOSH. Notably, LH levels and LH pulse amplitude are reduced with obesity, both in women with and without PCOS, suggesting that an obesity-related secondary hypogonadism may also exist in women akin to MOSH in men. Herein, we examine the evidence for the existence of a putative non-PCOS "female obesity-related secondary hypogonadism" (FOSH). We précis possible underlying mechanisms for the occurrence of hypogonadism in this context and consider how such mechanisms differ from MOSH in men, and from PCOS in women without obesity. In this review, we consider relevant etiological factors that are altered in obesity and that could impact on GnRH pulsatility to ascertain whether they could contribute to obesity-related secondary hypogonadism including: anti-Müllerian hormone, androgen, insulin, fatty acid, adiponectin, and leptin. More precise phenotyping of hypogonadism in women with obesity could provide further validation for non-PCOS FOSH and preface the ability to define/investigate such a condition.
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Affiliation(s)
- Pei Chia Eng
- Section of Endocrinology and Investigative Medicine, Imperial College London, London W12 0NN, UK
- Department of Endocrinology, National University of Singapore, Singapore 117549
| | - Maria Phylactou
- Section of Endocrinology and Investigative Medicine, Imperial College London, London W12 0NN, UK
- Department of Endocrinology, Imperial College Healthcare NHS Trust, London W12 0NN, UK
| | - Ambreen Qayum
- Section of Endocrinology and Investigative Medicine, Imperial College London, London W12 0NN, UK
- Department of Endocrinology, Imperial College Healthcare NHS Trust, London W12 0NN, UK
| | - Casper Woods
- Section of Endocrinology and Investigative Medicine, Imperial College London, London W12 0NN, UK
| | - Hayoung Lee
- Section of Endocrinology and Investigative Medicine, Imperial College London, London W12 0NN, UK
| | - Sara Aziz
- Section of Endocrinology and Investigative Medicine, Imperial College London, London W12 0NN, UK
| | - Benedict Moore
- Section of Endocrinology and Investigative Medicine, Imperial College London, London W12 0NN, UK
| | - Alexander D Miras
- Section of Endocrinology and Investigative Medicine, Imperial College London, London W12 0NN, UK
- Department of Endocrinology, Imperial College Healthcare NHS Trust, London W12 0NN, UK
| | - Alexander N Comninos
- Section of Endocrinology and Investigative Medicine, Imperial College London, London W12 0NN, UK
- Department of Endocrinology, Imperial College Healthcare NHS Trust, London W12 0NN, UK
| | - Tricia Tan
- Section of Endocrinology and Investigative Medicine, Imperial College London, London W12 0NN, UK
- Department of Endocrinology, Imperial College Healthcare NHS Trust, London W12 0NN, UK
| | - Steve Franks
- Section of Endocrinology and Investigative Medicine, Imperial College London, London W12 0NN, UK
- Department of Endocrinology, Imperial College Healthcare NHS Trust, London W12 0NN, UK
| | - Waljit S Dhillo
- Section of Endocrinology and Investigative Medicine, Imperial College London, London W12 0NN, UK
- Department of Endocrinology, Imperial College Healthcare NHS Trust, London W12 0NN, UK
| | - Ali Abbara
- Section of Endocrinology and Investigative Medicine, Imperial College London, London W12 0NN, UK
- Department of Endocrinology, Imperial College Healthcare NHS Trust, London W12 0NN, UK
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13
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Oliveira TF, Comim FV. Understanding hirsutism in PCOS. Expert Rev Endocrinol Metab 2024; 19:103-110. [PMID: 38305206 DOI: 10.1080/17446651.2024.2310558] [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: 10/04/2023] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
INTRODUCTION Hirsutism is a prevalent condition among women and represents a primary clinical feature of polycystic ovary syndrome (PCOS). AREAS COVERED Our study aims to address the principal challenges associated with this hyperandrogenic manifestation in PCOS women. Our narrative review based on the available indexed literature explored the complexities of establishing mFG cutoff values for various ethnic groups, investigated hirsutism during peri- and postmenopausal stages, and examined the role of oxyandrogens. EXPERT OPINION Hirsutism may have a negative impact on the quality of life and on the mental health, being associated with anxiety and depression. Future perspectives for its diagnosis include the use of artificial intelligence and the consideration of the distress caused by excessive hair growth.
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Affiliation(s)
- Talita Fischer Oliveira
- Department of Clinical Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Fabio Vasconcellos Comim
- Department of Clinical Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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14
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Liu W, Tang T, Feng J, Wang C, Lin L, Wang S, Zeng K, Zou R, Yang Z, Zhao Y. Knowledge graph construction based on granulosa cells transcriptome from polycystic ovary syndrome with normoandrogen and hyperandrogen. J Ovarian Res 2024; 17:38. [PMID: 38347589 PMCID: PMC10860235 DOI: 10.1186/s13048-024-01361-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 01/27/2024] [Indexed: 02/15/2024] Open
Abstract
PCOS is a widespread disease that primarily caused in-pregnancy in pregnant-age women. Normoandrogen (NA) and Hyperandrogen (HA) PCOS are distinct subtypes of PCOS, while bio-markers and expression patterns for NA PCOS and HA PCOS have not been disclosed. We performed microarray analysis on granusola cells from NA PCOS, HA PCOS and normal tissue from 12 individuals. Afterwards, microarray data were processed and specific genes for NA PCOS and HA PCOS were identified. Further functional analysis selected IL6R and CD274 as new NA PCOS functional markers, and meanwhile selected CASR as new HA PCOS functional marker. IL6R, CD274 and CASR were afterwards experimentally validated on mRNA and protein level. Subsequent causal relationship analysis based on Apriori Rules Algorithm and co-occurrence methods identified classification markers for NA PCOS and HA PCOS. According to classification markers, downloaded transcriptome datasets were merged with our microarray data. Based on merged data, causal knowledge graph was constructed for NA PCOS or HA PCOS and female infertility on NA PCOS and HA PCOS. Gene-drug interaction analysis was then performed and drugs for HA PCOS and NA PCOS were predicted. Our work was among the first to indicate the NA PCOS and HA PCOS functional and classification markers and using markers to construct knowledge graphs and afterwards predict drugs for NA PCOS and HA PCOS based on transcriptome data. Thus, our study possessed biological and clinical value on further understanding the inner mechanism on the difference between NA PCOS and HA PCOS.
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Affiliation(s)
- Wensu Liu
- Health Sciences Institute, China Medical University, Shenyang, 110122, Liaoning Province, China
| | - Tianyu Tang
- Department of Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, and Key Laboratory of Medical Cell Biology, Ministry of Education, School of Life Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China
| | - Jianwei Feng
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning Province, China
| | - Chunyu Wang
- Department of Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, and Key Laboratory of Medical Cell Biology, Ministry of Education, School of Life Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China
| | - Lin Lin
- Department of Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, and Key Laboratory of Medical Cell Biology, Ministry of Education, School of Life Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China
| | - Shengli Wang
- Department of Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, and Key Laboratory of Medical Cell Biology, Ministry of Education, School of Life Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China
| | - Kai Zeng
- Department of Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, and Key Laboratory of Medical Cell Biology, Ministry of Education, School of Life Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China
| | - Renlong Zou
- Department of Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, and Key Laboratory of Medical Cell Biology, Ministry of Education, School of Life Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China
| | - Zeyu Yang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning Province, China.
| | - Yue Zhao
- Department of Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, and Key Laboratory of Medical Cell Biology, Ministry of Education, School of Life Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China.
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15
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Moss KM, Doust J, Copp T, Homer H, Mishra GD. Fertility treatment pathways and births for women with and without polycystic ovary syndrome-a retrospective population linked data study. Fertil Steril 2024; 121:314-322. [PMID: 38099868 DOI: 10.1016/j.fertnstert.2023.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 02/05/2024]
Abstract
OBJECTIVE To study the fertility treatment pathways used by women with and without polycystic ovary syndrome (PCOS) and which pathways were more likely to result in a birth. DESIGN This retrospective national community-based cohort study used longitudinal self-report survey data (collected 1996-2022; aged 18-49 years) from women born in 1973-1978 who are participants in the Australian Longitudinal Study on Women's Health. The study also used linked administrative data on fertility treatments (1996-2021). PATIENTS Of the 8,463 eligible women, 1,109 accessed fertility treatment and were included. EXPOSURE Polycystic ovary syndrome diagnosis was self-reported. MAIN OUTCOME MEASURE use of ovulation induction (OI), intrauterine insemination, and/or in vitro fertilization (IVF) was established through linked administrative data. Births were self-reported. RESULTS One in 10 of the eligible participants had PCOS (783/7,987, 10%) and 1 in 4 of the women who used fertility treatment had PCOS (274/1,109, 25%). Women with PCOS were 3 years younger on average at first fertility treatment (M = 31.4 years, SD = 4.18) than women without PCOS (M = 34.2 years, SD = 4.56). Seven treatment pathways were identified and use differed by PCOS status. Women with PCOS were more likely to start with OI (71%; odds ratio [OR] 4.20, 95% confidence interval [CI]: 2.91, 6.07) than women without PCOS (36%). Of the women with PCOS who started with OI, 46% required additional types of treatment. More women without PCOS ended up in IVF (72% vs. 51%). Overall, 63% (701/1,109) had an attributed birth, and in adjusted regressions births did not vary by last type of treatment (IVF: 67%, reference; intrauterine insemination: 67%, OR 0.94 95% CI: 0.56, 1.58; OI: 61%, OR 0.71, 95% CI: 0.52, 0.98), or by PCOS status (OR 1.27, 95% CI: 0.91, 1.77). By age, 74% of women under 35 years (471/639) and 49% of women 35 years or older had a birth. CONCLUSION More women with PCOS used fertility treatment but births were equivalent to women without PCOS. Most women followed clinical recommendations. Births did not differ between pathways, so there was no disadvantage in starting with less invasive treatments (although there may be financial or emotional disadvantages).
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Affiliation(s)
- Katrina M Moss
- Australian Women and Girls' Health Research Centre, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
| | - Jenny Doust
- Australian Women and Girls' Health Research Centre, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Tessa Copp
- Faculty of Medicine and Health, Sydney School of Public health, The University of Sydney, Sydney, New South Wales, Australia
| | - Hayden Homer
- University of Queensland Centre for Clinical Research, The University of Queensland, Herston, Queensland, Australia; Queensland Fertility Group, Brisbane, Queensland, Australia
| | - Gita D Mishra
- Australian Women and Girls' Health Research Centre, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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16
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Xing L, Xu J, Wei Y, Chen Y, Zhuang H, Tang W, Yu S, Zhang J, Yin G, Wang R, Zhao R, Qin D. Depression in Polycystic Ovary Syndrome: Focusing on Pathogenesis and Treatment. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2024; 22:109-119. [PMID: 38694155 PMCID: PMC11058923 DOI: 10.1176/appi.focus.23021032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
Polycystic ovary syndrome (PCOS) is one of the most prevalent gynecological endocrine conditions affecting reproductive women. It can feature a variety of symptoms, such as obesity, insulin resistance, skin conditions, and infertility. Women with PCOS are susceptible to illnesses including mood disorders, diabetes, hypertension, and dyslipidemia. Among them, depression is the most common in PCOS and has a detrimental effect on quality of life. Depression may occasionally develop due to the pathological traits of PCOS, but its exact pathogenesis in PCOS have eluded researchers to date. Therefore, there is an urgent need to explore the pathogenesis and treatments of depression in PCOS. The present review discusses the epidemiology of depression in PCOS, potential pathogenic mechanisms underlying PCOS and depression, as well as some potential factors causing depression in PCOS, including obesity, insulin resistance, hyperandrogenism, inflammation, and infertility. Meanwhile, some common treatment strategies for depression in PCOS, such as lifestyle intervention, acupuncture, oral contraceptive pills, psychological intervention, and insulin-sensitizer, are also reviewed. To fully understand the pathogenesis and treatment of depression in PCOS, a need remains for future large-scale multi-center randomized controlled trials and in-depth mechanism studies. Appeared originally in Front Psychiatry 2022; 13:1001484.
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Affiliation(s)
- Liwei Xing
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Jinlong Xu
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Yuanyuan Wei
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Yang Chen
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Haina Zhuang
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Wei Tang
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Shun Yu
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Junbao Zhang
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Guochen Yin
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Ruirui Wang
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Rong Zhao
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Dongdong Qin
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
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17
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Yong EL, Teoh WS, Huang ZW. Polycystic ovary syndrome v.2023: Simplified diagnostic criteria for an East Asian phenotype. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2023; 52:669-678. [PMID: 38920160 DOI: 10.47102/annals-acadmedsg.202369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Introduction Two decades after the Rotterdam 2003 consensus workshop, there have been considerable advances in elucidating the pathophysiology and epidemiology of polycystic ovary syndrome (PCOS). This has prompted the re-examination of the features that characterise this common condition. Current definitions have led to great heterogeneity in the prevalence of PCOS and have contributed to inconsistent treatment protocols and assessment of therapeutic outcomes. Diagnosis is further complicated by the lack of universal agreement on threshold cut-offs for ovarian dysfunction and ethnic differences in hirsutism; both of which are key features in the definitions that are commonly used currently. These challenges often result in dissatisfaction with medical care among PCOS patients and their physicians. Method Our factor analysis mathematically identified anti-Mullerian hormone (AMH), associated polycystic ovarian morphology (PCOM) and serum testosterone as the only significant cluster associated with menstrual cycle length variability. Results and Conclusion As such, we propose a simplified criteria wherein the presence of at least 2 of the 3 features below would be sufficient to define PCOS: (1) chronic oligo-ovulation or anovulation as indicated by oligomenorrhea (cycle lengths >35 days) or amenorrhea; (2) PCOM: raised AMH ≥37.0 pmol/L instead of transvaginal ultrasound assessment of ovaries; and (3) Androgen excess, or raised serum androgens above the laboratory reference for women. Further studies are required to examine whether the proposed criteria would reduce diagnostic confusion and improve care and outcomes, especially among patients of East Asian ethnicities.
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Affiliation(s)
- Eu-Leong Yong
- Department of Obstetrics and Gynaecology, National University Hospital, National University of Singapore, Singapore
| | - Wei Shan Teoh
- Department of Obstetrics and Gynaecology, National University Hospital, National University of Singapore, Singapore
| | - Zhong Wei Huang
- Department of Obstetrics and Gynaecology, National University Hospital, National University of Singapore, Singapore
- NUS Bia-Echo Asia Centre for Reproductive Longevity and Equality, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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18
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Miller MA, Howarth NE. Sleep and cardiovascular disease. Emerg Top Life Sci 2023; 7:457-466. [PMID: 38084859 PMCID: PMC10754327 DOI: 10.1042/etls20230111] [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: 09/18/2023] [Revised: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
This review centres around the recent evidence in examining the intersection of sleep and cardiovascular disease (CVD). Sleep in this review will be further subdivided to consider both sleep quantity and quality along and will also consider some of the more common sleep disorders, such as insomnia and obstructive sleep apnoea, in the context of CVD. Sleep disorders have been further explored in several specific populations which are both at risk of sleep disorders and CVD. Secondly, the review will present some of the risk factors for CVD that are affected by sleep and sleep disorders which include hypertension, diabetes, and obesity. It will also examine the potential underlying mechanisms including inflammation, appetite control, endocrine, and genetic processes that are affected by sleep and sleep disorders leading to increased risk of CVD development. In addition, we will consider the observed bi-directional relationships between sleep and cardiovascular risk factors. For example, obesity, a risk factor for CVD can be affected by sleep, but in turn can increase the risk of certain sleep disorder development which disrupts sleep, leading to further risk of obesity development and increased CVD risk. Finally, the review will explore emerging evidence around lifestyle interventions that have included a sleep component and how it impacts the management of CVD risk factor. The need for increased awareness of the health effects of poor sleep and sleep disorders will be discussed alongside the need for policy intervention to improve sleep to facilitate better health and well-being.
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Affiliation(s)
- Michelle A. Miller
- Division of Health Sciences (Mental Health and Wellbeing), Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, U.K
| | - Nathan E. Howarth
- Division of Health Sciences (Mental Health and Wellbeing), Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, U.K
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19
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Namlı Kalem M, Anadol E, Kalem Z, Sezginer PY, Elmas C, Yılmaz C, Bakirarar B. A rat study on the PTEN expression in ovarian tissue in PCOS and folliculogenesis. Sci Rep 2023; 13:20774. [PMID: 38008769 PMCID: PMC10679187 DOI: 10.1038/s41598-023-47809-y] [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: 05/08/2023] [Accepted: 11/18/2023] [Indexed: 11/28/2023] Open
Abstract
The objective of this investigation was to examine alterations in PTEN expression within ovarian tissue in a rat model of polycystic ovary syndrome (PCOS). The analysis also encompassed the examination of PTEN alterations in the ovarian tissue throughout the process of folliculogenesis in rats with normal ovulatory cycles. The study involved 12 adult female Sprague‒Dawley rats randomly assigned to the letrozole-induced polycystic ovary syndrome (PCOS) group as part of an animal-based research endeavour. The sections derived from the ovaries were subjected to immunohistochemical staining for PTEN. The evaluation of PTEN staining levels in ovarian tissues was conducted using electron microscopy. Follicle counts, as well as hormonal and biochemical analyses (serum luteinising hormone (LH), follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH), testosterone, oestradiol levels and serum glucose, triglyceride, HDL and LDL-cholesterol levels), were conducted to provide evidence of the manifestation of polycystic ovary syndrome (PCOS) in rats. The number of primordial and Graafian follicles in the PCOS group decreased significantly, and the number of primary, secondary and antral follicles increased significantly. PTEN expression was found to be significantly higher in the PCOS group than in the control group in the primordial follicle oocyte cytoplasm, primordial follicle granulosa cells, primary follicle oocyte cytoplasm, primary follicle granulosa cells, antral follicle oocyte cytoplasm, antral follicle granulosa cells, and corpus luteum (p = 0.007, p = 0.001, p = 0.001, p = 0.001, p = 0.001, p = 0.002, and p = 0.018, respectively). In the non-PCOS group, a time-dependent comparison of the amount of oocyte cytoplasm and PTEN staining in granulosa cells of the oocytes at different stages of development was performed. While the follicles were developing from the primordial follicle to the primary and antral follicle, the amount of PTEN staining in the oocyte cytoplasm decreased, whereas the PTEN activity in the granulosa cells increased as the oocyte developed (p = 0.001 and p = 0.001, respectively). The current investigation demonstrated changes in PTEN expression in ovarian tissue throughout the course of normal folliculogenesis, as well as in instances of disrupted folliculogenesis, with a focus on rats with PCOS.
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Affiliation(s)
| | - Elvan Anadol
- Laboratory Animal Breeding and Experimental Researches Center, Gazi University, Ankara, Turkey
| | - Ziya Kalem
- Obstetrics and Gynecology Department, Istinye University, Istanbul, Turkey
| | | | - Cigdem Elmas
- Department of Histology and Embryology, Gazi University, Antalya, Turkey
| | - Canan Yılmaz
- Department of Biochemistry, Gazi University, Ankara, Turkey
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20
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Talebi S, Shab-Bidar S, Mohammadi H, Moini A, Djafarian K. The effects of intermittent fasting diet alone or in combination with probiotic supplementation in comparison with calorie-restricted diet on metabolic and hormonal profile in patients with polycystic ovary syndrome: study protocol for a randomized clinical trial. Trials 2023; 24:690. [PMID: 37880791 PMCID: PMC10601288 DOI: 10.1186/s13063-023-07691-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/29/2023] [Indexed: 10/27/2023] Open
Abstract
INTRODUCTION Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in females characterized by ovulatory dysfunction, hyperandrogenism, and other metabolic disorders. Both intermittent fasting and specific probiotics have been suggested to help improve patients with PCOS through changes in gut microbial composition, circadian clock, and metabolic regulation. Therefore, the present study aims to investigate the effects of intermittent fasting alone or in combination with probiotic supplementation compared to the calorie-restricted (CR) diet on anthropometric measures, metabolic status, inflammation, and oxidative stress in women with PCOS. METHODS We will carry out a randomized clinical trial for 8 weeks. Participants will be randomly assigned (1:1:1) to one of the three groups: (1) a 14:10 early time-restricted feeding (TRF) diet with probiotic supplementation (n = 30); (2) a 14:10 early TRF diet with placebo supplementation (n = 30); (3) a CR diet (energy-restricted 25% of required calories) with placebo supplementation as a control group (n = 30). The primary outcomes will be changes in body weight and insulin resistance. However, glycemic control, lipid profile, metabolic parameters, sex hormone-binding globulin, dehydroepiandrosterone, anti-Mullerian hormone, free androgen index, hirsutism, acne, antioxidant and oxidant status, inflammation, anthropometric measures, mental health, sleep quality, appetite, eating behavior, food craving, and blood pressure are secondary outcomes. All outcomes of this study will be evaluated in pre- and post-intervention. DISCUSSION We hypothesized that 10-h TRE administered alone or in combination with probiotic supplementation to overweight and obese PCOS subjects would lead to weight loss and improved metabolic, hormonal, inflammatory, and antioxidant markers compared to control subjects following a standard 3-meal-per-day CR diet. ETHICAL ASPECTS The current trial received approval from the Medical Ethics Committee of Tehran University of Medical Sciences, Tehran, Iran (IR.TUMS.MEDICNE.REC.1401.425). TRIAL REGISTRATION Iranian Registry of Clinical Trials IRCT20121110011421N5. Registered on 3 October 2022.
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Affiliation(s)
- Sepide Talebi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ashraf Moini
- Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran
- Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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21
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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: 6] [Impact Index Per Article: 6.0] [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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22
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Li Y, Han T, Wang Y, Gao J, Zhang J, Wu Y, Luo J. Association of Calpain10 polymorphisms with polycystic ovarian syndrome susceptibility: a systematic review and meta-analysis with trial sequential analysis. Front Genet 2023; 14:1153960. [PMID: 37727373 PMCID: PMC10505618 DOI: 10.3389/fgene.2023.1153960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 08/21/2023] [Indexed: 09/21/2023] Open
Abstract
Insulin resistance plays an important role in the pathogenesis of polycystic ovarian syndrome (PCOS). Calpain10 (CAPN10) gene was the first identified susceptibility gene for type 2 diabetes mellitus and closely related to insulin sensitivity. A lot of research attention has been attracted on the relationship between CAPN10 polymorphisms and PCOS risk, but they didn't reach a consistent conclusion. We therefore performed this systematic review and meta-analysis to assess the association of CAPN10 common variants with PCOS susceptibility. A total of 21 studies were eligible for inclusion. Meta-analyses were done for 5 variants that had at least two data sources: UCSNP-19, -43, -44, -56 and -63. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated under five genetic models. Subgroup analyses by ethnicity, PCOS diagnostic criteria, and source of controls were conducted. Moreover, false-positive report probability (FPRP) test and trial sequential analysis (TSA) were performed to assess the significant associations. The results showed a possible negative association between UCSNP-19 and PCOS risk (ins/ins vs. del/del + del/ins: OR = 0.84, 95% CI: 0.72-0.98). In subgroup analyses, FPRP test indicated that noteworthy associations were observed in mixed ethnicities for UCSNP-43 (A vs. G: OR = 1.81, 95% CI: 1.17-2.79; AA + AG vs. GG: OR = 2.14, 95% CI: 1.20-3.80) and in Asians for UCSNP-44 (CC vs. TT: OR = 2.07, 95% CI: 1.21-3.51; CC vs. CT + TT: OR = 2.19, 95% CI: 1.31-3.69), but TSA plots showed that the accumulated sample sizes of these associations were insufficient to draw firm conclusions. In summary, our study suggested that UCSNP-19, UCSNP-43, and UCSNP-44 in CAPN10 gene may be involved in PCOS susceptibility. These findings warrant further studies.
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Affiliation(s)
- Yamei Li
- NHC Key Laboratory for Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
- Department of Women Health Care, Hunan Provincial Maternal and Child Healthcare Hospital, Changsha, China
| | - Ting Han
- Department of Women Health Care, Hunan Provincial Maternal and Child Healthcare Hospital, Changsha, China
| | - Yingxia Wang
- Department of Women Health Care, Hunan Provincial Maternal and Child Healthcare Hospital, Changsha, China
| | - Jie Gao
- Department of Women Health Care, Hunan Provincial Maternal and Child Healthcare Hospital, Changsha, China
| | - Jianglin Zhang
- Department of Women Health Care, Hunan Provincial Maternal and Child Healthcare Hospital, Changsha, China
| | - Yinglan Wu
- Department of Women Health Care, Hunan Provincial Maternal and Child Healthcare Hospital, Changsha, China
| | - Jiayou Luo
- Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, China
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23
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Geng X, He Z, Bao Z, Di W, Gu Z. Aberrant HPO Axis Alterations and Autoimmune Abnormalities in PCOS Patients with DOR: A Retrospective Analysis. J Clin Med 2023; 12:5212. [PMID: 37629254 PMCID: PMC10455465 DOI: 10.3390/jcm12165212] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/20/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND There is a group of polycystic ovary syndrome (PCOS) patients in clinic who have diminished ovarian reserve (DOR) in combination. This study was designed to evaluate the differences in glucolipid metabolism, hypothalamic-pituitary-ovarian (HPO) axis-related parameters, and autoimmune antibodies in PCOS patients with and without DOR. METHODS A total of 2307 PCOS patients, including 1757 patients with PCOS alone and 550 patients who have both PCOS and DOR, were enrolled in this retrospective study. Parameters of glucolipid metabolism, HPO axis-related parameters, and autoimmune antibodies were measured and analyzed. RESULTS The prevalence of DOR among all patients with PCOS was 23.84%. Many HPO axis-related parameters, such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and prolactin (PRL) were significantly different in PCOS with DOR compared with PCOS without DOR. The FSH levels were positively correlated with LH, testosterone (T), and androstenedione (AD) levels, but had no association with glucolipid metabolism after adjusting for body mass index (BMI). Moreover, anti-ovarian antibody (AOAb) and anti-21-OH antibody (21-OHAb) levels were significantly elevated in PCOS patients with DOR. CONCLUSIONS PCOS patients with DOR showed more chaotic HPO axis hormone levels and elevated autoimmune antibodies, suggesting that autoimmune factors may be the cause of DOR in women with PCOS.
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Affiliation(s)
- Xueying Geng
- Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
- Center for Reproductive Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200135, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, China
| | - Zhihong He
- Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Zhouzhou Bao
- Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Wen Di
- Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
- Shanghai Key Laboratory of Gynecologic Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
- State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Zhuowei Gu
- Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
- Shanghai Key Laboratory of Gynecologic Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
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Hanna F, Wu P, Heald A, Fryer A. Diabetes detection in women with gestational diabetes and polycystic ovarian syndrome. BMJ 2023; 382:e071675. [PMID: 37402524 DOI: 10.1136/bmj-2022-071675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
Gestational diabetes mellitus (GDM) and polycystic ovarian syndrome (PCOS) represent two of the highest risk factors for development of type 2 diabetes mellitus in young women. As these increasingly common conditions generally affect younger women, early detection of dysglycemia is key if preventative measures are to be effective. While international guidance recommends screening for type 2 diabetes, current screening strategies suffer from significant challenges.First, guidance lacks consensus in defining which tests to use and frequency of monitoring, thereby sending mixed messages to healthcare professionals.Second, conformity to guidance is poor, with only a minority of women having tests at the recommended frequency (where specified). Approaches to improve conformity have focused on healthcare related factors (largely technology driven reminder systems), but patient factors such as convenience and clear messaging around risk have been neglected.Third, and most critically, current screening strategies are too generic and rely on tests that become abnormal far too late in the trajectory towards dysglycemia to offer opportunities for effective preventative measures. Risk factors show wide interindividual variation, and insulin sensitivity and β cell function are often abnormal during pre-diabetes stage, well before frank diabetes.New, consistent, targeted screening strategies are required that incorporate early, prevention focused testing and personalised risk stratification.
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Affiliation(s)
- Fahmy Hanna
- Department of Diabetes and Endocrinology, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, Staffordshire, UK
- Centre for Health and Development, Staffordshire University, Staffordshire UK
- School of Medicine, Keele University, Keele, Staffordshire, UK
| | - Pensee Wu
- School of Medicine, Keele University, Keele, Staffordshire, UK
- Department of Obstetrics and Gynaecology, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, Staffordshire, UK
- Department of Obstetrics and Gynecology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Adrian Heald
- Department of Diabetes and Endocrinology, Salford Royal NHS Foundation Trust, Salford, UK
- School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Anthony Fryer
- School of Medicine, Keele University, Keele, Staffordshire, UK
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25
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Sheikh J, Khalil H, Shaikh S, Hebbar M, Zia N, Wicks S, Jayaprakash S, Narendran A, Subramanian A, Malhotra K, Chapman R, Gillett C, Gleeson HK, Robinson L, Chu JJ, Lathia T, Selvan C, O'Reilly MW, Manolopoulos KN, Arlt W, Kempegowda P. Emotional and psychosexual well-being is influenced by ethnicity and birthplace in women and individuals with polycystic ovary syndrome in the UK and India. BJOG 2023; 130:978-986. [PMID: 36807756 PMCID: PMC10952802 DOI: 10.1111/1471-0528.17428] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 02/04/2023] [Accepted: 02/11/2023] [Indexed: 02/20/2023]
Abstract
OBJECTIVE To assess the association of ethnicity and birthplace on emotional and psychosexual well-being in women with polycystic ovary syndrome (PCOS). DESIGN Cross-sectional study. SETTING Community recruitment via social media campaigns. POPULATION Women with PCOS completing an online questionnaire in September-October 2020 (UK) and May-June 2021 (India). METHODS The survey has five components, with a baseline information and sociodemographic section followed by four validated questionnaires: Hospital Anxiety and Depression Scale (HADS); Body Image Concern Inventory (BICI); Beliefs About Obese Persons Scale (BAOP); and Female Sexual Function Index (FSFI). MAIN OUTCOME MEASURES We used adjusted linear and logistic regression models, adjusting for age, education, marital status and parity, to evaluate the impact of ethnicity and birthplace on questionnaire scores and outcomes (anxiety and/or depression, HADS ≥ 11; body dysmorphic disorder (BDD), BICI ≥ 72). RESULTS A total of 1008 women with PCOS were included. Women of non-white ethnicity (613/1008) reported higher rates of depression (OR 1.96, 95% CI 1.41-2.73) and lower BDD (OR 0.57, 95% CI 0.41-0.79) than white women (395/1008). Women born in India (453/1008) had higher anxiety (OR 1.57, 95% CI 1.00-2.46) and depression (OR 2.20, 95% CI 1.52-3.18) but lower BDD rates (OR 0.42, 95% CI 0.29-0.61) than women born in the UK (437/1008). All sexual domains, excluding desire, scored lower for non-white women and women born in India. CONCLUSIONS Non-white women and women born in India reported higher emotional and sexual dysfunction, whereas white women and women born in the UK reported higher body image concerns and weight stigma. Ethnicity and birthplace need to be considered for tailored, multidisciplinary care.
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Affiliation(s)
- Jameela Sheikh
- College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Halimah Khalil
- College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Salomi Shaikh
- DY Patil University School of MedicineNavi MumbaiIndia
| | - Meghnaa Hebbar
- College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Nawal Zia
- College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | | | | | | | | | | | - Rachel Chapman
- University Hospitals Coventry and Warwickshire NHS TrustCoventryUK
| | - Caroline Gillett
- Institute of Metabolism and Systems ResearchUniversity of BirminghamBirminghamUK
| | - Helena K. Gleeson
- Department of Endocrinology, Queen Elizabeth HospitalUniversity Hospitals Birmingham NHS Foundation TrustBirminghamUK
| | - Lynne Robinson
- Birmingham Women's HospitalBirmingham Women's and Children's NHS Foundation TrustBirminghamUK
| | - Justin J. Chu
- Birmingham Women's HospitalBirmingham Women's and Children's NHS Foundation TrustBirminghamUK
| | | | - Chitra Selvan
- Department of EndocrinologyMS Ramaiah Medical CollegeBengaluruIndia
| | - Michael W. O'Reilly
- Institute of Metabolism and Systems ResearchUniversity of BirminghamBirminghamUK
- Department of MedicineRoyal College of Surgeons in Ireland (RCSI) University of Medicine and Health SciencesDublinIreland
| | | | - Wiebke Arlt
- Institute of Metabolism and Systems ResearchUniversity of BirminghamBirminghamUK
- Department of Endocrinology, Queen Elizabeth HospitalUniversity Hospitals Birmingham NHS Foundation TrustBirminghamUK
- NIHR Birmingham Biomedical Research Centre at the University Hospitals Birmingham NHS Foundation TrustUniversity of BirminghamBirminghamUK
| | - Punith Kempegowda
- Institute of Metabolism and Systems ResearchUniversity of BirminghamBirminghamUK
- Department of Endocrinology, Queen Elizabeth HospitalUniversity Hospitals Birmingham NHS Foundation TrustBirminghamUK
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26
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Pingarrón Santofímia C, Poyo Torcal S, López Verdú H, Henríquez Linares A, Calvente Aguilar V, Terol Sánchez P, Martínez García MS, Lafuente González P. Evaluation of the efficacy of an antioxidant combination for the modulation of metabolic, endocrine, and clinical parameters in patients with polycystic ovary syndrome. Gynecol Endocrinol 2023; 39:2227277. [PMID: 37356455 DOI: 10.1080/09513590.2023.2227277] [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: 11/29/2022] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/27/2023] Open
Abstract
OBJECTIVE To evaluate the efficacy of dietary supplementation with a combination of antioxidants (lipoic acid, N-acetylcysteine, vitamin B6, and S-adenosyl-L-methionine) for the modulation of metabolic, endocrine, and clinical parameters in comparison with oral contraception in non-diabetic women newly diagnosed with polycystic ovary syndrome (PCOS). METHODS This was a prospective, partially randomized, multicenter study in which non-diabetic women with PCOS were recruited under routine clinical practice conditions and distributed in three groups to receive the following regimen for 6 months: 1) antioxidant combination (MN group); 2) oral contraception (OC group); or 3) oral contraception and the antioxidant combination (MN + OC group). General recommendation of healthy diet and regular exercise was given to all patients. Metabolic, endocrine, clinical, and quality of life parameters were recorded at baseline and after 6 months of therapy. RESULTS A total of 96 women with PCOS were included in the study. After 6 months of treatment, the homeostasis model assessment-estimated insulin resistance (HOMA-IR) level was reduced only in the MN group, with a significant mean reduction of -0.92 points. Androstenedione was significantly reduced in all groups. Clinical parameters that significantly improved in all groups were hirsutism, acne, irregular menstruation, and quality of life, with no statistical differences between the groups. CONCLUSIONS This study showed that the antioxidant combination might be a suitable therapy for patients with PCOS when oral contraceptive is not indicated, because in all groups clinical parameters, irregular menstruation as well as androstenedione and quality of life were significantly improved with no statistical difference between groups.
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Affiliation(s)
- Carmen Pingarrón Santofímia
- Universidad Europea de Madrid. Servicio de Ginecología y Oncoginecología, Hospital Quirónsalud San José, Madrid, Spain
| | - Silvia Poyo Torcal
- Servicio de Ginecología y Oncoginecología, Hospital Quirónsalud San José, Madrid, Spain
| | - Helena López Verdú
- Servicio de Ginecología y Oncoginecología, Hospital Quirónsalud San José, Madrid, Spain
| | | | | | - Pablo Terol Sánchez
- Servicio de Ginecología y Oncoginecología, Hospital Quirónsalud San José, Madrid, Spain
| | | | - Pilar Lafuente González
- Universidad Europea de Madrid. Servicio de Ginecología y Oncoginecología, Hospital Quirónsalud San José, Madrid, Spain
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27
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Piltonen TT, Komsi E, Morin-Papunen LC, Korhonen E, Franks S, Järvelin MR, Arffman RK, Ollila MM. AMH as part of the diagnostic PCOS workup in large epidemiological studies. Eur J Endocrinol 2023; 188:547-554. [PMID: 37294941 DOI: 10.1093/ejendo/lvad065] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/06/2023] [Accepted: 06/08/2023] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Previous studies have shown good correlation between polycystic ovarian morphology (PCOM) and serum anti-Müllerian hormone (AMH) levels. We evaluated the utility of AMH as a surrogate for PCOM as a part of the polycystic ovary syndrome (PCOS) diagnosis by describing how the use of different AMH cut-off values would change the prevalence of PCOS. METHODS A general population-based birth cohort study. Anti-Müllerian hormone concentrations were measured from serum samples taken at age 31 years (n = 2917) using the electrochemiluminescence immunoassay (Elecsys). Anti-Müllerian hormone data were combined with data on oligo/amenorrhoea and hyperandrogenism to identify women with PCOS. RESULTS The addition of AMH as a surrogate marker for PCOM increased the number of women fulfilling at least two PCOS features in accordance with the Rotterdam criteria. The prevalence of PCOS was 5.9% when using the AMH cut-off based on the 97.5% quartile (10.35 ng/mL) and 13.6% when using the recently proposed cut-off of 3.2 ng/mL. When using the latter cut-off value, the distribution of PCOS phenotypes A, B, C, and D was 23.9%, 4.7%, 36.6%, and 34.8%, respectively. Compared with the controls, all PCOS groups with different AMH concentration cut-offs showed significantly elevated testosterone (T), free androgen index (FAI), luteinizing hormone (LH), LH/follicle-stimulating hormone (FSH) ratio, body mass index (BMI), waist circumference, and homoeostatic model assessment of insulin resistance (HOMA-IR) values, as well as significantly decreased sex hormone-binding globulin (SHBG) values. CONCLUSIONS Anti-Müllerian hormone could be useful surrogate for PCOM in large data sets, where transvaginal ultrasound is not feasible, to aid the capturing of women with typical PCOS characteristics. Anti-Müllerian hormone measurement from archived samples enables retrospective PCOS diagnosis when combined with oligo/amenorrhoea or hyperandrogenism.
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Affiliation(s)
- Terhi T Piltonen
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, FI-90029, Oulu, Finland
| | - Elina Komsi
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, FI-90029, Oulu, Finland
| | - Laure C Morin-Papunen
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, FI-90029, Oulu, Finland
| | - Elisa Korhonen
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, FI-90029, Oulu, Finland
| | - Stephen Franks
- Institute of Reproductive and Developmental Biology, Imperial College London, W12 0NN, London, United Kingdom
| | - Marjo-Riitta Järvelin
- Faculty of Medicine, Center for Life Course Health Research, University of Oulu, FI-90014, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, FI-90220, Oulu, Finland
- Department of Epidemiology and Biostatistics, School of Public Health, MRC Centre for Environment and Health, Imperial College London, W2 1PG, London, United Kingdom
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, UB8 3PH, London, United Kingdom
| | - Riikka K Arffman
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, FI-90029, Oulu, Finland
| | - Meri-Maija Ollila
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, FI-90029, Oulu, Finland
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28
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Albahlol IA, Neamatallah M, Serria MS, El-Gilany AH, Setate YA, Alkasaby NM, Mostafa SA, Abdelaziz M, Elazab H, Ammar OA. Vitamin D receptor gene polymorphism and polycystic ovary syndrome susceptibility. BMC Med Genomics 2023; 16:108. [PMID: 37202765 DOI: 10.1186/s12920-023-01541-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 05/11/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women. This study was designed to investigate the associations of vitamin D receptor (VDR) gene variants with PCOS risk and the severity of the disease phenotype among Egyptian women. METHODS In this study, 185 women with PCOS and 207 fertile women as controls were recruited. Cases were divided into phenotype groups based on their clinical and paraclinical features. Clinical and laboratory data were measured in the patient and control groups. All individuals were genotyped for nine single-nucleotide polymorphisms (SNPs) located across the VDR gene using TaqMan allelic discrimination real-time polymerase chain reaction. RESULTS Women with PCOS were significantly (P ≤ 0.001) higher body mass index (BMI) (22.77 ± 2.5) than controls (21.68 ± 1.85 kg/m2). Women with PCOS had significantly higher anti-Mullerian hormone, prolactin, luteinizing hormone (LH), LH/follicle-stimulating hormone (FSH), free testosterone, total testosterone, and dehydroepiandrosterone sulfate levels than the control group (P ≤ 0.001). The level of FSH was significantly lower in women with PCOS than in the control group (P ≤ 0.001). Analysis of the VDR rs4516035, rs2107301, rs1544410 (BsmI), and rs731236 (TaqI) SNPs showed a significant association with PCOS phenotype A. Furthermore, rs2228570 (FokI), rs3782905, rs7975232 (ApaI), and rs739837 SNPs showed a significant association with PCOS phenotype C. Furthermore, rs11568820 SNP showed a significant association with PCOS phenotype D (P < 0.05). CONCLUSIONS The findings of this study indicate that variations in the VDR gene were associated with an increased risk of PCOS in Egyptian women.
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Affiliation(s)
- Ibrahim A Albahlol
- Department of Obstetrics and Gynecology, Jouf College of Medicine, Jouf University, Mansoura College of Medicine, Mansoura University, Mansoura, SA, Egypt
| | - Mustafa Neamatallah
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed Saad Serria
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Abdel-Hady El-Gilany
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Yomna A Setate
- Infection Control Unit, Mansoura Specialized Hospital (MSH), Mansoura, Egypt
| | - Nashwa M Alkasaby
- Departments of Medical Microbiology & Immunology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Sally Abdallah Mostafa
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Hossam Elazab
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Omar A Ammar
- Basic Science Department, Delta University for Science and Technology, Gamasa, Egypt.
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Yang Z, Liu F, Bai J, Ye Z, Yin J, Peng T, Shan H, Yu Y, Zhou P, Li R. Circ_0115118 regulates endometrial functions through the miR-138-1-3p/WDFY2 axis in patients with PCOS†. Biol Reprod 2023; 108:744-757. [PMID: 36780172 DOI: 10.1093/biolre/ioad017] [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: 08/06/2022] [Revised: 01/08/2023] [Accepted: 02/04/2023] [Indexed: 02/14/2023] Open
Abstract
To investigate the expression profiles of circular RNAs (circRNAs) in the endometria of women with polycystic ovary syndrome (PCOS) and to explore the role of aberrant circ_0115118 expression in endometrial dysfunction in patients with PCOS. CircRNA microarray hybridization and bioinformatic analyses were performed to determine the expression patterns of circRNAs in the endometria of patients with or without PCOS, the expression of target circRNA was evaluated by real-time polymerase chain reaction (PCR). Cell counting kit-8 and Transwell assays were used to detect cellular proliferative, invasive, and migratory capacities. The influence of the circRNA on decidualization was explored by real-time PCR. Animal models were established to investigate the regulatory effect of the circRNA on embryo implantation. Downstream microRNAs and genes were predicted using bioinformatic websites and verified by dual-luciferase reporter assays, real-time PCR, and western blotting. In the endometria of patients with PCOS, there were 113 differentially expressed circRNAs in the secretory phase and 1119 differentially expressed circRNAs in the proliferative phase. The expression of circ_0115118 was significantly higher in endometrial stromal cells during the proliferative phase in patients with PCOS, leading to inhibition of cellular mobilization and embryo implantation. In addition, circ_0115118 exerted effects by sponging miR-138-1-3p, subsequently increasing the expression of WD repeat and FYVE domain-containing protein 2 (WDFY2). Circ_0115118 expression is dysregulated in the endometria of patients with PCOS and adversely affects endometrial function. Our findings reveal that circ_0115118 may be a potential therapeutic target to improve pregnancy outcomes in women with PCOS.
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Affiliation(s)
- Zi Yang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Fenting Liu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Jiali Bai
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Zhenhong Ye
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Jingwen Yin
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Tianliu Peng
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Hongying Shan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Yang Yu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Ping Zhou
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Rong Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
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30
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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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Presswala B, De Souza LR. The diagnostic experience of polycystic ovary syndrome: A scoping review of patient perspectives. PATIENT EDUCATION AND COUNSELING 2023; 113:107771. [PMID: 37141692 DOI: 10.1016/j.pec.2023.107771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/02/2023] [Accepted: 04/21/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Polycystic Ovary Syndrome (PCOS) is a common endocrine condition with a complex diagnostic process. The present study aims to understand patient perceptions of the process of PCOS diagnosis, and how challenges during diagnosis can influence patient understanding of PCOS and trust in healthcare providers (HCPs). METHODS A scoping review framework was followed. Six databases were searched for patient experiences of PCOS diagnosis, between January 2006 - July 2021. Data extraction and thematic analyses were conducted. RESULTS Of the 338 studies screened, 21 studies fulfilled the inclusion criteria. Patient experiences of the diagnostic process were stratified into three themes: emotional, negotiating, and incomplete. As a result of these experiences, patients begin to perceive their HCPs as lacking knowledge and empathy. CONCLUSION There are prevailing gaps in how PCOS diagnostic criteria are understood and applied in the clinical setting, leading to a lengthy diagnostic process. Additionally, poor HCP communication negatively affects patient trust in HCPs. PRACTICE IMPLICATIONS Practicing patient-centered care and empowering patients by addressing their specific information needs are essential to improving the diagnostic experience and care of individuals living with PCOS. These recommendations may also apply to the diagnosis of other complex chronic conditions.
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Affiliation(s)
- Batul Presswala
- Faculty of Health Sciences, McMaster University, 1280 Main St. West, MDCL 3500, Hamilton, ON L8S 4K1, Canada; Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON K1A 0K9, Canada.
| | - Leanne R De Souza
- Human Biology Program, Health Studies Program, University College, University of Toronto, Room 281, 15 King's College Circle, Toronto, ON M5S 3H7, Canada
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Yuan X, Yang J, Sun D, Luo K, Jiang X, Wang L, Xiang S, Jiang Y, Ge K, Zhou Z, Li B, Hua F. 1,25-Dihydroxyvitamin D inhibits hepatic diacyglycerol accumulation and ameliorates metabolic dysfunction in polycystic ovary syndrome rat models. Front Pharmacol 2023; 14:1077014. [PMID: 37124226 PMCID: PMC10136241 DOI: 10.3389/fphar.2023.1077014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 03/06/2023] [Indexed: 04/08/2023] Open
Abstract
Introduction: We aimed to evaluate the influence of 1,25-dihydroxyvitamin D (1,25(OH)2D) on metabolic dysfunction and elucidate its underlying mechanism using a rat model of polycystic ovary syndrome (PCOS).Methods: Twenty-four Sprague-Dawley rats were randomly divided into four groups: control group (CON, 2 ml/kg of oral 0.5% CMC), 1,25VD group (oral 0.5% CMC and 2.5 ug/kg intraperitoneal 1,25(OH)2D), PCOS group (1 mg/kg oral letrozole), PCOS+1,25VD group (1 mg/kg oral letrozole orally 2.5 ug/kg intraperitoneal 1,25(OH)2D). The treatments were administered for 8 weeks. Body weight, estrus cycle, insulin tolerance, and oral glucose tolerance of the rats in the different groups were assessed. The rats were euthanized at the 8th weeks, and plasma, ovarian, and liver samples were collected and analyzed. The hepatic lipid profile was characterized using HPLC/MRM.Results: Letrozole-induced PCOS rats exhibited increased weight, insulin resistance, postprandial glucose abnormalities, and dyslipidemia. Compared with the PCOS group rats, the PCOS+1,25VD group rats showed reduced body weight, increased sensitivity to insulin, decreased postprandial glucose, and elevated levels of high-density lipoprotein cholesterol. Moreover, abnormally increased liver concentrations of total diacylglycerol (DG) and DG species in the PCOS rats were reversed by treatment with 1,25(OH)2D. Additionally, hepatic DG and insulin sensitivity were correlated.Conclusion: 1,25(OH)2D inhibited hepatic DG accumulation and ameliorated metabolic dysfunction in PCOS rat models.
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Affiliation(s)
- Xin Yuan
- Department of Endocrinology, The First People’s Hospital of Changzhou, Changzhou, China
| | - Jianshu Yang
- Health Management Center, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Danlin Sun
- Department of Neurosurgery, The First People’s Hospital of Changzhou, Changzhou, China
- Clinical Medical Research Center, The First People’s Hospital of Changzhou, Changzhou, China
| | - Kaiming Luo
- Department of Endocrinology, The First People’s Hospital of Changzhou, Changzhou, China
| | - Xiaohong Jiang
- Department of Endocrinology, The First People’s Hospital of Changzhou, Changzhou, China
| | - Long Wang
- Department of Endocrinology, The First People’s Hospital of Changzhou, Changzhou, China
| | - Shoukui Xiang
- Department of Endocrinology, The First People’s Hospital of Changzhou, Changzhou, China
| | - Yijie Jiang
- Department of Endocrinology, The First People’s Hospital of Changzhou, Changzhou, China
| | - Kele Ge
- Department of Oncology, The First People’s Hospital of Changzhou, Changzhou, China
| | - Zhiyang Zhou
- LipidALL Technologies Company Limited, Changzhou, China
| | - Bowen Li
- LipidALL Technologies Company Limited, Changzhou, China
| | - Fei Hua
- Department of Endocrinology, The First People’s Hospital of Changzhou, Changzhou, China
- *Correspondence: Fei Hua,
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Guo Y, Liu Y, Ding R, Yan X, Tan H, Wang Y, Wang X, Wang L. A structural equation model linking health literacy, self-efficacy, and quality of life in patients with polycystic ovary syndrome. BMC Womens Health 2023; 23:98. [PMID: 36894980 PMCID: PMC9999555 DOI: 10.1186/s12905-023-02223-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/13/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Health literacy is a crucial factor that affects health outcomes. Understanding the current status of health literacy among patients with polycystic ovary syndrome (PCOS) is the basis for helping patients better manage risk factors and improve their health outcomes. This study aimed to explore the status of and factors influencing health literacy in patients with PCOS, and to validate the pathway between health literacy, quality of life, and self-efficacy for these patients. METHODS A cross-sectional study was conducted using a convenience sample of 300 patients with PCOS in the gynecology outpatient clinic of a tertiary hospital in Zunyi from March to September 2022. Data on health literacy, demographic features, quality of life, and self-efficacy were collected. Multiple stepwise linear regression was conducted to assess the risk factors associated with health literacy for the study participants. A structural equation model was used to construct and validate the pathways. RESULTS Most participants exhibited low health literacy (3.61 ± 0.72), and only 25.70% had adequate health literacy. Multiple regression analysis revealed that the main factors associated with health literacy among participants included Body Mass Index (BMI) (B = -0.95, p < 0.01), education (B = 3.44, p < 0.01), duration of PCOS (B = 4.66, p < 0.01), quality of life (B = 0.25, p < 0.01), and self-efficacy (B = 0.76, p < 0.01). Multiple fit values indicated that the model fit the data effectively. The direct effect of health literacy on self-efficacy and quality of life was 0.06 and 0.32, respectively. The indirect effect of health literacy on quality of life was -0.053, and the total effect of health literacy on quality of life was 0.265. CONCLUSIONS Health literacy was low among patients with PCOS. Healthcare providers should pay more attention to health literacy and to developing the corresponding intervention strategies urgently needed to improve the quality of life and health behavior of patients with PCOS.
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Affiliation(s)
- Yunmei Guo
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Ying Liu
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Rui Ding
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Xin Yan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Huiwen Tan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Yousha Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Xueting Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - LianHong Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China. .,Nursing College, Zunyi Medical University, Zunyi, China.
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Haas CL, Varbo A, Laursen PN, Schnecke V, Balen AH. Association between body mass index, weight loss and the chance of pregnancy in women with polycystic ovary syndrome and overweight or obesity: a retrospective cohort study in the UK. Hum Reprod 2023; 38:471-481. [PMID: 36637246 PMCID: PMC9977115 DOI: 10.1093/humrep/deac267] [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: 08/18/2022] [Revised: 11/29/2022] [Indexed: 01/14/2023] Open
Abstract
STUDY QUESTION What are the associations between baseline BMI (Study 1) and change in body weight (Study 2) with the likelihood of pregnancy in women with polycystic ovary syndrome (PCOS). SUMMARY ANSWER In women with PCOS, higher baseline BMI was associated with a lower chance of pregnancy; however, weight loss was associated with an increased chance of pregnancy versus maintaining a stable weight or gaining weight. WHAT IS KNOWN ALREADY Two studies in large cohorts of Danish women with the intention to become pregnant showed a decline in fecundability ratios with higher BMI. Furthermore, a meta-analysis found that overweight/obesity significantly worsened metabolic and reproductive outcomes in women with PCOS. STUDY DESIGN, SIZE, DURATION Data were extracted from the UK Clinical Practice Research Datalink GOLD database. Patients included women aged 18-45 years with BMI ≥18.5 (Study 1) or ≥25 kg/m2 (Study 2) at time of PCOS diagnosis (index date). The primary outcome was the time to first pregnancy recorded during 36-months' follow-up, analysed with Cox proportional hazard models and presented as hazard ratios (HRs). PARTICIPANTS/MATERIALS, SETTING, METHODS Study 1 included 9955 women with PCOS. Study 2 included 7593 women with PCOS and median BMI of 34.0 kg/m2. MAIN RESULTS AND THE ROLE OF CHANCE Higher BMI was associated with a lower chance of pregnancy in the 3 years following diagnosis. It was estimated that 41% of women with normal weight (18.5-24.9 kg/m2) would become pregnant compared to 17% of women with obesity class III (BMI ≥40.0 kg/m2) during follow-up. Furthermore, the chance of pregnancy for women with obesity class III was estimated to be 63% lower than for women with normal weight, with the same age and glycaemic status (HR 0.37, 95% CI 0.31-0.44; P < 0.0001). A significant inverse association was found between BMI change and chance of pregnancy: 10% weight loss was estimated to increase the chance of pregnancy by 68% for women with baseline BMI of 40 kg/m2 (HR 1.68, 95% CI 1.49-1.90). LIMITATIONS, REASONS FOR CAUTION Multiple factors influence the chance of pregnancy (the ability and willingness to become pregnant), which was addressed by exclusion criteria employed. The real-world nature of the study means that use of non-prescription contraceptives was not available. Bias may have been introduced by the fact that only around 40% of women with PCOS in the CPRD GOLD database had their BMI recorded during the year prior to PCOS diagnosis. BMI categories used in the analyses may not be applicable to women of all ethnicities. The study population was only representative of women in the UK and results may not be generalizable to other regions. PCOS diagnoses were based on codes entered into the system by primary care providers, and no information was available regarding the criteria used for diagnosis, although symptoms used to diagnose PCOS have not changed over time. WIDER IMPLICATIONS OF THE FINDINGS Our observations provide further evidence of the benefits of weight loss in women with overweight/obesity and PCOS who are seeking to become pregnant. STUDY FUNDING/COMPETING INTEREST(S) Novo Nordisk A/S. A.H.B. declares fees for consultancy from Novo Nordisk. P.N.L. and C.L.H. are employees of Novo Nordisk. V.S. and A.V. are employees of, and hold shares in, Novo Nordisk. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
| | | | | | | | - Adam H Balen
- Leeds Centre for Reproductive Medicine, Leeds Teaching Hospitals, Leeds, UK
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Emamat H, Najafpour Boushehri S, Eslami MA, Saneei Totmaj A, Ghalandari H. The effects of flaxseed or its oil supplementations on polycystic ovary syndrome: A systematic review of clinical trials. Phytother Res 2023; 37:1082-1091. [PMID: 36433633 DOI: 10.1002/ptr.7698] [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: 06/25/2022] [Revised: 08/26/2022] [Accepted: 10/08/2022] [Indexed: 11/28/2022]
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders around the world that can endanger reproductive, metabolic, and psychological health in women. Flaxseed is considered as a functional food which provides remarkable amounts of α-linolenic acid (ALA), phytosterogenic lignans, and dietary fibers. This study aimed to investigate the effectiveness of flaxseed or its oil supplementation on PCOS patients. We systematically searched all published randomized clinical trials indexed in PubMed, Scopus, and Google Scholar databases from inception up to May 2022. Intended exposure and outcome were flaxseed or its oil and metabolic, anthropometric, and hormonal status of women with PCOS, respectively. Initial search via related keywords revealed 69 articles. After excluding duplicates, title and abstract of 55 remaining papers were screened. Fourteen papers were obtained for full text screening. Finally, nine clinical trials published between 2011 and 2021 were included in qualitative synthesis. Based on the results of the present systematic review, we suggest that flaxseed supplementation has the potential to improve metabolic, hormonal, and anthropometric parameters in women with PCOS. However, we also deduce that due to the scarcity of high-quality studies, additional studies need to be conducted in order to derive a solid conclusion.
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Affiliation(s)
- Hadi Emamat
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Saeid Najafpour Boushehri
- Department of Nutrition, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mohammad Ali Eslami
- General Practitioner, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Saneei Totmaj
- Nutrition Department, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Ghalandari
- Department of Clinical Nutrition, Faculty of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Association study to evaluate Foxo1 and Foxo3 gene polymorphisms in polycystic ovary syndrome: a preliminary case-control study and in silico analysis. Mol Biol Rep 2023; 50:3569-3580. [PMID: 36790598 DOI: 10.1007/s11033-023-08292-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/17/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is known as a multifactorial and multi-gene-mediated endocrine disorder among women of reproductive age. FoxO1 and FoxO3 are members of the forkhead transcriptional factors family that play a pivotal role in the function of ovaries. The current work is aimed at investigating the association between gene variants of FoxO1 and FoxO3 and the risk of PCOS in a sample of the Iranian population. METHODS AND RESULTS We recruited 200 women diagnosed with PCOS and 200 healthy women. Both polymerase PCR-RFLP and ARMS-PCR methods were used for genotyping. Sanger sequencing was recruited to confirm the genotyping results. The T allele of rs17592236 and the C allele of rs12585277 decreased PCOS risk by 29 and 28%, respectively. In contrast, the C allele of rs2253310 and G allele of rs2802292 increased the risk of PCOS by 1.39 and 1.63 folds, correspondingly. Bioinformatics results showed that some genes, including matrix metallopeptidase 9 (MMP-9), phosphoinositide-3-Kinase Regulatory Subunit 224 1 (PIK3R1), peroxisome proliferator-activated receptor Gamma (PPARG), and glycogen synthase 225 kinase-3 beta (GSK-3 beta) have significant interactions with FoxO1, suggesting that FoxO1 might have crucial roles in regulating different signaling pathways in ovarian cells. CONCLUSION We found that FoxO1 rs17592236C > T and rs12585277C > T had a protective role against PCOS, while FoxO3 rs2253310C > G and rs2802292G > T enhanced the risk of this metabolic disorder in our population. Additional studies on larger populations with varying races are needed to confirm these findings.
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Zhao J, Dong L, Lin Z, Sui X, Wang Y, Li L, Liu T, Liu J. Effects of selenium supplementation on Polycystic Ovarian Syndrome: a systematic review and meta-analysis on randomized clinical trials. BMC Endocr Disord 2023; 23:33. [PMID: 36740666 PMCID: PMC9901141 DOI: 10.1186/s12902-023-01286-6] [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: 07/11/2021] [Accepted: 01/27/2023] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND This study provides a systematic review and meta-analysis of randomized controlled trials, which examined the effect of the selenium supplementation on polycystic ovary syndrome (PCOS). METHODS Confirmed studies related to selenium supplementation and PCOS were searched from the databases of EMBASE, PubMed and Web of Science. Data were reported as weighted mean difference (WMD) or standard mean difference (SMD) and associated 95% confidence intervals (CIs). Analysis was performed with Stata version 12.0. RESULTS A total of 389 cases (selenium group n = 195, control group n = 194) were included in this studies. This meta-analysis showed that selenium supplementation has a positive effect on TAC, and supplementation of selenium does not significantly improve the level of BMI, Weight, LDL, HDL, Triglycerides, Total Testosterone, HOMA-IR, NO, GSH, MDA and FPG. CONCLUSION Although selenium can improve TAC in PCOS patients, it has no significant effect on BMI, Total Testosterone, et al. In terms of the results of this meta-analysis, it is not recommended for patients with PCOS to use selenium as a regular trace element supplement. Based on the improving effect of selenium on TAC, supplementation of selenium may have a positive effect on improving follicle quality for some PCOS patients who have poor follicle quality caused by oxidative stress or who want to undergo IVF.
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Affiliation(s)
- Junde Zhao
- Shandong University of Traditional Chinese Medicine, 16369 Jingshi Road, Lixia District, Jinan, 250011 Shandong China
| | - Lingfen Dong
- Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, China
| | - Zhiheng Lin
- Shandong University of Traditional Chinese Medicine, 16369 Jingshi Road, Lixia District, Jinan, 250011 Shandong China
| | - Xiaohui Sui
- Shandong University of Traditional Chinese Medicine, 16369 Jingshi Road, Lixia District, Jinan, 250011 Shandong China
| | - Ying Wang
- Shandong University of Traditional Chinese Medicine, 16369 Jingshi Road, Lixia District, Jinan, 250011 Shandong China
| | - Lijuan Li
- Changchun University of Science and Technology, Jilin, 130022 Changchun China
| | - Tingting Liu
- Shandong University of Traditional Chinese Medicine, 16369 Jingshi Road, Lixia District, Jinan, 250011 Shandong China
| | - Jinxing Liu
- Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, China
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Shah D, Rasool S. Ethnicity in polycystic ovary syndrome. Climacteric 2023; 26:15-20. [PMID: 36459492 DOI: 10.1080/13697137.2022.2144211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Polycystic ovary syndrome (PCOS) is the commonest gynecological endocrinopathy. Little is known about the exact etiopathogenesis and cardiometabolic mortality and morbidity in women with PCOS. PCOS is beyond the cosmetic concerns of an adolescent and fertility concerns of an adult and can cause serious unhealthy consequences in perimenopausal and postmenopausal age. This area needs to be assessed and addressed since the majority of these patients are lost to follow-up after completion of their families. Good evidence suggests that there are significant racial and ethnic differences in prevalence, insulin resistance, metabolic syndrome, hyperandrogenemia and the related cardiometabolic risk in women with PCOS.
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Affiliation(s)
- D Shah
- The Center for Women's Health and Fertility, Gynaecworld, Mumbai, India
| | - S Rasool
- Government Medical College, Dr Sabahat's Fertility Center, Srinagar, India
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Modulating Morphological and Redox/Glycative Alterations in the PCOS Uterus: Effects of Carnitines in PCOS Mice. Biomedicines 2023; 11:biomedicines11020374. [PMID: 36830911 PMCID: PMC9953026 DOI: 10.3390/biomedicines11020374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/23/2023] [Accepted: 01/23/2023] [Indexed: 01/31/2023] Open
Abstract
(1) Background: Polycystic ovarian syndrome (PCOS) is a common and multifactorial disease affecting reproductive-age women. Although PCOS ovarian and metabolic features have received extensive research, uterine dysfunction has been poorly investigated. This research aims to investigate morphological and molecular alterations in the PCOS uterus and search for modulating effects of different carnitine formulations. (2) Methods: CD1 mice were administered or not with dehydroepiandrosterone (DHEA, 6 mg/100 g body weight) for 20 days, alone or with 0.40 mg L-carnitine (LC) and 0.20 mg acetyl-L-carnitine (ALC) in the presence or absence of 0.08 mg propionyl-L-carnitine (PLC). Uterine horns from the four groups were subjected to histology, immunohistochemistry and immunoblotting analyses to evaluate their morphology, collagen deposition, autophagy and steroidogenesis. Oxidative-/methylglyoxal (MG)-dependent damage was investigated along with the effects on the mitochondria, SIRT1, SOD2, RAGE and GLO1 proteins. (3) Results: The PCOS uterus suffers from tissue and oxidative alterations associated with MG-AGE accumulation. LC-ALC administration alleviated PCOS uterine tissue alterations and molecular damage. The presence of PLC prevented fibrosis and maintained mitochondria content. (4) Conclusions: The present results provide evidence for oxidative and glycative damage as the main factors contributing to PCOS uterine alterations and include the uterus in the spectrum of action of carnitines on the PCOS phenotype.
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Yanagihara R, Matsuzaki T, Aoki H, Tamura K, Nagashima M, Minato S, Kamada S, Yamamoto Y, Irahara M, Iwasa T. Compatible cut-off values for luteinizing hormone and the luteinizing hormone/follicle-stimulating hormone ratio in diagnostic criteria of the Japan Society of Obstetrics and Gynecology for polycystic ovary syndrome. J Obstet Gynaecol Res 2023; 49:253-264. [PMID: 36307043 DOI: 10.1111/jog.15423] [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: 02/22/2022] [Revised: 07/25/2022] [Accepted: 08/10/2022] [Indexed: 01/20/2023]
Abstract
AIM The abnormal secretion of luteinizing hormone (LH) is one of the typical features of polycystic ovary syndrome (PCOS) and adopted in the diagnostic criteria of the Japan Society of Obstetrics and Gynecology (JSOG). We investigated cut-off values for LH and the LH/follicle-stimulating hormone (FSH) ratio in resent two measurement systems for the diagnosis of PCOS. METHODS Ninety-nine controls and 106 patients with PCOS were enrolled. Serum LH and FSH levels were measured using an electrochemiluminescence immunoassay (ARCHITECT) and chemiluminescence immunoassay (ECLusys). We examined the distribution of the measured levels, selected the conversion closest to the standard normal distribution in the control group, and calculated mean + 1 SD values for LH and the LH/FSH ratio as candidates. Cut-off values coincided with the medians of the candidates in the two assay systems using a regression equation. We calculated the endocrinological abnormality rate in PCOS according to the JSOG criteria by abnormal LH secretion and elevated T. RESULTS Cut-off values for LH (mIU/mL) and the LH/FSH ratio were 7.1 and 1.21, respectively, in ARCHITECT, and 9.9 and 1.51, respectively, in ECLusys. The detection rates of endocrinological abnormalities in PCOS were 72.2% and 70.6% in the nonoverweight/obese PCOS group and overweight/obese PCOS group, respectively, in ARCHITECT, and 69.4% and 73.5%, respectively, in ECLusys. CONCLUSION We obtained cut-off values of LH and the LH/FSH ratio for diagnostic criteria of JSOG criteria for PCOS, that were highly compatible between two major assay systems. These cut-off values will contribute to the diagnosis of PCOS in Japan and presumably in women of Asian ethnicities.
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Affiliation(s)
- Rie Yanagihara
- Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Toshiya Matsuzaki
- Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan.,Department of Obstetrics and Gynecology, Yoshinogawa Medical Center, Tokushima, Japan
| | - Hidenori Aoki
- Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Kou Tamura
- Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Mao Nagashima
- Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan.,Student Laboratory, Faculty of Medicine, Tokushima University, Tokushima, Japan
| | - Saki Minato
- Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Shuhei Kamada
- Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Yuri Yamamoto
- Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Minoru Irahara
- Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Takeshi Iwasa
- Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
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Zhang Q, Ren J, Wang F, Li M, Pan M, Zhang H, Qu F. Chinese herbal medicine alleviates the pathogenesis of polycystic ovary syndrome by improving oxidative stress and glucose metabolism via mitochondrial Sirtuin 3 signaling. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2023; 109:154556. [PMID: 36610149 DOI: 10.1016/j.phymed.2022.154556] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/29/2022] [Accepted: 11/11/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women, and the curative effects of its current management are not satisfactory. A formula of Chinese herbal medicine (CHM), called Bu-Shen-Tian-Jing Formula (BSTJF), has clinically shown beneficial effects in treating PCOS. PURPOSE This study aimed to investigate the mechanism underlying BSTJF for treatment of PCOS. METHODS Whole blood samples were collected from women with PCOS treated and not treated with BSTJF (n = 5 per group). Whole transcriptome sequencing of leukocytes and untargeted metabonomic analysis of the plasma were performed. Three groups of 18 female Sprague-Dawley rats were randomly selected: control, PCOS, and BSTJF. A PCOS rat model was established using testosterone propionate. The estrous cycle; glucose tolerance; ovarian morphology; serum markers of oxidative stress; and expression of Sirtuin 3 (SIRT3), phospho-p38 mitogen-activated protein kinase, phosphatidylinositol 3-kinase (PI3K), and phospho-protein kinase B in the ovary were measured. Palmitate was initially applied to KGN cells, followed by freeze-dried BSTJF powder. The glucose uptake, reactive oxygen species (ROS) production, and protein levels of SIRT3, PI3K, and glucose transporter type 4 (GLUT4) were detected in KGN cells. RESULTS The transcriptomic and metabolomic profiles showed alterations in 572 genes and 73 metabolites in women with PCOS treated with BSTJF. The enriched pathways in women with PCOS treated with BSTJF were mainly involved in inflammation, insulin resistance, glucose and lipid metabolism, and neuro and associated signaling pathways. In PCOS rat models, BSTJF improved the estrous cycle, glucose tolerance, and ovarian morphology; relieved oxidative stress; increased ovarian SIRT3 expression; inhibited p38 MAPK activation; and promoted the activation of PI3K/AKT signaling in the ovary. In the in-vitro study with KGN cells, BSTJF rescued the palmitate-induced impaired glucose uptake and SIRT3 expression, reduced mitochondrial ROS production mediated by SIRT3, and restored the impaired insulin-induced PI3K/AKT signaling pathway. CONCLUSION BSTJF effectively alleviated the pathogenesis of PCOS by improving oxidative stress and glucose metabolism via mitochondrial SIRT3 and the following insulin signaling pathway. This study innovatively revealed the action mechanism of CHM in treating PCOS.
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Affiliation(s)
- Qing Zhang
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, China; Zhejiang Hospital, Hangzhou, Zhejiang 310000, China
| | - Jun Ren
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, China
| | - Fangfang Wang
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, China
| | - Mingqian Li
- Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang 310012, China
| | - Manman Pan
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, China
| | - Hui Zhang
- Zhejiang Vocational College of Special Education, Hangzhou, Zhejiang 310023, China
| | - Fan Qu
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, China.
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Bharali MD, Rajendran R, Goswami J, Singal K, Rajendran V. Prevalence of Polycystic Ovarian Syndrome in India: A Systematic Review and Meta-Analysis. Cureus 2022; 14:e32351. [PMID: 36628015 PMCID: PMC9826643 DOI: 10.7759/cureus.32351] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2022] [Indexed: 12/13/2022] Open
Abstract
Stein-Leventhal syndrome, often known as polycystic ovarian syndrome (PCOS), is a syndrome that affects women's reproductive health. PCOS is one of the most common endocrine and metabolic disorders in women of reproductive age. The etiology of PCOS remains unknown mainly, and the estimation of PCOS burden in a specific geographical location will impact disease control strategies. Hence, this study estimated the pooled prevalence of PCOS in Indian women. Databases such as PubMed, CINHAL, Scopus, and Google Scholar were thoroughly searched. Only those published Indian studies that reported the prevalence of PCOS from 2010 to 2021 and had at least one of the following diagnostic PCOS criteria were included in the systematic review: the National Institutes of Health (NIH), Rotterdam's criteria, or/and Androgen Excess Society (AES). MetaXL version 5.3 software was used for data analysis. The risk of bias was assessed using modified Joanna Briggs Institute criteria for cross-sectional studies. Out of 17132 articles, 11 articles were selected for systematic review and meta-analysis. The pooled prevalence of PCOS was 11.33(7.69-15.59) using the random effect. The proportion of Hirsute using the Ferriman-Gallwey score was highly variable, ranging from 1.6% to 37.9% (n=6). The prevalence rate of PCOS is high among Indian women. The pooled prevalence of PCOS was close to 10% using Rotterdam's criteria and AES criteria, while it was 5.8% using NIH criteria. The study's overall finding emphasizes the need for more acceptable and uniform diagnostic criteria for screening PCOS. At the same time, policy-makers should consider giving more importance to PCOS in their effort to control non-communicable diseases.
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Affiliation(s)
- Mintu Dewri Bharali
- Department of Community Medicine, Guwahati Medical College and Hospital, Guwahati, IND
| | - Radhika Rajendran
- Department of Biotechnology, Indian Institute of Technology, Guwahati, Guwahati, IND
| | - Jayshree Goswami
- Department of Obstetrics and Gynecology, Gauhati Medical College and Hospital, Guwahati, IND
| | - Kusum Singal
- Center For Advanced Research Evidence-Based Child Health, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, IND
| | - Vinoth Rajendran
- Department of Community Medicine/Family Medicine, All India Institute of Medical Sciences, Jodhpur, IND
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Kamrul-Hasan ABM, Aalpona FTZ. Comparison of Serum Vitamin B12 Levels Among Drug-Naïve and Metformin-Treated Patients With Polycystic Ovary Syndrome. Cureus 2022; 14:e30447. [PMID: 36415424 PMCID: PMC9674047 DOI: 10.7759/cureus.30447] [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] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Background Metformin is frequently prescribed for polycystic ovary syndrome (PCOS). There is a well-established causal relationship between metformin use in type 2 diabetes and vitamin B12 deficiency; such a relationship is seldom studied in PCOS. We conducted this study to compare vitamin B12 levels among newly diagnosed and metformin-treated patients with PCOS. Methodology This cross‑sectional comparative study was conducted from July 2021 to June 2022, among patients with PCOS attending a specialized endocrinology clinic of a tertiary hospital in Mymensingh, Bangladesh. A total of 50 patients newly diagnosed with PCOS and 52 with PCOS who had received metformin for at least six months were evaluated. The serum vitamin B12 level was measured by utilizing the chemiluminescent microparticle immunoassay principle. Results The new drug-naïve and metformin-treated subjects with PCOS had similar clinical and laboratory parameters except for the metformin group’s lower hemoglobin levels and higher plateletcrit. Metformin receivers had lower serum vitamin B12 levels than the drug-naïve subjects (385.5 pg/mL [interquartile range, or IQR, 298.7-535.2] vs. 272.0 pg/mL [IQR 217.0-395.7]; P < 0.001). The metformin group had higher frequencies of B12 deficiency and borderline deficiency (15.4% vs. 6% and 42.3% vs. 18%, respectively; P = 0.003). Conclusions This study observed lower serum B12 levels in PCOS patients using metformin than in the newly diagnosed ones. Large-scale data are needed to recommend routine periodic screening for B12 levels in metformin-treated PCOS.
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Chiaffarino F, Cipriani S, Dalmartello M, Ricci E, Esposito G, Fedele F, La Vecchia C, Negri E, Parazzini F. Prevalence of Polycystic Ovary Syndrome in European countries and USA: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2022; 279:159-170. [DOI: 10.1016/j.ejogrb.2022.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/04/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022]
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Walters KA, Moreno-Asso A, Stepto NK, Pankhurst MW, Rodriguez Paris V, Rodgers RJ. Key signalling pathways underlying the aetiology of polycystic ovary syndrome. J Endocrinol 2022; 255:R1-R26. [PMID: 35980384 DOI: 10.1530/joe-22-0059] [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: 06/09/2022] [Accepted: 07/11/2022] [Indexed: 11/08/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine condition characterised by a range of reproductive, endocrine, metabolic and psychological abnormalities. Reports estimate that around 10% of women of reproductive age are affected by PCOS, representing a significant prevalence worldwide, which poses a high economic health burden. As the origin of PCOS remains largely unknown, there is neither a cure nor mechanism-based treatments leaving patient management suboptimal and focused solely on symptomatic treatment. However, if the underlying mechanisms underpinning the development of PCOS were uncovered then this would pave the way for the development of new interventions for PCOS. Recently, there have been significant advances in our understanding of the underlying pathways likely involved in PCOS pathogenesis. Key insights include the potential involvement of androgens, insulin, anti-Müllerian hormone and transforming growth factor beta in the development of PCOS. This review will summarise the significant scientific discoveries on these factors that have enhanced our knowledge of the mechanisms involved in the development of PCOS and discuss the impact these insights may have in shaping the future development of effective strategies for women with PCOS.
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Affiliation(s)
- Kirsty A Walters
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Alba Moreno-Asso
- Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
- Australian Institute of Musculoskeletal Science, Victoria University, St. Albans, Victoria, Australia
| | - Nigel K Stepto
- Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
- Australian Institute of Musculoskeletal Science, Victoria University, St. Albans, Victoria, Australia
- Monash Centre for Health Research and Implementation, Monash University and Monash Health, Clayton, Victoria, Australia
- Medicine at Western Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Michael W Pankhurst
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Valentina Rodriguez Paris
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Raymond J Rodgers
- The Robinson Research Institute, School of Biomedicine, The University of Adelaide, Adelaide, South Australia, Australia
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Acupuncture Improves Endometrial Angiogenesis by Activating PI3K/AKT Pathway in a Rat Model with PCOS. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1790041. [PMID: 36062171 PMCID: PMC9433287 DOI: 10.1155/2022/1790041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/20/2022] [Accepted: 08/09/2022] [Indexed: 11/17/2022]
Abstract
Background. Acupuncture, a treatment derived from traditional Chinese medicine, can effectively relieve the symptoms and improve pregnancy outcome in patients with polycystic ovary syndrome (PCOS); however, its mechanism remains unclear. This study aimed at investigating whether acupuncture could improve endometrial angiogenesis and thus endometrial receptivity via activating PI3K/AKT pathway in PCOS rats. Methods. We established a rat model with PCOS, which was induced by DHEA. Acupuncture was performed every other day for 15 days, and the PI3K inhibitor (LY294002) was intraperitoneal injected 30 mins before acupuncture treatment. Females rats were mated with male SPF SD rats in a ratio of 2 : 1 after treatment and sacrificed on the 5th day when the vaginal plug was identified. The number of implantation sites was observed, followed by ovarian and endometrial morphology detected with hematoxylin-eosin staining and a scanning electron microscope, estrous cycle detected with vaginal smear analysis, and sex hormones and angiogenesis-related PI3K/AKT gene/protein expression detected with enzyme-linked immunosorbent assay, western blotting, immune histochemistry, and quantitative real-time PCR. Results. Acupuncture notably improved implantation sites’ number, endometrial receptivity factors including endometrial morphology, pinopodes, HOX-10, and LIF protein expression, as well as angiogenesis and PI3K/AKT pathway factors such as VEGF, VEGFR2, Ang-1, PI3K, AKT, and P-AKT gene/protein expression and the level of eNOS and NO in the endometrium of rats with PCOS; PCOS-like symptoms were alleviated as well. The efficacy of acupuncture on a rat model with PCOS was counteracted by the combination with the PI3K inhibitor. Conclusion. Acupuncture improves endometrial angiogenesis by activating the PI3K/AKT pathway, thus promoting endometrial receptivity and the number of implantation sites in rats with PCOS.
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Guo Y, Liu Y, Yan X, Ding R, Wang L. Effects of multidimensional life management on healthy behavior in polycystic ovary syndrome patients: A randomized controlled trial. Front Psychol 2022; 13:918991. [PMID: 36059725 PMCID: PMC9434338 DOI: 10.3389/fpsyg.2022.918991] [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: 04/14/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To confirm the effects of a transtheoretical model (TTM) based on multidimensional life management on healthy behavior in patients with polycystic ovary syndrome (PCOS). Methods In total, eighty eligible patients were recruited from March 2021 to June 2021 and randomly assigned to either the intervention (n = 40) or control (n = 40) groups. Outcome measures include health-promoting behavior, self-efficacy, anthropometrics, and the number of unplanned outpatient admissions. Data were collected at baseline, 3, and 6 months after the intervention. The chi-square test, rank-sum test, t-test, and repeated measurement analysis of variance (ANOVA) were used to analyze the data. Results In total, sixty-six participants completed the study: 35 participants in the intervention group and 31 participants in the control group. After 6 months of intervention, the healthy behavior level of patients with PCOS increased from moderate [health-promoting lifestyle profile (HPLP)-II score of 105.37 ± 12.57] to good (156.94 ± 19.36) in the intervention group; and there was no change observed in the control group. In addition, the total self-efficacy score (p < 0.001), PCOS-related unplanned outpatient admissions (p = 0.008), waist circumference (WC) (p = 0.016), and body mass index (BMI) (p = 0.011) were found to have a significant difference in the intervention group at 6 months. Meanwhile, repeated measures analysis of variance showed a significantly greater improvement in health-promoting behavior and self-efficacy over time in the intervention group than in the control group (p < 0.001). Conclusion The transtheoretical model based on multidimensional life management positively affected healthy behavior, self-efficacy, the number of unplanned outpatient admissions, and anthropometrics in patients with PCOS. Clinical Trial Registration www.chictr.org.cn, ChiCTR2000034572.
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Affiliation(s)
- Yunmei Guo
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Nursing College, Zunyi Medical University, Zunyi, China
| | - Ying Liu
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Nursing College, Zunyi Medical University, Zunyi, China
| | - Xin Yan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Nursing College, Zunyi Medical University, Zunyi, China
| | - Rui Ding
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Nursing College, Zunyi Medical University, Zunyi, China
| | - LianHong Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Nursing College, Zunyi Medical University, Zunyi, China
- *Correspondence: LianHong Wang
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Zhao J, Sui X, Shi Q, Su D, Lin Z. Effects of antioxidant intervention in patients with polycystic ovarian syndrome: A systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e30006. [PMID: 35960093 PMCID: PMC9371494 DOI: 10.1097/md.0000000000030006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The role of antioxidant intervention in polycystic ovary syndrome (PCOS) patients has been increasingly investigated in recent years. In order to further clarify whether antioxidant therapy is beneficial for PCOS patients and the emphasis of its effects, this study provides a systematic review and meta-analysis of randomized controlled trials examining the effect of antioxidant intervention on PCOS. METHODS Enrolled study designs related to antioxidant interventions and PCOS, published from 1999 to 2020, were searched from EMBASE, PubMed, and Web of Science databases to sort out proven studies on antioxidant interventions and PCOS. Data were reported as weighted mean difference (WMD) or standard mean difference with associated confidence intervals of 95%. The analysis was conducted using Stata version 16.0. RESULTS Twenty-three studies were included in total. Antioxidant intervention had a positive impact on homeostasis model assessment of insulin resistance (WMD = -0.37, P = .011) and Triglycerides (WMD = -25.51, P < .001). And antioxidant intervention did not improve testosterone levels significantly (WMD = -0.20, P = .2611). Subgroup analysis showed that except for the D-chiro-inosito subgroup, no difference in body mass index was observed between the intervention group and the control group. CONCLUSIONS This meta-analysis demonstrates the efficacy of antioxidant intervention in patients with PCOS, demonstrating that antioxidant intervention has a significant effect on insulin resistance and lipid metabolism improvement. However, antioxidant intervention therapy has no discernible impact on testosterone levels or body mass index. Omega-3 may be a more effective antioxidant intervention for PCOS. In addition, this meta-analysis provides important reference opinions and treatment recommendations for PCOS.
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Affiliation(s)
- Junde Zhao
- Shandong University of Traditional Chinese Medicine, JinanShandong, China
| | - Xiaohui Sui
- Shandong University of Traditional Chinese Medicine, JinanShandong, China
| | - Qingyu Shi
- Shandong University of Finance and Economics, JinanShandong, China
| | - Dan Su
- People’s Hospital of Lixia District of Jinan, Jinan, Shandong, China
| | - Zhiheng Lin
- Shandong University of Traditional Chinese Medicine, JinanShandong, China
- *Correspondence: Zhiheng Lin, Shandong University of Traditional Chinese Medicine, 16369 Jingshi Road, Lixia District, Jinan, Shandong, China (e-mail: )
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Objectification and ambiguity of body image in women with Polycystic Ovary Syndrome: A mixed-method study. J Affect Disord 2022; 310:296-303. [PMID: 35561883 DOI: 10.1016/j.jad.2022.05.028] [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: 11/01/2021] [Revised: 04/18/2022] [Accepted: 05/05/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND The manifestations of Polycystic Ovary Syndrome (PCOS), including acne, hirsutism, obesity, uncertain fertility, etc., can make women anxious, worried, or even depressed with their appearance and body. However, little relevant research has been conducted in the Chinese context. This mixed-method study aimed to understand how women with PCOS in China perceive their bodies and to examine the association between body image and depression. METHODS First, 101 PCOS patients participated in a survey using the Body Surveillance subscale of the Objectified Body Consciousness Scale, the Short-form Mishel Uncertainty in Illness Scale, the Appearance Anxiety Scale, and the Beck Depression Inventory-II, which measured participants' self-objectification, illness ambiguity, appearance anxiety, and depression, respectively. Second, fifteen women joined face-to-face semi-structured in-depth interviews, investigating their illness ambiguity, objectified experience, and behaviors to pursue beauty. RESULTS Results indicated a high level of self-objectification, illness ambiguity, appearance anxiety, and depression among women with PCOS in China and supported the significant associations among the outcomes. Qualitative findings presented a body image of the precarious body, indiscernible identity, and distraught mind. LIMITATIONS A convenient sampling method was used. The generalization of the study results needs further validation. Future longitudinal studies are necessary to clarify the causal relationships among outcomes. CONCLUSIONS This study presented women's body image with PCOS and found the negative impact of body image on their depression levels. This study was of both theoretical and practical significance. Appropriate mind-body therapies were suggested for them.
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Xiong T, Rodriguez Paris V, Edwards MC, Hu Y, Cochran BJ, Rye KA, Ledger WL, Padmanabhan V, Handelsman DJ, Gilchrist RB, Walters KA. Androgen signaling in adipose tissue, but less likely skeletal muscle, mediates development of metabolic traits in a PCOS mouse model. Am J Physiol Endocrinol Metab 2022; 323:E145-E158. [PMID: 35658542 DOI: 10.1152/ajpendo.00418.2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a common, multifactorial disorder characterized by endocrine, reproductive, and metabolic dysfunction. As the etiology of PCOS is unknown, there is no cure and symptom-oriented treatments are suboptimal. Hyperandrogenism is a key diagnostic trait, and evidence suggests that androgen receptor (AR)-mediated actions are critical to PCOS pathogenesis. However, the key AR target sites involved remain to be fully defined. Adipocyte and muscle dysfunction are proposed as important sites involved in the manifestation of PCOS traits. We investigated the role of AR signaling in white adipose tissue (WAT), brown adipose tissue (BAT), and skeletal muscle in the development of PCOS in a hyperandrogenic PCOS mouse model. As expected, dihydrotestosterone (DHT) exposure induced key reproductive and metabolic PCOS traits in wild-type (WT) females. Transplantation of AR-insensitive (AR-/-) WAT or BAT from AR knockout females (ARKO) into DHT-treated WT mice ameliorated some metabolic PCOS features, including increased body weight, adiposity, and adipocyte hypertrophy, but not reproductive PCOS traits. In contrast, DHT-treated ARKO female mice transplanted with AR-responsive (AR+/+) WAT or BAT continued to resist developing PCOS traits. DHT-treated skeletal muscle-specific AR knockout females (SkMARKO) displayed a comparable phenotype with that of DHT-treated WT females, with full development of PCOS traits. Taken together, these findings infer that both WAT and BAT, but less likely skeletal muscle, are key sites of AR-mediated actions involved in the experimental pathogenesis of metabolic PCOS traits. These data further support targeting adipocyte AR-driven pathways in future research aimed at developing novel therapeutic interventions for PCOS.NEW & NOTEWORTHY Hyperandrogenism is a key feature in the pathogenesis of polycystic ovary syndrome (PCOS); however, the tissue sites of androgen receptor (AR) signaling are unclear. In this study, AR signaling in white and brown adipose tissue, but less likely in skeletal muscle, was found to be involved in the development of metabolic PCOS traits, highlighting the importance of androgen actions in adipose tissue and obesity in the manifestation of metabolic disturbances.
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Affiliation(s)
- Ting Xiong
- Fertility and Research Centre, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Valentina Rodriguez Paris
- Fertility and Research Centre, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Melissa C Edwards
- Fertility and Research Centre, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Ying Hu
- Fertility and Research Centre, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Blake J Cochran
- Lipid Research Group, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Kerry-Anne Rye
- Lipid Research Group, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - William L Ledger
- Fertility and Research Centre, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | | | - David J Handelsman
- Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Robert B Gilchrist
- Fertility and Research Centre, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Kirsty A Walters
- Fertility and Research Centre, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia
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