1
|
Soumya V, Deepa S, Thachil KK, Saravanan J, Hariprasad R. GC-MS analysis and in silico docking of constituents of Cinnamomum malabatrum against CYP450 17α and CYP450 19 (Aromatase)- Key targets for hyperandrogenism. Drug Res (Stuttg) 2023; 73:441-447. [PMID: 37591259 DOI: 10.1055/a-2142-5774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Poly cystic ovary syndrome (PCOS) is considered as one of the common hormonal disorders affecting 6-20% of women in their reproductive age with characteristic features include anovulatory infertility, hyperandrogenism, cystic follicles and insulin resistance. The gene CYP play an important role in pathophysiology of hyperandrogenism associated with PCOS. An elevated androgens are reported in PCOS condition due to overexpression of the enzyme CYP450 17 α: . As well as diminished levels of aromatase (CYP450 19) were observed in several hyperandrogenic PCOS patients. The powdered leafy material of Cinnamomum malabatrum was subjected to Soxhlet extraction. The plant extract was subjected to Gas chromatography-MS analysis (GC-MS), and the chromatogram obtained revealed the presence of active chemical constituents like 1(10),9(11)-B-Homolanistadiene for the first time and other potential compounds. Hypothesis has raised to interpret the efficiency of phytoconstituents of Cinnamomum malabatrum on these enzyme targets and which may be a novel drug candidate for the treatment and maintenance of hyperandrogenism associated with PCOS. Thus, the results obtained from the in-silico study of Cinnamomum malabatrum leaf extract using computational approaches indicate that the phytoconstituents have good affinities for the selected two key targets. ADME and PASS studies has been performed for active phytoconstituents homolanistadiene, β-sitosterol, cycloartenol and a pyrazole derivative, and results revealed the Lipinski drug-likeness and pharmacological potential. In conclusion, this work throws a new insight into the possibility of the active phytoconstituents on binding the two active CYP45017 α and CYP45019 aromatase enzymes which facilitates development of novel compounds for hyperandrogenism associated with PCOS.
Collapse
Affiliation(s)
- V Soumya
- Department of Pharmaceutical chemistry, Faculty of pharmacy, Sri Ramachandra Institute of Higher Education and Research, SRMC(DU) Porur, Chennai, India
| | - S Deepa
- Department of Pharmaceutical chemistry, Faculty of pharmacy, Sri Ramachandra Institute of Higher Education and Research, SRMC(DU) Porur, Chennai, India
| | - Knolin K Thachil
- Department of Pharmaceutical chemistry, Faculty of Pharmacy, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - J Saravanan
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Ooty, India
| | - R Hariprasad
- Department of Pharmaceutics, PSG College of Pharmacy, Peelamedu, Coimbatore, India
| |
Collapse
|
2
|
Babapour M, Mohammadi H, Kazemi M, Hadi A, Rezazadegan M, Askari G. Associations Between Serum Magnesium Concentrations and Polycystic Ovary Syndrome Status: a Systematic Review and Meta-analysis. Biol Trace Elem Res 2021; 199:1297-1305. [PMID: 32812171 DOI: 10.1007/s12011-020-02275-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/29/2020] [Indexed: 12/11/2022]
Abstract
Magnesium (Mg) is the second most frequent intracellular cation in humans with a critical role in insulin metabolism and glucoregulation. Women with polycystic ovary syndrome (PCOS) often present with insulin resistance and impaired glucoregulatory status; however, their Mg status remains unclear. Therefore, we aimed to conduct a systematic review and meta-analysis to evaluate serum Mg concentration in women with PCOS and compare it with that of controls without PCOS. Online databases of PubMed, Scopus, Cochrane Library, and ISI Web of Science were searched for studies evaluating the relationship between Mg concentrations and PCOS status until October 2019. Pooled weighted mean differences (WMDs) of serum Mg levels were calculated using random effects models. A total of eight studies (10 arms; n = 2026 women) were included. Pooled effect sizes, expressed as WMD and 95% CI, revealed decreased serum Mg concentrations in women with PCOS compared with controls (- 0.09 (- 0.17, - 0.02) mmol/L; P = 0.01). However, significant heterogeneity was detected across the studies (I 2 = 98.0%, P < 0.001). Despite the classification of studies based on baseline BMI classes, we did not detect the potential source of the observed heterogeneity. Subgroup analysis showed that overweight and obese women (BMI ≥ 25 kg/m2, 0.07 mmol/L (- 0.14, - 0.01); P = 0.02) with PCOS had lower magnesium concentrations than normal women (BMI < 25 kg/m2, - 0.11 (- 0.25, 0.04) mmol/L; P = 0.14) compared with the control group. Serum Mg concentrations appear to be declined in overweight or obese women with PCOS, which may warrant screening and management of Mg status in this clinical population. High-quality studies are needed to elucidate the relationship between Mg concentrations and the development of PCOS.
Collapse
Affiliation(s)
- Maedeh Babapour
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamed Mohammadi
- Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, PO Box 81745, Isfahan, Iran
| | - Maryam Kazemi
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
| | - Amir Hadi
- Halal Research Center of IRI, FDA, Tehran, Iran
| | - Mahsa Rezazadegan
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Askari
- Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, PO Box 81745, Isfahan, Iran.
| |
Collapse
|
3
|
Panjeshahin A, Salehi-Abargouei A, Anari AG, Mohammadi M, Hosseinzadeh M. Association between empirically derived dietary patterns and polycystic ovary syndrome: A case-control study. Nutrition 2020; 79-80:110987. [DOI: 10.1016/j.nut.2020.110987] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 08/01/2020] [Accepted: 08/20/2020] [Indexed: 02/06/2023]
|
4
|
Kwon CY, Cho IH, Park KS. Therapeutic Effects and Mechanisms of Herbal Medicines for Treating Polycystic Ovary Syndrome: A Review. Front Pharmacol 2020; 11:1192. [PMID: 32903374 PMCID: PMC7434855 DOI: 10.3389/fphar.2020.01192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/22/2020] [Indexed: 12/19/2022] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is one of the most common disorders of endocrinology in reproductive-age women. In this study, we reviewed data on the effects and underlying mechanisms of herbal medicines used in the treatment of PCOS in laboratory studies. Methods Articles published in English up to June 30, 2018 were searched in Medline and EMBASE. We extracted data regarding herbal intervention; target cell (or animal model) usage; method of herbal extraction; route of administration; dosage and periods; and outcomes of the compounds isolated from herbs, individual herbal extracts, and herbal formula decoctions. We summarized the actions and the mechanisms underlying the beneficial effects of herbal medicines on PCOS. Results A total of 27 studies involving 22 herbal medicines reported their efficacy on PCOS. The herbal interventions in the 27 studies comprised four compounds isolated from herbs (6 studies), nine individual herbal extracts (11 studies), and nine herbal formula decoctions (10 studies). Herbal medicines normalized female hormones, diminished male hormones, recovered the estrous cycle, ameliorated insulin resistance, and improved lipid metabolism in PCOS. The mechanisms underlying the beneficial effects of herbal medicines on PCOS were found to be associated with anti-inflammation, anti-oxidative stress, inhibition of autophagy and/or apoptosis, and ovarian nerve growth factor reduction. Conclusions Herbal medicines are thought to be promising resources in the development of effective therapeutic agents for PCOS. Further studies that include methodological quality assessment and quantitative synthesis of outcomes are recommended.
Collapse
Affiliation(s)
- Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, Busan, South Korea
| | - Ik-Hyun Cho
- Department of Convergence Medical Science, Brain Korea 21 Plus Program, and Institute of Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Kyoung Sun Park
- Jaseng Hospital of Korean Medicine, Seoul, South Korea.,Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, South Korea
| |
Collapse
|
5
|
Pourteymour Fard Tabrizi F, Hajizadeh-Sharafabad F, Vaezi M, Jafari-Vayghan H, Alizadeh M, Maleki V. Quercetin and polycystic ovary syndrome, current evidence and future directions: a systematic review. J Ovarian Res 2020; 13:11. [PMID: 32005271 PMCID: PMC6993490 DOI: 10.1186/s13048-020-0616-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 01/28/2020] [Indexed: 12/15/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a polygenic endocrine disorder and the most common gynecological endocrinopathy among reproductive-aged women. Current remedies are often used only to control its signs and symptoms, while they are not thoroughly able to prevent complications. Quercetin is an herbal bioactive flavonoid commonly used for the treatment of metabolic and inflammatory disorders. Thus, this systematic review was conducted to evaluate the efficacy of quercetin supplementation in subjects with PCOS. Databases until March 2019 were searched. All human clinical trials and animal models evaluating the effects of quercetin on PCOS women were included. Out of 253 articles identified in our search, 8 eligible articles (5 animal studies and 3 clinical trials) were reviewed. The majority of studies supported the beneficial effects of quercetin on the ovarian histomorphology, folliculogenesis, and luteinisation processes. The effects of quercetin on reducing the levels of testosterone, luteinizing hormone (LH), and insulin resistance were also reported. Although quercetin improved dyslipidemia, no significant effect was reported for weight loss. It is suggested that the benefits of quercetin may be more closely related to antioxidant and anti-inflammatory features of quercetin rather than weight-reducing effects. Therefore, this review article provides evidence that quercetin could be considered as a potential agent to attenuate PCOS complications. However, due to the paucity of high-quality clinical trials, further studies are needed.
Collapse
Affiliation(s)
| | - Fatemeh Hajizadeh-Sharafabad
- Student Research Committee, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Vaezi
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Obstetrics and Gynecology, AL Zahra Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Mohammad Alizadeh
- Nutrition Research Center, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran. .,Department of Clinical Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Vahid Maleki
- Student Research Committee, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran. .,Nutrition Research Center, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran. .,Department of Clinical Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran.
| |
Collapse
|
6
|
Bevilacqua A, Bizzarri M. Inositols in Insulin Signaling and Glucose Metabolism. Int J Endocrinol 2018; 2018:1968450. [PMID: 30595691 PMCID: PMC6286734 DOI: 10.1155/2018/1968450] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 10/03/2018] [Accepted: 11/07/2018] [Indexed: 12/25/2022] Open
Abstract
In the past decades, both the importance of inositol for human health and the complex interaction between glucose and inositol have been the subject of increasing consideration. Glucose has been shown to interfere with cellular transmembrane transport of inositol, inhibiting, among others, its intestinal absorption. Moreover, intracellular glucose is required for de novo biosynthesis of inositol through the inositol-3-phosphate synthase 1 pathway, while a few glucose-related metabolites, like sorbitol, reduce intracellular levels of inositol. Furthermore, inositol, via its major isomers myo-inositol and D-chiro-inositol, and probably some of its phosphate intermediate metabolites and correlated enzymes (like inositol hexakisphosphate kinase) participate in both insulin signaling and glucose metabolism by influencing distinct pathways. Indeed, clinical data support the beneficial effects exerted by inositol by reducing glycaemia levels and hyperinsulinemia and buffering negative effects of sustained insulin stimulation upon the adipose tissue and the endocrine system. Due to these multiple effects, myoIns has become a reliable treatment option, as opposed to hormonal stimulation, for insulin-resistant PCOS patients.
Collapse
Affiliation(s)
- Arturo Bevilacqua
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, via dei Marsi 78, 00185 Rome, Italy
- Center for Research in Neurobiology “Daniel Bovet” (CRiN), Sapienza University of Rome, 00185 Rome, Italy
| | - Mariano Bizzarri
- Department of Experimental Medicine, Systems Biology Group Lab, Sapienza University of Rome, via A. Scarpa 16, 00161 Rome, Italy
| |
Collapse
|
7
|
Dinicola S, Chiu TTY, Unfer V, Carlomagno G, Bizzarri M. The rationale of the myo-inositol and D-chiro-inositol combined treatment for polycystic ovary syndrome. J Clin Pharmacol 2014; 54:1079-92. [PMID: 25042908 DOI: 10.1002/jcph.362] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 07/10/2014] [Indexed: 01/11/2023]
Abstract
PCOS is one of the most common endocrine disorders affecting women and it is characterized by a combination of hyper-androgenism, chronic anovulation, and insulin resistance. While a significant progress has recently been made in the diagnosis for PCOS, the optimal infertility treatment remains to be determined. Two inositol isomers, myo-inositol (MI) and D-chiro-inositol (DCI) have been proven to be effective in PCOS treatment, by improving insulin resistance, serum androgen levels and many features of the metabolic syndrome. However, DCI alone, mostly when it is administered at high dosage, negatively affects oocyte quality, whereas the association MI/DCI, in a combination reproducing the plasma physiological ratio (40:1), represents a promising alternative in achieving better clinical results, by counteracting PCOS at both systemic and ovary level.
Collapse
Affiliation(s)
- Simona Dinicola
- Dept of Experimental Medicine, Systems Biology Group, University La Sapienza, Roma, Italy
| | | | | | | | | |
Collapse
|
8
|
Artini PG, Di Berardino OM, Papini F, Genazzani AD, Simi G, Ruggiero M, Cela V. Endocrine and clinical effects of myo-inositol administration in polycystic ovary syndrome. A randomized study. Gynecol Endocrinol 2013; 29:375-9. [PMID: 23336594 DOI: 10.3109/09513590.2012.743020] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To evaluate the effects the administration of myo-inositol (MYO) on hormonal parameters in a group of polycystic ovary syndrome (PCOS) patients. DESIGN Controlled clinical study. SETTING PCOS patients in a clinical research environment. PATIENTS 50 overweight PCOS patients were enrolled after informed consent. INTERVENTIONS All patients underwent hormonal evaluations and an oral glucose tolerance test (OGTT) before and after 12 weeks of therapy (Group A (n¼10): MYO 2 g plus folic acid 200 mg every day; Group B (n¼10): folic acid 200 mg every day). Ultrasound examinations and Ferriman-Gallwey score were also performed. MAIN OUTCOME MEASURES Plasma LH, FSH, PRL, E2, 17OHP, A, T, glucose, insulin, C peptide concentrations, BMI, HOMA index and glucose-to-insulin ratio. RESULTS After 12 weeks of MYO administration plasma LH, PRL, T, insulin levels and LH/FSH resulted significantly reduced. Insulin sensitivity, expressed as glucose-to-insulin ratio and HOMA index resulted significantly improved after 12 weeks of treatment. Menstrual cyclicity was restored in all amenorrheic and oligomenorrheic subjects. No changes occurred in the patients treated with folic acid. CONCLUSIONS MYO administration improves reproductive axis functioning in PCOS patients reducing the hyperinsulinemic state that affects LH secretion.
Collapse
Affiliation(s)
- P G Artini
- Department of Reproductive Medicine and Child Development, Division of Obstetrics and Gynecology, University of Pisa, Pisa, Italy.
| | | | | | | | | | | | | |
Collapse
|
9
|
Tarkun I, Cetinarslan B, Türemen E, Cantürk Z, Biyikli M. Association between Circulating Tumor Necrosis Factor-Alpha, Interleukin-6, and Insulin Resistance in Normal-Weight Women with Polycystic Ovary Syndrome. Metab Syndr Relat Disord 2012; 4:122-8. [PMID: 18370758 DOI: 10.1089/met.2006.4.122] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Insulin resistance is a common finding in both obese and lean women with polycystic ovary syndrome (PCOS). Factors contributing to insulin resistance are still controversial. The purpose of the study was to compare the tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) concentrations in normal weight women with PCOS and a weightmatched healthy control group, and also to evaluate the role of these cytokines in the pathogenesis of insulin resistance. METHODS Thirty-two women with PCOS and 25 age- and weight-matched healthy controls participated in this study. Patients were evaluated clinically and by pelvic ultrasound. Fasting insulin, glucose, lipid profile, follicle-stimulating hormone (FSH), leutinizing hormone (LH), prolactin, testosterone, sex hormone binding globulin (SHBG), 17-hydroxyprogesterone, IL-6, TNF-alpha concentrations, and insulin sensitiviy indices homeostasis model assessment (HOMA) and quantitative insulin sensitivity check index (QUICKI) were measured. RESULTS TNF-alpha and IL-6 concentrations were significantly higher in women with PCOS than in the control group. Significant correlations were found between TNF-alpha serum concentrations and Body Mass Index (BMI), waist circumference, triglyceride concentrations, fasting insulin, and insulin resisitance indices (p < 0.001). IL-6 concentrations were correlated with fasting glucose and insulin resistance (p < 0.05). CONCLUSIONS The study demonstrated that TNF-alpha and IL-6 concentrations were elevated in normal weight women with PCOS. The findings may contribute to evidence of insulin resistance in lean women with PCOS.
Collapse
Affiliation(s)
- Ilhan Tarkun
- Department of Endocrinology and Metabolism, Kocaeli University Hospital, Kocaeli, Turkey
| | | | | | | | | |
Collapse
|
10
|
Unfer V, Carlomagno G, Dante G, Facchinetti F. Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials. Gynecol Endocrinol 2012; 28:509-15. [PMID: 22296306 DOI: 10.3109/09513590.2011.650660] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) affects 5%-10% of women in reproductive age, and it is the most common cause of infertility due to ovarian dysfunction and menstrual irregularity. Several studies have reported that insulin resistance is common in PCOS women, regardless of the body mass index. The importance of insulin resistance in PCOS is also suggested by the fact that insulin-sensitizing compounds have been proposed as putative treatments to solve the hyperinsulinemia-induced dysfunction of ovarian response to endogenous gonadotropins. Rescuing the ovarian response to endogenous gonadotropins reduces hyperandrogenemia and re-establishes menstrual cyclicity and ovulation, increasing the chance of a spontaneous pregnancy. Among the insulin-sensitizing compounds, there is myo-inosiol (MYO). Previous studies have demonstrated that MYO is capable of restoring spontaneous ovarian activity, and consequently fertility, in most patients with PCOS. With the present review, we aim to provide an overview on the clinical outcomes of the MYO use as a treatment to improve ovarian function and metabolic and hormonal parameters in women with PCOS.
Collapse
Affiliation(s)
- V Unfer
- Gynecology Association Unfer Costabile, Obstetrics and Gynecology Center, Rome, Italy.
| | | | | | | |
Collapse
|
11
|
Genazzani AD, Lanzoni C, Ricchieri F, Jasonni VM. Myo-inositol administration positively affects hyperinsulinemia and hormonal parameters in overweight patients with polycystic ovary syndrome. Gynecol Endocrinol 2008; 24:139-44. [PMID: 18335328 DOI: 10.1080/09513590801893232] [Citation(s) in RCA: 114] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To evaluate the effects the administration of myo-inositol (MYO) on hormonal parameters in a group of PCOS patients. DESIGN Controlled clinical study. SETTING PCOS patients in a clinical research environment. PATIENTS 20 overweight PCOS patients were enrolled after informed consent. INTERVENTIONS All patients underwent hormonal evaluations and an oral glucose tollerance test (OGTT) before and after 12 weeks of therapy (Group A (n = 10): myo-inositol 2 gr. plus folic acid 200 mug every day; Group B (n = 10): folic acid 200 mug every day). Ultrasound examinations and Ferriman-Gallwey score were also performed. MAIN OUTCOME MEASURES Plasma LH, FSH, PRL, E2, 17OHP, A, T, glucose, insulin, C peptide concentrations, BMI, HOMA index and glucose-to-insulin ratio. RESULTS After 12 weeks of MYO administration plasma LH, PRL, T, insulin levels and LH/FSH resulted significantly reduced. Insulin sensitivity, expressed as glucose-to-insulin ratio and HOMA index resulted significantly improved after 12 weeks of treatment. Menstrual cyclicity was restored in all amenorrheic and oligomenorrheic subjects. No changes occurred in the patients treated with folic acid. CONCLUSIONS Myo-inositol administration improves reproductive axis functioning in PCOS patients reducing the hyperinsulinemic state that affects LH secretion.
Collapse
|
12
|
Zanolin ME, Tosi F, Zoppini G, Castello R, Spiazzi G, Dorizzi R, Muggeo M, Moghetti P. Clustering of cardiovascular risk factors associated with the insulin resistance syndrome: assessment by principal component analysis in young hyperandrogenic women. Diabetes Care 2006; 29:372-8. [PMID: 16443890 DOI: 10.2337/diacare.29.02.06.dc05-1478] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Hyperinsulinemia is often associated with several metabolic abnormalities and increased blood pressure, which are risk factors for cardiovascular disease. It has been hypothesized that insulin resistance may underlie all these features. However, recent data suggest that some links between insulin resistance and these alterations may be indirect. The aim of our study was to further investigate this issue in a sample of young hyperandrogenic women, who often show insulin resistance and other metabolic abnormalities typical of the insulin resistance syndrome. RESEARCH DESIGN AND METHODS We tested the hypothesis of a single factor underlying these features by principal component analysis, which should recognize one component if a single mechanism explains this association. The analysis was carried out in a sample of 255 young nondiabetic hyperandrogenic women. Variables selected for this analysis included the basic features of the insulin resistance syndrome and some endocrine parameters related to hyperandrogenism. RESULTS Principal component analysis identified four separate factors, explaining 64.5% of the total variance in the data: the first included fasting and postchallenge insulin levels, BMI, triglycerides, HDL cholesterol, and uric acid; the second, BMI, blood pressure, and serum free testosterone; the third, fasting plasma glucose, postchallenge glucose and insulin levels, serum triglycerides, and free testosterone; and the fourth, postchallenge plasma insulin, serum free testosterone, and gonadotropin-releasing hormone agonist-stimulated 17-hydroxyprogesterone. CONCLUSIONS These results support the hypothesis of multiple determinants in the clustering of abnormalities in the so-called insulin resistance syndrome.
Collapse
Affiliation(s)
- M Elisabetta Zanolin
- Unit of Epidemiology and Medical Statistics, Department of Public Medicine and Health, University of Verona, Verona, Italy
| | | | | | | | | | | | | | | |
Collapse
|
13
|
|
14
|
Abstract
This review discusses the role of central obesity in polycystic ovary syndrome. There is increasing evidence that intraabdominal or visceral fat is either causative or a very early effect of polycystic ovary syndrome. The clinical implications of this are discussed. The simplest technique for assessing visceral fat and monitoring treatment is to measure waist circumference rather than waist:hip ratio or body weight. Weight loss is an effective treatment even where there is only a very modest reduction. The key element in lifestyle modification is regular exercise.
Collapse
Affiliation(s)
- Jonathan Lord
- South West Centre for Reproductive Medicine, Derriford Hospital, Plymouth, Devon PL6 8DH, UK
| | | |
Collapse
|
15
|
Bayram F, Unluhizarci K, Kelestimur F. Potential Utility of Insulin Sensitizers in the Treatment of Patients with Polycystic Ovary Syndrome. ACTA ACUST UNITED AC 2002; 1:45-53. [PMID: 15765620 DOI: 10.2165/00024677-200201010-00005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a form of functional ovarian hyperandrogenism. It is one of the most common endocrinologic disorders in women of reproductive age. Women with PCOS may present with menstrual irregularities, chronic anovulation, infertility, obesity and hyperandrogenism. PCOS is associated with insulin resistance and hyperinsulinemia in most, if not all, patients. Besides its gynecological manifestations, PCOS is also associated with increased metabolic and cardiovascular risks. These risks are strongly linked to insulin resistance, and during recent years a novel therapeutic approach using insulin-sensitizing agents has been extensively investigated. In most studies conducted to date, metformin and the thiazolidinedione agent troglitazone have resulted in improved insulin sensitivity, resumption of regular menses and decreased serum androgen levels. Insulin-sensitizing agents may be a useful adjuvant therapy for women with PCOS.
Collapse
Affiliation(s)
- Fahri Bayram
- Department of Endocrinology, Erciyes University Medical School, Kayseri, Turkey.
| | | | | |
Collapse
|