1
|
Moazzam A, Saleem A, Shah S, Hussain L, Baig MMFA, Alshammari A, Albekairi NA, Akhtar MF. A combination of gliclazide and metformin attenuates obesity-induced polycystic ovary syndrome in female Wistar rats. Heliyon 2024; 10:e29015. [PMID: 38596120 PMCID: PMC11002689 DOI: 10.1016/j.heliyon.2024.e29015] [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: 12/24/2023] [Revised: 03/18/2024] [Accepted: 03/28/2024] [Indexed: 04/11/2024] Open
Abstract
Presently, it is known that the progression of obesity concomitantly leads to polycystic ovary syndrome and infertility. This study aimed to evaluate the potential effects of metformin (M; insulin secretagogues) and gliclazide (G; insulin sensitizer) alone and their combination at different doses to treat obesity-induced PCOS. High high-fat diet was given to all female Wistar rats for nine weeks to induce obesity except for the normal control group which received a normal chow diet. Estradiol valerate (0.8 mg/kg) was also given to all obese rats to induce polycystic ovarian syndrome. After the induction, M (100, 300 mg/kg) and G (5, 10 mg/kg) were given orally either individually or in combination for 28 days. The notable (p < 0.0001) reduction in body weight and blood glucose level was observed in treatment groups in contrast to disease control (DCG). The marked (p < 0.05-0.0001) decrease in hemocylated hemoglobin, serum insulin, cholesterol, triglycerides, and testosterone was observed in treated groups, notably in combination groups (M100+G10 mg/kg) in contrast to DCG. There was a considerable (p < 0.01-0.0001) increase in progesterone E2, estradiol, luteinizing, and follicle-stimulating hormones in treated groups as compared to DCG. Treatment with M and G treated groups also exhibited marked (p < 0.05-0.0001) increases in SOD, CAT, and GSH while decreased in NO and MDA levels in ovary tissue as evidenced by the histological study of the ovary. Treatment with M and G alone and in combination significantly (p < 0.0001) restored the serum IL-6, NrF2, and NF-κB levels as compared to DCG. The results inveterate that the M and G combination (M100+G10, and M300+G10) was useful in treating obesity-induced infertility due to antioxidant properties, hypolipidemic effects, and modulation of inflammatory markers.
Collapse
Affiliation(s)
- Anam Moazzam
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore Campus, Lahore, 5400, Pakistan
| | - Ammara Saleem
- Department of Pharmacology, Government College University Faisalabad, Faisalabad, 38000, Pakistan
| | - Shahid Shah
- Department of Pharmacy Practice, Government College University, Faisalabad, 38000, Pakistan
| | - Liaqat Hussain
- Department of Pharmacology, Government College University Faisalabad, Faisalabad, 38000, Pakistan
| | | | - Abdulrahman Alshammari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Post Box 2455, Riyadh, 11451, Saudi Arabia
| | - Norah A. Albekairi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Post Box 2455, Riyadh, 11451, Saudi Arabia
| | - Muhammad Furqan Akhtar
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore Campus, Lahore, 5400, Pakistan
| |
Collapse
|
2
|
Alnaeem L, Alnasser M, AlAli Y, Almarri F, Al Sultan AA, Almuhaysin FA, Boubshait NA, Almulhim LA. Depression and Anxiety in Patients With Polycystic Ovary Syndrome: A Cross-Sectional Study in Saudi Arabia. Cureus 2024; 16:e51530. [PMID: 38170129 PMCID: PMC10760600 DOI: 10.7759/cureus.51530] [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] [Accepted: 12/31/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in females of childbearing age. It causes irregular menstruation, infertility, acne vulgaris, androgenic alopecia, and hirsutism. It is associated with a higher risk of mental disorders. This study aimed to determine the prevalence of depression and anxiety among females with PCOS and the factors associated with these disorders. METHODS This cross-sectional study was conducted between 15th January and 19th November 2023. We invited Saudi women to do an online survey. We sent the survey link privately, got their permission, and explained the research to ensure privacy and reliability. Females with a previous psychiatric history were excluded. Depression, Anxiety, and Stress Scale-21 Items (DASS-21) were used to assess depression, anxiety, and distress. One-way analysis of variance (ANOVA) and two-sample t-tests were used to identify determinants of depression and anxiety. RESULTS About 967 females participated, of whom 474 (49%) were married, and 358 (37%) had a healthy weight. About 367 (37.9%) of participants were diagnosed with PCOS, and it was associated with age (26-35 years), divorce, and family history of PCOS (p < 0.05). About 112 (30.5%) of PCOS patients experienced extremely severe depression, and 144 (39.2%) had extreme anxiety. People in the age range of 15-25 years had a higher risk of depression and stress (p < 0.05). Divorced participants faced a higher risk of depression, anxiety, and stress than singles (p < 0.05). Those advised on diet and healthy lifestyles exhibited a higher risk of depression, anxiety, and stress than those who were not (p < 0.05). Additionally, being overweight was associated with a higher risk of depression (p < 0.05). CONCLUSION The prevalence of PCOS was found to be 37.9% in our study, which may seem higher compared to the existing literature on PCOS. It is associated with being in the age group of 26-35 years, being divorced, and having a positive family history. Almost two-thirds of females with PCOS had depression, anxiety, and stress. Factors associated with the three disorders include divorce and management with diet and lifestyle modifications. Depression and stress were associated with young age. High body mass index (BMI) was associated with depression.
Collapse
Affiliation(s)
| | | | - Yaqin AlAli
- College of Medicine, King Faisal University, Al-Ahsa, SAU
| | | | | | | | | | | |
Collapse
|
3
|
ÇATAL A, KOVALAK EE. Evaluation of sestrin 2 and tribbles homolog 3 levels in obese and nonobese women with polycystic ovary syndrome. Turk J Med Sci 2023; 53:1697-1703. [PMID: 38813505 PMCID: PMC10760568 DOI: 10.55730/1300-0144.5738] [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: 08/24/2022] [Revised: 12/12/2023] [Accepted: 12/04/2023] [Indexed: 05/31/2024] Open
Abstract
Background/aim This study was designed to evaluate the relationship of two new biomarkers [tribbles homolog 3 (TRB3) and sestrin 2 levels], which were previously associated with obesity, with metabolic parameters in obese and nonobese women with polycystic ovary syndrome (PCOS). Materials and methods This cross-sectional case control study was conducted between September 2017 and August 2019 in the gynecology department of a tertiary referral hospital. The values of the plasma sestrin 2, TRB3, insulin, fasting plasma glucose, lipid profile, and homeostasis model assessment of insulin resistance (HOMA-IR) were compared in 90 obese women with PCOS (BMI > 30), 90 women with nonobese PCOS (BMI < 30), and 90 control patients (BMI < 30). Results The mean age of the study group consisting of all PCOS patients (26.11 ± 4.64 years) and the mean age of the control group (26.3 ± 4.4 years) were statistically similar (p = 0.239). The serum sestrin 2 values of the obese PCOS group were found to be statistically significantly lower than the control and non-obese PCOS groups (p = 0.001, p = 0.0001), while the sestrin 2 values of the nonobese PCOS group were found to be statistically significantly lower than the control group (p = 0.0001). The TRB3 values of the control group were found to be statistically significantly lower than the obese and nonobese PCOS groups (p = 0.0001), while the TRB3 values of the nonobese PCOS group were found to be statistically significantly lower than the obese PCOS group (p = 0.0001). A negative correlation was observed between the sestrin 2 level and BMI (r = -0.272 p = 0.0001), insulin (r = -0.261 p = 0.0001), and HOMA-IR levels (r = -0.250 p = 0.0001). A positive correlation was observed between the TRB3 values and TG (r = 0.248 p = 0.0001), and LDL-C values (r = 0.235 p = 0.0001). Conclusion According to the findings in this study, low sestrin 2 and high TRB3 levels may be related to impaired metabolic status in the obese PCOS group. Thus, it may be promising for the development of treatment of PCOS and associated metabolic disorder in the future.
Collapse
Affiliation(s)
- Ayşegül ÇATAL
- Department of Medical Biochemistry, University of Health Sciences, Bağcılar Training and Research Hospital, İstanbul,
Turkiye
| | - Evrim Ebru KOVALAK
- Department of Obstetrics and Gynecology, University of Health Sciences, Bağcılar Training and Research Hospital, İstanbul,
Turkiye
| |
Collapse
|
4
|
Rathi N, Reche A. Risk of Periodontal Diseases in Women With Polycystic Ovary Syndrome: An Overview. Cureus 2023; 15:e47169. [PMID: 38021744 PMCID: PMC10652058 DOI: 10.7759/cureus.47169] [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: 10/02/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most prevalent condition seen in reproductive-aged women, which has a negative impact on their health system. There is a serious concern for women having PCOS that they may experience long-term metabolic conditions. PCOS also has a negative impact on periodontium components such as gingiva, periodontal ligament (PDL), and alveolar bone. It has been said that there may be a bidirectional link between PCOS and periodontal diseases. Moreover, PCOS and periodontal disorders both have common risk factors. Periodontal diseases are exacerbated by systemic low-grade inflammation, including obesity, constant immunological imbalance, and oxidative stress caused by PCOS. On the other hand, periodontal diseases can also increase the risk of causing PCOS. According to recent data, women with PCOS may be more likely to suffer from periodontal diseases. A PubMed and Google Scholar search was conducted for literature relating to PCOS and its relationship with different comorbidities which also included periodontal disorders. Analyses were performed, and data was synthesized and assembled in a presentable form. Therefore, the focus of this review will be on the relationship between PCOS and periodontal disorders, as well as the risk factors for both. However, in order to establish a more distinct and solid link, more studies with a large sample size need to be done.
Collapse
Affiliation(s)
- Netal Rathi
- Public Health Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Amit Reche
- Public Health Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
5
|
Ghobrial S, Ott J, Steininger J, Dewailly D, Prager G. Outcome of Gastric Bypass Surgery on Patients with Polycystic Ovary Syndrome: A Review. J Clin Med 2023; 12:3940. [PMID: 37373633 DOI: 10.3390/jcm12123940] [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: 05/11/2023] [Revised: 05/28/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Polycystic ovary syndrome (PCOS), the most common endocrine disorder in women of reproductive age, is associated with obesity. The most effective method to achieve and maintain long-term weight loss is by the Roux-en-Y gastric bypass (RYGB). In this review, an overview about metabolic and PCOS-specific outcomes after RYGB in obese PCOS women is provided. The RYGB leads to an adequate excess weight loss and reduction in BMI in this patient population. Testosterone levels decline significantly at 6- and 12-months follow-up, as does the incidence of hirsutism and cycle irregularities. Data about fertility are scarce in this patient population. In conclusion, RYGB surgery seems to be an efficient treatment option for obese PCOS patients and leads to weight loss and improvements in metabolic parameters as well as in an improvement of PCOS-specific characteristics. However, larger prospective studies are warranted, which include all PCOS-specific outcome data in one patient population at the same time.
Collapse
Affiliation(s)
- Stefan Ghobrial
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Johannes Ott
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Johanna Steininger
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Didier Dewailly
- Faculty of Medicine, University of Lille, 59000 Lille, France
| | - Gerhard Prager
- Department of Surgery, Division of General Surgery, Medical University of Vienna, 1090 Vienna, Austria
| |
Collapse
|
6
|
Genazzani AD, Genazzani AR. Polycystic Ovary Syndrome as Metabolic Disease: New Insights on Insulin Resistance. TOUCHREVIEWS IN ENDOCRINOLOGY 2023; 19:71-77. [PMID: 37313240 PMCID: PMC10258623 DOI: 10.17925/ee.2023.19.1.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 02/28/2023] [Indexed: 06/15/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a very frequent disease that affects reproductive ability and menstrual regularity. Other than the criteria established at the Rotterdam consensus, in these last few years a new issue, insulin resistance, has been found frequently, and at a very high grade, in patients with PCOS. Insulin resistance occurs for several factors, such as overweight and obesity, but it is now clear that it occurs in patients with PCOS with normal weight, thus supporting the hypothesis that insulin resistance is independent of body weight. Evidence shows that a complex pathophysiological situation occurs that impairs post-receptor insulin signalling, especially in patients with PCOS and familial diabetes. In addition, patients with PCOS have a high incidence of non-alcoholic fatty liver disease related to the hyperinsulinaemia. This narrative review focuses on the recent new insights about insulin resistance in patients with PCOS, to better understand the metabolic impairment accounting for most of the clinical signs/symptoms of PCOS.
Collapse
Affiliation(s)
- Alessandro D Genazzani
- Gynaecological Endocrinology Center, Department of Obstetrics and Gynaecology, University of Modena and Reggio Emilia, Modena, Italy
| | - Andrea R Genazzani
- Department of Obstetrics and Gynaecology, University of Pisa, Pisa, Italy
| |
Collapse
|
7
|
Semaglutide and social media: implications for young women with polycystic ovarian syndrome. THE LANCET. CHILD & ADOLESCENT HEALTH 2023; 7:301-303. [PMID: 36803633 DOI: 10.1016/s2352-4642(23)00033-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/03/2023] [Accepted: 02/03/2023] [Indexed: 02/19/2023]
|
8
|
Han C, Li X, Wang S, Hong R, Ji J, Chen J, Zhu H, Morrison ER, Lei X. The picky men: Men's preference for women's body differed among attractiveness, health, and fertility conditions. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023. [DOI: 10.1016/j.paid.2022.111921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
9
|
Greff D, Juhász AE, Váncsa S, Váradi A, Sipos Z, Szinte J, Park S, Hegyi P, Nyirády P, Ács N, Várbíró S, Horváth EM. Inositol is an effective and safe treatment in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. Reprod Biol Endocrinol 2023; 21:10. [PMID: 36703143 PMCID: PMC9878965 DOI: 10.1186/s12958-023-01055-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/03/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Metformin is the gold standard insulin sensitizer, which is widely used to treat insulin resistance in polycystic ovary syndrome (PCOS). However, metformin may induce gastrointestinal side effects. OBJECTIVE Inositols have long been debated as a potential alternative for metformin in treating PCOS. Therefore, the present systematic review aimed to evaluate the efficacy and safety of inositols in treating PCOS. METHODS The present systematic search was performed in CENTRAL, MEDLINE, and Embase from the inception until October 20th, 2021. Eligible randomized controlled trials (RCTs) included women diagnosed with PCOS and compared any inositols with metformin or placebo. Our primary outcome was cycle normalization, whereas secondary outcomes were body mass index (BMI), parameters of carbohydrate metabolism and clinical and laboratory hyperandrogenism. Results are reported as risk ratios or mean differences (MDs) with 95% confidence intervals (CIs). RESULTS Twenty-six RCTs were identified, including data of 1691 patients (806 inositol, 311 with placebo, and 509 metformin groups). In patients treated with inositols, the risk (CI: 1.13; 2.85) of having a regular menstrual cycle was found by 1.79 higher than in the case of placebo. Moreover, the inositols showed non-inferiority compared to metformin in this outcome. In the case of BMI (MD = -0.45; CI: -0.89; -0.02), free testosterone (MD = -0,41, CI: -0.69; -0.13), total testosterone (MD = -20.39, CI: -40.12; -0.66), androstenedione (MD = -0.69, CI: -1,16; -0.22), glucose (MD = -3.14; CI: -5.75; -0.54) levels and AUC insulin (MD = -2081.05, CI: -2745.32; -1416.78) inositol treatment induced greater decrease compared to placebo. Inositol increased sex-hormone-binding globulin significantly compared to placebo (MD = 32.06, CI:1.27; 62.85). CONCLUSION Inositol is an effective and safe treatment in PCOS. Moreover, inositols showed non-inferiority in most outcomes compared to the gold standard treatment; metformin. TRIAL REGISTRATION PROSPERO registration number: CRD42021283275.
Collapse
Affiliation(s)
- Dorina Greff
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, 1182, Budapest, Üllői Út 78/A, Hungary
- Department of Physiology, Semmelweis University, Budapest, Hungary
| | - Anna E Juhász
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Dietetics and Nutrition Sciences, Semmelweis University, Budapest, Hungary
| | - Szilárd Váncsa
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Alex Váradi
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Zoltán Sipos
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Julia Szinte
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Obstetrics and Gynecology, Semmelweis University, 1182, Budapest, Üllői Út 78/A, Hungary
- Department of Physiology, Semmelweis University, Budapest, Hungary
| | - Sunjune Park
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Physiology, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Péter Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Nándor Ács
- Department of Obstetrics and Gynecology, Semmelweis University, 1182, Budapest, Üllői Út 78/A, Hungary
| | - Szabolcs Várbíró
- Department of Obstetrics and Gynecology, Semmelweis University, 1182, Budapest, Üllői Út 78/A, Hungary.
- Workgroup for Science Management, Doctoral School, Semmelweis University, Budapest, Hungary.
| | - Eszter M Horváth
- Department of Physiology, Semmelweis University, Budapest, Hungary
| |
Collapse
|
10
|
Dou Y, Xin J, Zhou P, Tang J, Xie H, Fan W, Zhang Z, Wu D. Bidirectional association between polycystic ovary syndrome and periodontal diseases. Front Endocrinol (Lausanne) 2023; 14:1008675. [PMID: 36755917 PMCID: PMC9899846 DOI: 10.3389/fendo.2023.1008675] [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: 08/01/2022] [Accepted: 01/03/2023] [Indexed: 01/24/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) and periodontal disease (PDD) share common risk factors. The bidirectional interaction between PCOS and PDD has been reported, but until now, the underlying molecular mechanisms remain unclear. Endocrine disorders including hyperandrogenism (HA) and insulin resistance (IR) in PCOS disturb the oral microbial composition and increase the abundance of periodontal pathogens. Additionally, PCOS has a detrimental effect on the periodontal supportive tissues, including gingiva, periodontal ligament, and alveolar bone. Systemic low-grade inflammation status, especially obesity, persistent immune imbalance, and oxidative stress induced by PCOS exacerbate the progression of PDD. Simultaneously, PDD might increase the risk of PCOS through disturbing the gut microbiota composition and inducing low-grade inflammation and oxidative stress. In addition, genetic or epigenetic predisposition and lower socioeconomic status are the common risk factors for both diseases. In this review, we will present the latest evidence of the bidirectional association between PCOS and PDD from epidemiological, mechanistic, and interventional studies. A deep understanding on their bidirectional association will be beneficial to provide novel strategies for the treatment of PCOS and PDD.
Collapse
Affiliation(s)
- Yang Dou
- Department of Stomatology, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen, Guangdong, China
| | - Jinglei Xin
- Department of Stomatology, Guangdong Women and Children hospital, Guangzhou, Guangdong, China
| | - Peng Zhou
- Department of Stomatology, Guangdong Women and Children hospital, Guangzhou, Guangdong, China
| | - Jianming Tang
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Hongliang Xie
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Wanting Fan
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Zheng Zhang
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
| | - Donglei Wu
- Department of Stomatology, Shenzhen People’s Hospital, Shenzhen, Guangdong, China
- *Correspondence: Donglei Wu,
| |
Collapse
|
11
|
Hossain MA, Al Ashik SA, Mahin MR, Al Amin M, Rahman MH, Khan MA, Emran AA. Systems biology and in silico-based analysis of PCOS revealed the risk of metabolic disorders. Heliyon 2022; 8:e12480. [PMID: 36619413 PMCID: PMC9816984 DOI: 10.1016/j.heliyon.2022.e12480] [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: 02/04/2022] [Revised: 07/18/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
Background Polycystic ovarian syndrome (PCOS) is a common condition of hyperandrogenism, chronic ovulation, and polycystic ovaries in females during the reproduction and maturation of the ovum. Although PCOS has been associated with metabolic disorders, including type 2 diabetes (T2D), obesity (OBE), and cardiovascular disease (CVD), Causal connection and molecular features are still unknown. Purpose Therefore, we investigated the shared common differentially expressed genes (DEGs), pathways, and networks of associated proteins in PCOS and metabolic diseases with therapeutic intervention. Methods We have used a bioinformatics pipeline to analyze transcriptome data for the polycystic ovarian syndrome (PCOS), type 2 diabetes (T2D), obesity (OBE), and cardiovascular diseases (CVD) in female patients. Then we employed gene-disease association network, gene ontology (GO) and signaling pathway analysis, selection of hub genes from protein-protein interaction (PPI) network, molecular docking, and gold benchmarking approach to screen potential hub proteins. Result We discovered 2225 DEGs in PCOS patients relative to healthy controls and 34, 91, and 205 significant DEGs with T2D, Obesity, and CVD, respectively. Gene Ontology analysis revealed several significant shared and metabolic pathways from signaling pathway analysis. Furthermore, we identified ten potential hub proteins from PPI analysis that may serve as a therapeutic intervention in the future. Finally, we targeted one significant hub protein, IGF2R (PDB ID: 2V5O), out of ten hub proteins based on the Maximal clique centrality (MCC) algorithm and literature review for molecular docking study. Enzastaurin (-12.5), Kaempferol (-9.1), Quercetin (-9.0), and Coumestrol (-8.9) kcal/mol showed higher binding affinity in the molecular docking approach than 19 drug compounds. We have also found that the selected four compounds displayed favorable ADMET properties compared to the native ligand. Conclusion Our in-silico research findings identified a shared molecular etiology between PCOS and metabolic diseases that may suggest new therapeutic targets and warrants future experimental validation of the key targets.
Collapse
Affiliation(s)
- Md. Arju Hossain
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, 1092, Bangladesh
| | - Sheikh Abdullah Al Ashik
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, 1092, Bangladesh
| | - Moshiur Rahman Mahin
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, 1092, Bangladesh
| | - Md. Al Amin
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, 1092, Bangladesh
| | - Md Habibur Rahman
- Department of Computer Science and Engineering, Islamic University, Kushtia, 7003, Bangladesh
| | - Md. Arif Khan
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, 1092, Bangladesh,Department of Biotechnology and Genetic Engineering, University of Development Alternative, 4/4B, Block A, Lalmatia, Dhaka, 1209, Bangladesh
| | - Abdullah Al Emran
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, 1092, Bangladesh,Corresponding author.
| |
Collapse
|
12
|
Guo H, Wang B, Gao H, Zhu Q. The effect of body mass index on neonatal outcomes in Chinese women with polycystic ovary syndrome. Front Med (Lausanne) 2022; 9:996927. [PMID: 36452898 PMCID: PMC9704359 DOI: 10.3389/fmed.2022.996927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/06/2022] [Indexed: 03/19/2024] Open
Abstract
AIM This study aimed to explore the effect of body mass index (BMI) on neonatal outcomes in patients with polycystic ovary syndrome following the frozen embryo transfer (FET). METHODS This study included 1,676 singletons born from mothers with polycystic ovary syndrome (PCOS) after FET between 1 Jan 2007 and 31 Dec 2019. BMI was categorized into three groups: underweight (BMI less than 18.5 kg/m2), normal weight (BMI between 18.5 and 24.9 kg/m2), and overweight (BMI between 25.0 and 29.9 kg/m2). Logistic regression models with generalized estimating equations were used for clustering by patients to explore the effect of BMI on neonatal outcomes. RESULTS When compared to normal-weight mothers, the rate of large for gestational age (LGA) babies (adjusted odds ratio [aOR] 0.45, 95% confidence interval [95%CI] 0.22-0.93) significantly decreased for underweight mothers and significantly increased (aOR 1.82, 95%CI 1.38-2.41) for overweight mothers. The rate of high birth weight among infants from overweight mothers (aOR 1.75, 95%CI 1.15-2.65) was significantly higher than those from normal-weight mothers after adjusting for known confounding factors. The rate of small for gestational age (SGA) singleton (aOR 2.37, 95%CI 1.14-4.93) was lower among underweight mothers than normal-weight mothers. CONCLUSION Maternal underweight was a significant protective factor against LGA infants for singletons born from patients with PCOS after FET, whereas maternal overweight was an adverse factor for LGA infants.
Collapse
Affiliation(s)
| | | | | | - Qianqian Zhu
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital Affiliated to Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
13
|
Positive Effects of α-Lactalbumin in the Management of Symptoms of Polycystic Ovary Syndrome. Nutrients 2022; 14:nu14153220. [PMID: 35956395 PMCID: PMC9370664 DOI: 10.3390/nu14153220] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 11/18/2022] Open
Abstract
To date, the involvement of α-Lactalbumin (α-LA) in the management of polycystic ovary syndrome (PCOS) refers to its ability to improve intestinal absorption of natural molecules like inositols, overcoming the inositol resistance. However, due to its own aminoacidic building blocks, α-LA is involved in various biological processes that can open new additional applications. A great portion of women with PCOS exhibit gastrointestinal dysbiosis, which is in turn one of the triggering mechanisms of the syndrome. Due to its prebiotic effect, α-LA can recover dysbiosis, also improving the insulin resistance, obesity and intestinal inflammation frequently associated with PCOS. Further observations suggest that altered gut microbiota negatively influence mental wellbeing. Depressive mood and low serotonin levels are indeed common features of women with PCOS. Thanks to its content of tryptophan, which is the precursor of serotonin, and considering the strict link between gut and brain, using α-LA contributes to preserving mental well-being by maintaining high levels of serotonin. In addition, considering women with PCOS seeking pregnancy, both altered microbiota and serotonin levels can induce later consequences in the offspring. Therefore, a deeper knowledge of potential applications of α-LA is required to transition to preclinical and clinical studies extending its therapeutic advantages in PCOS.
Collapse
|
14
|
Abdel-Mottaleb Y, Ali HS, El-Kherbetawy MK, Elkazzaz AY, ElSayed MH, Elshormilisy A, Eltrawy AH, Abed SY, Alshahrani AM, Hashish AA, Alamri ES, Zaitone SA. Saponin-rich extract of Tribulus terrestris alleviates systemic inflammation and insulin resistance in dietary obese female rats: Impact on adipokine/hormonal disturbances. Biomed Pharmacother 2022; 147:112639. [DOI: 10.1016/j.biopha.2022.112639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/09/2022] [Accepted: 01/12/2022] [Indexed: 01/25/2023] Open
|
15
|
Shen W, Pan Y, Jin B, Zhang Z, You T, Qu Y, Han M, Yuan X, Zhang Y. Effects of Tea Consumption on Anthropometric Parameters, Metabolic Indexes and Hormone Levels of Women with Polycystic Ovarian Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Endocrinol (Lausanne) 2021; 12:736867. [PMID: 34966355 PMCID: PMC8710535 DOI: 10.3389/fendo.2021.736867] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/23/2021] [Indexed: 11/13/2022] Open
Abstract
Objective Our aim was to conduct a systematic review and meta-analysis to assess the effectiveness and safety of tea supplements for patients with polycystic ovary syndrome (PCOS). Methods We conducted searches of the published literature in PubMed, EMBASE, Cochrane Library, Web of Science, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure (CNKI), VIP database, and Wanfang Database in 1985 to September 2021. Data from randomized controlled trials (RCTs) were obtained to assess the effects of tea versus placebo in women with PCOS. Weighted mean differences (WMDs) were pooled using a random-effects model or risks ratios (RRs) using a random-effects model. Results Six RCTs (235 participants) were included in our systematic review. Tea supplements as adjuvant therapy led to greater improvement in body weight (WMD -2.71, 95% CI -4.95 to -0.46, P = 0.02, I2 = 0%), fasting blood glucose (FBG: WMD -0.40, 95% CI -0.59 to -0.20, P < 0.0001, I2 = 0%) and fasting insulin (FINS: WMD -3.40, 95% CI -4.76 to -2.03, P < 0.00001, I2 = 0%) when compared with placebo. There were no significant differences of body mass index, waist circumference, hip circumference, waist-to-hip ratio (WHR), body fat rate, total testosterone, free testosterone (FT), dehydroepiandrosterone, luteinizing hormone or follicular-stimulating hormone (FSH) between the two groups. In addition, subgroup analysis suggested that green tea was effective on body weight, FINS, FBG, FT, and FSH, and herbal tea can also reduce FT levels, tea supplements had a significant impact on FBG and FSH in trials with intervention duration ≥ 3 months, and intervention lasting less than 3 months can improve FINS. Tea had significant effect on reducing WHR, FBG and FSH in Asian PCOS patients, but not in Caucasians. And there was no statistically significant effect of tea on weight and FINS in Asians, but it was effective for Caucasian participants. Compared with placebo, tea supplements did not cause significant adverse reactions (RR 1.45, 95% CI 0.30 to 6.90, P = 0.65, I2 = 0%). Conclusion This meta-analysis suggests that consumption of tea supplementation in women with PCOS could significantly decrease the levels of FBG and FINS as well as reduce body weight. Especially green tea, not only has the above effects, but also has a significant effect on improving a variety of reproductive hormone indexes. Furthermore, tea supplementation is a relatively safe therapy for PCOS patients. Systematic Review Registration PROSPERO https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=212755, identifier CRD42021249196.
Collapse
Affiliation(s)
- Wenjuan Shen
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yujia Pan
- Department of Obstetrics and Gynecology, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Bao Jin
- Department of Obstetrics and Gynecology, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Zongyu Zhang
- Department of Obstetrics and Gynecology, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Tianjiao You
- Department of Obstetrics and Gynecology, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yangfan Qu
- Department of Obstetrics and Gynecology, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Mei Han
- Centre for Evidence-Based Chinese Medicine, Beijing University of Traditional Chinese Medicine, Beijing, China
| | - Xingxing Yuan
- Department of Obstetrics and Gynecology, Heilongjiang University of Chinese Medicine, Harbin, China
- Department of Gastroenterology, Heilongjiang Academy of Traditional Chinese Medicine, Harbin, China
| | - Yang Zhang
- Department of Internal Medicine, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| |
Collapse
|
16
|
Jafari-Gharabaghlou D, Vaghari-Tabari M, Oghbaei H, Lotz L, Zarezadeh R, Rastgar Rezaei Y, Ranjkesh M, Nouri M, Fattahi A, Nikanfar S, Dittrich R. Role of adipokines in embryo implantation. Endocr Connect 2021; 10:R267-R278. [PMID: 34559064 PMCID: PMC8558901 DOI: 10.1530/ec-21-0288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/24/2021] [Indexed: 11/08/2022]
Abstract
Embryo implantation is a complex process in which multiple molecules acting together under strict regulation. Studies showed the production of various adipokines and their receptors in the embryo and uterus, where they can influence the maternal-fetal transmission of metabolites and embryo implantation. Therefore, these cytokines have opened a novel area of study in the field of embryo-maternal crosstalk during early pregnancy. In this respect, the involvement of adipokines has been widely reported in the regulation of both physiological and pathological aspects of the implantation process. However, the information about the role of some recently identified adipokines is limited. This review aims to highlight the role of various adipokines in embryo-maternal interactions, endometrial receptivity, and embryo implantation, as well as the underlying molecular mechanisms.
Collapse
Affiliation(s)
- Davoud Jafari-Gharabaghlou
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Clinical Biochemistry and Laboratory Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mostafa Vaghari-Tabari
- Department of Clinical Biochemistry and Laboratory Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hajar Oghbaei
- Department of Physiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Laura Lotz
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen–Nürnberg, Erlangen, Germany
| | - Reza Zarezadeh
- Department of Clinical Biochemistry and Laboratory Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yeganeh Rastgar Rezaei
- Department of Medical Biotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahnaz Ranjkesh
- Medical Radiation Science Research Group (MRSRG), Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Nouri
- Department of Clinical Biochemistry and Laboratory Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Fattahi
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen–Nürnberg, Erlangen, Germany
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Correspondence should be addressed to A Fattahi or S Nikanfar: or
| | - Saba Nikanfar
- Department of Clinical Biochemistry and Laboratory Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Correspondence should be addressed to A Fattahi or S Nikanfar: or
| | - Ralf Dittrich
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen–Nürnberg, Erlangen, Germany
| |
Collapse
|
17
|
|
18
|
Greenfield AM, Charkoudian N, Alba BK. Influences of ovarian hormones on physiological responses to cold in women. Temperature (Austin) 2021; 9:23-45. [DOI: 10.1080/23328940.2021.1953688] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Andrew Martin Greenfield
- Thermal & Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
- Oak Ridge Institute of Science and Education, Belcamp, MD, USA
| | - Nisha Charkoudian
- Thermal & Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Billie Katherine Alba
- Thermal & Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
| |
Collapse
|
19
|
Involvement of Kisspeptin in androgen-induced hypothalamic endoplasmic reticulum stress and its rescuing effect in PCOS rats. Biochim Biophys Acta Mol Basis Dis 2021; 1867:166242. [PMID: 34389474 DOI: 10.1016/j.bbadis.2021.166242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/28/2021] [Accepted: 08/03/2021] [Indexed: 11/24/2022]
Abstract
Endoplasmic reticulum (ER) stress, with adaptive unfolded protein response (UPR), is a key link between obesity, insulin resistance and type 2 diabetes, all of which are often present in the most common endocrine-metabolic disorder in women of reproductive age, polycystic ovary syndrome (PCOS), which is characterized with hyperandrogenism. However, the link between excess androgen and Endoplasmic reticulum (ER) stress/insulin resistance in patients with polycystic ovary syndrome (PCOS) is unknown. An unexpected role of kisspeptin was reported in the regulation of UPR pathways and its involvement in the androgen-induced ER stress in hypothalamic neuronal cells. To evaluate the relationship of kisspeptin and ER stress, we detected Kisspeptin and other factors in blood plasm of PCOS patients, rat models and hypothalamic neuronal cells. We detected higher testosterone and lower kisspeptin levels in the plasma of PCOS than that in non-PCOS women. We established a PCOS rat model by dihydrotestosterone (DHT) chronic exposure, and observed significantly downregulated kisspeptin expression and activated UPR pathways in PCOS rat hypothalamus compared to that in controls. Inhibition or knockdown of kisspeptin completely mimicked the enhancing effect of DHT on UPR pathways in a hypothalamic neuronal cell line, GT1-7. Kp10, the most potent peptide of kisspeptin, effectively reversed or suppressed the activated UPR pathways induced by DHT or thapsigargin, an ER stress activator, in GT1-7 cells, as well as in the hypothalamus in PCOS rats. Similarly, Kisspeptin attenuated thapsigargin-induced Ca2+ response and the DHT- induced insulin resistance in GT1-7 cells. Collectively, the present study has revealed an unexpected protective role of kisspeptin against ER stress and insulin resistance in the hypothalamus and provided a new treatment strategy targeting hypothalamic ER stress and insulin resistance with kisspeptin as a potential therapeutic agent.
Collapse
|
20
|
Acetyl-L-Carnitine Ameliorates Metabolic and Endocrine Alterations in Women with PCOS: A Double-Blind Randomized Clinical Trial. Adv Ther 2021; 38:3842-3856. [PMID: 34047916 DOI: 10.1007/s12325-021-01789-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/13/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic disorder and the main cause of infertility in women of reproductive age. Affected women suffer from insulin resistance and present with an intense stress response. Treatment with insulin sensitizers alone and in combination is used to ameliorate the signs and symptoms associated with the disease. This study was designed to compare the endocrine and metabolic parameters as well as subjective and objective measures of stress in women with PCOS before and after treatment with acetyl-L-carnitine (ALC) and metformin plus pioglitazone. METHODS A total of 147 women with PCOS were randomly assigned into two groups: the combo group (n = 72) received a combination of metformin, pioglitazone, and ALC (500 mg, 15 mg, and 1500 mg, respectively), twice daily; the Met + Pio group (n = 75) received metformin plus pioglitazone (500 mg, 15 mg, respectively) and placebo (citric acid plus calcium carbonate), twice daily for 12 weeks. Medications were discontinued when pregnancy was confirmed. The Perceived Stress Scale (PSS14) and Profile of Mood States (POMS) were employed as subjective measures of stress. The endocrine and metabolic functions of women with PCOS were assessed by measuring insulin, leutinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, and adiponectin levels in fasting blood samples. Insulin resistance was calculated by Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). RESULTS Women at baseline had significantly elevated circulating concentration of insulin and low level of adiponectin. Treatment decreased insulin in both groups; however, the combo group showed a significant decrease (p = 0.001). Serum adiponectin level was raised significantly after treatment in both groups (p < 0.001). HOMA-IR also decreased in both groups (both p < 0.001). Testosterone, FSH, and LH significantly improved in both groups. LH also decreased in both groups; however, the change was significant only in the combo (metformin plus pioglitazone plus ALC) group (p = 0.013). Interestingly, there was a significant improvement in body circumference (p < 0.001) in the combo group. The PSS scores of the patients improved significantly (p < 0.001) in the combo group. Interestingly, regular menstrual cycles were found (97.2%) in the carnitine group, but in only 12.9% of the other group. CONCLUSION We conclude that addition of ALC therapy is superior to metformin plus pioglitazone in ameliorating insulin resistance, polycystic ovaries, menstrual irregularities, and hypoadiponectinemia in women with PCOS. TRIAL REGISTRATION Trial registration: clinicalTrial.gov NCT04113889. Registered 3 October, 2019. https://clinicaltrials.gov/ct2/show/NCT04113889 .
Collapse
|
21
|
Mousa M, Al-Jefout M, Alsafar H, Kirtley S, Lindgren CM, Missmer SA, Becker CM, Zondervan KT, Rahmioglu N. Prevalence of Common Gynecological Conditions in the Middle East: Systematic Review and Meta-Analysis. FRONTIERS IN REPRODUCTIVE HEALTH 2021; 3:661360. [PMID: 36304010 PMCID: PMC9580651 DOI: 10.3389/frph.2021.661360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/22/2021] [Indexed: 02/04/2023] Open
Abstract
Introduction: High prevalence of gynecological conditions in women of Middle Eastern origin is reported, likely due to regional risk factors and mediators. The objective of this systematic review and meta-analysis is to investigate the prevalence of polycystic ovary syndrome (PCOS), endometriosis, uterine fibroids, and adenomyosis in women of Middle Eastern origin. Methods: MEDLINE, EMBASE, PsycINFO, Global Health, and Google Scholar databases were searched from database inception until 14 February 2021 to identify relevant studies. Peer-reviewed research articles that reported the prevalence of PCOS, endometriosis, uterine fibroids, and adenomyosis in the Middle Eastern population were written in English or Arabic. The primary outcome was the estimated pooled prevalence of PCOS, endometriosis, uterine fibroids, and adenomyosis in the Middle Eastern populations. The secondary outcome was to assess the evidence in the data for the presence of heterogeneity, by conducting subtype-pooled analysis of prevalence estimates of the conditions. Total weighted prevalence was calculated via Freeman-Tukey arcsine transformation and heterogeneity through the I 2 statistic. Quality control was performed using GRADE criteria. Results: A total of 47 studies, 26 on PCOS, 12 on endometriosis, eight on uterine fibroids, and seven on adenomyosis, were included. The pooled prevalence of PCOS diagnosed according to the NIH criteria was 8.9% (95% CI: 6.5-11.7; prevalence range: 4.0-27.6%), with a higher prevalence from the Gulf Arab states (18.8%, 95% CI: 9.5-30.3; range: 12.1-27.6%). According to the Rotterdam criteria, the pooled prevalence of PCOS was 11.9% (95% CI: 7.1-17.7; range: 3.4-19.9%) with studies limited to the Persian and Levant regions. Endometriosis was diagnosed in 12.9% (95% CI: 4.2-25.4; range: 4.2-21.0%) of women undergoing laparoscopy, for any indication. Uterine fibroid and adenomyosis prevalence of women was 30.6% (95% CI: 24.9-36.7; range: 18.5-42.6%) and 30.8% (95% CI: 27.1-34.6, range: 25.6-37.7%), respectively. Heterogeneity was present between studies due to statistical and methodological inconsistencies between studies, and quality of evidence was low due to sample size and unrepresentative participant selection. Conclusion: This is the first review that has reported the prevalence of gynecological diseases in the Middle Eastern population, suggesting that gynecological morbidity is a public health concern. Due to the health disparities in women, further research is required to understand the relative roles of environmental and genetic factors in the region to serve as a benchmark for evaluation and comparative purposes with other populations.
Collapse
Affiliation(s)
- Mira Mousa
- Nuffield Department of Women's and Reproductive Health, Endometriosis CaRe Centre, University of Oxford, Oxford, United Kingdom
| | - Moamar Al-Jefout
- Department of Obstetrics and Gynaecology, College of Medical and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Department of Obstetrics and Gynaecology No. 1. Moscow, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Habiba Alsafar
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Department of Genetics and Molecular Biology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Shona Kirtley
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom
| | - Cecilia M. Lindgren
- Li Ka Shing Centre for Health Information and Discovery, The Big Data Institute, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Medicine (C.M.L.), Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Stacey A. Missmer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Department of Obstetrics, Gynaecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Christian M. Becker
- Nuffield Department of Women's and Reproductive Health, Endometriosis CaRe Centre, University of Oxford, Oxford, United Kingdom
| | - Krina T. Zondervan
- Nuffield Department of Women's and Reproductive Health, Endometriosis CaRe Centre, University of Oxford, Oxford, United Kingdom
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Nilufer Rahmioglu
- Nuffield Department of Women's and Reproductive Health, Endometriosis CaRe Centre, University of Oxford, Oxford, United Kingdom
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
22
|
Kim SH, Yoon JT. Morphological changes in mouse ovary due to hormonal hypersecretion and matrix metalloproteinase -2 activity. Histol Histopathol 2021; 36:527-534. [PMID: 33620082 DOI: 10.14670/hh-18-318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We analyzed whether aberrant gonadotropin secretion affects the morphological remodeling of murine ovarian tissues facilitated by activated matrix metalloproteinase (MMP) enzymes. Six mice were intraperitoneally injected with 5 IU of pregnant mare serum gonadotropin (PMSG) or human chorionic gonadotropin (HCG) every two days after estrus synchronization. Morphology and expression of various MMPs were assessed following the successful induction of hormonal secretion in these tissues. HCG treatment, but not PMSG treatment, resulted in the expanded production of granulose second follicular cells. In addition, the number of developing follicular cells in the HCG group increased compared with that in the PMSG group. Ovarian diameters were also very small in the PMSG group. Immunohistochemistry revealed decreased MMP-2 protein activity in the HCG group and increased MMP-2 activity in the PMSG group. Activity was particularly high in theca and granulose cells of the PMSG group, but only partial activity was observed in the theca cells of the HCG group. Vascular endothelial growth factor activity was increased in both the external and internal theca cell walls in the PMSG group while the HCG group showed high overall expression of this protein in the internal theca cells. These data indicate that follicular cell activity and remodeling of the ovaries differ based on the type of secretory hormone signals they receive. Inappropriate gonadotropin secretion may induce functional changes in the ovaries, and follicular remodeling may be facilitated by the activity of various MMPs.
Collapse
Affiliation(s)
- Sang-Hwan Kim
- Institute of Genetic Engineering, Hankyong National University, Jungang-ro, Ansung, Gyeonggi-do, South Korea
| | - Jong-Taek Yoon
- Institute of Genetic Engineering, Hankyong National University, Jungang-ro, Ansung, Gyeonggi-do, South Korea.,Department of Animal Life and Environment Science, Hankyong National University, Jungang-ro, Ansung, Gyeonggi-do, South Korea.
| |
Collapse
|
23
|
Lin W, Wen L, Wen J, Xiang G. Effects of Sleeve Gastrectomy on Fecal Gut Microbiota and Short-Chain Fatty Acid Content in a Rat Model of Polycystic Ovary Syndrome. Front Endocrinol (Lausanne) 2021; 12:747888. [PMID: 34858330 PMCID: PMC8631770 DOI: 10.3389/fendo.2021.747888] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/22/2021] [Indexed: 01/17/2023] Open
Abstract
PURPOSE Sleeve gastrectomy (SG) is a surgical intervention for polycystic ovary syndrome (PCOS), especially for patients with obesity. Here, we explored the effects of SG on the gut microbiota of rats with PCOS and investigated the association between the intestinal flora and efficacy of SG in PCOS. METHODS Dehydroepiandrosterone (DHEA) injection was administered alone and in combination with a high-fat diet to induce PCOS in rats. SG was performed in rats with PCOS, and the effects of SG on the fecal and gut microbiota and the short-chain fatty acid (SCFA) content were observed. Furthermore, the association among gut microbiota, SCFA content and hyperandrogenism or other hallmarks of PCOS was evaluated. RESULTS The abundance of Firmicutes reduced and that of Bacteroidetes increased in response to SG in the DHEA-induced PCOS rat model. At the genus level, the abundances of Bacteroides and Blautia increased and those of Ruminococcus, Clostridium, and Alistipes reduced distinctly in the PCOS-SG groups. Moreover, the levels of fecal SCFAs, especially butyric acid, reduced after SG. SG significantly ameliorated PCOS-related symptoms such as hyperandrogenism, disrupted ovary function, and impaired glucose tolerance. Bacteroides and Blautia exhibited a negative correlation and Ruminococcus, Clostridium, and Alistipes exhibited a positive correlation with the levels of fecal SCFAs, luteinizing hormone, testosterone, and inflammatory factors. CONCLUSIONS The amelioration of PCOS-related reproductive and metabolic disorders following SG was associated with the regulation of microbial taxa and SCFA content. Our findings provide a novel perspective on the microbial mechanisms in PCOS after SG.
Collapse
Affiliation(s)
- Wei Lin
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Endocrinology, General Hospital of Central Theater Command, Wuhan, China
- Department of Endocrinology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
| | - Lingying Wen
- Department of Endocrinology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
- Department of Neonatology, The First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Junping Wen
- Department of Endocrinology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China
- *Correspondence: Guangda Xiang, ; Junping Wen,
| | - Guangda Xiang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Endocrinology, General Hospital of Central Theater Command, Wuhan, China
- *Correspondence: Guangda Xiang, ; Junping Wen,
| |
Collapse
|
24
|
Choudhary N, Choudhary S, Kumar A, Singh V. Deciphering the multi-scale mechanisms of Tephrosia purpurea against polycystic ovarian syndrome (PCOS) and its major psychiatric comorbidities: Studies from network pharmacological perspective. Gene 2020; 773:145385. [PMID: 33383117 DOI: 10.1016/j.gene.2020.145385] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 11/08/2020] [Accepted: 12/18/2020] [Indexed: 12/21/2022]
Abstract
Tephrosia purpurea (T. purpurea), a plant belonging to Fabaceae (pea) family, is a well-known Ayurvedic herb and commonly known as Sarapunkha in traditional Indian medicinal system. Described as "Sarwa wranvishapaka", i.e. having a capability to heal all types of wounds, it is particularly recognized for its usage in splenomegaly. Towards exploring the comprehensive effects of T. purpurea against polycystic ovarian syndrome (PCOS) and three comorbid neuropsychiatric diseases (anxiety, depression, and bipolar disorder), its constituent phytochemicals (PCs) were extensively reviewed and their network pharmacology evaluation was carried out in this study. The complex regulatory potential of its 76 PCs against PCOS is enquired by developing and analyzing high confidence tripartite networks of protein targets of each phytochemical at both pathway and disease association scales. We also developed a high-confidence human Protein-Protein Interaction (PPI) sub-network specific to PCOS, explored its modular architecture, and probed 30 drug-like phytochemicals (DPCs) having multi-module regulatory potential. The phytochemicals showing good binding affinity towards their protein targets were also evaluated for similarity against currently available approved drugs present in DrugBank. Multi-targeting and synergistic capacities of 12 DPCs against 10 protein targets were identified and evaluated using molecular docking and interaction analyses. Eight DPCs as a potential source of PCOS and its comorbidity regulators are reported in T. purpurea. The results of network-pharmacology study highlight the therapeutic relevance of T. purpurea as PCOS-regulator and demonstrate the effectiveness of the approach in revealing action-mechanism of Ayurvedic herbs from holistic perspective.
Collapse
Affiliation(s)
- Neha Choudhary
- Centre for Computational Biology and Bioinformatics, School of Life Sciences, Central University of Himachal Pradesh, Dharamshala 176206, India
| | - Shilpa Choudhary
- Centre for Computational Biology and Bioinformatics, School of Life Sciences, Central University of Himachal Pradesh, Dharamshala 176206, India
| | - Arun Kumar
- Molecular Biology Laboratory, Drug Standardization Unit, Dr. DP Rastogi Central Research Institute of Homeopathy, Ministry of AYUSH, Govt. of India, Noida, Uttar Pradesh 201301, India
| | - Vikram Singh
- Centre for Computational Biology and Bioinformatics, School of Life Sciences, Central University of Himachal Pradesh, Dharamshala 176206, India.
| |
Collapse
|
25
|
Bedrick BS, Eskew AM, Chavarro JE, Jungheim ES. Self-Administered Questionnaire to Screen for Polycystic Ovarian Syndrome. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2020; 1:566-573. [PMID: 33786523 PMCID: PMC7785063 DOI: 10.1089/whr.2020.0073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/21/2020] [Indexed: 06/12/2023]
Abstract
Background: Polycystic ovary syndrome (PCOS) is a common yet underdiagnosed endocrinopathy with potentially serious sequelae. A screening questionnaire for PCOS can improve early identification and diagnosis. Objective: The purpose of this study was to test the utility of a self-administered questionnaire to help identify women at risk for PCOS. Study Design: We recruited women ages 18-50 with and without PCOS as defined by modified Rotterdam criteria to complete a self-administered survey of common PCOS signs and symptoms. The survey included questions regarding menstrual cycle characteristics and hyperandrogenism as measured by images from the Ferriman-Gallwey (FG) scoring system, and by report of depilatory practices. Results: Fifty-one women with PCOS and 50 women without PCOS participated in this study. Many study participants were current users of hormonal contraceptives making it difficult to discern menstrual cycle characteristics. Hirsutism, defined by a modification of the FG score of ≥3 from the upper lip and abdomen based on self-assessments, provided a sensitivity of 76% and specificity of 70%, whereas report of any depilatory practices provided a sensitivity of 71% and specificity of 74%. The combined sensitivity of these measures was 93% with a specificity of 52%. In multivariate logistic regression, women who used depilatory techniques had an adjusted odds ratio (aOR) of PCOS of 6.6 (95% confidence interval [CI] 2.5-17.3, p = 0.0002). Those with obesity had similar aOR of PCOS (aOR 6.7, 95% CI 2.5-17.9, p = 0.0001). Addition of other variables did not improve model fit and the net sensitivity and specificity of these two variables did not improve those of depilatory practices and hirsutism. Conclusions: Self-report of depilatory practices or hirsutism is sensitive for identifying women with PCOS. Given the prevalence of PCOS in reproductive-age women and the potentially serious health sequelae, it would be worthwhile to include questions about terminal hair growth and depilatory practices when providing general medical care to reproductive-age women to determine if further testing and screening for PCOS are indicated. This tool may also be helpful in populations where complete diagnostic evaluation may not be feasible.
Collapse
Affiliation(s)
- Bronwyn S. Bedrick
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ashley M. Eskew
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Obstetrics and Gynecology, Atrium Health, Charlotte, North Carolina, USA
| | - Jorge E. Chavarro
- Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Emily S. Jungheim
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| |
Collapse
|
26
|
Thong EP, Milat F, Joham AE, Mishra GD, Teede H. Obesity, menstrual irregularity and polycystic ovary syndrome in young women with type 1 diabetes: A population-based study. Clin Endocrinol (Oxf) 2020; 93:564-571. [PMID: 32640055 DOI: 10.1111/cen.14281] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/01/2020] [Accepted: 06/25/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Type 1 diabetes (T1D) is associated with reproductive dysfunction, particularly in the setting of poor metabolic control. Improvements in contemporary management ameliorate these problems, albeit at the cost of increased exogenous insulin and rising obesity, with emerging reproductive implications. OBJECTIVE To evaluate changes in body mass index (BMI) and the relationship between obesity, menstrual irregularity and polycystic ovary syndrome (PCOS) in young women with T1D, compared with controls. METHODS Longitudinal observational study using data from the Australian Longitudinal Study in Women's Health of the cohort born in 1989-95, from 2013 to 2015. Three questionnaires administered at baseline and yearly intervals were used to evaluate self-reported menstrual irregularity, PCOS and BMI. RESULTS Overall, 15 926 women were included at baseline (T1D, n = 115; controls, n = 15 811). 61 women with T1D and 8332 controls remained at Year 2. Median BMI was higher in women with type 1 diabetes (25.5 vs 22.9 kg/m2 , P < .001), where over half were overweight or obese (54.4% vs 32.9%, P < .001). Median BMI increased by 1.11 and 0.45 kg/m2 , in the T1D and control groups, respectively. T1D was independently associated with an increased risk of menstrual irregularity (RR 1.22, 95% CI 1.02-1.46) and PCOS (RR 2.41, 95% CI 1.70-3.42). Obesity conferred a 4-fold increased risk of PCOS, compared to those with normal BMI (RR 3.93, 95% CI 3.51-4.42). CONCLUSIONS Obesity is prevalent amongst women with T1D and may be a key contributor to the higher risk of menstrual irregularity and PCOS in this cohort, representing an important opportunity for prevention and intervention.
Collapse
Affiliation(s)
- Eleanor P Thong
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, Vic., Australia
- Departments of Endocrinology & Diabetes, Monash Health, Clayton, Vic., Australia
| | - Frances Milat
- Departments of Endocrinology & Diabetes, Monash Health, Clayton, Vic., Australia
- Hudson Institute of Medical Research, Clayton, Vic., Australia
| | - Anju E Joham
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, Vic., Australia
- Departments of Endocrinology & Diabetes, Monash Health, Clayton, Vic., Australia
| | - Gita D Mishra
- Centre for Longitudinal and Life Course Research, School of Public Health, University of Queensland, St Lucia, Qld, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, Vic., Australia
- Departments of Endocrinology & Diabetes, Monash Health, Clayton, Vic., Australia
| |
Collapse
|
27
|
Idicula-Thomas S, Gawde U, Bhaye S, Pokar K, Bader GD. Meta-analysis of gene expression profiles of lean and obese PCOS to identify differentially regulated pathways and risk of comorbidities. Comput Struct Biotechnol J 2020; 18:1735-1745. [PMID: 32695266 PMCID: PMC7352056 DOI: 10.1016/j.csbj.2020.06.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 06/13/2020] [Accepted: 06/14/2020] [Indexed: 12/13/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a complex multigenic disorder and women with PCOS suffer from several comorbidities. Although, obesity is a known risk factor for PCOS, the incidence of lean women with PCOS is on the rise. A systematic and comparative study on lean and obese PCOS with respect to genes, pathways and comorbidity analysis has not been attempted so far. Analysis of differentially expressed genes (DEGs) across tissue types for lean and obese PCOS revealed that the majority of them were downregulated for lean and obese PCOS. Ovarian and endometrial tissues shared several commonly dysregulated genes, suggesting shared PCOS pathophysiology mechanisms exist across tissues. Several pathways for cellular homeostasis, such as inflammation and immune response, insulin signaling, steroidogenesis, hormonal and metabolic signaling, regulation of gonadotrophic hormone secretion, cell structure and signaling that are known to be affected in PCOS were found to be enriched in our gene expression analysis of lean and obese PCOS. The gene-disease network is denser for obese PCOS with a higher comorbidity score as compared to lean PCOS.
Collapse
Affiliation(s)
- Susan Idicula-Thomas
- Biomedical Informatics Centre, Indian Council of Medical Research-National Institute for Research in Reproductive Health, Mumbai 400012, India.,The Donnelly Centre, University of Toronto, Toronto, ON, Canada
| | - Ulka Gawde
- Biomedical Informatics Centre, Indian Council of Medical Research-National Institute for Research in Reproductive Health, Mumbai 400012, India
| | - Sameeksha Bhaye
- Biomedical Informatics Centre, Indian Council of Medical Research-National Institute for Research in Reproductive Health, Mumbai 400012, India
| | - Khushal Pokar
- Biomedical Informatics Centre, Indian Council of Medical Research-National Institute for Research in Reproductive Health, Mumbai 400012, India
| | - Gary D Bader
- The Donnelly Centre, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
28
|
Daghestani MH, Daghestani MH, Daghistani M, Ambreen K, Albalawi FS, AlNeghery LM, Warsy AS. Influence of KISS1 gene polymorphisms on the risk of polycystic ovary syndrome and its associated variables, in Saudi women. BMC Endocr Disord 2020; 20:59. [PMID: 32380991 PMCID: PMC7203813 DOI: 10.1186/s12902-020-0537-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 04/22/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a complex multifactorial disorder, affecting millions of women worldwide. The role of genetic polymorphisms of the KISS1 gene on the development of PCOS is still obscure. This study was designed to investigate the probable influence of KISS1 gene polymorphisms on PCOS and its associated variables: BMI, waist-hip ratio, kisspeptin, LH, FSH, and LH-FSH ratio. METHODS The study comprised 104 PCOS women and 109 controls, with age ranging from 19 to 36 years. BMI, waist-hip ratio, and circulating levels of kisspeptin, LH, and FSH were measured. DNA was extracted, and genotyping of the KISS1 gene was carried out by nucleotide sequencing. The PCOS-associated variables were analyzed in different genotypes of single nucleotide polymorphisms (SNPs) of the KISS1 gene. RESULTS The values of waist-hip ratio (WHR), LH, and LH-FSH ratio were significantly higher in PCOS women than controls. BMI, kisspeptin, and FSH levels exhibited no significant difference between the groups. Six novel SNPs of KISS1 gene were identified. Three: rs372790354G > A, rs12998G > A, and rs35431622A > T were investigated. Among these SNPs, the genotype and allele frequencies of rs372790354 showed significant association with PCOS (GA: p = 0.018, AA: p = 0.022, mutant allele-A: p = 0.021) and the G allele was protective. The values of LH, kisspeptin, and WHR of PCOS women were significantly influenced (p < 0.05) by the AA genotype of rs372790354. The other two SNPs rs12998G > A and rs35431622A > T revealed no significant influence on PCOS and associated variables. Haplotypes were constructed, but there was no significant difference between the patients and controls. CONCLUSION In conclusion, this is the first study, which reports a significant influence of KISS1 gene polymorphism (rs372790354G > A) on PCOS and its associated variables. However, more extensive research is necessary to confirm these findings.
Collapse
Affiliation(s)
- Maha H Daghestani
- Department of Zoology, Female Center for Scientific and Medical Colleges, King Saud University, Riyadh, Saudi Arabia
| | - Mazin H Daghestani
- Department of Obstetrics & Gynaecology, Umm-Al-Qura University, Makkah, Saudi Arabia
| | - Mamoon Daghistani
- Department of Surgery, King Abdulaziz Medical City, National Guard Heath Affairs, Jeddah, Saudi Arabia
| | - Khushboo Ambreen
- Department of Biotechnology, Integral University, Lucknow, India
| | - Fadwa S Albalawi
- Department of Zoology, Female Center for Scientific and Medical Colleges, King Saud University, Riyadh, Saudi Arabia
| | - Lina M AlNeghery
- Department of Biology, College of Science, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Arjumand S Warsy
- Central Laboratory, Female Center for Scientific and Medical Colleges, King Saud University, Riyadh, Saudi Arabia.
| |
Collapse
|
29
|
Beydoun HA, Beydoun MA, Hossain S, Stadtmauer L, Eid SM, Zonderman AB. Patterns of Bariatric Surgeries Among U.S. Women Diagnosed with Polycystic Ovarian Syndrome. J Womens Health (Larchmt) 2020; 29:585-595. [PMID: 32077783 DOI: 10.1089/jwh.2019.7947] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: To examine patterns and outcomes of bariatric surgeries, including Roux-en-Y gastric bypass (RYGB), laparoscopic sleeve gastrectomy (LSG) and laparoscopic adjustable gastric banding (LAGB), among women diagnosed with polycystic ovarian syndrome (PCOS). Materials and Methods: Retrospective cohort study using 1998-2011 Nationwide Inpatient Sample data. A total of 52,668 hospital discharge records met eligibility criteria among PCOS women, 18-49 years. Of those, 17,759 had an obesity/overweight diagnosis and 4310 underwent bariatric surgery. Furthermore, 3086 underwent RYGB (n = 2411), LSG (n = 126), or LAGB (n = 549), and were compared to 78,931 non-PCOS controls. Multiple regression models were constructed to examine patient- and hospital-level predictors of obesity/overweight and bariatric surgery, as well as type of bariatric surgery (RYGB, LSG, or LAGB) as a predictor of in-hospital outcomes and PCOS status. Results: The prevalence of obesity/overweight (≈34%) among women diagnosed with PCOS, and of bariatric surgery (≈24%) among women diagnosed with PCOS and obese/overweight varied by patient- and hospital-level characteristics. Women having PCOS and overweight/obesity, who underwent LSG or LAGB, had shorter hospital stay, reduced hospital charges, and better disposition at discharge compared to those who underwent RYGB. PCOS cases and non-PCOS controls experienced similar treatment selection and in-hospital outcomes after bariatric surgery. Also, PCOS cases and non-PCOS controls experienced similar in-hospital outcomes after undergoing RYGB, LSG, or LAGB. Conclusions: Compared to RYGB, LSG and LAGB resulted in improved in-hospital outcomes among obese/overweight PCOS and non-PCOS patients. Further research is needed to examine health care disparities in the context of PCOS, obesity/overweight, and bariatric surgery.
Collapse
Affiliation(s)
- Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, Virginia
| | - May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, Maryland
| | - Sharmin Hossain
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, Maryland
| | - Laurel Stadtmauer
- Department of Obstetrics and Gynecology, Jones Institute for Reproductive Medicine, Eastern Virginia Medical School, Norfolk, Virginia
| | - Shaker M Eid
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alan B Zonderman
- Department of Obstetrics and Gynecology, Jones Institute for Reproductive Medicine, Eastern Virginia Medical School, Norfolk, Virginia
| |
Collapse
|
30
|
Li Y, Tan J, Wang Q, Duan C, Hu Y, Huang W. Comparing the individual effects of metformin and rosiglitazone and their combination in obese women with polycystic ovary syndrome: a randomized controlled trial. Fertil Steril 2019; 113:197-204. [PMID: 31718828 DOI: 10.1016/j.fertnstert.2019.09.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 07/06/2019] [Accepted: 09/09/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To compare the effects of metformin, rosiglitazone, and their combination in obese polycystic ovary syndrome (PCOS) patients with insulin resistance. DESIGN Prospective randomized controlled trail. SETTING Tertiary teaching hospital. PATIENT(S) Obese Chinese women (body mass index [BMI] ≥25 kg/m2) with insulin resistance who fulfilled the Rotterdam criteria of PCOS. INTERVENTION(S) In group 1, 68 patients administered metformin (1,500 mg/day); in group 2, 67 patients administered rosiglitazone (4 mg/day); in group 3, 69 patients administered metformin (1,000 mg/day) and rosiglitazone (4 mg/day) for 6 months, all with the same diet and regular exercise lifestyle recommendation. MAIN OUTCOME MEASURE(S) Average menstrual interval, anthropometric measurements, androgen-related parameters, and metabolic features of insulin, carbohydrates, and lipids, with intention-to-treat analysis. RESULT(S) The baseline parameters showed no statistically significant differences. After the 6-month treatment, most participants showed an improved menstrual pattern. There were statistically significant decreases in acne scores, weight, BMI, waist circumference, waist-to-hip ratio, and serum testosterone. The metabolic indexes of insulin, carbohydrates, and lipids were improved obviously compared with the baseline in each group. Among the three groups, the patients administered 1,500 mg/day metformin experienced greater reductions in weight. However, the rosiglitazone users (alone or combined with metformin) showed a more notable decline in total cholesterol and triglyceride levels. CONCLUSION(S) Considering the benefits of metformin on weight loss, high-dose metformin (1,500 mg/day) along with lifestyle modification should be recommended for obese, insulin-resistant women with PCOS. Rosiglitazone alone or combined with low-dosage metformin plus lifestyle modification should be considered for the women with abnormal lipid profiles. CLINICAL TRIAL REGISTRATION NUMBER ChiCTR-TRC-13003642 (Chinese Clinical Trial Registry).
Collapse
Affiliation(s)
- Yujing Li
- Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, People's Republic of China
| | - Jing Tan
- Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, People's Republic of China
| | - Qiuyi Wang
- Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, People's Republic of China
| | - Changling Duan
- Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, People's Republic of China
| | - Yuanyuan Hu
- Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, People's Republic of China
| | - Wei Huang
- Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, Sichuan, People's Republic of China.
| |
Collapse
|
31
|
Ely BR, Francisco MA, Halliwill JR, Bryan SD, Comrada LN, Larson EA, Brunt VE, Minson CT. Heat therapy reduces sympathetic activity and improves cardiovascular risk profile in women who are obese with polycystic ovary syndrome. Am J Physiol Regul Integr Comp Physiol 2019; 317:R630-R640. [PMID: 31483156 DOI: 10.1152/ajpregu.00078.2019] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Polycystic ovary syndrome (PCOS) affects up to 15% of women and is associated with increased risk of obesity and cardiovascular disease. Repeated passive heat exposure [termed "heat therapy" (HT)] is a lifestyle intervention with the potential to reduce cardiovascular risk in obesity and PCOS. Women with obesity (n = 18) with PCOS [age 27 ± 4 yr, body mass index (BMI) 41.3 ± 4.7 kg/m2] were matched for age and BMI, then assigned to HT (n = 9) or time control (CON; n = 9). HT subjects underwent 30 one-hour hot tub sessions over 8-10 wk, whereas CON subjects did not undergo HT. Muscle sympathetic nerve activity (MSNA), blood pressure, cholesterol, C-reactive protein, and markers of vascular function were assessed at the start (Pre) and end (Post) of 8-10 wk. These measures included carotid and femoral artery wall thickness and flow-mediated dilation (FMD), measured both before and after 20 min of ischemia-20 min of reperfusion (I/R) stress. HT subjects exhibited reduced MSNA burst frequency (Pre: 20 ± 8 bursts/min, Post: 13 ± 5 bursts/min, P = 0.012), systolic (Pre: 124 ± 5 mmHg, Post: 114 ± 6 mmHg; P < 0.001) and diastolic blood pressure (Pre: 77 ± 6 mmHg, Post: 68 ± 3 mmHg; P < 0.001), C-reactive protein (Pre: 19.4 ± 13.7 nmol/L, Post: 15.2 ± 12.3 nmol/L; P = 0.018), total cholesterol (Pre: 5.4 ± 1.1 mmol/L, Post: 5.0 ± 0.8 mmol/L; P = 0.028), carotid wall thickness (Pre: 0.054 ± 0.005 cm, Post: 0.044 ± 0.005 cm; P = 0.010), and femoral wall thickness (Pre: 0.056 ± 0.009 cm, Post: 0.042 ± 0.005 cm; P = 0.003). FMD significantly improved in HT subjects over time following I/R (Pre: 5.6 ± 2.5%, Post: 9.5 ± 1.7%; P < 0.001). No parameters changed over time in CON, and BMI did not change in either group. These findings indicate that HT reduces sympathetic nerve activity, provides protection from I/R stress, and substantially improves cardiovascular risk profiles in women who are obese with PCOS.
Collapse
Affiliation(s)
- Brett R Ely
- Department of Human Physiology, University of Oregon, Eugene, Oregon.,Department of Sport and Movement Science, Salem State University, Salem, Massachusetts
| | | | - John R Halliwill
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Samantha D Bryan
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Lindan N Comrada
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Emily A Larson
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Vienna E Brunt
- Department of Human Physiology, University of Oregon, Eugene, Oregon.,Department of Integrative Physiology, University of Colorado, Boulder, Colorado
| | | |
Collapse
|
32
|
Hepsen S, Cakal E, Karakose M, Eyerci N, Saat H, Beysel S, Oztekin S, Pinarli F, Parlak M. Melanocortin 3 receptor gene polymorphism is associated with polycystic ovary syndrome in Turkish population. Gynecol Endocrinol 2019; 35:685-690. [PMID: 30784330 DOI: 10.1080/09513590.2019.1576614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a frequent complex disorder with an ill-defined etiology. Genetic factors seem rather effective at the occurrence of the disease, however, the evidence of established various studies results are unsatisfied. We aimed to make a contribution to the genetic baseline of the disease by investigating melanocortin 3 receptor gene polymorphism in affected patients. 101 PCOS patients and 162 age-matched healthy volunteered control subjects recruited to the study. PCOS patients classified according to their BMI class and insulin resistance situation. Anthropometric measurements, physical examination results, laboratory findings, and hormone levels were recorded for each participant and analysis of two SNPs on the MC3R gene; rs3746619 and rs3827103 were performed. Although no significant difference was observed in rs3827103 polymorphism between PCOS patients and controls; rs3746619 polymorphism was determined associated with PCOS in the heritage of dominant (AA + AC) and co-dominant (AA) genotypes. Two polymorphisms did not found related to obesity and insulin resistance in PCOS subgroups analysis. MC3R gene rs 3746619 polymorphism was found associated with PCOS in the Turkish population and may make a contribution to the genetic baseline of the disease.
Collapse
Affiliation(s)
- Sema Hepsen
- a Department of Endocrinology and Metabolism , University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital , Ankara , Turkey
| | - Erman Cakal
- a Department of Endocrinology and Metabolism , University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital , Ankara , Turkey
| | - Melia Karakose
- b Department of Endocrinology and Metabolism , Necmettin Erbakan University, Meram Medicine Faculty , Konya , Turkey
| | - Nilnur Eyerci
- c Department of Medical Biology , Kafkas University , Kars , Turkey
| | - Hanife Saat
- d Department of Medical Genetic , University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital , Ankara , Turkey
| | - Selvihan Beysel
- e Department of Endocrinology and Metabolism , Eskisehir State Hospital , Eskisehir , Turkey
| | - Sanem Oztekin
- f Department of Internal Medicine , University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital , Ankara , Turkey
| | - Ferda Pinarli
- g Department of Medical Genetic , University of Health Sciences Diskapi Yildirim Beyazit Training and Research Hospital , Ankara , Turkey
| | - Mesut Parlak
- h Department of Pharmacology , Sivas Numune Hospital , Sivas , Turkey
| |
Collapse
|
33
|
Seyyed Anvari S, Dehgan GH, Razi M. Preliminary Findings of Platelet-Rich Plasma-Induced Ameliorative Effect on Polycystic Ovarian Syndrome. CELL JOURNAL 2019; 21:243-252. [PMID: 31210429 PMCID: PMC6582424 DOI: 10.22074/cellj.2019.5952] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 11/19/2018] [Indexed: 01/22/2023]
Abstract
Objective Polycystic ovarian syndrome (PCOS) is characterized by hormonal imbalance, oxidative stress and chronic
anovulation. The present study was designed to assess ameliorative effect of auto-locating platelet-rich plasma (PRP),
as a novel method, for inhibiting PCOS-induced pathogenesis in experimentally-induced hyperandrogenic PCOS.
Materials and Methods In this experimental study, 30 immature (21 days old) female rats were assigned into five
groups, including control (sampled after 30 days with no treatment), 15 and 30 days PCOS-sole-induced as well as
15 and 30 days PRP auto-located PCOS-induced groups. Serum levels of estrogen, progesterone, androstenedione,
testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), ovarian total antioxidant capacity (TAC),
malondialdehyde (MDA), glutathione peroxidase (GSH-px) and superoxide dismutase (SOD) were evaluated.
Expression of estrogen receptor α (Erα), β (Erβ) and c-Myc were assessed. Finally, the numbers of intact follicles per
ovary and mRNA damage ratio were analyzed.
Results PRP groups significantly (P<0.05) decreased serum levels of FSH, LH, testosterone and androstenedione
and remarkably (P<0.05) increased estrogen and progesterone syntheses versus PCOS-sole groups. The PRP
auto-located animals exhibited increased TAC, GSH-px and SOD levels, while they showed diminished MDA content
(P<0.05) versus PCOS-sole groups. The PRP auto-located groups exhibited an elevated expression of Erα and Erβ
versus PCOS-sole groups. Moreover, PRP groups significantly (P<0.05) decreased c-Myc expression and mRNA
damage compared to PCOS-sole groups, and remarkably improved follicular growth.
Conclusion PRP is able to regulate hormonal interaction, improve the ovarian antioxidant potential as well as folliculogenesis
and its auto-location could be considered as a novel method to prevent/ameliorate PCOS-induced pathogenesis.
Collapse
Affiliation(s)
- Samira Seyyed Anvari
- Department of Biology, Collage of Post Graduate, Ahar Islamic Azad University, Ahar, Iran
| | - G Holamreza Dehgan
- Department of Biochemistry, Faculty of Natural Science, University of Tabriz, Tabriz, Iran
| | - Mazdak Razi
- Department of Basic Science, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran.Electronic Address:
| |
Collapse
|
34
|
Li M, Guo T, Cui R, Feng Y, Bai H, Zhang Z. Weight control is vital for patients with early-stage endometrial cancer or complex atypical hyperplasia who have received progestin therapy to spare fertility: a systematic review and meta-analysis. Cancer Manag Res 2019; 11:4005-4021. [PMID: 31190979 PMCID: PMC6512613 DOI: 10.2147/cmar.s194607] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 02/17/2019] [Indexed: 12/15/2022] Open
Abstract
Objectives: This study aimed to identify potential prognostic factors for patients with complex atypical hyperplasia (CAH) or early-stage endometrial cancer (EC) who received progestin therapy to spare fertility and, thus, improve the management of this patient group. Materials and methods: The PubMed, PMC, EMBASE, Web of Science, and Cochrane databases were searched for correlational studies published in English. Studies that evaluated the prognosis of patients with CAH or early-stage EC were pooled for a systematic review and meta-analysis. Results: In total, 31 eligible studies, including 8 prospective and 23 retrospective studies involving 1099 patients, were included in this analysis. The most commonly used progestin agents were medroxyprogesterone acetate (MPA, 47.0%) and megestrol acetate (MA, 25.5%). The total complete response (CR) rate was 75.8% (833/1099), and the median time to CR with first-line progestin therapy was 6 months. In total, 294 (26.8%) patients who achieved CR became pregnant spontaneously (28 cases) or through assisted reproductive technology (127 cases). During the median follow-up of 39 months, 245 (22.3%) women developed recurrence. Only one patient (0.09%) died of the disease. The meta-analysis showed that compared to a BMI<25 kg/m2 and CAH, a body mass index (BMI) ≥25 kg/m2 (P=0.0004, odds ratios (OR), 0.4; 95% confidence interval, 0.3-0.6) and EC (P=0.0000, OR, 0.3; 95% confidence interval, 0.2-0.6) were significantly associated with a higher likelihood of a CR. Patients with a BMI≥25 kg/m2 (P=0.0007, OR, 2.5; 95% confidence interval, 1.4-4.3), PCOS (P=0.0006, OR, 3.4; 95% confidence interval, 1.5-7.9), and EC (P=0.0344, OR, 2.8; 95% confidence interval, 1.4-5.3) had a significantly higher risk of recurrence. Conclusion: In general, patients with CAH or early-stage EC who were treated with progesterone therapy had a favorable prognosis. However, the recurrence risk was not insignificant. Weight control is crucial for improving the clinical management of this patient group.
Collapse
Affiliation(s)
- Miaomiao Li
- Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Tao Guo
- Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Ran Cui
- Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Ying Feng
- Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Huimin Bai
- Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Zhenyu Zhang
- Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| |
Collapse
|
35
|
Charifson MA, Trumble BC. Evolutionary origins of polycystic ovary syndrome: An environmental mismatch disorder. Evol Med Public Health 2019; 2019:50-63. [PMID: 31367382 PMCID: PMC6658700 DOI: 10.1093/emph/eoz011] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 03/14/2019] [Indexed: 12/14/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common female endocrine disorder and has important evolutionary implications for female reproduction and health. PCOS presents an interesting paradox, as it results in significant anovulation and potential sub-fecundity in industrialized populations, yet it has a surprisingly high prevalence and has a high heritability. In this review, we discuss an overview of PCOS, current diagnostic criteria, associated hormonal pathways and a review of proposed evolutionary hypotheses for the disorder. With a multifactorial etiology that includes ovarian function, metabolism, insulin signaling and multiple genetic risk alleles, PCOS is a complex disorder. We propose that PCOS is a mismatch between previously neutral genetic variants that evolved in physically active subsistence settings that have the potential to become harmful in sedentary industrialized environments. Sedentary obesogenic environments did not exist in ancestral times and exacerbate many of these pathways, resulting in the high prevalence and severity of PCOS today. Overall, the negative impacts of PCOS on reproductive success would likely have been minimal during most of human evolution and unlikely to generate strong selection. Future research and preventative measures should focus on these gene-environment interactions as a form of evolutionary mismatch, particularly in populations that are disproportionately affected by obesity and metabolic disorders. LAY SUMMARY The most severe form of polycystic ovary syndrome (PCOS) is likely a result of interactions between genetic predispositions for PCOS and modern obesogenic environments. PCOS would likely have been less severe ancestrally and the fitness reducing effects of PCOS seen today are likely a novel product of sedentary, urban environments.
Collapse
Affiliation(s)
- Mia A Charifson
- School of Human Evolution and Social Change, Arizona State University, 900 Cady Mall, Tempe, AZ, USA
- Center for Evolution and Medicine, Arizona State University, 427 E. Tyler Mall, Tempe, AZ, USA
| | - Benjamin C Trumble
- School of Human Evolution and Social Change, Arizona State University, 900 Cady Mall, Tempe, AZ, USA
- Center for Evolution and Medicine, Arizona State University, 427 E. Tyler Mall, Tempe, AZ, USA
| |
Collapse
|
36
|
Beydoun HA, Hossain S, Beydoun MA, Weiss J, Zonderman AB, Eid SM. Anti-Müllerian Hormone Levels and Cardiometabolic Disturbances by Weight Status Among Men in the 1999 to 2004 National Health and Nutrition Examination Survey. J Endocr Soc 2019; 3:921-936. [PMID: 31020056 PMCID: PMC6469951 DOI: 10.1210/js.2018-00414] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/12/2019] [Indexed: 12/27/2022] Open
Abstract
Context Serum anti-Müllerian hormone level (AMH) and body mass index may be jointly associated with cardiometabolic risk. Objectives Examine the contribution of AMH to cardiometabolic disturbances by weight status among US adult men. Design Cross-sectional analysis using data from the 1999 to 2004 waves of the National Health and Nutrition Examination Survey. Setting Multistage probability sampling of the noninstitutionalized US population. Participants US men aged ≥18 years. Final analytic sample sizes ranged from 517 to 1063 participants. Main Outcome and Exposure Measures Cardiometabolic disturbances (metabolic syndrome and its components, insulin resistance, diabetes, and chronic inflammation) and AMH were obtained from trained staff and nurses in a mobile examination center or during in-home visits. Results AMH was directly associated with insulin resistance among obese men [OR 1.08 (95% CI 1.00, 1.15); P = 0.046; N = 146], whereas AMH was inversely associated with waist circumference (WC) among obese men [OR 0.95 (95% CI 0.91, 0.99); P = 0.049; N = 146]. An inverse relationship was also observed between categorical AMH and diabetes status [medium vs low AMH; OR 0.19 (95% CI 0.043, 0.84); P = 0.030; N = 145] among obese men, with a strong inverse relationship also detected among overweight men [high vs low AMH; OR 0.011 (95% CI 0.0004, 0.27); P = 0.007; N = 193]. An inverse relationship between continuous AMH and diabetes [OR 0.75 (95% CI: 0.59, 0.93); P = 0.011; N = 193] was also detected among overweight men. Conclusions AMH was associated with specific cardiometabolic risk factors, including WC, diabetes status, and insulin resistance, in overweight and obese US men.
Collapse
Affiliation(s)
- Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, Virginia
| | - Sharmin Hossain
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health Intramural Research Program, Baltimore, Maryland
| | - May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health Intramural Research Program, Baltimore, Maryland
| | - Jordan Weiss
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health Intramural Research Program, Baltimore, Maryland
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health Intramural Research Program, Baltimore, Maryland
| | - Shaker M Eid
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| |
Collapse
|
37
|
Effect of orlistat on obese women with polycystic ovary syndrome. JOURNAL OF BIO-X RESEARCH 2018. [DOI: 10.1097/jbr.0000000000000017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
38
|
Rosta K, Ott J, Kelemen F, Temsch W, Lahner T, Reischer T, Helmer H, Somogyi A. Is vaginal progesterone treatment associated with the development of gestational diabetes? A retrospective case-control study. Arch Gynecol Obstet 2018; 298:1079-1084. [PMID: 30225687 PMCID: PMC6244685 DOI: 10.1007/s00404-018-4895-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 09/06/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the incidence of gestational diabetes mellitus (GDM) in pregnant women who received vaginal progesterone due to short cervical length or to prevent recurrent preterm birth. METHODS In this retrospective study, we included 190 women with singleton pregnancies at risk for preterm birth who received vaginal natural progesterone (200 mg daily between gestational weeks 16 + 0 and 36 + 0) for a minimum of 4 weeks and delivered > 28 weeks. The control group consisted of 242 age- and body mass index (BMI)-matched patients without progesterone administration. Data were acquired from a database containing prospectively collected information. Patients with pre-existing diabetes, and conception after in vitro fertilisation procedure were excluded. RESULTS The incidence of GDM did not differ significantly between the progesterone-treated and the control group (14.7% vs. 16.9%, respectively; p = 0.597). In a binary regression model, patients with higher pre-pregnancy BMI (OR 1.1; p = 0.006), and those with a family history of diabetes had a higher risk for GDM development (OR 1.8; p = 0.040), whereas vaginal progesterone treatment had no significant influence (p = 0.580). CONCLUSION The use of vaginal progesterone for the prevention of recurrent preterm delivery and in women with a short cervix does not seem to be associated with an increased risk of GDM.
Collapse
Affiliation(s)
- Klara Rosta
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Johannes Ott
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - Fanni Kelemen
- University of Szeged, 12 Dóm tér, 6720, Szeged, Hungary
| | - Wilhelm Temsch
- Center for Medical Statistic and Informatics and Intelligent Systems, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Tobias Lahner
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Theresa Reischer
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Hanns Helmer
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Aniko Somogyi
- 2nd Department of Internal Medicine, Semmelweis University, Szentkirályi u.46, Budapest, Hungary
| |
Collapse
|
39
|
Li Y, Lin H, Pan P, Yang D, Zhang Q. Impact of Central Obesity on Women with Polycystic Ovary Syndrome Undergoing In Vitro Fertilization. Biores Open Access 2018; 7:116-122. [PMID: 30083428 PMCID: PMC6076435 DOI: 10.1089/biores.2017.0040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Central obesity (CO) is a defining characteristic of polycystic ovary syndrome (PCOS) and PCOS-induced disorders are likely to be exacerbated in the presence of CO. This study aims to evaluate the impact of CO on infertile women with PCOS undergoing in vitro fertilization (IVF).It is a retrospective and case-control study. One hundred eighty-eight infertile PCOS women undergoing IVF were divided into CO group (n = 70, waist circumference [WC] ≥80 cm) and noncentral obesity (NCO) group (n = 118, WC <80 cm). Baseline characteristics, parameters of ovarian stimulation and laboratory, and pregnancy outcomes were compared between two groups. After controlling for body mass index (BMI), WC positively correlated with fasting insulin (r = 0.210, p = 0.007), homeostatic model assessment for insulin resistance (r = 0.249, p = 0.006) and free androgen index (r = 0.249, p = 0.006). Compared with NCO group, CO group had significantly increased endocrine and metabolic disorders and needed significantly higher dose of gonadotropins, longer duration of ovarian stimulation (p < 0.05), but had significantly lower peak serum estradiol level (p < 0.01) and less oocytes retrieved (p = 0.032). CO group had significantly lower live birth and implantation rates (53.8% vs. 86.8%, p = 0.001; and 24.3% vs. 36.3%, p = 0.019, respectively) and higher early spontaneous miscarriage rate (38.5% vs. 7.5%, p = 0.002). For the multivariate analysis, by adjusting for age, BMI, insulin resistance, and hyperandrogenism (HA), CO was significantly independent risk factor for early miscarriage (adjusted relative ratio = 16.87, 95% confidence interval = 2.15-132.70, p = 0.007). CO is associated with insulin resistance, hyperinsulinemia, and HA independent of BMI and is associated with poor pregnancy outcome in infertile women with PCOS undergoing IVF.
Collapse
Affiliation(s)
- Yu Li
- Department of Gynecology and Obstetrics, Reproductive Medicine Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Haiyan Lin
- Department of Gynecology and Obstetrics, Reproductive Medicine Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ping Pan
- Department of Gynecology and Obstetrics, Reproductive Medicine Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Dongzi Yang
- Department of Gynecology and Obstetrics, Reproductive Medicine Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qingxue Zhang
- Department of Gynecology and Obstetrics, Reproductive Medicine Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
40
|
Qasim A, Turcotte M, de Souza RJ, Samaan MC, Champredon D, Dushoff J, Speakman JR, Meyre D. On the origin of obesity: identifying the biological, environmental and cultural drivers of genetic risk among human populations. Obes Rev 2018; 19:121-149. [PMID: 29144594 DOI: 10.1111/obr.12625] [Citation(s) in RCA: 125] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 08/28/2017] [Accepted: 09/08/2017] [Indexed: 12/12/2022]
Abstract
Genetic predisposition to obesity presents a paradox: how do genetic variants with a detrimental impact on human health persist through evolutionary time? Numerous hypotheses, such as the thrifty genotype hypothesis, attempt to explain this phenomenon yet fail to provide a justification for the modern obesity epidemic. In this critical review, we appraise existing theories explaining the evolutionary origins of obesity and explore novel biological and sociocultural agents of evolutionary change to help explain the modern-day distribution of obesity-predisposing variants. Genetic drift, acting as a form of 'blind justice,' may randomly affect allele frequencies across generations while gene pleiotropy and adaptations to diverse environments may explain the rise and subsequent selection of obesity risk alleles. As an adaptive response, epigenetic regulation of gene expression may impact the manifestation of genetic predisposition to obesity. Finally, exposure to malnutrition and disease epidemics in the wake of oppressive social systems, culturally mediated notions of attractiveness and desirability, and diverse mating systems may play a role in shaping the human genome. As an important first step towards the identification of important drivers of obesity gene evolution, this review may inform empirical research focused on testing evolutionary theories by way of population genetics and mathematical modelling.
Collapse
Affiliation(s)
- A Qasim
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - M Turcotte
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - R J de Souza
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - M C Samaan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Department of Pediatrics, McMaster University, Hamilton, ON, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, ON, Canada
| | - D Champredon
- Department of Biology, McMaster University, Hamilton, ON, Canada.,Agent-Based Modelling Laboratory, York University, Toronto, ON, Canada
| | - J Dushoff
- Department of Biology, McMaster University, Hamilton, ON, Canada
| | - J R Speakman
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK.,State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - D Meyre
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
41
|
Lepine S, Jo J, Metwally M, Cheong YC. Ovarian surgery for symptom relief in women with polycystic ovary syndrome. Cochrane Database Syst Rev 2017; 11:CD009526. [PMID: 29125183 PMCID: PMC6486107 DOI: 10.1002/14651858.cd009526.pub2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common endocrine condition, affecting approximately one in 10 women. PCOS is defined by two of three features: oligo- or anovulation, clinical or biochemical hyperandrogenism or both, or polycystic ovaries.Women with PCOS can have a wide range of health problems, including infrequent and irregular periods, unwanted hair growth and acne, and subnormal fertility. Long-term health concerns include an increased risk of heart disease, diabetes and the development of precancerous disease of the womb. OBJECTIVES To assess the effectiveness and harms of ovarian surgery as a treatment for symptomatic relief of hirsutism, acne and menstrual irregularity in PCOS. SEARCH METHODS We searched the Cochrane Gynaecology and Fertility Group specialized register, CENTRAL, MEDLINE, Embase and PsycINFO (from inception to 17 October 2016). We handsearched citation lists, registers of ongoing trials and conference proceedings. SELECTION CRITERIA We included randomized controlled trials (RCTs) of women undergoing ovarian drilling in comparison to no treatment, medical treatment, or other forms of surgical treatment for the symptoms of PCOS. DATA COLLECTION AND ANALYSIS We used standard methodological procedures recommended by Cochrane. The primary outcome measures were improvement in menstrual regularity and androgenic symptoms of PCOS (hirsutism, acne); the secondary outcome measures included harms, change of body mass index (BMI), waist circumference, androgen levels, metabolic measures and quality of life. We assessed the quality of the evidence using GRADE methods. MAIN RESULTS We included 22 RCTs (2278 women analyzed) of participants with PCOS and symptoms of acne, hirsutism or irregular menstrual cycles, all of which included laparoscopic ovarian drilling (LOD) as an intervention.Two studies reported their funding source (Farquhar 2002 - supported in part by the Auckland Medical Research Foundation; Sarouri 2015 - the authors thank the Vice Chancellor for Research of Guilan University of Medical Sciences for funding this project).The quality of the evidence ranged from very low to moderate quality. The main limitations were imprecision associated with the low number of studies, inconsistency and risk of bias associated with the inability to blind participants. There were too few studies to assess risk of publication bias. Menstrual RegularityTwo studies compared LOD versus metformin (n=226) but no conclusions could be drawn with regard to menstrual regularity, as their findings were inconsistent and they were unsuitable for pooling. There appeared to be little or no difference in the rate of women reporting improvement in menstrual regularity when LOD was compared with medical treatment including metformin + clomiphene (OR 1.02, 95% CI 0.64 to 1.64, 2 studies, 332 women, I2 = 13%, low-quality evidence), letrozole (OR 1.08, 95% CI 0.64 to 1.84, 1 study, 260 women, low-quality evidence), or metformin + letrozole (OR 0.95, 95% CI 0.49 to 1.81, 1 study, 146 women, low-quality evidence). However, one study reported that LOD was superior to gonadotrophin (OR 19.2, 95% CI 3.17 to 116.45, 1 study, 35 women, very low-quality evidence).There appeared to be little or no difference in the rate of women reporting improvement in menstrual regularity when bilateral unipolar LOD was compared to unilateral LOD (OR 1.51, 95% CI 0.62 to 3.71, 2 studies, 104 women, I2 = 0%, moderate-quality evidence), transvaginal ultrasound-guided LOD (OR 1.23, 95% CI 0.64 to 2.37, 1 study, 147 women, low-quality evidence), LOD using adjusted thermal dose in accordance with the ovarian volume (OR 0.42, 95% CI 0.16 to 1.14, 1 study, 115 women, low-quality evidence) or bipolar LOD (OR 1.00, 95% CI 0.05 to 18.57, 1 study, 18 women, low-quality evidence).Four to five punctures per ovary may improve the rate of women reporting menstrual regularity compared with two or fewer (OR 16.04, 95% CI 4.19 to 61.34, 2 studies, 73 women, I2 = 0%, low-quality evidence). Androgenic SymptomsThere was probably little or no difference in improvement in androgenic symptoms when LOD was compared to metformin (OR 1.00, 95% CI 0.42 to 2.37, 1 study, 126 women, moderate-quality evidence) or gonadotrophins; acne (OR 3.20, 95% CI 0.33 to 30.94, 1 study, 25 women, low-quality evidence), hirsutism (OR 2.31, 95% CI 0.22 to 23.89, 1 study, 25 women, low-quality evidence).There appeared to be little or no difference in improvement of androgenic symptoms when LOD was compared to transvaginal ultrasound-guided LOD, with respect to hirsutism (OR 1.09, 95% CI 0.30 to 3.91, 1 study, 39 women, low-quality evidence) or acne (OR 0.84, 95% CI 0.20 to 3.50, 1 study, 31 women, low-quality evidence). HarmsLOD was associated with fewer gastrointestinal side effects than metformin plus clomiphene (OR 0.05, 95% CI 0.01 to 0.36, 2 studies, 332 women, I2 = 0%, moderate-quality evidence). One study suggested little or no difference in rates of ovarian hyperstimulation syndrome between LOD and gonadotrophins (OR 0.08, 95% CI 0.00 to 1.61, 1 study, 33 women, low-quality evidence).There were fewer adhesions with transvaginal hydrolaparoscopy compared to LOD (OR 0.10, 95% CI 0.05 to 0.18, 1 study, 246 women, moderate-quality evidence). There appeared to be little or no difference in adhesions when variable energy LOD was compared with standard LOD (OR 0.96, 95% CI 0.32 to 2.88, 1 study, 64 women, low-quality evidence). Another study (44 women) reported that none of the women who returned for surgery following either traditional or unilateral LOD were found to have adhesions. AUTHORS' CONCLUSIONS There was no clear evidence that LOD improves menstrual regularity or the androgenic symptoms of PCOS, compared to most of the medical treatments used in the included studies. LOD was associated with fewer gastrointestinal side effects compared to metformin and clomiphene.There was also no clear evidence of different effectiveness between types of LOD, except that LOD with four to five punctures per ovary may be more effective than two or fewer punctures. There was little evidence comparing LOD with different types of surgery, although one study concluded that transvaginal hydrolaparoscopy had a lower risk of adhesions than LOD.There was evidence from one small study of benefit from LOD compared to gonadotrophins for menstrual regulation. However, gonadotrophins are seldom used for this indication.
Collapse
Affiliation(s)
- Sam Lepine
- Capital and Coast District Health BoardDepartment of Obstetrics and GynaecologyWellingtonNew Zealand
| | - Junyoung Jo
- Conmaul Hospital of Korean MedicineDepartment of Korean Obstetrics and GynecologyFl. 5, Lotte Castle Medici, 1656‐4, Seocho‐dong, Seocho‐guSeoulKorea, South
| | - Mostafa Metwally
- Sheffield Teaching HospitalsThe Jessop Wing and Royal Hallamshire HospitalSheffieldUKS10 2JF
| | - Ying C Cheong
- University of SouthamptonDepartment of Obstetrics and GynaecologyLevel F, Princess Anne HospitalCoxford RoadSouthamptonUKSO16 5YA
| | | |
Collapse
|
42
|
Unfer V, Facchinetti F, Orrù B, Giordani B, Nestler J. Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials. Endocr Connect 2017; 6:647-658. [PMID: 29042448 PMCID: PMC5655679 DOI: 10.1530/ec-17-0243] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 09/20/2017] [Indexed: 12/17/2022]
Abstract
Myo-inositol (MI) supplementation in women with polycystic ovary syndrome (PCOS) has been evaluated over the last years. Many hormonal and reproductive impairments associated with this disorder seem relieved by the supplement. The objective of the meta-analysis was to assess the effects of MI alone or combined with d-chiro-inositol (DCI) on the endocrine and metabolic abnormalities of women with PCOS. Literature was retrieved from selected databases, MEDLINE, EMBASE, PubMed and Research Gate (up to November 2016). Only randomized controlled trials (RCTs) investigating the effects of MI alone or combined with DCI were reviewed. Nine RCTs involving 247 cases and 249 controls were included. Significant decreases in fasting insulin (SMD = -1.021 µU/mL, 95% CI: -1.791 to -0.251, P = 0.009) and homeostasis model assessment (HOMA) index (SMD = -0.585, 95% CI: -1.145 to -0.025, P = 0.041) were identified after MI supplementation. The trial sequential analysis of insulin meta-analysis illustrates that the cumulative z-curve crossed the monitoring boundary, providing firm evidence of the intervention effect. A slight trend toward a reduction of testosterone concentration by MI with respect to controls was found (SMD = -0.49, 95% CI: -1.072 to 0.092, P = 0.099), whereas androstenedione levels remained unaffected. Throughout a subgroup's meta-analysis, a significant increase in serum SHBG was observed only in those studies where MI was administered for at least 24 weeks (SMD = 0.425 nmol/L, 95% CI: 0.050-0.801, P = 0.026). These results highlight the beneficial effect of MI in improving the metabolic profile of women with PCOS, concomitantly reducing their hyperandrogenism.
Collapse
Affiliation(s)
- Vittorio Unfer
- Health DepartmentUniPoliSi - Institut des Etudes Universitaires, Disentis, Switzerland
| | - Fabio Facchinetti
- Mother-Infant DepartmentUniversity of Modena and Reggio Emilia, Modena, Italy
| | - Beatrice Orrù
- Medical Affairs DepartmentLo.Li. Pharma, Rome, Italy
| | | | - John Nestler
- Departments of Medicine and Obstetrics and GynecologyVirginia Commonwealth University, Richmond, Virginia, USA
| |
Collapse
|
43
|
Gheller BJF, Riddle ES, Lem MR, Thalacker-Mercer AE. Understanding Age-Related Changes in Skeletal Muscle Metabolism: Differences Between Females and Males. Annu Rev Nutr 2017; 36:129-56. [PMID: 27431365 DOI: 10.1146/annurev-nutr-071715-050901] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Skeletal muscle is the largest metabolic organ system in the human body. As such, metabolic dysfunction occurring in skeletal muscle impacts whole-body nutrient homeostasis. Macronutrient metabolism changes within the skeletal muscle with aging, and these changes are associated in part with age-related skeletal muscle remodeling. Moreover, age-related changes in skeletal muscle metabolism are affected differentially between males and females and are likely driven by changes in sex hormones. Intrinsic and extrinsic factors impact observed age-related changes and sex-related differences in skeletal muscle metabolism. Despite some support for sex-specific differences in skeletal muscle metabolism with aging, more research is necessary to identify underlying differences in mechanisms. Understanding sex-specific aging skeletal muscle will assist with the development of therapies to attenuate adverse metabolic and functional outcomes.
Collapse
Affiliation(s)
- Brandon J F Gheller
- Division of Nutritional Sciences, Cornell University, Ithaca, New York 14853;
| | - Emily S Riddle
- Division of Nutritional Sciences, Cornell University, Ithaca, New York 14853;
| | - Melinda R Lem
- Division of Nutritional Sciences, Cornell University, Ithaca, New York 14853;
| | | |
Collapse
|
44
|
Wang L, Li N, Yao X, Chang G, Zhang D, Heizhati M, Wang M, Luo Q, Kong J. Detection of Secondary Causes and Coexisting Diseases in Hypertensive Patients: OSA and PA Are the Common Causes Associated with Hypertension. BIOMED RESEARCH INTERNATIONAL 2017; 2017:8295010. [PMID: 28691036 PMCID: PMC5485286 DOI: 10.1155/2017/8295010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 02/19/2017] [Accepted: 03/16/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND Since the control rate of blood pressure is lower in mainland China, the aim of this study is to investigate the proportion of secondary causes and coexisting diseases of hypertension in hypertensive patients. METHODS Data on consecutive patients with hypertension who visited the Hypertension Center. Diseases were detected using an established strict screening protocol. RESULTS Detection rate of secondary causes and coexisting diseases of hypertension was 39.5% among 3003 hypertensive patients. Obstructive sleep apnea (OSA) was the most common, accounting for 24.7% of patients, followed by primary aldosteronism (PA) (5.8%) and PA + OSA (4.9%). Endocrine hypertension accounted for 12.1% of patients, including 10.7% of patients with PA, 1.1% with hypothyroidism, 0.1% with pheochromocytoma, 0.1% with Cushing's syndrome, and 0.1% with hyperthyroidism, respectively. Those who smoke, those who are obese, and those who have diabetes accounted for 31.3%, 27.5%, and 16.6% of total patients, respectively. There were overlapping conditions in secondary causes and coexisting diseases of hypertension. OSA was the most common in each age- and BMI-stratified group. CONCLUSION Findings from the current study suggest an increasing frequency of secondary forms of hypertension, highlighting the burden of OSA and PA in hypertensive patients.
Collapse
Affiliation(s)
- Lei Wang
- Hypertension Institute of Xinjiang, Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Nanfang Li
- Hypertension Institute of Xinjiang, Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Xiaoguang Yao
- Hypertension Institute of Xinjiang, Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Guijuan Chang
- Hypertension Institute of Xinjiang, Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Delian Zhang
- Hypertension Institute of Xinjiang, Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Mulalibieke Heizhati
- Hypertension Institute of Xinjiang, Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Menghui Wang
- Hypertension Institute of Xinjiang, Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Qin Luo
- Hypertension Institute of Xinjiang, Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Jianqiong Kong
- Hypertension Institute of Xinjiang, Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| |
Collapse
|
45
|
de Melo AS, Dos Reis RM, Ferriani RA, Vieira CS. Hormonal contraception in women with polycystic ovary syndrome: choices, challenges, and noncontraceptive benefits. Open Access J Contracept 2017; 8:13-23. [PMID: 29386951 PMCID: PMC5774551 DOI: 10.2147/oajc.s85543] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is an endocrine disorder among women of reproductive age characterized by chronic anovulation and polycystic ovary morphology and/or hyperandrogenism. Management of clinical manifestations of PCOS, such as menstrual irregularities and hyperandrogenism symptoms, includes lifestyle changes and combined hormonal contraceptives (CHCs). CHCs contain estrogen that exerts antiandrogenic properties by triggering the hepatic synthesis of sex hormone-binding globulin that reduces the free testosterone levels. Moreover, the progestogen present in CHCs and in progestogen-only contraceptives suppresses luteinizing hormone secretion. In addition, some types of progestogens directly antagonize the effects of androgens on their receptor and also reduce the activity of the 5α reductase enzyme. However, PCOS is related to clinical and metabolic comorbidities that may limit the prescription of CHCs. Clinicians should be aware of risk factors, such as age, smoking, obesity, diabetes, systemic arterial hypertension, dyslipidemia, and a personal or family history, of a venous thromboembolic event or thrombophilia. This article reports a narrative review of the available evidence of the safety of hormonal contraceptives in women with PCOS. Considerations are made for the possible impact of hormonal contraceptives on endocrine, metabolic, and cardiovascular health.
Collapse
Affiliation(s)
- Anderson Sanches de Melo
- Department of Gynecology and Obstetrics, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Rosana Maria Dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Rui Alberto Ferriani
- Department of Gynecology and Obstetrics, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Carolina Sales Vieira
- Department of Gynecology and Obstetrics, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| |
Collapse
|
46
|
Hakim C, Padmanabhan V, Vyas AK. Gestational Hyperandrogenism in Developmental Programming. Endocrinology 2017; 158:199-212. [PMID: 27967205 PMCID: PMC5413081 DOI: 10.1210/en.2016-1801] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 12/07/2016] [Indexed: 12/16/2022]
Abstract
Androgen excess (hyperandrogenism) is a common endocrine disorder affecting women of reproductive age. The potential causes of androgen excess in women include polycystic ovary syndrome, congenital adrenal hyperplasia (CAH), adrenal tumors, and racial disparity among many others. During pregnancy, luteoma, placental aromatase deficiency, and fetal CAH are additional causes of gestational hyperandrogenism. The present report reviews the various phenotypes of hyperandrogenism during pregnancy and its origin, pathophysiology, and the effect of hyperandrogenism on the fetal developmental trajectory and offspring consequences.
Collapse
Affiliation(s)
- Christopher Hakim
- College of Human Medicine, Michigan State University, East Lansing, Michigan 48824
| | - Vasantha Padmanabhan
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan 48109; and
| | - Arpita K. Vyas
- College of Human Medicine, Michigan State University, East Lansing, Michigan 48824
- Department of Pediatrics, Texas Tech University Health Sciences Center, Permian Basin Campus, Odessa, Texas 79763
| |
Collapse
|
47
|
Vartanyan EV, Tsaturova KA, Devyatova EA, Mikhaylyukova AS, Levin VA, Petuhova NL, Markin AV, Steptsova EM. Improvement in quality of oocytes in polycystic ovarian syndrome in programs of in vitro fertilization. Gynecol Endocrinol 2017; 33:8-11. [PMID: 29264980 DOI: 10.1080/09513590.2017.1399699] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Inositol therapy is aimed at improving the quality of oocytes during preconception care in patients with polycystic ovarian syndrome (PCOS), a cause of infertility and reproductive dysfunction. The objectives of this observational comparative multicentre study were to evaluate the effectiveness of inositol in improving the quality of oocytes/embryos and IVF cycle outcome. Group 1 patients (N = 133) received inositol 1000 mg (Inofert or Nutrilinea) + folic acid 0.1 mg. Group 2 consisted of patients with preserved ovarian reserve without PCOS (N = 137), not administered inositol prior to pregnancy. Effectiveness criteria were numbers of mature oocytes and good quality embryos, pregnancy rates per ET, 'take home baby' index and miscarriage rates. Pregnancy rates per ET (87.0% vs. 87.4%), 'take home baby' index (79.6% vs. 89.4%) and miscarriage rates (14.3% vs. 10.6%) were comparable. Use of inositol in patients with PCOS during preconception care is an effective method allowing improvement of oocytes quality and positively affecting IVF cycle prognosis. High pregnancy rates per ET and 'take home baby' index after treatment are justifying inositol usage in patients with PCOS and infertility.
Collapse
Affiliation(s)
- E V Vartanyan
- a Clinic for Assisted Reproductive Technologies 'Test-Tube Babies' LLC , Moscow , Russia
- b Department of Obstetrics, Gynecology and Reproductive Medicine , Peoples' Friendship University of Russia , Moscow , Russia
| | - K A Tsaturova
- a Clinic for Assisted Reproductive Technologies 'Test-Tube Babies' LLC , Moscow , Russia
| | - E A Devyatova
- a Clinic for Assisted Reproductive Technologies 'Test-Tube Babies' LLC , Moscow , Russia
| | - A S Mikhaylyukova
- a Clinic for Assisted Reproductive Technologies 'Test-Tube Babies' LLC , Moscow , Russia
| | - V A Levin
- a Clinic for Assisted Reproductive Technologies 'Test-Tube Babies' LLC , Moscow , Russia
| | - N L Petuhova
- a Clinic for Assisted Reproductive Technologies 'Test-Tube Babies' LLC , Moscow , Russia
| | - A V Markin
- a Clinic for Assisted Reproductive Technologies 'Test-Tube Babies' LLC , Moscow , Russia
| | - E M Steptsova
- a Clinic for Assisted Reproductive Technologies 'Test-Tube Babies' LLC , Moscow , Russia
| |
Collapse
|
48
|
Genazzani AD. Inositol as putative integrative treatment for PCOS. Reprod Biomed Online 2016; 33:770-780. [DOI: 10.1016/j.rbmo.2016.08.024] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 08/12/2016] [Accepted: 08/17/2016] [Indexed: 01/28/2023]
|
49
|
Pkhaladze L, Barbakadze L, Kvashilava N. Myo-Inositol in the Treatment of Teenagers Affected by PCOS. Int J Endocrinol 2016; 2016:1473612. [PMID: 27635134 PMCID: PMC5007307 DOI: 10.1155/2016/1473612] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 07/28/2016] [Accepted: 08/01/2016] [Indexed: 12/13/2022] Open
Abstract
Objective. To compare the effectiveness of myo-inositol (MI) and oral contraceptive pills (OCPs) in monotherapy and MI in combination with OCPs in the treatment of teenagers affected by polycystic ovary syndrome (PCOS). Methods. 61 adolescent girls aged 13-19 years, with PCOS, were involved in the prospective, open-label study. Patients were randomized into three groups: I group, 20 patients receiving drospirenone 3 mg/ethinyl estradiol 30 μg; II group, 20 patients receiving 4 g myo-inositol plus 400 mg folic acid; III group, 21 patients receiving both medications. Results. After receiving MI significant reduction in weight, BMI, glucose, C-peptide, insulin, HOMA-IR, FT, and LH was detected. The levels of SHBG, TT, FAI, DHEA-S, and AMH did not change statistically significantly. After receiving OCPs weight and BMI slightly increased, but metabolic parameters did not change. Combination of MI and OCPs did not change weight and BMI, but reduction in C-peptide, insulin, and HOMA-IR was detected. TT, FT, FAI, DHEA-S, LH, and AMH levels decreased and SHBG increased. Conclusions. Administration of MI is a safe and effective method to prevent and correct metabolic disorders in teenagers affected by PCOS. With combination of MI and OCPs antiandrogenic effects are enhanced, negative impact of OCPs on weight gain is balanced, and metabolic profile is improved.
Collapse
Affiliation(s)
- Lali Pkhaladze
- Archil Khomasuridze Institute of Reproductology, 0112 Tbilisi, Georgia
| | | | - Nana Kvashilava
- Archil Khomasuridze Institute of Reproductology, 0112 Tbilisi, Georgia
| |
Collapse
|
50
|
Mobeen H, Afzal N, Kashif M. Polycystic Ovary Syndrome May Be an Autoimmune Disorder. SCIENTIFICA 2016; 2016:4071735. [PMID: 27274883 PMCID: PMC4871972 DOI: 10.1155/2016/4071735] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 03/10/2016] [Accepted: 04/11/2016] [Indexed: 05/15/2023]
Abstract
Polycystic ovarian syndrome (PCOS) is the most prevalent endocrine disorder affecting females. It is a common cause of menstrual irregularities and infertility during reproductive age. Genetic and hormonal factors play crucial role in the pathogenesis of PCOS. Low level of progesterone in PCOS causes overstimulation of immune system that produces more estrogen which leads to various autoantibodies. Different autoantibodies have been documented in PCOS, for example, anti-nuclear (ANA), anti-thyroid, anti-spermatic, anti-SM, anti-histone, anti-carbonic anhydrase, anti-ovarian, and anti-islet cell antibodies. There is an association between PCOS and autoimmune diseases such as ANA and anti-TPO that have been documented in systemic lupus erythematosus and Hashimoto thyroiditis, respectively, and it is suspected that there are autoantibodies that might affect the long term clinical management of these patients. Therefore fluctuating levels of autoantibodies in different PCOS patients give us the way to open new chapter for future research on molecular level. This may lead to discovery of better treatment options for PCOS in near future.
Collapse
Affiliation(s)
- Hifsa Mobeen
- Department of Immunology, University of Health Sciences, Lahore 54600, Pakistan
| | - Nadeem Afzal
- Department of Immunology, University of Health Sciences, Lahore 54600, Pakistan
| | - Muhammad Kashif
- Department of Immunology, University of Health Sciences, Lahore 54600, Pakistan
| |
Collapse
|