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Alenezi SA, Elkmeshi N, Alanazi A, Alanazi ST, Khan R, Amer S. The Impact of Diet-Induced Weight Loss on Inflammatory Status and Hyperandrogenism in Women with Polycystic Ovarian Syndrome (PCOS)-A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:4934. [PMID: 39201076 PMCID: PMC11355208 DOI: 10.3390/jcm13164934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Revised: 08/12/2024] [Accepted: 08/16/2024] [Indexed: 09/02/2024] Open
Abstract
Background: Currently, the primary strategy for addressing polycystic ovarian syndrome (PCOS) involves lifestyle modifications, with a focus on weight loss. The purpose of this meta-analysis was to assess the impact of weight loss through dietary interventions on inflammatory status and hyperandrogenism in PCOS women. Methods: A comprehensive search was conducted to identify randomised controlled trials (RCTs) and cohort studies assessing the impact of diet-induced weight loss on circulating inflammatory markers (CRP, IL-6, IL-1β, TNF-α), androgens (testosterone, androstenedione), SHBG, and luteinising hormone (LH) in PCOS women. The quality and risk of bias of the included studies were assessed using the Cochrane Collaboration's tool for RCTs and the Newcastle-Ottawa Scale for cohort studies. Data were entered into RevMan software v5.9 for the calculation of standard mean difference (SMD) and the 95% confidence interval (95%CI) of circulating inflammatory markers, androgens, and LH between baseline and post-weight loss values. Results: Eleven studies (n = 323) were eligible for the systematic review, of which nine (n = 286) were included in the meta-analysis. Pooled analysis of data revealed a statistically significant decrease in circulating CRP (SMD 0.39, 95%CI 0.22, 0.56; 9 studies, n = 286), IL-6 (SMD 0.37, 95%Cl, 0.12, 0.61; 3 Studies, n = 140), TNF-α (SMD 0.30, 95%Cl, 0.07, 0.53; 4 Studies, n = 162), androstenedione (SMD 0.36, 95%Cl, 0.13, 0.60; 4 studies, n = 147) and LH (SMD 0.30, 95% Cl, 0.09, 0.51; 5 studies, n = 197) after weight loss compared to baseline levels among PCOS women. A meta-analysis of five studies (n = 173) showed a statistically significant increase in circulating SHBG after weight loss compared to baseline levels (SMD -0.43, 95%Cl, -0.65, -0.21). Conclusions: These findings suggest that weight loss induced by dietary interventions seems to improve PCOS-related chronic inflammation and hyperandrogenism. The possible causative relationship between the improvement in inflammation and hyperandrogenism remains to be determined.
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Affiliation(s)
- Salih Atalah Alenezi
- Division of Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK or (S.A.A.); (N.E.); (R.K.)
- Prince Mohammed Bin Abdulaziz Medical City, Ministry of Health, Riyadh 14214, Saudi Arabia
| | - Nusaiba Elkmeshi
- Division of Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK or (S.A.A.); (N.E.); (R.K.)
| | - Abdullah Alanazi
- Health Sciences, Applied Sciences, Petaling Jaya 47301, Malaysia; (A.A.); (S.T.A.)
| | - Sulaiman T. Alanazi
- Health Sciences, Applied Sciences, Petaling Jaya 47301, Malaysia; (A.A.); (S.T.A.)
| | - Raheela Khan
- Division of Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK or (S.A.A.); (N.E.); (R.K.)
| | - Saad Amer
- Division of Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK or (S.A.A.); (N.E.); (R.K.)
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Chang KJ, Chen JH, Chen KH. The Pathophysiological Mechanism and Clinical Treatment of Polycystic Ovary Syndrome: A Molecular and Cellular Review of the Literature. Int J Mol Sci 2024; 25:9037. [PMID: 39201722 PMCID: PMC11354688 DOI: 10.3390/ijms25169037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Revised: 08/07/2024] [Accepted: 08/10/2024] [Indexed: 09/03/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is a prevalent metabolic disorder among women of reproductive age, characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. The pathogenesis of PCOS involves a complex interplay of genetic and environmental factors, including insulin resistance (IR) and resultant hyperinsulinemia. Insulin receptors, primarily in skeletal muscle, liver, and adipose tissue, activate downstream signaling pathways like PI3K-AKT and MAPK-ERK upon binding. These pathways regulate glucose uptake, storage, and lipid metabolism. Genome-wide association studies (GWASs) have identified several candidate genes related to steroidogenesis and insulin signaling. Environmental factors such as endocrine-disrupting chemicals and lifestyle choices also exacerbate PCOS traits. Other than lifestyle modification and surgical intervention, management strategies for PCOS can be achieved by using pharmacological treatments like antiandrogens, metformin, thiazolidinediones, aromatase inhibitor, and ovulation drugs to improve insulin sensitivity and ovulatory function, as well as combined oral contraceptives with or without cyproterone to resume menstrual regularity. Despite the complex pathophysiology and significant economic burden of PCOS, a comprehensive understanding of its molecular and cellular mechanisms is crucial for developing effective public health policies and treatment strategies. Nevertheless, many unknown aspects of PCOS, including detailed mechanisms of actions, along with the safety and effectiveness for the treatment, warrant further investigation.
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Affiliation(s)
- Kai-Jung Chang
- Department of Obstetrics and Gynecology, Taipei Tzu-Chi Hospital, The Buddhist Tzu-Chi Medical Foundation, New Taipei City 23142, Taiwan;
| | - Jie-Hong Chen
- Department of Medicine, MacKay Medical College, New Taipei City 25245, Taiwan;
| | - Kuo-Hu Chen
- Department of Obstetrics and Gynecology, Taipei Tzu-Chi Hospital, The Buddhist Tzu-Chi Medical Foundation, New Taipei City 23142, Taiwan;
- School of Medicine, Tzu-Chi University, Hualien 97004, Taiwan
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Fereidouni F, Kashani L, Amidi F, Khodarahmian M, Zhaeentan S, Ardehjani NA, Rastegar T. Astaxanthin treatment decreases pro-inflammatory cytokines and improves reproductive outcomes in patients with polycystic ovary syndrome undergoing assisted reproductive technology: A randomized clinical trial. Inflammopharmacology 2024; 32:2337-2347. [PMID: 38916710 DOI: 10.1007/s10787-024-01504-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 06/02/2024] [Indexed: 06/26/2024]
Abstract
RESEARCH QUESTION In a randomized, triple-blind, placebo-controlled clinical trial (RCT), we investigated the effect of astaxanthin (AST) on pro-inflammatory cytokines, oxidative stress (OS) markers, and assisted reproductive technology (ART) outcomes in 44 infertile Polycystic Ovary Syndrome (PCOS) patients. DESIGN Patients with PCOS were randomly divided into two groups. The intervention group received 6 mg AST, and the control group received placebo daily for 8 weeks. Blood samples were obtained from all patients before and after intervention and follicular fluid (FF) was collected during the ART procedure. Interleukin (IL) -6, IL-1β were evaluated from serum samples and FF and OS markers (malondialdehyde [MDA], catalase [CAT], superoxide dismutase [SOD], and reactive oxygen species [ROS]) were measured from FF. The groups were compared for ART outcomes as well. RESULTS A significant decrease in IL-6 and IL-1β concentrations (both, P = < 0.01) serum levels was found following AST treatment. FF cytokine levels and OS markers did not differ significantly between the groups. Reproductive outcomes, including the number of oocytes retrieved (P = 0.01), the MII oocyte count (P = 0.007), oocyte maturity rate (MII %) (P = 0.02) and number of frozen embryos (P = 0.03) significantly improved after intervention. No significant differences were found in chemical, clinical and multiple pregnancies between the groups. CONCLUSIONS AST pretreatment may modify inflammation and improve ART outcomes in PCOS infertile patients. Further investigations are recommended to verify these findings.
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Affiliation(s)
- Farzane Fereidouni
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ladan Kashani
- Department of infertility, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fardin Amidi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahshad Khodarahmian
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of infertility, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrzad Zhaeentan
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Ajabi Ardehjani
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Tayebeh Rastegar
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Piao C, Li J, Liang C, Zhang J, Li X, Zhao Z, Wang K. Effect of vitamin D on pregnancy in women with polycystic ovary syndrome: retrospective and prospective studies. Reprod Biomed Online 2024; 49:103909. [PMID: 38776748 DOI: 10.1016/j.rbmo.2024.103909] [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: 08/02/2023] [Revised: 01/12/2024] [Accepted: 02/06/2024] [Indexed: 05/25/2024]
Abstract
RESEARCH QUESTION Does vitamin D affect the pregnancy rate of patients with polycystic ovary syndrome (PCOS) receiving ovulation-induction therapy? DESIGN The retrospective study included 200 patients with PCOS and 200 healthy women. The prospective study included 160 patients with PCOS receiving vitamin D or placebo supplementation. Pregnancy rates were assessed after a maximum of three cycles of ovulation induction. Serum concentrations of 25-hydroxycalciferol [25-(OH)D3], LH, FSH, progesterone, oestradiol, testosterone and fasting insulin; LH/FSH ratio; and body mass index were evaluated. RESULTS In the retrospective study, patients with PCOS had lower 25-(OH)D3 concentrations than healthy women, pregnant patients with PCOS had higher 25-(OH)D3 concentrations than non-pregnant patients with PCOS (both P = 0.000), and the pregnancy rate was lower in the vitamin-D-deficient group compared with the non-vitamin-D-deficient group (P = 0.022). In the prospective study, compared with placebo supplementation, vitamin D supplementation increased the serum concentration of 25-(OH)D3 (P = 0.000), and reduced the LH/FSH ratio, and concentrations of LH and testosterone significantly (all P ≤ 0.049). After the intervention, it was found that the LH/FSH ratio, and concentrations of LH and testosterone were significantly lower in both groups compared with pre-intervention (P = 0.000). After ovulation induction, the pregnancy rate was higher in patients in the vitamin D supplementation group compared with the placebo supplementation group (P = 0.049). CONCLUSIONS Vitamin D deficiency is common in patients with PCOS, and vitamin-D-deficient patients with PCOS have lower pregnancy rates after ovulation induction compared with non-vitamin-D-deficient patients with PCOS. Vitamin D supplementation can improve the pregnancy rate and mitigate basic hormone disorders. Therefore, monitoring vitamin D supplementation and checking vitamin D concentrations before and during interventions are essential for patients with PCOS.
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Affiliation(s)
- Chunmei Piao
- Department of Obstetrics and Gynaecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; Key Laboratory of Remodelling-Related Research Centre for Cardiovascular Diseases, Ministry of Education, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China
| | - Jia Li
- Department of Obstetrics and Gynaecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; Department of Obstetrics and Gynaecology, The Second Affiliated Hospital of Shandong First Medical University, Shandong, China
| | - Chao Liang
- Department of Obstetrics and Gynaecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; Department of Obstetrics, Qingdao Women and Children's Hospital, Qingdao, China
| | - Jun Zhang
- Department of Obstetrics and Gynaecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xin Li
- Department of Obstetrics and Gynaecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhihong Zhao
- Department of Obstetrics and Gynaecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Kefang Wang
- Department of Obstetrics and Gynaecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
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Christ JP, Shinkai K, Corley J, Pasch L, Cedars MI, Huddleston HG. Metabolic and endocrine status associate with obstructive sleep apnea risk among patients with polycystic ovary syndrome. J Clin Sleep Med 2024; 20:871-877. [PMID: 38217476 PMCID: PMC11145041 DOI: 10.5664/jcsm.11012] [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: 04/17/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/15/2024]
Abstract
STUDY OBJECTIVES Risk of obstructive sleep apnea (OSA) appears to be increased among patients with polycystic ovary syndrome (PCOS), but the underlying physiology is unclear. We sought to identify predictors of OSA risk among patients with PCOS. METHODS A cross-sectional analysis of patients evaluated for PCOS at a single tertiary center from 2017-2022 was completed. Inclusion criteria included patients 18-44 years of age who had Rotterdam criteria for PCOS and had completed a Berlin Questionnaire (BQ) for OSA risk assessment. All patients underwent standardized anthropometric, ultrasound, endocrine, and metabolic phenotyping. RESULTS Of the 572 patients screened during the study period, 309 patients with PCOS met inclusion criteria, and 104 (33.7%) had a high-risk BQ. Those with a high-risk BQ, compared with those without, had significantly (P < .05) higher waist:hip ratio, low-density-lipoprotein cholesterol, triglycerides, fasting insulin, 2-hour insulin, fasting glucose, 2-hour glucose, homeostatic model assessment for insulin resistance, hemoglobin A1C, C-reactive protein, free testosterone, and free androgen index and had lower high-density-lipoprotein cholesterol and sex hormone binding globulin. In multivariable modeling controlling for all significantly differing variables in univariate analyses, hemoglobin A1C (β [standard error] 1.05 [0.45], P = .02), C-reactive protein (0.09 [0.04], P = .01), and sex hormone binding globulin (-0.02 [0.01], P = .02) associated with high-risk BQ. CONCLUSIONS Dysglycemia, inflammation, and androgen status independently associate with predicted OSA risk by BQ. Future studies are needed to comprehensively assess the impact of treatment of OSA on these outcomes among patients with PCOS to better clarify the directionality and clinical implications of these associations. CITATION Christ JP, Shinkai K, Corley J, Pasch L, Cedars MI, Huddleston HG. Metabolic and endocrine status associate with obstructive sleep apnea risk among patients with polycystic ovary syndrome. J Clin Sleep Med. 2024;20(6):871-877.
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Affiliation(s)
- Jacob P. Christ
- Center for Reproductive Health, University of California San Francisco, San Francisco, California
| | - Kanade Shinkai
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Jamie Corley
- Center for Reproductive Health, University of California San Francisco, San Francisco, California
| | - Lauri Pasch
- Center for Reproductive Health, University of California San Francisco, San Francisco, California
| | - Marcelle I. Cedars
- Center for Reproductive Health, University of California San Francisco, San Francisco, California
| | - Heather G. Huddleston
- Center for Reproductive Health, University of California San Francisco, San Francisco, California
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Tatarchuk T, Pedachenko N, Kosei N, Malysheva I, Snizhko T, Kozub T, Zolotarevska O, Kosianenko S, Tutchenko T. Distribution and anthropometric characteristics of Rotterdam criteria-based phenotypic forms of Polycystic ovaries syndrome in Ukraine. Eur J Obstet Gynecol Reprod Biol 2024; 295:104-110. [PMID: 38354601 DOI: 10.1016/j.ejogrb.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/30/2024] [Accepted: 02/07/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE To explore the distribution of Rotterdam-based PCOS phenotypes and their associations with anthropometric parameters predictive of cardiometabolic risks in Ukrainian referral PCOS women. STUDY DESIGN It was a cross-sectional study conducted by the Ukrainian Society of Gynecological Endocrinology between September 2021 and January 2022 involving 42 clinics in 10 regional centres representing the major geographical parts of Ukraine. Two hundred obstetrician-gynecologists whose practice facilities corresponded to study criteria were committed to entering records of their PCOS patients aged 20-45 years into the uniform data collection forms. The recorded parameters were: PCOS phenotype with the mandatory assessment of biochemical hyperandrogenism, age, BMI, waist circumference, and hyperandrogenism symptoms. RESULTS 5254 patients' records were completed. Phenotype A was the most prevalent - 47.7 %, phenotypes B, C, and D were almost equally distributed in the studied population: 17.6 %, 17.4 %, and 17.3 % respectively. The total prevalence of androgenic phenotypes based on the presence of biochemical hyperandrogenism was 82.7 %. The incidence of obesity and hyperandrogenism symptoms, and mean BMI values were higher in phenotypes A and B compared to C and D. At the same time, the presence of 34.1 % and 46.2 % of normal-weight subjects in phenotypes A and B respectively, supports the fact that the excessive BMI is not a universal characteristic of androgenic phenotypes. In younger age groups, phenotypes C and D demonstrated the predominance of normal weight, but in older subgroups, the situation changed: in the age group of 36-45 y.o. compared to 18-25 y.o., the percentage of overweight and obese subjects for the non-classic phenotypes increased more than for the classic ones: C (OR = 3.91, 95 % CI: 2.41-6.38), D (OR = 4.14, 95 % CI: 2.64-6.52), A (OR = 2.30, 95 % CI:1.72-2.08), and B (OR = 2.56, 95 % CI:1.69-3.89). CONCLUSIONS In thoroughly assessed Ukrainian referral PCOS population the classic phenotypes prevailed as in other clinical cohorts. The classic phenotypes were characterized by the higher rate of adiposity and severity of clinical hyperandrogenism. At the same time, obese, overweight, and normal-weight subjects were present in all phenotypes, and the risk of obesity in non-classic phenotypes was higher in older age groups.
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Affiliation(s)
- Tetiana Tatarchuk
- Endocrine Gynecology Department, Institute of Pediatrics, Obstetrics and Gynecology, Kyiv 04050, Ukraine; Reproductive Health, Centre of Innovative Medical Technologies, Kyiv 04053, Ukraine
| | - Natalia Pedachenko
- Obstetrics, Gynecology and Perinatology Department, Shupyk National Healthcare University, Kyiv 04112, Ukraine
| | - Nataliia Kosei
- Reproductive Health, Centre of Innovative Medical Technologies, Kyiv 04053, Ukraine
| | - Iryna Malysheva
- Clinic of Reproductive Technologies of Shupyk National Healthcare University, Kyiv 01004, Ukraine
| | - Tetiana Snizhko
- Obstetrics, Gynecology Department, National Medical University, 76018 Ivano-Frankivsk, Ukraine
| | - Tetiana Kozub
- Kharkiv City Student Hospital, 61000 Kharkiv, Ukraine
| | - Olga Zolotarevska
- Communal Non-profit Enterprise of the Kamian City Council Primary Healthcare Centre 3, Kamian, Ukraine
| | | | - Tetiana Tutchenko
- Endocrine Gynecology Department, Institute of Pediatrics, Obstetrics and Gynecology, Kyiv 04050, Ukraine; Reproductive Health, Centre of Innovative Medical Technologies, Kyiv 04053, Ukraine.
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Pea J, Bryan J, Wan C, Oldfield AL, Ganga K, Carter FE, Johnson LM, Lujan ME. Ultrasonographic criteria in the diagnosis of polycystic ovary syndrome: a systematic review and diagnostic meta-analysis. Hum Reprod Update 2024; 30:109-130. [PMID: 37804097 PMCID: PMC10762001 DOI: 10.1093/humupd/dmad027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/08/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Polycystic ovary morphology (PCOM) on ultrasonography is considered as a cardinal feature of polycystic ovarian syndrome (PCOS). Its relevance as a diagnostic criterion for PCOS was reaffirmed in the most recent International Evidence-Based Guideline for the Assessment and Management of PCOS. However, there remains a lack of clarity regarding the best practices and specific ultrasonographic markers to define PCOM. OBJECTIVE AND RATIONALE The aim of this systematic review and diagnostic meta-analysis was to assess the diagnostic accuracy of various ultrasonographic features of ovarian morphology in the diagnosis of PCOS. SEARCH METHODS Relevant studies published from 1 January 1990 to 12 June 2023 were identified by a systematic search in PubMed, Web of Science, Scopus, CINAHL, and CENTRAL. Studies that generated diagnostic accuracy measures (e.g. proposed thresholds, sensitivity, specificity) for PCOS using the following ultrasonographic markers met criteria for inclusion: follicle number per ovary (FNPO) or per single cross-section (FNPS), ovarian volume (OV), and stromal features. Studies on pregnant or post-menopausal women were excluded. Risk of bias and applicability assessment for diagnostic test accuracy studies were determined using the QUADAS-2 and QUADAS-C tool for a single index test or between multiple index tests, respectively. Diagnostic meta-analysis was conducted using a bivariate model of pooled sensitivity and specificity, and visualized using forest plots and summary receiver-operating characteristic (SROC) curves. OUTCOMES From a total of 2197 records initially identified, 31 studies were included. Data from five and two studies were excluded from the meta-analysis due to duplicate study populations or limited data for the index test, leaving 24 studies. Pooled results of 20 adult studies consisted of 3883 control participants and 3859 individuals with PCOS. FNPO was the most accurate diagnostic marker (sensitivity: 84%, CI: 81-87%; specificity: 91%, CI: 86-94%; AUC: 0.905) in adult women. OV and FNPS had similar pooled sensitivities (OV: 81%, CI: 76-86%; FNPS: 81%, CI: 70-89%) but inferior pooled specificities (OV: 81%, CI: 75-86%; FNPS: 83%, CI: 75-88%) and AUCs (OV: 0.856; FNPS: 0.870) compared to FNPO. Pooled results from four adolescent studies consisting of 210 control participants and 268 girls with PCOS suggested that OV may be a robust ultrasonographic marker for PCOS diagnosis albeit the current evidence remains limited. The majority of the studies had high risk of bias for the patient selection (e.g. lack of randomized/consecutive patient selection) and index test (e.g. lack of pre-proposed thresholds for comparison) domains across all ultrasonographic markers. As such, diagnostic meta-analysis was unable to determine the most accurate cutoff for ultrasonographic markers to diagnose PCOS. Subgroup analysis suggested that stratification based on previously proposed diagnostic thresholds, age, BMI, or technology did not account for the heterogeneity in diagnostic accuracy observed across the studies. Studies that diagnosed PCOS using the Rotterdam criteria had improved sensitivity for FNPO. Studies from North America had lower diagnostic accuracy when compared to Asian studies (FNPO: sensitivity) and European studies (OV: specificity, diagnostic odds ratio and positive likelihood ratio). Geographic differences in diagnostic accuracy may potentially be due to differences in age, BMI, and diagnostic criteria of the PCOS group across regions. WIDER IMPLICATIONS This diagnostic meta-analysis supports the use of FNPO as the gold standard in the ultrasonographic diagnosis of PCOS in adult women. OV and FNPS provide alternatives if total antral follicle counts cannot be accurately obtained. Our findings support the potential for ultrasonographic evidence of PCOM in adolescents as more data becomes available. Subgroup analysis suggests the need to investigate any relative contributions of geographical differences on PCOS phenotypes. These findings may provide the basis for the development of strategies and best practices toward a standardized definition of PCOM and a more accurate ultrasonographic evaluation of PCOS.
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Affiliation(s)
- Jeffrey Pea
- Human Metabolic Research Unit, Division of Nutritional Sciences, Colleges of Human Ecology and Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
| | - Jahnay Bryan
- Human Metabolic Research Unit, Division of Nutritional Sciences, Colleges of Human Ecology and Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
| | - Cynthia Wan
- Human Metabolic Research Unit, Division of Nutritional Sciences, Colleges of Human Ecology and Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
| | - Alexis L Oldfield
- Human Metabolic Research Unit, Division of Nutritional Sciences, Colleges of Human Ecology and Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
| | - Kiran Ganga
- Human Metabolic Research Unit, Division of Nutritional Sciences, Colleges of Human Ecology and Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
| | - Faith E Carter
- Human Metabolic Research Unit, Division of Nutritional Sciences, Colleges of Human Ecology and Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
| | - Lynn M Johnson
- Cornell Statistical Consulting Unit, Cornell University, Ithaca, NY, USA
| | - Marla E Lujan
- Human Metabolic Research Unit, Division of Nutritional Sciences, Colleges of Human Ecology and Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA
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Tian X, Ruan X, Du J, Cheng J, Ju R, Mueck AO. Sexual function in Chinese women with different clinical phenotypes of polycystic ovary syndrome. Gynecol Endocrinol 2023; 39:2221736. [PMID: 37302412 DOI: 10.1080/09513590.2023.2221736] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/12/2023] [Accepted: 05/31/2023] [Indexed: 06/13/2023] Open
Abstract
Objective: To investigate sexual function stratified according to four clinical phenotypes of polycystic ovary syndrome (PCOS) and its association with clinical and quality of life parameters, and to compare these with healthy controls in Chinese women with PCOS. Methods: A cross-sectional study was designed in 1000 PCOS women and 500 control women aged 18-45 years. PCOS women were grouped into four clinical phenotypes according to the Rotterdam Criteria. FSFI (Female Sexual Function Index), SF-12 (the 12-item short form health survey) and clinical and hormonal characteristics likely to affect sexual function were determined. Results: 809 PCOS women and 385 control women with complete parameters were evaluated after screening. Phenotype A had a lower total FSFI mean score (23.14 ± 3.22) compared with phenotype D and control group (p < 0.05). The control group had the highest total FSFI mean score (24.98 ± 3.78). For the percentage at risk of sexual dysfunction, phenotype A (87.5%) and phenotype B (82.46%) had a higher risk of female sexual dysfunction (FSD) than that in phenotype C (75.34%), phenotype D (70.56%) and control group (61.30%) (p < 0.05). SF-12 mental domain scores were significantly lower in phenotypes A and B compared with phenotypes C and control group (p < 0.05). Infertility treatment, bioavailable testosterone, psychological factors, age and waist circumference presented negative correlation with female sexual function. Conclusions: The risk of FSD in PCOS women seemed to be associated with PCOS clinical phenotypes. The classical PCOS phenotype with oligo-ovulation and hyperandrogenism had a higher risk of sexual dysfunction.
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Affiliation(s)
- Xuanxuan Tian
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department of Women's Health, Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany
| | - Juan Du
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Jiaojiao Cheng
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Rui Ju
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Alfred O Mueck
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department of Women's Health, Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany
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9
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Polak AM, Łebkowska A, Krentowska A, Buczyńska A, Adamski M, Krętowski AJ, Kowalska I, Adamska A. Elevated Serum Concentration of Adipocyte Fatty Acid-Binding Protein Correlates with the Markers of Abdominal Obesity Independently of Thyroid Hormones in Non-Obese Women with Polycystic Ovary Syndrome. J Clin Med 2023; 12:4610. [PMID: 37510725 PMCID: PMC10380473 DOI: 10.3390/jcm12144610] [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: 04/04/2023] [Revised: 07/08/2023] [Accepted: 07/09/2023] [Indexed: 07/30/2023] Open
Abstract
Adipocyte fatty acid-binding protein (A-FABP) is mainly expressed in adipocytes. The risk of abdominal obesity and autoimmune thyroid disease is increased in women with polycystic ovary syndrome (PCOS). The objective of this study was to explore the relationship of serum concentration of A-FABP with parameters of obesity, e.g., waist to hip ratio (WHR) and the amount of adipose tissue assessed by bioelectrical impedance analysis (BIA), and thyroid hormone homeostasis in women with PCOS. We examined 66 women with PCOS and 67 healthy women. Serum concentrations of A-FABP and thyroid hormones were measured; the FT3/FT4 ratio, thyroid-stimulating hormone index (TSHI), thyrotrope thyroxine resistance index (TT4RI) and thyroid feedback quantile-based index (TFQI) were calculated. In the PCOS group, serum concentrations of A-FABP, FT3 and the FT3/FT4 ratio were significantly higher in comparison to the control group (all p < 0.05). A correlation of A-FABP with WHR (r = 0.26, p = 0.04) and the percentage of adipose tissue (r = 0.33, p = 0.01) has been found only in women with PCOS. We observed no correlation between serum levels of A-FABP and TSHI, TT4RI or TFQI in women with PCOS (all p > 0.05). Our results indicate that A-FABP is an adipokine that may be connected with abdominal obesity independently of thyroid hormone homeostasis in PCOS patients.
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Affiliation(s)
- Aleksandra Maria Polak
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, 15-276 Białystok, Poland
| | - Agnieszka Łebkowska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, 15-276 Białystok, Poland
| | - Anna Krentowska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, 15-276 Białystok, Poland
| | - Angelika Buczyńska
- Clinical Research Centre, Medical University of Białystok, 15-276 Białystok, Poland
| | - Marcin Adamski
- Faculty of Computer Science, Bialystok University of Technology, 15-351 Białystok, Poland
| | - Adam Jacek Krętowski
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, 15-276 Białystok, Poland
- Clinical Research Centre, Medical University of Białystok, 15-276 Białystok, Poland
| | - Irina Kowalska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, 15-276 Białystok, Poland
| | - Agnieszka Adamska
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, 15-276 Białystok, Poland
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Timur HT, Cimrin D, Gursoy Doruk O, Dogan OE. Determining the age group-based cut-off values of serum anti-Mullerian hormone concentrations to diagnose polycystic ovary syndrome. Curr Med Res Opin 2023; 39:855-863. [PMID: 37074782 DOI: 10.1080/03007995.2023.2204768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/15/2023] [Accepted: 04/17/2023] [Indexed: 04/20/2023]
Abstract
OBJECTIVE To determine the cut-off values of the serum anti-Müllerian hormone (AMH) concentration for different age groups (21-25, 26-30, 31-35 years) to diagnose polycystic ovary syndrome (PCOS). METHODS In total, 187 women aged 21-35 years were included in this descriptive study. Patients diagnosed with PCOS according to the Rotterdam Criteria formed the PCOS group (n = 93), whereas those without symptoms related to PCOS formed the control group (n = 94). Follicular phase serum hormone concentrations were evaluated during the endocrinological assessment of patients with PCOS. Serum levels of estradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, total testosterone, dehydroepiandrosterone sulfate, sex hormone-binding globulin, androstenedione, and AMH were measured. The free androgen index and LH/FSH ratio were calculated. Cut-off values of serum AMH concentrations for the age groups were measured using receiver operating characteristic curve analysis. RESULTS The prevalence rates of frank, ovulatory, normoandrogenic, and non-polycystic ovary PCOS were 69.9, 10.8, 10.8, and 8.6%, respectively. Serum AMH concentrations >5.56 ng/mL were associated with PCOS in the 21-25-year-old group. The cut-off value was 4.01 ng/mL in the 26-30-year-old group, whereas it was 3.42 ng/mL in the oldest age group. The correlation between the antral follicle count (AFC) and serum AMH level was strong for each age group. CONCLUSIONS The serum AMH concentration is a valuable parameter for assessing patients with symptoms indicative of PCOS. We recommend measuring serum AMH levels to support the diagnosis or to use them instead of the AFC for the Rotterdam criteria.
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Affiliation(s)
- Hikmet Tunc Timur
- Obstetrics and Gynecology Clinic, Urla State Hospital, Urla, Izmir, Turkey
| | - Dilek Cimrin
- Deparment of Biochemistry, Dokuz Eylul University School of Medicine, Balcova, Izmir, Turkey
| | - Ozlem Gursoy Doruk
- Deparment of Biochemistry, Dokuz Eylul University School of Medicine, Balcova, Izmir, Turkey
| | - Omer Erbil Dogan
- Department of Obstetrics and Gynecology, Dokuz Eylul University School of Medicine, Balcova, Izmir, Turkey
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11
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Current Guidelines for Diagnosing PCOS. Diagnostics (Basel) 2023; 13:diagnostics13061113. [PMID: 36980421 PMCID: PMC10047373 DOI: 10.3390/diagnostics13061113] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/25/2023] [Accepted: 03/03/2023] [Indexed: 03/17/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of reproductive-aged women. Much of the confusion surrounding PCOS diagnosis stems from the broad heterogeneity of symptomology experienced by women with PCOS. The diverse features of the syndrome have led to a number of diagnostic criteria over the years. This manuscript describes each of the current composite criteria and individually breaks down each component. The importance of accurate diagnosis for both clinical care and research is emphasized.
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Shukla P, Mukherjee S, Patil A, Joshi B. Molecular characterization of variants in mitochondrial DNA encoded genes using next generation sequencing analysis and mitochondrial dysfunction in women with PCOS. Gene 2023; 855:147126. [PMID: 36563715 DOI: 10.1016/j.gene.2022.147126] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 12/07/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
Emerging studies indicates mitochondrial dysfunction and involvement of mitochondrial DNA (mtDNA) variants in the pathogenesis of polycystic ovary syndrome (PCOS). Cumulative effect of mtDNA rare variants are now gaining considerable interest apart from common variants in the pathogenesis of complex diseases. Rare variants may modify the effect of polymorphism or in combination with the common variants may affect the risk of disease. With the evolution of high throughput sequencing techniques, which can be utilized to identify common as well as rare variants along with heteroplasmy levels, comprehensive characterization of the mtDNA variants is possible. Till date, few studies reported common mtDNA variants using traditional sequencing techniques but rare variants in mtDNA encoding genes remain unexplored in women with PCOS. These mtDNA variants may be responsible for mitochondrial dysfunction and may contribute in PCOS pathogenesis. In this study we determined mtDNA copy number, a biomarker of mitochondrial dysfunction and first time analysed variants in mtDNA encoded genes in women with PCOS using mitochondrial Next Generation sequencing (NGS) approach and compared allele frequency from mitochondrial 1000 genome dataset. Variant annotation and prioritization was done using highly automated pipeline, MToolBox that excludes reads mapped from nuclear mitochondrial DNA sequences (NumtS) to identify unique mtDNA reads. The present study identified significant reduction in mtDNA copy number in women with PCOS compared to non-PCOS women. A total of unique 214 prioritized common to rare variants were identified in mtDNA encoded genes, 183 variants in OXPHOS complexes, 14 variants in MT-tRNA and 17 variants in MT-rRNA genes that may be involved in mitochondrial dysfunction in PCOS. Numerous variants were heteroplasmic, pathogenic in nature and occurred in evolutionary conserved region. Heteroplasmic variants were more frequently occurred in MT-CO3 gene. Non-synonymous variants were more than synonymous variants and mainly occurred in OXPHOS complex I and IV. Few variants were found to be associated with diseases in MITOMAP database. The study provides a better understanding towards pathogenesis of PCOS from novel aspects focusing on mitochondrial genetic defects as underlying cause for contributing mitochondrial dysfunction in women with PCOS.
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Affiliation(s)
- Pallavi Shukla
- Department of Molecular Endocrinology, Indian Council of Medical Research-National Institute for Research in Reproductive and Child Health (ICMR-NIRRCH), J.M. Street, Parel, Mumbai 400012, India.
| | - Srabani Mukherjee
- Department of Molecular Endocrinology, Indian Council of Medical Research-National Institute for Research in Reproductive and Child Health (ICMR-NIRRCH), J.M. Street, Parel, Mumbai 400012, India
| | - Anushree Patil
- Department of Clinical Research, Indian Council of Medical Research-National Institute for Research in Reproductive and Child Health (ICMR-NIRRCH), J.M. Street, Parel, Mumbai 400012, India
| | - Beena Joshi
- Department of Operational Research, Indian Council of Medical Research-National Institute for Research in Reproductive and Child Health (ICMR-NIRRCH), J.M. Street, Parel, Mumbai 400012, India
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13
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Wang S, Zhang M, Hu X, Duan N, Chen X, Yin Y, Wang Z. Diagnostic values of MRI indexes for polycystic ovary syndrome. Acta Radiol 2023; 64:806-813. [PMID: 35188811 DOI: 10.1177/02841851221080521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) is a useful non-invasive modality for observation of ovarian morphologic characteristics. Few studies have focused on the value of MRI-derived indexes in reproductive-aged women with polycystic ovary syndrome (PCOS). PURPOSE To assess the diagnostic value of MRI in women with PCOS. MATERIAL AND METHODS This prospective case-control study included 85 women with PCOS and 50 controls who underwent pelvic MRI during 2017-2019. Ovarian volume (OV), follicle count (FC; counts of follicles sizing 2-3, 4-6, 7-9, 2-9 mm, respectively), follicular peripheral distribution, absence of a dominant follicle and stromal to total area ratio (S:A) were determined with MRI. The diagnostic value (sensitivity, specificity, area under the receiver operating characteristic curve [AUC]) of OV, FC2-9, and follicular peripheral distribution for PCOS were assessed. RESULTS The AUCs were 0.94 for OV, 0.96 for FC2-9, and 0.78 for follicular peripheral distribution. The optimal threshold to detect PCOS was 8.5 mL for OV (sensitivity 78%; specificity 96%) and 26 for FC2-9 (sensitivity 85%; specificity 98%). Sensitivity and specificity were 73% and 82% for follicular peripheral distribution, respectively. Reproducibility was perfect for OV (ICC = 0.96) and absence of a dominant follicle (k = 0.85), substantial for FC2-9 (ICC = 0.79) and S:A (ICC = 0.69), and moderate for follicular peripheral distribution (k = 0.56). CONCLUSION Detected by MRI, OV >8.5 mL or FC2-9 >26 are accurate for diagnosing PCOS.
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Affiliation(s)
- Shaojuan Wang
- Department of Radiology, 375808Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Meimei Zhang
- Departments of Ultrasonography, 375808Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Xuyu Hu
- Department of Radiology, 375808Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Na Duan
- Department of Radiology, 375808Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Xiao Chen
- Department of Radiology, 375808Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Yanyun Yin
- Departments of Gynecology, 375808Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Zhongqiu Wang
- Department of Radiology, 375808Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, PR China
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14
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Guscott A, Deslandes A, Parange N, Childs J. Australasian sonographers' knowledge, awareness, and attitudes towards the international evidence-based guidelines for the diagnosis of polycystic ovarian syndrome. Australas J Ultrasound Med 2023; 26:34-45. [PMID: 36960132 PMCID: PMC10030092 DOI: 10.1002/ajum.12331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Introduction/Purpose Many guidelines have been utilised to diagnose polycystic ovarian syndrome (PCOS). The most recent are the International Evidence Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome 2018 (2018 IEBG). This study aimed to assess the awareness, knowledge, and attitudes of Australasian sonographers' regarding these guidelines. Methods An online cross-sectional survey was disseminated to sonographers. Qualitative and quantitative questions were asked around awareness, knowledge, and attitudes towards the 2018 IEBG. Statistical and thematic analyses of the results were performed. Results Ninety responses were included in the final analysis. Fifty-two percent (52.2%) of participants were aware of the 2018 IEBG but only 31.1% used it in their workplaces. Fifty-eight percent (57.9%) of participants correctly identified the sonographic features that suggest PCOS, and 3.5% correctly identified all minimum recommended inclusions for reporting a gynaecological ultrasound for PCOS. Prior to being supplied the 2018 IEBG, 15.8% of participants correctly answered clinical scenario-based knowledge questions, which increased to 29.4% correctly after being supplied the guideline; however, this difference was not statistically significant. There were no statistically significant associations between demographics and knowledge of the 2018 IEBG. Discussion Several areas of confusion surrounding wording and interpretation of the 2018 IEBG were highlighted. Consideration should be given to barriers of implementation and strategies to overcome these. Conclusion More education surrounding the sonographic diagnosis of PCOS and the 2018 IEBG is needed. Scanning protocols used amongst sonographers varied, suggesting that inconsistency in sonographic diagnosis may exist. Future reviews of the 2018 IEBG should focus on reducing ambiguity in wording, which may be responsible for some of the varied interpretation of these guidelines.
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Affiliation(s)
- Alexandra Guscott
- Allied Health and Human PerformanceUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | - Alison Deslandes
- Allied Health and Human PerformanceUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | - Nayana Parange
- Allied Health and Human PerformanceUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | - Jessie Childs
- Allied Health and Human PerformanceUniversity of South AustraliaAdelaideSouth AustraliaAustralia
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15
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Sahoo SM. Exploring the natural history of polycystic ovary syndrome: still a long road to traverse. Hum Reprod 2023; 38:191-192. [PMID: 36433770 DOI: 10.1093/humrep/deac252] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Sushree Monika Sahoo
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Dumuduma, Bhubaneswar, Odisha, India
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16
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Singh S, Kaur M, Kaur R, Beri A, Kaur A. Association analysis of LHCGR variants and polycystic ovary syndrome in Punjab: a case-control approach. BMC Endocr Disord 2022; 22:335. [PMID: 36585675 PMCID: PMC9805054 DOI: 10.1186/s12902-022-01251-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/13/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is an endocrine-metabolic disorder that affects women at their child bearing age. The exact etiology is uncertain, however the involvement of multiple genes and environmental interactions has been proposed for the advancement of PCOS. The aim of present study was to evaluate the association of LHCGR variants (rs2293275 and rs12470652) with PCOS in Punjab. METHODS The present case-control study comprised a total of 743 women (421 PCOS cases and 322 healthy controls). Genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism technique (PCR-RFLP). Biochemical analysis was carried out to measure the levels of cholesterol, High-density lipoprotein (HDL), Low-density lipoprotein (LDL), Very low-density lipoprotein (VLDL), triglycerides, testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH). All the statistical analysis was done using SPSS (version21, IBM SPSS, NY, USA). RESULTS The mutant genotype (AA) and mutant allele (A) of rs2293275 conferred 1.7 and 1.3 fold risk, respectively and mutant allele (C) of rs12470652 conferred 2.3 fold risks towards PCOS progression. Levels of cholesterol and triglycerides were elevated and HDL levels were lower in PCOS cases as compared to controls. Total testosterone and luteinizing hormone levels were also found to be higher in PCOS cases. CONCLUSION Our study postulated that LHCGR variants are playing a cardinal role in the progression of PCOS and can be used to assess the risk of PCOS in women of reproductive age.
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Affiliation(s)
- Sukhjashanpreet Singh
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, India, 143005
| | - Mandeep Kaur
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, India, 143005
| | - Ratneev Kaur
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, India, 143005
| | - Archana Beri
- Beri Maternity Hospital, Southend Beri Fertility and IVF, Amritsar, Punjab, 143001, India
| | - Anupam Kaur
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, India, 143005.
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Carmina E, Lobo RA. Comparing Lean and Obese PCOS in Different PCOS Phenotypes: Evidence That the Body Weight Is More Important than the Rotterdam Phenotype in Influencing the Metabolic Status. Diagnostics (Basel) 2022; 12:diagnostics12102313. [PMID: 36292002 PMCID: PMC9600591 DOI: 10.3390/diagnostics12102313] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
Polycystic Ovary Syndrome (PCOS) represents a heterogeneous disorder and, using Rotterdam diagnostic criteria, four main phenotypes (A, B, C, and D) have been distinguished. However, it remains unclear whether lean versus obesity status influences findings in the various phenotypes of women with PCOS. 274 women with PCOS were consecutively assessed. Among these women, there were 149 with phenotype A, 24 with phenotype B, 94 with phenotype C, and 7 with phenotype D. We found normal body weight to be very common (65%) in phenotype C patients, common (43%) in phenotype A and D patients, and less represented (but still 25%) in phenotype B patients. Obesity was common in phenotype B (54%) and phenotype A (33%) patients and uncommon in phenotype C (only 11%) and phenotype D (14%) patients. Obese and lean patients of each phenotype were compared. Compared to the phenotype C PCOS patients, both phenotype A and B patients had higher total testosterone circulating values and higher luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio (p < 0.01) while anti-Mullerian hormone (AMH) levels were higher only in phenotype A PCOS patients. Instead, in the three obese PCOS phenotypes no differences in serum insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) calculation, and lipid blood values were observed. Analysis of data of lean patients gave similar results. Compared to the phenotype C PCOS patients, both phenotype A and B patients had higher total testosterone circulating values and higher LH/FSH ratio (p < 0.01) while AMH levels were higher only in phenotype A PCOS patients. However, no differences were observed in the circulating insulin levels, HOMA-IR calculation, or blood lipids between the three groups of lean PCOS patients. We conclude that Rotterdam phenotypes express the differences between PCOS patients in terms of ovulatory pattern and androgen secretion but fail to differentiate between obese patients with altered metabolic patterns and lean patients with normal metabolic patterns. A new classification of PCOS patients is needed and it should consider the influence of body weight on the metabolic patterns of PCOS patients.
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Affiliation(s)
- Enrico Carmina
- Endocrinology Unit, University of Palermo School of Medicine, 90133 Palermo, Italy
- Correspondence: or
| | - Rogerio A. Lobo
- Department of Obstetrics and Gynecology, Columbia University, New York, NY 10027, USA
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18
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PCOS Physiopathology and Vitamin D Deficiency: Biological Insights and Perspectives for Treatment. J Clin Med 2022; 11:jcm11154509. [PMID: 35956124 PMCID: PMC9369478 DOI: 10.3390/jcm11154509] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/25/2022] [Accepted: 08/01/2022] [Indexed: 12/12/2022] Open
Abstract
Recent literature has stressed the importance of vitamin D (VD) in polycystic ovary syndrome (PCOS). Women with PCOS are deficient in VD, particularly those with a higher weight. Hypovitaminosis is a risk factor for glucose intolerance, and reduced levels of VD is associated with insulin resistance and increased diabetes risk. Since women with PCOS and hirsutism seem to have lower levels of VD than women with PCOS without hirsutism, a correlation between VD deficiency and hyperandrogenism may be suggested. Interestingly, VD is crucial for many human physiological functions, including to counteract inflammation and oxidative stress. Some studies evaluated effects of VD supplementation on glucose homeostasis variables, hormonal status, lipid concentrations, and biomarkers of inflammation and oxidative stress among VD-deficient women. Moreover, VD has been shown to play a role in egg quality and fertility. This review aims to show the relationship between VD and the endocrine and metabolic profile of PCOS patients, as well as its implications for their fertility. The supplement of VD to the common therapy can lead to an improvement of the insulin resistance and lipid metabolism, a reduction of circulating androgens, as well as a better response to the induction of ovulation in PCOS women.
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19
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Vitale SG, Fulghesu AM, Mikuš M, Watrowski R, D’Alterio MN, Lin LT, Shah M, Reyes-Muñoz E, Sathyapalan T, Angioni S. The Translational Role of miRNA in Polycystic Ovary Syndrome: From Bench to Bedside—A Systematic Literature Review. Biomedicines 2022; 10:biomedicines10081816. [PMID: 36009364 PMCID: PMC9405312 DOI: 10.3390/biomedicines10081816] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 12/04/2022] Open
Abstract
MicroRNAs (miRNAs) are small, non-coding RNAs that are essential for the regulation of post-transcriptional gene expression during tissue development and differentiation. They are involved in the regulation of manifold metabolic and hormonal processes and, within the female reproductive tract, in oocyte maturation and folliculogenesis. Altered miRNA levels have been observed in oncological and inflammatory diseases, diabetes or polycystic ovary syndrome (PCOS). Therefore, miRNAs are proving to be promising potential biomarkers. In women with PCOS, circulating miRNAs can be obtained from whole blood, serum, plasma, urine, and follicular fluid. Our systematic review summarizes data from 2010–2021 on miRNA expression in granulosa and theca cells; the relationship between miRNAs, hormonal changes, glucose and lipid metabolism in women with PCOS; and the potential role of altered miRNAs in fertility (oocyte quality) in PCOS. Furthermore, we discuss miRNAs as a potential therapeutic target in PCOS and as a diagnostic marker for PCOS.
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Affiliation(s)
- Salvatore Giovanni Vitale
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, 95124 Catania, Italy;
| | - Anna Maria Fulghesu
- Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy; (A.M.F.); (M.N.D.)
| | - Mislav Mikuš
- Department of Obstetrics and Gynecology, University Hospital Centre Zagreb, 10 000 Zagreb, Croatia;
| | - Rafał Watrowski
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany;
| | - Maurizio Nicola D’Alterio
- Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy; (A.M.F.); (M.N.D.)
| | - Li-Te Lin
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung City 81362, Taiwan;
- Department of Obstetrics and Gynecology, School of Medicine, National Yang-Ming University, Pei-Tou, Taipei 112, Taiwan
- Department of Biological Science, National Sun Yat-sen University, 70 Lienhai Rd., Kaohsiung City 80424, Taiwan
| | - Mohsin Shah
- Department of Physiology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar 25100, Pakistan;
| | - Enrique Reyes-Muñoz
- Department of Gynecological and Perinatal Endocrinology, Instituto Nacional de Perinatología, Mexico City 11000, Mexico;
| | - Thozhukat Sathyapalan
- Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Kingston upon Hull HU6 7RX, UK;
| | - Stefano Angioni
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, 95124 Catania, Italy;
- Correspondence:
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Hestiantoro A, Astuti BPK, Joyo EO, Febri RR, Silvana V, Muharam R. Vitamin B3 (niacin), B6, C, and iron intake are associated with the free androgen index, especially in normoandrogenic polycystic ovary syndrome. J Turk Ger Gynecol Assoc 2022; 23:130-136. [PMID: 35781735 PMCID: PMC9450921 DOI: 10.4274/jtgga.galenos.2022.2022-2-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective Nutritional intake is one of the most common environmental risk factors of polycystic ovary syndrome (PCOS) because it is associated with obesity and insulin resistance. This study aims to determine the relationship between micronutrient intake and androgen levels associated with PCOS. Material and Methods This cross-sectional study was performed on 79 PCOS patients, consisted of 50 normoandrogenic (NA) and 29 hyperandrogenic (HA) patients and 66 healthy controls. Dietary intake assessment was performed using a modified 38-item semi-quantitative food frequency questionnaire. Bivariate, correlation, and multivariate analyses were performed to determine the association between study variables, and p-value less than 0.05 was considered as statistically significant difference. Results The baseline characteristics in all groups were similar, except for body mass index and hormonal profile, compared to those in the other groups, found to be higher in the hyperandrogenic PCOS group. There was found a significantly negative correlation between the free androgen index and intake of vitamin B1, vitamin B2, niacin, vitamin B6, calcium, and iron in the normoandrogenic PCOS group, while we did not observe it in the hyperandrogenic PCOS group. Multivariate linear regression analysis reveals that the intake of vitamin B6, vitamin C, niacin, and iron had a significant effect on the free androgen index. Conclusion There is an effect of micronutrient intake on androgen levels in women with PCOS. The association was more significant in the normoandrogenic PCOS than in the hyperandrogenic PCOS. These findings reveal an association between micronutrients and androgens and PCOS at a systemic level.
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Affiliation(s)
- Andon Hestiantoro
- Department of Obstetrics and Gynecology, Division of Reproductive Immunoendocrinology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.,Human Reproductive, Infertility and Family Planning Research Center, Indonesian Medical Education and Research Institute (IMERI), Universitas Indonesia, Jakarta, Indonesia
| | - Brilliant Putri Kusuma Astuti
- Human Reproductive, Infertility and Family Planning Research Center, Indonesian Medical Education and Research Institute (IMERI), Universitas Indonesia, Jakarta, Indonesia
| | - Ericko Ongko Joyo
- Department of Obstetrics and Gynecology, Division of Reproductive Immunoendocrinology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Ririn Rahmala Febri
- Human Reproductive, Infertility and Family Planning Research Center, Indonesian Medical Education and Research Institute (IMERI), Universitas Indonesia, Jakarta, Indonesia
| | - Vita Silvana
- Department of Obstetrics and Gynecology, Division of Reproductive Immunoendocrinology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.,Human Reproductive, Infertility and Family Planning Research Center, Indonesian Medical Education and Research Institute (IMERI), Universitas Indonesia, Jakarta, Indonesia
| | - Raden Muharam
- Department of Obstetrics and Gynecology, Division of Reproductive Immunoendocrinology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.,Human Reproductive, Infertility and Family Planning Research Center, Indonesian Medical Education and Research Institute (IMERI), Universitas Indonesia, Jakarta, Indonesia
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21
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Grindheim S, Ebbing C, Karlsen HO, Skulstad SM, Real FG, Lønnebotn M, Løvvik T, Vanky E, Kessler J. Metformin exposure, maternal PCOS status and fetal venous liver circulation: A randomized, placebo-controlled study. PLoS One 2022; 17:e0262987. [PMID: 35089960 PMCID: PMC8797196 DOI: 10.1371/journal.pone.0262987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 11/16/2021] [Indexed: 11/19/2022] Open
Abstract
Background Metformin is prescribed to women with polycystic ovary syndrome (PCOS) to prevent pregnancy complications. Children exposed to metformin vs. placebo in utero, have increased head circumference at birth and are more overweight and obese at 8 years of age. Also, maternal PCOS-status seems to alter the long-term cardio-metabolic health of offspring. We hypothesized that the long-term effects of metformin-exposure and/or maternal PCOS may be mediated by circulatory adaptations during fetal life. Material and methods This is a sub-study of a larger double-blinded, placebo-controlled trial, where women with PCOS were randomized to metformin (2g/day) or placebo in pregnancy, a total of 487 women. A sub-group of participants (N = 58) took part in this sub-study and had an extended ultrasound examination at gestational week 32, including blood flow velocity and diameter measurements of the umbilical vein (UV), the ductus venosus (DV) and the portal vein (PV). Blood flow volume was calculated and adjusted for estimated fetal weight (EFW) (normalized flow). Metformin exposed fetuses were compared to placebo exposed fetuses. Fetuses of mothers with PCOS (metformin [n = 30] and placebo [n = 28]) were compared to a low-risk reference population (N = 160) by z-score statistics. Results There was no difference in fetal liver flow between metformin vs. placebo-exposed fetuses. Fetuses of mothers with PCOS had higher EFW (0.63 [95% CI 0.44–0.83] p<0.001), lower normalized UV, DV, PV, and lower total venous liver blood flows than the reference population. Conclusion Metformin during pregnancy did not affect fetal liver blood-flow. In our population, maternal PCOS-status was associated with reduced total venous liver blood-flow, which may explain altered growth and metabolism later in life.
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Affiliation(s)
- Sindre Grindheim
- Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway
- * E-mail:
| | - Cathrine Ebbing
- Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Svein Magne Skulstad
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Francisco Gómez Real
- Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Marianne Lønnebotn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Tone Løvvik
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Obstetrics and Gynaecology, St. Olav’s Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Eszter Vanky
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Obstetrics and Gynaecology, St. Olav’s Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jørg Kessler
- Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
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22
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Altinkaya SO. Galanin and glypican-4 levels depending on metabolic and cardiovascular risk factors in patients with polycystic ovary syndrome. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2021; 65:479-487. [PMID: 33740336 PMCID: PMC10522184 DOI: 10.20945/2359-3997000000340] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 01/04/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Galanin is a neuropeptide which has effects not only on metabolic syndrome but also on reproduction. Glypican-4 is an adipokine associated with insulin sensitivity by interacting directly with the insulin receptor. This study evaluated serum concentrations of galanin and glypican-4 in relation with the hormonal profile as well as metabolic and cardiovascular risk factors in patients with and without polycystic ovary syndrome (PCOS). METHODS A total of 44 women with PCOS and 44 age-matched controls were eligible. Hirsutism scores, hormonal profile, metabolic and cardiovascular risk factors as well as galanin and glypican-4 levels were evaluated in each subject. RESULTS Women with PCOS exhibited lower levels of galanin (20.2 pg/mL versus 26.4 pg/mL, p = 0.002) and higher concentrations of glypican-4 (3.1 ng/mL versus 2.6 ng/mL, p < 0.001) than controls. Both adipokines were correlated positively with body mass index (BMI), insulin, triglyceride and Homeostasis Model Assessment (HOMA) index; glypican-4 also showed positive correlations with fasting blood glucose, free testosterone, modified Ferriman-Gallwey scores (p < 0.05). Multiple Linear Regression analyses showed that PCOS and BMI were the best predictors affecting galanin levels with a decreasing and increasing effect respectively; however BMI was the best predictor affecting glypican-4 levels with an increasing effect (p < 0.001). CONCLUSION Galanin levels were lower and glypican-4 levels were higher in women with PCOS than controls. Further studies are needed to determine whether these adipokines could be used as additional markers for insulin sensitivity and lipid profile and whether they might play a role in the pathogenesis of PCOS, in which metabolic cardiovascular risks are increased.
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23
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Le NSV, Le MT, Nguyen ND, Tran NQT, Nguyen QHV, Cao TN. A Cross-Sectional Study on Potential Ovarian Volume and Related Factors in Women with Polycystic Ovary Syndrome from Infertile Couples. Int J Womens Health 2021; 13:793-801. [PMID: 34512036 PMCID: PMC8412837 DOI: 10.2147/ijwh.s329082] [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: 07/12/2021] [Accepted: 08/15/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose This study was designed to explore the value of ovarian volume (OV) measured by transvaginal ultrasound and its relationship with anthropometry and serum hormonal levels in a polycystic ovary syndrome (PCOS) population. Patients and Methods A total of 119 women with PCOS from infertile couples were recruited in this cross-sectional study. On days 2-4 of the menstrual cycle, transvaginal ultrasound examinations were performed, and hormonal profiles were measured. PCOS diagnosis was based on the Rotterdam 2003 criteria and classified into four phenotype groups. The PCOS group (study group) and the non-PCOS group (control group) were compared. Results The mean age of the participants was 32.66±4.10 years compared to 33.99±4.78 years in 273 cases (69.6%) without PCOS. The mean OV was statistically larger in the PCOS group than in the non-PCOS group (7.65±3.23 mL vs 6.08±3.67 mL, p < 0.001) and positively correlated with serum anti-Mullerian (AMH) and luteinizing hormone (LH) levels (r=0.30; p < 0.001 and r=0.23; p < 0.001, respectively), and weakly and inversely correlated with age (-0.182, p < 0.001). The area under the receiver operating characteristic (ROC) curve of OV in the diagnosis of PCOS was 0.613 (0.557-0.670, 95% CI). Conclusion The enlarged OV is remarkable in women with PCOS and is related to AMH and LH concentrations. Although the diagnostic potential of PCOS is substantially low, OV alone may contribute to predicting the severity of PCOS and better performance for the diagnosis of PCOS phenotypes.
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Affiliation(s)
- Nguyen Sa Viet Le
- Department of Assisted Reproduction, Hue Central Hospital, Hue, Vietnam.,Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Minh Tam Le
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.,Center for Reproductive Endocrinology and Infertility, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Nguyen Dac Nguyen
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.,Center for Reproductive Endocrinology and Infertility, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Nhu Quynh Thi Tran
- Center for Reproductive Endocrinology and Infertility, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Quoc Huy Vu Nguyen
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Thanh Ngoc Cao
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.,Center for Reproductive Endocrinology and Infertility, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
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24
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Bhattacharya K, Sengupta P, Dutta S, Chaudhuri P, Das Mukhopadhyay L, Syamal AK. Waist-to-height ratio and BMI as predictive markers for insulin resistance in women with PCOS in Kolkata, India. Endocrine 2021; 72:86-95. [PMID: 33400176 DOI: 10.1007/s12020-020-02555-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 11/15/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Polycystic ovarian syndrome (PCOS) is most commonly presented with insulin resistance (IR). Simple anthropometric indices may serve as surrogate markers of these conditions with population-based cut-off values. The present study suggests the cut-off values of waist-to-height ratio (WHtR) and body mass index (BMI) in early prediction of PCOS and IR in PCOS women based in Kolkata, a major metropolitan city in India. METHODS This cross-sectional study included 66 women (aged 16-30 years) from Kolkata, India, with confirmed PCOS, using Rotterdam criteria. IR was defined following the homeostasis model assessment (HOMA). Anthropometric and biochemical data were obtained using standard protocol and compared among the PCOS subjects grouped as per IR prevalence, BMI, and WHtR values. The receiver operating characteristics (ROC) curve was applied to evaluate and compare the cut-off values of WHtR and BMI in the prediction of PCOS and IR in women with PCOS. RESULTS As per ROC analysis, WHtR showed significantly higher AUC in the detection of PCOS and IR in PCOS subjects respectively, than that of BMI. The cut-off values of WHtR and BMI for PCOS were 0.560 and 28.47 respectively, and for IR in PCOS patients, were 0.620 and 29.14 respectively. CONCLUSIONS The present study suggests a cut-off value of WHtR to be used as an inexpensive and noninvasive screening tool for early prediction of PCOS and IR among PCOS afflicted women based in Kolkata, India and for this prediction, the study also claims WHtR as a better index than BMI.
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Affiliation(s)
- Koushik Bhattacharya
- Post Graduate Department of Physiology, Hooghly Mohsin College, University of Burdwan, Bardhaman, West Bengal, India
- Department of Physiology, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
| | - Pallav Sengupta
- Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom, Selangor, Malaysia
| | - Sulagna Dutta
- Faculty of Dentistry, MAHSA University, Jenjarom, Selangor, Malaysia
| | - Prasenjit Chaudhuri
- Department of Physiology, Government General Degree College, Paschim Medinipur, West Bengal, India
| | - Lipika Das Mukhopadhyay
- Department of Obstetrics and Gynecology, KPC Medical College, Jadavpur, Kolkata, West Bengal, India.
| | - Alak Kumar Syamal
- Post Graduate Department of Physiology, Hooghly Mohsin College, University of Burdwan, Bardhaman, West Bengal, India.
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Dadachanji R, Patil A, Joshi B, Mukherjee S. Elucidating the impact of obesity on hormonal and metabolic perturbations in polycystic ovary syndrome phenotypes in Indian women. PLoS One 2021; 16:e0246862. [PMID: 33635862 PMCID: PMC7909663 DOI: 10.1371/journal.pone.0246862] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 01/27/2021] [Indexed: 12/23/2022] Open
Abstract
Polycystic ovary syndrome is a complex endocrinopathy with heterogeneous presentation and multifactorial etiology. We have undertaken this case-control study to compare metabolic and endocrine characteristics in different phenotypic subgroups of women with PCOS and the impact of obesity on them. Women with PCOS (n = 489) were classified into 4 phenotypes according to Rotterdam criteria. Comparisons of clinical, biochemical and hormonal parameters were performed across all phenotypic groups of PCOS and with controls (n = 270) by Welch’s ANOVA with subsequent Games-Howell post-hoc test. We found maximum prevalence of normoandrogenic phenotype D, which is milder form of PCOS in terms of insulin resistance, gonadotropin levels and dyslipidemia, followed by phenotype A, in our total study population. After classification of the study group into lean and obese groups, only few insulin and lipid-related traits showed marked differences between phenotypes. Further, we noted that obese women showed adverse metabolic but not androgenic traits compared to lean counterparts in the same phenotype. Metabolic syndrome frequency is increased in hyperandrogenic phenotypes with HDL-C and waist circumference being most predominant contributing factors in total, lean and obese groups. We demonstrate that in our study population there is greater occurrence of phenotype D of PCOS. Our study highlights the importance of clinicians concurrently employing Rotterdam criteria along with obesity status for ascertaining accurate PCOS status and formulating suitable therapeutic intervention.
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Affiliation(s)
- Roshan Dadachanji
- Department of Molecular Endocrinology, ICMR-National Institute for Research in Reproductive Health, Parel, Mumbai, India
| | - Anushree Patil
- Department of Clinical Research, ICMR-National Institute for Research in Reproductive Health, Parel, Mumbai, India
| | - Beena Joshi
- Department of Operational Research, ICMR-National Institute for Research in Reproductive Health, Parel, Mumbai, India
| | - Srabani Mukherjee
- Department of Molecular Endocrinology, ICMR-National Institute for Research in Reproductive Health, Parel, Mumbai, India
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26
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Spritzer PM, Ramos RB, Marchesan LB, de Oliveira M, Carmina E. Metabolic profile of women with PCOS in Brazil: a systematic review and meta-analysis. Diabetol Metab Syndr 2021; 13:18. [PMID: 33593439 PMCID: PMC7885437 DOI: 10.1186/s13098-021-00636-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/03/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common endocrine disease affecting women of reproductive age and associated with reproductive and metabolic dysfunction. Few studies are available regarding metabolic traits in Brazilian women with PCOS. The aim of this systematic review and meta-analysis was to summarize the available evidence regarding metabolic traits and comorbidities in Brazilian women with polycystic ovary syndrome (PCOS). METHODS We systematically searched PubMed, Cochrane Central Register of Controlled Trials, and Embase for cross-sectional, case-control, or cohort studies focusing on populations of different regions from Brazil, published until July 31, 2019. Studies were selected if they reported PCOS diagnostic criteria. Studies without a control group were included if they presented relevant metabolic data. RESULTS Of 4856 studies initially identified, 27 were included in the systematic review and 12 were included in the meta-analysis, for a total of 995 women with PCOS defined by Rotterdam criteria and 2275 controls from different regions of Brazil. Obesity, metabolic syndrome and IGT were prevalent, and standard mean differences for BMI (SMD 0.67, 95% CI, 0.29, 1.05), waist circumference (SMD 0.22, 95% CI 0.02, 0.41), systolic (SMD 0.66, 95% CI 0.30, 1.01) and diastolic blood pressure (SMD 0.55, 95% CI 0.24, 0.87), glucose (SMD 0.21, 95% CI 0.04, 0.38) and HOMA (SMD 0.78, 95% CI 0.52, 1.04) were significantly higher in Brazilian women with PCOS compared to controls. Lipid profile was more adverse in PCOS vs. non-PCOS women. Between-study heterogeneities were low/moderate for glucose and HOMA and moderate/high for the other variables. CONCLUSIONS The data of this systematic review and meta-analysis indicate that Brazilian women with PCOS have a worse metabolic profile than women without PCOS with no important regional differences. The prevalence of metabolic changes is intermediate in Brazil vs. other countries.
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Affiliation(s)
- Poli Mara Spritzer
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
- Department of Physiology, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil.
- Post-Graduate Program in Endocrinology, Medicine School, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil.
- Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, 90035-003, Brazil.
| | - Ramon Bossardi Ramos
- Post-Graduate Program in Endocrinology, Medicine School, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
- Department of Molecular and Cellular Physiology, Albany Medical College, Albany, NY, USA
| | - Lucas Bandeira Marchesan
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Post-Graduate Program in Endocrinology, Medicine School, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
| | - Monica de Oliveira
- Instituto de Medicina Integral Professor Fernando Figueira Hospital, Recife, Pernambuco, Brazil
| | - Enrico Carmina
- University of Palermo School of Medicine, Palermo, Italy
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27
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Yacoub S, Cadesky K, Casper RF. Low risk of OHSS with follitropin delta use in women with different polycystic ovary syndrome phenotypes: a retrospective case series. J Ovarian Res 2021; 14:31. [PMID: 33579321 PMCID: PMC7881448 DOI: 10.1186/s13048-021-00773-5] [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: 09/14/2020] [Accepted: 01/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To explore the efficacy of follitropin delta in ovarian stimulation of patients with the Rotterdam ESHRE/ASRM 2003 phenotypes of polycystic ovarian syndrome (PCOS) using a retrospective case series with an electronic file search in a reproductive medicine clinic. CASE PRESENTATION Seventy-four patients with PCOS undergoing ovarian stimulation according to the individualized dosing algorithm of follitropin delta for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI)/oocyte freezing were included. Follitropin delta resulted in a high number of pre-ovulatory follicles at the end of stimulation as expected in patients with PCOS. There was a large number of oocytes retrieved with an acceptable percentage of metaphase II (MII) oocytes. There were no cases of moderate or severe OHSS across all phenotypes. CONCLUSION Follitropin delta, using the individualized dosing algorithm, appears to be a safe method of ovarian stimulation with a low risk of OHSS in PCOS patients without sacrificing successful stimulation outcomes.
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Affiliation(s)
- Stephanie Yacoub
- Present address: Department of Obstetrics and Gynecology, Saint Georges Hospital University Medical Center, Beirut, Lebanon
| | - Kenneth Cadesky
- TRIO Fertility, and Department of Obstetrics and Gynecology, University of Toronto, 655 Bay St, Suite 1101, Toronto, ON, M5G2K4, Canada
| | - Robert F Casper
- TRIO Fertility, and Department of Obstetrics and Gynecology, University of Toronto, 655 Bay St, Suite 1101, Toronto, ON, M5G2K4, Canada. .,Lunenfeld-Tanenbaum Research Institute, Mount Sinai System, Toronto, ON, Canada.
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Deswal R, Narwal V, Dang A, Pundir CS. The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. J Hum Reprod Sci 2020; 13:261-271. [PMID: 33627974 PMCID: PMC7879843 DOI: 10.4103/jhrs.jhrs_95_18] [Citation(s) in RCA: 190] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/27/2019] [Accepted: 06/18/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Polycystic ovary syndrome (PCOS), the major endocrinopathy among reproductive-aged women, is not yet perceived as an important health problem in the world. It affects 4%–20% of women of reproductive age worldwide. The prevalence, diagnosis, etiology, management, clinical practices, psychological issues, and prevention are some of the most confusing aspects associated with PCOS. Aim: The exact prevalence figures regarding PCOS are limited and unclear. The aim of this review is to summarize comprehensively the current knowledge on the prevalence of PCOS. Materials and Methods: Literature search was performed through PubMed, ScienceDirect, Cochrane Library, and Google Scholar (up to December 2019). All relevant articles published in English language were identified following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Our analysis yielded 27 surveys with a pooled mean prevalence of 21.27% using different diagnostic criteria. The proportion of women with PCOS also increased in the last decade. Conclusion: The current review summarizes and interprets the results of all published prevalence studies and highlights the burden of the syndrome, thereby supporting early identification and prevention of PCOS in order to reverse the persistent upward trend of prevalence.
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Affiliation(s)
- Ritu Deswal
- Center for Medical Biotechnology, MD University, Rohtak, Haryana, India
| | - Vinay Narwal
- Department of Biochemistry, MD University, Rohtak, Haryana, India
| | - Amita Dang
- Center for Medical Biotechnology, MD University, Rohtak, Haryana, India
| | - Chandra S Pundir
- Department of Biochemistry, MD University, Rohtak, Haryana, India
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Wen Y, Wu X, Peng H, Li C, Jiang Y, Su Z, Liang H, Liu J, He J, Liang W. Breast cancer risk in patients with polycystic ovary syndrome: a Mendelian randomization analysis. Breast Cancer Res Treat 2020; 185:799-806. [PMID: 33128677 DOI: 10.1007/s10549-020-05973-z] [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] [Received: 04/24/2020] [Accepted: 10/08/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The association between polycystic ovary syndrome (PCOS) and breast cancer remains inconclusive. Conventional observational studies are susceptible to inverse causality and potential confounders. With a Mendelian randomization (MR) approach, we aimed to investigate the causal relationship between genetically predicted PCOS and breast cancer risk. METHODS Our study included 11 PCOS-associated single nucleotide polymorphisms as instrumental variables identified by the latest genome-wide association study. Individual-level genetic summary data of participants were obtained from the Breast Cancer Association Consortium, with a total of 122,977 cases and 105,974 controls. The inverse-variance weighted method was applied to estimate the causality between genetically predicted PCOS and breast cancer risk. To further evaluate the pleiotropy, the weighted median and MR-Egger regression methods were implemented as well. RESULTS Our study demonstrated that genetically predicted PCOS was causally associated with an increased risk of overall breast cancer (odds ratio (OR) = 1.07; 95% confidence interval (CI) 1.02-1.12, p = 0.005). The subgroup analyses according to immunohistochemical type further illustrated that genetically predicted PCOS was associated with an increased risk of estrogen receptor (ER)-positive breast cancer (OR = 1.09; 95% CI 1.03-1.15, p = 0.002), while no causality was observed for ER-negative breast cancer (OR = 1.02; 95% CI 0.96-1.09, p = 0.463). In addition, no pleiotropy was found in our study. CONCLUSIONS Our findings indicated that PCOS was likely to be a causal factor in the development of ER-positive breast cancer, providing a better understanding for the etiology of breast cancer and the prevention of breast cancer.
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Affiliation(s)
- Yaokai Wen
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China.,Nanshan School, Guangzhou Medical University, Jingxiu Road, Panyu District, Guangzhou, 511436, China
| | - Xiangrong Wu
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China.,Nanshan School, Guangzhou Medical University, Jingxiu Road, Panyu District, Guangzhou, 511436, China
| | - Haoxin Peng
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China.,Nanshan School, Guangzhou Medical University, Jingxiu Road, Panyu District, Guangzhou, 511436, China
| | - Caichen Li
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China
| | - Yu Jiang
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China.,Nanshan School, Guangzhou Medical University, Jingxiu Road, Panyu District, Guangzhou, 511436, China
| | - Zixuan Su
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China.,Nanshan School, Guangzhou Medical University, Jingxiu Road, Panyu District, Guangzhou, 511436, China
| | - Hengrui Liang
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China
| | - Jun Liu
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China
| | - Jianxing He
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China.
| | - Wenhua Liang
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China.
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Lorzadeh N, Kazemirad N, Kazemirad Y. Human immunodeficiency: Extragonadal comorbidities of infertility in women. IMMUNITY INFLAMMATION AND DISEASE 2020; 8:447-457. [PMID: 32621331 PMCID: PMC7416027 DOI: 10.1002/iid3.327] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/21/2020] [Indexed: 12/12/2022]
Abstract
Introduction Infertility is mediated by several changes system‐wide. These changes are likely to cause other systems‐related pathologies, such as changes in systemic immune response, particularly inflammatory response can lead to cardiovascular diseases and breast cancer. Methods These morbidities can exist immediately or years after the diagnosis of infertility. Therefore, understanding the mechanism is important to move toward therapeutic interventions. Results Several extragonadal pathologies are reported due to infertility, as well as, how these might also contribute to reproductive disabilities. Detailed evidence are still not present that can give stronger result. Conclusion This review highlights some of the most frequent comorbidities that are seen in infertile women, hence requiring a need for complete clinical screening and care, as well as diagnosis and treatment in early stages.
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Affiliation(s)
- Nahid Lorzadeh
- Department of Obstetrics and Gynecology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Nastaran Kazemirad
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Wiweko B, Handayani LK, Harzif AK, Pratama G, Muharam R, Hestiantoro A, Sumapraja K. Correlation of anti-Müllerian hormone levels with metabolic syndrome events in polycystic ovary syndrome: A cross-sectional study. Int J Reprod Biomed 2020; 18:187-192. [PMID: 32309767 PMCID: PMC7142316 DOI: 10.18502/ijrm.v18i3.6716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 08/14/2019] [Accepted: 10/03/2019] [Indexed: 11/24/2022] Open
Abstract
Background Various endocrine disorders have been reported in women of reproductive age, 10% of which is affected by polycystic ovary syndrome (PCOS). Objective This study aimed to evaluate the correlation of anti-Müllerian hormone (AMH) levels with the metabolic syndrome in patients with PCOS. Materials and Methods This cross-sectional study employed a consecutive sampling method using medical records from January 2013 to December 2017 at Dr. Cipto Mangunkusumo General Hospital polyclinic and Yasmin in vitro fertilization Clinic (Kencana), Jakarta, Indonesia. The primary outcome of the study was the AMH levels as independent variable correlated with metabolic syndrome. The secondary outcome was also the AMH levels correlated with each PCOS phenotype. The tertiary outcome was each PCOS phenotype as independent variable correlated with metabolic syndrome. Results Women with phenotype 1 of PCOS had a median AMH level of 13.92 (range: 3.88-34.06) ng/ml. 21% patients had metabolic syndrome, with a median AMH level 7.65 (3.77-20.20) ng/ml, higher than the women without metabolic syndrome (p = 0.38). The most frequent phenotype in women with PCOS was phenotype 4, oligo- or anovulation and polycystic ovary morphology (OA/PCOM) in 41.3%. The most frequent phenotype in women with metabolic syndrome was phenotype 1, OA + PCOM + hyperandrogenism in 56.5%. Conclusion All PCOS phenotypes exhibited significant correlations with the AMH level. Phenotype 1 (OA + PCOM + hyperandrogenism) was associated with the highest AMH level and was significantly associated with metabolic syndrome.
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Affiliation(s)
- Budi Wiweko
- Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia, Jakarta, 10430, Indonesia.,Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, 10430, Indonesia.,Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Lieke Koes Handayani
- Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Achmad Kemal Harzif
- Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia, Jakarta, 10430, Indonesia.,Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, 10430, Indonesia.,Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Gita Pratama
- Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia, Jakarta, 10430, Indonesia.,Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, 10430, Indonesia.,Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Raden Muharam
- Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia, Jakarta, 10430, Indonesia.,Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, 10430, Indonesia.,Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Andon Hestiantoro
- Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia, Jakarta, 10430, Indonesia.,Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, 10430, Indonesia.,Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia
| | - Kanadi Sumapraja
- Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia, Jakarta, 10430, Indonesia.,Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, 10430, Indonesia.,Human Reproductive, Infertility and Family Planning Research Center, Indonesia Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia
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Polak AM, Adamska A, Krentowska A, Łebkowska A, Hryniewicka J, Adamski M, Kowalska I. Body Composition, Serum Concentrations of Androgens and Insulin Resistance in Different Polycystic Ovary Syndrome Phenotypes. J Clin Med 2020; 9:jcm9030732. [PMID: 32182752 PMCID: PMC7141288 DOI: 10.3390/jcm9030732] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 02/22/2020] [Accepted: 03/05/2020] [Indexed: 02/07/2023] Open
Abstract
Insulin resistance and hyperandrogenemia observed in polycystic ovary syndrome (PCOS) are associated with metabolic disturbances and could be connected with body composition pattern. To date, several studies defining the parameters of body composition using dual energy X-ray absorptiometry (DXA) method in the group of PCOS patients have been published, however, without the analysis in different phenotypes. The aim of the present study was to investigate the relationships between serum androgens concentration, insulin resistance and distribution of fat mass using DXA method in various PCOS phenotypes according to the Rotterdam criteria. We examined 146 women: 34 (38%) had PCOS phenotype A, 20 (23%) phenotype B, 20 (23%) phenotype C and 15 (16%) phenotype D (with mean age of each phenotype 25 years), and 57 control subjects (mean age of 25.5 years). Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Serum concentrations of testosterone, androstenedione and dehydroepiandrosterone sulfate (DHEA-S) were assessed and free androgen index (FAI) was calculated. In phenotypes A, B and C, we observed higher FAI in comparison to the control group (all p < 0.01). Serum concentrations of androstenedione and DHEA-S were higher in phenotypes A and C in comparison to the control group (all p < 0.01). However, only in phenotype A we found higher visceral adipose tissue (VAT) mass and android/gynoid ratio (A/G ratio) in comparison to the control group (all p < 0.01). In phenotype A, we observed connection of VAT with FAI (r = 0.58, p < 0.01). Accordingly, A/G ratio was related with FAI in all phenotypes (all p < 0.05). Additionally, in phenotype C, A/G ratio was related to serum concentrations of DHEA-S and androstenedione (r = 0.46, p = 0.03; r = 0.53, p = 0.01, respectively). We also found connections of HOMA-IR with VAT and A/G ratio in all phenotypes (all p < 0.05). Women with phenotype A had higher amount of VAT and A/G ratio in comparison to the control group. Serum concentration of androgens and insulin resistance are connected with VAT and A/G ratio in normoandrogenic and hyperandrogenic PCOS phenotypes.
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Affiliation(s)
- Aleksandra Maria Polak
- Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, 15-276 Białystok, Poland; (A.M.P.); (A.K.); (A.Ł.); (I.K.)
| | - Agnieszka Adamska
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, 15-276 Białystok, Poland;
- Correspondence: ; Tel.: +48-85-7468660; Fax: +48-85-744-7611
| | - Anna Krentowska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, 15-276 Białystok, Poland; (A.M.P.); (A.K.); (A.Ł.); (I.K.)
| | - Agnieszka Łebkowska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, 15-276 Białystok, Poland; (A.M.P.); (A.K.); (A.Ł.); (I.K.)
| | - Justyna Hryniewicka
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, 15-276 Białystok, Poland;
| | - Marcin Adamski
- Faculty of Computer Science, Bialystok University of Technology, 15-351 Białystok, Poland;
| | - Irina Kowalska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, 15-276 Białystok, Poland; (A.M.P.); (A.K.); (A.Ł.); (I.K.)
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Adamska A, Łebkowska A, Krentowska A, Hryniewicka J, Adamski M, Leśniewska M, Polak AM, Kowalska I. Ovarian Reserve and Serum Concentration of Thyroid Peroxidase Antibodies in Euthyroid Women With Different Polycystic Ovary Syndrome Phenotypes. Front Endocrinol (Lausanne) 2020; 11:440. [PMID: 32849259 PMCID: PMC7399035 DOI: 10.3389/fendo.2020.00440] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/04/2020] [Indexed: 11/25/2022] Open
Abstract
Objective: It has been shown that women with polycystic ovary syndrome (PCOS), as well as Hashimoto's thyroiditis (HT), are characterized by increased incidence of infertility. Serum anti-Müllerian hormone (AMH), which reflects ovarian reserve, is elevated in PCOS women and is decreased in women with HT. The Rotterdam criteria recognize four clinical PCOS phenotypes, i.e., phenotypes A, B, C, and D. The aim of the present study was to investigate the relation between serum concentrations of thyroid peroxidase antibodies (TPOAbs) and ovarian reserve in different PCOS phenotypes. Patients and methods: We examined 141 women with PCOS [phenotype A was diagnosed in 67 (47.5%) women, phenotype B in 30 (21.3%), phenotype C in 28 (19.9%), and phenotype D in 16 (11.3%)] and 88 control subjects of similar age; all women were euthyroid. Serum concentrations of AMH, thyroid-stimulating hormone (TSH), thyroid hormones, and TPOAbs were assessed. Results: We observed positive serum TPOAbs in 21.9% women with PCOS and in 23.9% controls (p = 0.07). We did not find differences in the frequency of detection of positive serum TPOAbs between phenotypes A, B, and C and the control group (p > 0.05). We did not observe a difference in AMH levels between TPOAbs-positive and TPOAbs-negative women, both in the control group and the PCOS women (all p > 0.05). However, serum AMH concentration was markedly higher in the whole PCOS group (p < 0.01) and in phenotype A (p < 0.01) vs. controls when the serum concentration of TPOAbs was negative. In the groups with positive serum levels of TPOAbs, serum concentration of AMH did not differ between PCOS phenotypes and controls (p = 0.23). Additionally, we observed that serum AMH concentration was related to the level of TPOAbs in the PCOS group (r = -0.4, p = 0.02). Conclusions: The frequency of serum detection of positive TPOAbs did not differ between PCOS phenotypes with clinical/biochemical hyperandrogenism and the control group. The observation of the difference in serum AMH between the PCOS and control groups only in TPOAbs negative women together with the inverse relation of TPOAbs with serum AMH only in the PCOS group might suggest that ovarian reserve is influenced by TPOAbs in PCOS.
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Affiliation(s)
- Agnieszka Adamska
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, Białystok, Poland
- *Correspondence: Agnieszka Adamska
| | - Agnieszka Łebkowska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, Białystok, Poland
| | - Anna Krentowska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, Białystok, Poland
| | - Justyna Hryniewicka
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Białystok, Białystok, Poland
| | - Marcin Adamski
- Faculty of Computer Science, Bialystok University of Technology, Białystok, Poland
| | - Monika Leśniewska
- Department of Reproduction and Gynecological Endocrinology, Medical University of Białystok, Białystok, Poland
| | - Aleksandra Maria Polak
- Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, Białystok, Poland
| | - Irina Kowalska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, Białystok, Poland
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Kazemi M, Pierson RA, Lujan ME, Chilibeck PD, McBreairty LE, Gordon JJ, Serrao SB, Zello GA, Chizen DR. Comprehensive Evaluation of Type 2 Diabetes and Cardiovascular Disease Risk Profiles in Reproductive-Age Women with Polycystic Ovary Syndrome: A Large Canadian Cohort. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019; 41:1453-1460. [DOI: 10.1016/j.jogc.2018.11.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 11/23/2018] [Indexed: 12/16/2022]
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Carmina E, Nasrallah MP, Guastella E, Lobo RA. Characterization of metabolic changes in the phenotypes of women with polycystic ovary syndrome in a large Mediterranean population from Sicily. Clin Endocrinol (Oxf) 2019; 91:553-560. [PMID: 31306504 DOI: 10.1111/cen.14063] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To better characterize the metabolic alterations in various phenotypes of polycystic ovary syndrome (PCOS) in a large homogeneous (Sicilian) Mediterranean population with a low prevalence of obesity. DESIGN Retrospective study. PATIENTS A total of 1215 consecutively evaluated women with PCOS divided into four Rotterdam phenotypes (A, B, C and D) and in 108 matched ovulatory, nonhyperandrogenic women. MEASUREMENTS BMI, fasting glucose, total cholesterol, HDL cholesterol, triglycerides, LDL cholesterol and an oral glucose tolerance test. RESULTS The overall prevalence of obesity was 31%, metabolic syndrome 6.6%, diabetes 2.1%, altered glucose metabolism 13.1%, and abnormal lipid profile 60%. Phenotype B had the highest prevalence of obesity, metabolic syndrome, altered glucose metabolism and lipid abnormalities compared to other PCOS phenotypes and controls. Phenotype A was more obese and more women had metabolic syndrome compared to phenotypes C and D but phenotype C had a similar prevalence of altered glucose metabolism and lipid abnormalities compared to phenotype A which had a higher BMI. These metabolic abnormalities in A and C were higher compared to phenotype D and controls. Multivariate analysis showed that BMI predicts only abnormalities in fasting glucose and triglycerides, while there was no association with androgens. CONCLUSIONS In Mediterranean women with PCOS from Sicily with a lower prevalence of obesity, the prevalence of diabetes, altered glucose metabolism and metabolic syndrome were much lower than reported in US studies. Phenotype B was the most metabolically affected phenotype, followed by phenotype A. Phenotype C had an intermediate disorder but with a high prevalence of altered glucose metabolism and lipid alterations. Only the normoandrogenic phenotype D had no metabolic abnormalities.
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Affiliation(s)
- Enrico Carmina
- Department of Health Sciences, Child and Mother Care, and General and Specialist Medicine, University of Palermo, Palermo, Italy
| | - Mona P Nasrallah
- Department of Internal Medicine, Endocrinology and Metabolism, American University of Beirut, Beirut, Lebanon
| | - Ettore Guastella
- Department of Health Sciences, Child and Mother Care, and General and Specialist Medicine, University of Palermo, Palermo, Italy
| | - Rogerio A Lobo
- Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA
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Impact of right-left differences in ovarian morphology on the ultrasound diagnosis of polycystic ovary syndrome. Fertil Steril 2019; 112:939-946. [PMID: 31395310 DOI: 10.1016/j.fertnstert.2019.06.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/31/2019] [Accepted: 06/10/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess right-left differences in ultrasonographic markers of ovarian morphology and determine the impact on the diagnosis of polycystic ovarian morphology (PCOM). DESIGN A cross-sectional study of data collected from 2006 to 2018. SETTING Academic clinical research centers. PATIENT(S) Women with polycystic ovary syndrome (PCOS; n = 87) and controls (n = 67). INTERVENTION(S) None. MAIN OUTCOMES MEASURE(S) Follicle number per ovary (FNPO), follicle number per cross-section (FNPS), and ovarian volume (OV) were assessed in both ovaries using transvaginal ultrasonography. PCOM was identified based on recent international consensus guidelines or proposed diagnostic thresholds. RESULT(S) Overall, mean right-left differences were two follicles for FNPO, one follicle for FNPS, and 2 mL for OV. FNPO showed the strongest correlation between ovaries. Its assessment in a single ovary did not impact the diagnosis of PCOM in women with PCOS. However, there were differences in the probability of unilateral versus bilateral PCOM based on FNPS and OV in both groups. CONCLUSION(S) FNPO is the most reliable unilateral marker of PCOM in light of right-left differences in ovarian morphology. Use of FNPS or OV to define PCOM is discouraged when only one ovary is visualized.
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Jarrett BY, Vantman N, Mergler RJ, Brooks ED, Pierson RA, Chizen DR, Lujan ME. Dysglycemia, Not Altered Sex Steroid Hormones, Affects Cognitive Function in Polycystic Ovary Syndrome. J Endocr Soc 2019; 3:1858-1868. [PMID: 31583367 PMCID: PMC6767628 DOI: 10.1210/js.2019-00112] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 07/24/2019] [Indexed: 02/07/2023] Open
Abstract
Context Polycystic ovary syndrome (PCOS) is a complex endocrine condition characterized by multiple reproductive and metabolic abnormalities. Because individual reproductive and metabolic abnormalities modulate working memory in the general population, there is growing interest in whether cognitive function is dually and negatively affected in PCOS. Objective To examine the association of reproductive and metabolic features with cognitive function in women with and without PCOS. Design An observational, cross-sectional study was conducted at an academic clinical research center in North America between 2006 and 2009. Common tests of working memory (i.e., manual dexterity, perceptual speed, and visuospatial ability) were performed by women with PCOS (n = 40) and control subjects (n = 40). Markers of sex steroid hormones, ovulatory function, and cardiometabolic health were also assessed. Results Reduced visuospatial ability was observed in women with PCOS compared with control subjects (P < 0.01). Reduced visuospatial ability was linked to higher levels of hemoglobin A1c in the entire study cohort, independent of body mass index or PCOS status. No associations were observed between visuospatial ability and reproductive features, after controlling for confounding variables. Conclusion Our findings support a role for glycemic control, and not PCOS per se, in cognitive dysfunction in women of reproductive age. Additional studies are needed to understand the short- and long-term effects of dysglycemia on brain health in women with PCOS, given their increased propensity for metabolic comorbidities, compared with control subjects.
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Affiliation(s)
| | - Natalie Vantman
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
| | - Reid J Mergler
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
| | - Eric D Brooks
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
| | - Roger A Pierson
- Department of Obstetrics and Gynecology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Donna R Chizen
- Department of Obstetrics and Gynecology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Marla E Lujan
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
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Sipahi M, Tokgöz VY, Keskin Ö, Atasever M, Menteşe A, Demir S. Is ovarian volume a good predictor to determine metabolic syndrome development in polycystic ovary patients. J OBSTET GYNAECOL 2019; 39:372-376. [DOI: 10.1080/01443615.2018.1522530] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Mehmet Sipahi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Giresun University, Giresun, Turkey
| | - Vehbi Yavuz Tokgöz
- Department of Obstetrics and Gynecology, Faculty of Medicine, Giresun University, Giresun, Turkey
| | - Özlem Keskin
- Department of Cardiovascular Surgery, Faculty of Medicine, Giresun University, Giresun, Turkey
| | - Melahat Atasever
- Department of Obstetrics and Gynecology, Faculty of Medicine, Giresun University, Giresun, Turkey
| | - Ahmet Menteşe
- Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Selim Demir
- Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
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Tavares A, Rêgo Barros RC. The Prevalence of Metabolic Syndrome in the Different Phenotypes of Polycystic Ovarian Syndrome. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2019; 41:37-43. [PMID: 30716785 PMCID: PMC10418812 DOI: 10.1055/s-0038-1676568] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 10/31/2018] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE To evaluate the prevalence of metabolic syndrome (MetS) in the phenotypes of polycystic ovarian syndrome (PCOS). METHODS This was a cross-sectional study involving 111 women aged between 18 and 39 years old diagnosed with PCOS, according to the Rotterdam Criteria, and grouped into four phenotypes: A: ovulatory dysfunction + hyperandrogenism + polycystic ovaries; B: ovulatory dysfunction + hyperandrogenism; C: hyperandrogenism + polycystic ovaries; D: ovulatory dysfunction + polycystic ovaries. To evaluate the presence of MetS, we measured serum triglyceride levels, HDL cholesterol, fasting blood glucose, blood pressure, and waist circumference. RESULTS The prevalence of MetS found in this sample was 33.6%, and there was no statistically significant difference (p < 0.05) among the 4 phenotypes. However, phenotype D presented a significantly higher mean glucose level after fasting (93.6 mg/dL) and 2 hours after ingesting a solution with 75 g of anhydrous glucose (120 mg/dL), as well as the lowest mean level of high-density lipoprotein (HDL) cholesterol (44.7 mg/dL). The women in this group demonstrated a high prevalence of abdominal circumference ≥ 80 cm (68.2%), as well as the highest mean abdominal circumference (90.1 cm). Amongst the women with an abdominal circumference ≥ 80 cm, phenotype A increased approximately six-fold the chance of developing metabolic syndrome in relation to phenotype C. CONCLUSION The four phenotypes of PCOS demonstrated similar prevalence rates of metabolic syndrome; abdominal obesity presented a relevant role in the development of metabolic alterations, regardless of the phenotype.
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Deshmukh H, Papageorgiou M, Kilpatrick ES, Atkin SL, Sathyapalan T. Development of a novel risk prediction and risk stratification score for polycystic ovary syndrome. Clin Endocrinol (Oxf) 2019; 90:162-169. [PMID: 30339716 DOI: 10.1111/cen.13879] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 10/10/2018] [Accepted: 10/13/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aim of this study was to develop a simple phenotypic algorithm that can capture the underlying clinical and hormonal abnormalities to help in the diagnosis and risk stratification of polycystic ovary syndrome (PCOS). METHODS The study consisted of 111 women with PCOS fulfilling the Rotterdam diagnostic criteria and 67 women without PCOS. A Firth's penalized logistic regression model was used for independent variable section. Model optimism, discrimination and calibration were assessed using bootstrapping, area under the curve (AUC) and Hosmer-Lemeshow statistics, respectively. The prognostic index (PI) and risk score for developing PCOS were calculated using independent variables from the regression model. RESULTS Firth penalized logistic regression model with backward selection identified four independent predictors of PCOS namely free androgen index [β 0.30 (0.12), P = 0.008], 17-OHP [β = 0.20 (0.01), P = 0.026], anti-mullerian hormone [AMH; β = 0.04 (0.01) P < 0.0001] and waist circumference [β = 0.08 (0.02), P < 0.0001]. The model estimates indicated high internal validity (minimal optimism on 1000-fold bootstrapping), good discrimination ability (bias corrected c-statistic = 0.90) and good calibration (Hosmer-Lemeshow χ2 = 3.7865). PCOS women with a high-risk score (q1 + q2 + q3 vs q4) presented with a worse metabolic profile characterized by a higher 2-hour glucose (P = 0.01), insulin (P = 0.0003), triglycerides (P = 0.0005), C-reactive protein (P < 0.0001) and low HDL-cholesterol (P = 0.02) as compared to those with lower risk score for PCOS. CONCLUSIONS We propose a simple four-variable model, which captures the underlying clinical and hormonal abnormalities in PCOS and can be used for diagnosis and metabolic risk stratification in women with PCOS.
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Affiliation(s)
- Harshal Deshmukh
- Department of Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK
| | - Maria Papageorgiou
- Department of Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK
| | - Eric S Kilpatrick
- Department of Pathology, Sidra Medical and Research Center, Doha, Qatar
| | | | - Thozhukat Sathyapalan
- Department of Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK
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Kazemi M, McBreairty LE, Chizen DR, Pierson RA, Chilibeck PD, Zello GA. A Comparison of a Pulse-Based Diet and the Therapeutic Lifestyle Changes Diet in Combination with Exercise and Health Counselling on the Cardio-Metabolic Risk Profile in Women with Polycystic Ovary Syndrome: A Randomized Controlled Trial. Nutrients 2018; 10:E1387. [PMID: 30274344 PMCID: PMC6212867 DOI: 10.3390/nu10101387] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 09/21/2018] [Accepted: 09/27/2018] [Indexed: 01/12/2023] Open
Abstract
We compared the effects of a low-glycemic index pulse-based diet, containing lentils, beans, split peas, and chickpeas, to the Therapeutic Lifestyle Changes (TLC) diet on cardio-metabolic measures in women with polycystic ovary syndrome (PCOS). Ninety-five women (18⁻35 years) enrolled in a 16-week intervention; 30 women in the pulse-based and 31 in the TLC groups completed the study. Women participated in aerobic exercise training (minimum 5 days/week for 45 min/day) and were counselled (monthly) about PCOS and lifestyle modification. Women underwent longitudinal follow-up post-intervention. The pulse-based group had a greater reduction in total area under the curve for insulin response to a 75-g oral glucose tolerance test (mean change ± SD: -121.0 ± 229.9 vs. -27.4 ± 110.2 µIU/mL × min; p = 0.05); diastolic blood pressure (-3.6 ± 6.7 vs. -0.2 ± 6.7 mmHg, p = 0.05); triglyceride (-0.2 ± 0.6 vs. 0.0 ± 0.5 mmol/L, p = 0.04); low-density lipoprotein cholesterol (-0.2 ± 0.4 vs. -0.1 ± 0.4 mmol/L, p = 0.05); total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C; -0.4 ± 0.4 vs. 0.1 ± 0.4, p < 0.001); and a greater increase in HDL-C (0.1 ± 0.2 vs. -0.1 ± 0.2 mmol/L, p < 0.01) than the TLC group. Decreased TC/HDL-C (p = 0.02) at six-month and increased HDL-C and decreased TC/HDL-C (p ≤ 0.02) at 12-month post-intervention were maintained in the pulse-based group. A pulse-based diet may be more effective than the TLC diet at improving cardio-metabolic disease risk factors in women with PCOS. TRIAL REGISTRATION CinicalTrials.gov identifier, NCT01288638.
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Affiliation(s)
- Maryam Kazemi
- Division of Nutrition and Dietetics, College of Pharmacy and Nutrition, 104 Clinic Place, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada.
| | - Laura E McBreairty
- Division of Nutrition and Dietetics, College of Pharmacy and Nutrition, 104 Clinic Place, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada.
| | - Donna R Chizen
- Obstetrics and Gynecology, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada.
| | - Roger A Pierson
- Obstetrics and Gynecology, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada.
| | - Philip D Chilibeck
- College of Kinesiology, Physical Activity Complex, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK S7N 5B2, Canada.
| | - Gordon A Zello
- Division of Nutrition and Dietetics, College of Pharmacy and Nutrition, 104 Clinic Place, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada.
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Karamali M, Kashanian M, Alaeinasab S, Asemi Z. The effect of dietary soy intake on weight loss, glycaemic control, lipid profiles and biomarkers of inflammation and oxidative stress in women with polycystic ovary syndrome: a randomised clinical trial. J Hum Nutr Diet 2018; 31:533-543. [PMID: 29468748 DOI: 10.1111/jhn.12545] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The present study aimed to evaluate the effects of dietary soy intake on weight loss and metabolic status of patients with polycystic ovary syndrome (PCOS). METHODS A randomised clinical trial was conducted among 60 women with PCOS. Participants were randomly assigned into two groups to receive either a test diet (n = 30) or a control diet (n = 30) for 8 weeks. Participants in the test group consumed a diet containing 0.8 g protein kg-1 body weight (35% animal proteins, 35% soy protein and 30% vegetable proteins) and participants in the control group consumed a similar diet containing 70% animal proteins and 30% vegetable proteins. RESULTS Adherence to the test diet, compared with the control diet, resulted in significant decreases [mean (SD)] in body mass index (BMI) [-0.3 (0.6) versus +0.1 (0.5) kg m-2 , P = 0.02], fasting plasma glucose [-0.2 (0.5) versus +0.1 (0.3) mmol L-1 , P = 0.01], total testosterone [-0.3 (0.7) versus +0.3 (0.3) mmol L-1 , P < 0.001], insulin [-15.0 (18.0) versus +4.8 (18.6) pmol L-1 , P < 0.001] and insulin resistance [-0.6 (0.6) versus +0.2 (0.7), P < 0.001], as well as a significant increase in quantitative insulin sensitivity check index [+0.01 (0.01) versus -0.002 (0.02), P = 0.01]. In addition, significant decreases in triglycerides [-0.1 (0.4) versus +0.2 (0.3) mmol L-1 , P = 0.01] and malondialdehyde (MDA) [-1.2 (1.0) versus +0.2 (1.2) μmol L-1 , P < 0.001] and significant increases in nitric oxide (NO) [+13.6 (14.1) versus +0.9 (24.3) μmol L-1 , P = 0.01] and glutathione (GSH) [+170.1 (175.5) versus +24.2 (168.7) μmol L-1 , P = 0.002] were seen in the test group compared to the control. CONCLUSIONS Adherence to test diet among subjects with PCOS significantly decreased BMI, glycaemic control, total testosterone, triglycerides and MDA, and significantly increased NO and GSH compared to the control diet.
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Affiliation(s)
- M Karamali
- Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - M Kashanian
- Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Z Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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Abstract
Polycystic ovary syndrome (PCOS) is a commonly occurring endocrine disorder characterized by hirsutism, anovulation, and polycystic ovaries. Often comorbid with insulin resistance, dyslipidemia, and obesity, it also carries significant risk for the development of cardiovascular and metabolic sequelae, including diabetes and metabolic syndrome. Traditionally, the treatment of patients with PCOS has focused on relief of symptoms. Here, the criteria for the diagnosis of PCOS are reviewed with an emphasis on the stratification of subtypes by metabolic features. Then treatment options are reviewed according to the management goal: relief of hyperandrogenic symptoms, regulation of menstruation, and restoration of fertility.
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Affiliation(s)
- Renate K Meier
- Department of Obstetrics and Gynecology, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, 1161 21st Avenue South, Nashville, TN 37232, USA.
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Nasri K, Jamilian M, Rahmani E, Bahmani F, Tajabadi-Ebrahimi M, Asemi Z. The effects of synbiotic supplementation on hormonal status, biomarkers of inflammation and oxidative stress in subjects with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. BMC Endocr Disord 2018; 18:21. [PMID: 29649996 PMCID: PMC5898079 DOI: 10.1186/s12902-018-0248-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/06/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To our knowledge, no reports are available indicating the effects of synbiotic supplementation on hormonal status, biomarkers of inflammation and oxidative stress in subjects with polycystic ovary syndrome (PCOS). This research was done to assess the effects of synbiotic supplementation on hormonal status, biomarkers of inflammation and oxidative stress in subjects with PCOS. METHODS This randomized double-blind, placebo-controlled trial was conducted on 60 subjects diagnosed with PCOS according to the Rotterdam criteria. Subjects were randomly assigned into two groups to take either synbiotic (n = 30) or placebo (n = 30) for 12 weeks. Endocrine, inflammation and oxidative stress biomarkers were quantified at baseline and after the 12-week intervention. RESULTS After the 12-week intervention, compared with the placebo, synbiotic supplementation significantly increased serum sex hormone-binding globulin (SHBG) (changes from baseline in synbiotic group: + 19.8 ± 47.3 vs. in placebo group: + 0.5 ± 5.4 nmol/L, p = 0.01), plasma nitric oxide (NO) (changes from baseline in synbiotic group: + 5.5 ± 4.8 vs. in placebo group: + 0.3 ± 9.1 μmol/L, p = 0.006), and decreased modified Ferriman Gallwey (mF-G) scores (changes from baseline in synbiotic group: - 1.3 ± 2.5 vs. in placebo group: - 0.1 ± 0.5, p = 0.01) and serum high-sensitivity C-reactive protein (hs-CRP) (changes from baseline in synbiotic group: - 950.0 ± 2246.6 vs. in placebo group: + 335.3 ± 2466.9 ng/mL, p = 0.02). We did not observe any significant effect of synbiotic supplementation on other hormonal status and biomarkers of oxidative stress. CONCLUSIONS Overall, synbiotic supplementation for 12 weeks in PCOS women had beneficial effects on SHBG, mFG scores, hs-CRP and NO levels, but did not affect other hormonal status and biomarkers of oxidative stress. TRIAL REGISTRATION This study was retrospectively registered in the Iranian website ( www.irct.ir ) for registration of clinical trials ( IRCT201509115623N53 ), on 2015-09-27.
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Affiliation(s)
- Khadijeh Nasri
- Endocrinology and Metabolism Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Mehri Jamilian
- Endocrinology and Metabolism Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Elham Rahmani
- Endocrinology and Metabolism Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Fereshteh Bahmani
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Maryam Tajabadi-Ebrahimi
- Faculty member of Science department, Science Faculty, Islamic Azad University, Tehran Central Branch, Tehran, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, IR Iran
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Maktabi M, Jamilian M, Asemi Z. Magnesium-Zinc-Calcium-Vitamin D Co-supplementation Improves Hormonal Profiles, Biomarkers of Inflammation and Oxidative Stress in Women with Polycystic Ovary Syndrome: a Randomized, Double-Blind, Placebo-Controlled Trial. Biol Trace Elem Res 2018; 182:21-28. [PMID: 28668998 DOI: 10.1007/s12011-017-1085-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 06/21/2017] [Indexed: 01/04/2023]
Abstract
Data on the effects of magnesium-zinc-calcium-vitamin D co-supplementation on hormonal profiles, biomarkers of inflammation, and oxidative stress among women with polycystic ovary syndrome (PCOS) are scarce. The objective of this study was to assess the effects of magnesium-zinc-calcium-vitamin D co-supplementation on hormonal profiles, biomarkers of inflammation, and oxidative stress in women with PCOS. Sixty PCOS women were randomized into two groups and treated with 100 mg magnesium, 4 mg zinc, 400 mg calcium plus 200 IU vitamin D supplements (n = 30), or placebo (n = 30) twice a day for 12 weeks. Hormonal profiles, biomarkers of inflammation, and oxidative stress were assessed at baseline and at end-of-treatment. After the 12-week intervention, compared with the placebo, magnesium-zinc-calcium-vitamin D co-supplementation resulted in significant reductions in hirsutism (-2.4 ± 1.2 vs. -0.1 ± 0.4, P < 0.001), serum high sensitivity C-reactive protein (-0.7 ± 0.8 vs. +0.2 ± 1.8 mg/L, P < 0.001), and plasma malondialdehyde (-0.4 ± 0.3 vs. +0.2 ± 1.0 μmol/L, P = 0.01), and a significant increase in plasma total antioxidant capacity concentrations (+46.6 ± 66.5 vs. -7.7 ± 130.1 mmol/L, P = 0.04). We failed to find any significant effect of magnesium-zinc-calcium-vitamin D co-supplementation on free androgen index, and other biomarkers of inflammation and oxidative stress. Overall, magnesium-zinc-calcium-vitamin D co-supplementation for 12 weeks among PCOS women had beneficial effects on hormonal profiles, biomarkers of inflammation, and oxidative stress.
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Affiliation(s)
- Maryam Maktabi
- Endocrinology and Metabolism Research Center, Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Mehri Jamilian
- Endocrinology and Metabolism Research Center, Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran.
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Gao J, Zhou L, Hong J, Chen C. Assessment of insulin resistance in Chinese PCOS patients with normal glucose tolerance. Gynecol Endocrinol 2017; 33:888-891. [PMID: 28675705 DOI: 10.1080/09513590.2017.1342238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The study aimed to investigate insulin resistance (IR) status in polycystic ovary syndrome (PCOS) women with normal glucose tolerance (NGT), and further to evaluate feasible diagnostic method for those patients. Three hundred and twenty-five PCOS women with NGT and ninety-five healthy age-matched controls were recruited with Rotterdam criterion and 75 g oral glucose tolerance test (OGTT). IR status was estimated following a glycemic and insulinemic OGTT (0, 30, 60, 120, and 180 min). A modified HOMA-IR formula was applied to each time-course value of glycemia and insulinemia. The predictive performance of each IR index was analyzed with the use of ROC curves. Compared with healthy controls, both non-obese and obese PCOS patients with NGT had a higher BMI, serum glucose, insulin value (p < .05). The best predictive index of IR in non-obese PCOS-NGT was a HOMA-M30 value of 20.36 or more (AUC: 0.753). In obese PCOS-NGT population, the best predictive performance was obtained by a HOMA-M60 value of 32.17 or more (AUC: 0.868). IR was common in Chinese PCOS women with NGT, and the early assessment of IR should be heeded. We recommended HOMA-M30 (Cutoff: 20.36) and HOMA-M60 (Cutoff: 32.17) as the best predictive parameters for non-obese and obese PCOS-NGT patients, respectively.
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Affiliation(s)
- Jing Gao
- a Department of Gynecology and Obstetrics, Rui-Jin Hospital , Shanghai Jiao Tong University School of Medicine , Shanghai , PR China
- b Department of Gynecology and Obstetrics , The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , PR China
| | - Li Zhou
- a Department of Gynecology and Obstetrics, Rui-Jin Hospital , Shanghai Jiao Tong University School of Medicine , Shanghai , PR China
| | - Jie Hong
- c Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism , Rui-Jin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , PR China
| | - Chen Chen
- a Department of Gynecology and Obstetrics, Rui-Jin Hospital , Shanghai Jiao Tong University School of Medicine , Shanghai , PR China
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Vickramarajah S, Stewart V, van Ree K, Hemingway AP, Crofton ME, Bharwani N. Subfertility: What the Radiologist Needs to Know. Radiographics 2017; 37:1587-1602. [DOI: 10.1148/rg.2017170053] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Saranya Vickramarajah
- From the Department of Radiology, St Mary’s Hospital, 3rd Floor QEQM Building, London W2 1NY, England; Imperial College Healthcare NHS Trust, London, England (N.B.); and Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (N.B.)
| | - Victoria Stewart
- From the Department of Radiology, St Mary’s Hospital, 3rd Floor QEQM Building, London W2 1NY, England; Imperial College Healthcare NHS Trust, London, England (N.B.); and Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (N.B.)
| | - Katherine van Ree
- From the Department of Radiology, St Mary’s Hospital, 3rd Floor QEQM Building, London W2 1NY, England; Imperial College Healthcare NHS Trust, London, England (N.B.); and Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (N.B.)
| | - Anne P. Hemingway
- From the Department of Radiology, St Mary’s Hospital, 3rd Floor QEQM Building, London W2 1NY, England; Imperial College Healthcare NHS Trust, London, England (N.B.); and Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (N.B.)
| | - Mary E. Crofton
- From the Department of Radiology, St Mary’s Hospital, 3rd Floor QEQM Building, London W2 1NY, England; Imperial College Healthcare NHS Trust, London, England (N.B.); and Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (N.B.)
| | - Nishat Bharwani
- From the Department of Radiology, St Mary’s Hospital, 3rd Floor QEQM Building, London W2 1NY, England; Imperial College Healthcare NHS Trust, London, England (N.B.); and Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (N.B.)
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Hapangama DK, Kamal A, Saretzki G. Implications of telomeres and telomerase in endometrial pathology. Hum Reprod Update 2017; 23:166-187. [PMID: 27979878 PMCID: PMC5850744 DOI: 10.1093/humupd/dmw044] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 12/02/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Eukaryotic chromosomal ends are linear and are protected by nucleoprotein complexes known as telomeres. The complex structural anatomy and the diverse functions of telomeres as well as the unique reverse transcriptase enzyme, telomerase that maintains telomeres are under intensive scientific scrutiny. Both are involved in many human diseases including cancer, but also in ageing and chronic disease such as diabetes. Their intricate involvement in many cellular processes and pathways is being dynamically deciphered in many organs including the endometrium. This review summarizes our current knowledge on the topic of telomeres and telomerase and their potential role in providing plausible explanations for endometrial aberrations related to common gynaecological pathologies. OBJECTIVE AND RATIONALE This review outlines the recent major findings in telomere and telomerase functions in the context of endometrial biology. It highlights the contemporary discoveries in hormonal regulation, normal endometrial regeneration, stem cells and common gynaecological diseases such as endometriosis, infertility, recurrent reproductive failure and endometrial cancer (EC). SEARCH METHODS The authors carried out systematic PubMed (Medline) and Ovid searches using the key words: telomerase, telomeres, telomere length, human telomerase reverse transcriptase, telomeric RNA component, with endometrium, hormonal regulation, endometrial stem/progenitor cells, endometrial regeneration, endometriosis, recurrent miscarriage, infertility, endometrial hyperplasia, EC and uterine cancer. Publications used in this review date from 1995 until 31st June 2016. OUTCOMES The human endometrium is a unique somatic organ, which displays dynamic telomerase activity (TA) related to the menstrual cycle. Telomerase is implicated in almost all endometrial pathologies and appears to be crucial to endometrial stem cells. In particular, it is vital for normal endometrial regeneration, providing a distinct route to formulate possible curative, non-hormonal therapies to treat chronic endometrial conditions. Furthermore, our current understanding of telomere maintenance in EC is incomplete. Data derived from other malignancies on the role of telomerase in carcinogenesis cannot be extrapolated to EC because unlike in other cancers, TA is already present in proliferating healthy endometrial cells. WIDER IMPLICATIONS Since telomerase is pivotal to endometrial regeneration, further studies elucidating the role of telomeres, telomerase, their associated proteins and their regulation in normal endometrial regeneration as well as their role in endometrial pathologies are essential. This approach may allow future development of novel treatment strategies that are not only non-hormonal but also potentially curative.
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Affiliation(s)
- D K Hapangama
- Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, L8 7SS, UK.,Liverpool Women's Hospital NHS Foundation Trust, Crown Street, Liverpool L8 7SS, UK
| | - A Kamal
- Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, L8 7SS, UK.,The National Center for Early Detection of Cancer, Oncology Teaching Hospital, Baghdad Medical City, Baghdad, Iraq
| | - G Saretzki
- Institute for Ageing and Institute for Cell and Molecular Biosciences, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
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Kiranmayee D, Kavya K, Himabindu Y, Sriharibabu M, Madhuri GLJ, Venu S. Correlations Between Anthropometry and Lipid Profile in Women With PCOS. J Hum Reprod Sci 2017; 10:167-172. [PMID: 29142444 PMCID: PMC5672721 DOI: 10.4103/jhrs.jhrs_108_16] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in reproductive age women and is associated with both reproductive and metabolic abnormalities. Recent studies have demonstrated an early onset of abnormal cardiovascular risk profile in women with PCOS. Abnormal lipid profile patterns are common in women with PCOS, and these abnormalities are not uniform in all populations. Anthropometry is a simple and commonly used research tool for assessing metabolic risk in women with PCOS. Therefore, this study examined the correlations between anthropometric parameters and lipid profile in women with PCOS. OBJECTIVES The objectives of the study were (1) To study the anthropometric profile of women with PCOS, (2) To examine the lipid profile pattern of these women with PCOS and (3) To see whether there exists any correlation between these anthropometric parameters and lipid profile. MATERIALS AND METHODS This observational cross-sectional study examined anthropometry and lipid profile in 86 married women with PCOS in the age group of 18-35 years and correlated them by using Pearson's correlation coefficient. RESULTS More than 80% of the women with PCOS demonstrated abnormal anthropometric parameters, and in more than 70% women, lipid abnormalities such as low levels of high-density lipoprotein (HDL) cholesterol and high levels of triglycerides and low-density lipoprotein cholesterol were observed. Significant positive correlations were seen between body mass index (BMI) and triglycerides (P ≤ 0.001) and waist circumference (WC) and triglycerides (P ≤ 0.029). Negative correlations were observed between BMI and HDL cholesterol (P ≤ 0.013). CONCLUSION This study revealed that BMI and WC are the most important anthropometric parameters correlated to dyslipidemia in the south Indian women with PCOS.
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Affiliation(s)
- Donthu Kiranmayee
- Department of Obstetrics and Gynaecology, GSL Medical College & General Hospital, Rajahmundry, Andhra Pradesh, India
| | - Kothapalli Kavya
- Department of Obstetrics and Gynaecology, GSL Medical College & General Hospital, Rajahmundry, Andhra Pradesh, India
| | - Yalamanchali Himabindu
- Department of Obstetrics and Gynaecology, GSL Medical College & General Hospital, Rajahmundry, Andhra Pradesh, India
| | - Manne Sriharibabu
- Department of Medicine, GSL Medical College & General Hospital, Rajahmundry, Andhra Pradesh, India
| | - Gadi Leela Jaya Madhuri
- Department of Medicine, GSL Medical College & General Hospital, Rajahmundry, Andhra Pradesh, India
| | - Swargam Venu
- Department of Medicine, GSL Medical College & General Hospital, Rajahmundry, Andhra Pradesh, India
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50
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Mahalingaiah S, Sun F, Cheng JJ, Chow ET, Lunetta KL, Murabito JM. Cardiovascular risk factors among women with self-reported infertility. FERTILITY RESEARCH AND PRACTICE 2017; 3:7. [PMID: 28620545 PMCID: PMC5424365 DOI: 10.1186/s40738-017-0034-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 03/27/2017] [Indexed: 12/31/2022]
Abstract
Background Amongst women with certain types of ovulatory disorder infertility, the studies are conflicting whether there is an increased risk of long-term cardiovascular disease risk. This paper evaluates the associations of several CVD risk factors among Framingham women with self-reported infertility. Methods Women who completed the Framingham Heart Study Third Generation and Omni Cohort 2 Exam 2 (2008–2011), and reported on past history of infertility and current cardiovascular disease status were included in this cross-sectional study. Directly measured CVD risk factors were: resting blood pressure, fasting lipid levels, fasting blood glucose, waist circumference, and body mass index (BMI). Multivariable models adjusted for age, smoking, physical activity, and cohort. Generalized estimating equations adjusted for family correlations. We performed sensitivity analyses to determine whether the association between infertility and CVD risk factors is modified by menopausal status and menstrual cycle length. Results Comparing women who self-reported infertility to those who did not, there was an average increase in BMI (β = 1.03 kg/m2, 95% CI: 0.18, 1.89), waist circumference (β = 3.08 in., 95% CI: 1.06, 5.09), triglycerides (β = 4.47 mg/dl, 95% CI:−1.54, 10.49), and a decrease in HDL cholesterol (β = −1.60 mg/dl, 95% CI: −3.76, 0.56). We estimated that infertile premenopausal women have an increased odds of obesity (BMI ≥ 30 kg/m2) (OR = 1.56, 95% CI: 1.11, 4.49) and diabetes (OR = 1.96, 95% CI: 0.86, 4.49). Conclusions BMI and waist circumference were the most strongly correlated CVD risk factors amongst women reporting a history of infertility.
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Affiliation(s)
- Shruthi Mahalingaiah
- Department of Obstetrics and Gynecology, Boston University School of Medicine, 85 East Concord Street, Boston, MA 02118 USA.,Department of Epidemiology, Boston University School of Public Health, Talbot 3E, 715 Albany Street, Boston, MA 02118 USA
| | - Fangui Sun
- Department of Biostatistics, Boston University School of Public Health, Crossstown Center, 801 Albany St, Boston, MA 02118 USA
| | - J Jojo Cheng
- Department of Obstetrics and Gynecology, Boston University School of Medicine, 85 East Concord Street, Boston, MA 02118 USA
| | - Erika T Chow
- Department of Obstetrics and Gynecology, Boston University School of Medicine, 85 East Concord Street, Boston, MA 02118 USA
| | - Kathryn L Lunetta
- Department of Biostatistics, Boston University School of Public Health, Crossstown Center, 801 Albany St, Boston, MA 02118 USA
| | - Joanne M Murabito
- Framingham Heart Study, Massachusetts. Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA USA
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