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Sairally BZF, Dhillon-Smith RK, Jethwani G, Latthe P. Myoinositol or D-chiro-inositol for PCOS symptoms in adolescents: a narrative review. J Pediatr Endocrinol Metab 2024; 37:91-101. [PMID: 38117862 DOI: 10.1515/jpem-2023-0458] [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: 08/08/2023] [Accepted: 11/09/2023] [Indexed: 12/22/2023]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) treatment in adolescents currently focuses on lifestyle interventions, with pharmacological treatment options often limited to hormonal contraceptives. Several of these carry broad side-effect profiles and are not always accepted by young girls. There is growing interest in non-hormonal therapies for PCOS. We aimed to collate the evidence on the use of myoinositol or D-chiro-inositol in the improvement of PCOS symptoms in symptomatic adolescents. CONTENT A systematic literature review identifying key articles from inception to March 2023. Participants: Female adolescents (aged 12-19 years) with PCOS or PCOS-like features. Intervention: Myoinositol or D-chiro-inositol with or without additional interventions. Comparison: Any other treatment, including lifestyle interventions, hormonal therapy, metformin or no treatment. The main outcome measure were improvement in symptoms, quality of life and adverse effects. SUMMARY Eight studies were included: two randomised open-label trials, one quasi-randomised and three non-randomised interventional studies, one case-control study and one cohort study. All studies showed improvements in some biochemical markers, metabolic parameters or clinical symptoms, but these were not reproducible across all studies. OUTLOOK The benefit of myoinositol in adolescents with PCOS remains unclear, with limited high-quality evidence. This review highlights the need for robustly conducted research to inform clinical practice.
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Affiliation(s)
| | | | - Geetu Jethwani
- Birmingham Women's & Children's NHS Foundation Trust, Birmingham, UK
| | - Pallavi Latthe
- Birmingham Women's & Children's NHS Foundation Trust, Birmingham, UK
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Bodepudi R, Seher S, Khan SA, Emmanuel S, Shantha Kumar V, Nerella R, Shaman Ameen B, Patel D, David John J, Khan S. Myoinositol Versus Metformin in the Treatment of Polycystic Ovarian Syndrome: A Systematic Review. Cureus 2023; 15:e41748. [PMID: 37575860 PMCID: PMC10421410 DOI: 10.7759/cureus.41748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 07/09/2023] [Indexed: 08/15/2023] Open
Abstract
Polycystic ovarian syndrome (PCOS) is a widespread, complex, and multi-system hormonal disorder that occurs in women of reproductive age. The wide variation in practice in the treatment of PCOS is a direct consequence of the lack of sufficient evidence on alternative treatment strategies, as well as a poor understanding of the disorder itself. The aim of our systematic review was to assess the therapeutic advantages and adverse effects of metformin (MET), a standard treatment modality, with myoinositol (MI), a recent substitute that may be used alone or in combination with other remedies to treat PCOS. A literature search was done using PubMed Central, PubMed, Medline, Cochrane, Science Direct, and Google Scholar. Studies were limited to those published in English between 2012 and 2022 that focused on the management of PCOS with both MET and MI. The systematic review complied with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Using standard quality assessment tools, two reviewers independently assessed the content of the incorporated studies. Three meta-analyses, eight randomized controlled trials (RCTs), and one non-randomized non-controlled trial (NN-RCT) were deemed eligible. Following extensive analysis, we found that MET and MI are comparable in their effects on clinical, hormonal, and biochemical profiles. MI, however, had a better safety profile and tolerance due to minimal side effects compared to MET. These results demonstrate the potential role of MI as a novel asset in the armamentarium in the management of PCOS.
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Affiliation(s)
- Ranita Bodepudi
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Saniya Seher
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Shenel A Khan
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sonya Emmanuel
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Vivig Shantha Kumar
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Resheek Nerella
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Basim Shaman Ameen
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Dev Patel
- Internal Medicine, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, IND
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Jabez David John
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Safeera Khan
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Cowan S, Lim S, Alycia C, Pirotta S, Thomson R, Gibson-Helm M, Blackmore R, Naderpoor N, Bennett C, Ee C, Rao V, Mousa A, Alesi S, Moran L. Lifestyle management in polycystic ovary syndrome - beyond diet and physical activity. BMC Endocr Disord 2023; 23:14. [PMID: 36647089 PMCID: PMC9841505 DOI: 10.1186/s12902-022-01208-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 11/09/2022] [Indexed: 01/18/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common condition affecting reproductive-aged women with reproductive, metabolic and psychological consequences. Weight and lifestyle (diet, physical activity and behavioural) management are first-line therapy in international evidence-based guidelines for PCOS. While these recommend following population-level diet and physical activity guidelines, there is ongoing interest and research in the potential benefit of including psychological and sleep interventions, as well as a range of traditional, complimentary and integrative medicine (TCIM) approaches, for optimal management of PCOS. There is limited evidence to recommend a specific diet composition for PCOS with approaches including modifying protein, carbohydrate or fat quality or quantity generally having similar effects on the presentations of PCOS. With regards to physical activity, promising evidence supports the provision of vigorous aerobic exercise, which has been shown to improve body composition, cardiorespiratory fitness and insulin resistance. Psychological and sleep interventions are also important considerations, with women displaying poor emotional wellbeing and higher rates of clinical and subclinical sleep disturbance, potentially limiting their ability to make positive lifestyle change. While optimising sleep and emotional wellbeing may aid symptom management in PCOS, research exploring the efficacy of clinical interventions is lacking. Uptake of TCIM approaches, in particular supplement and herbal medicine use, by women with PCOS is growing. However, there is currently insufficient evidence to support integration into routine clinical practice. Research investigating inositol supplementation have produced the most promising findings, showing improved metabolic profiles and reduced hyperandrogenism. Findings for other supplements, herbal medicines, acupuncture and yoga is so far inconsistent, and to reduce heterogeneity more research in specific PCOS populations, (e.g. defined age and BMI ranges) and consistent approaches to intervention delivery, duration and comparators are needed. While there are a range of lifestyle components in addition to population-recommendations for diet and physical activity of potential benefit in PCOS, robust clinical trials are warranted to expand the relatively limited evidence-base regarding holistic lifestyle management. With consumer interest in holistic healthcare rising, healthcare providers will be required to broaden their knowledge pertaining to how these therapies can be safely and appropriately utilised as adjuncts to conventional medical management.
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Affiliation(s)
- Stephanie Cowan
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia.
| | - Siew Lim
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
| | - Chelsea Alycia
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Stephanie Pirotta
- Health and Social Care Unit, Monash University, Clayton, Victoria, Australia
| | - Rebecca Thomson
- Robinson Research Institute, The University of Adelaide, North Adelaide, South Australia, Australia
| | - Melanie Gibson-Helm
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
- Te Tātai Hauora o Hine - National Centre for Women's Health Research Aotearoa, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
| | - Rebecca Blackmore
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Negar Naderpoor
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Christie Bennett
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Vibhuti Rao
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Simon Alesi
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Lisa Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
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Shamkhi Al- Ghazali B, Ali Mohammed A, Muhi Fahad A. The association of serum visfatin in women with polycystic ovary syndrome: A case-control study. BIONATURA 2022. [DOI: 10.21931/rb/2022.07.04.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Polycystic ovarian syndrome (PCOS) is the most common endocrinopathy among women of reproductive age. Visfatin is an adipokine secreted by fat tissue and macrophages involved in regulating glucose homeostasis, adipose tissue inflammation, chronic systemic inflammation, cardiovascular disease and endothelial dysfunction. The study sample (100 patients) includes 50 PCOS women and 50 control matched for age and body mass index (BMI). The women with PCOS were divided into obese or overweighed according to BMI ≥ 25 Kg/m2 and non-obese BMI ≤ 25 Kg/m2. The control group was also divided into obese and non-obese. The results showed that serum visfatin was significantly increased in obese women with POCS compared to obese control (5.61 ± 1.27 ng/mL vs. 0.48 ±0.28 ng/mL) and in non-obese women with polycystic ovarian syndrome compared to non-obese control (5.22± 1.36 ng/mL vs. 0.33± 0.26 ng/mL). These findings might suggest that visfatin could play a role in pathogenesis and the long-term consequences of PCOS.
Keywords: visfatin; polycystic ovarian syndrome; body mass index; obese women
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Affiliation(s)
| | - Ayyam Ali Mohammed
- Department of Gynecology and Obstetrics, Al-Najaf Health Directorate, Ministry of Health, Al-Najaf, Iraq
| | - Ahmed Muhi Fahad
- Department of Cardiothoracic and Vascular Surgery, Al-Sadder Teaching Medical City, Al-Najaf Health Directorate, Ministry of Health, Al-Najaf, Iraq
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5
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Zhang J, Xing C, He B. Sodium-glucose cotransporter-2 inhibitors for improving endocrine and metabolic profiles in overweight and obese individuals with polycystic ovary syndrome: a meta-analysis protocol. BMJ Open 2022; 12:e058260. [PMID: 35470198 PMCID: PMC9039375 DOI: 10.1136/bmjopen-2021-058260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Polycystic ovary syndrome (PCOS) is a heterogeneous reproductive endocrine disorder. Several ongoing trials test sodium-glucose cotransporter-2 (SGLT-2) inhibitors for women with PCOS. However, their effectiveness has not been fully elucidated owing to the lack of high-confidence evidence. Our group agrees with the statement that SGLT-2 inhibition could treat PCOS as it is supported by reports demonstrating the benefits of SGLT-2 inhibition on metabolic status and weight control. Moreover, the functions of chronic inflammation amelioration and cardiovascular system protection make it a more attractive candidate for PCOS therapy. Therefore, to provide physicians with a reference, we intend to perform a meta-analysis on the efficacy and safety of SGLT-2 inhibitors on the endocrine and metabolic profiles of patients with PCOS. METHODS AND ANALYSIS We will search for randomised controlled trials performed until September 2022 using PubMed, Web of Science, EMBASE, the Cochrane Library, Google Scholar, the PhRMA Clinical Study Results Database (www. CLINICALTRIALS gov), the China National Knowledge Infrastructure, the Wanfang, the Weipu and the Chinese biomedical literature databases. The outcomes will include androgen-associated outcomes, body fat, glucose and lipid homoeostasis, inflammatory outcomes and adverse events. In addition, two investigators will independently assess methodological quality using the revised Cochrane risk-of-bias tool 2. The analysis will be performed using RevMan V.5.3 software, and subgroup and sensitivity analyses and a meta-regression will be used to determine the heterogeneity source. ETHICS AND DISSEMINATION Ethical approval is not required because this is a meta-analysis. We will disseminate these results by publishing them in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42021281176.
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Affiliation(s)
- Jiaqi Zhang
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chuan Xing
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Bing He
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
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Śledziński M, Hliwa A, Gołębiewska J, Mika A. The Impact of Kidney Transplantation on the Serum Fatty Acid Profile in Patients with End-Stage Kidney Disease. Nutrients 2022; 14:nu14040772. [PMID: 35215422 PMCID: PMC8876092 DOI: 10.3390/nu14040772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/28/2022] [Accepted: 02/08/2022] [Indexed: 02/01/2023] Open
Abstract
Epidemiological data indicate that metabolic disturbances and increased cardiovascular risk in renal transplant patients are a significant and common problem. Therefore, it is important to search for new solutions and, at the same time, counteract the negative effects of currently used therapies. In this study, we examined the effect of kidney transplantation on the serum levels of fatty acids (FAs) in order to assess the role of these compounds in the health of transplant patients. The FA profile was analyzed by gas chromatography-mass spectrometry in the serum of 35 kidney transplant recipients, just before transplantation and 3 months later. The content of total n-3 polyunsaturated FAs (PUFAs) decreased after transplantation (3.06 ± 0.13% vs. 2.66 ± 0.14%; p < 0.05). The total amount of ultra-long-chain FAs containing 26 and more carbon atoms was significantly reduced (0.08 ± 0.009% vs. 0.05 ± 0.007%; p < 0.05). The desaturation index (18:1/18:0) increased after transplantation (3.92 ± 0.11% vs. 4.36 ± 0.18%; p < 0.05). The study showed a significant reduction in n-3 PUFAs in renal transplant recipients 3 months after transplantation, which may contribute to increased cardiovascular risk in this patient population.
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Affiliation(s)
- Maciej Śledziński
- Department of General, Endocrine and Transplant Surgery, Faculty of Medicine, Medical University of Gdansk, 80-214 Gdansk, Poland;
| | - Aleksandra Hliwa
- Department of Pharmaceutical Biochemistry, Faculty of Pharmacy, Medical University of Gdansk, 80-211 Gdansk, Poland;
| | - Justyna Gołębiewska
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, 80-211 Gdansk, Poland;
| | - Adriana Mika
- Department of Pharmaceutical Biochemistry, Faculty of Pharmacy, Medical University of Gdansk, 80-211 Gdansk, Poland;
- Correspondence:
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Xing C, Zhang J, Zhao H, He B. Effect of Sex Hormone-Binding Globulin on Polycystic Ovary Syndrome: Mechanisms, Manifestations, Genetics, and Treatment. Int J Womens Health 2022; 14:91-105. [PMID: 35140526 PMCID: PMC8818772 DOI: 10.2147/ijwh.s344542] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 01/19/2022] [Indexed: 12/18/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases causing infertility in women of childbearing age. It is characterized by hyperandrogenemia (HA), chronic anovulation, and polycystic ovary morphology (PCOM). Most women with PCOS have metabolic abnormalities. Sex hormone-binding globulin (SHBG), a transport carrier that binds estrogen and androgens and regulates their biological activity, is usually used as an indicator of hyperandrogenism in women with PCOS. Low serum SHBG levels are considered a biomarker of metabolic abnormalities and are associated with insulin resistance (IR), HA, and abnormal glucose and lipid metabolism in PCOS patients. SHBG is also related to the long-term prognosis of PCOS, whereas SHBG gene polymorphism is associated with PCOS risk. In addition, the administration of metformin (MET), glucagon-like peptide-1 receptor agonists (GLP-1 RAs), thiazolidinediones (TZDs), compound oral contraceptives (COCs), as well as nutrient supplements such as inositol (MI), vitamin D, and synbiotics can regulate SHBG levels to ameliorate PCOS complications and improve prognosis. This review focuses on the interaction between SHBG and various PCOS complications as well as the regulation of SHBG by various drugs and nutrients and its therapeutic effects on PCOS.
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Affiliation(s)
- Chuan Xing
- The First Department of Endocrine, Shengjing Hospital of China Medical University, Shenyang City, Liaoning Province, People's Republic of China
| | - Jiaqi Zhang
- The First Department of Endocrine, Shengjing Hospital of China Medical University, Shenyang City, Liaoning Province, People's Republic of China
| | - Han Zhao
- The First Department of Endocrine, Shengjing Hospital of China Medical University, Shenyang City, Liaoning Province, People's Republic of China
| | - Bing He
- The First Department of Endocrine, Shengjing Hospital of China Medical University, Shenyang City, Liaoning Province, People's Republic of China
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Islam H, Masud J, Islam YN, Haque FKM. An update on polycystic ovary syndrome: A review of the current state of knowledge in diagnosis, genetic etiology, and emerging treatment options. WOMEN'S HEALTH 2022; 18:17455057221117966. [PMID: 35972046 PMCID: PMC9386861 DOI: 10.1177/17455057221117966] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Polycystic ovary syndrome is the most common endocrine disorder in women of reproductive age, which is still incurable. However, the symptoms can be successfully managed with proper medication and lifestyle interventions. Despite its prevalence, little is known about its etiology. In this review article, the up-to-date diagnostic features and parameters recommended on the grounds of evidence-based data and different guidelines are explored. The ambiguity and insufficiency of data when diagnosing adolescent women have been put under special focus. We look at some of the most recent research done to establish relationships between different gene polymorphisms with polycystic ovary syndrome in various populations along with the underestimated impact of environmental factors like endocrine-disrupting chemicals on the reproductive health of these women. Furthermore, the article concludes with existing treatments options and the scopes for advancement in the near future. Various therapies have been considered as potential treatment through multiple randomized controlled studies, and clinical trials conducted over the years are described in this article. Standard therapies ranging from metformin to newly found alternatives based on vitamin D and gut microbiota could shine some light and guidance toward a permanent cure for this female reproductive health issue in the future.
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Affiliation(s)
- Hiya Islam
- Biotechnology Program, Department of Mathematics and Natural Sciences, School of Data and Sciences, Brac University, Dhaka, Bangladesh
| | - Jaasia Masud
- Biotechnology Program, Department of Mathematics and Natural Sciences, School of Data and Sciences, Brac University, Dhaka, Bangladesh
| | - Yushe Nazrul Islam
- Biotechnology Program, Department of Mathematics and Natural Sciences, School of Data and Sciences, Brac University, Dhaka, Bangladesh
| | - Fahim Kabir Monjurul Haque
- Microbiology Program, Department of Mathematics and Natural Sciences, School of Data and Sciences, Brac University, Dhaka, Bangladesh
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Duan X, Zhou M, Zhou G, Zhu Q, Li W. Effect of metformin on adiponectin in PCOS: A meta-analysis and a systematic review. Eur J Obstet Gynecol Reprod Biol 2021; 267:61-67. [PMID: 34717078 DOI: 10.1016/j.ejogrb.2021.10.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 09/08/2021] [Accepted: 10/17/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Conflicting results have been reported regarding the effect of metformin on adiponectin levels in women with polycystic ovary syndrome (PCOS). This meta-analysis reviewed all studies comparing adiponectin levels before and after metformin treatment in PCOS women. Additionally, changes in other indicators, including long-term complications associated with PCOS, such as inflammatory, metabolism factors and hormonal profile, were investigated following metformin treatment. We conducted subgroup analysis based on body mass index (BMI) stratification and appropriate pooling. METHODS We searched literature in PUBMED, EMBASE, the Cochrane Library, and CNKI databases. The main meta-analysis included 11 studies containing data on 353 subjects. RESULTS Metformin treatment was associated with significantly increased serum adiponectin concentrations [10 studies, random-effects SMD (95% CI) -0.58 [-1.03, -0.13]; I2 = 86%; P = 0.01]. Additionally, the meta-analysis revealed that circulating tumor necrosis factor-α(TNF-α) and C-reactive protein (CRP) concentrations were significantly decreased after metformin treatment, with corresponding SMDs of 1.01 (95% CI: 0.74-1.28, P<0.00001) and 0.48(95% CI: 0.35-0.60, P<0.00001). CONCLUSION Following metformin administration, serum adiponectin concentrations of PCOS women were found to be significantly increased, accompanied by a significant improvement in other indicators. Further investigation with a larger sample size should be conducted to validate optimal dose and duration of metformin.
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Affiliation(s)
- Xuan Duan
- Reproductive Medical Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Meiying Zhou
- Reproductive Medical Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Guangqin Zhou
- Reproductive Medical Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Qiyu Zhu
- Reproductive Medical Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Weihong Li
- Reproductive Medical Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
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Shen HR, Xu X, Ye D, Li XL. Berberine Improves the Symptoms of DHEA-Induced PCOS Rats by Regulating Gut Microbiotas and Metabolites. Gynecol Obstet Invest 2021; 86:388-397. [PMID: 34515131 DOI: 10.1159/000518040] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 05/10/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the effects of berberine on polycystic ovary syndrome (PCOS) with insulin resistance (IR). DESIGN This study performed 16S rRNA sequencing and metabolomic analysis on dehydroepiandrosterone (DHEA)-induced PCOS rats treated with berberine, focusing on the improvement of PCOS-IR by modifying gut microbiota and metabolism. METHODS Forty-two female Sprague Dawley rats were randomly divided into 4 experimental groups of 8 rats each (PCOS + HFD, PCOS + HFD + BBR, NCD + PCOS, and NCD + PCOS + BBR groups). Homeostasis model assessment of insulin resistance (HOMA-IR) index-related indicators and hormone level in serum were analyzed. 16S rRNA sequencing and metabolomic analysis were performed on DHEA-induced PCOS rats treated with berberine. In addition, the differential microbiotas and metabolites were screened. Also, enrichment analysis was carried out on the differential metabolites. Finally, we constructed a correlation network to analyze the correlation between differential microbiotas and metabolites. RESULTS Firmicutes and Bacteroidetes were changed at the phylum level, and Romboutsia, Bacteroides, and Clostridium_sensu_stricto_1 were changed at the genus level after berberine treatment. In addition, a total of 26 differential operational taxonomic units and 3 metabolites (glutamine, unsaturated acids [CH = CH], and glucose) between 2 groups were obtained. Moreover, these metabolites were mainly involved in type 2 diabetes mellitus, 2-component system, and ABC transporter Kyoto Encyclopedia of Genes and Genomes pathways. And, 3 microbiotas (Lachnospiraceae_NC2004_group, Flavonifractor, and Parasutterella) were regulated by glucose and glutamine. LIMITATIONS The sample size involved in this study is relatively small. In addition, relevant experiments need to be performed to verify the obtained results from this study, and in-depth functional studies are needed. CONCLUSIONS Berberine is effective in improving the pathological condition in PCOS by regulating the gut microbiotas and metabolites. This study will provide evidence for therapeutic efforts to treat PCOS-IR using berberine.
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Affiliation(s)
- Hao-Ran Shen
- Department of Gynecology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China
| | - Xiao Xu
- Department of Gynecology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China
| | - Dan Ye
- Department of Gynecology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China
| | - Xue-Lian Li
- Department of Gynecology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
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Wang Y, Zeng Z, Zhao S, Tang L, Yan J, Li N, Zou L, Fan X, Xu C, Huang J, Xia W, Zhu C, Rao M. Humanin Alleviates Insulin Resistance in Polycystic Ovary Syndrome: A Human and Rat Model-Based Study. Endocrinology 2021; 162:bqab056. [PMID: 33693742 DOI: 10.1210/endocr/bqab056] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Indexed: 11/19/2022]
Abstract
Polycystic ovary syndrome (PCOS), the most common endocrine disorder in women of reproductive age, is characterized by hyperandrogenism and insulin resistance (IR); however, the pathogenesis of local ovarian IR in PCOS remains largely unclear. Humanin, a mitochondria-derived peptide, has been reported to be associated with IR. Our previous study confirmed that humanin is expressed in multiple cell types in the ovary and is present in follicular fluid. However, it remains unknown whether humanin participates in the pathogenesis of local ovarian IR or whether humanin supplementation can improve IR in PCOS patients. In this study, we compared humanin concentrations in follicular fluid from PCOS patients with and without IR. We further investigated the effect of humanin analogue (HNG) supplementation on IR in a rat model of dehydroepiandrosterone-induced PCOS. Humanin concentrations in the follicular fluid were found to be significantly lower in PCOS patients with IR than in those without IR. HNG supplementation attenuated both the increases in the levels of fasting plasma glucose and fasting insulin in rats with PCOS and the decreases in phosphorylation of IRS1, PI3K, AKT, and GLUT4 proteins in the granulosa cells of these rats. Combined supplementation with HNG and insulin significantly improved glucose consumption in normal and humanin-siRNA-transfected COV434 cells. In conclusion, downregulated humanin in the ovaries may be involved in the pathogenesis of IR in PCOS, and exogenous supplementation with HNG improved local ovarian IR through modulation of the IRS1/PI3K/Akt signaling pathway in a rat model. This finding supports the potential future use of HNG as a therapeutic drug for PCOS.
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Affiliation(s)
- Yingying Wang
- Reproductive Health Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhengyan Zeng
- Department of General Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Shuhua Zhao
- Department of Reproduction and Genetics, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Li Tang
- Department of Reproduction and Genetics, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Jin Yan
- Department of Reproduction and Genetics, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Nianyu Li
- Reproductive Health Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Liping Zou
- Reproductive Health Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiaorong Fan
- Reproductive Health Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Chengcheng Xu
- Reproductive Health Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jin Huang
- Reproductive Health Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Wei Xia
- Reproductive Health Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Reproductive Medicine Centre, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Changhong Zhu
- Reproductive Health Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Reproductive Medicine Centre, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Meng Rao
- Department of Reproduction and Genetics, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
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12
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Abstract
Managing dyslipidemia over a women's life, including a focus on pregnancy, contraception, and atherosclerotic cardiovascular disease risk prevention can decrease the burden of cardiovascular disease.
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13
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Di Tucci C, Galati G, Mattei G, Bonanni V, Capri O, D'Amelio R, Muzii L, Benedetti Panici P. The role of alpha lipoic acid in female and male infertility: a systematic review. Gynecol Endocrinol 2021; 37:497-505. [PMID: 33345661 DOI: 10.1080/09513590.2020.1843619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Infertility is an increasingly frequent health condition, which may depend on female or male factors. Oxidative stress (OS), resulting from a disrupted balance between reactive oxygen species (ROS) and protective antioxidants, affects the reproductive lifespan of men and women. In this review, we examine if alpha lipoic acid (ALA), among the oral supplements currently in use, has an evidence-based beneficial role in the context of female and male infertility. METHODS We performed a search from English literature using PubMed database with the following keywords: 'female infertility', 'male infertility', 'semen', 'sperm', 'sub-fertile man', 'alpha-lipoic acid', ' alpha lipoic acid', 'lipoid acid', 'endometriosis', 'chronic pelvic pain', 'follicular fluid' and 'oocytes'. We included clinical trials, multicentric studies and reviews. The total number of references found after automatically and manually excluding duplicates was 180. After primary and secondary screening, 28 articles were selected. RESULTS The available literature demonstrates the positive effects of ALA in multiple processes from oocyte maturation (0.87 ± 0.9% of oocyte in MII vs 0.81 ± 3.9%; p < .05) to fertilization, embryo development (57.7% vs 75.7% grade 1 embryo; p < .05) and reproductive outcomes. Its regular administration both in sub-fertile women and men shows to reduce pelvic pain in endometriosis (p < .05), regularize menstrual flow and metabolic disorders (p < .01) and improve sperm quality (p < .001). CONCLUSIONS ALA represents a promising new molecule in the field of couple infertility. More clinical studies are needed in order to enhance its use in clinical practice.
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Affiliation(s)
- Chiara Di Tucci
- Departments of Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Giulia Galati
- Departments of Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Giulia Mattei
- Departments of Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Valentina Bonanni
- Departments of Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Oriana Capri
- Departments of Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Renzo D'Amelio
- Departments of Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Ludovico Muzii
- Departments of Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
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14
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Di Bari F, Catalano A, Bellone F, Martino G, Benvenga S. Vitamin D, Bone Metabolism, and Fracture Risk in Polycystic Ovary Syndrome. Metabolites 2021; 11:metabo11020116. [PMID: 33670644 PMCID: PMC7922814 DOI: 10.3390/metabo11020116] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 02/06/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among premenopausal women. PCOS may have reproductive, metabolic, cardiovascular, and psychological implications. Vitamin D deficit is often encountered in PCOS women and may contribute to the pathophysiology of this disorder. As of the key role of vitamin D in bone and mineral metabolism, and because the vitamin D status appears to be closely linked with the PCOS manifestations including insulin resistance, obesity, ovulatory and menstrual irregularities, oxidative stress and PTH elevation, hypovitaminosis D may directly and indirectly via the different facets of PCOS impair bone health in these women. Although limited data are available on life-long fracture risk in women with PCOS, the importance of preserving bone health in youth and adults to prevent osteoporosis and related fractures is also recognized in PCOS women. Evidence of the association between vitamin D and the clinical hallmarks of PCOS are summarized and discussed. Vitamin D arises as a cornerstone in women with PCOS and contributes to the pathophysiological link between PCOS and bone metabolism.
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Affiliation(s)
- Flavia Di Bari
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Viale Gazzi, 98125 Messina, Italy; (F.D.B.); (F.B.); (G.M.); (S.B.)
| | - Antonino Catalano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Viale Gazzi, 98125 Messina, Italy; (F.D.B.); (F.B.); (G.M.); (S.B.)
- Correspondence: ; Tel.: +39-090-2213987
| | - Federica Bellone
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Viale Gazzi, 98125 Messina, Italy; (F.D.B.); (F.B.); (G.M.); (S.B.)
| | - Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Viale Gazzi, 98125 Messina, Italy; (F.D.B.); (F.B.); (G.M.); (S.B.)
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Viale Gazzi, 98125 Messina, Italy; (F.D.B.); (F.B.); (G.M.); (S.B.)
- Master Program on Childhood, Adolescent and Women’s Endocrine Health, University of Messina, Viale Gazzi, 98125 Messina, Italy
- Interdepartmental Program of Molecular & Clinical Endocrinology and Women’s Endocrine Health, University Hospital, A.O.U. Policlinico G. Martino, Viale Gazzi, 98125 Messina, Italy
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15
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Vaidya A, Yadav S, Vaidya A. A Study on the Clinical and Hormonal Profile of Polycystic Ovarian Syndrome Patients Attending a Tertiary Care Hospital: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2020; 58:875-888. [PMID: 34506401 PMCID: PMC7775009 DOI: 10.31729/jnma.5694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Polycystic ovarian syndrome is the most common endocrinological disorder in women of reproductive age and has a considerable metabolic, reproductive, and cardiovascular consequences. This study was designed to provide an overview of the presentation of he clinical profile and hormonal presentation of the patients with polycystic ovarian syndrome attending a tertiary care hospital. METHODS A descriptive cross-sectional study was conducted between September 14, 2019 to October 16, 2019 on patients presenting to a tertiary care hospital, after obtaining ethical clearance from Institutional Review Committee (Dated 03/09/2019) and informed consent from the patient or patient relatives. Data entry and analysis were done in Microsoft Excel 10. The data was statistically analysed using Statistical Package for the Social Sciences (SPSS) version 20.0. RESULTS The study included 100 PCOS patients. The mean age of the patients was 24.9±4.52 years and the most common group was 26-34 years. The most common presenting symptom was menstrual irregularity which was seen in 86 (86%) of the patients, followed by weight gain in 55 (55%) of the patients. Thirty percent (30 in number) of the patients were overweight, while eleven (11%) of the patients had grade I obesity. LH/FSH ratio was more than or equal to 2 in eighty-three percent 83 (83%) of the patients. CONCLUSIONS Polycystic ovarian syndrome has varying clinical manifestations, most commonly affecting the young women of reproductive age group. The commonest presenting complaint in the current study was menstrual abnormality. Majority of the patients had deranged hormonal profile which can lead to an increased risk of cardiovascular disease and type 2 DM. Thus, awareness regarding PCOS is important for early diagnosis and to prevent its sequalae to various complications.
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Affiliation(s)
- Achala Vaidya
- Department of Obstetrics and Gynaecology, Norvic International Hospital, Kathmandu, Nepal
| | - Sweta Yadav
- Department of Obstetrics and Gynaecology, Norvic International Hospital, Kathmandu, Nepal
| | - Anshu Vaidya
- Department of Obstetrics and Gynaecology, Norvic International Hospital, Kathmandu, Nepal
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Rouhani M, Motavasselian M, Taghipoor A, Layegh P, Asili J, Hamedi SS, Badiee Avval S. Efficacy of a Persian Herbal Remedy and Electroacupuncture on Metabolic Profiles and Anthropometric Parameters in Women with Polycystic Ovary Syndrome: A Randomized Controlled Trial. Galen Med J 2019; 8:e1389. [PMID: 34466504 PMCID: PMC8344036 DOI: 10.31661/gmj.v8i0.1389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 11/12/2018] [Accepted: 03/12/2019] [Indexed: 11/16/2022] Open
Abstract
Background: The most prevalent endocrine disorder in women of reproductive age is polycystic ovary syndrome (PCOS). The purpose of this study was to evaluate the efficaciousness of a Persian herbal remedy, as well as electroacupuncture and the combination of them on metabolic profiles and anthropometric parameters in these patients. Materials and Methods: Eighty overweight women with PCOS were randomly divided into four groups. All of them received metformin 1000 mg and the second group received 5 g of herbal medicine per day (main components: Foeniculum vulgare, Urtica dioica, and Daucus carota), the third group were subjected to 20 electroacupuncture sessions, and the fourth group received both therapies. Results: After 12 weeks, the body fat and body mass index decreased the most in the herbal medicine+electroacupuncture group, and waist to hip ratio decreased the most in the electroacupuncture group. A significant decrease was also observed in fasting insulin, homeostasis model assessment of insulin resistance. A significant increase was seen in the quantitative insulin sensitivity check index in all intervention groups, but there was no noteworthy difference in these parameters in the control group. Total cholesterol and low-density lipoprotein cholesterol decreased significantly in the electroacupuncture groups and herbal medicine+electroacupuncture. Also, a significant decrease was observed in triglycerides, aspartate aminotransferase, and alanine aminotransferase in the herbal medicine groups and herbal medicine+electroacupuncture. Conclusion: It is advisable to use this herbal remedy and electroacupuncture for better treatment of metabolic complications and overweight problems in these patients.
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Affiliation(s)
- Maryam Rouhani
- School of Persian and Complementary Medicine, Mashhad University of Medical Science, Mashhad, Iran
- Students Research Committee, Mashhad University of Medical Science, Mashhad, Iran
| | - Malihe Motavasselian
- School of Persian and Complementary Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Ali Taghipoor
- Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences Mashhad, Iran
| | - Parvaneh Layegh
- Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Javad Asili
- Department of Pharmacognosy, Faculty of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shokouh Sadat Hamedi
- School of Persian and Complementary Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Shapour Badiee Avval
- School of Persian and Complementary Medicine, Mashhad University of Medical Science, Mashhad, Iran
- Correspondence to: Shapour Badiee Avval, School of Persian and Complementary Medicine, Mashhad University of Medical Science, Mashhad, Iran Telephone Number: 09151237348 Email Address:
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17
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Maleki V, Jafari-Vayghan H, Kashani A, Moradi F, Vajdi M, Kheirouri S, Alizadeh M. Potential roles of carnitine in patients with polycystic ovary syndrome: a systematic review. Gynecol Endocrinol 2019; 35:463-469. [PMID: 30806529 DOI: 10.1080/09513590.2019.1576616] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is recognized as the most prevalent endocrinopathy in reproductive-aged women. This systematic review was performed with focus on the current knowledge on carnitine concerning metabolic variables in PCOS. PubMed, Scopus, Embase, ClinicalTrials.gov and Google Scholar databases were searched from inception until May 2018. All clinical trials and observational studies published in English-language journals were eligible. Studies that provided insufficient outcomes, animal and in vitro studies were excluded. Out of 451 articles identified in our search, only six articles were eligible for analysis. Two observational studies evaluated the association of serum carnitine levels with metabolic variables, and four clinical trials examined the effect of carnitine supplementation in patients with PCOS. Serum carnitine levels had inverse relationship with glycemic status, body mass index (BMI) and waist circumference. Also, carnitine supplementation resulted in improved weight loss, glycemic status, oxidative stress, follicles and size of ovarian cells; no significant effects were reported on sex hormones and lipid profile. According to the current evidence, carnitine might improve weight loss, glycemic status and oxidative stress. However, to explore the exact mechanisms of carnitine role in patients with PCOS, further studies are recommended.
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Affiliation(s)
- Vahid Maleki
- a Student Research Committee , Tabriz University of Medical Sciences , Tabriz , Iran
- b Department of Clinical Nutrition , Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences , Tabriz , Iran
- c Nutrition Research Center, Faculty of Nutrition and Food Sciences , Tabriz University of Medical Sciences , Tabriz , Iran
| | | | - Arvin Kashani
- e Faculty of Nutritional Sciences and Dietetics , Tehran University of Medical Sciences , Tehran , Iran
| | - Fardin Moradi
- a Student Research Committee , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Mahdi Vajdi
- a Student Research Committee , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Sorayya Kheirouri
- c Nutrition Research Center, Faculty of Nutrition and Food Sciences , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Mohammad Alizadeh
- c Nutrition Research Center, Faculty of Nutrition and Food Sciences , Tabriz University of Medical Sciences , Tabriz , Iran
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Fruzzetti F, Capozzi A, Canu A, Lello S. Treatment with d-chiro-inositol and alpha lipoic acid in the management of polycystic ovary syndrome. Gynecol Endocrinol 2019; 35:506-510. [PMID: 30612488 DOI: 10.1080/09513590.2018.1540573] [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] [Indexed: 02/06/2023] Open
Abstract
To evaluate the effects of the combination of d-chiro inositol and alpha lipoic acid on menstrual cycles and insulin sensitivity in women with polycystic ovary syndrome (PCOS). Forty-one women with PCOS and 31 controls have been enrolled in the study. The menstrual cycle, BMI, homeostasis model assessment index (HOMA-I), and insulin secretion in response to an OGTT were evaluated before and after 6 months of treatment. During the observation period, the patients have been asked to not modify their diet and physical activity. The menstrual cycle length improved in 76.7% of the women. Ovulation was restored in 40%. During treatment, BMI significantly decreased (p<.002). The HOMA-I and insulin secretion were unchanged by treatment. However, when women were divided according to the presence of insulin resistance (IR; HOMA-I > 2.5), in those with IR the HOMA-I and the insulin secretion significantly decreased (p<.05 and p<.006). The association of d-chiro-inositol and alpha lipoic acid improves menstrual cycle length, restoring ovulation in the majority of women. Insulin sensitivity improved in women with IR only, confirming that in presence of IR the d-chiro-inositol has a role in restoring the insulin action overcoming the inactivity of epimerase in transforming myo-inositol to d-chiro inositol.
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Affiliation(s)
- Franca Fruzzetti
- a Department of Obstetrics and Gynecology , Santa Chiara Hospital , Pisa , Italy
| | - Anna Capozzi
- b Department of Woman and Child Health , Policlinico Gemelli Foundation IRCCS , Rome , Italy
| | - Alessandro Canu
- a Department of Obstetrics and Gynecology , Santa Chiara Hospital , Pisa , Italy
| | - Stefano Lello
- b Department of Woman and Child Health , Policlinico Gemelli Foundation IRCCS , Rome , Italy
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Mika A, Sledzinski T, Stepnowski P. Current Progress of Lipid Analysis in Metabolic Diseases by Mass Spectrometry Methods. Curr Med Chem 2019; 26:60-103. [PMID: 28971757 DOI: 10.2174/0929867324666171003121127] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 09/14/2016] [Accepted: 10/10/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Obesity, insulin resistance, diabetes, and metabolic syndrome are associated with lipid alterations, and they affect the risk of long-term cardiovascular disease. A reliable analytical instrument to detect changes in the composition or structures of lipids and the tools allowing to connect changes in a specific group of lipids with a specific disease and its progress, is constantly lacking. Lipidomics is a new field of medicine based on the research and identification of lipids and lipid metabolites present in human organism. The primary aim of lipidomics is to search for new biomarkers of different diseases, mainly civilization diseases. OBJECTIVE We aimed to review studies reporting the application of mass spectrometry for lipid analysis in metabolic diseases. METHOD Following an extensive search of peer-reviewed articles on the mass spectrometry analysis of lipids the literature has been discussed in this review article. RESULTS The lipid group contains around 1.7 million species; they are totally different, in terms of the length of aliphatic chain, amount of rings, additional functional groups. Some of them are so complex that their complex analyses are a challenge for analysts. Their qualitative and quantitative analysis of is based mainly on mass spectrometry. CONCLUSION Mass spectrometry techniques are excellent tools for lipid profiling in complex biological samples and the combination with multivariate statistical analysis enables the identification of potential diagnostic biomarkers.
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Affiliation(s)
- Adriana Mika
- Department of Environmental Analysis, Faculty of Chemistry, University of Gdansk, Poland.,Department of Pharmaceutical Biochemistry, Medical University of Gdansk, Gdansk, Poland
| | - Tomasz Sledzinski
- Department of Pharmaceutical Biochemistry, Medical University of Gdansk, Gdansk, Poland
| | - Piotr Stepnowski
- Department of Environmental Analysis, Faculty of Chemistry, University of Gdansk, Poland
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Facchinetti F, Orrù B, Grandi G, Unfer V. Short-term effects of metformin and myo-inositol in women with polycystic ovarian syndrome (PCOS): a meta-analysis of randomized clinical trials. Gynecol Endocrinol 2019; 35:198-206. [PMID: 30614282 DOI: 10.1080/09513590.2018.1540578] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Metformin (MET), the most commonly used insulin sensitizer, is the reference off-label drug for the treatment of polycystic ovary syndrome (PCOS), worldwide. However, its use may be limited mainly by gastrointestinal adverse effects. Myo-inositol (MI), a well-recognized food supplement, also represents an evidence-based treatment for PCOS women, popular in many countries. Our aim is to provide a systematic review of the literature and a meta-analysis which compares these two treatments, for their short-term efficacy and safety in PCOS patients. Systematic review and meta-analysis of randomized clinical trials (RCTs). RCTs were identified from 1994 through 2017 using MEDLINE, Cochrane Library, PubMed, and ResearchGate. Included studies were limited to those one directly comparing MET to MI on several hormones changes. Standardized mean difference (SMD) or risk ratios (RRs) with 95% CIs were calculated. Changes in fasting insulin was the main outcome of measure. Six trials with a total of 355 patients were included. At the end of treatment, no difference between MET and MI was found on fasting insulin (SMD=0.08 µU/ml, 95% CI: -0.31-0.46, p=.697), HOMA index (SMD =0.17, 95% CI: -0.53-0.88, p=.635), testosterone (SMD= -0.01, 95% CI: -0.24-0.21, p=.922), SHBG levels (SMD= -0.50 nmol/l, 95% CI: -1.39-0.38, p=.263) and body mass index (BMI) (SMD= -0.22, 95% CI: -0.60-0.16, p=.265). There was strong evidence of an increased risk of adverse events among women receiving MET compared to those receiving MI (RR =5.17, 95% CI: 2.91-9.17, p<.001). No differences were found in the effect of MET and MI on short-term hormone changes. The better tolerability of MI makes it more acceptable for the recovery of androgenic and metabolic profile in PCOS women.
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Affiliation(s)
- Fabio Facchinetti
- a Department of Medical and Surgical Sciences for Mother, Child and Adult , Azienda Ospedaliero Universitaria Policlinico, University of Modena and Reggio Emilia , Modena , Italy
| | - Beatrice Orrù
- b Department of Medical Affairs , Lo.Li. Pharma , Rome , Italy
| | - Giovanni Grandi
- a Department of Medical and Surgical Sciences for Mother, Child and Adult , Azienda Ospedaliero Universitaria Policlinico, University of Modena and Reggio Emilia , Modena , Italy
| | - Vittorio Unfer
- c Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome , Rome , Italy
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21
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Zhang F, Ma T, Cui P, Tamadon A, He S, Huo C, Yierfulati G, Xu X, Hu W, Li X, Shao LR, Guo H, Feng Y, Xu C. Diversity of the Gut Microbiota in Dihydrotestosterone-Induced PCOS Rats and the Pharmacologic Effects of Diane-35, Probiotics, and Berberine. Front Microbiol 2019; 10:175. [PMID: 30800111 PMCID: PMC6375883 DOI: 10.3389/fmicb.2019.00175] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 01/22/2019] [Indexed: 01/11/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a frequent endocrine and metabolic syndrome in reproductive-age women. Recently, emerging evidence has shown that gut microbiota is closely related to metabolic diseases such as type 2 diabetes, obesity and PCOS. In the present study, we established dihydrotestosterone (DHT)-induced PCOS rats and used Illumina MiSeq sequencing (PE300) to examine the composition, diversity, and abundance of the gut microbiota in PCOS. We compared the effects of three PCOS treatments: Diane-35 (estrogen and progesterone), probiotics and berberine. The DHT-induced rats showed constant estrous cycles, the loss of mature ovarian follicles, insulin resistance and obesity. The reproductive and metabolic functions in the PCOS rats were improved by treatment with Diane-35 and probiotics. Diane-35 and probiotics could restore the diversity of the gut microbiota, and the recovery of gut microbiota disorders improved the reproductive function in PCOS-like rats. However, berberine drastically reduced the species diversity and amount of gut microbiota and showed no improvement in PCOS. The findings of this study will help us to better understand the influence of the gut microbiota in the metabolic and reproductive alterations in PCOS as well as suggest opportunities for future personal dietary guidance for PCOS.
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Affiliation(s)
- Feifei Zhang
- School of Public Health, Fudan University, Shanghai, China
- Obstetrics and Gynecology, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
| | - Tong Ma
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Peng Cui
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Amin Tamadon
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Shan He
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Chuanbing Huo
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Gulinazi Yierfulati
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Xiaoqing Xu
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Wei Hu
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Xin Li
- Obstetrics and Gynecology, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
| | - Linus R. Shao
- Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hongwei Guo
- School of Public Health, Fudan University, Shanghai, China
| | - Yi Feng
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology, Fudan Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Congjian Xu
- Obstetrics and Gynecology, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
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Pourghasem S, Bazarganipour F, Taghavi SA, Kutenaee MA. The effectiveness of inositol and metformin on infertile polycystic ovary syndrome women with resistant to letrozole. Arch Gynecol Obstet 2019; 299:1193-1199. [PMID: 30847561 DOI: 10.1007/s00404-019-05064-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 01/24/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose is a comparison of effectiveness of myo-inositol and metformin in infertile women with polycystic ovary syndrome (PCOS) treated with letrozole. METHODS This study is a randomized single-blind controlled clinical trial undertaken in 150 infertile PCOS women. For all patients, letrozole is prescribed at a dose of 7.5 mg per day from the third day of menstruation for 5 days. Patients who did not ovulate were included and divided into three pretreatment groups: group I(control group), 200 µg of folic acid (as a placebo); group II, 1500 mg of metformin daily plus 200 µg of folic acid, and group III, inositol 2 g plus 200 µg of folic acid received twice daily for 3 months. In the last cycle, 7.5 mg letrozole was prescribed for the induction of ovulation. Primary outcomes were ovary function and pregnancy. RESULTS The ovarian function was not significantly different in those groups, whereas the ovarian function of inositol + folic acid group in normal BMI found significantly higher than other BMI spectra. In addition, the ovarian function is significantly higher in the inositol + folic acid group by increasing the infertility duration. The incidence of pregnancy is lower in letrozole + folic acid + inositol group than the other groups; however, it is not significant. CONCLUSION The addition of inositol and metformin to the treatment of infertile PCOS women with letrozole resistance improves the ovarian function; however, it is not significant. Of note, inositol was more effective than metformin in patients with normal BMI. IRCT REGISTRATION NUMBER IRCT2017070234845N1.
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Affiliation(s)
- Sajadeh Pourghasem
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Fatemeh Bazarganipour
- Midwifery Department, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Seyed Abdolvahab Taghavi
- Gynecologic and Obstetrics Department, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Maryam Azizi Kutenaee
- Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
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Jamilian M, Sabzevar NK, Asemi Z. The Effect of Magnesium and Vitamin E Co-Supplementation on Glycemic Control and Markers of Cardio-Metabolic Risk in Women with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial. Horm Metab Res 2019; 51:100-105. [PMID: 30286483 DOI: 10.1055/a-0749-6431] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Data on the effects of magnesium and vitamin E co-supplementation on glycemic control and markers of cardio-metabolic risk of patients with polycystic ovary syndrome (PCOS) were collected. This investigation was conducted to evaluate the effects of magnesium and vitamin E co-supplementation on glycemic control and markers of cardio-metabolic risk in women with PCOS. This randomized, double-blind, placebo-controlled trial was carried out on 60 women with PCOS, aged 18-40 years old. Participants were randomly divided into two groups to receive 250 mg/day magnesium plus 400 mg/day vitamin E supplements or placebo (n=30 each group) for 12 weeks. Fasting blood samples were taken at baseline and after the 12-week intervention to quantify related variables. After the 12-week intervention, compared with the placebo, magnesium and vitamin E co-supplementation led to a significant reduction in serum insulin levels (-1.1±3.0 vs. +1.6±3.7 μIU/ml, p=0.003) and homeostatic model of assessment for insulin resistance (-0.2±0.7 vs. +0.4±0.9, p=0.002), and a significant increase in the quantitative insulin sensitivity check index (+0.01±0.01 vs. -0.009±0.02, p=0.003). Furthermore, magnesium plus vitamin E supplementation significantly decreased serum triglycerides (-15.0±24.4 vs. +6.7±22.2 mg/dl, p=0.001) and VLDL-cholesterol concentrations (-3.0±4.9 vs. +0.6±2.4 mg/dl, P=0.01) compared with the placebo. A trend toward a greater decrease in total cholesterol levels was observed in magnesium plus vitamin E group compared to placebo group (-7.0±32.6 vs. +8.1±26.6 mg/dl, p=0.05). In conclusion, magnesium and vitamin E co-supplementation for 12 weeks to PCOS women had beneficial effects on parameters of insulin metabolism and few markers of cardio-metabolic risk.
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Affiliation(s)
- Mehri Jamilian
- Endocrinology and Metabolism Research Center, 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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Kupreeva M, Diane A, Lehner R, Watts R, Ghosh M, Proctor S, Vine D. Effect of metformin and flutamide on insulin, lipogenic and androgen-estrogen signaling, and cardiometabolic risk in a PCOS-prone metabolic syndrome rodent model. Am J Physiol Endocrinol Metab 2019; 316:E16-E33. [PMID: 30153063 PMCID: PMC6417686 DOI: 10.1152/ajpendo.00018.2018] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 08/10/2018] [Accepted: 08/22/2018] [Indexed: 02/06/2023]
Abstract
Polycystic ovary syndrome (PCOS) is highly associated with cardiometabolic risk and the metabolic syndrome (MetS), predisposing women to increased risk of developing type 2 diabetes and cardiovascular disease. Metformin is commonly used to treat insulin resistance-glucose intolerance, and flutamide, an androgen receptor (AR) antagonist, is used to target hyperandrogenemia and dyslipidemia. Currently, the physiological mechanism of action of these treatments on androgen, lipidogenic, and insulin signaling pathways remains unclear in PCOS. The aim of this study was to investigate the effects and mechanisms of action of metformin and flutamide on plasma lipid-apolipoprotein (Apo)B-lipoprotein and insulin-glucose metabolism, and endocrine-reproductive indices in a PCOS-prone MetS rodent model. PCOS-prone rodents were treated with metformin (300 mg/kg body wt), flutamide (30 mg/kg body wt), or metformin + flutamide combination treatment for 6 wk. Metformin was shown to improve fasting insulin and HOMA-IR, whereas flutamide and combination treatment were shown to reduce plasma triglycerides, ApoB48, and ApoB100, and this was associated with decreased intestinal secretion of ApoB48/triglyceride. Flutamide and metformin were shown to reduce plasma androgen indices and to improve ovarian primary and preovulatory follicle frequency. Metformin treatment increased hepatic estrogen receptor (ER)α, and metformin-flutamide decreased intestinal AR and increased ERα mRNA expression. Metformin-flutamide treatment upregulated hepatic and intestinal insulin signaling, including insulin receptor, MAPK1, and AKT2. In conclusion, cardiometabolic risk factors, in particular ApoB-hypertriglyceridemia, are independently modulated via the AR, and understanding the contribution of AR and insulin-signaling pathways further may facilitate the development of targeted interventions in high-risk women with PCOS and MetS.
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Affiliation(s)
- M. Kupreeva
- Metabolic and Cardiovascular Disease Laboratory, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | - A. Diane
- Metabolic and Cardiovascular Disease Laboratory, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | - R. Lehner
- Group on Molecular Cell Biology of Lipids, University of Alberta, Edmonton, Alberta, Canada
| | - R. Watts
- Group on Molecular Cell Biology of Lipids, University of Alberta, Edmonton, Alberta, Canada
| | - M. Ghosh
- Division of Endocrinology and Metabolism, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - S. Proctor
- Metabolic and Cardiovascular Disease Laboratory, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
- Group on Molecular Cell Biology of Lipids, University of Alberta, Edmonton, Alberta, Canada
| | - D. Vine
- Metabolic and Cardiovascular Disease Laboratory, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
- Group on Molecular Cell Biology of Lipids, University of Alberta, Edmonton, Alberta, Canada
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Jamilian H, Jamilian M, Foroozanfard F, Afshar Ebrahimi F, Bahmani F, Asemi Z. Comparison of myo-inositol and metformin on mental health parameters and biomarkers of oxidative stress in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. J Psychosom Obstet Gynaecol 2018; 39:307-314. [PMID: 28980870 DOI: 10.1080/0167482x.2017.1383381] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 09/15/2017] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Data on comparison of myo-inositol and metformin on mental health parameters and biomarkers of oxidative stress in subjects with polycystic ovary syndrome (PCOS) are scarce. This purpose of this study was to compare of myo-inositol and metformin on mental health parameters and biomarkers of oxidative stress in subjects with PCOS. METHODS This randomized controlled trial was conducted among 60 subjects diagnosed with PCOS according to the Rotterdam criteria. Subjects were randomly assigned into two groups to intake either myo-inositol (n = 30) or metformin (n = 30) for 12 weeks. Parameters of mental health were recorded at baseline and after the 12-week intervention. Fasting blood samples were obtained at baseline and the end of the study to determine biomarkers of biomarkers of oxidative stress. RESULTS After the 12-week intervention, changes in beck depression inventory total score (-1.0 ± 1.7 vs. -0.3 ± 0.7, p = 0.03), general health questionnaire scores (-1.7 ± 2.9 vs. -0.5 ± 1.2, p = 0.02), depression anxiety and stress scale scores (-3.9 ± 6.4 vs. -0.9 ± 1.9, p = 0.01) and plasma total antioxidant capacity (TAC) concentrations (+106.1 ± 69.6 vs. +2.1 ± 132.4 mmol/L, p < 0.001) in the myo-inositol group were significantly different from the changes in these indicators in the metformin group. Myo-inositol supplementation for 12 weeks among patients with PCOS did not affect plasma glutathione and malondialdehyde levels. CONCLUSIONS Overall, our data supported that myo-inositol supplementation for 12 weeks among patients with PCOS had favorable effects on parameters of mental health and plasma TAC levels.
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Affiliation(s)
- Hamidreza Jamilian
- a Department of Psychiatry , Arak University of Medical Sciences , Arak , Iran
| | - Mehri Jamilian
- b Endocrinology and Metabolism Research Center, Department of Gynecology and Obstetrics , School of Medicine, Arak University of Medical Sciences , Arak , Iran
| | - Fatemeh Foroozanfard
- c Department of Gynecology and Obstetrics, School of Medicine , Kashan University of Medical Sciences , Kashan , Iran
| | - Faraneh Afshar Ebrahimi
- c Department of Gynecology and Obstetrics, School of Medicine , Kashan University of Medical Sciences , Kashan , Iran
| | - Fereshteh Bahmani
- d Research Center for Biochemistry and Nutrition in Metabolic Diseases , Kashan University of Medical Sciences , Kashan , Iran
| | - Zatollah Asemi
- d Research Center for Biochemistry and Nutrition in Metabolic Diseases , Kashan University of Medical Sciences , Kashan , Iran
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Jamilian M, Samimi M, Mirhosseini N, Afshar Ebrahimi F, Aghadavod E, Talaee R, Jafarnejad S, Hashemi Dizaji S, Asemi Z. The influences of vitamin D and omega-3 co-supplementation on clinical, metabolic and genetic parameters in women with polycystic ovary syndrome. J Affect Disord 2018; 238:32-38. [PMID: 29859385 DOI: 10.1016/j.jad.2018.05.027] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/15/2018] [Accepted: 05/20/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of the co-administration of vitamin D and omega-3 fatty acid on clinical, metabolic and genetic parameters in women with polycystic ovary syndrome (PCOS). METHODS This randomized, double-blinded, placebo-controlled clinical trial was conducted on 60 subjects, aged 18-40 years old with PCOS. Subjects were randomly allocated to take either 50,000 IU vitamin D every 2 weeks plus 2000 mg/day omega-3 fatty acid from fish oil (n = 30) or placebo (n = 30) for 12 weeks. Gene expression analysis of inflammatory cytokines was conducted on peripheral blood mononuclear cells (PBMCs) of PCOS women using RT-PCR method. RESULTS Vitamin D and omega -3 fatty acid co-supplementation significantly decreased serum total testosterone levels (-0.2 ± 0.5 vs. + 0.1 ± 0.4 ng/mL, P = 0.02) compared with the placebo. In addition, vitamin D and omega-3 fatty acid co-supplementation resulted in a significant improvement in beck depression inventory (-1.4 ± 1.6 vs. -0.5 ± 0.6, P = 0.01), general health questionnaire scores (-4.5 ± 4.3 vs. -1.9 ± 2.3, P = 0.005) and depression anxiety and stress scale scores (-5.0 ± 5.1 vs. -2.3 ± 3.5, P = 0.01) compared with the placebo. Additionally, vitamin D and omega-3 fatty acid co-administration significantly decreased serum high-sensitivity C-reactive protein (hs-CRP) (-1.2 ± 1.9 vs. + 0.1 ± 0.7 mg/L, P = 0.001) and malondialdehyde (MDA) levels (-0.4 ± 0.4 vs. + 0.2 ± 0.6 µmol/L, P < 0.001), and significantly increased plasma total antioxidant capacity (TAC) levels (+ 114.6 ± 122.2 vs. -2.4 ± 168.2 mmol/L, P = 0.003) compared with the placebo. Results of RT-PCR demonstrated that vitamin D and omega-3 fatty acid co-supplementation significantly downregulated gene expression of interleukin-1 (IL-1) (P = 0.03), and upregulated vascular endothelial growth factor (VEGF) (P = 0.004) in PBMCs of subjects with PCOS, when compared with placebo. CONCLUSIONS Overall, the co-administration of vitamin D and omega-3 fatty acid for 12 weeks had beneficial effects on mental health parameters, serum total testosterone, hs-CRP, plasma TAC and MDA levels, and gene expression of IL-1 and VEGF among women with PCOS.
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Affiliation(s)
- Mehri Jamilian
- Endocrinology and Metabolism Research Center, Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Mansooreh Samimi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, IR, Iran
| | | | - Faraneh Afshar Ebrahimi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, IR, Iran
| | - Esmat Aghadavod
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, IR, Iran
| | - Rezavan Talaee
- Department of Dermatology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Sadegh Jafarnejad
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, IR, Iran
| | - Shahrzad Hashemi Dizaji
- Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, 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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Liao D, Zhong C, Li C, Mo L, Liu Y. Meta-analysis of the effects of probiotic supplementation on glycemia, lipidic profiles, weight loss and C-reactive protein in women with polycystic ovarian syndrome. Minerva Med 2018; 109:479-487. [PMID: 30256077 DOI: 10.23736/s0026-4806.18.05728-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Several studies have been designed to investigate the beneficial effects of probiotic supplementation on metabolic parameters and inflammation status in women with polycystic ovarian syndrome (PCOS), but results have been inconsistent. Herein, we perform a meta-analysis of randomized controlled trials (RCTs) to evaluate the effects of probiotic supplementation on glycemia control, lipidic profiles, weight loss and C-reactive protein (CRP) in women with PCOS. EVIDENCE ACQUISITION MELINE, EMBASE, and Cochrane Library were searched for RCTs that investigated the effects of probiotic in women with PCOS. Two investigators independently performed the screening, data extraction, and methodological quality assessment. Data were pooled as mean differences (MDs) with 95% confidence intervals (CIs). The statistical heterogeneity was assessed with the I2 test. Sensitivity analyses were performed by the leave-one-out approach. EVIDENCE SYNTHESIS From the literature search, 26 publications were screened and 6 RCTs involving 406 PCOS participants (aged 25-28.5 years) with follow-up period between 8-12 weeks were included. The pooled results showed that probiotic supplement significantly affected the levels of fasting blood insulin (FBI), quantitative insulin sensitivity check index (QUICKI), triglycerides (TG), and very low density lipoprotein-cholesterol (VLDL-C). However, no significant changes were found in other markers, including fasting plasma glucose, homeostatic model assessment-insulin resistance, total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, body weight, CRP, and dehydroepiandrosterone sulfate levels. The pooled result was robust after the sensitivity analysis. CONCLUSIONS Our finding provides evidence that daily probiotic consumption has beneficial effects on decreasing FBI, TG, and VLDL-C, and increasing the QUICKI score in PCOS patients.
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Affiliation(s)
- Dan Liao
- Department of Gynecology and Obstetrics, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, Guangdong, China
| | - Chunhua Zhong
- Department of Gynecology and Obstetrics, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, Guangdong, China
| | - Cuifen Li
- Department of Gynecology and Obstetrics, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, Guangdong, China
| | - Lifang Mo
- Department of Gynecology and Obstetrics, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, Guangdong, China
| | - Yanyan Liu
- Department of Gynecology and Obstetrics, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, Guangdong, China -
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Rashidi H, Ghaderian SB, Moradi L. The effect of vitamin D3 on improving lipid profile, fasting glucose and insulin resistance in polycystic ovary syndrome women with vitamin D deficiency. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2018. [DOI: 10.1016/j.mefs.2017.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Shabani A, Noshadian M, Jamilian M, Chamani M, Mohammadi S, Asemi Z. The effects of a novel combination of selenium and probiotic on weight loss, glycemic control and markers of cardio-metabolic risk in women with polycystic ovary syndrome. J Funct Foods 2018. [DOI: 10.1016/j.jff.2018.04.071] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Yilmaz B, Vellanki P, Ata B, Yildiz BO. Diabetes mellitus and insulin resistance in mothers, fathers, sisters, and brothers of women with polycystic ovary syndrome: a systematic review and meta-analysis. Fertil Steril 2018; 110:523-533.e14. [PMID: 29960703 DOI: 10.1016/j.fertnstert.2018.04.024] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 04/02/2018] [Accepted: 04/16/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVE(S) To analyze whether first-degree relatives (FDR) of patients with polysystic ovary syndrome (PCOS) have an increased risk of insulin resistance and glucose intolerance. DESIGN Systematic review and meta-analysis. SETTING None. PATIENT(S) Parents and siblings of women with and without PCOS. INTERVENTION(S) Search of PubMed database from 1960 to September 2017 with cross-checking of references of relevant articles in English. MAIN OUTCOME MEASURE(S) Prevalence of type 2 diabetes mellitus (T2DM) and impaired glucose tolerance, and levels of fasting insulin, 2-hour insulin levels, and homeostatic model assessment insulin resistance (HOMA IR). RESULT(S) Our search retrieved 4,796 articles of which 19 were included. The prevalence of T2DM was significantly increased in mothers and fathers of PCOS probands (rate ratio [RR] 2.43; 95% confidence interval [CI], 1.58-3.75, and RR 2.27; 95% CI, 1.25-4.12). Moreover, the fasting insulin (in mothers, fathers, and sisters) and HOMA IR (in mothers, fathers, and sisters) levels were statistically significantly higher in parents and siblings of PCOS patients. The sisters (RR 1.34; 95% CI, 0.59-3.03) and brothers (RR 1.51; 95% CI, 0.63-3.62) had a higher prevalence of T2DM than the control subjects, but the difference was not statistically significant. CONCLUSION(S) Our meta-analysis provides quantitative evidence demonstrating clustering of T2DM and insulin resistance in the parents and siblings of PCOS probands. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO 2016 CRD42016048551.
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Affiliation(s)
- Bulent Yilmaz
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, School of Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - Priyathama Vellanki
- Division of Endocrinology, Metabolism, and Molecular Medicine, Northwestern University, Chicago, Illinois
| | - Baris Ata
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, School of Medicine, Koc University, Istanbul, Turkey
| | - Bulent Okan Yildiz
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Hacettepe University, Ankara, Turkey.
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Bodur S, Dundar O, Kanat-Pektas M, Kinci MF, Tutuncu L. The effects of different therapeutic modalities on cardiovascular risk factors in women with polycystıc ovary syndrome: A randomızed controlled study. Taiwan J Obstet Gynecol 2018; 57:411-416. [DOI: 10.1016/j.tjog.2018.04.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2017] [Indexed: 01/08/2023] Open
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Song J, Ruan X, Gu M, Wang L, Wang H, Mueck AO. Effect of orlistat or metformin in overweight and obese polycystic ovary syndrome patients with insulin resistance. Gynecol Endocrinol 2018; 34:413-417. [PMID: 29172796 DOI: 10.1080/09513590.2017.1407752] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The aim of this study was to evaluate the effect of orlistat or metformin combined with Diane-35 on anthropometric, hormonal and metabolic parameters in overweight and obese polycystic ovary syndrome (PCOS) patients with insulin resistance (fasting insulin > 10 mIU/L). A total of 240 PCOS women were randomly allocated to orlistat plus Diane-35(OD group), metformin plus Diane-35(MD group), orlistat plus metformin plus Diane-35(OMD group) or Diane-35 (D group). Body weight, BMI, waist and hip circumference, blood pressure, endocrine profile, lipid profile and insulin resistance were assessed at baseline and after 3 months. Significant reductions in waist and hip circumference, serum LH, total testosterone and uric acid were observed in all groups compared with baseline. TG and TC significantly decreased in the OD group. Homeostasis model assessment insulin resistance (HOMA-IR) index was reduced in the OD (p = .015), MD (p = .001) and OMD (p = .004) groups. Body weight, BMI, systolic BP and HDL-C significantly changed in the OD and OMD group compared with the D group (p < .05). Side effects were less with orlistat than metformin. This study demonstrated that orlistat is more effective in reducing weight and lipid profile than metformin. Besides, orlistat has mild side-effects and is better tolerated compared with metformin.
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Affiliation(s)
- Jinghua Song
- a Department of Gynecological Endocrinology Beijing Obstetrics and Gynecology Hospital , Capital Medical University , Beijing , China
- b Department of Obstetrics and Gynecology , Beijing Anzhen Hospital, Capital Medical University , Beijing , China
| | - Xiangyan Ruan
- a Department of Gynecological Endocrinology Beijing Obstetrics and Gynecology Hospital , Capital Medical University , Beijing , China
- c Department of Women's Health , University Hospitals of Tuebingen , Tuebingen , Germany
| | - Muqing Gu
- a Department of Gynecological Endocrinology Beijing Obstetrics and Gynecology Hospital , Capital Medical University , Beijing , China
| | - Lijuan Wang
- a Department of Gynecological Endocrinology Beijing Obstetrics and Gynecology Hospital , Capital Medical University , Beijing , China
| | - Husheng Wang
- a Department of Gynecological Endocrinology Beijing Obstetrics and Gynecology Hospital , Capital Medical University , Beijing , China
| | - Alfred Otto Mueck
- a Department of Gynecological Endocrinology Beijing Obstetrics and Gynecology Hospital , Capital Medical University , Beijing , China
- c Department of Women's Health , University Hospitals of Tuebingen , Tuebingen , Germany
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The Effects of Synbiotic Supplementation on Metabolic Status in Women With Polycystic Ovary Syndrome: a Randomized Double-Blind Clinical Trial. Probiotics Antimicrob Proteins 2018. [DOI: 10.1007/s12602-018-9405-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Baldani DP, Skrgatic L, Ougouag R, Kasum M. The cardiometabolic effect of current management of polycystic ovary syndrome: strategies of prevention and treatment. Gynecol Endocrinol 2018; 34:87-91. [PMID: 28944709 DOI: 10.1080/09513590.2017.1381681] [Citation(s) in RCA: 11] [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] [Indexed: 01/10/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder amongst women of reproductive age, which is characterized by reproductive and cardiometabolic disturbances with long-term health repercussions. Insulin resistance (IR), impaired glucose tolerance, type 2 diabetes mellitus (DM2), obesity and dyslipidemia occur more in women with PCOS than in age-comparable women without PCOS. Long term data regarding risks or benefits of medical intervention for metabolic dysfunction of PCOS are lacking. Therapies, such as oral contraceptives (OCPs) and anti-androgenic medications used to manage the reproductive manifestations of PCOS, may themselves be the cause of cardiometabolic perturbations. Hence, strategies regarding the management of reproductive issues in PCOS encompass a patient-specific tailored approach. Factors that influence the cardiometabolic side effects arising during treatment of the reproductive manifestations of PCOS (hirsutism/anovulation) are also discussed in this paper in order to build future strategies to minimize the overall cardiometabolic risk.
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Affiliation(s)
- Dinka Pavicic Baldani
- a Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility , University of Zagreb, School of Medicine, Clinical Hospital Centre Zagreb , Zagreb , Croatia
| | - Lana Skrgatic
- a Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility , University of Zagreb, School of Medicine, Clinical Hospital Centre Zagreb , Zagreb , Croatia
| | - Roya Ougouag
- b Medical Student , School of Medicine, University of Zagreb , Zagreb , Croatia
| | - Miro Kasum
- a Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility , University of Zagreb, School of Medicine, Clinical Hospital Centre Zagreb , Zagreb , Croatia
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Insulin resistance improvement by cinnamon powder in polycystic ovary syndrome: A randomized double-blind placebo controlled clinical trial. Phytother Res 2017; 32:276-283. [DOI: 10.1002/ptr.5970] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 10/06/2017] [Accepted: 10/09/2017] [Indexed: 01/05/2023]
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Ahmadi S, Jamilian M, Karamali M, Tajabadi-Ebrahimi M, Jafari P, Taghizadeh M, Memarzadeh MR, Asemi Z. Probiotic supplementation and the effects on weight loss, glycaemia and lipid profiles in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. HUM FERTIL 2017; 20:254-261. [PMID: 28142296 DOI: 10.1080/14647273.2017.1283446] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 09/07/2016] [Indexed: 12/31/2022]
Abstract
The aim of the current study was to assess the effects of probiotic supplementation on weight loss, glycaemia and lipid profiles in women with polycystic ovary syndrome (PCOS). In a randomized, double-blind, placebo-controlled trial, 60 women with PCOS were randomized to receive probiotic capsule (n = 30) or placebo (n = 30) for 12 weeks. Consumption of probiotic supplements resulted in a significant reduction in weight (-0.5 ± 0.4 vs. +0.1 ± 1.0 kg, p = 0.004) and BMI (-0.2 ± 0.2 vs. +0.03 ± 0.4 kg/m2, p = 0.004) compared with the placebo. In addition, compared with the placebo, probiotic administration was associated with a significant decrease in fasting plasma glucose (-2.4 ± 8.4 vs. +2.1 ± 7.0 mg/dL, p = 0.02), serum insulin concentrations (-2.0 ± 5.8 vs. +1.6 ± 5.0 μIU/mL, p = 0.01), homoeostasis model of assessment-insulin resistance (-0.5 ± 1.4 vs. +0.3 ± 1.1, p = 0.01), homoeostatic model assessment-beta cell function (-7.5 ± 22.3 vs. +6.3 ± 21.7, p = 0.01), serum triglycerides (-13.3 ± 51.3 vs. +13.6 ± 37.1 mg/dL, p= 0.02) and a significant increase in quantitative insulin sensitivity check index (QUICKI) (+0.006 ± 0.01 vs. -0.005 ± 0.02, p = 0.01). When we adjusted the analysis for baseline values of biochemical parameters, age and baseline BMI, except for QUICKI (p = 0.08), other findings did not alter. We found that probiotic supplementation among PCOS women for 12 weeks had favourable effects on weight loss, markers of insulin resistance, triglycerides and VLDL-cholesterol concentrations.
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Affiliation(s)
- Shahnaz Ahmadi
- a Department of Gynecology and Obstetrics, School of Medicine , Iran University of Medical Sciences , Tehran , Iran
- b Department of Gynecology and Obstetrics, School of Medicine , Bushehr University of Medical Sciences , Bushehr , Iran
| | - Mehri Jamilian
- c Endocrinology and Metabolism Research Center, Department of Gynecology and Obstetrics, School of Medicine , Arak University of Medical Sciences , Arak , Iran
| | - Maryam Karamali
- a Department of Gynecology and Obstetrics, School of Medicine , Iran University of Medical Sciences , Tehran , Iran
| | - Maryam Tajabadi-Ebrahimi
- d Science Department, Science Faculty , Islamic Azad University, Tehran Central branch , Tehran , Iran
| | - Parvaneh Jafari
- e Department of Microbiology, Science Faculty , Islamic Azad University, Arak branch , Arak , Iran
| | - Mohsen Taghizadeh
- f Research Center for Biochemistry and Nutrition in Metabolic Diseases , Kashan University of Medical Sciences , Kashan , Iran
| | | | - Zatollah Asemi
- f Research Center for Biochemistry and Nutrition in Metabolic Diseases , Kashan University of Medical Sciences , Kashan , Iran
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Tang XL, Sun Z, Gong L. Chromium supplementation in women with polycystic ovary syndrome: Systematic review and meta-analysis. J Obstet Gynaecol Res 2017; 44:134-143. [PMID: 28929602 DOI: 10.1111/jog.13462] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 06/20/2017] [Accepted: 07/09/2017] [Indexed: 01/20/2023]
Abstract
AIM Increasing evidence has suggested that chromium supplementation may improve the clinical symptoms of polycystic ovary syndrome (PCOS), yet the results have been inconsistent. To derive a more precise estimation of the efficacy of chromium, a meta-analysis was performed. METHODS Studies published in PubMed, EMBASE and the Cochrane Library up to April 2017 were retrieved. Standardized mean differences (SMD) with 95%CI were calculated for net changes using random-effects or fixed-effects models. RESULTS A total of six randomized clinical trials (RCT) with 351 PCOS women were ultimately collected in this meta-analysis. All included RCT were of moderate-high quality. On pooled analysis, insulin resistance was significantly decreased (SMD, -0.84; 95%CI: -1.30 to -0.38; P = 0.0004), while the total testosterone (SMD, 0.36; 95%CI: 0.07-0.65; P = 0.02) and free testosterone (SMD, 0.80; 95%CI: 0.48-1.12; P < 0.00001) were markedly increased in chromium-treated PCOS patients compared with control groups. No significant difference was found in other indexes of insulin metabolism (body mass index, fasting insulin, fasting blood sugar and quantitative insulin sensitivity check index), hormone status (luteinizing hormone, follicle-stimulating hormone and prolactin) and lipid profiles (cholesterol and triglycerides) between the two groups. CONCLUSION Supplementation with chromium may not have significant benefits for women with PCOS. More RCT with low heterogeneity, however, are required to corroborate the present findings.
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Affiliation(s)
- Xiao-Lei Tang
- Taishan Medical College, Taian, Shandong Province, China
| | - Zheng Sun
- Taishan Medical College, Taian, Shandong Province, China
| | - Lei Gong
- Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong Province, China
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Pedersen AJT, Stage TB, Glintborg D, Andersen M, Christensen MMH. The Pharmacogenetics of Metformin in Women with Polycystic Ovary Syndrome: A Randomized Trial. Basic Clin Pharmacol Toxicol 2017; 122:239-244. [PMID: 28834135 DOI: 10.1111/bcpt.12874] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 08/09/2017] [Indexed: 12/23/2022]
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age. PCOS is associated with obesity, dyslipidaemia and insulin resistance, and metformin treatment may improve such metabolic features. The effect of genetic variants in key metformin transporters, their transcriptional regulators or in metformin target genes on metformin response in women with PCOS is unclear. Associations between pharmacodynamic responses to metformin (changes in weight, lipid profile, insulin sensitivity evaluated by oral glucose tolerance testing) and polymorphisms in OCT1 (rs12208357 and rs72552763), HNF1A (rs1169288 and rs2464196), MATE1 (rs2289669 and rs2252281), MATE2-K (rs12943590) and ATM (rs11212617) were studied in 40 women with PCOS randomized to 12 months of treatment with metformin 1000 mg twice daily ± oral contraceptive pills (150 μg desogestrel + 30 μg ethinylestradiol). In the entire study population, treatment was associated with reduced weight (median weight change -2.4 kg, 25th-75th percentile -5.2 to 0.3 kg, p < 0.001) and increased triglycerides (0.2 mmol/L (0.0-0.6 mmol/L), p < 0.01) without significant changes in other lipid parameters or insulin sensitivity (insulinAUC , glucoseAUC during OGTT). None of the evaluated polymorphisms significantly affected any treatment outcome. In conclusion, the genetic variants investigated were not crucial for the clinical response to metformin in PCOS.
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Affiliation(s)
- Andreas J T Pedersen
- Department of Clinical Chemistry and Pharmacology, Odense University Hospital, Odense, Denmark.,Department of Medical Evaluation & Biostatistics, Danish Medicines Agency, Copenhagen, Denmark
| | - Tore Bjerregaard Stage
- Department of Public Health, Clinical Pharmacology, University of Southern Denmark, Odense, Denmark.,Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Dorte Glintborg
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
| | - Marianne Andersen
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
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Jamilian M, Farhat P, Foroozanfard F, Afshar Ebrahimi F, Aghadavod E, Bahmani F, Badehnoosh B, Jamilian H, Asemi Z. Comparison of myo-inositol and metformin on clinical, metabolic and genetic parameters in polycystic ovary syndrome: A randomized controlled clinical trial. Clin Endocrinol (Oxf) 2017; 87:194-200. [PMID: 28485095 DOI: 10.1111/cen.13366] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 04/09/2017] [Accepted: 04/27/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To our knowledge, data on comparison of myo-inositol and metformin on clinical, metabolic and genetic parameters in subjects with polycystic ovary syndrome (PCOS) are limited. This study was carried out to compare myo-inositol and metformin on clinical, metabolic and genetic parameters in subjects with PCOS. DESIGN, PATIENTS AND MEASUREMENTS This randomized controlled trial was conducted among 60 subjects with PCOS aged 18-40 years. Subjects were randomly allocated into two groups to receive either myo-inositol (N=30) or metformin (N=30) for 12 weeks. Gene expression of inflammatory cytokines was assessed in peripheral blood mononuclear cells (PBMCs) of PCOS women by RT-PCR. RESULTS After the 12-week intervention, compared with metformin, myo-inositol intake significantly decreased serum total testosterone (-1.4±4.2 vs +0.7±1.4 nmol/L, P=.03), modified Ferriman-Gallwey (mF-G) scores (-1.1±0.7 vs -0.5±0.8, P=.01) and serum high-sensitivity C-reactive protein (hs-CRP) levels (-2.6±3.9 vs +0.2±1.5 mg/L, P<.001). RT-PCR demonstrated that compared with metformin, myo-inositol downregulated gene expression of interleukin-1 (IL-1) (P=.02) in PBMCs of subjects with PCOS. We did not observe any significant effect of myo-inositol intake compared with metformin on other hormonal profiles, plasma nitric oxide (NO) or gene expression of IL-8 and tumour necrosis factor alpha (TNF-α). CONCLUSIONS Overall, taking myo-inositol, compared with metformin, for 12 weeks in patients with PCOS with hyperinsulinism and normoinsulinism had beneficial effects on total testosterone, mFG scores, serum hs-CRP levels and gene expression of IL-1, but did not affect other hormonal profiles, NO levels or gene expression of IL-8 and TNF-α.
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Affiliation(s)
- Mehri Jamilian
- Endocrinology and Metabolism Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Pegah Farhat
- Endocrinology and Metabolism Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Fatemeh Foroozanfard
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Faraneh Afshar Ebrahimi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Esmat Aghadavod
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Fereshteh Bahmani
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Bita Badehnoosh
- Department of Gynecology and Obstetrics, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Hamidreza Jamilian
- Department of Psychiatry, 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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Mika A, Sledzinski T. Alterations of specific lipid groups in serum of obese humans: a review. Obes Rev 2017; 18:247-272. [PMID: 27899022 DOI: 10.1111/obr.12475] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 08/16/2016] [Accepted: 09/05/2016] [Indexed: 12/15/2022]
Abstract
Obesity is a major contributor to the dysfunction of liver, cardiac, pulmonary, endocrine and reproductive system, as well as a component of metabolic syndrome. Although development of obesity-related disorders is associated with lipid abnormalities, most previous studies dealing with the problem in question were limited to routinely determined parameters, such as serum concentrations of triacylglycerols, total cholesterol, low-density and high-density lipoprotein cholesterol. Many authors postulated to extend the scope of analysed lipid compounds and to study obesity-related alterations in other, previously non-examined groups of lipids. Comprehensive quantitative, structural and functional analysis of specific lipid groups may result in identification of new obesity-related alterations. The review summarizes available evidence of obesity-related alterations in various groups of lipids and their impact on health status of obese subjects. Further, the role of diet and endogenous lipid synthesis in the development of serum lipid alterations is discussed, along with potential application of various lipid compounds as risk markers for obesity-related comorbidities.
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Affiliation(s)
- A Mika
- Department of Environmental Analysis, Faculty of Chemistry, University of Gdansk, Gdansk, Poland
| | - T Sledzinski
- Department of Pharmaceutical Biochemistry, Medical University of Gdansk, Gdansk, Poland
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Fruzzetti F, Perini D, Russo M, Bucci F, Gadducci A. Comparison of two insulin sensitizers, metformin and myo-inositol, in women with polycystic ovary syndrome (PCOS). Gynecol Endocrinol 2017; 33:39-42. [PMID: 27808588 DOI: 10.1080/09513590.2016.1236078] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Insulin resistance (IR) plays a pivotal role in PCOS. Insulin-sensitizer agents such as metformin and inositols have been shown to improve the endocrine and metabolic aspects of PCOS. The purpose of this study is to compare their effects on the clinical and metabolic features of the women with PCOS. Fifty PCOS women with IR and/or hyperinsulinemia were randomized to treatment with metformin (1500 mg/day) or myo-inositol (4 g/day). IR was defined as HOMA-IR >2.5, while hyperinsulinemia was defined as a value of AUC for insulin after a glucose load over the cutoff of our laboratory obtained in normal women. The Matsusa Index has been calculated. The women have been evaluated for insulin secretion, BMI, menstrual cycle length, acne and hirsutism, at baseline and after 6 months of therapy. The results obtained in both groups were similar. The insulin sensitivity improved in both treatment groups. The BMI significantly decreased and the menstrual cycle was normalized in about 50% of the women. No significant changes in acne and hirsutism were observed. The two insulin-sensitizers, metformin and myo-inositol, show to be useful in PCOS women in lowering BMI and ameliorating insulin sensitivity, and improving menstrual cycle without significant differences between the two treatments.
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Affiliation(s)
- Franca Fruzzetti
- a Department of Obstetrics and Gynecology , University of Pisa , Pisa , Italy
| | - Daria Perini
- a Department of Obstetrics and Gynecology , University of Pisa , Pisa , Italy
| | - Marinella Russo
- a Department of Obstetrics and Gynecology , University of Pisa , Pisa , Italy
| | - Fiorella Bucci
- a Department of Obstetrics and Gynecology , University of Pisa , Pisa , Italy
| | - Angiolo Gadducci
- a Department of Obstetrics and Gynecology , University of Pisa , Pisa , Italy
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Mika A, Stepnowski P, Kaska L, Proczko M, Wisniewski P, Sledzinski M, Sledzinski T. A comprehensive study of serum odd- and branched-chain fatty acids in patients with excess weight. Obesity (Silver Spring) 2016; 24:1669-76. [PMID: 27355152 DOI: 10.1002/oby.21560] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/13/2016] [Accepted: 04/26/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE While small amounts of odd-chain fatty acids (OCFAs) and branched-chain fatty acids (BCFAs) were known to be present in mammals, it was quite recently that they were shown to play an important role in human health. However, still little is known on OCFA and BCFA profiles in subjects who have obesity. The aim of this study was to verify whether obesity is associated with changes in serum OCFA and BCFA profiles. METHODS Serum content of fatty acids was determined by gas chromatography-mass spectroscopy in 23 patients with excess weight and 21 nonobese controls. RESULTS Six OCFAs and six BCFAs (three iso-BCFAs and three anteiso-BCFAs) were found in sera from the examined subjects. Patients with excess weight presented with significantly lower serum iso-BCFA levels than the controls. Total serum content of iso-BCFAs correlated inversely with serum insulin, triglycerides, and 18:1/18:0 desaturation index. Both OCFA and iso-BCFA levels correlated inversely with C-reactive protein concentration. CONCLUSIONS Lower iso-BCFA content in patients with excess weight may be involved in elevation of serum concentration of triglycerides and inflammation. Decreased contents of iso-BCFAs in subjects with have obesity, and established anti-inflammatory, antidiabetic, and anticancer properties of these fatty acids, point to potential beneficial effects of an iso-BCFA-rich diet.
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Affiliation(s)
- Adriana Mika
- Department of Environmental Analysis, Faculty of Chemistry, University of Gdansk, Gdansk, Poland
| | - Piotr Stepnowski
- Department of Environmental Analysis, Faculty of Chemistry, University of Gdansk, Gdansk, Poland
| | - Lukasz Kaska
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Monika Proczko
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Piotr Wisniewski
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Maciej Sledzinski
- Department of Emergency Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Tomasz Sledzinski
- Department of Pharmaceutical Biochemistry, Medical University of Gdansk, Gdansk, Poland
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Jamilian M, Bahmani F, Siavashani MA, Mazloomi M, Asemi Z, Esmaillzadeh A. The Effects of Chromium Supplementation on Endocrine Profiles, Biomarkers of Inflammation, and Oxidative Stress in Women with Polycystic Ovary Syndrome: a Randomized, Double-Blind, Placebo-Controlled Trial. Biol Trace Elem Res 2016; 172:72-78. [PMID: 26613790 DOI: 10.1007/s12011-015-0570-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 11/18/2015] [Indexed: 02/05/2023]
Abstract
UNLABELLED Limited data are available indicating the effects of chromium administration on endocrine profiles, biomarkers of inflammation, and oxidative stress among women with polycystic ovary syndrome (PCOS). This study was done to assess the effects of chromium administration on endocrine profiles, biomarkers of inflammation, and oxidative stress in women with PCOS. Participants of this randomized, double-blind, placebo-controlled trial consisted of 60 patients with PCOS who received either 200 μg chromium supplements (n = 30) or placebo daily (n = 30) for 8 weeks. Endocrine profiles, inflammatory factors, and biomarkers of oxidative stress were assessed at study baseline and at the end of intervention. After 8 weeks of intervention, pregnancy rate in chromium group was higher than that in the placebo group: 16.7 % (5/30) vs. 3.3 % (1/30), P = 0.08. In addition, prevalence of acne (20.0 vs. 3.3 %, P = 0.04) decreased following the administration of chromium supplements compared with the placebo. Taking chromium led to a significant reduction in hirsutism (-1.8 ± 2.5 vs. -0.2 ± 0.8, P = 0.002), serum high-sensitivity C-reactive protein (hs-CRP) (-717.0 ± 1496.1 vs. +227.1 ± 1669.6 ng/mL, P = 0.02), plasma malondialdehyde (MDA) (-0.1 ± 0.7 vs. +1.1 ± 1.5 μmol/L, P < 0.001), and a significant increase in plasma total antioxidant capacity (TAC) concentrations (+250.7 ± 265.2 vs. +13.0 ± 201.6 mmol/L, P < 0.001). We failed to find any significant effect of chromium administration on endocrine profiles and nitric oxide (NO) and glutathione (GSH) levels. Overall, taking chromium for 8 weeks among women with PCOS had beneficial effects on acne, hirsutism, hs-CRP, TAC, and MDA levels, but it did not affect endocrine profiles, NO, and GSH. CLINICAL TRIAL REGISTRATION NUMBER IRCT201506105623N44 ( www.irct.ir ).
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Affiliation(s)
- Mehri Jamilian
- Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Fereshteh Bahmani
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Mehrnush Amiri Siavashani
- Department of Gynecology and Obstetrics, School of Medicine, Ghazvin University of Medical Sciences, Ghazvin, Iran
| | - Maryam Mazloomi
- Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran.
| | - Ahmad Esmaillzadeh
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Samimi M, Jamilian M, Ebrahimi FA, Rahimi M, Tajbakhsh B, Asemi Z. Oral carnitine supplementation reduces body weight and insulin resistance in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Clin Endocrinol (Oxf) 2016; 84:851-7. [PMID: 26666519 DOI: 10.1111/cen.13003] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 11/10/2015] [Accepted: 12/09/2015] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Limited data are available for evaluating the effects of oral carnitine supplementation on weight loss and metabolic profiles of women with polycystic ovary syndrome (PCOS). This study was designed to determine the effects of oral carnitine supplementation on weight loss, and glycaemic and lipid profiles in women with PCOS. DESIGN, PATIENTS AND MEASUREMENTS In a prospective, randomized, double-blind, placebo-controlled trial, 60 overweight patients diagnosed with PCOS were randomized to receive either 250 mg carnitine supplements (n = 30) or placebo (n = 30) for 12 weeks. Fasting blood samples were obtained at the beginning and the end of the study to quantify parameters of glucose homoeostasis and lipid concentrations. RESULTS At the end of the 12 weeks, taking carnitine supplements resulted in a significant reduction in weight (-2·7 ± 1·5 vs +0·1 ± 1·8 kg, P < 0·001), BMI (-1·1 ± 0·6 vs +0·1 ± 0·7 kg/m(2) , P < 0·001), waist circumference (WC) (-2·0 ± 1·3 vs -0·3 ± 2·0 cm, P < 0·001) and hip circumference (HC) (-2·5 ± 1·5 vs -0·3 ± 1·8 cm, P < 0·001) compared with placebo. In addition, compared with placebo, carnitine administration in women with PCOS led to a significant reduction in fasting plasma glucose (-0·38 ± 0·36 vs +0·11 ± 0·97 mmol/l, P = 0·01), serum insulin levels (-14·39 ± 25·80 vs +3·01 ± 37·25 pmol/l, P = 0·04), homoeostasis model of assessment-insulin resistance (-0·61 ± 1·03 vs +0·11 ± 1·43, P = 0·04) and dehydroepiandrosterone sulphate (-3·64 ± 7·00 vs -0·59 ± 3·20 μmol/l, P = 0·03). CONCLUSIONS Overall, 12 weeks of carnitine administration in PCOS women resulted in reductions in weight, BMI, WC and HC, and beneficial effects on glycaemic control; however, it did not affect lipid profiles or free testosterone.
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Affiliation(s)
- Mansooreh Samimi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Mehri Jamilian
- Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Faraneh Afshar Ebrahimi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Maryam Rahimi
- Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Banafsheh Tajbakhsh
- Department of Gynecology and Obstetrics, School of Medicine, Yasouj University of Medical Sciences, Yasouj, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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Jamilian M, Foroozanfard F, Bahmani F, Talaee R, Monavari M, Asemi Z. Effects of Zinc Supplementation on Endocrine Outcomes in Women with Polycystic Ovary Syndrome: a Randomized, Double-Blind, Placebo-Controlled Trial. Biol Trace Elem Res 2016; 170:271-8. [PMID: 26315303 DOI: 10.1007/s12011-015-0480-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 08/14/2015] [Indexed: 02/08/2023]
Abstract
The current study was conducted to evaluate the effects of zinc supplementation on endocrine outcomes, biomarkers of inflammation, and oxidative stress in patients with polycystic ovary syndrome (PCOS). This study was a randomized double-blind, placebo-controlled trial. Forty-eight women (18-40 years) with PCOS diagnosed according to Rotterdam criteria were randomly assigned to receive either 220 mg zinc sulfate (containing 50 mg zinc) (group 1; n = 24) and/or placebo (group 2; n = 24) for 8 weeks. Hormonal profiles, biomarkers of inflammation, and oxidative stress were measured at study baseline and after 8-week intervention. After 8 weeks of intervention, alopecia (41.7 vs. 12.5%, P = 0.02) decreased compared with the placebo. Additionally, patients who received zinc supplements had significantly decreased hirsutism (modified Ferriman-Gallwey scores) (-1.71 ± 0.99 vs. -0.29 ± 0.95, P < 0.001) and plasma malondialdehyde (MDA) levels (-0.09 ± 1.31 vs. +2.34 ± 5.53 μmol/L, P = 0.04) compared with the placebo. A trend toward a significant effect of zinc intake on reducing high-sensitivity C-reactive protein (hs-CRP) levels (P = 0.06) was also observed. We did observe no significant changes of zinc supplementation on hormonal profiles, inflammatory cytokines, and other biomarkers of oxidative stress. In conclusion, using 50 mg/day elemental zinc for 8 weeks among PCOS women had beneficial effects on alopecia, hirsutism, and plasma MDA levels; however, it did not affect hormonal profiles, inflammatory cytokines, and other biomarkers of oxidative stress.
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Affiliation(s)
- Mehri Jamilian
- Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, Islamic Republic of Iran
| | - Fatemeh Foroozanfard
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran
| | - Fereshteh Bahmani
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran
| | - Rezvan Talaee
- Department of Dermatology, School of Medicine, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran
| | - Mahshid Monavari
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran.
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Razavi M, Jamilian M, Kashan ZF, Heidar Z, Mohseni M, Ghandi Y, Bagherian T, Asemi Z. Selenium Supplementation and the Effects on Reproductive Outcomes, Biomarkers of Inflammation, and Oxidative Stress in Women with Polycystic Ovary Syndrome. Horm Metab Res 2016; 48:185-90. [PMID: 26267328 DOI: 10.1055/s-0035-1559604] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Selenium supplementation could be effective on reproductive outcomes, biomarkers of inflammation, and oxidative stress among women with polycystic ovary syndrome (PCOS). The aim of the study was to determine the effects of selenium supplementation on reproductive outcomes, biomarkers of inflammation, and oxidative stress in PCOS patients. The present randomized double-blind, placebo-controlled trial was conducted on 64 women aged 18-40 years old with PCOS at the clinic affiliated to Ardabil University of Medical Sciences, Ardabil, Iran. The participants were randomly assigned to 2 groups receiving either 200 μg selenium daily (n=32) or placebo (n=32) for 8 weeks. Hormonal profiles, biomarkers of inflammation, and oxidative stress were measured and compared both before and after the treatment. After 8 weeks of intervention, pregnancy rate in the selenium group was higher than in the placebo group: 18.8 (6/32) vs. 3.1% (1/32), p=0.04. In addition, alopecia (40.6 vs. 9.4%, p=0.004) and acne (46.9 vs. 12.5 %, p=0.003) decreased following the consumption of selenium supplements compared with placebo. Additionally, patients who received selenium supplements had significantly decreased serum dehydroepiandrosterone (DHEA) levels (p=0.02), hirsutism (modified Ferriman-Gallwey scores) (p<0.001), serum high sensitivity C-reactive protein (hs-CRP) (p=0.02), and plasma malondialdehyde (MDA) levels (p=0.01) compared with placebo. We did not observe any significant effects of taking selenium supplements on other hormonal profiles, nitric oxide (NO), and other biomarkers of oxidative stress. Taken together, selenium supplementation for 8 weeks among PCOS women had beneficial effects on reproductive outcomes, DHEA, hs-CRP, and MDA levels. Supporting Information for this article is available online at http://www.thieme-connect.de/products.
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Affiliation(s)
- M Razavi
- Department of Gynecology and Obstetrics, School of Medicine, Ardabil University of Medical Sciences, Ardabil, I. R. Iran
| | - M Jamilian
- Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, I. R. Iran
| | - Z Fakhrieh Kashan
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I. R. Iran
| | - Z Heidar
- Department of Gynecology and Obstetrics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, I. R. Iran
| | - M Mohseni
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I. R. Iran
| | - Y Ghandi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I. R. Iran
| | - T Bagherian
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I. R. Iran
| | - Z Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I. R. Iran
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Mehrabian F, Ghasemi-Tehrani H, Mohamadkhani M, Moeinoddini M, Karimzadeh P. Comparison of the effects of metformin, flutamide plus oral contraceptives, and simvastatin on the metabolic consequences of polycystic ovary syndrome. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2016; 21:7. [PMID: 27904553 PMCID: PMC5122242 DOI: 10.4103/1735-1995.177354] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 12/14/2015] [Accepted: 01/20/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is one of the common endocrine disorders in women of reproductive ages. It is associated with a range of disorders, such as dyslipidemia, hypertension, insulin resistance (IR), compensatory hyperinsulinemia, gestational, and type 2 diabetes, and increased risk of cardiovascular morbidity. There are different treatments available for PCOS. The purpose of this study was to determine and compare the effects of metformin, flutamide plus oral contraceptives (OCs), and simvastatin on the metabolic consequences of PCOS. MATERIALS AND METHODS This study was a single-blind clinical trial. The subjects were selected from a group of patient with PCOS and metabolic syndrome, who were referred to the midwifery clinic of Al-Zahra Hospital and Beheshti Hospital, Isfahan, Iran. A total of 111 subjects were randomly assigned to three groups: metformin, flutamide plus OCs, and simvastatin groups. The measurements were performed at baseline and after 6 months of therapy. Paired t-test, analysis of variance (ANOVA), and chi-square test were applied in this study. RESULTS A total of 102 subjects were analyzed in this study, 34 subjects were allotted in each group. The prevalence of IR was statistically different between three groups (P-value = 0.001). After a 6-month course, metformin showed larger reduction in fasting blood sugar (FBS) level (P-value < 0.001). However, except for metformin, two other treatments reduced C-reactive protein (CRP) level significantly (both P-values < 0.001). The level of triglycerides (TGs) decreased considerably in all groups (all P-values < 0.001). Both metformin and simvastatin decreased BMI significantly (both P-values < 0.001). None of the treatments changed high-density lipoprotein (HDL) level (all P-values > 0.05). CONCLUSION Metformin performed better in FBS reduction. Simvastatin had better performance in terms of reducing TG level and waist circumference.
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Affiliation(s)
- Ferdous Mehrabian
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hatav Ghasemi-Tehrani
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahboobe Mohamadkhani
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Moeinoddini
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Pooya Karimzadeh
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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48
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Tian Y, Zhang W, Zhao S, Sun Y, Bian Y, Chen T, Du Y, Zhang J, Wang Z, Huang T, Peng Y, Yang P, Zhao H, Chen ZJ. FADS1-FADS2 gene cluster confers risk to polycystic ovary syndrome. Sci Rep 2016; 6:21195. [PMID: 26879377 PMCID: PMC4754766 DOI: 10.1038/srep21195] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 01/19/2016] [Indexed: 01/22/2023] Open
Abstract
Dyslipidemia is common in polycystic ovary syndrome (PCOS). This study was aimed to investigate whether fatty acid desaturase genes (FADS), a dyslipidemia-related gene cluster, are associated with PCOS. We scanned variations of FADS genes using our previous data of genome-wide association study (GWAS) for PCOS and selected rs174570 for further study. The case-control study was conducted in an independent cohort of 1918 PCOS cases and 1889 age-matched controls and family-based study was conducted in a set of 243 core family trios with PCOS probands. Minor allele frequency (allele T) of rs174570 was significantly lower in PCOS cases than that in age-matched controls (P = 2.17E-03, OR = 0.85), even after adjustment of BMI and age. PCOS subjects carrying CC genotype had higher testosterone level and similar lipid/glucose level compared with those carrying TT or TC genotype. In trios, transmission disequilibrium test (TDT) analysis revealed risk allele C of rs174570 was significantly over-transmitted (P = 2.00E-04). Decreased expression of FADS2 was detected in PCOS cases and expression quantitative trait loci (eQTL) analysis revealed the risk allele C dosage was correlated with the decline of FADS2 expression (P = 0.002). Our results demonstrate that FADS1-FADS2 are susceptibility genes for PCOS.
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Affiliation(s)
- Ye Tian
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China.,Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, China; The Key laboratory for Reproductive Endocrinology of Ministry of Education, China; Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Wei Zhang
- Department of joint and bone oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Shigang Zhao
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Yinhua Sun
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, China; The Key laboratory for Reproductive Endocrinology of Ministry of Education, China; Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Yuehong Bian
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, China; The Key laboratory for Reproductive Endocrinology of Ministry of Education, China; Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Tailai Chen
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, China; The Key laboratory for Reproductive Endocrinology of Ministry of Education, China; Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Yanzhi Du
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Jiangtao Zhang
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, China; The Key laboratory for Reproductive Endocrinology of Ministry of Education, China; Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Zhao Wang
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, China; The Key laboratory for Reproductive Endocrinology of Ministry of Education, China; Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Tao Huang
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, China; The Key laboratory for Reproductive Endocrinology of Ministry of Education, China; Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Yingqian Peng
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, China; The Key laboratory for Reproductive Endocrinology of Ministry of Education, China; Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Ping Yang
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, China; The Key laboratory for Reproductive Endocrinology of Ministry of Education, China; Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Han Zhao
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, China; The Key laboratory for Reproductive Endocrinology of Ministry of Education, China; Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China.,Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, China; The Key laboratory for Reproductive Endocrinology of Ministry of Education, China; Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, China
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Facchinetti F, Bizzarri M, Benvenga S, D’Anna R, Lanzone A, Soulage C, Di Renzo GC, Hod M, Cavalli P, Chiu TT, Kamenov ZA, Bevilacqua A, Carlomagno G, Gerli S, Oliva MM, Devroey P. Results from the International Consensus Conference on Myo-inositol and d-chiro-inositol in Obstetrics and Gynecology: the link between metabolic syndrome and PCOS. Eur J Obstet Gynecol Reprod Biol 2015; 195:72-76. [DOI: 10.1016/j.ejogrb.2015.09.024] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 09/11/2015] [Accepted: 09/17/2015] [Indexed: 02/08/2023]
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Mahalingaiah S, Diamanti-Kandarakis E. Targets to treat metabolic syndrome in polycystic ovary syndrome. Expert Opin Ther Targets 2015; 19:1561-74. [PMID: 26488852 DOI: 10.1517/14728222.2015.1101067] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Metabolic syndrome is comprised of a combination of the following states: increased insulin resistance, dyslipidemia, cardiovascular disease, and increased abdominal obesity. Women with polycystic ovary syndrome (PCOS) have an increased risk of developing metabolic syndrome over the course of their lives. Metabolic syndrome increases risk of major cardiovascular events, morbidity, quality of life, and overall health care costs. Though metabolic syndrome in women with PCOS is an area of great concern, there is no effective individual medical therapeutic to adequately treat this issue. AREAS COVERED This article will review key aspects of metabolic syndrome in PCOS. We will discuss classic and novel therapeutics to address metabolic syndrome in women with PCOS. We will conclude with the importance of developing strategic interventions to increase the compliance to lifestyle and dietary modification, in addition to appreciation of the emerging pharmaceutical therapeutics available. EXPERT OPINION Innovation in lifestyle modification, including diet, exercise, with and without dedicated stress reduction techniques is the future in treatment of metabolic syndrome in PCOS. Application of novel interventions, such as group medical care, may improve future adherence to lifestyle modification recommendations, in addition to or in combination with pharmaceutical therapeutics.
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Affiliation(s)
- Shruthi Mahalingaiah
- a Department of Obstetrics and Gynecology , Boston University School of Medicine , Boston , MA 02118 , USA
| | - Evanthia Diamanti-Kandarakis
- b Department of Endocrinology, Diabetes & Metabolism , University of Athens Medical School , Athens 11521 , Greece
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