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Kim N, Chun S. Association between the serum estrone-to-estradiol ratio and parameters related to glucose metabolism and insulin resistance in women with polycystic ovary syndrome. Clin Exp Reprod Med 2021; 48:374-379. [PMID: 34875745 PMCID: PMC8651759 DOI: 10.5653/cerm.2021.04553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/27/2021] [Indexed: 11/10/2022] Open
Abstract
Objective We aimed to evaluate associations between the ratio of serum estrone (E1) to estradiol (E2) and parameters related to serum glucose metabolism and insulin resistance in women with polycystic ovary syndrome (PCOS). Methods In total, 133 women between the ages of 18 and 35 diagnosed with PCOS were enrolled in this study. All participants with PCOS underwent blood tests to determine hormonal and biochemical metabolic parameters and a standard 2-hour 75-g oral glucose tolerance test. They were divided into two groups according to the serum E1-to-E2 ratio: group 1 (E1/E2 ratio <2.0) and group 2 (E1/E2 ratio ≥2.0). Results In the comparative analysis, the waist-to-hip ratio (WHR) was the only clinical variable that was significantly different between the two groups. Patients with a higher E1/E2 ratio showed higher fasting insulin levels, homeostasis model for insulin resistance, and postprandial glucose level at 2 hours (PPG2). In a correlation analysis, only PPG2 was significantly related to the serum E1/E2 ratio. However, after controlling for the confounding effects of body mass index (BMI) and WHR, fasting glucose was also significantly correlated with the serum E1/E2 ratio. Conclusion Women with PCOS with a higher serum E1/E2 ratio were found to be more likely to show higher fasting insulin and postprandial glucose levels. Significant correlations were found between the serum E1/E2 ratio and both fasting and postprandial serum glucose levels after adjusting for BMI and WHR in women with PCOS.
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Affiliation(s)
- Nayoung Kim
- Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Sungwook Chun
- Department of Obstetrics and Gynecology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
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Nazeer K, Munawar Lone N, Sadique S, Sultan S, Zia Eupash A, Riaz S. Association of Angiotensin-Converting Enzyme gene polymorphism in Pakistani women with the atypical steroidogenesis in Polycystic ovarian syndrome: A case-control study. Saudi J Biol Sci 2021; 28:3483-3489. [PMID: 34121888 PMCID: PMC8176000 DOI: 10.1016/j.sjbs.2021.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 11/29/2022] Open
Abstract
Background Polymorphism in the angiotensin-converting enzyme gene (ACE) is responsible for elevated ACE concentrations in plasma. High ACE levels induce insulin resistance and hyperandrogenism, which are the main attributes of polycystic ovary syndrome (PCOS). Therefore, it was hypothesized that I/D polymorphism plays a role in the pathogenesis of PCOS. Objective A case-control study was designed to investigate the association of I/D polymorphism of the ACE gene with PCOS in Pakistani women of reproductive age. Methods ACE I/D polymorphism was assessed in 252 women of age group 16–40 years. For genotypic analysis, PCR amplification of genomic DNA was carried out. Statistical analysis was performed to interpret the results using SPSS software. Results Our study showed that PCOS women were more likely to have a high body mass index and waist circumferences. Most PCOS patients had menstrual irregularities 99.3%, hirsutism 75.2% and cysts in ovaries 66.6%, along with other hyperandrogenic conditions (P-value = 0.001). The genotypic and allelic frequencies were significantly different between patients and controls. There was a significant association of three genotypes with the ratio of LH: FSH among PCOS patients (P = 0.05). Anthropometric characters, comorbidities, clinical symptoms, and PCOS conditions showed no statistical significance with ACE polymorphism. Conclusions ACE I/D polymorphism was not found associated with clinical conditions of PCOS in women of reproductive age. However, it was associated with atypical steroidogenesis. So, it indicates that ACE I/D polymorphism aggravates the pathogenesis of PCOS.
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Key Words
- A-II, Angiotensin-II
- ACE, Angiotensin-converting enzyme
- BMI, Body mass index
- CVD, Cardiovascular diseases
- Ca, Calcium
- EDTA, Ethylenediamine tetraacetic acid
- FSH, Follicular stimulating hormone
- Gene polymorphism
- HWE, Hardy-weinberg equilibrium
- Hyperandrogenism
- IR:Insulin resistanceRAS, Renin-Angiotensin System
- LH, Leutinizing hormone
- LH: FSH ratio
- PCO, Polycystic ovarian syndrome
- PCR, Polymerase chain reaction
- Polycystic ovarian syndrome
- ROS, Reactive oxygen specie
- Renin-angiotensin system
- SPSS, Statistical Package for Social Sciences
- Vit, Vitamin
- WC, Waist circumference
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Affiliation(s)
- Kiran Nazeer
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
| | - Nasira Munawar Lone
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
| | - Shumaila Sadique
- Gynecology Unit: 2, Jinnah Hospital, Lahore, Pakistan.,Sana Medical Complex, Esmat Muslim Street, Near hajj and awqaf directorate shahr-e- new Kabul, Afghanistan
| | - Sikandar Sultan
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
| | - Amna Zia Eupash
- LadyWilingdon, Hospital Ravi Road Walled City Lahore, Pakistan
| | - Saba Riaz
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan.,Citilab and Research Centre, Faisal Town Lahore, Pakistan
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Aboeldalyl S, James C, Seyam E, Ibrahim EM, Shawki HED, Amer S. The Role of Chronic Inflammation in Polycystic Ovarian Syndrome-A Systematic Review and Meta-Analysis. Int J Mol Sci 2021; 22:ijms22052734. [PMID: 33800490 PMCID: PMC7962967 DOI: 10.3390/ijms22052734] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 02/07/2023] Open
Abstract
Although the current literature associates polycystic ovarian syndrome (PCOS) with chronic inflammation, the evidence for this link remains inconclusive and its causal nature remains unclear. The purpose of this systematic review was to assess the inflammatory status in PCOS women and to determine whether it is related to PCOS or to its associated adiposity. We searched electronic databases including PUBMED, EMBASE and MEDLINE, SCOPUS, DynaMed plus, TRIP, ScienceDirect and Cochrane Library, for studies investigating C-reactive protein (CRP) and other inflammatory makers in PCOS women versus healthy controls. Quality and risk of bias for selected studies were assessed using the modified Newcastle-Ottawa scale. CRP data were extracted and pooled using RevMan for calculation of the standardized mean difference (SMD) and 95% confidence interval (CI). Eighty-five eligible studies were included in the systematic review, of which 63 were included in the meta-analysis. Pooled analysis of the 63 studies revealed significantly higher circulating CRP in PCOS women (n = 4086) versus controls (n = 3120) (SMD 1.26, 95%CI, 0.99, 1.53). Sensitivity meta-analysis of 35 high quality studies including non-obese women showed significantly higher circulating CRP in PCOS women versus controls (SMD 1.80, 95%CI, 1.36, 2.25). In conclusion, circulating CRP is moderately elevated in PCOS women independent of obesity, which is indicative of low-grade chronic inflammation.
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Affiliation(s)
- Shaimaa Aboeldalyl
- Academic Unit of Translational Medical Sciences, School of Medicine, Royal Derby Hospital Centre, University of Nottingham, Derby DE22 3DT, UK;
- Faculty of Medicine, Obstetrics and Gynaecology, University of Minia, Minia 61519, Egypt; (E.S.); (E.M.I.); (H.E.-D.S.)
| | - Cathryn James
- University Hospitals of Derby and Burton NHS Foundation Trust, Library & Knowledge Service, Derby DE22 3NT, UK;
| | - Emaduldin Seyam
- Faculty of Medicine, Obstetrics and Gynaecology, University of Minia, Minia 61519, Egypt; (E.S.); (E.M.I.); (H.E.-D.S.)
| | - Emad Moussa Ibrahim
- Faculty of Medicine, Obstetrics and Gynaecology, University of Minia, Minia 61519, Egypt; (E.S.); (E.M.I.); (H.E.-D.S.)
| | - Hossam El-Din Shawki
- Faculty of Medicine, Obstetrics and Gynaecology, University of Minia, Minia 61519, Egypt; (E.S.); (E.M.I.); (H.E.-D.S.)
| | - Saad Amer
- Academic Unit of Translational Medical Sciences, School of Medicine, Royal Derby Hospital Centre, University of Nottingham, Derby DE22 3DT, UK;
- Correspondence: ; Tel.: +44-(1332)-786773
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Salehpour S, Nazari L, Hoseini S, Moghaddam PB, Gachkar L. Effects of L-carnitine on Polycystic Ovary Syndrome. JBRA Assist Reprod 2019; 23:392-395. [PMID: 31294953 PMCID: PMC6798588 DOI: 10.5935/1518-0557.20190033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Objective: Polycystic ovary syndrome (PCOS) is a common disorder in women of
reproductive age. This study investigated the effects of L-carnitine on the
clinical and laboratory findings of women with PCOS. Methods: Eighty women diagnosed with PCOS between 2017 and 2018 by the Rotterdam
Criteria were enrolled in the study; six were lost during the study. The
participants were given L-carnitine 3 g daily (Pursinapharma, Iran) for
three months. Blood samples were taken after overnight fasting at baseline
and three months into the study to assess the levels of fasting glucose,
insulin, triglycerides, high-density lipoprotein (HDL), low-density
lipoprotein (LDL), free testosterone, dehydroepiandrosterone (DHEA), and the
insulin resistance index (HOMA-IR). The patients were weighed before and
after treatment and had their body mass index (BMI) calculated. Menstrual
cycles and manifestations of hirsutism were also assessed. Results: The data showed a significant improvement in insulin sensitivity and
decreases in serum LDL levels and the BMI after three months of treatment.
There was a significant increase in serum HDL levels. More regular menstrual
cycles and decreased hirsutism were also observed. Conclusion: It appears that treatment with L-carnitine might decrease the risk of
cardiovascular events by normalizing metabolic profiles and the BMI.
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Affiliation(s)
- Saghar Salehpour
- Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Nazari
- Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sedighe Hoseini
- Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parya Bameni Moghaddam
- Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Latif Gachkar
- Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Rahimi Z, Mohammadi M Sc E. The CYP17 MSP AI (T-34C) and CYP19A1 (Trp39Arg) variants in polycystic ovary syndrome: A case-control study. Int J Reprod Biomed 2019; 17. [PMID: 31435594 PMCID: PMC6661133 DOI: 10.18502/ijrm.v17i3.4519] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 06/18/2018] [Accepted: 01/19/2019] [Indexed: 12/20/2022] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is a common and chronic disorder of endocrine glands where genetic factors play a major role in the susceptibility to the disease. The cytochrome (CYP) 17 enzyme is essential for androgens biosynthesis. Also, the CYP19 enzyme converts the androgens to the aromatic estrogens. Objective We aimed to investigate the association of CYP 17 MSP AI (T-34C) and CYP 19A1 (Trp39Arg) variants with the pathogenesis of PCOS in a population from Western Iran with Kurdish ethnic background. Materials and Methods The present case-control study consisted of 50 patients with PCOS and 109 controls. The CYP17 T-34C and CYP19A1 (Trp39Arg) polymorphisms were identified by polymerase chain reaction-restriction fragment length polymorphism. The serum lipid and lipoprotein profile were detected by the Bionic Diagnostic Kits. Estradiol, dehydroepiandrosterone (DHEA), and sex hormone-binding globulin (SHBG) levels were measured using the chemiluminescent method. Results The serum levels of estradiol and SHBG in PCOS patients were lower than controls (p < 0.001 and p = 0.06, respectively). However, the level of DHEA was higher (p = 0.01) in patients compared to controls. The higher frequency of CYP17 TC genotype in patients (30%) compared to controls (15.6%) was associated with 2.31-fold susceptibility to PCOS (p = 0.038). The frequency of CYP19 TC genotype was 6.4% in controls and 10% in patients (p = 0.42).
Conclusion The present study suggests that CYP17 TC genotype could be associated with the risk of PCOS. Also, the study indicated the sex steroid hormones level alteration and the lower level of SHBG in PCOS patients compared to healthy individuals.
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Affiliation(s)
- Zohreh Rahimi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Department of Clinical Biochemistry, Medical School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Mohammadi M Sc
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Department of Clinical Biochemistry, Medical School, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Zohrabi M, Rahmani E, Motamed N, Akbarzadeh S. CXC Ligand 5 cytokine serum level in women with polycystic ovary syndrome and normal body mass index: A case-control study. Int J Reprod Biomed 2017; 15:619-624. [PMID: 29387827 PMCID: PMC5767642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the most common endocrine disease and associated with insulin resistance. CXC Ligand 5 (CXCL5) is a new cytokine which is secreted from white adipose tissue during obesity and by blocking insulin signaling pathway inhibits the activity of insulin and promotes insulin resistance. OBJECTIVE The aim of this study was to assess serum level of CXCL5 in PCOS women with normal body mass index. MATERIALS AND METHODS In this case-control study, 30 PCOS women with normal body mass index as the case group and 30 non-PCOS women as the controls were enrolled. Serum levels of CXCL5, insulin and other hormones factors related with PCOS were measured by ELISA method, also the biochemical parameters were measured by autoanalyzer. RESULTS Significant increases in serum insulin concentration, homeostasis model assessments of insulin resistance, luteinizing hormone, luteinizing hormone/follicle-stimulating hormone, fasting blood sugar, testosterone, and prolactin were observed in the case group compared to the controls. were in the serum level of CXCL5, cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol,dehydroepiandrosterone-sulfate, creatinine, and homeostasis model assessment of beta cell function between these two groups. CONCLUSION In this study, no significant change was observed in serum concentrations of CXCL5 in PCOS women with normal BMI.
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Affiliation(s)
- Marzieh Zohrabi
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Elham Rahmani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Niloofar Motamed
- Department of Community Medicine, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Samad Akbarzadeh
- Department of Biochemistry, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.
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7
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Bothou A, Koutlaki N, Iatrakis G, Mastorakos G, Tsikouras P, Liberis V, Galazios G, Liberis A, Lykeridou A, Zervoudis S. ANTIMÜLLERIAN HORMONE AS INDICATOR OF OVARIAN DYSFUNCTION. ACTA ENDOCRINOLOGICA-BUCHAREST 2017; 13:237-245. [PMID: 31149181 DOI: 10.4183/aeb.2017.237] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Aim The purpose of this study was to examine various hormonal, biochemical and environmental factors (i.e., smoking and alcohol intake) and to investigate their possible correlation to the development of polycystic ovary syndrome (PCOS). The main objective was to evaluate the associations between hormonal profile and the antimüllerian hormone (AMH) levels in PCOS patients and their relation to environmental factors. Patients and Methods In two gynecological clinics, 38 women with PCOS (defined according to the Rotterdam criteria) were enrolled and observed in relation to AMH, follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), Δ4-androstendione (Δ4-A), dehydroepiandrosterone sulfate (DHEA-S) and glucose plasma concentrations. Obesity, smoking and alcohol exposure were also studied. Results AMH, T, Δ4-Α, DHEA-S, LH and FSH were increased in 76.3%, 50%, 31.8%, 23.7%, 21% and 18.4% of the patients, respectively. The LH/FSH ratio and glucose concentrations increased abnormally in 18.4% and 15.8% of the patients, respectively. AMH and T levels were both increased in 47.4% of the patients whereas both AMH and LH levels increased in 21% of the patients. Smoking, alcohol intake, obesity and glucose concentrations were not associated with AMH concentrations. On the contrary, high levels of T and LH were linked to higher levels of AMH. FSH concentrations were not increased in these patients. Conclusion AMH is an important hormonal parameter for the diagnosis of PCOS. Larger clinical controlled studies are necessary in an effort to further investigate the inclusion of AMH measurement in the diagnostic criteria of PCOS.
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Affiliation(s)
- A Bothou
- Democritus University of Thrace, Research on Female Reproduction, Athens, Greece
| | - N Koutlaki
- Democritus University of Thrace, Department of Obstetrics and Gynaecology, Komotini, Athens, Greece
| | - G Iatrakis
- TEI Technical University of Athens, Athens, Greece
| | - G Mastorakos
- University of Athens, Aretaieion Hospital, Athens, Greece
| | - P Tsikouras
- Democritus University of Thrace, Department of Obstetrics and Gynaecology, Komotini, Athens, Greece
| | - V Liberis
- Democritus University of Thrace, Department of Obstetrics and Gynaecology, Komotini, Athens, Greece
| | - G Galazios
- Democritus University of Thrace, Department of Obstetrics and Gynaecology, Komotini, Athens, Greece
| | - A Liberis
- Democritus University of Thrace, Department of Obstetrics and Gynaecology, Komotini, Athens, Greece
| | - A Lykeridou
- TEI Technical University of Athens, Athens, Greece
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Salehpour S, Nazari L, Hoseini S, Saharkhiz N, Ghazi F, Sohrabi MR. A Potential Therapeutic Role of Myoinositol in the Metabolic and Cardiovascular Profile of PCOS Iranian Women Aged between 30 and 40 Years. Int J Endocrinol 2016; 2016:7493147. [PMID: 27648072 PMCID: PMC5014950 DOI: 10.1155/2016/7493147] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 08/03/2016] [Indexed: 01/11/2023] Open
Abstract
Introduction. Polycystic ovary syndrome (PCOS) is a common disorder in reproductive age. This pilot study investigated the effects of myoinositol (MI) treatment on metabolic and cardiovascular profile in PCOS women over 30 years of age. Methods. Between 2015 and 2016, 50 women with diagnosis of PCOS by the Rotterdam Criteria were included in the study. All women received MI 2 g plus 200 μg of folic acid (Inofolic, Health Parsian, Iran; twice daily) for 3 months. Baseline and 3-month serum samples were taken after an overnight fast to evaluate the insulin resistance index (HOMA-IR), fasting glucose, and the levels of triglyceride, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), homocysteine, systolic blood pressure, and diastolic blood pressure. Participants' weight was measured before and after treatment and body mass index (BMI) was calculated. Results. The data showed a significant improvement in the serum level of insulin sensitivity and a reduction of cholesterol, LDL, and homocysteine after three months of treatment. Furthermore, blood pressure was significantly reduced in the treated patients. Three participants became pregnant during treatment. Conclusion. Results showed that supplementation with MI and folic acid in PCOS patients over 30 years of age could decrease the risk of cardiovascular problems by normalizing the metabolic profile.
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Affiliation(s)
- Saghar Salehpour
- Department of Obstetrics and Gynecology, Preventive Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Nazari
- Department of Obstetrics and Gynecology, Preventive Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- *Leila Nazari:
| | - Sedighe Hoseini
- Department of Obstetrics and Gynecology, Preventive Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Saharkhiz
- Department of Obstetrics and Gynecology, Preventive Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Ghazi
- Department of Obstetrics and Gynecology, Preventive Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Sohrabi
- Department of Obstetrics and Gynecology, Preventive Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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