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Ding H, Xiang Y, Zhu Q, Wu H, Xu T, Huang Z, Ge H. Endoplasmic reticulum stress-mediated ferroptosis in granulosa cells contributes to follicular dysfunction of polycystic ovary syndrome driven by hyperandrogenism. Reprod Biomed Online 2024; 49:104078. [PMID: 39024925 DOI: 10.1016/j.rbmo.2024.104078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/28/2024] [Accepted: 04/23/2024] [Indexed: 07/20/2024]
Abstract
RESEARCH QUESTION Does hyperandrogenaemia affect the function of ovarian granulosa cells by activating ferroptosis, and could this process be regulated by endoplasmic reticulum stress? DESIGN Levels of ferroptosis and endoplasmic reticulum stress in granulosa cells were detected in women with and without polycystic ovary syndrome (PCOS) undergoing IVF. Ferroptosis and endoplasmic reticulum stress levels of ovarian tissue and follicle development were detected in control mice and PCOS-like mice models, induced by dehydroepiandrosterone. An in-vitro PCOS model of KGN cells was constructed with testosterone and ferroptosis inhibitor Fer-1. Endoplasmic reticulum stress inhibitor, tauroursodeoxycholate (TUDCA), determined the potential mechanism associated with excessive induction of ferroptosis in granulosa cells related to PCOS, and levels of ferroptosis and endoplasmic reticulum stress were detected. RESULTS Activation of ferroptosis and endoplasmic reticulum stress occurred in granulosa cells of women with PCOS and the varies of PCOS-like mice. The findings in KGN cells demonstrated that testosterone treatment results in elevation of oxidative stress levels, particularly lipid peroxidation, and intracellular iron accumulation in granulosa cells. The expression of genes and proteins associated with factors related to ferroptosis, mitochondrial membrane potential and ultrastructure showed that testosterone activated ferroptosis, whereas Fer-1 reversed these alterations. During in-vitro experiments, activation of endoplasmic reticulum stress induced by testosterone treatment was detected in granulosa cells. In granulosa cells, TUDCA, an inhibitor of endoplasmic reticulum stress, significantly mitigated testosterone-induced ferroptosis. CONCLUSIONS Ferroptosis plays a part in reproductive injury mediated by hyperandrogens associated with PCOS, and may be regulated by endoplasmic reticulum stress.
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Affiliation(s)
- Huimin Ding
- Department of Obstetrics and Gynecology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, China; Graduate School, Nanjing University Of Chinese Medicine, Nanjing, China
| | - Yu Xiang
- Department of Obstetrics and Gynecology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, China; Graduate School, Nanjing University Of Chinese Medicine, Nanjing, China
| | - Qi Zhu
- Department of Obstetrics and Gynecology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, China; Graduate School, Nanjing Medical University, Nanjing, China
| | - Honghui Wu
- Department of Obstetrics and Gynecology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, China; Graduate School, Dalian Medical University, Liaoning, China
| | - Tianyue Xu
- Department of Obstetrics and Gynecology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, China; Graduate School, Nanjing University Of Chinese Medicine, Nanjing, China
| | - Zichao Huang
- Department of Obstetrics and Gynecology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, China; Graduate School, Nanjing University Of Chinese Medicine, Nanjing, China
| | - Hongshan Ge
- Department of Obstetrics and Gynecology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, China; Graduate School, Nanjing University Of Chinese Medicine, Nanjing, China; Graduate School, Nanjing Medical University, Nanjing, China; Graduate School, Dalian Medical University, Liaoning, China.
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Shen J, Xu L, Wu X, Ding Y. Mineral Metabolism and Polycystic Ovary Syndrome and Metabolic Risk Factors: A Mendelian Randomization Study. Reprod Sci 2024; 31:2209-2218. [PMID: 38366089 DOI: 10.1007/s43032-024-01476-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/31/2024] [Indexed: 02/18/2024]
Abstract
Observational investigations recommend that mineral supplements were associated with a higher risk of polycystic ovary syndrome (PCOS) and its risk factors (insulin resistance, hyperandrogenism, and obesity), but the relationship with risk of PCOS, hyperandrogenism, obesity, and insulin resistance was unclear. This study was to investigate the potential causal impact of genetically predicted levels of magnesium (Mg), calcium (Ca), selenium (Se), zinc (Zn), iron (Fe), and omega-3 (ω-3) on polycystic ovary syndrome (PCOS) and its associated risk factors. A two-sample Mendelian randomization (MR) analysis was conducted. The genetic variations obtained from GWAS of individuals with European ancestry were found to be associated with the genetically predicted levels of Ca, Mg, Zn, Se, Fe, or ω-3. The data obtained from the FinnGen Consortium and MAGIC were utilized for the outcome of GWAS. The study found that there was a correlation between genetically predicted higher levels of Se and a reduced risk of insulin resistance, with a decrease of 2.2% according to random-effect IVW (OR 0.978, 95% CI 0.960-0.996, p = 0.015). The association between genetically determined mineral levels and PCOS was found to be limited, with an odds ratio (OR) ranging from 0.875 (95% CI: 0.637-1.202, p value = 0.411) for Ca. Limited scientific proof was found for the efficacy of other genetically determined mineral levels on hyperandrogenism, obesity, and insulin resistance. These findings suggested a causal relationship between genetically predicted higher levels of Se and a reduced risk of insulin resistance. Nonetheless, there is limited evidence supporting a causal association between various genetically determined mineral levels and the risk factors associated with PCOS.
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Affiliation(s)
- Jiayan Shen
- Department of Reproductive Medicine, Huzhou Maternity & Child Health Care Hospital, Huzhou, 313000, Zhejiang Province, China
| | - Li Xu
- Department of Obstetrics and Gynecology, Huzhou Maternity & Child Health Care Hospital, Huzhou, 313000, Zhejiang Province, China
| | - Xiaoyun Wu
- Department of Reproductive Medicine, Huzhou Maternity & Child Health Care Hospital, Huzhou, 313000, Zhejiang Province, China.
| | - Yang Ding
- Health Management Center, Department of Dermatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, No. 158, Shangtang Road, Hangzhou, 310014, China.
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Hu L, Hong T, He Y, Wang H, Cao J, Pu D, Gao L, Gao C, Cui Y, Wu J, Tan R. Chromosome Segregation-1-like Gene Participates in Ferroptosis in Human Ovarian Granulosa Cells via Nucleocytoplasmic Transport. Antioxidants (Basel) 2024; 13:911. [PMID: 39199156 PMCID: PMC11352033 DOI: 10.3390/antiox13080911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/22/2024] [Accepted: 07/26/2024] [Indexed: 09/01/2024] Open
Abstract
Premature ovarian insufficiency (POI) is defined as the depletion of ovarian function before the age of 40 years. The global prevalence of POI is 3.5%. To date, genetic factors account for 23.5% of the etiology of POI. Herein, a previously uncharacterized pathogenic homozygous variant of the chromosome segregation-1-like gene (CSE1L) was identified in POI patients via targeted panel sequencing. It is reported that dysregulated iron metabolism is involved in many reproductive endocrine disorders; however, its precise role in POI remains obscure. In this study, we identified CSE1L as a potential candidate gene that plays an important role in maintaining iron homeostasis. Deficiency of CSE1L led to ferroptosis in human granulosa cells, which was confirmed by transmission electron microscopy. Mechanistically, coimmunoprecipitation identified the direct interaction between CSE1L and FoxO1. Inhibition of CSE1L led to the excessive accumulation of FoxO1 in the nucleus via nucleocytoplasmic transport. Then, FoxO1 bound to the promoter region of NCOA4 and promoted its transcription, which was verified by a chromatin immunoprecipitation assay. Moreover, inhibition of CSE1L in cumulus cell monolayer could impede oocyte maturation, which might be associated with oxidative stress. Consequently, our study first revealed that CSE1L participated in ferroptosis in human ovarian granulosa cells via nucleocytoplasmic transportation, which might be helpful in revealing the molecular mechanism of CSE1L in the development of POI. Importantly, these findings might provide new insights into the application of ferroptosis inhibitors in the treatment of POI.
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Affiliation(s)
- Luanqian Hu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China; (L.H.); (T.H.); (Y.H.); (H.W.); (J.C.); (D.P.); (L.G.); (C.G.); (Y.C.)
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 210000, China
| | - Tongtong Hong
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China; (L.H.); (T.H.); (Y.H.); (H.W.); (J.C.); (D.P.); (L.G.); (C.G.); (Y.C.)
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 210000, China
| | - Yuheng He
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China; (L.H.); (T.H.); (Y.H.); (H.W.); (J.C.); (D.P.); (L.G.); (C.G.); (Y.C.)
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 210000, China
| | - Huiyuan Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China; (L.H.); (T.H.); (Y.H.); (H.W.); (J.C.); (D.P.); (L.G.); (C.G.); (Y.C.)
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 210000, China
| | - Jinxiang Cao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China; (L.H.); (T.H.); (Y.H.); (H.W.); (J.C.); (D.P.); (L.G.); (C.G.); (Y.C.)
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 210000, China
| | - Danhua Pu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China; (L.H.); (T.H.); (Y.H.); (H.W.); (J.C.); (D.P.); (L.G.); (C.G.); (Y.C.)
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 210000, China
| | - Li Gao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China; (L.H.); (T.H.); (Y.H.); (H.W.); (J.C.); (D.P.); (L.G.); (C.G.); (Y.C.)
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 210000, China
| | - Chao Gao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China; (L.H.); (T.H.); (Y.H.); (H.W.); (J.C.); (D.P.); (L.G.); (C.G.); (Y.C.)
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 210000, China
| | - Yugui Cui
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China; (L.H.); (T.H.); (Y.H.); (H.W.); (J.C.); (D.P.); (L.G.); (C.G.); (Y.C.)
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 210000, China
| | - Jie Wu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China; (L.H.); (T.H.); (Y.H.); (H.W.); (J.C.); (D.P.); (L.G.); (C.G.); (Y.C.)
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 210000, China
| | - Rongrong Tan
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China; (L.H.); (T.H.); (Y.H.); (H.W.); (J.C.); (D.P.); (L.G.); (C.G.); (Y.C.)
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 210000, China
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Liu M, Wu K, Wu Y. The emerging role of ferroptosis in female reproductive disorders. Biomed Pharmacother 2023; 166:115415. [PMID: 37660655 DOI: 10.1016/j.biopha.2023.115415] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/29/2023] [Accepted: 08/29/2023] [Indexed: 09/05/2023] Open
Abstract
Iron, as an essential trace element for the organism, is vital for maintaining the organism's health. Excessive iron can promote reactive oxygen species (ROS) accumulation, thus damaging cells and tissues. Ferroptosis is a novel form of programmed cell death distinguished by iron overload and lipid peroxidation, which is unique from autophagy, apoptosis and necrosis, more and more studies are focusing on ferroptosis. Recent evidence suggests that ferroptosis is associated with the development of female reproductive disorders (FRDs), including polycystic ovary syndrome (PCOS), premature ovarian insufficiency (POI), endometriosis (EMs), ovarian cancer (OC), preeclampsia (PE) and spontaneous abortion (SA). Pathways and genes associated with ferroptosis may participate in processes that regulate granulosa cell proliferation and secretion, oocyte development, ovarian reserve function, early embryonic development and placental oxidative stress. However, its exact mechanism has not been fully revealed. Therefore, our review systematically elaborates the occurrence mechanism of ferroptosis and its research progress in the development of FRDs, with a view to providing literature references for clinical targeting of ferroptosis -related pathways and regulatory factors for the management of FRDs.
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Affiliation(s)
- Min Liu
- Department of Gynecology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610032, China; Department of Gynecology, School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Keming Wu
- Department of Gynecology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610032, China; Department of Gynecology, School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China.
| | - Yeke Wu
- Department of Stomatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610032, China.
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Effect of Iron Depletion by Bloodletting vs. Observation on Oxidative Stress Biomarkers of Women with Functional Hyperandrogenism Taking a Combined Oral Contraceptive: A Randomized Clinical Trial. J Clin Med 2022; 11:jcm11133864. [PMID: 35807149 PMCID: PMC9267723 DOI: 10.3390/jcm11133864] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 01/27/2023] Open
Abstract
Women with functional hyperandrogenism show both increased markers of oxidative stress and a mild iron overload. Combined oral contraceptives (COC) may worsen redox status in the general population. Since iron depletion ameliorates oxidative stress in other iron overload states, we aimed to address the changes in the redox status of these women as a consequence of COC therapy and of bloodletting, conducting a randomized, controlled, parallel, open-label clinical trial in 33 adult women with polycystic ovary syndrome or idiopathic hyperandrogenism. After three months of treatment with a COC, participants were randomized (1:1) to three scheduled bloodlettings or observation for another nine months. After taking a COC, participants showed a mild decrease in their plasma electrochemical antioxidant capacity, considering fast-acting antioxidants [MD: −1.51 (−2.43 to −0.60) μC, p = 0.002], and slow-acting antioxidants [MD: −1.90 (−2.66 to −1.14) μC, p < 0.001]. Women submitted to bloodletting showed a decrease in their non-enzymatic antioxidant capacity levels (NEAC) throughout the trial, whereas those individuals in the control arm showed a mild increase in these levels at the end of the study (Wilks’ λ: 0.802, F: 3.572, p = 0.041). Decreasing ferritin and plasma hemoglobin during the trial were associated with worse NEAC levels. COC may impair redox status in women with functional hyperandrogenism. Decreasing iron stores by scheduled bloodletting does not override this impairment.
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Alesi S, Ee C, Moran LJ, Rao V, Mousa A. Nutritional Supplements and Complementary Therapies in Polycystic Ovary Syndrome. Adv Nutr 2021; 13:1243-1266. [PMID: 34970669 PMCID: PMC9340985 DOI: 10.1093/advances/nmab141] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/25/2021] [Accepted: 11/17/2021] [Indexed: 12/17/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) affects 1 in 5 women of reproductive age, and is characterized by menstrual irregularities, clinical or biochemical hyperandrogenism, and the presence of polycystic ovary morphology. One of the recommended treatment strategies in the international evidence-based guidelines is lifestyle modification, which includes diet and exercise, with the aim of improving a range of health outcomes. The incurable nature of PCOS reinforces the importance of developing novel and innovative symptomatic relief strategies, which are currently the only available approaches for improving quality of life for these women. Women with PCOS tend to be nutrient deficient in many common vitamins and minerals, thought to be associated with the psychological (depression, anxiety, etc.) and physiological (insulin resistance, diabetes, infertility, etc.) sequelae of the condition. Nutrient supplementation and the integration of complementary medicine as adjuncts to traditional lifestyle-based therapies in PCOS could therefore provide additional benefits to these women. In this review, we synthesize the evidence regarding nutrient supplementation and complementary therapies in PCOS, predominantly from randomized controlled trials, systematic reviews, and meta-analyses, to provide an overview of the state of knowledge in this field. The evidence to date suggests that specific vitamins (B-12, inositols, folate, vitamins D, E, and K), vitamin-like nutrients (bioflavonoids and α-lipoic acid), minerals (calcium, zinc, selenium, and chromium picolinate), and other formulations (melatonin, ω-3 fatty acids, probiotics, and cinnamon), as well as some complementary approaches such as acupuncture and yoga may be beneficial in PCOS. However, there remain areas of uncertainty and key limitations in the literature that must be overcome before these therapies can be integrated into routine clinical practice.
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Affiliation(s)
- Simon Alesi
- Monash Centre for Health Research and Implementation (MCHRI), Monash University, Clayton, Victoria, Australia
| | - Carolyn Ee
- The National Institute of Complementary Medicine, Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation (MCHRI), Monash University, Clayton, Victoria, Australia
| | - Vibhuti Rao
- The National Institute of Complementary Medicine, Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Aya Mousa
- Address correspondence to AM (e-mail: )
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Ortiz-Flores AE, Martínez-García MÁ, Nattero-Chávez L, Álvarez-Blasco F, Fernández-Durán E, Quintero-Tobar A, Escobar-Morreale HF, Luque-Ramírez M. Iron Overload in Functional Hyperandrogenism: In a Randomized Trial, Bloodletting Does Not Improve Metabolic Outcomes. J Clin Endocrinol Metab 2021; 106:e1559-e1573. [PMID: 33462622 DOI: 10.1210/clinem/dgaa978] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Indexed: 12/13/2022]
Abstract
CONTEXT Functional hyperandrogenism may be associated with a mild increase in body iron stores. Iron depletion exerts a beneficial effect on metabolic endpoints in other iron overload states. OBJECTIVES (i) To determine the effect of iron depletion on the insulin sensitivity and frequency of abnormal glucose tolerance in patients with functional hyperandrogenism submitted to standard therapy with combined oral contraceptives (COC). ii) To assess the overall safety of this intervention. DESIGN Randomized, parallel, open-label, clinical trial. SETTING Academic hospital. PATIENTS Adult women with polycystic ovary syndrome or idiopathic hyperandrogenism. INTERVENTION After a 3-month run-in period of treatment with 35 μg ethinylestradiol plus 2 mg cyproterone acetate, participants were randomized (1:1) to 3 scheduled bloodlettings or observation for another 9 months. MAIN OUTCOME MEASURES Changes in insulin sensitivity index and frequency of prediabetes/diabetes, and percentage of women in whom bloodletting resulted in plasma hemoglobin <120 g/L and/or hematocrit <0.36. RESULTS From 2015 to 2019, 33 women were included by intention-to-treat. During the follow-up, insulin sensitivity did not change in the whole group of women or between study arms [mean of the differences (MD): 0.0 (95%CI: -1.6 to 1.6)]. Women in the experimental arm showed a similar odds of having prediabetes/diabetes than women submitted to observation [odds ratio: 0.981 (95%CI: 0.712 to 1.351)]. After bloodletting, 4 (21.1%) and 2 women (10.5%) in the experimental arm had hemoglobin (Hb) levels <120 g/L and hematocrit (Hct) values <0.36, respectively, but none showed Hb <110 g/L or Hct <0.34. CONCLUSIONS Scheduled bloodletting does not improve insulin sensitivity in women with functional hyperandrogenism on COC.
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Affiliation(s)
- Andrés E Ortiz-Flores
- Diabetes, Obesity, and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Department of Endocrinology and Nutrition. Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
| | - María Ángeles Martínez-García
- Diabetes, Obesity, and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Lía Nattero-Chávez
- Diabetes, Obesity, and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Francisco Álvarez-Blasco
- Diabetes, Obesity, and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Elena Fernández-Durán
- Diabetes, Obesity, and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Alejandra Quintero-Tobar
- Diabetes, Obesity, and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Héctor F Escobar-Morreale
- Diabetes, Obesity, and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Manuel Luque-Ramírez
- Diabetes, Obesity, and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain
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He S, Gu H, Yang J, Su Q, Li X, Qin L. Hemoglobin concentration is associated with the incidence of metabolic syndrome. BMC Endocr Disord 2021; 21:53. [PMID: 33740939 PMCID: PMC7980652 DOI: 10.1186/s12902-021-00719-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 03/10/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND An association between hemoglobin and metabolic syndrome (MetS) has been reported. However, the relationships between hemoglobin and individual MetS components remain unclear. Therefore, we investigated these associations at baseline and at the 3-year follow-up. METHODS We enrolled 9960 middle-aged and elderly subjects (6726 women and 3234 men) and performed a 3-year follow-up cohort study. All subjects completed a questionnaire and underwent anthropometric measurements and laboratory tests. Logistic regression models were developed to assess the association between hemoglobin and MetS and its components. RESULTS MetS was present in 45.1% of women and 41.4% of men at baseline. The hemoglobin concentration was positively correlated with SBP, DBP, TGs, WC, FPG, insulin, HOMA-IR, BMI and uric acid (p < 0.05). The mean hemoglobin concentration was higher in subjects with hypertension, high TGs, abdominal obesity or elevated FPG (p < 0.01). At follow-up, elevated hemoglobin correlated with an increased incidence and ORs for MetS, high TGs, low HDL-c, hyperuricemia and NAFLD but not abdominal obesity, BP or FPG in women. Increased hemoglobin corresponded with an increased incidence and ORs for MetS, abdominal obesity, low HDL-c, hyperuricemia and NAFLD but not BP, high TGs or FPG in men. CONCLUSIONS Hemoglobin may play a role in predicting new-onset MetS in both women and men. Hemoglobin was notably correlated with future risk of high TGs, low HDL-c, hyperuricemia, and NAFLD among women and abdominal obesity, low HDL-c, hyperuricemia, and NAFLD among men.
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Affiliation(s)
- Sunyue He
- Department of Endocrinology, Xinhua Hospital Chongming Branch, School of Medicine, Shanghai Jiaotong University, 25 Nanmen Road, Shanghai, 202150, China
| | - Hongxia Gu
- Department of Endocrinology, Xinhua Hospital Chongming Branch, School of Medicine, Shanghai Jiaotong University, 25 Nanmen Road, Shanghai, 202150, China
| | - Jie Yang
- Department of Endocrinology, Xinhua Hospital Chongming Branch, School of Medicine, Shanghai Jiaotong University, 25 Nanmen Road, Shanghai, 202150, China
| | - Qing Su
- Department of Endocrinology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Xiaoyong Li
- Department of Endocrinology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Li Qin
- Department of Endocrinology, Xinhua Hospital Chongming Branch, School of Medicine, Shanghai Jiaotong University, 25 Nanmen Road, Shanghai, 202150, China.
- Department of Endocrinology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China.
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9
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Combined effect of hemoglobin and mean corpuscular volume levels on incident metabolic syndrome: A population-based cohort study. Clin Nutr ESPEN 2020; 40:314-319. [DOI: 10.1016/j.clnesp.2020.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 08/25/2020] [Indexed: 11/21/2022]
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10
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Tippairote T, Bjørklund G, Peana M, Roytrakul S. The Proteomics Study of Compounded HFE/TF/TfR2/HJV Genetic Variations in a Thai Family with Iron Overload, Chronic Anemia, and Motor Neuron Disorder. J Mol Neurosci 2020; 71:545-555. [PMID: 32895881 DOI: 10.1007/s12031-020-01676-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/31/2020] [Indexed: 01/04/2023]
Abstract
The mutation of the homeostatic iron regulatory genes (HFE) impaired the hepatic hepcidin transcription leading to the chronic excess of the iron pool, with the adverse consequences of free radical oxidative damages. We herein reported the findings of Thai family members who had the compound of uncommon HFE rs2794719, together with transferrin (TF) rs1867504, transferrin receptor 2 (TfR2) rs7385804, and hemojuvelin (HJV) rs16827043 genetic variants involved in the hepcidin transcriptional pathway. These compounded genetic variants could produce the spectrum of clinical phenotypes that spanned from mild to moderate symptoms of chronic anemia to an established motor neuron disorder. The feasible pathophysiologies were the impairment of the transferrin receptor functions, which affected the endocytic uptake of halo-transferrin into the erythroblast precursors. Such a defect left the erythropoiesis depleted of their iron supply. These alterations also promoted the TfR-independent uptake of iron into other target tissues and left the TrF2/BMP-dependent-hepcidin activation pathway unattended. We used the predicted molecular interactive proteomes to support our speculated dysregulated iron metabolism. During the early stage of an elevated ferritin level, there was no inhibition of ferroportin activities from hepcidin. These pathophysiological processes went on to the point of an iron overload threshold. After that, the hepcidin transcription started to kick in with the resulting decreased serum iron levels and deterioration of clinical symptoms.
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Affiliation(s)
- Torsak Tippairote
- Doctor of Philosophy Program in Nutrition, Faculty of Medicine, Ramathibodi Hospital and Institute of Nutrition, Mahidol University, Bangkok, Thailand.,BBH Hospital, Bangkok, Thailand
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Toften 24, 8610, Mo i Rana, Norway.
| | - Massimiliano Peana
- Department of Chemistry and Pharmacy, University of Sassari, Sassari, Italy
| | - Sittiruk Roytrakul
- Proteomics Research Laboratory, National Center for Genetic Engineering and Biotechnology (BIOTEC), Pathum Thani, Thailand
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11
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Liu Y, Wu Y, Tian M, Luo W, Zhang C, Liu Y, Li K, Cheng W, Liu D. Protein Expression Profile in IVF Follicular Fluid and Pregnancy Outcome Analysis in Euthyroid Women with Thyroid Autoimmunity. ACS OMEGA 2020; 5:11439-11447. [PMID: 32478232 PMCID: PMC7254522 DOI: 10.1021/acsomega.0c00463] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 04/30/2020] [Indexed: 05/05/2023]
Abstract
The objective of this study is to investigate the influence of the thyroid autoantibodies on the protein expression in follicular fluid and the clinical outcome of assisted reproductive technology. A total of 602 patients treated for infertility were screened; 49 euthyroid women who were positive for thyroid autoantibodies and 63 negative controls were recruited. Follicular fluid samples were analyzed using proteomics. Validation of target proteins in follicular fluid was performed by using parallel reaction monitoring. Differentially expressed proteins in follicular fluid, clinical pregnancy rate, abortion rate, and live-birth rate were analyzed. Clinical pregnancy rates and take-home baby rates in the thyroid autoimmunity (TAI) group were less than in the control group, but abortion rates in the TAI group were higher than in the control group (all P < 0.005). A total of 49 proteins were differentially expressed in the TAI-positive group. In Gene Ontology secondary annotations of all the proteins identified, five types of proteins were associated with the reproductive process. Among 11 proteins quantitatively identified by parallel reaction monitoring, angiotensinogen and fetuin-B were associated with reproduction. These differentially expressed proteins identified in this study involved multiple pathways according to the Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis. Our study provides evidence that some differentially expressed proteins between TAI-positive women and controls were associated with the reproductive process and closely related to important physiologic effects, which could partially explain the underlying mechanism link between TAI and the adverse outcomes of assisted reproductive technology.
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Affiliation(s)
- Yuting Liu
- Department
of Endocrinology and Metabolism, The Second
Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
- Department
of Endocrinology and Metabolism, The Ninth
People’s Hospital of Chongqing, Chongqing 400700, China
| | - Yijia Wu
- Reproductive
Medical Center, Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Chongqing Medical
University, Chongqing 400010, China
| | - Mingyuan Tian
- Department
of Endocrinology and Metabolism, The Second
Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Wenwen Luo
- Department
of Endocrinology and Metabolism, The Second
Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Chanyu Zhang
- Reproductive
Medical Center, Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Chongqing Medical
University, Chongqing 400010, China
| | - Yongjian Liu
- Department
of Endocrinology and Metabolism, The Second
Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Ke Li
- Department
of Endocrinology and Metabolism, The Second
Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Wei Cheng
- Department
of Endocrinology and Metabolism, The Second
Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Dongfang Liu
- Department
of Endocrinology and Metabolism, The Second
Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
- ,
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12
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Hahn KA, Wesselink AK, Wise LA, Mikkelsen EM, Cueto HT, Tucker KL, Vinceti M, Rothman KJ, Sorensen HT, Hatch EE. Iron Consumption Is Not Consistently Associated with Fecundability among North American and Danish Pregnancy Planners. J Nutr 2019; 149:1585-1595. [PMID: 31152673 PMCID: PMC6735943 DOI: 10.1093/jn/nxz094] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/21/2018] [Accepted: 04/10/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Infertility is an important public health problem with few known modifiable risk factors. Dietary factors including folic acid have been associated with improved fertility, but the association between iron and fertility is understudied. One study among US nurses found a 40% lower risk of ovulatory infertility with higher intake of nonheme iron and iron supplements. OBJECTIVES The aim of this study was to determine the extent to which iron intake from diet and supplements reported on structured questionnaires is associated with fecundability. METHODS We conducted parallel analyses that used data from 2 prospective cohort studies of pregnancy planners from Denmark (Snart Foraeldre; n = 1693) and North America (PRESTO; n = 2969) during 2013-2018. Follow-up comprised menstrual cycles at risk until pregnancy or censoring for fertility treatment, stopped trying to conceive, withdrawal, loss to follow-up, or 12 cycles of attempt. We used proportional probabilities regression models to estimate fecundability ratios (FRs) and 95% CIs, adjusting for confounders. RESULTS We found little association between dietary heme iron intake and fecundability in either cohort. The FR for nonheme iron intake (≥11 mg/d compared with <9 mg/day) was 1.11 for Snart Foraeldre participants (95% CI: 0.92, 1.34) and 1.01 for PRESTO participants (95% CI: 0.89, 1.14). The FR for iron-containing supplements was 1.01 in Snart Foraeldre (95% CI: 0.90, 1.13) and 1.19 in PRESTO (95% CI: 1.03, 1.38). In PRESTO, but not Snart Foraeldre, stronger positive associations were found for nonheme iron intake and iron supplement use among women with heavy menses or short menstrual cycles. CONCLUSIONS Overall, dietary intake of iron was not consistently associated with fecundability, although there was some evidence for a positive association among women with risk factors for iron deficiency. We also found a small positive association between supplemental iron intake and fecundability among North American, but not Danish, pregnancy planners.
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Affiliation(s)
- Kristen A Hahn
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Amelia K Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Ellen M Mikkelsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Denmark
| | - Heidi T Cueto
- Department of Clinical Epidemiology, Aarhus University Hospital, Denmark
| | - Katherine L Tucker
- Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts Lowell, MA
| | - Marco Vinceti
- Department of Epidemiology, Boston University School of Public Health, Boston, MA,Public Health Section of the Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Kenneth J Rothman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA,RTI Health Solutions, NC
| | | | - Elizabeth E Hatch
- Department of Epidemiology, Boston University School of Public Health, Boston, MA,Address correspondence to EEH (E-mail: )
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13
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Behboudi-Gandevani S, Abtahi H, Saadat N, Tohidi M, Ramezani Tehrani F. Effect of phlebotomy versus oral contraceptives containing cyproterone acetate on the clinical and biochemical parameters in women with polycystic ovary syndrome: a randomized controlled trial. J Ovarian Res 2019; 12:78. [PMID: 31470879 PMCID: PMC6716867 DOI: 10.1186/s13048-019-0554-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 08/15/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Reduction of the body iron stores can improve hyperandrogenemia and insulin resistance. This study aimed to compare clinical and para-clinical responses to the treatment of phlebotomy using oral contraceptive pills (OCs) containing cyproterone acetate in women with PCOS. METHODS In this randomized clinical trial, 64 patients with PCOS were randomly assigned to the phlebotomy and OCs groups (n = 32 in each group). The intervention group, using a single treatment procedure, underwent venesection of 450 mL of whole blood at the early follicular phase of the spontaneous or progesterone-induced menstrual cycle. The control group received OCs pills for 3 months from the 1th day of spontaneous or progesterone-induced menstrual cycle onwards for 3 weeks, followed by a pill-free interval of 7 days. The women were evaluated after the 3-month intervention. The primary outcome measure was a change in the HOMA-IR and free androgen index (FAI). Secondary outcomes were changes in the Ferriman-Gallwey (FG) score and other clinical, biochemical and hormonal changes from the baseline (pre-treatment) to week 12. RESULTS In the phlebotomy group, 27 (84.3%) and in the OCs group 30 (93.7%) of the women completed the 3-month follow-up. The median HOMA-IR significantly decreased from 3.5 to 2.7 in the phlebotomy, and from 3.1 to 2.8 in the OCs group, and the changes were comparable between the groups. Median changes in the FAI significantly decreased in both groups, but the differences were not statistically significant between the groups (P = 0.061). With regard to secondary outcomes, mean FG scores in both groups significantly decreased [from 16.8 (6) to 13.3 (7.4), P < 0.028] in the phlebotomy group and [from 14.3 (7) to 9.8 (7.6) in the OCs group, P = 0.001] after 3 months of treatment, but such changes had no statistically significant differences between the groups. During treatment, menstrual cycles became regular in all women in the OCs group and in 12.27 (44.4%) of the women in the phlebotomy group, and the difference was statistically significant (P = 0.001). Despite no statistically significant differences in lipid profiles between the groups at the baseline, triglycerides were significantly higher in the OCs group compared to the phlebotomy at end of follow up (p = 0.019). CONCLUSION Both treatment modalities had similar beneficial effects on insulin resistance and on androgenic profiles. However, OCs was reported more effective in treating menstrual irregularities and phlebotomy had less adverse effects on triglyceride concentrations. TRIAL REGISTRATION Code: IRCT2013080514277N1 .
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Affiliation(s)
- Samira Behboudi-Gandevani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 24, Parvane Street, Yaman Street, Velenjak, P.O.Box: 19395-4763, Tehran, Iran
| | - Hayedeh Abtahi
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 24, Parvane Street, Yaman Street, Velenjak, P.O.Box: 19395-4763, Tehran, Iran
| | - Navid Saadat
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 24, Parvane Street, Yaman Street, Velenjak, P.O.Box: 19395-4763, Tehran, Iran.
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14
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Jeelani H, Ganie MA, Amin S, Fatima Q, Kawa IA, Manzoor S, Parvez T, Ahmad DN, Rashid F. Effect of Paraoxonase1 (PON1) gene polymorphisms on PON1 activity, HDL, LDL and MDA levels in women with polycystic ovary syndrome (PCOS): A case-control study. Meta Gene 2019. [DOI: 10.1016/j.mgene.2019.100552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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15
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Tiongco RE, Rivera N, Clemente B, Dizon D, Salita C, Pineda-Cortel MR. Serum ferritin as a candidate diagnostic biomarker of polycystic ovarian syndrome: a meta-analysis. Biomarkers 2019; 24:484-491. [PMID: 31096807 DOI: 10.1080/1354750x.2019.1620335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective: In this study, we investigated about the potential of serum ferritin as a complementary diagnostic biomarker of polycystic ovarian syndrome (PCOS) by performing a meta-analysis of existing literature. Materials and methods: Eleven studies written in English were retrieved up to 30 June 2018. Data were extracted from the selected studies by two of the authors and was subjected to statistical analysis. Levels of serum ferritin were compared between women with PCOS and controls using the standardized mean difference (SMD) and 95% confidence interval (CI). Subgroup analysis was also performed and stratified by ethnicity (Asians versus Caucasians). Results: Overall post-outlier outcomes indicated that elevated serum ferritin is strongly associated with PCOS (SMD: 0.52; 95% CI: 0.40-0.64; PA = 10-5). Subgroup analysis by ethnicity showed no significant difference between Asian and Caucasian population. Post-outlier receiving operations characteristics curve were plotted and showed that values for serum ferritin showed good potential in discriminating patients with and without PCOS (AUC = 0.827, p = 0.006). Conclusion: Our findings suggest that high serum ferritin level is significantly associated with PCOS and its potential as a biomarker is evident in its high diagnostic accuracy. However, additional studies are needed to confirm our claims.
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Affiliation(s)
- Raphael Enrique Tiongco
- a Department of Medical Technology, College of Allied Medical Professions , Angeles University Foundation , Angeles City , Philippines
| | - Nicole Rivera
- a Department of Medical Technology, College of Allied Medical Professions , Angeles University Foundation , Angeles City , Philippines
| | - Benjie Clemente
- b Department of Medical Technology, Faculty of Pharmacy , University of Santo Tomas , Manila , Philippines
| | - Dianne Dizon
- a Department of Medical Technology, College of Allied Medical Professions , Angeles University Foundation , Angeles City , Philippines
| | - Crizelda Salita
- a Department of Medical Technology, College of Allied Medical Professions , Angeles University Foundation , Angeles City , Philippines
| | - Maria Ruth Pineda-Cortel
- b Department of Medical Technology, Faculty of Pharmacy , University of Santo Tomas , Manila , Philippines.,c Research Center for the Natural and Applied Sciences , University of Santo Tomas , Manila , Philippines.,d The Graduate School , University of Santo Tomas , Manila , Philippines
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16
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Hossein Rashidi B, Shams S, Shariat M, Bagheri M, Mohebi M, Haghollahi F. The Association of Serum Hepcidin Levels and Insulin Resistance in PCOS Patients: A Case-Control Study. J Family Reprod Health 2018; 12:210-216. [PMID: 31239849 PMCID: PMC6581661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: To investigate the relationship between insulin resistance and hepcidin levels in patients with PCOS. Materials and methods: In this case-control study fifty- six patients with PCOS and forty - one healthy control subjects were included. Plasma levels of hepcidin, IL-6, Serum Insulin and ferritin using ELISA method, serum iron levels using a spectrophotometric method, and Insulin resistance by using HOMA were measured in the two groups of PCOS (case group) and healthy subjects (control group). The results were analyzed by student's t-test, General Linear Model, Binary logistic and linear regression tests. Results: The mean hepcidin level was 1.97 ± 0.53 pg/ml and 2.40 ± 0.25pg/ml in the case and control groups, respectively. The t-test results showed a significant difference between the two groups (p = 0.0001). The mean of insulin level in case and control group was 30.65 ± 15.02g/dl and 14.71 ± 10.46g/dl, respectively. The t-test analysis indicated a significant difference between the two groups (p = 0.0001). There was an inverse relationship between the level of hepcidin with HOMA-IR (β = -0.629, p = 0.04), and IL-6 (β = -0.243, p = 0.015) in both groups. The adjusted OR proved a statistically significant association between serum hepcidin (OR = 0.063; 95 % CI: 0.01-0.385, p-value = 0. 003) and HOMA (OR = 1.569; 95 % CI: 1.254-1.964, p-value = 0.001) with PolycysticOvarian Syndrome. Conclusion: There was an inverse relationship between hepcidin levels and insulin resistance in both groups meaning decrease in hepcidin levels and increase in insulin resistance may increase the risk of PCOS.
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Affiliation(s)
- Batool Hossein Rashidi
- Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheila Shams
- Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mamak Shariat
- Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Bagheri
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Marziyeh Mohebi
- Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fedyeh Haghollahi
- Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
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17
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Huang LL, Dou DM, Liu N, Wang XX, Fu LY, Wu X, Wang P. Association of erythrocyte parameters with metabolic syndrome in the Pearl River Delta region of China: a cross sectional study. BMJ Open 2018; 8:e019792. [PMID: 29326194 PMCID: PMC5781098 DOI: 10.1136/bmjopen-2017-019792] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Increasing studies have reported that erythrocyte parameters, including red blood cells (RBCs), haematocrit (HCT), haemoglobin (Hb) and red blood cell distribution width (RDW), are associated with metabolic syndrome (MetS) in adults worldwide. However, the association, stratified by sex, remains to be elucidated, particularly in the Pearl River Delta region of China. Therefore, our aim was to explore the association of erythrocyte parameters with MetS, stratified by sex, in the Pearl River Delta region of China. METHODS In this cross sectional study, 2161 men and 2511 women were enrolled. MetS was diagnosed using a modified version of the Adult Treatment Panel III criteria. Logistic regression analyses were performed to calculate adjusted ORs of erythrocyte parameters associated with MetS stratified by sex. RESULTS The prevalence of MetS was higher in women than in men (35.2%vs26.7%). RBC, HCT, Hb and RDW values increased linearly with the number of MetS components from 0 to 5 identified in both men and women. Among men, the ORs of MetS risk increased across the tertiles of Hb (Q2: OR=1.921, 95% CI=1.170 to 3.151; Q3: OR=1.992, 95%CI=1.198 to 3.312). Men in the highest tertiles of RDW had a 2.752-fold increased risk of suffering from MetS compared with those in the reference group. Among women, the ORs of MetS risk also increased across the tertiles of Hb (Q2: OR=1.538, 95%CI=1.008 to 2.348; Q3: OR=1.665, 95%CI=1.075 to 2.578). Women in the highest tertiles of RBC had a 1.718-fold increased risk of experiencing MetS compared with those in the reference group. CONCLUSIONS MetS was more prevalent in women than in men. The association between erythrocyte parameters and MetS differed between the sexes. RBC and Hb were identified as risk factors for MetS in women and Hb and RDW as risk factors in men.
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Affiliation(s)
- Ling Ling Huang
- Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China
| | - Dong-Mei Dou
- Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China
| | - Nan Liu
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Xiao Xiao Wang
- Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China
| | - Li-Ying Fu
- Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China
| | - Xiao Wu
- Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China
| | - Peixi Wang
- Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China
- School of Public Health, Guangzhou Medical University, Guangzhou, China
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18
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Attia HR, Kamel SA, Ibrahim MH, Farouk HA, Rahman AH, Sayed GH, Musa NI. Open-array analysis of genetic variants in Egyptian patients with type 2 diabetes and obesity. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2017. [DOI: 10.1016/j.ejmhg.2017.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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19
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Effects of glucose ingestion on circulating inflammatory mediators: Influence of sex and weight excess. Clin Nutr 2017; 36:522-529. [DOI: 10.1016/j.clnu.2016.01.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 12/19/2015] [Accepted: 01/24/2016] [Indexed: 12/11/2022]
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20
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Wilson MS, Thompson EW. Venesection is an effective non-pharmacological treatment for patients with high serum ferritin type 2 diabetes. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY CASE REPORTS 2017. [DOI: 10.1016/j.jecr.2016.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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21
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Spritzer PM, Lecke SB, Fabris VC, Ziegelmann PK, Amaral L. Blood Trace Element Concentrations in Polycystic Ovary Syndrome: Systematic Review and Meta-analysis. Biol Trace Elem Res 2017; 175:254-262. [PMID: 27301656 DOI: 10.1007/s12011-016-0774-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 06/05/2016] [Indexed: 02/08/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a prevalent condition in women of reproductive age. PCOS is characterized by androgen excess and chronic anovulation and associated with low-grade inflammation and metabolic comorbidities. Some trace elements have been linked to pathophysiological mechanisms of oxidative stress and inflammation in different disorders. Therefore, we conducted a systematic review and meta-analysis of the available evidence regarding trace element concentrations in PCOS. We reviewed MEDLINE and EMBASE in search of case-control, cross-sectional, and cohort studies published until September 2015. Of 183 studies identified, six were selected for systematic review. All used the Rotterdam criteria for the diagnosis of PCOS. Two studies evaluating chromium and one assessing cobalt levels did not observe differences between PCOS and controls. Another study recorded similar nickel and vanadium levels between the groups, but lower selenium concentrations in women with PCOS compared to controls. Four studies were included in the random effects model meta-analysis, for a total of 264 PCOS and 151 control women. Copper levels were found to be higher in women with PCOS than in controls [mean difference 0.12 ppm (95 % CI 0.07; 0.17 ppm); I 2 = 0 %]. Manganese [mean difference 0.04 ppm (95 % CI -0.05; 0.13 ppm); I 2 = 94.4 %] and zinc concentrations [mean difference 0.02 ppm (95 % CI -0.12; 0.16 ppm); I 2 = 92.4 %] were similar between the groups. The present results suggest a relationship between increased copper concentration and PCOS. This systematic review and meta-analysis is registered in PROSPERO under number CRD42016034036.
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Affiliation(s)
- Poli Mara Spritzer
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, 90035-003, Porto Alegre, RS, Brazil.
- Department of Physiology, Laboratory of Molecular Endocrinology, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2350, 90035-003, Porto Alegre, RS, Brazil.
| | - Sheila Bünecker Lecke
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, 90035-003, Porto Alegre, RS, Brazil
- Department of Diagnostic Methods, Federal University of Health Sciences of Porto Alegre, Rua Sarmento Leite, 245, 90050-170, Porto Alegre, RS, Brazil
| | - Vitor Costa Fabris
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, 90035-003, Porto Alegre, RS, Brazil
| | - Patrícia Klarmann Ziegelmann
- Department of Statistics, Institute of Mathematics, Federal University of Rio Grande do Sul, Av. Bento Gonçalves, 9500, 91501-970, Porto Alegre, RS, Brazil
| | - Lívio Amaral
- Ion Implantation Laboratory, Institute of Physics, Federal University of Rio Grande do Sul, Av. Bento Gonçalves, 9500, 91501-970, Porto Alegre, RS, Brazil
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de Alencar JB, Alves HV, Elpidio LNS, Visentainer JEL, Sell AM. Polymorphisms of Cytokine Genes and Polycystic Ovary Syndrome: A Review. Metab Syndr Relat Disord 2016; 14:468-474. [PMID: 27809669 DOI: 10.1089/met.2016.0101] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the endocrinopathy that affects women in their reproductive age. The physiopathology involves multifactorial mechanisms, including cytokine gene regulation. METHODS The review was conducted in the database PubMed, with articles published between 2005 and 2015. The selected studies evaluated the single-nucleotide polymorphisms (SNPs) of cytokines genes in association with PCOS. Twenty-four studies met the inclusion criteria and showed the SNPs of cytokines that were associated or not with PCOS. RESULTS The disease susceptibility was associated with interleukin (IL) 1A, IL1B, IL1RN, and IL6 alleles and genotypes. The tumor necrosis factor (TNF) -1032 C/T genotype and C allele were risk factors and T/T genotype was a protector marker to disease. The IL18 SNPs were not associated with PCOS per se, but IL18-137 C and G alleles were related to the protection of insulin resistance and glucose tolerance, respectively. One research found association between TGFB1 and PCOS. However, the TNF -308, IL10, and interferon (IFN) SNPs did not appear to influence PCOS genetic susceptibility. CONCLUSIONS This study sought to contribute and clarify the SNPs in cytokine genes that influence the development of PCOS. Most studies occurred in Asia; most SNPs studied were in IL1B -511, TNF -1031, and IL6-174; and most of them were associated with the susceptibility to PCOS development. Nevertheless, further investigations based on genome-wide association studies and cytokine gene SNPs are needed to better characterize the risk factors to PCOS.
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Affiliation(s)
- Josiane Bazzo de Alencar
- 1 Program of Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, UEM, Paraná, Brazil
| | - Hugo Vicentin Alves
- 1 Program of Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, UEM, Paraná, Brazil
| | - Laise Nayana Sala Elpidio
- 1 Program of Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, UEM, Paraná, Brazil
| | - Jeane Eliete Laguila Visentainer
- 1 Program of Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, UEM, Paraná, Brazil .,2 Immunogenetics Laboratory, Department of Basic Health Sciences, State University of Maringá, UEM, Maringá, Paraná, Brazil
| | - Ana Maria Sell
- 1 Program of Biosciences and Physiopathology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, UEM, Paraná, Brazil
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Stechemesser L, Eder SK, Wagner A, Patsch W, Feldman A, Strasser M, Auer S, Niederseer D, Huber-Schönauer U, Paulweber B, Zandanell S, Ruhaltinger S, Weghuber D, Haschke-Becher E, Grabmer C, Rohde E, Datz C, Felder TK, Aigner E. Metabolomic profiling identifies potential pathways involved in the interaction of iron homeostasis with glucose metabolism. Mol Metab 2016; 6:38-47. [PMID: 28123936 PMCID: PMC5220278 DOI: 10.1016/j.molmet.2016.10.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 10/17/2016] [Accepted: 10/24/2016] [Indexed: 02/06/2023] Open
Abstract
Objective Elevated serum ferritin has been linked to type 2 diabetes (T2D) and adverse health outcomes in subjects with the Metabolic Syndrome (MetS). As the mechanisms underlying the negative impact of excess iron have so far remained elusive, we aimed to identify potential links between iron homeostasis and metabolic pathways. Methods In a cross-sectional study, data were obtained from 163 patients, allocated to one of three groups: (1) lean, healthy controls (n = 53), (2) MetS without hyperferritinemia (n = 54) and (3) MetS with hyperferritinemia (n = 56). An additional phlebotomy study included 29 patients with biopsy-proven iron overload before and after iron removal. A detailed clinical and biochemical characterization was obtained and metabolomic profiling was performed via a targeted metabolomics approach. Results Subjects with MetS and elevated ferritin had higher fasting glucose (p < 0.001), HbA1c (p = 0.035) and 1 h glucose in oral glucose tolerance test (p = 0.002) compared to MetS subjects without iron overload, whereas other clinical and biochemical features of the MetS were not different. The metabolomic study revealed significant differences between MetS with high and low ferritin in the serum concentrations of sarcosine, citrulline and particularly long-chain phosphatidylcholines. Methionine, glutamate, and long-chain phosphatidylcholines were significantly different before and after phlebotomy (p < 0.05 for all metabolites). Conclusions Our data suggest that high serum ferritin concentrations are linked to impaired glucose homeostasis in subjects with the MetS. Iron excess is associated to distinct changes in the serum concentrations of phosphatidylcholine subsets. A pathway involving sarcosine and citrulline also may be involved in iron-induced impairment of glucose metabolism. This metabolomic study focuses on pathways linking iron status to insulin resistance. Metabolomic differences in Metabolic Syndrome with/without iron overload are shown. Phlebotomy changes methionine, glutamate and long-chain phosphatidylcholines levels. Phosphatidylcholines are involved in the interaction of iron and glucose homeostasis.
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Key Words
- +Fe, with iron overload
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- Akt/PKB, Akt/protein kinase B
- BMI, body mass index
- CDP, Cytidinediphosphat
- CRP, C-reactive protein
- DIOS, dysmetabolic iron overload syndrome
- FoxO1, forkhead transcription factor O1
- GGT, gamma-glutamyl transpeptidase
- GLUT1, glucose transporter 1
- GNMT, glycine N-methyltransferase
- GSK3β, glycogen synthase kinase 3β
- Glucose
- HDL, high density lipoproteins
- HIF1α, hypoxia-inducible factor 1α
- HOMA-IR, homeostatic model assessment-insulin resistance
- Hyperferritinemia
- IL, interleukin
- IR, insulin resistance
- Iron overload
- LDL, low density lipoproteins
- MRI, magnet resonance imaging
- MetS, metabolic syndrome
- Metabolic syndrome
- Metabolomics
- NAFLD, non-alcoholic fatty liver disease
- PC, phosphatidylcholine
- PCOS, polycystic ovary syndrome
- PC_E, plasmalogens
- PEMT, phosphatidylethanolamine N-methyltransferase
- RBC, red blood count
- T2D, type 2 diabetes mellitus
- TNF, tumor necrosis factor
- VLDL, very low-densitylipoproteins
- WHO, World Health Organization
- WHR, waist hip ratio
- oGTT, oral glucose tolerance test
- −Fe, without iron overload
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Affiliation(s)
- Lars Stechemesser
- First Department of Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
| | - Sebastian K Eder
- First Department of Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria; Obesity Research Unit, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
| | - Andrej Wagner
- First Department of Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
| | - Wolfgang Patsch
- Department of Pharmacology and Toxicology, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria
| | - Alexandra Feldman
- First Department of Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria; Obesity Research Unit, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
| | - Michael Strasser
- First Department of Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
| | - Simon Auer
- Department of Laboratory Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
| | - David Niederseer
- Department of Internal Medicine, Hospital Oberndorf, Paracelsusstrasse 37, 5110 Oberndorf, Austria; Department of Cardiology, University Heart Center Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
| | - Ursula Huber-Schönauer
- Department of Internal Medicine, Hospital Oberndorf, Paracelsusstrasse 37, 5110 Oberndorf, Austria
| | - Bernhard Paulweber
- First Department of Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
| | - Stephan Zandanell
- First Department of Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
| | - Sandra Ruhaltinger
- First Department of Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
| | - Daniel Weghuber
- Obesity Research Unit, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
| | - Elisabeth Haschke-Becher
- Department of Laboratory Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
| | - Christoph Grabmer
- Department of Blood Group Serology and Transfusion Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
| | - Eva Rohde
- Department of Blood Group Serology and Transfusion Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
| | - Christian Datz
- Obesity Research Unit, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria; Department of Internal Medicine, Hospital Oberndorf, Paracelsusstrasse 37, 5110 Oberndorf, Austria
| | - Thomas K Felder
- Obesity Research Unit, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria; Department of Laboratory Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria
| | - Elmar Aigner
- First Department of Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria; Obesity Research Unit, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria.
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Ko PC, Huang SY, Hsieh CH, Hsu MI, Hsu CS. Serum ferritin levels and polycystic ovary syndrome in obese and nonobese women. Taiwan J Obstet Gynecol 2016; 54:403-7. [PMID: 26384059 DOI: 10.1016/j.tjog.2014.06.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2014] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE The aim of this study is to evaluate serum ferritin levels and polycystic ovary syndrome (PCOS)-related complications in obese and nonobese women. MATERIALS AND METHODS This retrospective study included 539 (286 with PCOS and 253 without PCOS). RESULTS Serum ferritin correlated with menstrual cycle length, sex hormone-binding globulin, total testosterone, androstenedione, triglyceride, and total cholesterol in both obese and nonobese women. Obese women with high ferritin levels exhibited higher insulin resistance, impaired glucose tolerance, and liver enzymes (glutamic oxaloacetic transaminase, glutamic pyruvic transaminase) than obese women with low ferritin levels. However, among nonobese women, insulin resistance and risk of diabetes were not significantly different between the high and low ferritin groups. Independent of obesity, hypertriglyceridemia was the major metabolic disturbance observed in women with elevated serum ferritin levels. CONCLUSION Elevated serum ferritin levels are associated with increased insulin resistance and risk of diabetes in obese women but not in nonobese women. However, higher serum ferritin levels were correlated with a greater risk of hyperglyceridemia in both obese and nonobese women. Therefore, hypertriglyceridemia in women with PCOS might be associated with iron metabolism.
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Affiliation(s)
- Po-Chun Ko
- Department of Obstetrics and Gynaecology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Shih-Yi Huang
- School of Nutrition and Health Sciences, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Ching-Hung Hsieh
- Department of Obstetrics and Gynecology, Clinic of Fu Jen Catholic University, Taipei, Taiwan
| | - Ming-I Hsu
- Department of Obstetrics and Gynaecology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Chun-Sen Hsu
- Department of Obstetrics and Gynaecology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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25
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Ojeda-Ojeda M, Martínez-García M, Alpañés M, Luque-Ramírez M, Escobar-Morreale HF. Association of TLR2 S450S and ICAM1 K469E polymorphisms with polycystic ovary syndrome (PCOS) and obesity. J Reprod Immunol 2016; 113:9-15. [DOI: 10.1016/j.jri.2015.09.072] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 09/15/2015] [Accepted: 09/28/2015] [Indexed: 10/22/2022]
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26
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Behboudi-Gandevani S, Ramezani Tehrani F, Rostami Dovom M, Farahmand M, Bahri Khomami M, Noroozzadeh M, Kabir A, Azizi F. Insulin resistance in obesity and polycystic ovary syndrome: systematic review and meta-analysis of observational studies. Gynecol Endocrinol 2016; 32:343-53. [PMID: 27052492 DOI: 10.3109/09513590.2015.1117069] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We aimed at investigating whether insulin resistance (IR)/sensitivity are impaired in obese/non-obese polycystic ovary syndrome (PCOS) and obese/non-obese healthy controls. A comprehensive literature search was performed for observational, English language studies. Meta-analysis was performed with the random effects model according to the heterogeneity. Eligible studies, involving 3037 women in four groups of: 1-obese, PCOS; 2-non-obese, PCOS, 3-obese, non-PCOS and 4-Non-obese, non-PCOS were included. Based on the insulin resistance index (HOMA-IR) analysis, the pooled mean (95% Conf. Interval) of HOMA IR in groups 1-4 were 4.38 (3.84, 4.92), 2.68 (2.16, 3.20), 2.44 (2.06, 2.82) and 1.34 (1.06, 1.63), respectively. Meta-analysis showed that group 1 (obese, PCOS patients) statistically have the highest IR and group 4 (non-obese, non-PCOS women) have the highest insulin sensitivity. Group 2 (non-obese, PCOS patients) and group 3 (obese, non-PCOS women) were between this range and they had lower IR than group 1 (obese, PCOS) and lower insulin sensitivity than group 4 (non-obese, non-PCOS). So, there were statistical differences between all groups except between groups 2 and 3. Insulin sensitivity indexes (quickie and ISI), also confirm the IR index (HOMA-IR) results. Based on different IR/sensitivity indexes, we found no evidence of any different effects of BMI ≥ 30 kg/m(2) on IR/sensitivity. In conclusion, PCOS status intensifies the adverse effects of obesity on IR, it has to be appropriately addressed in primary and secondary preventive cares and treatments provided for these women.
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Affiliation(s)
- Samira Behboudi-Gandevani
- a Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Fahimeh Ramezani Tehrani
- a Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Marzieh Rostami Dovom
- a Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Maryam Farahmand
- a Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Mahnaz Bahri Khomami
- a Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Mahsa Noroozzadeh
- a Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Ali Kabir
- c Minimally Invasive Surgery Research Center, Department of Community Medicine, School of Medicine, Iran University of Medical Sciences , Tehran , Iran
| | - Fereidoun Azizi
- b Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran , and
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27
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Yang JH, Chou CH, Yang WS, Ho HN, Yang YS, Chen MJ. Iron stores and obesity are negatively associated with ovarian volume and anti-Müllerian hormone levels in women with polycystic ovary syndrome. Taiwan J Obstet Gynecol 2015; 54:686-92. [DOI: 10.1016/j.tjog.2014.11.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2014] [Indexed: 01/21/2023] Open
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28
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Hashimoto Y, Tanaka M, Kimura T, Kitagawa N, Hamaguchi M, Asano M, Yamazaki M, Oda Y, Toda H, Nakamura N, Fukui M. Hemoglobin concentration and incident metabolic syndrome: a population-based large-scale cohort study. Endocrine 2015; 50:390-6. [PMID: 25863486 DOI: 10.1007/s12020-015-0587-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 03/27/2015] [Indexed: 02/06/2023]
Abstract
Previous cross-sectional studies revealed an association between hemoglobin concentration and a prevalence of metabolic syndrome (MetS). However, the association between hemoglobin concentration and incident MetS remains to be elucidated. Thus, the aim of this study was to investigate the association between hemoglobin concentration and incident MetS. We enrolled 2695 subjects (1454 men and 1241 women) and performed 8-year follow-up cohort study. MetS was diagnosed, according to the joint interim statement, when a subject had three or more of the following components: hypertension; hyperglycemia; hypertriglyceridemia; low high-density lipoprotein cholesterol; and abdominal obesity. Logistic regression analyses were performed to assess the impact of hemoglobin concentration on incident MetS by adjusting for age, body mass index, lifestyle factors, including smoking status, habit of alcohol and habit of exercise, systolic blood pressure, fasting plasma glucose, triglycerides, high-density lipoprotein cholesterol, creatinine, and uric acid. The highest (≥157 g/L) and third (151-156 g/L) hemoglobin concentration quartiles were associated with the increased risk of incident MetS compared to the lowest (<145 g/L) hemoglobin concentration quartile after adjusting for covariates in men (multivariate odds ratio (OR) 2.24, 95% CI 1.34-3.85, P = 0.0021 and multivariate OR 2.03, 95% CI 1.21-3.45, P = 0.0070). On the other hand, there was no association between hemoglobin concentration and incident MetS in women. Hemoglobin concentration was a novel risk marker for incident MetS in men.
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Affiliation(s)
- Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Muhei Tanaka
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Toshihiro Kimura
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Noriyuki Kitagawa
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Mai Asano
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Masahiro Yamazaki
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yohei Oda
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Hitoshi Toda
- Department of Internal Medicine, Oike Clinic, Kyoto, Japan
| | - Naoto Nakamura
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
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Aigner E, Weiss G, Datz C. Dysregulation of iron and copper homeostasis in nonalcoholic fatty liver. World J Hepatol 2015; 7:177-188. [PMID: 25729473 PMCID: PMC4342600 DOI: 10.4254/wjh.v7.i2.177] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 12/12/2014] [Accepted: 12/31/2014] [Indexed: 02/06/2023] Open
Abstract
Elevated iron stores as indicated by hyperferritinemia with normal or mildly elevated transferrin saturation and mostly mild hepatic iron deposition are a characteristic finding in subjects with non-alcoholic fatty liver disease (NAFLD). Excess iron is observed in approximately one third of NAFLD patients and is commonly referred to as the “dysmetabolic iron overload syndrome”. Clinical evidence suggests that elevated body iron stores aggravate the clinical course of NAFLD with regard to liver-related and extrahepatic disease complications which relates to the fact that excess iron catalyses the formation of toxic hydroxyl-radicals subsequently resulting in cellular damage. Iron removal improves insulin sensitivity, delays the onset of type 2 diabetes mellitus, improves pathologic liver function tests and likewise ameliorates NAFLD histology. Several mechanisms contribute to pathologic iron accumulation in NAFLD. These include impaired iron export from hepatocytes and mesenchymal Kupffer cells as a consequence of imbalances in the concentrations of iron regulatory factors, such as hepcidin, cytokines, copper or other dietary factors. This review summarizes the knowledge about iron homeostasis in NAFLD and the rationale for its therapeutic implications.
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Li L, Ruau DJ, Patel CJ, Weber SC, Chen R, Tatonetti NP, Dudley JT, Butte AJ. Disease risk factors identified through shared genetic architecture and electronic medical records. Sci Transl Med 2014; 6:234ra57. [PMID: 24786325 DOI: 10.1126/scitranslmed.3007191] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Genome-wide association studies have identified genetic variants for thousands of diseases and traits. We evaluated the relationships between specific risk factors (for example, blood cholesterol level) and diseases on the basis of their shared genetic architecture in a comprehensive human disease-single-nucleotide polymorphism association database (VARIMED), analyzing the findings from 8962 published association studies. Similarity between traits and diseases was statistically evaluated on the basis of their association with shared gene variants. We identified 120 disease-trait pairs that were statistically similar, and of these, we tested and validated five previously unknown disease-trait associations by searching electronic medical records (EMRs) from three independent medical centers for evidence of the trait appearing in patients within 1 year of first diagnosis of the disease. We validated that the mean corpuscular volume is elevated before diagnosis of acute lymphoblastic leukemia; both have associated variants in the gene IKZF1. Platelet count is decreased before diagnosis of alcohol dependence; both are associated with variants in the gene C12orf51. Alkaline phosphatase level is elevated in patients with venous thromboembolism; both share variants in ABO. Similarly, we found that prostate-specific antigen and serum magnesium levels were altered before the diagnosis of lung cancer and gastric cancer, respectively. Disease-trait associations identify traits that could serve as future prognostics, if validated through EMR and subsequent prospective trials.
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Affiliation(s)
- Li Li
- Division of Systems Medicine, Department of Pediatrics, Stanford University School of Medicine, 1265 Welch Road, Stanford, CA 94305, USA
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Polycystic Ovary Syndrome as a Paradigm for Prehypertension, Prediabetes, and Preobesity. Curr Hypertens Rep 2014; 16:500. [DOI: 10.1007/s11906-014-0500-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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32
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Study of circulating hepcidin in association with iron excess, metabolic syndrome, and BMP-6 expression in granulosa cells in women with polycystic ovary syndrome. Fertil Steril 2014; 102:548-554.e2. [DOI: 10.1016/j.fertnstert.2014.04.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 04/14/2014] [Accepted: 04/21/2014] [Indexed: 11/23/2022]
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33
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Altunoğlu E, Müderrisoğlu C, Erdenen F, Ulgen E, Ar MC. The impact of obesity and insulin resistance on iron and red blood cell parameters: a single center, cross-sectional study. Turk J Haematol 2014; 31:61-7. [PMID: 24764731 PMCID: PMC3996629 DOI: 10.4274/tjh.2012.0187] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 05/08/2013] [Indexed: 12/26/2022] Open
Abstract
Objective: Obesity and iron deficiency (ID) are the 2 most common nutritional disorders worldwide causing significant public health implications. Obesity is characterized by the presence of low-grade inflammation, which may lead to a number of diseases including insulin resistance (IR) and type 2 diabetes. Increased levels of acute-phase proteins such as C-reactive protein (CRP) have been reported in obesity-related inflammation. The aim of this study was to investigate the impact of obesity/IR on iron and red blood cell related parameters. Materials and Methods: A total of 206 patients and 45 control subjects of normal weight were included in this cross-sectional study. Venous blood samples were taken from each patient to measure hemoglobin (Hb), serum iron (Fe), iron-binding capacity (IBC), ferritin, CRP, fasting blood glucose, and fasting insulin. Body mass index (BMI) and waist-to-hip ratio (WHR) were calculated for each patient. IR was determined using the HOMA-IR formula. Results: Subjects were divided into 3 groups according to BMI. There were 152 severely obese (BMI: 42.6±10.1), 54 mildly obese (BMI: 32.4±2.1), and 45 normal-weight (BMI: 24.3±1.3) patients. Hb levels in severely obese patients and normal controls were 12.8±1.3 g/dL and 13.6±1.8 g/dL, respectively. We found decreasing Fe levels with increasing weight (14.9±6.9 µmol/L, 13.6±6.3 µmol/L, and 10.9±4.6 µmol/L for normal controls and mildly and severely obese patients, respectively). Hb levels were slightly lower in patients with higher HOMA-IR values (13.1±1.5 g/dL vs. 13.2±1.2 g/dL; p=0.36). Serum iron levels were significantly higher in the group with low HOMA-IR values (13.6±5.9 µmol/L vs. 11.6±4.9 µmol/L; p=0.008). IBC was found to be similar in both groups (60.2±11.4 µmol/L vs. 61.9±10.7 µmol/L; p=0.23). Ferritin was slightly higher in patients with higher HOMA-IR values (156.1±209.5 pmol/L vs. 145.3±131.5 pmol/L; p=0.62). Conclusion: Elevated BMI and IR are associated with lower Fe and hemoglobin levels. These findings may be explained by the chronic inflammation of obesity and may contribute to obesity-related co-morbidities. People with IR may present with ID without anemia.
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Affiliation(s)
- Esma Altunoğlu
- İstanbul Training and Research Hospital, Department of Internal Medicine, İstanbul, Turkey
| | - Cüneyt Müderrisoğlu
- İstanbul Training and Research Hospital, Department of Internal Medicine, İstanbul, Turkey
| | - Füsun Erdenen
- İstanbul Training and Research Hospital, Department of Internal Medicine, İstanbul, Turkey
| | - Ender Ulgen
- İstanbul Training and Research Hospital, Department of Internal Medicine, İstanbul, Turkey
| | - M Cem Ar
- Istanbul University, Cerrahpaşa Medical Faculty, Department of Internal Medicine, Division of Haematology, Istanbul, Turkey
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Ferk P, Gersak K. Association of -108 C>T PON1 polymorphism with polycystic ovary syndrome. Biomed Rep 2013; 2:255-259. [PMID: 24649106 DOI: 10.3892/br.2013.214] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 11/11/2013] [Indexed: 11/05/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is possibly the most common endocrine disorder in premenopausal women. In this study, we aimed to investigate the association of the -108 C>T polymorphism in the PON1 gene, which encodes the antioxidant enzyme paraoxonase-1, with PCOS. A total of 118 women with PCOS and 108 control subjects were included in this case-control study. The PON1 polymorphism was genotyped, biochemical and clinical parameters were determined and the correlations between the parameters were statistically evaluated. The differences in the PON1 allele and genotype distributions between PCOS patients and controls did not reach a statistical significance. The serum fasting glucose (GLU) levels did not differ significantly between the PCOS patients and the controls. However, the serum fasting insulin (INS) concentration, INS/GLU ratio and homeostasis model assessment (HOMA) index, although within the normal range, were significantly higher in the PCOS group. When considering PCOS patients and controls as separate groups or as a single group of patients, none of the analyzed biochemical or clinical parameters were found to be significantly correlated with the PON1 polymorphism. Therefore, the -108 C>T PON1 polymorphism was not found to be significantly associated with the presence of PCOS or with its particular clinical and biochemical characteristics in non-insulin resistant, non-obese patients.
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Affiliation(s)
- Polonca Ferk
- Department of Pharmacology and Experimental Toxicology, Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Ksenija Gersak
- Department of Obstetrics and Gynaecology, Ljubljana University Medical Centre, Ljubljana, Slovenia ; Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Datz C, Felder TK, Niederseer D, Aigner E. Iron homeostasis in the metabolic syndrome. Eur J Clin Invest 2013; 43:215-24. [PMID: 23289518 DOI: 10.1111/eci.12032] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 11/21/2012] [Indexed: 02/06/2023]
Abstract
The metabolic syndrome (MetS) affects iron homeostasis in a many-faceted fashion. On the one side, hyperferritinaemia with normal or mildly elevated transferrin saturation is observed in approximately one-third of patients with non-alcoholic fatty liver disease (NAFLD) or the MetS. This constellation has been named the 'dysmetabolic iron overload syndrome (DIOS)'. Current evidence suggests that elevated body iron stores exert a detrimental effect on the clinical course of obesity-related conditions and that iron removal improves insulin sensitivity and delays the onset of T2DM. On the other side, iron deficiency is a frequent finding in more progressed stages of obesity. The mechanisms underlying the DIOS and obesity-related iron deficiency appear strikingly similar as elevated hepcidin concentrations, low expression of duodenal ferroportin (FPN) and impaired iron absorption are found in both conditions. This review summarizes the current knowledge about the dysregulation of iron homeostasis in the MetS and particularly in its hepatic manifestation NAFLD.
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Affiliation(s)
- Christian Datz
- Department of Internal Medicine, General Hospital Oberndorf, 5110 Oberndorf, Austria.
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36
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Prenatal hyperandrogenism and lipid profile during different age stages: an experimental study. Fertil Steril 2013; 99:551-7. [DOI: 10.1016/j.fertnstert.2012.10.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 10/09/2012] [Accepted: 10/09/2012] [Indexed: 12/12/2022]
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Kim MH, Bae YJ. Postmenopausal vegetarians' low serum ferritin level may reduce the risk for metabolic syndrome. Biol Trace Elem Res 2012; 149:34-41. [PMID: 22528775 DOI: 10.1007/s12011-012-9405-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 03/26/2012] [Indexed: 11/24/2022]
Abstract
The present study was conducted to compare the serum ferritin status between the postmenopausal vegetarians and non-vegetarians and to identify the relation of serum ferritin with metabolic syndrome (MetS) risk factors in postmenopausal women. The two study groups consisted of postmenopausal vegetarians (n=59) who maintained a vegetarian diet for over 20 years and age-matched non-vegetarian controls (n=48). Anthropometric measurements, dietary intakes, serum metabolic syndrome-related parameters, and serum ferritin level between the two groups were compared. The vegetarians exhibited significantly lower weight (p<0.01), body mass index (BMI) (p<0.001), percentage of body fat (p<0.001), waist circumference (p<0.01), SBP (p<0.001), DBP (p<0.001), and fasting glucose (p<0.05). According to the National Cholesterol Education Program (NCEP)-Adult Treatment Panel III criteria for MetS applying Korean guidelines for waist circumference, the prevalence of MetS was lower in vegetarians (33.9 %) than in non-vegetarians (47.9 %). Vegetarians had significantly lower serum level of ferritin (p<0.01) than non-vegetarians. In the correlation analysis, serum ferritin was positively related to fasting glucose (r=0.264, p<0.01), triglycerides (r=0.232, p<0.05), and the NCEP score (r=0.214, p<0.05) and negatively related to high-density lipoprotein-cholesterol (r=-0.225, p<0.05) after adjusting for BMI, lifestyle, and dietary factors (animal protein, animal fat, and dietary fiber intake). In conclusion, postmenopausal vegetarians had lower MetS presence and a lower serum ferritin level compared to non-vegetarians. Furthermore, vegetarians' low serum ferritin level may reduce the risk of MetS in postmenopausal women.
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Affiliation(s)
- Mi-Hyun Kim
- Department of Food and Nutrition, Kangwon National University, Samcheok 245-711, South Korea.
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38
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Escobar-Morreale HF. Iron metabolism and the polycystic ovary syndrome. Trends Endocrinol Metab 2012; 23:509-15. [PMID: 22579050 DOI: 10.1016/j.tem.2012.04.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Revised: 04/11/2012] [Accepted: 04/12/2012] [Indexed: 01/17/2023]
Abstract
The polycystic ovary syndrome (PCOS) is associated with insulin resistance and abnormal glucose tolerance. Iron overload may lead also to insulin resistance and diabetes. Serum ferritin levels are increased in PCOS, especially when glucose tolerance is abnormal, suggesting mild iron overload. Factors contributing to potential iron overload in PCOS include the iron sparing effect of chronic menstrual dysfunction, insulin resistance, and a decrease in hepcidin leading to increased iron absorption. Enhancement of erythropoiesis by androgen excess is unlikely, because soluble transferrin receptor levels are not increased in PCOS. Future venues of research should address the long-term effects of PCOS treatment on iron overload and, conversely, the possible effects of iron lowering strategies on the glucose tolerance of patients with PCOS.
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Affiliation(s)
- Héctor F Escobar-Morreale
- Diabetes, Obesity and Human Reproduction Research Group, University of Alcalá and Hospital Universitario Ramón y Cajal and Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM & Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS, Carretera de Colmenar km 9'1, E-28034 Madrid, Spain.
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Escobar-Morreale HF, Samino S, Insenser M, Vinaixa M, Luque-Ramírez M, Lasunción MA, Correig X. Metabolic Heterogeneity in Polycystic Ovary Syndrome Is Determined by Obesity: Plasma Metabolomic Approach Using GC-MS. Clin Chem 2012; 58:999-1009. [DOI: 10.1373/clinchem.2011.176396] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
BACKGROUND
Abdominal adiposity and obesity influence the association of polycystic ovary syndrome (PCOS) with insulin resistance and diabetes. We aimed to characterize the intermediate metabolism phenotypes associated with PCOS and obesity.
METHODS
We applied a nontargeted GC-MS metabolomic approach to plasma samples from 36 patients with PCOS and 39 control women without androgen excess, matched for age, body mass index, and frequency of obesity.
RESULTS
Patients with PCOS were hyperinsulinemic and insulin resistant compared with the controls. The increase in plasma long-chain fatty acids, such as linoleic and oleic acid, and glycerol in the obese patients with PCOS suggests increased lipolysis, possibly secondary to impaired insulin action at adipose tissue. Conversely, nonobese patients with PCOS showed a metabolic profile consisting of suppression of lipolysis and increased glucose utilization (increased lactic acid concentrations) in peripheral tissues, and PCOS patients as a whole showed decreased 2-ketoisocaproic and alanine concentrations, suggesting utilization of branched-chain amino acids for protein synthesis and not for gluconeogenesis. These metabolic processes required effective insulin signaling; therefore, insulin resistance was not universal in all tissues of these women, and different mechanisms possibly contributed to their hyperinsulinemia. PCOS was also associated with decreased α-tocopherol and cholesterol concentrations irrespective of obesity.
CONCLUSIONS
Substantial metabolic heterogeneity, strongly influenced by obesity, underlies PCOS. The possibility that hyperinsulinemia may occur in the absence of universal insulin resistance in nonobese women with PCOS should be considered when designing diagnostic and therapeutic strategies for the management of this prevalent disorder.
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Affiliation(s)
- Héctor F Escobar-Morreale
- Diabetes, Obesity and Human Reproduction Research Group, Hospital Universitario Ramón y Cajal & Universidad de Alcalá, Madrid, Spain
- CIBER Diabetes y Enfermedades Metabólicas Asociadas, Spain
- Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Sara Samino
- CIBER Diabetes y Enfermedades Metabólicas Asociadas, Spain
- Metabolomics Platform, Universitat Rovira i Virgili & Institut d'Investigació Sanitaria Pere Virgili, Tarragona, Spain
| | - María Insenser
- Diabetes, Obesity and Human Reproduction Research Group, Hospital Universitario Ramón y Cajal & Universidad de Alcalá, Madrid, Spain
- CIBER Diabetes y Enfermedades Metabólicas Asociadas, Spain
- Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - María Vinaixa
- CIBER Diabetes y Enfermedades Metabólicas Asociadas, Spain
- Metabolomics Platform, Universitat Rovira i Virgili & Institut d'Investigació Sanitaria Pere Virgili, Tarragona, Spain
| | - Manuel Luque-Ramírez
- Diabetes, Obesity and Human Reproduction Research Group, Hospital Universitario Ramón y Cajal & Universidad de Alcalá, Madrid, Spain
- CIBER Diabetes y Enfermedades Metabólicas Asociadas, Spain
| | - Miguel A Lasunción
- Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
- Department of Biochemistry-Research, Hospital Universitario Ramón y Cajal & Universidad de Alcalá, Madrid, Spain, and CIBER Fisiopatología de la Obesidad y la Nutrición, Spain
| | - Xavier Correig
- CIBER Diabetes y Enfermedades Metabólicas Asociadas, Spain
- Metabolomics Platform, Universitat Rovira i Virgili & Institut d'Investigació Sanitaria Pere Virgili, Tarragona, Spain
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Al-Hakeim HK. Correlation between Iron Status Parameters and Hormone Levels in Women with Polycystic Ovary Syndrome. CLINICAL MEDICINE INSIGHTS. WOMEN'S HEALTH 2012. [DOI: 10.4137/cmwh.s8780] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Much research has shown that iron store parameters are increased in women with polycystic ovary syndrome (PCOS), but an exact explanation for this phenomenon remains unavailable. The objective of this study was to investigate the correlation between iron status parameters and hormonal disturbances in women with PCOS that accounts for their increased iron store levels. Iron status parameters and hormones were measured using colorimetric and enzyme-linked immunosorbent assays, respectively. The results demonstrated a mild iron overload in the patients with PCOS. Good positive correlations between iron status parameters and serum testosterone, prolactin, and insulin were detected in the patient group, whereas iron status parameters and BMI were not significantly correlated. The data also suggest that the increase in serum ferritin and body iron store levels in patients with PCOS are associated with hyperandrogenemia, hyperprolactinemia, and hyperinsulinemia. The findings of this study expand current knowledge on the factors affecting iron stores and suggest a different mechanism of interaction between iron stores and the endocrine system through the harmful deposition of iron in endocrine glands and through hormonal effects on iron absorption and metabolism.
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Lee BK, Kim Y, Kim YI. Association of serum ferritin with metabolic syndrome and diabetes mellitus in the South Korean general population according to the Korean National Health and Nutrition Examination Survey 2008. Metabolism 2011; 60:1416-24. [PMID: 21489582 DOI: 10.1016/j.metabol.2011.02.008] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Revised: 02/14/2011] [Accepted: 02/15/2011] [Indexed: 12/28/2022]
Abstract
We examined the association of serum ferritin levels with metabolic syndrome (MS) and diabetes mellitus in a representative sample of the adult South Korean population using data from the 2008 Korean National Health and Nutrition Examination Survey. We conducted a cross-sectional study of 6311 adults older than 20 years who participated in the 2008 Korean National Health and Nutrition Examination Survey. Metabolic syndrome was defined as the presence of at least 3 of the following: elevated blood pressure, low high-density lipoprotein cholesterol, elevated serum triglycerides, elevated plasma glucose, and abdominal obesity. Diabetes mellitus was defined as fasting glucose of at least 126 mg/dL. Insulin resistance was determined using the homeostasis model assessment estimate of insulin resistance. In a representative sample of the adult Korean population, MS was more prevalent in the highest quartile compared with the lowest quartile of serum ferritin concentrations in women following adjustments for age, education, smoking, alcohol intake, body mass index, aspartate aminotransferase, and alanine aminotransferase. Diabetes mellitus was more prevalent in the highest quartile compared with the lowest quartile of serum ferritin concentrations in premenopausal women and men. The geometric means of fasting insulin and insulin resistance determined using the homeostasis model assessment of insulin resistance in the fourth serum ferritin quartiles of postmenopausal women and men were significantly higher compared with those in the first quartile of the respective groups. The present study demonstrates that elevated serum ferritin concentrations are associated with an increased risk of MS and diabetes mellitus in a representative sample of the adult South Korean population.
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Affiliation(s)
- Byung-Kook Lee
- Institute of Environmental & Occupational Medicine, Soonchunhyang University 646 Eupnae-ri, Shinchang-myun, Asan-si, Choongnam 336-745, South Korea
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Chang CC, Kuan TC, Hsieh YY, Ho YJ, Sun YL, Lin CS. Effects of diosgenin on myometrial matrix metalloproteinase-2 and -9 activity and expression in ovariectomized rats. Int J Biol Sci 2011; 7:837-47. [PMID: 21814480 PMCID: PMC3149279 DOI: 10.7150/ijbs.7.837] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Accepted: 07/07/2011] [Indexed: 12/23/2022] Open
Abstract
Diosgenin, a traditional Yam extraction, has been used in hormone replacement for menopausal women. We aimed to investigate the influences of diosgenin administration upon the MMP-2 and -9 activity and expression and reproductive hormones of ovariectomized (OVX) rats, a model of menopausal status. Seven-week old female Wistar rats with bilateral OVX or sham operation (controls) were divided and administered different dosages of diosgenin (0, 10, 50, or 100 mg/kg/day) for 8 weeks. Serum was then sampled for progesterone (P4) and estradiol (E2) assay and uterine horns harvested. Myometrial MMP-2 and -9 activity and expression were surveyed and myometrial collagen expression was also assayed. The results show higher body weight in OVX rats across the 8 weeks post surgery and no significant differences were noted among OVX or Sham rats with diosgenin supplements. There were lower P4 and E2 concentrations in OVX rats compared to Sham rats, and higher P4 concentration of Sham rats post diosgenin supplement. MMP-2 and -9 mRNA expression and activity was lower in OVX rats, although higher MMP-2 and lower MMP-9 activity/mRNA expression was observed in OVX rats post diosgenin supplementation. Collagen mRNA expression was higher in OVX rats compared to Sham controls, and diosgenin administration decreased collagen mRNA expression in OVX rats. In conclusion, diosgenin is associated with gelatinase expression and collagen metabolism in OVX rats. Diosgenin administration can partially reverse the effects of OVX upon MMP functions and hormone status. Adequate diosgenin supplement might modulate myometrial gelatinase expression and collagen metabolism in menopausal subjects.
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Affiliation(s)
- Chi-Chen Chang
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
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Toulis KA, Goulis DG, Mintziori G, Kintiraki E, Eukarpidis E, Mouratoglou SA, Pavlaki A, Stergianos S, Poulasouchidou M, Tzellos TG, Makedos A, Chourdakis M, Tarlatzis BC. Meta-analysis of cardiovascular disease risk markers in women with polycystic ovary syndrome. Hum Reprod Update 2011; 17:741-60. [PMID: 21628302 DOI: 10.1093/humupd/dmr025] [Citation(s) in RCA: 138] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The relation between polycystic ovary syndrome (PCOS) and cardiovascular disease (CVD) remains unclear. In an attempt to provide high-quality evidence on the relation between PCOS and CVD, relevant literature for CVD risk markers [C-reactive protein (CRP), homocysteine (Hcy), tumor necrosis factor-alpha (TNF-α), plasminogen activator inhibitor-1 (PAI-1), lipoprotein (a) [Lp(a)], advanced glycation end-products (AGEs), vascular endothelial growth factor (VEGF), interleukin-6 (IL-6), asymmetric dimethylarginine (ADMA), endothelin-1 (ET-1) and fibrinogen] in women with PCOS was reviewed and analyzed. METHODS A systematic search was conducted electronically using specific eligibility criteria. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated and combined appropriately. To ensure synthesis of the best available evidence, sensitivity analyses were performed. RESULTS A total of 130 data sets were included in 11 different outcomes, involving 7174 and 5076 CVD markers in women with PCOS and controls, respectively. Women with PCOS demonstrated significantly elevated CRP [WMD (95% CI) 0.99 (0.77-1.21)], Hcy [2.25 (1.46-3.03)], PAI-1 antigen [16.96 (7.25-26.28)], PAI-1 activity [0.71 (0.18-1.23)], VEGF [1.72 (0.96-2.48)], ADMA [0.19 (0.08-0.3)], AGEs [3.91 (2.36-5.45)] and Lp(a) [0.81 (0.58-1.04)] concentrations compared with controls, yet with significant between-study heterogeneity. Borderline significance (not robust in the sensitivity analyses) was detected for TNF-α [0.75 (0.07-1.44)], ET-1 [1.06 (0.52-1.59)] and fibrinogen [0.20 (0.01-0.39)], whereas no difference was detected for IL-6 [0.71 (-0.16 to 1.59)]. CONCLUSIONS Women with PCOS have increased serum concentrations of CVD risk markers compared with controls. Whether this apparent risk is translated into increased incidence of CVD in later life remains to be elucidated.
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Affiliation(s)
- Konstantinos A Toulis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Ring Road, 56403 Nea Efkapria, Thessaloniki, Greece
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Escobar-Morreale HF, Luque-Ramírez M. Role of androgen-mediated enhancement of erythropoiesis in the increased body iron stores of patients with polycystic ovary syndrome. Fertil Steril 2011; 95:1730-5.e1. [DOI: 10.1016/j.fertnstert.2011.01.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 01/06/2011] [Accepted: 01/07/2011] [Indexed: 11/26/2022]
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Luque-Ramírez M, Álvarez-Blasco F, Alpañés M, Escobar-Morreale HF. Role of decreased circulating hepcidin concentrations in the iron excess of women with the polycystic ovary syndrome. J Clin Endocrinol Metab 2011; 96:846-52. [PMID: 21209031 DOI: 10.1210/jc.2010-2211] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CONTEXT Hepcidin inhibits the intestinal absorption of iron and its deficiency causes juvenile hemochromatosis. OBJECTIVE The objective of the investigation was to study the involvement of hepcidin in the iron overload of patients with polycystic ovary syndrome (PCOS). DESIGN This was a case-control study followed by a randomized clinical trial. SETTING The study was conducted at an academic hospital. PATIENTS Thirty-four patients with PCOS and 30 women without hyperandrogenism, matched for age and body mass index, participated in the study. INTERVENTION Patients with PCOS were randomly allocated to treatment with either an antiandrogenic oral contraceptive or metformin for 24 wk. MAIN OUTCOME MEASURES Serum hepcidin levels and ferritin to hepcidin molar ratios were measured. RESULTS Patients with PCOS showed decreased circulating hepcidin levels and increased ferritin to hepcidin molar ratios compared with controls. Patients with PCOS presenting with chronic oligoamenorrhea (an iron sparing mechanism) showed a paradoxical decrease in serum hepcidin levels and an increase in ferritin to hepcidin molar ratios compared with the patients who had regular anovulatory menstrual cycles and with the controls. The major predictor of circulating hepcidin concentrations was the presence of PCOS, whereas the main determinants of the ferritin to hepcidin molar ratio were the insulin sensitivity index and menstrual dysfunction. Serum hepcidin levels did not change during treatment with either metformin or the antiandrogenic oral contraceptive pill, yet patients treated with the oral contraceptive pill normalized the ferritin to hepcidin molar ratio. CONCLUSIONS Patients with PCOS had reduced serum hepcidin concentrations that might contribute to their iron overload by favoring the intestinal absorption of iron. The imbalance between increased iron stores and reduced hepcidin levels was related to the insulin resistance and androgen excess characteristic of this syndrome.
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Affiliation(s)
- Manuel Luque-Ramírez
- Department of Endocrinology, Hospital Universitario Ramón y Cajal and Universidad de Alcalá, Carretera de Colmenar Viejo Km 9.1, E-28034 Madrid, Spain
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Barton JC, Barton JC. Hemochromatosis, HFE C282Y homozygosity, and polycystic ovary syndrome: report of two cases and possible effects of androgens and hepcidin. Acta Haematol 2011; 126:138-40. [PMID: 21701160 DOI: 10.1159/000328045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 03/24/2011] [Indexed: 01/03/2023]
Affiliation(s)
- James C Barton
- Southern Iron Disorders Center, University of Alabama at Birmingham, Birmingham, AL, USA.
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Circulating inflammatory markers in polycystic ovary syndrome: a systematic review and metaanalysis. Fertil Steril 2010; 95:1048-58.e1-2. [PMID: 21168133 DOI: 10.1016/j.fertnstert.2010.11.036] [Citation(s) in RCA: 325] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Revised: 10/15/2010] [Accepted: 11/15/2010] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To perform a review and metaanalysis of the studies evaluating the status of serum inflammatory markers in women with polycystic ovary syndrome (PCOS). DESIGN Systematic review and metaanalysis of articles published in English before January 2010 and identified using the PubMed search engine. SETTING Academic hospital. PATIENT(S) Women with PCOS and appropriate controls. INTERVENTION(S) Measurement of serum concentrations of inflammatory markers by high-sensitivity techniques. MAIN OUTCOME MEASURE(S) Metaanalyses of the mean difference in serum C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) concentrations among patients with PCOS and appropriate controls, applying random-effects models to limit interstudy variability, and using appropriate estimates of evidence dissemination bias. RESULT(S) Metaanalysis of the 31 articles meeting inclusion criteria showed that circulating CRP was 96% higher in women with PCOS compared to controls (95% confidence interval, 71%-122%; z = 7.32) without evidence of dissemination bias (Egger's regression intercept, 0.45; 95% confidence interval, -2.30 to 3.21). These findings persisted after excluding five studies with mismatches in body mass, frequency of obesity, or both, between women with PCOS and controls. Metaanalyses involving 10 studies of IL-6, and nine studies of TNF-α revealed no statistically significant differences between PCOS and controls. CONCLUSION(S) Women with PCOS exhibit an elevation in circulating CRP that is independent of obesity. This finding corroborates existing molecular evidence of the chronic low-grade inflammation that may underpin the pathogenesis of this disorder.
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Insenser M, Martínez-García MA, Montes R, San-Millán JL, Escobar-Morreale HF. Proteomic analysis of plasma in the polycystic ovary syndrome identifies novel markers involved in iron metabolism, acute-phase response, and inflammation. J Clin Endocrinol Metab 2010; 95:3863-70. [PMID: 20484478 DOI: 10.1210/jc.2010-0220] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CONTEXT Hypothesis-free approaches such as proteomic analysis may identify novel biomarkers for disease. OBJECTIVE The objective of the study was to compare the plasma proteome of patients presenting with the polycystic ovary syndrome (PCOS) with that of women without hyperandrogenism. DESIGN This was a case-control study. SETTINGS The study was conducted at an academic hospital. PATIENTS Patients included 12 PCOS patients and 12 women without hyperandrogenism. INTERVENTIONS Interventions included basal blood sampling. MAIN OUTCOME MEASURES Two-dimensional difference in-gel electrophoresis, matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry, Western blot, and ELISA analyses were measured. RESULTS Two-dimensional difference in-gel electrophoresis and matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry analyses identified haptoglobin beta-chain and alpha2-macroglobulin as proteins underexpressed in PCOS samples, whereas transferrin and kappa-free light chain were overexpressed. We were able to confirm only the underexpression of haptoglobin beta-chain in subsequent Western blot and ELISA analyses. CONCLUSIONS Proteomic analysis of plasma from PCOS patients revealed changes in protein expression in several acute-phase response proteins including isoforms of plasma haptoglobin, alpha2-macroglobulin, and transferrin and in kappa-free light chain. In addition to their role as inflammatory markers, some of these molecules play major roles in iron metabolism, further suggesting that iron metabolism and low-grade chronic inflammation may be involved in the pathogenesis of insulin-resistant disorders such as PCOS.
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Affiliation(s)
- María Insenser
- Department of Endocrinology, Hospital Universitario Ramón y Cajal and Universidad de Alcalá, Carretera de Colmenar Viejo Km 9,1 Madrid E-28034, Spain
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Current Opinion in Endocrinology, Diabetes & Obesity. Current world literature. Curr Opin Endocrinol Diabetes Obes 2010; 17:293-312. [PMID: 20418721 DOI: 10.1097/med.0b013e328339f31e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mascitelli L, Pezzetta F, Goldstein MR. Body iron stores and gender differences in risk factors for coronary heart disease. Maturitas 2010; 66:107. [DOI: 10.1016/j.maturitas.2010.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Accepted: 02/01/2010] [Indexed: 11/27/2022]
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