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Raihanah C, Sukrasno S, Kurniati NF. Activity of isoflavone in managing polycystic ovary syndrome symptoms (Review). Biomed Rep 2024; 20:80. [PMID: 38590945 PMCID: PMC10999901 DOI: 10.3892/br.2024.1768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 01/17/2024] [Indexed: 04/10/2024] Open
Abstract
Polycystic ovary syndrome (PCOS), a hormonal and metabolic disorder manifested in women of reproductive age, is still being treated using drugs with side effects. As an alternative to these drugs, isoflavone, also identified as phytoestrogen, has anti-PCOS activity. Isoflavone can help relieve PCOS symptoms by lowering the level of testosterone, which causes hyperandrogenism, thereby normalizing the menstrual cycle and restoring normal ovarian morphology. Furthermore, isoflavone influences the improvement of the metabolic profile, which changes because of PCOS, as well as the reduction of inflammatory markers and oxidative stress. However, both significant and non-significant results have been generated on the activity of isoflavones in PCOS. The present review aims to discuss the existing literature on the effect of isoflavone on PCOS symptoms based on in vivo and clinical trial studies.
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Affiliation(s)
- Cut Raihanah
- Department of Pharmaceutical Biology, School of Pharmacy, Bandung Institute of Technology, Bandung 40132, Indonesia
| | - Sukrasno Sukrasno
- Department of Pharmaceutical Biology, School of Pharmacy, Bandung Institute of Technology, Bandung 40132, Indonesia
| | - Neng Fisheri Kurniati
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Bandung Institute of Technology, Bandung 40132, Indonesia
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2
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Amirkhizi F, Taghizadeh M, Khalese-Ranjbar B, Hamedi-Shahraki S, Asghari S. Association of Serum Selenium and Selenoprotein P with Oxidative Stress Biomarkers in Patients with Polycystic Ovary Syndrome. Biol Trace Elem Res 2024; 202:947-954. [PMID: 37391553 DOI: 10.1007/s12011-023-03747-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/24/2023] [Indexed: 07/02/2023]
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age which is characterized by various reproductive and metabolic disorders. Oxidative stress (OS) is now recognized to be involved in the pathogenesis of PCOS which could be targeted in the management of PCOS-related complications. Selenium (Se), as an antioxidant trace element, has been shown to decrease in PCOS patients. This study aimed to investigate the relationship between the Se and selenoprotein P (SELENOP) levels with OS markers in women with PCOS. In this cross-sectional study, 125 females aged 18-45 years diagnosed with PCOS were included. Demographic, clinical, and lifestyle information of participants were obtained using the relevant questionnaires. Fasting blood samples were collected to measure biochemical parameters. Serum levels of thiobarbituric acid reactive substances (TBARS), total antioxidant capacity (TAC), erythrocyte superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase activities as well as anthropometric measurements were assessed across tertiles of serum concentrations of Se and SELENOP. Higher serum levels of Se were associated with higher serum TAC levels (β=0.42, P<0.001) and erythrocytes GPx activity (β=0.28, P=0.002) as well as with lower serum TBARS levels (β= -0.26, P=0.003). Similarly, higher serum levels of SELENOP were associated with higher TAC (β=0.32, P<0.001) and erythrocyte GPx activity (β=0.30, P=0.001). SELENOP also showed an inverse association with serum levels of TBARS (β= -0.40, P<0.001). Nevertheless, erythrocytes SOD and CAT activities showed no significant relationships with serum Se and SELENOP concentrations (all P>0.05). The present study found that serum Se and SELENOP levels were inversely associated with TBARS levels and positively associated with TAC levels and erythrocytes GPx activity.
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Affiliation(s)
- Farshad Amirkhizi
- Department of Nutrition, Faculty of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Mahdiyeh Taghizadeh
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Banafshe Khalese-Ranjbar
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Soudabeh Hamedi-Shahraki
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Somayyeh Asghari
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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3
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Bhattacharya K, Dey R, Sen D, Paul N, Basak AK, Purkait MP, Shukla N, Chaudhuri GR, Bhattacharya A, Maiti R, Adhikary K, Chatterjee P, Karak P, Syamal AK. Polycystic ovary syndrome and its management: In view of oxidative stress. Biomol Concepts 2024; 15:bmc-2022-0038. [PMID: 38242137 DOI: 10.1515/bmc-2022-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/11/2023] [Indexed: 01/21/2024] Open
Abstract
In the past two decades, oxidative stress (OS) has drawn a lot of interest due to the revelation that individuals with many persistent disorders including diabetes, polycystic ovarian syndrome (PCOS), cardiovascular, and other disorders often have aberrant oxidation statuses. OS has a close interplay with PCOS features such as insulin resistance, hyperandrogenism, and chronic inflammation; there is a belief that OS might contribute to the development of PCOS. PCOS is currently recognized as not only one of the most prevalent endocrine disorders but also a significant contributor to female infertility, affecting a considerable proportion of women globally. Therefore, the understanding of the relationship between OS and PCOS is crucial to the development of therapeutic and preventive strategies for PCOS. Moreover, the mechanistic study of intracellular reactive oxygen species/ reactive nitrogen species formation and its possible interaction with women's reproductive health is required, which includes complex enzymatic and non-enzymatic antioxidant systems. Apart from that, our current review includes possible regulation of the pathogenesis of OS. A change in lifestyle, including physical activity, various supplements that boost antioxidant levels, particularly vitamins, and the usage of medicinal herbs, is thought to be the best way to combat this occurrence of OS and improve the pathophysiologic conditions associated with PCOS.
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Affiliation(s)
- Koushik Bhattacharya
- School of Paramedics and Allied Health Sciences, Centurion University of Technology and Management, Khurda Road, Bhubaneswar, Odisha, India
| | - Rajen Dey
- Department of Medical Laboratory Technology, Swami Vivekananda University, Barrackpore, West Bengal, India
| | - Debanjana Sen
- Post-Graduate Department of Physiology, Hooghly Mohsin College, Chinsurah, West-Bengal, India
| | - Nimisha Paul
- Department of General Human Physiology and Biochemistry, Hitkarini Dental College and Hospital, Jabalpur, Madhya Pradesh, India
| | - Asim Kumar Basak
- School of Allied Health Sciences, Brainware University, Barasat, West-Bengal, India
| | | | - Nandini Shukla
- Department of Anatomy, Pt. J.N.M. Medical College, Raipur, Chhattisgarh, India
| | - Gargi Ray Chaudhuri
- Department of Physiotherapy, Nopany Institute of Health Care Studies, Kolkata, West-Bengal, India
| | - Aniruddha Bhattacharya
- Department of Physiology, International Medical School, Management and Science University, Selangor, Malaysia
| | - Rajkumar Maiti
- Department of Physiology, Bankura Christian College, Bankura, West Bengal, India
| | - Krishnendu Adhikary
- Department of Interdisciplinary Science, Centurion University of Technology and Management, Khurda Road, Bhubaneswar, Odisha, India
| | - Prity Chatterjee
- Department of Biotechnology, Paramedical College, Durgapur, West Bengal, India
| | - Prithviraj Karak
- Department of Physiology, Bankura Christian College, Bankura, West Bengal, India
| | - Alak Kumar Syamal
- Post-Graduate Department of Physiology, Hooghly Mohsin College, Chinsurah, West-Bengal, India
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4
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Awonuga AO, Camp OG, Abu-Soud HM. A review of nitric oxide and oxidative stress in typical ovulatory women and in the pathogenesis of ovulatory dysfunction in PCOS. Reprod Biol Endocrinol 2023; 21:111. [PMID: 37996893 PMCID: PMC10666387 DOI: 10.1186/s12958-023-01159-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/05/2023] [Indexed: 11/25/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a heterogeneous functional endocrine disorder associated with a low-grade, chronic inflammatory state. Patients with PCOS present an increased risk of metabolic comorbidities and often menstrual dysregulation and infertility due to anovulation and/or poor oocyte quality. Multiple mechanisms including oxidative stress and low-grade inflammation are believed to be responsible for oocyte deterioration; however, the influence of nitric oxide (NO) insufficiency in oocyte quality and ovulatory dysfunction in PCOS is still a matter for debate. Higher production of superoxide (O2•-) mediated DNA damage and impaired antioxidant defense have been implicated as contributory factors for the development of PCOS, with reported alteration in superoxide dismutase (SOD) function, an imbalanced zinc/copper ratio, and increased catalase activity. These events may result in decreased hydrogen peroxide (H2O2) accumulation with increased lipid peroxidation events. A decrease in NO, potentially due to increased activity of NO synthase (NOS) inhibitors such as asymmetric dimethylarginine (ADMA), and imbalance in the distribution of reactive oxygen species (ROS), such as decreased H2O2 and increased O2•-, may offset the physiological processes surrounding follicular development, oocyte maturation, and ovulation contributing to the reproductive dysfunction in patients with PCOS. Thus, this proposal aims to evaluate the specific roles of NO, oxidative stress, ROS, and enzymatic and nonenzymatic elements in the pathogenesis of PCOS ovarian dysfunction, including oligo- anovulation and oocyte quality, with the intent to inspire better application of therapeutic options. The authors believe more consideration into the specific roles of oxidative stress, ROS, and enzymatic and nonenzymatic elements may allow for a more thorough understanding of PCOS. Future efforts elaborating on the role of NO in the preoptic nucleus to determine its influence on GnRH firing and follicle-stimulating hormone/Luteinizing hormone (FSH/LH) production with ovulation would be of benefit in PCOS. Consequently, treatment with an ADMA inhibitor or NO donor may prove beneficial to PCOS patients experiencing reproductive dysfunction and infertility.
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Affiliation(s)
- Awoniyi O Awonuga
- Departments of Obstetrics and Gynecology and Biochemistry and Molecular Biology, The C.S. Mott Center for Human Growth and Development, Wayne State University School of Medicine, 275 E. Hancock Detroit, Detroit, MI, 48201, USA.
| | - Olivia G Camp
- Departments of Obstetrics and Gynecology and Biochemistry and Molecular Biology, The C.S. Mott Center for Human Growth and Development, Wayne State University School of Medicine, 275 E. Hancock Detroit, Detroit, MI, 48201, USA
| | - Husam M Abu-Soud
- Departments of Obstetrics and Gynecology and Biochemistry and Molecular Biology, The C.S. Mott Center for Human Growth and Development, Wayne State University School of Medicine, 275 E. Hancock Detroit, Detroit, MI, 48201, USA
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI, 48201, USA
- Department of Microbiology, Immunology and Biochemistry, Wayne State University School of Medicine, Detroit, MI, 48201, USA
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5
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Zeber-Lubecka N, Ciebiera M, Hennig EE. Polycystic Ovary Syndrome and Oxidative Stress-From Bench to Bedside. Int J Mol Sci 2023; 24:14126. [PMID: 37762427 PMCID: PMC10531631 DOI: 10.3390/ijms241814126] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/06/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Oxidative stress (OS) is a condition that occurs as a result of an imbalance between the production of reactive oxygen species (ROS) and the body's ability to detoxify and neutralize them. It can play a role in a variety of reproductive system conditions, including polycystic ovary syndrome (PCOS), endometriosis, preeclampsia, and infertility. In this review, we briefly discuss the links between oxidative stress and PCOS. Mitochondrial mutations may lead to impaired oxidative phosphorylation (OXPHOS), decreased adenosine triphosphate (ATP) production, and an increased production of ROS. These functional consequences may contribute to the metabolic and hormonal dysregulation observed in PCOS. Studies have shown that OS negatively affects ovarian follicles and disrupts normal follicular development and maturation. Excessive ROS may damage oocytes and granulosa cells within the follicles, impairing their quality and compromising fertility. Impaired OXPHOS and mitochondrial dysfunction may contribute to insulin resistance (IR) by disrupting insulin signaling pathways and impairing glucose metabolism. Due to dysfunctional OXPHOS, reduced ATP production, may hinder insulin-stimulated glucose uptake, leading to IR. Hyperandrogenism promotes inflammation and IR, both of which can increase the production of ROS and lead to OS. A detrimental feedback loop ensues as IR escalates, causing elevated insulin levels that exacerbate OS. Exploring the relations between OS and PCOS is crucial to fully understand the role of OS in the pathophysiology of PCOS and to develop effective treatment strategies to improve the quality of life of women affected by this condition. The role of antioxidants as potential therapies is also discussed.
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Affiliation(s)
- Natalia Zeber-Lubecka
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland;
- Department of Genetics, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Michał Ciebiera
- Second Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland;
- Warsaw Institute of Women’s Health, 00-189 Warsaw, Poland
| | - Ewa E. Hennig
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland;
- Department of Genetics, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
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6
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Parker J. Pathophysiological Effects of Contemporary Lifestyle on Evolutionary-Conserved Survival Mechanisms in Polycystic Ovary Syndrome. Life (Basel) 2023; 13:life13041056. [PMID: 37109585 PMCID: PMC10145572 DOI: 10.3390/life13041056] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/15/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is increasingly being characterized as an evolutionary mismatch disorder that presents with a complex mixture of metabolic and endocrine symptoms. The Evolutionary Model proposes that PCOS arises from a collection of inherited polymorphisms that have been consistently demonstrated in a variety of ethnic groups and races. In utero developmental programming of susceptible genomic variants are thought to predispose the offspring to develop PCOS. Postnatal exposure to lifestyle and environmental risk factors results in epigenetic activation of developmentally programmed genes and disturbance of the hallmarks of health. The resulting pathophysiological changes represent the consequences of poor-quality diet, sedentary behaviour, endocrine disrupting chemicals, stress, circadian disruption, and other lifestyle factors. Emerging evidence suggests that lifestyle-induced gastrointestinal dysbiosis plays a central role in the pathogenesis of PCOS. Lifestyle and environmental exposures initiate changes that result in disturbance of the gastrointestinal microbiome (dysbiosis), immune dysregulation (chronic inflammation), altered metabolism (insulin resistance), endocrine and reproductive imbalance (hyperandrogenism), and central nervous system dysfunction (neuroendocrine and autonomic nervous system). PCOS can be a progressive metabolic condition that leads to obesity, gestational diabetes, type two diabetes, metabolic-associated fatty liver disease, metabolic syndrome, cardiovascular disease, and cancer. This review explores the mechanisms that underpin the evolutionary mismatch between ancient survival pathways and contemporary lifestyle factors involved in the pathogenesis and pathophysiology of PCOS.
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Affiliation(s)
- Jim Parker
- School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia
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Rahmatnezhad L, Moghaddam-Banaem L, Behrouzi Lak T, Shiva A, Rasuli J. Free androgen index (FAI)'s relations with oxidative stress and insulin resistance in polycystic ovary syndrome. Sci Rep 2023; 13:5118. [PMID: 36991023 PMCID: PMC10060256 DOI: 10.1038/s41598-023-31406-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/11/2023] [Indexed: 03/31/2023] Open
Abstract
This study aimed to determine the levels of the free androgen index (FAI) and its association with oxidative stress and insulin resistance (IR) in patients with polycystic ovary syndrome (PCOS). This cross-sectional study was performed on 160 women aged 18-45 years, visiting gynecology clinics of Urmia in northwestern Iran during 2020-2021 who were diagnosed with PCOS and exhibited one of the four phenotypes of PCOS. All the participants underwent clinical examinations, paraclinical tests, and ultrasounds. FAI cut-off point was considered to be 5%. The significance level was set at < 0.05. Among the 160 participants, the prevalence of the four phenotypes was as follows: phenotype A: 51.9%, phenotype B: 23.1%, phenotype C: 13.1%, and phenotype D: 11.9%. High FAI was detected in 30 participants (18.75%). Additionally, It was found that phenotype C had the highest FAI levels among the PCOS phenotypes, with a significant difference between phenotypes A and C (p value = 0.03). IR was observed in 119 (74.4%) of the participants, and the median (interquartile range: IQR) of malondialdehyde (MDA) levels among the participants was 0.64 (0.86) μM/L. In linear regression, the PCOS phenotype (standard beta = 0.198, p-value = 0.008), follicle-stimulating hormone (FSH) levels (standard beta = 0.213, p-value = 0.004), and MDA levels (standard beta = 0.266, p-value < 0.001) were significantly related to the FAI level, but the homeostatic model assessment for insulin resistance (HOMA-IR) was not statistically associated with FAI. Thus, in this study, PCOS phenotypes and MDA levels (an indicator of stress oxidative) were significantly related to FAI, but HOMA-IR (the indicator of IR) was not associated with it.
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Affiliation(s)
- Leili Rahmatnezhad
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Lida Moghaddam-Banaem
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | | | - Afshin Shiva
- Experimental and Applied Pharmaceutical Sciences Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Javad Rasuli
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
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Abedi H, Zarrin-Mehr A, Ebrahimi B, Haghshenas H, Parvin N, Kargar Jahromi H. The effect of aqueous extract of orchid root on the structure of ovary and hypothalamic-pituitary-gonadal hormones in polycystic ovary syndrome rat model: An experimental study. Int J Reprod Biomed 2023; 22:203-210. [PMID: 38868447 PMCID: PMC11165220 DOI: 10.18502/ijrm.v22i3.16164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/25/2023] [Accepted: 02/19/2024] [Indexed: 06/14/2024] Open
Abstract
Background Some medical conditions, including polycystic ovarian syndrome (PCOs), may lead to infertility. In PCOs, hormonal imbalance is significant. Antioxidants such as natural antioxidants have many health benefits, including positive effects on hormone production. Objective Since herbal medicines are more acceptable to people, the present study was designed to evaluate the effect of an aqueous extract of orchid (SA), with antioxidative effects, on the structure of the ovary and the hypothalamic-pituitary-gonadal axis hormones and free testosterone in PCOs rats. Materials and Methods In this experimental study, 64 healthy female Wistar rats (180-200 gr) were randomly divided into 60 and 89 day control groups, PCOs, and 4 PCOs + SA groups that received 40, 80, 160, and 320 mg/kg of SA. Serum levels of gonadotropin-releasing hormone, estrogen, progesterone, testosterone, follicle-stimulating hormone, and luteinizing hormone were measured. In addition, the ovaries were extracted and examined histologically. Results The amount of primordial, primary, secondary, and Graafian follicles and serum levels of follicle-stimulating hormone and progesterone hormones decreased in PCOs groups, while atretic follicles and the serum levels of gonadotropin-releasing hormone, luteinizing hormone, estrogen, and free testosterone were increased. SA at different doses regulated hormonal and histological imbalances caused by PCOs, and 320 mg/kg was the most effective. Conclusion The aqueous extract of orchids root can have a positive effect on the improvement of polycystic ovary syndrome. This effect can be achieved by regulating the level of sex hormones and correcting follicular abnormalities in the ovarian tissue.
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Affiliation(s)
- Hassanali Abedi
- Research Center for Noncommunicable Disease, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Armin Zarrin-Mehr
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Bahareh Ebrahimi
- Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hoda Haghshenas
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Negar Parvin
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Hossein Kargar Jahromi
- Research Center for Noncommunicable Disease, Jahrom University of Medical Sciences, Jahrom, Iran
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Rudnicka E, Duszewska AM, Kucharski M, Tyczyński P, Smolarczyk R. OXIDATIVE STRESS AND REPRODUCTIVE FUNCTION: Oxidative stress in polycystic ovary syndrome. Reproduction 2022; 164:F145-F154. [PMID: 36279177 DOI: 10.1530/rep-22-0152] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
In brief A genetic, epigenetic, and environmental association exists between oxidative stress (OS) and polycystic ovary syndrome (PCOS), expressed in a multifaceted clinical profile. This review summarizes and discusses the role of OS in the pathogenesis of PCOS syndrome, focusing on metabolic, reproductive, and cancer complications. Abstract Oxidative stress (OS), an imbalance between oxidants and antioxidants in cells, is one of many factors playing essential roles in the pathogenesis of polycystic ovary syndrome (PCOS). PCOS is described mainly as a disproportion of reproductive hormones, leading to chronic anovulation and infertility in women. Interestingly, OS in PCOS may be associated with many disorders and diseases. This review focuses on characteristic markers of OS in PCOS and the relationship between OS and PCOS related to insulin resistance (IR), hyperandrogenemia, obesity, chronic inflammation, cardiovascular diseases, and cancer. Interestingly, in patients with PCOS, an increase in oxidative status and insufficient compensation of the increase in antioxidant status before any cardiovascular complications are observed. Moreover, free radicals promote carcinogenesis in PCOS patients. However, despite these data, it has not been established whether oxygen stress influences PCOS development or a secondary disorder resulting from hyperglycemia, IR, and cardiovascular and cancer complications in women.
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Affiliation(s)
- Ewa Rudnicka
- Department of Gynaecological Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Anna Maria Duszewska
- Department of Morphological Sciences, Faculty of Veterinary Medicine, Warsaw, University of Life Science, Warsaw, Poland
| | - Marek Kucharski
- Department of Gynaecological Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Tyczyński
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland
| | - Roman Smolarczyk
- Department of Gynaecological Endocrinology, Medical University of Warsaw, Warsaw, Poland
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Nawrocka-Rutkowska J, Szydłowska I, Jakubowska K, Olszewska M, Chlubek D, Szczuko M, Starczewski A. The Role of Oxidative Stress in the Risk of Cardiovascular Disease and Identification of Risk Factors Using AIP and Castelli Atherogenicity Indicators in Patients with PCOS. Biomedicines 2022; 10:biomedicines10071700. [PMID: 35885005 PMCID: PMC9312468 DOI: 10.3390/biomedicines10071700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/02/2022] [Accepted: 07/12/2022] [Indexed: 01/11/2023] Open
Abstract
Polycystic ovarian syndrome (PCOS) is one of the most common endocrinopathies in females of reproductive age and may affect 5-14% of women. In women with PCO syndrome, metabolic disorders such as insulin resistance, hyperinsulinemia, obesity, diabetes mellitus, and other elements of metabolic syndrome may occur. Patients with PCOS often have overweight and obesity, especially abdominal obesity, which is one of the risk factors for developing atherosclerosis. The atherogenicity indicators of AIP (atherogenic index of plasma) and Castelli's index are used to assess the risk of developing atherosclerosis. Studies have shown an increase in the concentration and activity of oxidative stress markers in patients with PCOS compared to women without the disease. The aim of the present study was to evaluate oxidative stress parameters in patients with PCOS in relation to insulin resistance, BMI, and hyperandrogenemia and to correlate them with cardiovascular risk parameters. Conclusions: The severity of oxidative stress in women with PCOS correlates with exposure to cardiovascular diseases. The assessment of additional cardiovascular disease (CVD) parameters is useful in identifying the risk groups for cardiometabolic disease among PCOS patients. When additional risk factors such as hyperandrogenism and insulin resistance (IR) are present in patients with PCOS, it is reasonable to include preventive examinations early. It is also important to evaluate lipidograms, which will make it possible to determine indicators of atherogenicity. Patients with PCOS and IR are at particular risk for cardiovascular complications. PCOS should be considered an important risk factor for CVD, which occurs independently of the occurrence of obesity. This factor is related to the important role of insulin resistance, which occurs independently of obesity. Atherogenic factors (AIP and Castelli index) are useful additional parameters to assess the risk of cardiometabolic disease in PCOS patients, especially among groups with insulin resistance. The early detection of risk factors should be an integral part of the care of PCOS patients. In laboratory studies of women with PCOS, TG, TChol, HDL-c and LDL-c levels, and glutathione peroxidase (GPx) activity were most clearly correlated with exposure to cardiovascular disease.
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Affiliation(s)
- Jolanta Nawrocka-Rutkowska
- Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University, Unii Lubelskiej Street 1, 71-252 Szczecin, Poland; (I.S.); (A.S.)
- Correspondence: ; Tel.: +48-914250541
| | - Iwona Szydłowska
- Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University, Unii Lubelskiej Street 1, 71-252 Szczecin, Poland; (I.S.); (A.S.)
| | - Katarzyna Jakubowska
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wielkopolskich Street 72, 70-111 Szczecin, Poland; (K.J.); (M.O.); (D.C.)
| | - Maria Olszewska
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wielkopolskich Street 72, 70-111 Szczecin, Poland; (K.J.); (M.O.); (D.C.)
| | - Dariusz Chlubek
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wielkopolskich Street 72, 70-111 Szczecin, Poland; (K.J.); (M.O.); (D.C.)
| | - Małgorzata Szczuko
- Department of Human Nutrition and Metabolomic, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland;
| | - Andrzej Starczewski
- Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University, Unii Lubelskiej Street 1, 71-252 Szczecin, Poland; (I.S.); (A.S.)
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11
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Antioxidative Effects of Standardized Aronia melanocarpa Extract on Reproductive and Metabolic Disturbances in a Rat Model of Polycystic Ovary Syndrome. Antioxidants (Basel) 2022; 11:antiox11061099. [PMID: 35739998 PMCID: PMC9220112 DOI: 10.3390/antiox11061099] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 02/04/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) represents the most common endocrinopathy among childbearing-age women, with oxidative stress (OS) underlying its etiopathogenesis. Metformin (MET) represents a frequently used agent in PCOS. However, weak results encourage alternative treatments. We aimed to investigate isolated and synergistic effects of Standardized Aronia melanocarpa extract (SEA) and MET for alleviating reproductive and metabolic PCOS abnormalities. PCOS induction was followed by 28-day treatment with MET, SAE, or MET + SEA. Bodyweight (BW), cyclicity, histological, and ultrasonographical ovarian analyses were performed. Hormonal, glycemic, and lipid profiles were accessed, as well as systemic and ovarian oxidative status; BW, cyclicity, ovarian histomorphology, ovarian volume, testosterone and progesterone levels, as well as LDL, triglycerides, and total cholesterol levels were aggravated after PCOS-induction and improved after MET, SEA, and MET + SEA treatment. MET + SEA had the greatest impact on glycoregulation. Alterations in OS parameters (TBARS, O2−, H2O2, catalase, superoxide dismutase, and reduced glutathione) could be responsible for observed differences; (4) Conclusions: Our findings confirmed that SAE alone or along with MET was capable of ameliorating reproductive and metabolic disturbances in the PCOS rat model, with the restoration of OS parameters. SAE alone did not alter the protective effects of MET in PCOS.
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12
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Rhamnocitrin Attenuates Ovarian Fibrosis in Rats with Letrozole-Induced Experimental Polycystic Ovary Syndrome. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:5558599. [PMID: 35663203 PMCID: PMC9162838 DOI: 10.1155/2022/5558599] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/04/2022] [Accepted: 04/23/2022] [Indexed: 12/12/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine-related cause of infertility in women and has an unknown etiology. Studies have shown that rhamnocitrin (Rha) exhibits positive effects on the reproductive system. This study investigated Rha's antifibrotic effects on PCOS rats and revealed its underlying mechanisms. Female SD rats were randomized into 4 groups (n = 8, each); the control group received tea oil by intraperitoneal injection and 1% w/v CMC by oral gavage; the PCOS group received letrozole (1 mg/kg); the PCOS+Rha group received letrozole and Rha (5 mg/kg); the PCOS+Met group received letrozole and Met (265 mg/kg) for 21 days. At the study end, Rha treatment restored letrozole-induced alterations in the relative ovarian weights, body weight, and relative weights of uterine and visceral adipose tissues. Histological observation showed that Rha ameliorates ovarian structure and fibrosis in PCOS. Administration of Rha reduced letrozole-induced metabolic dysfunction by ameliorating the levels of TC, TG, and HDL-C in the PCOS rats. Rha treatment also modulated the serum levels of sex hormones, which decreased T, E2, and LH and increased FSH in PCOS rats. In addition, Rha treatment modulated insulin resistance and increased gene expression of antioxidant enzymes (Cat, Sod2, Gpx3, Mgst1, Prdx3, Gsta4, Gsr, and Sod1) in the ovaries of the PCOS rats. Finally, Rha treatment appeared to increase the activity of PPAR-γ and inhibit the TGF-β1/Smad pathway in the ovaries of the PCOS rats. Our findings suggest that Rha significantly ameliorated metabolic disturbances and ovarian fibrosis in the PCOS rats. Rha perhaps is an effective compound for preventing ovarian fibrosis in the future.
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13
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Bizoń A, Tchórz A, Madej P, Leśniewski M, Wójtowicz M, Piwowar A, Franik G. The Activity of Superoxide Dismutase, Its Relationship with the Concentration of Zinc and Copper and the Prevalence of rs2070424 Superoxide Dismutase Gene in Women with Polycystic Ovary Syndrome—Preliminary Study. J Clin Med 2022; 11:jcm11092548. [PMID: 35566673 PMCID: PMC9102417 DOI: 10.3390/jcm11092548] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 02/01/2023] Open
Abstract
Superoxide dismutase (SOD) is a crucial antioxidant enzyme involved in the antioxidant pathway during both normal cellular metabolism and different pathologic processes. We investigated the activity of the copper (Cu)-zinc (Zn) SOD1 as well as the level of Cu and Zn in the serum of women with polycystic ovary syndrome (PCOS) and control group. Moreover, the prevalence of rs2070424 gene polymorphism of the enzyme in the course of PCOS was evaluated. Significantly lower activity of SOD 1 and Cu, Zn concentration was found in the group of women with PCOS than without the syndrome. Insulin resistance in the group of women with PCOS caused a further SOD1 activity decrease, while Cu concentration and the value of Cu/Zn was increased when compared to women with normal insulin levels. Furthermore, we assessed for the first time the rs2070424 polymorphism of SOD1 in the women with PCOS, and in these patients we detected dominant variant AA (93.3%). Due to a small number of other genotypes, it is difficult to state if lower SOD1 activity was strictly associated with the AA variant or if other factors play a crucial role, but this should be taken into account.
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Affiliation(s)
- Anna Bizoń
- Department of Toxicology/Department of Biomedical and Environmental Analyses, Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wrocław, Poland
- Correspondence: ; Tel.: +48-71-7840455
| | - Agata Tchórz
- Students Scientific Society at the Department of Biomedical and Environmental Analyses, Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wrocław, Poland;
| | - Paweł Madej
- Department of Endocrinological Gynecology, Medical University of Silesia, 40-752 Katowice, Poland; (P.M.); (G.F.)
| | - Marcin Leśniewski
- Department of Gynaecological and Obstetrics, District Hospital, 43-200 Pszczyna, Poland;
| | - Mariusz Wójtowicz
- Women’s and Child Health Center, City Hospital, 41-803 Zabrze, Poland;
| | - Agnieszka Piwowar
- Department of Toxicology, Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wrocław, Poland;
| | - Grzegorz Franik
- Department of Endocrinological Gynecology, Medical University of Silesia, 40-752 Katowice, Poland; (P.M.); (G.F.)
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14
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Talat A, Satyanarayana P, Anand P. Association of Superoxide Dismutase Level in Women with Polycystic Ovary Syndrome. J Obstet Gynaecol India 2022; 72:6-12. [PMID: 35125733 PMCID: PMC8804132 DOI: 10.1007/s13224-021-01430-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 01/11/2021] [Indexed: 02/03/2023] Open
Abstract
Several biomarkers involved in oxidative stress may influence polycystic ovary syndrome (PCOS). Superoxide dismutase (SOD) has been commonly identified as dismutase enzyme catalyzes the conversion of superoxide to hydrogen peroxide and elemental oxygen, and could serve as an important biomarker in this direction. The objective of the present study to determine the precise role of SOD levels in women with PCOS using a meta-analysis approach. The electronic databases like PubMed, Google Scholar, Web of Sciences, Clinical trial.gov, Cochrane Database of Systematic Review were searched for obtaining relevant studies on the association of SOD level in women with PCOS. Pooled standardized mean difference with 95% CI was computed using the DerSimonian and Liard method. A total of 267 articles were screened, out of which 12 articles fulfilled the inclusion criteria of the present meta-analysis involving 558 cases and 529 controls. Analysis including overall studies observed a higher SOD level (statistically non-significant) in women with PCOS compared to controls (SMD 0.35, 95% Cl -0.91 to 1.62, P = 0.58), however, statistically significant higher SOD levels were noted in studies using serum as a source of sample (SMD 1.53, 95% CI 0.25 to 2.81, P = 0.019). In conclusion, women with PCOS exhibited increased SOD levels compared to controls suggesting that the byproduct of oxidative damage is expected to be increased in women with PCOS.
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Affiliation(s)
- Arshi Talat
- Department of Medical Biochemistry, Rama Medical College, Hospital & Research Center Mandhana, Kanpur, Uttar Pradesh India
| | - P. Satyanarayana
- Department of Biochemistry, RKDF Medical College behind Vrindavan Garden, Hoshangabad Road, Jatkhedi, Bhopal, MP 462026 India
| | - Pallavi Anand
- Department of Biochemistry, Faculty of Medical Sciences, Rama Medical College, Hospital & Research Center, Kanpur, Uttar Pradesh India
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15
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Assessment of the Parameters of Oxidative Stress Depending on the Metabolic and Anthropometric Status Indicators in Women with PCOS. Life (Basel) 2022; 12:life12020225. [PMID: 35207512 PMCID: PMC8875875 DOI: 10.3390/life12020225] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/23/2022] [Accepted: 01/29/2022] [Indexed: 11/17/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in females of reproductive age. In women with PCOS, metabolic disorders such as insulin resistance (IR), hyperinsulinemia, obesity, diabetes mellitus, and other elements of metabolic syndrome are likely to occur. Studies have shown an increase in the concentration and activity of oxidative stress (OS) markers in patients with PCOS, compared to that in unaffected women. The aim of this study was to evaluate the parameters of OS in PCOS and their activity in relation to women without menstrual disorders with a normal body weight. Then, we compared malonodialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx), including overweight and obesity, hyperandrogenemia, and IR in the PCOS group. The study included 35 women aged 18–46, hospitalized for menstrual disorders in the form of infrequent menstruation. In 26 women, PCOS was diagnosed on the basis of the Rotterdam Criteria; these patients qualified for the study group. The control group (n = 21) consisted of patients without menstrual disorders and without PCOS in an ultrasound examination. Patients were diagnosed between the 2nd and 5th day of the cycle. The parameters of OS were analyzed and compared with the anthropometric parameters and the lipid profile of the patients. Enzymatic activity of GPx, CAT, SOD, and MDA levels was determined in both groups. MDA levels and CAT activity differed significantly between the groups. There was a decrease in MDA levels in the IR group and the involvement of GPx in the excess weight and obesity and IR group accompanied by an increase in hip circumference. It therefore seems that IR may be the main risk factor to exposure to OS in patients with PCOS, independent from obesity. In addition, GPx is involved in every step in the development of the pathological condition in PCOS.
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16
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Wang D, He B. Current Perspectives on Nonalcoholic Fatty Liver Disease in Women with Polycystic Ovary Syndrome. Diabetes Metab Syndr Obes 2022; 15:1281-1291. [PMID: 35494531 PMCID: PMC9048954 DOI: 10.2147/dmso.s362424] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/31/2022] [Indexed: 12/29/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common reproductive, endocrine, and metabolic disorders in premenopausal women. Clinically, PCOS is mainly caused by androgen excess and ovarian dysfunction, manifested by anovulatory menstrual cycles, infertility, and hirsutism. In addition, PCOS increases the risk of insulin resistance, obesity, cardiovascular disease, anxiety and depression, dyslipidemia, and endometrial cancer. Nonalcoholic fatty liver disease (NAFLD) is defined as ≥5% fat accumulation in the liver in the absence of remaining secondary causes and has become one of the most common chronic liver diseases worldwide. The prevalence of NAFLD is significantly higher and more severe in women with PCOS, and its pathogenesis can be associated with various risk factors such as hyperandrogenemia, insulin resistance, obesity, chronic low-grade inflammation, and genetic factors. Although there is no definitive solution for the management of NAFLD in PCOS, some progress has been made. Lifestyle modification should be the basis of management, and drugs to improve metabolism, such as insulin sensitizers and glucagon-like peptide-1 agonists, may show better efficacy. Bariatric surgery may also be a treatment of NAFLD in obese women with PCOS. This paper reviews three aspects of prevalence, risk factors, and management, in order to better understand the current state of research on NAFLD in PCOS, to explore the pathogenesis of NAFLD in PCOS, and to encourage further research on the application of drugs in this field.
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Affiliation(s)
- Dongxu Wang
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of China
| | - Bing He
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of China
- Correspondence: Bing He, Department of Endocrinology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, 110004, People’s Republic of China, Tel/Fax +86-24-96615-23111, Email
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17
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Shoaibinobarian N, Eslamian G, Noormohammadi M, Malek S, Rouhani S, Mirmohammadali SN. Dietary Total Antioxidant Capacity and Risk of Polycystic Ovary Syndrome: A Case-Control Study. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2022; 16:200-205. [PMID: 36029057 PMCID: PMC9396001 DOI: 10.22074/ijfs.2021.526579.1107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Indexed: 11/30/2022]
Abstract
Among multiple factors that affect the etiology of polycystic ovary syndrome (PCOS), diet has<br />an important contribution. Chronic oxidative stress has also been implicated in the development of PCOS. The<br />present study is an attempt to evaluate dietary total antioxidant capacity (TAC) and its relationship with odds of<br />PCOS in Iran.<br />Materials and Methods: The study was carried out as a case-control study in hospital outpatient clinics, Tehran,<br />Iran. Totally, 310 female participants with a history of PCOS and 602 age-matched controls took part in this<br />study between June 2015 and December 2018. A reproducible and valid 168-item semi-quantitative food frequency<br />inventory was utilized to determine the entire antioxidants of the usual diet in order to calculate dietary<br />TAC. The relationship of dietary TAC with odds of PCOS were assessed adjusting for potential confounders<br />through an estimation of two multivariable conditional regression models. The first tertile was presented as a<br />reference category.<br />Results: In a fully adjusted model, the highest tertile of dietary TAC was associated with a reduced odds of<br />PCOS [odds ratio (OR): 0.81, 95% confidence interval (95% CI): 0.59, 0.96, P for trend: 0.038). In addition, PCOS odds decreased in the highest tertile of α-tocopherol intake (OR: 0.73, 95% CI: 0.56, 0.88, P for trend:<br />0.023). The adjusted ORs in the highest tertile of vitamin C, β-carotene and magnesium were 0.79 (95% CI: 0.83-0.97), 0.81 (95% CI: 0.67-0.98) and 0.91 (95% CI: 0.55-0.9 8) respectively, with a significant trend.<br />Conclusion: Our results provide evidence that there was a relationship between high TAC diets and lower odds of<br />PCOS.
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Affiliation(s)
- Nargeskhatoon Shoaibinobarian
- Department of Nutrition, School of Medical Sciences and Technologies, Islamic Azad University, Science and Research Branch,
Tehran, Iran
| | - Ghazaleh Eslamian
- Department of Cellular and Molecular Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology
Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran,P.O.Box: 19395-4741Department of Cellular and
Molecular NutritionFaculty of Nutrition and Food TechnologyNational Nutrition and Food Technology Research InstituteShahid Beheshti University
of Medical SciencesTehranIran
| | - Morvarid Noormohammadi
- Student Research Committee, Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Shirin Malek
- Department of Nutrition and Food Science, California State University, Chico, CA 95929, USA
| | - Shayesteh Rouhani
- Department of Nutrition, School of Medical Sciences and Technologies, Islamic Azad University, Science and Research Branch,
Tehran, Iran
| | - Seyedeh Nooshan Mirmohammadali
- Department of Nutrition, School of Medical Sciences and Technologies, Islamic Azad University, Science and Research Branch,
Tehran, Iran
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18
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Uçkan K, Demir H, Turan K, Sarıkaya E, Demir C. Role of Oxidative Stress in Obese and Nonobese PCOS Patients. Int J Clin Pract 2022; 2022:4579831. [PMID: 35685525 PMCID: PMC9159123 DOI: 10.1155/2022/4579831] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/15/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the relationship between the oxidant-antioxidant status, endothelial dysfunction, lipid metabolism, and metabolic syndrome risk in women with polycystic ovary syndrome (PCOS). MATERIALS AND METHODS Forty-five obese (BMI >30 kg/m2) woman diagnosed with PCOS in the study, forty-five nonobese (BMI <30 kg/m2) PCOS diagnosis working groups, and forty-nine healthy control groups were created with patients. Serum malondialdehyde (MDA) levels with antioxidant activities, such as SOD, GSH, GPx, and CAT activities, were measured by spectrophotometry. RESULTS There was a statistically significant difference in the mean serum MDA level in the obese PCOS group compared to the nonobese group and the control group (p < 0.001). When the antioxidant parameters, such as SOD, GPx, GSH, and CAT, were compared with the healthy control group, nonobese, and obese PCOS groups, the difference between the groups was statistically significant (p < 0.001). A positive correlation was observed between MDA and BMI, triglyceride, LDL, SBP, DBP, and HOMA-IR in the PCOS patient group. CONCLUSION Oxidative stress and decreased antioxidant parameters in PCOS patients were correlated with hyperinsulinemia, hypertension, and dyslipidemia findings, and we think that this oxidative stress condition may contribute to metabolic syndrome and cardiovascular diseases in PCOS patients.
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Affiliation(s)
- Kazım Uçkan
- Van Training and Research Hospital, Department of Obstetrics and Gynecology, Van, Turkey
| | - Halit Demir
- Van Yuzuncu Yil University, Department of Biochemistry, Van, Turkey
| | - Kasım Turan
- Clinic of Obstetrics and Gynecology Dr. KasımTuran, Van, Turkey
| | - Eren Sarıkaya
- Clinic of Obstetrics and Gynecology Dr. KasımTuran, Van, Turkey
| | - Canan Demir
- Van Yuzuncu Yil University, Vocational School of Health Services, Van, Turkey
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19
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Seth MK, Gulati S, Gulati S, Kumar A, Rawat D, Kumari A, Sehgal R, Zangmo R, Dixit V, Premlata, Gulati A. "Association of Leptin with Polycystic Ovary Syndrome: a Systematic Review and Meta-Analysis ". J Obstet Gynaecol India 2021; 71:567-576. [PMID: 34898893 DOI: 10.1007/s13224-021-01510-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/28/2021] [Indexed: 01/10/2023] Open
Abstract
Background Serum leptin has been considered as an important measurable diagnostic and prognostic biomarker for polycystic ovarian syndrome (PCOS), although its evidence for use in clinical practice is limited. We aim to synthesize the available evidence on the clinical use of serum leptin values in PCOS by doing a systematic review and meta-analysis of studies. Objective To conduct a meta-analysis to determine the pooled effect size of the association of leptin levels in patients with PCOS. Methods We searched electronic databases, i.e., PubMed, Google Scholar, Web of Science, ClinicalTrials.gov, and Medline from inception to September 2020, keeping filters for human studies and published in the English language. We used the random-effects model if heterogeneity between the studies was > 50%; otherwise, a fixed-effect model was applied to determine the standardized mean difference with 95% CI for comparison of leptin level between cases and controls. All the statistical analyses were completed using software STATA version 13. Results The meta-analysis included a total of 35 studies involving 2015 cases and 1767 controls that suggested statistically significantly higher leptin levels in the women with PCOS as compared to controls (SMD, 1.76, 95% CI 1.28 to 2.23, P < 0.001). In the stratified analysis when only high methodological quality studies were included, we did not observe a statistically significant difference in the leptin level between PCOS and controls (SMD 0.68, 95% CI -0.09 to 1.46). Analysis restricted to low methodological quality studies observed statistically significant high leptin levels in PCOS women as compared to controls (SMD 2.24, 95% CI 1.65 to 2.83). Conclusion The available evidence suggests that elevated leptin levels may be associated with risk of PCOS as compared to controls; however, failure to observe the similar association in high methodological quality studies demands further well-designed adequately powered studies to validate the findings.
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Affiliation(s)
- Mahesh Kumar Seth
- Clinical Epidemiology Unit, All India Institute of Medical Sciences, New Delhi, India.,Department of Orthopedics, J.J.M Medical College, Davanagere, Karnataka India
| | - Sarthak Gulati
- Clinical Epidemiology Unit, All India Institute of Medical Sciences, New Delhi, India.,Department of Orthopedics, J.J.M Medical College, Davanagere, Karnataka India
| | - Shreya Gulati
- Department of Orthopedics, J.J.M Medical College, Davanagere, Karnataka India.,Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Amit Kumar
- Department of Orthopedics, J.J.M Medical College, Davanagere, Karnataka India.,Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Dimple Rawat
- Clinical Epidemiology Unit, All India Institute of Medical Sciences, New Delhi, India.,Department of Orthopedics, J.J.M Medical College, Davanagere, Karnataka India
| | - Aradhana Kumari
- Clinical Epidemiology Unit, All India Institute of Medical Sciences, New Delhi, India.,Department of Orthopedics, J.J.M Medical College, Davanagere, Karnataka India
| | - Rohini Sehgal
- Department of Orthopedics, J.J.M Medical College, Davanagere, Karnataka India.,Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Rinchen Zangmo
- Department of Orthopedics, J.J.M Medical College, Davanagere, Karnataka India.,Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Dixit
- Department of Orthopedics, J.J.M Medical College, Davanagere, Karnataka India.,Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, India
| | - Premlata
- Clinical Epidemiology Unit, All India Institute of Medical Sciences, New Delhi, India.,Department of Orthopedics, J.J.M Medical College, Davanagere, Karnataka India
| | - Arti Gulati
- Clinical Epidemiology Unit, All India Institute of Medical Sciences, New Delhi, India.,Department of Orthopedics, J.J.M Medical College, Davanagere, Karnataka India
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20
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Alahmadi AA, Alahmadi BA, Wahman LF, El-Shitany NA. Chamomile flower extract ameliorates biochemical and histological kidney dysfunction associated with polycystic ovary syndrome. Saudi J Biol Sci 2021; 28:6158-6166. [PMID: 34764746 PMCID: PMC8568996 DOI: 10.1016/j.sjbs.2021.06.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 01/06/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder in females of childbearing age and research findings have revealed a potential association between PCOS and renal dysfunction. This study aimed to investigate renal dysfunction that might be associated with PCOS in rats and to evaluate the potential protective effect of chamomile against PCOS complicated by kidney damage. A rat model of PCOS was induced by injecting estradiol valerate (0.2 mg/rat × 2) into adult virgin female rats. Rats were treated with either ethyl alcohol extract of chamomile flower (75 mg/kg/day) or metformin (Met) (500 mg/kg/day). Induction of PCOS was associated with increased relative right kidney weight percentage and increased serum levels of urea, lipid peroxide product, and testosterone. PCOS was also associated with increased p53 expression in kidney glomeruli and medullary tubules with decreased Bcl2 expression in kidney glomeruli. Administration of chamomile extract significantly decreased levels of serum urea, testosterone, and lipid peroxide product, and p53 expression in kidney glomeruli and tubules. The extract significantly increased levels of antioxidant markers levels (reduced glutathione, catalase, and superoxide dismutase) and the expression of the anti-apoptotic gene Bcl2. Conversely, administration of Met did not improve serum levels of urea. Met also exerted no pronounced effect on p53 gene expression. The results of this study highlight the importance of monitoring kidney function in patients with PCOS and investigating the associated underlying mechanism. Chamomile extract was found to ameliorate kidney damage associated with PCOS through antioxidant, testosterone-lowering, and anti-apoptotic mechanisms.
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Affiliation(s)
- Ahlam A. Alahmadi
- Department of Biological Sciences, College of Science, King Abdulaziz University, Saudi Arabia
| | - Bassam A. Alahmadi
- Department of Biology, College of Science, Taibah University, Saudi Arabia
| | - Lobna F. Wahman
- Biology and Hormones Department, National Organization for Drug Control and Research (NODCAR), Egypt
| | - Nagla A. El-Shitany
- Department of Pharmacology and Toxicology, College of Pharmacy, King Abdulaziz University, Saudi Arabia
- Department of Pharmacology and Toxicology, College of Pharmacy, Tanta University, Egypt
- Yousef Abdullatif Jameel Chair of Prophetic Medicine Application, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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21
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Sandhu JK, Waqar A, Jain A, Joseph C, Srivastava K, Ochuba O, Alkayyali T, Ruo SW, Poudel S. Oxidative Stress in Polycystic Ovarian Syndrome and the Effect of Antioxidant N-Acetylcysteine on Ovulation and Pregnancy Rate. Cureus 2021; 13:e17887. [PMID: 34660086 PMCID: PMC8502752 DOI: 10.7759/cureus.17887] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 09/10/2021] [Indexed: 11/19/2022] Open
Abstract
Polycystic ovarian syndrome (PCOS) is an endocrinological condition that leads to infertility in many females. N-acetylcysteine (NAC), a novel antioxidant, is being used as an adjuvant to treat infertility in females suffering from PCOS. This review aims to evaluate oxidative stress in females suffering from PCOS and assess whether the anti-oxidizing properties of NAC are beneficial in enhancing the rate of ovulation and pregnancy in infertile PCOS females. A literature search was conducted manually on PubMed and Google Scholar databases using the following keywords: “N-Acetylcysteine,” “PCOS,” “Oxidative stress,” “Antioxidants,” and “infertility” alone and/or in combination for data collection. The studies were manually screened and, after applying inclusion-exclusion criteria, 32 studies consisting of 2466 females of the reproductive age group are included in this review. Our review revealed that females suffering from PCOS tend to show elevated levels of inflammatory markers and a decrease in antioxidant capacity. When used in combination with clomiphene citrate or letrozole, NAC increases ovulation and pregnancy rate in infertile females suffering from PCOS and positively affects the quality of oocytes and number of follicles ≥18mm. Moreover, its side effect profile is low. It also results in a mild increase in endometrial thickness in some females. Future studies on a large sample size using NAC alone are highly recommended to evaluate its role as a single-drug therapy for treating infertility in females suffering from PCOS.
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Affiliation(s)
- Jasmine K Sandhu
- Obstetrics and Gynecology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ahsan Waqar
- Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ashish Jain
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Christine Joseph
- Urology/Obstetrics and Gynecology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Kosha Srivastava
- Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Olive Ochuba
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Tasnim Alkayyali
- Internal Medicine, Marmara University, Istanbul, TUR.,Pathology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sheila W Ruo
- General Surgery, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sujan Poudel
- Psychiatry and Behavioral Sciences, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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22
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Influence of n-3 fatty acid supplementation on inflammatory and oxidative stress markers in patients with polycystic ovary syndrome: a systematic review and meta-analysis. Br J Nutr 2020; 125:657-668. [PMID: 32799935 DOI: 10.1017/s0007114520003207] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Polycystic ovary syndrome (PCOS) is defined as a reproductive endocrine disease that results in a low-grade inflammatory and pro-oxidant state. Dietary factors, including n-3 fatty acids, may have a key role in improving metabolic disorders in PCOS patients. The present study aimed to investigate the influence of n-3 fatty acid supplementation on inflammatory and oxidative stress (OS) markers in patients with PCOS. A systematic literature search of Medline/PubMed, Cochrane Central Register of Controlled Trials, Scopus and Lilacs, until November 2019, was conducted. Randomised clinical trials that reported inflammatory and OS markers as endpoints in women with PCOS receiving n-3 fatty acid supplementation were included. The pooled estimates of the weighted mean differences (WMD) and the standard mean differences (SMD) were calculated. Random effects models were adopted to measure the pooled outcomes. Among the 323 studies retrieved, ten fulfilled the inclusion criteria for a meta-analysis. We founded a significant decrease in high-sensitivity C-reactive protein (hs-CRP) (SMD -0·29 (95 % CI -0·56, -0·02) mg/l) and an increase in adiponectin (WMD 1·42 (95 % CI 1·09, 1·76) ng/ml) concentrations in the intervention group when compared with the placebo group. No statistically significant results were found in the meta-analysis for visfatin, nitric oxide, GSH or malondialdehyde levels or total antioxidant capacity. The data suggest that supplementation of n-3 fatty acids could reduce the inflammatory state in women with PCOS, through a decrease in hs-CRP and an increase in adiponectin levels.
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23
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Kuşaslan R, Ercan G, Ağcaoğlu O, Altınay S, Binboğa S, Altınel Y. A novel coenzyme-Q approach for the prevention of postsurgical adhesion. Turk J Surg 2020; 36:202-208. [PMID: 33015565 DOI: 10.5578/turkjsurg.4398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 12/30/2019] [Indexed: 11/15/2022]
Abstract
Objectives Postoperative intraperitoneal adhesions are an unsolved and important problem in abdominal surgery. In the present study, the probable preventive role of coenzyme-Q in the development of peritoneal adhesions was investigated. Material and Methods Sixteen Wistar Hannover male rats weighing 300-350 g were randomly separated into two groups of 8 rats each. The cecum was abraded with a sterile gauze until sub-serosal hemorrhage developed. A patch of peritoneum located opposite to the cecal abrasion was completely dissected. No treatment was given to Group 1. Group 2 received 30 mg/kg coenzyme-Q, which was injected 2 mL intraperitoneally. All the rats were sacrificed on the postoperative 21st day, and after adhesions were scored macroscopically, tissue specimens of the peritoneum and bowel were subjected to histopathological investigation. Tissue and blood specimens were also taken for biochemical analysis to investigate antioxidant efficiency. Results Adhesion scores were significantly different between the control group and the coenzyme-Q group (p= 0.001). According to the tissue levels of GSH-Px, MDA, and SOD levels, there was no significant difference between the study groups (p= 0.074, p= 0.208, p= 0.526). According to the plasma GSH-Px and SOD levels, there was significant difference between the groups (p= 0.002, p= 0.001), but the difference was not significant at MDA levels (p= 0.793). The differences between the pathological scores of the control and coenzyme-Q (p= 0.028 for fibrosis; p= 0.025 for inflammation) groups were statistically significant. Conclusion This study confirms that coenzyme-Q is the potential application in the prevention of early postoperative adhesions.
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Affiliation(s)
- Ramazan Kuşaslan
- Department of General Surgery, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Gülçin Ercan
- Department of General Surgery, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Orhan Ağcaoğlu
- Department of General Surgery, Koc University School of Medicine Hospital, Istanbul, Turkey
| | - Serdar Altınay
- Department of Pathology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Sinan Binboğa
- Department of General Surgery, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Yüksel Altınel
- Department of General Surgery, Bagcilar Training and Research Hospital, Istanbul, Turkey
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24
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Wu G, Hu X, Ding J, Yang J. The effect of glutamine on Dehydroepiandrosterone-induced polycystic ovary syndrome rats. J Ovarian Res 2020; 13:57. [PMID: 32386521 PMCID: PMC7211337 DOI: 10.1186/s13048-020-00650-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/15/2020] [Indexed: 11/10/2022] Open
Abstract
Background Previous studies have shown that chronic inflammation and oxidative stress may play an important role in the pathophysiology of polycystic ovary syndrome (PCOS), and glutamine (Gln) have showed the anti-inflammatory and antioxidant properties. So the aim of this study is to investigate the effect of glutamine supplementation on PCOS rats. Methods Female Sprague–Dawley rats were randomly assigned into four groups (n = 10 /group), control group, PCOS group, PCOS+ 0.5 g/kg Gln group and PCOS+ 1.0 g/kg Gln group. All the PCOS rats were administrated with 6 mg/100 g dehydroepiandrosterone (DHEA) for 20 consecutive days, all the PCOS+Gln groups were intraperitoneal injected glutamine twice in the next morning after the last DHEA injection. All the samples were collected 12 h after the last administration. Ovarian histological examinations were analyzed and the concentration of serum hormone, inflammatory and oxidative stress factors were measured. Results There was no obvious ovarian histological change among the PCOS group and PCOS+Gln groups. All the detected inflammation factors [C-reactive protein, interleukin (IL)-6, IL-18, tumor necrosis factor] showed significantly higher in all the PCOS groups compared to the control group (P < 0.01), and were significantly decreased with the supplementation of 0.5 g/kg glutamine (P < 0.01). Concentrations of superoxide dismutase were significantly lower in all the PCOS groups (P < 0.01) compared to the control group, and increased significantly with the supplementation of 0.5 g/kg glutamine (P < 0.01). Serum concentrations of malondialdehyde, nitric oxide synthase and nitric oxide were significantly higher in PCOS group (P < 0.01) compared with the control group, and significantly decreased to the comparative levels of control group with supplementation of 0.5 g/kg glutamine (P < 0.01). Conclusion There is low-grade inflammation and oxidative stress in DHEA-induced PCOS rats. The supplementation of 0.5 g/kg glutamine could effectively ameliorate the inflammation and oxidative stress conditions of PCOS.
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Affiliation(s)
- Gengxiang Wu
- Reproductive Medical Centre, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, People's Republic of China. .,Hubei Clinical Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan, 430060, People's Republic of China.
| | - Xue Hu
- Reproductive Medical Centre, Taihe Hospital, Shiyan, 442000, Hubei Province, People's Republic of China
| | - Jinli Ding
- Reproductive Medical Centre, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, People's Republic of China.,Hubei Clinical Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan, 430060, People's Republic of China
| | - Jing Yang
- Reproductive Medical Centre, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, People's Republic of China.,Hubei Clinical Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan, 430060, People's Republic of China
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