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Nisa KU, Tarfeen N, Mir SA, Waza AA, Ahmad MB, Ganai BA. Molecular Mechanisms in the Etiology of Polycystic Ovary Syndrome (PCOS): A Multifaceted Hypothesis Towards the Disease with Potential Therapeutics. Indian J Clin Biochem 2024; 39:18-36. [PMID: 38223007 PMCID: PMC10784448 DOI: 10.1007/s12291-023-01130-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/01/2023] [Indexed: 03/28/2023]
Abstract
Among the premenopausal women, Polycystic Ovary Syndrome (PCOS) is the most prevalent endocrinopathy affecting the reproductive system and metabolic rhythms leading to disrupted menstrual cycle. Being heterogeneous in nature it is characterized by complex symptomology of oligomennorhoea, excess of androgens triggering masculine phenotypic appearance and/or multiple follicular ovaries. The etiology of this complex disorder remains somewhat doubtful and the researchers hypothesize multisystem links in the pathogenesis of this disease. In this review, we attempt to present several hypotheses that tend to contribute to the etiology of PCOS. Metabolic inflexibility, aberrant pattern of gonadotropin signaling along with the evolutionary, genetic and environmental factors have been discussed. Considered a lifelong endocrinological implication, no universal treatment is available for PCOS so far however; multiple drug therapy is often advised along with simple life style intervention is mainly advised to manage its cardinal symptoms. Here we aimed to present a summarized view of pathophysiological links of PCOS with potential therapeutic strategies.
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Affiliation(s)
- Khair Ul Nisa
- Department of Environmental Science, University of Kashmir, Srinagar, 190006 India
- Centre of Research for Development (CORD), University of Kashmir, Srinagar, 190006 India
| | - Najeebul Tarfeen
- Centre of Research for Development (CORD), University of Kashmir, Srinagar, 190006 India
| | - Shahnaz Ahmad Mir
- Department of Endocrinology, Government Medical College, Shireen Bagh, Srinagar, 190010 India
| | - Ajaz Ahmad Waza
- Multidisciplinary Research Unit (MRU), Government Medical Collage (GMC), Srinagar, 190010 India
| | - Mir Bilal Ahmad
- Department of Biochemistry, University of Kashmir, Srinagar, 190006 India
| | - Bashir Ahmad Ganai
- Centre of Research for Development (CORD), University of Kashmir, Srinagar, 190006 India
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AKAD M, SOCOLOV D, AKAD F, COVALI R, CRAUCIUC E, STAN C, STAN C, SOCOLOV R. Treatments in Patients with Polycystic Ovary Syndrome and Effects on Kisspeptin Serum Levels. MAEDICA 2022; 17:799-804. [PMID: 36818240 PMCID: PMC9923052 DOI: 10.26574/maedica.2022.17.4.799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Introduction: Polycystic ovarian syndrome (PCOS) is a common and multifactorial pathology among young women of reproductive age and one of the main causes for female infertility. Most patients are referred to a gynecologist due to specific symptoms such as menstrual irregularities, hirsutism, facial or body acne and inability to obtain a pregnancy. Lately, kisspeptin, a neuropeptide produced in the anterior region of the hypothalamus that seems to modulate the GnRH secretion and therefore the hypothalamic-hypophyseal-ovarian axis (HHO-axis), has been considered responsible for PCOS occurrence. Objectives:The aim of our study was to observe the changes in hormonal balances and kisspeptin serum levels in patients with PCOS after treatment with myo-inositol and vitex. Materials and methods:A prospective clinical study was conducted by us, between 4 January 2021 and 1 March 2022, in "Elena Doamna" Clinical Hospital of Obstetrics and Gynecology, Iasi, Romania. After obtaining the subjects' informed consent and agreement to participate, we identified 14 patients with PCOS and primary or secondary infertility, who underwent laboratory investigations during the follicular phase of their menstrual cycles, testing for kisspeptin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, testosterone, insulin, blood sugar levels and prolactin. An abdominal-pelvic scan and full body examination were also performed. Patients, in accordance with their gynecologists' recommendation, preferred a medical therapy consisting of myo-inositol 750 mg/day and vitex 400 mg/day. After three months of treatment, patients agreed to have a second check up to see if any changes occurred. Results:We found significant positive differences when considering kisspeptin, estradiol, FSH and prolactin serum values. There was no significant difference in testosterone and insulin serum levels; on the other hand, we observed an increase in LH serum levels. The mean ovarian volume before treatment was 14.0 for the right ovaries and 13.8 for the left ovaries. After treatment and the recommended lifestyle changes, we noticed a decrease in the mean ovarian volume (13.5 for the right ovaries and 13.4 for the left ovaries). Discussions and conclusions: The etiology of PCOS, which is considered a multifactorial pathology, remains unclear. Multiple studies have been conducted and are still exploring the role of kisspeptin as an etiologic factor for PCOS associated with infertility. Our study showed a decrease in kisspeptin values after the use of myo-inositol and vitex in patients with PCOS, therefore supporting the long-standing theory that kisspeptin might have an essential role in the development of PCOS.
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Affiliation(s)
- Mona AKAD
- “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania,“Elena Doamna” Clinical Hospital of Obstetrics and Gynecology, Iasi, Romania
| | - Demetra SOCOLOV
- “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Fawzy AKAD
- “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Roxana COVALI
- “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania,“Elena Doamna” Clinical Hospital of Obstetrics and Gynecology, Iasi, Romania
| | - Eduard CRAUCIUC
- “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania,“Elena Doamna” Clinical Hospital of Obstetrics and Gynecology, Iasi, Romania
| | - Catalina STAN
- “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania,“Elena Doamna” Clinical Hospital of Obstetrics and Gynecology, Iasi, Romania
| | - Cristinel STAN
- “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Razvan SOCOLOV
- “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania,“Elena Doamna” Clinical Hospital of Obstetrics and Gynecology, Iasi, Romania
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Sharma M, Modi A, Goyal M, Sharma P, Purohit P. ANTI-THYROID ANTIBODIES AND THE GONADOTROPHINS PROFILE (LH/FSH) IN EUTHYROID POLYCYSTIC OVARIAN SYNDROME WOMEN. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2022; 18:79-85. [PMID: 35975253 PMCID: PMC9365406 DOI: 10.4183/aeb.2022.79] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
CONTEXT The current study aimed to determine association of anti-TPO with LH/FSH in PCOS women. DESIGN Current case control study included 33 diagnosed PCOS women and 32 age matched healthy women and were analysed for body mass index (BMI) and waist to hip ratio (WHR), fasting blood glucose (FBG), free T3 (FT3), free T4 (FT4), Thyroid stimulating hormone (TSH), dehydroepiandrostenedione (DHEA-S), total testosterone, follicular stimulating hormone (FSH), luteinizing hormone (LH) and anti thyroperoxidase antibodies (anti-TPO). Data was statistically analysed by Student's t - test and Pearson's correlation analysis. RESULTS Of the total PCOS women, 45% were obese and 34.37% had raised anti-TPO. The biochemical profile of obese PCOS women showed significantly raised FBG (p<0.0001), LH (p<0.0001), Testosterone (p<0.0001) and DHEA-S (p=0.0021) as compared to non-obese PCOS women. The LH/FSH ratio was significantly raised in PCOS women as compared to control (p<0.0001). Pearson's correlation analysis showed a significant association of anti-TPO with FBS, testosterone, LH and LH/FSH in obese PCOS and with Testosterone and LH in non-obese PCOS women using SPSS 21. CONCLUSION The current study shows a high prevalence of AITD in euthyroid PCOS women and suggests a strong link of euthyroid obese PCOS women to autoimmunity due to the hyper-anderogenism and a higher LH/FSH ratio.
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Affiliation(s)
- M. Sharma
- Under graduate 3 Professional MBBS, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - A. Modi
- Biochemistry, Jodhpur, Rajasthan, India
| | - M. Goyal
- Obstetrics and Gynecology, Jodhpur, Rajasthan, India
| | - P. Sharma
- Biochemistry, Jodhpur, Rajasthan, India
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Collée J, Mawet M, Tebache L, Nisolle M, Brichant G. Polycystic ovarian syndrome and infertility: overview and insights of the putative treatments. Gynecol Endocrinol 2021; 37:869-874. [PMID: 34338572 DOI: 10.1080/09513590.2021.1958310] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Infertility concerns 15% of the couples. Management of female infertility requires a complete history of the patient followed by a physical, gynecological and endocrine examination. Infertility etiology will be investigated thanks to different tests including ovarian function and reserve assessment, search for uterine abnormalities and evaluation of tubal permeability. Polycystic ovarian syndrome (PCOS) is a predominant cause of infertility and a common gyne-endocrine disorder affecting 7 to 15% of women in reproductive age. Behavioral, medical and surgical treatments have been evaluated in order to improve the fertility of women with PCOS. Lifestyle modifications (stop smoking, physical exercise and weight loss when necessary) are of the utmost importance. Clomiphene citrate remains the first line of medical treatment of infertility in women with PCOS in absence of other male or female causes of infertility. Use of metformin solely for infertility is not recommended in absence of metabolic anomaly and new treatment as myoinositol is emerging. Surgical techniques aiming to enhance ovulation and pregnancy rate are an option when medical treatment failed. Ovarian drilling by laparoscopy or by transvaginal hydrolaparoscopy is taking a larger place in the treatment of infertility. In vitro maturation and fertilization remain the third-line of treatment in PCOS.
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Affiliation(s)
- Julie Collée
- Department of Obstetrics and Gynecology, Hospital CHR Liège, University of Liège, Liège, Belgium
| | - Marie Mawet
- Department of Obstetrics and Gynecology, Hospital CHR Liège, University of Liège, Liège, Belgium
| | - Linda Tebache
- Department of Obstetrics and Gynecology, Hospital CHR Liège, University of Liège, Liège, Belgium
| | - Michelle Nisolle
- Department of Obstetrics and Gynecology, Hospital CHR Liège, University of Liège, Liège, Belgium
| | - Géraldine Brichant
- Department of Obstetrics and Gynecology, Hospital CHR Liège, University of Liège, Liège, Belgium
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Vitale SG, Fiore M, La Rosa VL, Rapisarda AMC, Mazza G, Paratore M, Commodari E, Caruso S. Liposomal ferric pyrophosphate and ascorbic acid supplementation in pregnant women with iron deficiency anaemia: haematochemical, obstetric, neonatal and psychological outcomes in a prospective observational study. Int J Food Sci Nutr 2021; 73:221-229. [PMID: 34238093 DOI: 10.1080/09637486.2021.1950129] [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] [Indexed: 01/01/2023]
Abstract
This study aimed to determine the effects of liposomal iron pyrophosphate/ascorbic acid on clinical and psychological outcomes in pregnant women. Women at the 11th-13th weeks of gestation with iron deficiency anaemia assuming Sideremil™ from April 2018 to May 2019 were recruited. Haematochemical, obstetric, neonatal and psychological outcomes were investigated at the enrolment, 21-23 weeks of gestation, 30-32 weeks of gestation and after 6 weeks from childbirth. Results showed significant positive effects on haemoglobin, ferritin, sideremia and transferrin levels, compared to baseline data. A significant improvement of anxiety and depression levels was also observed. Regarding the quality of life, all the domains significantly improved, especially the Physical Role domain. Our results indicate that Sideremil™ may be a valid treatment for iron deficiency anaemia in pregnant women, since it significantly improves haematological and mental health outcomes. However, further studies are needed to confirm these results.
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Affiliation(s)
- Salvatore Giovanni Vitale
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Maria Fiore
- Department of Medical Sciences, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy
| | | | - Agnese Maria Chiara Rapisarda
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Gabriele Mazza
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Marco Paratore
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Elena Commodari
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Salvatore Caruso
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
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Bizzarri M, Logoteta P, Monastra G, Laganà AS. An innovative approach to polycystic ovary syndrome. J OBSTET GYNAECOL 2021; 42:546-556. [PMID: 34169781 DOI: 10.1080/01443615.2021.1920006] [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] [Indexed: 10/21/2022]
Abstract
Myo-inositol and D-chiro-inositol are insulin sensitising agents. In the ovary, myo-inositol acts as second messenger of Follicle Stimulating Hormone (FSH). Both molecules were administered to Polycystic Ovary Syndrome (PCOS) women. The gynaecologist Vittorio Unfer was the first to give specific value to myo-inositol for the treatment of PCOS: this important innovation opened new ways of research to identify efficient therapies based on myo-inositol alone or with low doses of D-chiro-inositol. Significant successes were also gained using myo-inositol in treating male and female infertility. Unfer's researches allowed to identify "the D-Chiro-Inositol Paradox in the Ovary" and the best myo-inositol/D-chiro-inositol ratio (40:1) for the treatment of PCOS. Furthermore, his studies allowed to improve the inositol's efficacy using alpha-lactalbumin. As shown in this review, the main stages of Unfer's scientific career have been closely intertwined with important phases of the recent pharmacological research about the topic.
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Affiliation(s)
- Mariano Bizzarri
- Department of Experimental Medicine, Systems Biology Group Lab, Sapienza University of Rome, Rome, Italy
| | | | | | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
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Polycystic Ovary Syndrome Susceptibility Loci Inform Disease Etiological Heterogeneity. J Clin Med 2021; 10:jcm10122688. [PMID: 34207127 PMCID: PMC8234947 DOI: 10.3390/jcm10122688] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 11/24/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a complex disorder with heterogenous phenotypes and unclear etiology. A recent phenotypic clustering study identified metabolic and reproductive subtypes of PCOS. We hypothesize that the heterogeneity of PCOS manifestations reflects different mechanistic pathways and can be identified using a genetic approach. We applied k-means clustering to categorize the genome-wide significant PCOS variants into clusters based on their associations with selected quantitative traits that likely reflect PCOS etiological pathways. We evaluated the association of each cluster with PCOS-related traits and disease outcomes. We then applied Mendelian randomization to estimate the causal effects between the traits and PCOS. Three categories of variants were identified: adiposity, insulin resistant, and reproductive. Significant associations were observed for variants in the adiposity cluster with body mass index (BMI), waist circumference and breast cancer, and variants in the insulin-resistant cluster with fasting insulin, glucose values, and homeostatic model assessment of insulin resistance (HOMA-IR). Sex hormone binding globulin (SHBG) has strong association with all three clusters. Mendelian randomization suggested a causal role of BMI and SHBG on PCOS. No causal associations were observed for PCOS on disease outcomes.
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Rudnicka E, Suchta K, Grymowicz M, Calik-Ksepka A, Smolarczyk K, Duszewska AM, Smolarczyk R, Meczekalski B. Chronic Low Grade Inflammation in Pathogenesis of PCOS. Int J Mol Sci 2021; 22:ijms22073789. [PMID: 33917519 PMCID: PMC8038770 DOI: 10.3390/ijms22073789] [Citation(s) in RCA: 199] [Impact Index Per Article: 66.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/24/2021] [Accepted: 03/31/2021] [Indexed: 12/13/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a one of the most common endocrine disorders, with a prevalence rate of 5–10% in reproductive aged women. It’s characterized by (1) chronic anovulation, (2) biochemical and/or clinical hyperandrogenism, and (3) polycystic ovarian morphology. PCOS has significant clinical implications and can lead to health problems related to the accumulation of adipose tissue, such as obesity, insulin resistance, metabolic syndrome, and type 2 diabetes. There is also evidence that PCOS patients are at higher risk of cardiovascular diseases, atherosclerosis, and high blood pressure. Several studies have reported the association between polycystic ovary syndrome (PCOS) and low-grade chronic inflammation. According to known data, inflammatory markers or their gene markers are higher in PCOS patients. Correlations have been found between increased levels of C-reactive protein (CRP), interleukin 18 (IL-18), tumor necrosis factor (TNF-α), interleukin 6 (IL-6), white blood cell count (WBC), monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein-1α (MIP-1α) in the PCOS women compared with age- and BMI-matched controls. Women with PCOS present also elevated levels of AGEs and increased RAGE (receptor for advanced glycation end products) expression. This chronic inflammatory state is aggravating by obesity and hyperinsulinemia. There are studies describing mutual impact of hyperinsulinemia and obesity, hyperandrogenism, and inflammatory state. Endothelial cell dysfunction may be also triggered by inflammatory cytokines. Many factors involved in oxidative stress, inflammation, and thrombosis were proposed as cardiovascular risk markers showing the endothelial cell damage in PCOS. Those markers include asymmetric dimethylarginine (ADMA), C-reactive protein (CRP), homocysteine, plasminogen activator inhibitor-I (PAI-I), PAI-I activity, vascular endothelial growth factor (VEGF) etc. It was also proposed that the uterine hyperinflammatory state in polycystic ovary syndrome may be responsible for significant pregnancy complications ranging from miscarriage to placental insufficiency. In this review, we discuss the most importance evidence concerning the role of the process of chronic inflammation in pathogenesis of PCOS.
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Affiliation(s)
- Ewa Rudnicka
- Department of Gynaecological Endocrinology, Medical University of Warsaw, 00-315 Warsaw, Poland; (K.S.); (M.G.); (A.C.-K.); (R.S.)
- Correspondence: ; Tel.: +48-604167450
| | - Katarzyna Suchta
- Department of Gynaecological Endocrinology, Medical University of Warsaw, 00-315 Warsaw, Poland; (K.S.); (M.G.); (A.C.-K.); (R.S.)
| | - Monika Grymowicz
- Department of Gynaecological Endocrinology, Medical University of Warsaw, 00-315 Warsaw, Poland; (K.S.); (M.G.); (A.C.-K.); (R.S.)
| | - Anna Calik-Ksepka
- Department of Gynaecological Endocrinology, Medical University of Warsaw, 00-315 Warsaw, Poland; (K.S.); (M.G.); (A.C.-K.); (R.S.)
| | - Katarzyna Smolarczyk
- Department of Dermatology and Venereology, Medical University of Warsaw, 00-315 Warsaw, Poland;
| | - Anna M. Duszewska
- Department of Morphological Sciences, Faculty of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland;
| | - Roman Smolarczyk
- Department of Gynaecological Endocrinology, Medical University of Warsaw, 00-315 Warsaw, Poland; (K.S.); (M.G.); (A.C.-K.); (R.S.)
| | - Blazej Meczekalski
- Department of Gynaecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland;
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Association between melatonin receptor gene polymorphisms and polycystic ovarian syndrome: a systematic review and meta-analysis. Biosci Rep 2021; 40:225044. [PMID: 32463080 PMCID: PMC7317604 DOI: 10.1042/bsr20200824] [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: 03/19/2020] [Revised: 05/21/2020] [Accepted: 05/27/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Polycystic ovarian syndrome (PCOS) is a kind of common gynecological endocrine disorder. And the mutations of melatonin receptor (MTNR) genes are related to the occurrence of PCOS. But previous researches have shown opposite results. So, the object of our systematic review and meta-analysis is to investigate the relationship between MTNR 1A/B polymorphisms and PCOS. METHODS PubMed, Embase, Ovid, the Cochrane Library, Web of Science and three Chinese databases (VIP, CNKI and Wanfang) were used to retrieve eligible articles published between January 1980 and February 2020. And we used the odds ratio (OR) and its 95% confidence interval (CI) to investigate the strength of the association by six genetic models, allelic, codominant (homozygous and heterozygous), dominant, recessive and superdominant models. Review Manager 5.3, IBM SPSS statistics 25 and Stata MP 16.0 software were used to do this meta-analysis. RESULTS Our meta-analysis involved 2553 PCOS patients and 3152 controls, for two single nucleotide polymorphisms (rs10830963 C> G in MTNR1B and rs2119882 T> C in MTNR1A) and significant associations were found in some genetic models of these single nucleotide polymorphisms (SNPs). For rs10830963, strongly significant was found in the heterozygote model (GC vs. CC, P=0.02). Additionally, a slight trend was detected in the allelic (G vs. C), homozygote (GG vs. CC) and dominant (GG+GC vs. CC) model of rs10830963 (P=0.05). And after further sensitivity analysis, a study with high heterogeneity was removed. In the allelic (P=0.000), homozygote (P=0.001), dominant (P=0.000) and recessive (GG vs. GC+CC, P=0.001) model, strong associations between rs10830963 and PCOS were found. Moreover, for rs2119882, five genetic models, allelic (C vs. T, P=0.000), codominant (the homozygote (CC vs. TT, P=0.000) and heterozygote model (CT vs. TT, P=0.02), dominant (CC + CT vs. TT, P=0.03) and recessive model (CC vs. CT + TT, P=0.000) showed significant statistical associations with PCOS. CONCLUSION MTNR1B rs10830963 and MTNR1B rs2119882 polymorphisms are associated with PCOS risk. However, the above conclusions still require being confirmed by much larger multi-ethnic studies.
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Gong W, Bilixzi A, Wang X, Lu Y, Wan L, Han L. The role of serum β-trophin and endostatin in patients with polycystic ovary syndrome: Are they correlated? BMC WOMENS HEALTH 2021; 21:104. [PMID: 33706732 PMCID: PMC7953644 DOI: 10.1186/s12905-021-01198-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 01/28/2021] [Indexed: 11/10/2022]
Abstract
Background It’s necessary to investigate the serum β-trophin and endostatin (ES) level and its influencing factors in patients with newly diagnosed polycystic ovary syndrome (PCOS). Methods Newly diagnosed PCOS patients treated in our hospital were selected, and healthy women who took physical examination during the same period as healthy controls. We detected and compared the related serum indicators between two groups, Pearson correlation were conducted to identify the factors associated with β-trophin and ES, and the influencing factors of β-trophin and ES were analyzed by logistic regression. Results A total of 62 PCOS patients and 65 healthy controls were included. The BMI, WHI, LH, FSH, TT, FAI, FBG, FINS, HOMA-IR, TC, TG, LDL, ES in PCOS patients were significantly higher than that of healthy controls, while the SHBG and HDL in PCOS patients were significantly lower than that of healthy controls (all p < 0.05). β-trophin was closely associated with BMI (r = 0.427), WHR (r = 0.504), FBG (r = 0.385), TG (r = 0.405) and LDL (r = 0.302, all p < 0.05), and ES was closely associated with BMI (r = 0.358), WHR (r = 0.421), FBG (r = 0.343), TC (r = 0.319), TG (r = 0.404, all p < 0.05). TG, BMI, WHR and FBG were the main factors affecting the serum β-trophin levels (all p < 0.05). FBG, TC and BMI were the main factors affecting the serum ES levels (all p < 0.05). The TG, β-trophin, ES level in PCOS patients with insulin resistance (IR) were significantly higher than that of those without IR (all p < 0.05). Conclusion Increased β-trophin is closely associated with increased ES in patients with PCOS, which may be the useful indicators for the management of PCOS.
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Affiliation(s)
- Wei Gong
- Department of Gynecology, The Fourth Affiliated Hospital of Xinjiang Medical University, No. 116 Huanghe Road, Urumqi, 214000, Xinjiang, China
| | - Aikmu Bilixzi
- Department of Gynecology, The Fourth Affiliated Hospital of Xinjiang Medical University, No. 116 Huanghe Road, Urumqi, 214000, Xinjiang, China
| | - Xinmei Wang
- Department of Gynecology, The Fourth Affiliated Hospital of Xinjiang Medical University, No. 116 Huanghe Road, Urumqi, 214000, Xinjiang, China
| | - Yanli Lu
- Department of Gynecology, The Fourth Affiliated Hospital of Xinjiang Medical University, No. 116 Huanghe Road, Urumqi, 214000, Xinjiang, China
| | - Li Wan
- Department of Gynecology, The Fourth Affiliated Hospital of Xinjiang Medical University, No. 116 Huanghe Road, Urumqi, 214000, Xinjiang, China
| | - Lu Han
- Department of Gynecology, The Fourth Affiliated Hospital of Xinjiang Medical University, No. 116 Huanghe Road, Urumqi, 214000, Xinjiang, China.
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Ma Y, Ma L, Cao Y, Zhai J. Construction of a ceRNA-based lncRNA-mRNA network to identify functional lncRNAs in polycystic ovarian syndrome. Aging (Albany NY) 2021; 13:8481-8496. [PMID: 33714202 PMCID: PMC8034915 DOI: 10.18632/aging.202659] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/23/2020] [Indexed: 12/19/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a prevalent endocrine and metabolic disorder in women of childbearing age. Recent studies suggest important roles for lncRNAs in PCOS development. Based on the hypothesis that lncRNAs are able to regulate mRNA functions by competitive binding to shared miRNAs, the present work sought to construct a PCOS-related lncRNA-mRNA network (PCLMN) to identify key lncRNAs with dysregulated expression and potential prognostic and therapeutic relevance. A global background network was constructed after retrieving lncRNA-miRNA and miRNA-mRNA pairs from the lncRNASNP2, miRTarBase and StarBase databases. Based on gene expression profiles from ovarian granulosa cells from PCOS patients and controls in the GEO’s GSE95728 dataset, the PCLMN was then constructed by applying hypergeometric testing. Using topological analysis, we identified 3 lncRNAs (LINC00667, AC073172.1 and H19) ranking within the top-ten gene lists for all three centrality measures. We then explored their subcellular localization, performed functional module analyses, and identified 4 sex hormone-related transcription factors as potential regulators of their expression. Significant associations with inflammation, oxidative stress, and apoptosis-related processes and pathways were revealed for the key lncRNAs in our PCMLN. Further studies verifying the mRNA/lncRNA relationships identified herein are needed to clarify their clinical significance.
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Affiliation(s)
- Yue Ma
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Linna Ma
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yurong Cao
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jun Zhai
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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12
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Androgen Reduces Mitochondrial Respiration in Mouse Brown Adipocytes: A Model for Disordered Energy Balance in Polycystic Ovary Syndrome. Int J Mol Sci 2020; 22:ijms22010243. [PMID: 33383677 PMCID: PMC7796281 DOI: 10.3390/ijms22010243] [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: 12/03/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 12/15/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrinopathy that is associated with an adverse metabolic profile including reduced postprandial thermogenesis. Although abnormalities in adipose tissue function have been widely reported in women with PCOS, less is known about direct effects of androgen on white and, particularly, brown adipocytes. The purpose of this study was to investigate the effect of the nonaromatizable androgen dihydrotestosterone (DHT) on (1) lipid accumulation and expression of adipogenic markers in immortalized mouse brown adipose cell lines (IMBATs), (2) mitochondrial respiration in IMBATs, (3) mitochondrial DNA content and gene expression, (4) expression of brown adipose tissue (BAT) markers and thermogenic activation. In addition, we profiled the relative levels of 38 adipokines secreted from BAT explants and looked at androgen effects on adipokine gene expression in both IMBATs and immortalized mouse white adipose (IMWATs) cell lines. Androgen treatment inhibited IMBAT differentiation in a dose-dependent manner, reduced markers of adipogenesis, and attenuated the β-adrenoceptor-stimulated increase in uncoupling protein-1 (UCP1) expression. In explants of mouse interscapular BAT, androgen reduced expression of UCP1, peroxisome proliferator-activated receptor-γ coactivator-1 (PCG-1) and Cidea. Significantly, as well as affecting genes involved in thermogenesis in BAT, androgen treatment reduced mitochondrial respiration in IMBATs, as measured by the Seahorse XF method. The results of this study suggest a role for excess androgen in inhibiting brown adipogenesis, attenuating the activation of thermogenesis and reducing mitochondrial respiration in BAT. Together, these data provide a plausible molecular mechanism that may contribute to reduced postprandial thermogenesis and the tendency to obesity in women with PCOS.
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13
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Wang C, Yue S, Jiang Y, Mao Y, Zhao Z, Liu X, Zhang X, Pei D, Li Y. LncRNA GAS5 is upregulated in polycystic ovary syndrome and regulates cell apoptosis and the expression of IL-6. J Ovarian Res 2020; 13:145. [PMID: 33308258 PMCID: PMC7733246 DOI: 10.1186/s13048-020-00748-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 11/30/2020] [Indexed: 11/27/2022] Open
Abstract
Background GAS5 contains a hormone response element that can induce cell apoptosis in breast cancer. It is known that cell apoptosis and hormone response play crucial roles in polycystic ovary syndrome (PCOS), indicating the potential involvement of GAS5 in PCOS. This study was performed to investigate the potential involvement of GAS5 and IL-6 (a critical player in PCOS) in PCOS. Methods Research subjects of this study included 60 PCOS patients and 60 healthy controls. The expression levels of GAS5 and IL-6 in plasma of both patients and controls were measured by qPCR and ELISA, respectively. Cell transfections were performed to analyze the interaction between GAS5 and IL-6. Cell apoptosis was analyzed by cell apoptosis assay. Results GAS5 was upregulated in plasma of PCOS patients. The expression levels of GAS5 were positively correlated with the expression levels of IL-6. Altered expression levels of GAS5 and IL-6 distinguished PCOS patients from healthy controls. In cells of a granulosa-like tumor cell line (KGN), overexpression of GAS5 led to upregulated IL-6, while silencing of GAS5 played an opposite role. Cell apoptosis analysis showed that overexpression of GAS5 significantly decreased apoptosis rate of KGN cells. Silencing of GAS5 increased the rate of KGN cell apoptosis. Conclusions GAS5 is upregulated in PCOS and regulates cell apoptosis and the expression of IL-6.
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Affiliation(s)
- Chunxia Wang
- Department of Reproductive medicine, The Second Affiliated Hospital of Henan, University of TCM, Henan Province, 450002, Zhengzhou City, People's Republic of China
| | - Shishi Yue
- Henan University of TCM, 450046, Zhengzhou City, Henan Province, People's Republic of China
| | - Yaru Jiang
- Henan University of TCM, 450046, Zhengzhou City, Henan Province, People's Republic of China
| | - Yanjia Mao
- Henan University of TCM, 450046, Zhengzhou City, Henan Province, People's Republic of China
| | - Zhijing Zhao
- Henan University of TCM, 450046, Zhengzhou City, Henan Province, People's Republic of China
| | - Xinwei Liu
- Department of Clinical Laboratory, The Second Affiliated Hospital of Henan University of TCM, No.6 Dongfeng Road, Henan Province, 450002, Zhengzhou City, People's Republic of China
| | - Xiaoqian Zhang
- Department of Clinical Laboratory, The Second Affiliated Hospital of Henan University of TCM, No.6 Dongfeng Road, Henan Province, 450002, Zhengzhou City, People's Republic of China
| | - Dongxu Pei
- Department of Clinical Laboratory, The Second Affiliated Hospital of Henan University of TCM, No.6 Dongfeng Road, Henan Province, 450002, Zhengzhou City, People's Republic of China
| | - Yongwei Li
- Department of Clinical Laboratory, The Second Affiliated Hospital of Henan University of TCM, No.6 Dongfeng Road, Henan Province, 450002, Zhengzhou City, People's Republic of China.
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14
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Zito G, Della Corte L, Giampaolino P, Terzic M, Terzic S, Di Guardo F, Ricci G, Della Pietà I, Maso G, Garzon S. Gestational diabetes mellitus: Prevention, diagnosis and treatment. A fresh look to a busy corner. J Neonatal Perinatal Med 2020; 13:529-541. [PMID: 31903997 DOI: 10.3233/npm-190305] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a common pregnancy complication characterized by hyperglycaemia with onset or first recognition during pregnancy. Risk factors include family history of diabetes, previous GDM, genetic predisposition for GDM/type 2 diabetes, insulin resistance conditions such as overweight, obesity and ethnicity. Women with GDM are at high risk for fetal macrosomia, small for gestational age, neonatal hypoglycaemia, operative delivery and caesarean delivery. The aim of this narrative review is to summarize the most recent findings of diagnosis and treatment of GDM in order to underline the importance to promote adequate prevention of this disease, especially through lifestyle interventions such as diet and physical activity. METHODS The research was conducted using the following electronic databases, MEDLINE, EMBASE, Web of Science, Scopus, ClinicalTrial.gov, OVID and Cochrane Library, including all published randomized and non-randomized studies as well as narrative and systematic reviews. RESULTS The lack of universally accepted criteria makes the definition of diagnosis and prognosis of this condition difficult. Early diagnosis and glucose blood level control may improve maternal and fetal short and long-term outcomes. Treatment strategies include nutritional interventions and exercise. Medical treatment can be necessary if these strategies are not effective. Moreover, novel non-pharmacologic agents such as myo-inositol seem to be effective and safe both in the prevention and the treatment of GDM. CONCLUSIONS It is important to promote adequate prevention of GDM. Further studies are needed in order to better define the most appropriate strategies for the clinical management of women affected by GDM.
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Affiliation(s)
- G Zito
- Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - L Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - P Giampaolino
- Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy
| | - M Terzic
- Department of Medicine, Nazarbayev University School of Medicine, Astana, Kazakhstan.,Department of Obstetrics and Gynecology, National Research Center of Mother and Child Health, University Medical Center, Astana, Kazakhstan.,Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - S Terzic
- Department of Medicine, Nazarbayev University School of Medicine, Astana, Kazakhstan
| | - F Di Guardo
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - G Ricci
- Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy.,Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - I Della Pietà
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - G Maso
- Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - S Garzon
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
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15
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Safi A, Orazov M, Kalinchenko S. The role of cholecalciferol deficiency in the pathogenesis of polycystic ovary syndrome. ACTA ACUST UNITED AC 2020; 16:1745506520969606. [PMID: 33226913 PMCID: PMC7686588 DOI: 10.1177/1745506520969606] [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] [Indexed: 11/17/2022]
Abstract
OBJECTIVES to evaluate and compare clinical presentations, medical history, and laboratory data of patients with polycystic ovary syndrome, including vitamin 25(OH)D3 level. METHODS In total, 81 patients were examined. The patient group included 51 patients with signs of polycystic ovary syndrome. The control group included 30 healthy women without signs of polycystic ovary syndrome, comparable according to gender and age to the patient group. Polycystic ovary syndrome was verified based on the diagnostic Rotterdam and international polycystic ovary syndrome guidelines' criteria. The levels of cholecalciferol were determined by mass spectrometry (ng/mL). At the second stage of the study, the patient group with polycystic ovary syndrome was divided into two subgroups depending on the waist circumference and compared with each other by the level of insulin, low-density lipoproteins, triglycerides, anti-Mullerian hormone, follicle-stimulating hormone, and luteinizing hormone. Statistical analysis was carried out using the parametric t-test for two-independent samples with equal or different variance. For nominal data-Pearson's chi-test, when the means are not calculated and a test is carried out for the presence of a relationship between the nominal variables. RESULTS Patients with polycystic ovary syndrome and without polycystic ovary syndrome did not have a statistically significant difference in 25(OH)D3 level. Statistically significant differences in the level of 25(OH)D3 were found in women with polycystic ovary syndrome with the waist circumference ⩾80 cm. In these subgroups, differences in insulin, low-density lipoprotein, and triglycerides levels were also revealed. CONCLUSION The correlation of the 25(OH)D3 level does not differ in the groups of patients with polycystic ovary syndrome and without polycystic ovary syndrome, but significantly correlates with the metabolic profile of patients.
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Affiliation(s)
- Aigul Safi
- Department of Obstetrics and Gynecology with a Course in Perinatology, Institute of Medicine, People's Friendship University of Russia, Moscow, Russia.,"D-Doctor" Private Clinic, Nur-Sultan, Kazakhstan
| | - Mekan Orazov
- Department of Obstetrics and Gynecology with a Course in Perinatology, Institute of Medicine, People's Friendship University of Russia, Moscow, Russia
| | - Svetlana Kalinchenko
- Department of Endocrinology, Institute of Medicine, People's Friendship University of Russia, Moscow, Russia
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16
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Laganà AS, Unfer V, Garzon S, Bizzarri M. Role of inositol to improve surfactant functions and reduce IL-6 levels: A potential adjuvant strategy for SARS-CoV-2 pneumonia? Med Hypotheses 2020; 144:110262. [PMID: 33254564 PMCID: PMC7480225 DOI: 10.1016/j.mehy.2020.110262] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 08/30/2020] [Accepted: 09/05/2020] [Indexed: 01/18/2023]
Abstract
To date, the spread of SARS-CoV-2 infection is increasing worldwide and represents a primary healthcare emergency. Although the infection can be asymptomatic, several cases develop severe pneumonia and acute respiratory distress syndrome (ARDS) characterized by high levels of pro-inflammatory cytokines, primarily interleukin (IL)-6. Based on available data, the severity of ARDS and serum levels of IL-6 are key determinants for the prognosis. In this scenario, available in vitro and in vivo data suggested that myo-inositol is able to increase the synthesis and function of the surfactant phosphatidylinositol, acting on the phosphoinositide 3-kinase (PI3K)-regulated signaling, with amelioration of both immune system and oxygenation at the bronchoalveolar level. In addition, myo-inositol has been found able to decrease the levels of IL-6 in several experimental settings, due to an effect on the inositol-requiring enzyme 1 (IRE1)-X-box-binding protein 1 (XBP1) and on the signal transducer and activator of transcription 3 (STAT3) pathways. In this scenario, treatment with myo-inositol may be able to reduce IL-6 dependent inflammatory response and improve oxygenation in patients with severe ARDS by SARS-CoV-2. In addition, the action of myo-inositol on IRE1 endonuclease activity may also inhibit the replication of SARS-CoV-2, as was reported for the respiratory syncytial virus. Since the available data are extremely limited, if this potential therapeutic approach will be considered valid in the clinical practice, the necessary future investigations should aim to identify the best dose, administration route (oral, intravenous and/or aerosol nebulization), and cluster(s) of patients which may get beneficial effects from this treatment.
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Affiliation(s)
- Antonio Simone Laganà
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy; The Experts Group on Inositol in Basic and Clinical Research (EGOI), Italy(1).
| | - Vittorio Unfer
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), Italy(1); Systems Biology Group Lab, "La Sapienza" University, Rome, Italy
| | - Simone Garzon
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Mariano Bizzarri
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), Italy(1); Systems Biology Group Lab, "La Sapienza" University, Rome, Italy; Department of Experimental Medicine, "La Sapienza" University, Rome, Italy
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17
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Wawrzkiewicz-Jałowiecka A, Kowalczyk K, Trybek P, Jarosz T, Radosz P, Setlak M, Madej P. In Search of New Therapeutics-Molecular Aspects of the PCOS Pathophysiology: Genetics, Hormones, Metabolism and Beyond. Int J Mol Sci 2020; 21:ijms21197054. [PMID: 32992734 PMCID: PMC7582580 DOI: 10.3390/ijms21197054] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/20/2020] [Accepted: 09/22/2020] [Indexed: 12/11/2022] Open
Abstract
In a healthy female reproductive system, a subtle hormonal and metabolic dance leads to repetitive cyclic changes in the ovaries and uterus, which make an effective ovulation and potential implantation of an embryo possible. However, that is not so in the case of polycystic ovary syndrome (PCOS), in which case the central mechanism responsible for entraining hormonal and metabolic rhythms during the menstrual cycle is notably disrupted. In this review we provide a detailed description of the possible scenario of PCOS pathogenesis. We begin from the analysis of how a set of genetic disorders related to PCOS leads to particular malfunctions at a molecular level (e.g., increased enzyme activities of cytochrome P450 (CYP) type 17A1 (17α-hydroxylase), 3β-HSD type II and CYP type 11A1 (side-chain cleavage enzyme) in theca cells, or changes in the expression of aquaporins in granulosa cells) and discuss further cellular- and tissue-level consequences (e.g., anovulation, elevated levels of the advanced glycation end products in ovaries), which in turn lead to the observed subsequent systemic symptoms. Since gene-editing therapy is currently out of reach, herein special emphasis is placed on discussing what kinds of drug targets and which potentially active substances seem promising for an effective medication, acting on the primary causes of PCOS on a molecular level.
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Affiliation(s)
- Agata Wawrzkiewicz-Jałowiecka
- Department of Physical Chemistry and Technology of Polymers, Silesian University of Technology, 44-100 Gliwice, Poland;
- Correspondence: ; Tel.: +48-32-237-12-85
| | - Karolina Kowalczyk
- Department of Obstetrics and Gynecology, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (K.K.); (P.R.); (P.M.)
| | - Paulina Trybek
- Faculty of Science and Technology, University of Silesia in Katowice, 41-500 Chorzow, Poland;
| | - Tomasz Jarosz
- Department of Physical Chemistry and Technology of Polymers, Silesian University of Technology, 44-100 Gliwice, Poland;
| | - Patrycja Radosz
- Department of Obstetrics and Gynecology, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (K.K.); (P.R.); (P.M.)
| | - Marcin Setlak
- Department of Neurosurgery, Medical University of Silesia, 40-752 Katowice, Poland;
| | - Paweł Madej
- Department of Obstetrics and Gynecology, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; (K.K.); (P.R.); (P.M.)
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18
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Della Corte L, Noventa M, Ciebiera M, Magliarditi M, Sleiman Z, Karaman E, Catena U, Salvaggio C, Falzone G, Garzon S. Phytotherapy in endometriosis: an up-to-date review. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2020; 17:jcim-2019-0084. [PMID: 31532753 DOI: 10.1515/jcim-2019-0084] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/28/2019] [Indexed: 12/11/2022]
Abstract
Endometriosis is a benign gynecological disease which symptoms can provide a severe impact on patient's quality of life with subsequent impact on psychological well-being. Different therapeutic strategies are available to treat this disease, such as surgery, hormonal therapies, and nonsteroidal anti-inflammatory drugs. Nevertheless, the efficacy of conventional medical treatments is limited or intermittent in most of the patients due to the associated side effects. Therefore, a woman with endometriosis often search for additional and alternative options, and phytotherapy might be a promising alternative and complementary strategy. Different medicinal plants, multicomponent herbal preparations, and phytochemicals were investigated for pharmacological proprieties in endometriosis therapy. In most of the cases, the effect on endometriosis was related to phenolic compounds, such as flavonoids and phenolic acids reporting anti-inflammatory, proapoptotic, antioxidant, and immunomodulatory functions. Moreover, some phytochemicals have been related to a strong phytoestrogenic effect modulating the estrogen activity. Although promising, available evidence is based on in vitro and animal models of endometriosis with a limited number of well-performed clinical studies. There are almost none randomized control trials in this area. Therefore, properly constructed clinical trials are mandatory to achieve more conclusive results about the promising role of phytotherapy in the management of endometriosis.
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Affiliation(s)
- Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Marco Noventa
- Department of Women and Children's Health, Clinic of Gynecology and Obstetrics, University of Padua, Padua, Italy
| | - Michal Ciebiera
- Second Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Warsaw, Poland
| | - Maria Magliarditi
- Department of Obstetrics & Gynaecology, Policlinico Universitario Gazzi, University of Messina, Messina, Italy
| | - Zaki Sleiman
- Department of Obstetrics and Gynecology, Lebanese American University, Beirut, Lebanon
| | - Erbil Karaman
- Department of Obstetrics and Gynecology, Yuzuncu Yil University Medical Faculty, Van, Turkey
| | - Ursula Catena
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Calogero Salvaggio
- Azienda Sanitaria Provinciale 2 Caltanissetta, "Sant'Elia" Hospital, Caltanissetta, Italy
| | - Giovanni Falzone
- Obstetrics and Gynaecology Unit, "Umberto I" Hospital, Enna, Italy
| | - Simone Garzon
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
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Abstract
BACKGROUND To date, the gonadotropin-releasing hormone (GnRH) stimulation test is still the gold standard for precocious puberty (PP) diagnosis. However, it has many disadvantages, including low sensitivity, high cost, and invasive operation. This study aims to evaluate whether magnetic resonance imaging (MRI)-derived variables, including pituitary volume (PV), could be used as diagnostic factors for PP in girls, providing a non-invasive diagnostic approach for PP. METHODS A total of 288 young female patients who presented to the Clinic of Pediatric Endocrinology for evaluation of PP from January 2015 to December 2017 were enrolled. The sample included 90 girls diagnosed with premature thelarche (PT), 133 girls determined as idiopathic central precocious puberty (ICPP), 35 early pubertal girls, and 30 normal girls. All patients received pituitary MRI examinations. RESULTS The largest PV and pituitary height were shown in the ICPP and pubertal groups, followed by the PT group. The receiver operating characteristic (ROC) curve analysis showed that PV is a predictive marker for ICPP, with a sensitivity of 54.10% and a specificity of 72.20% at the cutoff value of 196.01 mm3. By univariate analysis, PV was positively associated with peak luteinizing hormone (LH), LH/follicle-stimulating hormone (FSH), age, bone age, and body mass index (BMI) (all P < 0.05). However, bone age and peak LH were the only significant predictors of PV as demonstrated by the stepwise multivariate regression analysis (Model: PV = 9.431 * bone age + 1.230 * peak LH + 92.625 [P = 0.000, R2 = 0.159]). CONCLUSIONS The PV in the ICPP group was significantly higher than in PT and control groups, but there was no reliable cutoff value to distinguish ICPP from PT. Pituitary MRI should be combined with clinical and laboratory tests to improve the diagnostic value of PV for PP.
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20
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Idicula-Thomas S, Gawde U, Bhaye S, Pokar K, Bader GD. Meta-analysis of gene expression profiles of lean and obese PCOS to identify differentially regulated pathways and risk of comorbidities. Comput Struct Biotechnol J 2020; 18:1735-1745. [PMID: 32695266 PMCID: PMC7352056 DOI: 10.1016/j.csbj.2020.06.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 06/13/2020] [Accepted: 06/14/2020] [Indexed: 12/13/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a complex multigenic disorder and women with PCOS suffer from several comorbidities. Although, obesity is a known risk factor for PCOS, the incidence of lean women with PCOS is on the rise. A systematic and comparative study on lean and obese PCOS with respect to genes, pathways and comorbidity analysis has not been attempted so far. Analysis of differentially expressed genes (DEGs) across tissue types for lean and obese PCOS revealed that the majority of them were downregulated for lean and obese PCOS. Ovarian and endometrial tissues shared several commonly dysregulated genes, suggesting shared PCOS pathophysiology mechanisms exist across tissues. Several pathways for cellular homeostasis, such as inflammation and immune response, insulin signaling, steroidogenesis, hormonal and metabolic signaling, regulation of gonadotrophic hormone secretion, cell structure and signaling that are known to be affected in PCOS were found to be enriched in our gene expression analysis of lean and obese PCOS. The gene-disease network is denser for obese PCOS with a higher comorbidity score as compared to lean PCOS.
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Affiliation(s)
- Susan Idicula-Thomas
- Biomedical Informatics Centre, Indian Council of Medical Research-National Institute for Research in Reproductive Health, Mumbai 400012, India.,The Donnelly Centre, University of Toronto, Toronto, ON, Canada
| | - Ulka Gawde
- Biomedical Informatics Centre, Indian Council of Medical Research-National Institute for Research in Reproductive Health, Mumbai 400012, India
| | - Sameeksha Bhaye
- Biomedical Informatics Centre, Indian Council of Medical Research-National Institute for Research in Reproductive Health, Mumbai 400012, India
| | - Khushal Pokar
- Biomedical Informatics Centre, Indian Council of Medical Research-National Institute for Research in Reproductive Health, Mumbai 400012, India
| | - Gary D Bader
- The Donnelly Centre, University of Toronto, Toronto, ON, Canada
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21
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Terzic M, Rapisarda AMC, Della Corte L, Manchanda R, Aimagambetova G, Norton M, Garzon S, Riemma G, King CR, Chiofalo B, Cianci A. Diagnostic work-up in paediatric and adolescent patients with adnexal masses: an evidence-based approach. J OBSTET GYNAECOL 2020; 41:503-515. [DOI: 10.1080/01443615.2020.1755625] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Milan Terzic
- Department of Medicine, Nazarbayev University School of Medicine, Astana, Kazakhstan
- Department of Obstetrics and Gynecology, National Research Center of Mother and Child Health, University Medical Center, Astana, Kazakhstan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Rahul Manchanda
- Department of Gynae Endoscopy, Manchanda’s Endoscopic Centre, Pushawati Singhania Research Institute, Delhi, India
| | - Gulzhanat Aimagambetova
- Department of Obstetrics and Gynecology, National Research Center of Mother and Child Health, University Medical Center, Astana, Kazakhstan
- Department of Biomedical Sciences, Nazarbayev University School of Medicine, Astana, Kazakhstan
| | - Melanie Norton
- Department of Urogynaecology, Whittington Hospital, London, UK
| | - Simone Garzon
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, Varese, Italy
| | - Gaetano Riemma
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Cara Robinson King
- Obstetrics, Gynecology, and Womens Health Institute, Section of Minimally Invasive Gynecologic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Benito Chiofalo
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, “Regina Elena” National Cancer Institute, Rome, Italy
| | - Antonio Cianci
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
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Cirillo F, Catellani C, Lazzeroni P, Sartori C, Tridenti G, Vezzani C, Fulghesu AM, Madeddu E, Amarri S, Street ME. HMGB1 is increased in adolescents with polycystic ovary syndrome (PCOS) and decreases after treatment with myo-inositol (MYO) in combination with alpha-lipoic acid (ALA). Gynecol Endocrinol 2020; 36:588-593. [PMID: 32054355 DOI: 10.1080/09513590.2020.1725967] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PCOS treatment should be based on pathophysiology. High-mobility-group-box-1 (HMGB1) was shown to increase in PCOS patients as a consequence of reduced cystic-fibrosis-transmembrane-conductance-regulator (CFTR) expression in the ovary, and was associated with insulin resistance and inflammation, both features of PCOS. Inositols and ALA derivatives could have positive effects on insulin sensitivity, reduce androgens, and improve ovulation rhythm. The aim of this study was to verify changes in HMGB1, in metabolic and endocrine parameters in adolescents with PCOS compared with controls and after treatment with a combination of MYO + ALA. Twenty-three PCOS adolescents and 21 controls matched for age and BMI were enrolled. In all subjects, metabolic and hormonal parameters were assayed. Homeostatic index (HOMA-IR) and the triglyceride/HDL-cholesterol ratio were calculated. Ovarian volumes were evaluated. Patients were treated with MYO + ALA for 6 months. HMGB1 was measured using a specific ELISA assay. HMGB1 was increased in PCOS compared with controls (19.76 ± 5.99 versus 5.65 ± 1.88 ng/ml; p < .05) and normalized after treatment (2.27 ± 0.36 ng/ml, p < .05). Treatment significantly reduced insulin (24.0 ± 4.11 versus 12.13 ± 2.13 uU/ml), HOMA-IR (3.91 ± 0.41 versus 2.42 ± 0.45), and 17-hydroxyprogesterone (1.20 ± 0.15 versus 0.78 ± 0.11 ng/ml). Cholesterol, luteinizing hormone, 17-β-estradiol, delta 4-androstenedione, and testosterone were unchanged. Circulating HMGB1 was increased in PCOS adolescents, and treatment was effective in normalizing HMGB1.
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Affiliation(s)
- Francesca Cirillo
- Department of Obstetrics Gynaecology and Paediatrics, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Cecilia Catellani
- Department of Obstetrics Gynaecology and Paediatrics, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Pietro Lazzeroni
- Department of Obstetrics Gynaecology and Paediatrics, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Chiara Sartori
- Department of Obstetrics Gynaecology and Paediatrics, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Gabriele Tridenti
- Department of Obstetrics Gynaecology and Paediatrics, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Cristina Vezzani
- Department of Obstetrics Gynaecology and Paediatrics, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Anna Maria Fulghesu
- Department of Obstetrics and Gynaecology, University of Cagliari, Cagliari, Italy
| | - Eleonora Madeddu
- Department of Obstetrics and Gynaecology, University of Cagliari, Cagliari, Italy
| | - Sergio Amarri
- Department of Obstetrics Gynaecology and Paediatrics, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria E Street
- Department of Obstetrics Gynaecology and Paediatrics, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Breastfeeding in Hospitals: Factors Influencing Maternal Choice in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103575. [PMID: 32443713 PMCID: PMC7277836 DOI: 10.3390/ijerph17103575] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/10/2020] [Accepted: 05/15/2020] [Indexed: 02/07/2023]
Abstract
Monitoring the prevalence of breastfeeding is one of the actions provided for in Italian National Health System. This study aims to observe the prevalence of breastfeeding in a representative set of birthing hospitals in the province of Catania, in Sicily, Italy, to assess the factors influencing women in their decisions to breastfeed during hospitalization after delivery. We conducted an observational study on 3813 questionnaires administered to mothers of newborns during their hospital stay from the years 2016 to 2018 in eight hospitals of various types. The average maternal age was 31.3 years ± 5.8. Sixty-nine percent of women did not attend a prenatal course. From childbirth to discharge, the percentage of women who breastfed was 88%, of whom 45% did exclusive breastfeeding. Only 35% of women who had a caesarean section adopted exclusive breastfeeding. In our experience, rooming-in was not associated with an increase in breastfeeding. We observed that both attendance to prenatal courses and the mother's education level played a minor role in influencing the mother's decision in breastfeeding A fairly high percentage of exclusive breastfeeding, 75%, was attained just in one hospital, where dedicated staff was deployed to encourage breastfeeding. The lowest percentage (12%) of exclusive breastfeeding was observed in a large private accredited health facility. Hospital presence of professionals trained in human lactation is a smart investment for society.
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Raei Sadigh A, Darabi M, Salmassi A, Hamdi K, Farzadi L, Ghasemzadeh A, Fattahi A, Nouri M. Fractalkine and apoptotic/anti-apoptotic markers in granulosa cells of women with polycystic ovarian syndrome. Mol Biol Rep 2020; 47:3593-3603. [PMID: 32350744 DOI: 10.1007/s11033-020-05452-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 04/09/2020] [Indexed: 12/29/2022]
Abstract
Owing to the role of fractalkine in regulating cellular apoptosis/proliferation, we investigated fractalkine effects on apoptosis/proliferation signaling of granulosa cells in polycystic ovarian syndrome (PCOS) patients through in vitro and in vivo experiments. In vivo, granulosa cells were collected from 40 women undergoing oocyte retrieval (20 controls and 20 PCOS). The expression levels of fractalkine, BAX, Bcl2, Bcl2-XL, Bad, and TNF-α were assessed using RT-PCR. In vitro, we determined the effect of different doses of fractalkine on the expression of the above mentioned genes in GCs of both groups. We found that the expression levels of fractalkine and Bcl-2 were significantly lower in the GCs of PCOS patients compared to the control group (p < 0.05). In contrast, the expression levels of TNF-α and BAX were higher in the patient's group than in the control group. The results suggested that expression levels of fractalkine were negatively and positively correlated with the number of oocytes and fertilized oocytes respectively. Moreover, fractalkine could dose-dependently increase fractalkine and decrease BAD, BAX, Bcl-xl, and TNF-α expressions in the control GCs. In contrast, GCs collected from PCOS patients revealed an increase in expression of BAD, BAX, and Bcl-xl following fractalkine treatment. Our findings indicated that insufficient expression of fractalkine in PCOS patients is related with elevated apoptotic and inflammatory markers and reduced anti-apoptotic genes in the GCs.
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Affiliation(s)
- Aydin Raei Sadigh
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Biochemistry and Clinical Laboratory, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoud Darabi
- Department of Biochemistry and Clinical Laboratory, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Salmassi
- Department of Reproductive Biology, School of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kobra Hamdi
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Laya Farzadi
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Aliye Ghasemzadeh
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Fattahi
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Reproductive Biology, School of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mohammad Nouri
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Biochemistry and Clinical Laboratory, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Reproductive Biology, School of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
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25
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Bhushan R, Rani A, Ali A, Singh VK, Dubey PK. Bioinformatics enrichment analysis of genes and pathways related to maternal type 1 diabetes associated with adverse fetal outcomes. J Diabetes Complications 2020; 34:107556. [PMID: 32046932 DOI: 10.1016/j.jdiacomp.2020.107556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 01/31/2020] [Accepted: 01/31/2020] [Indexed: 01/14/2023]
Abstract
Maternal type 1 diabetes mellitus (T1DM) may affect fetal development by altering the gene expression profile of the umbilical cord. The present study aimed to explore the T1DM-induced gene expression changes in the fetal umbilical cord. The raw gene expression profiles (ID: GSE51546) of umbilical cord tissue obtained from six normal mothers (non-diabetic) and six type 1 diabetic mothers were used to identify the differentially expressed genes. Genes that correspond to official gene symbols were selected for protein-protein interaction (PPI) and sub-network construction (combined score > 0.4). Functional annotation for Gene Ontology (GO) and pathway enrichment analysis were performed for genes involved in networking. A total of 110 differentially expressed genes were identified of which 38 were up-regulated while 72 were down-regulated. Only 37 genes were identified to significantly interact with each other. Hub genes including HSPA4, KCTD6, UBE2G1, FBXL19, and EHMT1 were up-regulated while KBTBD7, TRIM32, and NUP were down-regulated. T1DM had a major effect on the expression of genes involved in cellular death and differentiation, cell signaling and communication, protein modification and regulation of GTPase activity. Total 27 pathways were enriched and genes related to Wnt signaling, VEGF signaling, inflammation mediated by chemokine and cytokine signaling pathways, FGF signaling pathways and GnRH receptor pathways were found significantly affected by T1DM. Our results suggest that the T1DM environment seems to alter umbilical cord gene expression involved in the regulation of pathophysiology of the diabetic mother which in turn may lead to long-term consequences in various tissues in infants. This study provides insight into the molecular mechanism underlying the adverse pregnancy outcomes of maternal T1DM.
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Affiliation(s)
- Ravi Bhushan
- Centre for Genetic Disorders, Institute of Science, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India
| | - Anjali Rani
- Department of Obstetrics and Gynecology, Institute of Medical Science, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India
| | - Akhtar Ali
- Centre for Genetic Disorders, Institute of Science, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India
| | - Vinay Kumar Singh
- Centre for Bioinformatics, School of Biotechnology, Institute of Science, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India
| | - Pawan K Dubey
- Centre for Genetic Disorders, Institute of Science, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India.
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Terzic M, Aimagambetova G, Norton M, Della Corte L, Marín-Buck A, Lisón JF, Amer-Cuenca JJ, Zito G, Garzon S, Caruso S, Rapisarda AMC, Cianci A. Scoring systems for the evaluation of adnexal masses nature: current knowledge and clinical applications. J OBSTET GYNAECOL 2020; 41:340-347. [PMID: 32347750 DOI: 10.1080/01443615.2020.1732892] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Adnexal masses are a common finding in women, with 20% of them developing at least one pelvic mass during their lifetime. There are more than 30 different subtypes of adnexal tumours, with multiple different subcategories, and the correct characterisation of the pelvic masses is of paramount importance to guide the correct management. On that basis, different algorithms and scoring systems have been developed to guide the clinical assessment. The first scoring system implemented into the clinical practice was the Risk of Malignancy Index, which combines ultrasound evaluation, menopausal status, and serum CA-125 levels. Today, current guidelines regarding female patients with adnexal masses include the application of International Ovarian Tumours Analysis simple rules, logistic regression model 1 (LR1) and LR2, OVERA, cancer ovarii non-invasive assessment of treating strategy, and assessment of Different Neoplasias in the adnexa. In this scenario, the choice of the scoring system for the discrimination between benign and malignant ovarian tumours can be complex when approaching patients with adnexal masses. This review aims to summarise the available evidence regarding the different scoring systems to provide a complete overview of the topic.
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Affiliation(s)
- Milan Terzic
- Department of Medicine, Nazarbayev University School of Medicine, Astana, Kazakhstan.,Department of Obstetrics and Gynecology, National Research Center of Mother and Child Health, University Medical Center, Astana, Kazakhstan.,Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Gulzhanat Aimagambetova
- Department of Biomedical Sciences, Nazarbayev University School of Medicine, Astana, Kazakhstan
| | - Melanie Norton
- Department of Urogynaecology, Whittington Hospital, London, UK
| | - Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Alejandro Marín-Buck
- Department of Surgery, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain.,Department of Gynecology, Hospital Provincial de Castellón, Castellón, Spain
| | - Juan Francisco Lisón
- Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain.,CIBER of Physiopathology of Obesity and Nutrition CIBERobn, CB06/03 Carlos III Health Institute, Madrid, Spain
| | - Juan José Amer-Cuenca
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Gabriella Zito
- Department of Obstetrics and Gynecology, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Simone Garzon
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Salvatore Caruso
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Agnese Maria Chiara Rapisarda
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Antonio Cianci
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
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Duman M, Durgun Ozan Y. A comparison of physical anxiety levels in adolescent and young women with polycystic ovary syndrome and in other healthy adolescent and young women in a university hospital, Turkey. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-08-2019-0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PurposeThis study was conducted to investigate the Social Physique Anxiety (SPA) level in adolescent and young women with polycystic ovarian syndrome (PCOS).Design/methodology/approachThis is a descriptive study. It was conducted in Turkey. The study was conducted from January 1, 2017 to December 31, 2017. It was completed with a total of 150 young women – 75 of them had PCOS and 75 of them were healthy. Study data were collected using demographic information form and Social Physique Anxiety Scale (SPAS).FindingsThe study was found that the adolescent and young women with PCOS had higher subscales and total scores for total SPAS at a statistically significant level than healthy adolescent and young women (p < 0.05).Practice implicationThe findings of this study may be used for planning and implementing interventions in health-care practice such as screening and early treatment of SPA of women with PCOS.Originality/valueIt was found that PCOS in adolescent and young women increased the SPA level. In line with these results, health professionals must be particularly aware of the potential psychosocial and health needs of adolescent and young women with PCOS.
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Szczuko M, Hawryłkowicz V, Kikut J, Drozd A. The implications of vitamin content in the plasma in reference to the parameters of carbohydrate metabolism and hormone and lipid profiles in PCOS. J Steroid Biochem Mol Biol 2020; 198:105570. [PMID: 31883924 DOI: 10.1016/j.jsbmb.2019.105570] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/18/2019] [Accepted: 12/23/2019] [Indexed: 12/12/2022]
Abstract
So far, there have been no analyses of correlations between the level of water-soluble vitamins in women with polycystic ovary syndrome (PCOS) and hormone and lipid profiles as well as carbohydrate metabolism. The unpopular concept that PCOS may also be conditioned by a chronic infection leads to a suspicion that water-soluble vitamins may be involved in the struggle against PCOS. This is why the aim of this research was to determine whether there are any indications that could confirm this hypothesis. The study included 64 women of Caucasian race: 50 patients aged 29.52 ± 7.01 years with PCOS, diagnosed according to the Rotterdam criteria. The control group consisted of 14 women aged 30.23 ± 6.3 years with correct BMI. HPLC Infinity1260 Binary LC (Agilent Technologies, Waldbronn, Germany) was used to analyze nine vitamins. The vitamins were separated using the gradient method, a buffer of 25 mM HK2PO4 with pH equal to 7.0, and 100 % methanol buffer. The acquired results were compared using Statistica 12.0 (Statsoft, Tulsa, Oklahoma, USA). Non-parametric tests were used: Mann-Whitney tests for comparisons between groups (PCOS and control group, CG), in which p < 0.05 was considered statistically significant. Subsequently, we performed a correlation matrix of the biochemical parameters of blood with vitamins at p ≤ 0.05. Higher concentrations of ascorbic acid were observed in PCOS. The content of the remaining vitamins was higher in the control group, and the statistical differences were significant in reference to thiamine, riboflavin, pyridoxine and folic acid in comparison to the control group. A significant positive correlation was observed between vitamin C and testosterone/insulin, another between riboflavin and androstenedione/testosterone, next between biotin and thyrotropic hormone (TSH), between pantothenic acid and dehydroepiandrosteron (DHEA-SO4), and finally between pyridoxine and androstenedione. A negative correlation was observed in the case of niacin with sex hormone binding protein (SHBG) and high density lipoprotein (HDL). Water-soluble vitamins play an important role in the therapy of women with PCOS through the reduction of antioxidative stress and low-intensity inflammation caused by various factors, including chronic infection.
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Affiliation(s)
- Małgorzata Szczuko
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, Poland.
| | - Viktoria Hawryłkowicz
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, Poland.
| | - Justyna Kikut
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, Poland.
| | - Arleta Drozd
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, Poland.
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Tian S, Dong W, Chan KL, Leng X, Bedford LE, Liu J. Screening for chronic conditions with reproductive factors using a machine learning based approach. Sci Rep 2020; 10:2848. [PMID: 32071372 PMCID: PMC7028713 DOI: 10.1038/s41598-020-59825-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 01/19/2020] [Indexed: 11/30/2022] Open
Abstract
A large proportion of cases with chronic conditions including diabetes or pre-diabetes, hypertension and dyslipidemia remain undiagnosed. To include reproductive factors (RF) might be able to improve current screening guidelines by providing extra effectiveness. The objective is to study the relationships between RFs and chronic conditions' biomarkers. A cross-sectional study was conducted. Demographics, RFs and metabolic biomarkers were collected. The relationship of the metabolic biomarkers were shown by correlation analysis. Principal component analysis (PCA) and autoencoder were compared by cross-validation. The better one was adopted to extract a single marker, the general chronic condition (GCC), to represent the body's chronic conditions. Multivariate linear regression was performed to explore the relationship between GCC and RFs. In total, 1,656 postmenopausal females were included. A multi-layer autoencoder outperformed PCA in the dimensionality reduction performance. The extracted variable by autoencoder, GCC, was verified to be representative of three chronic conditions (AUC for patoglycemia, hypertension and dyslipidemia were 0.844, 0.824 and 0.805 respectively). Linear regression showed that earlier age at menarche (OR = 0.9976) and shorter reproductive life span (OR = 0.9895) were associated with higher GCC. Autoencoder performed well in the dimensionality reduction of clinical metabolic biomarkers. Due to high accessibility and effectiveness, RFs have potential to be included in screening tools for general chronic conditions and could enhance current screening guidelines.
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Affiliation(s)
- Siyu Tian
- Department of Obstetrics and Gynecology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Sassoon Road, Hong Kong, China
| | - Weinan Dong
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Ka Lung Chan
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Xinyi Leng
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Laura Elizabeth Bedford
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Jia Liu
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
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High antimüllerian hormone levels are associated with preterm delivery in patients with polycystic ovary syndrome. Fertil Steril 2020; 113:444-452.e1. [DOI: 10.1016/j.fertnstert.2019.09.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/25/2019] [Accepted: 09/26/2019] [Indexed: 01/09/2023]
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Piltonen TT, Ruokojärvi M, Karro H, Kujanpää L, Morin-Papunen L, Tapanainen JS, Stener-Victorin E, Sundrström-Poromaa I, Hirschberg AL, Ravn P, Glintborg D, Mellembakken JR, Steingrimsdottir T, Gibson-Helm M, Vanky E, Andersen M, Arffman RK, Teede H, Falah-Hassani K. Awareness of polycystic ovary syndrome among obstetrician-gynecologists and endocrinologists in Northern Europe. PLoS One 2019; 14:e0226074. [PMID: 31877155 PMCID: PMC6932801 DOI: 10.1371/journal.pone.0226074] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 11/18/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To date, little is known about differences in the knowledge, diagnosis making and treatment strategies of health care providers regarding polycystic ovary syndrome (PCOS) across different disciplines in countries with similar health care systems. To inform guideline translation, we aimed to study physician reported awareness, diagnosis and management of PCOS and to explore differences between medical disciplines in the Nordic countries and Estonia. METHODS This cross-sectional survey was conducted among 382 endocrinologists and obstetrician-gynaecologists in the Nordic countries and Estonia in 2015-2016. Of the participating physicians, 43% resided in Finland, 18% in Denmark, 16% in Norway, 13% in Estonia, and 10% in Sweden or Iceland, and 75% were obstetrician-gynaecologists. Multivariable logistic regression models were run to identify health care provider characteristics for awareness, diagnosis and treatment of PCOS. RESULTS Clinical features, lifestyle management and comorbidity were commonly recognized in women with PCOS, while impairment in psychosocial wellbeing was not well acknowledged. Over two-thirds of the physicians used the Rotterdam diagnostic criteria for PCOS. Medical endocrinologists more often recommended lifestyle management (OR = 3.6, CI 1.6-8.1) or metformin (OR = 5.0, CI 2.5-10.2), but less frequently OCP (OR = 0.5, CI 0.2-0.9) for non-fertility concerns than general obstetrician-gynaecologists. The physicians aged <35 years were 2.2 times (95% CI 1.1-4.3) more likely than older physicians to recommend lifestyle management for patients with PCOS for fertility concerns. Physicians aged 46-55 years were less likely to recommend oral contraceptive pills (OCP) for patients with PCOS than physicians aged >56 (adjusted odds ratio (OR) = 0.4, 95% CI 0.2-0.8). CONCLUSION Despite well-organized healthcare, awareness, diagnosis and management of PCOS is suboptimal, especially in relation to psychosocial comorbidities, among physicians in the Nordic countries and Estonia. Physicians need more education on PCOS and evidence-based information on Rotterdam diagnostic criteria, psychosocial features and treatment of PCOS, with the recently published international PCOS guideline well needed and welcomed.
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Affiliation(s)
- Terhi T. Piltonen
- Department of Obstetrics and Gynaecology, University of Oulu and Oulu University Hospital, Medical Research Centre, PEDEGO Research Unit, Oulu, Finland
| | - Maria Ruokojärvi
- Department of Obstetrics and Gynaecology, University of Oulu and Oulu University Hospital, Medical Research Centre, PEDEGO Research Unit, Oulu, Finland
| | - Helle Karro
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Linda Kujanpää
- Department of Obstetrics and Gynaecology, University of Oulu and Oulu University Hospital, Medical Research Centre, PEDEGO Research Unit, Oulu, Finland
| | - Laure Morin-Papunen
- Department of Obstetrics and Gynaecology, University of Oulu and Oulu University Hospital, Medical Research Centre, PEDEGO Research Unit, Oulu, Finland
| | - Juha S. Tapanainen
- Department of Obstetrics and Gynaecology, University of Oulu and Oulu University Hospital, Medical Research Centre, PEDEGO Research Unit, Oulu, Finland
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | | | - Angelica L. Hirschberg
- Department of Women’s and Children’s Health, Karolinska Institutet and Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Pernille Ravn
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Dorte Glintborg
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Jan Roar Mellembakken
- Department of Reproductive Medicine, Division of Gynaecology and Obstetrics, Oslo University Hospital, Oslo, Norway
| | - Thora Steingrimsdottir
- Department of Obstetrics and Gynecology, Landspitali University Hospital, School of Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Melanie Gibson-Helm
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Eszter Vanky
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Obstetrics and Gynecology, St Olav's Hospital, University Hospital of Trondheim, Trondheim, Norway
| | - Marianne Andersen
- Department of Language and Culture, UiT—The Arctic University of Norway, Tromsø, Norway
| | - Riikka K. Arffman
- Department of Obstetrics and Gynaecology, University of Oulu and Oulu University Hospital, Medical Research Centre, PEDEGO Research Unit, Oulu, Finland
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Kobra Falah-Hassani
- Department of Obstetrics and Gynaecology, University of Oulu and Oulu University Hospital, Medical Research Centre, PEDEGO Research Unit, Oulu, Finland
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Vazquez-Levin M, Verón G. Myo‐inositol in health and disease: its impact on semen parameters and male fertility. Andrology 2019; 8:277-298. [DOI: 10.1111/andr.12718] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 10/12/2019] [Accepted: 10/16/2019] [Indexed: 02/06/2023]
Affiliation(s)
- M.H. Vazquez-Levin
- Laboratorio de Estudios de Interacción Celular en Reproducción y Cáncer Instituto de Biología y Medicina Experimental (IBYME)Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)‐ Fundación IBYME (FIBYME) Ciudad Autónoma de Buenos Aires Argentina
| | - G.L. Verón
- Laboratorio de Estudios de Interacción Celular en Reproducción y Cáncer Instituto de Biología y Medicina Experimental (IBYME)Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)‐ Fundación IBYME (FIBYME) Ciudad Autónoma de Buenos Aires Argentina
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Tadaion Far F, Jahanian Sadatmahalleh S, Ziaei S, Kazemnejad A. Comparison of the umbilical cord Blood's anti-Mullerian hormone level in the newborns of mothers with polycystic ovary syndrome (PCOS) and healthy mothers. J Ovarian Res 2019; 12:111. [PMID: 31735163 PMCID: PMC6858970 DOI: 10.1186/s13048-019-0583-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 10/17/2019] [Indexed: 01/18/2023] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases. At present, the cause of the disease is not fully understood, but many studies have shown that PCOS is associated with genetic and environmental factors. The present study aimed to assess the umbilical cord blood’s Anti-mullerian hormone (AMH) level in the newborns of mothers suffering from PCOS comparing to healthy mothers. Methods This prospective cohort study was conducted on 120 pregnant women with PCOS, who were selected through Rotterdam criteria, and 60 healthy pregnant women as the control group. The subjects in each group were divided into obese and non-obese mothers according to their body mass index (BMI) before pregnancy. The cord blood samples were collected from the offsprings on the time of childbirth. Finally, the circulating concentrations of AMH in both sexes of the newborns were determined by specific assays. Results The research results showed that the blood level of AMH was higher in the neonates of obese mothers with PCOS comparing to the controls (P < 0.001). Mean AMH level was higher in male neonates born from non-obese PCOS mothers than in the controls (P < 0.001); however, there was not a significant difference in the level of AMH in female neonates between these two groups (P = 0.264). Also the level of the above biomarker was higher in both sexes of the neonates belonging to obese PCOS mothers compared with the neonates born from non-obese PCOS mothers (P < 0.001). Conclusion(s) It can be said that the cord blood AMH level of neonates from obese women with PCOS is higher than that in the newborns of non-obese PCOS mothers. Further longitudinal studies are needed to confirm the clinical findings of the present research.
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Affiliation(s)
- Faezeh Tadaion Far
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | | | - Saeideh Ziaei
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Anoshirvan Kazemnejad
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Sidra S, Tariq MH, Farrukh MJ, Mohsin M. Evaluation of clinical manifestations, health risks, and quality of life among women with polycystic ovary syndrome. PLoS One 2019; 14:e0223329. [PMID: 31603907 PMCID: PMC6788722 DOI: 10.1371/journal.pone.0223329] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 09/18/2019] [Indexed: 11/18/2022] Open
Abstract
This study aimed to evaluate the clinical manifestations and health risks associated with polycystic ovary syndrome (PCOS) and its impact on quality of life (QOL) in Pakistan. A detailed cross-sectional study was conducted on PCOS among women of reproductive age visiting the gynecology and obstetrics and endocrinology departments at primary and tertiary care hospitals located in Abbottabad, Kohat, and Islamabad. In total, 440 patients meeting the inclusion criteria were included. A checklist was specifically designed to identify symptoms and health risks, including adverse drug reactions, complications, irrational prescription or underprescription, and drug-drug interactions. The Short Form-12 questionnaire was used to evaluate the QOL of patients with PCOS. Data collected were analyzed for descriptive and inferential statistics using chi-square test, analysis of variance, and post hoc analysis. All patients exhibited the cardinal symptoms of PCOS, including obesity (n = 352, 80%), acne (n = 296, 67.3), hirsutism (n = 299, 68%), hyperglycemia (n = 278, 63.2%), and irregular menstruation (n = 316, 71.8%). Ultrasonography confirmed that 268 (61%) patients had multiple cysts of >10 mm in diameter. Patients with untreated PCOS exhibited a high prevalence of health risks including hypertension (n = 87, 19.8%), diabetes (n = 268, 60.9%), sleep apnea (n = 11, 2.5%), infertility (n = 146, 33.2%), increased endometrial thickness (n = 21, 4.8%), miscarriages (n = 68, 15.5%), high cholesterol level (n = 85, 19.3%), and hyperandrogenism (n = 342, 77.7%). Most patients exhibited low QOL scores (n = 374, 85%), with depression being the largest contributor to low QOL. Apart from novel results, this study found an association between depression and low QOL in patients with PCOS, suggesting the need for reviewing the management guidelines and psychological health assessment of women with PCOS.
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Affiliation(s)
- Syeda Sidra
- Faculty of Pharmaceutical Sciences, Riphah International University, Islamabad, Pakistan
| | - Muhammad Haseeb Tariq
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | | | - Muhammad Mohsin
- Faculty of Pharmaceutical Sciences, Riphah International University, Islamabad, Pakistan
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Ho CH, Chang CM, Li HY, Shen HY, Lieu FK, Wang PSG. Dysregulated immunological and metabolic functions discovered by a polygenic integrative analysis for PCOS. Reprod Biomed Online 2019; 40:160-167. [PMID: 31780352 DOI: 10.1016/j.rbmo.2019.09.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/22/2019] [Accepted: 09/23/2019] [Indexed: 12/28/2022]
Abstract
RESEARCH QUESTION Polycystic ovary syndrome (PCOS) is a complex disease and its pathophysiology is still unclear. This polygenic study may provide some clues. DESIGN A polygenic, functionome-based study with the ovarian gene expression profiles downloaded from the National Center for Biotechnology Information (NCBI) Gene Expression Omnibus (GEO) database, including 48 PCOS and 181 normal control samples. These profiles were converted to the gene set regularity (GSR) indices, which were computed by the modified differential rank conversion algorithm and were defined by the gene ontology terms. RESULTS Machine learning could accurately recognize the patterns of functional regularities between PCOS and normal controls. The significantly aberrant functions in PCOS included transporter activity, catalytic activity, the receptor signalling pathway via signal transducer and activator of transcription (STAT), the cellular metabolic process, and immune response. CONCLUSION This study provided a comprehensive view of the dysregulated functions and information for further studies on the management of PCOS.
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Affiliation(s)
- Chi-Hong Ho
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei Taiwan, Republic of China; Institute of Physiology, School of Medicine, National Yang-Ming University, Taipei Taiwan, Republic of China
| | - Chia-Ming Chang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei Taiwan, Republic of China; Department of Obstetrics and Gynecology, School of Medicine, National Yang-Ming University, Taipei Taiwan, Republic of China
| | - Hsin-Yang Li
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei Taiwan, Republic of China
| | - Heng-Yi Shen
- Department of Rehabilitation, Cheng Hsin General Hospital, Taipei Taiwan, Republic of China; Department of Physical Medicine and Rehabilitation, National Defense Medical Center, Taipei Taiwan, Republic of China
| | - Fu-Kong Lieu
- Department of Rehabilitation, Cheng Hsin General Hospital, Taipei Taiwan, Republic of China; Department of Physical Medicine and Rehabilitation, National Defense Medical Center, Taipei Taiwan, Republic of China
| | - Paulus Shyi-Gang Wang
- Institute of Physiology, School of Medicine, National Yang-Ming University, Taipei Taiwan, Republic of China; Medical Center of Ageing Research, China Medical University Hospital, Taichung Taiwan, Republic of China; Department of Biotechnology, College of Health Science, Asia University, Taichung Taiwan, Republic of China; Department of Medical Research, Taipei Veterans General Hospital, Taipei Taiwan, Republic of China.
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Herman AP, Skipor J, Krawczyńska A, Bochenek J, Wojtulewicz K, Pawlina B, Antushevich H, Herman A, Tomaszewska-Zaremba D. Effect of Central Injection of Neostigmine on the Bacterial Endotoxin Induced Suppression of GnRH/LH Secretion in Ewes during the Follicular Phase of the Estrous Cycle. Int J Mol Sci 2019; 20:ijms20184598. [PMID: 31533319 PMCID: PMC6769544 DOI: 10.3390/ijms20184598] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 09/10/2019] [Accepted: 09/16/2019] [Indexed: 12/29/2022] Open
Abstract
Induced by a bacterial infection, an immune/inflammatory challenge is a potent negative regulator of the reproduction process in females. The reduction of the synthesis of pro-inflammatory cytokine is considered as an effective strategy in the treatment of inflammatory induced neuroendocrine disorders. Therefore, the effect of direct administration of acetylcholinesterase inhibitor—neostigmine—into the third ventricle of the brain on the gonadotropin-releasing hormone (GnRH) and luteinizing hormone (LH) secretions under basal and immune stress conditions was evaluated in this study. In the study, 24 adult, 2-years-old Blackhead ewes during the follicular phase of their estrous cycle were used. Immune stress was induced by the intravenous injection of LPS Escherichia coli in a dose of 400 ng/kg. Animals received an intracerebroventricular injection of neostigmine (1 mg/animal) 0.5 h before LPS/saline treatment. It was shown that central administration of neostigmine might prevent the inflammatory-dependent decrease of GnRH/LH secretion in ewes and it had a stimulatory effect on LH release. This central action of neostigmine is connected with its inhibitory action on local pro-inflammatory cytokines, such as interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)α synthesis in the hypothalamus, which indicates the importance of this mediator in the inhibition of GnRH secretion during acute inflammation.
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Affiliation(s)
- Andrzej Przemysław Herman
- The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, 05-100 Jabłonna, Poland; (A.K.); (J.B.); (K.W.); (B.P.); (H.A.); (D.T.-Z.)
- Correspondence: ; Tel.: +48-22-765-33-02; Fax: +48-22-765-33-03
| | - Janina Skipor
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, 10-748 Olsztyn, Poland;
| | - Agata Krawczyńska
- The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, 05-100 Jabłonna, Poland; (A.K.); (J.B.); (K.W.); (B.P.); (H.A.); (D.T.-Z.)
| | - Joanna Bochenek
- The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, 05-100 Jabłonna, Poland; (A.K.); (J.B.); (K.W.); (B.P.); (H.A.); (D.T.-Z.)
| | - Karolina Wojtulewicz
- The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, 05-100 Jabłonna, Poland; (A.K.); (J.B.); (K.W.); (B.P.); (H.A.); (D.T.-Z.)
| | - Bartosz Pawlina
- The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, 05-100 Jabłonna, Poland; (A.K.); (J.B.); (K.W.); (B.P.); (H.A.); (D.T.-Z.)
| | - Hanna Antushevich
- The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, 05-100 Jabłonna, Poland; (A.K.); (J.B.); (K.W.); (B.P.); (H.A.); (D.T.-Z.)
| | - Anna Herman
- Faculty of Health Sciences, Warsaw School of Engineering and Health, 02-366 Warsaw, Poland;
| | - Dorota Tomaszewska-Zaremba
- The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, 05-100 Jabłonna, Poland; (A.K.); (J.B.); (K.W.); (B.P.); (H.A.); (D.T.-Z.)
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Fichera M, Török P, Tesarik J, Della Corte L, Rizzo G, Garzon S, Carlea A, Di Angelo Antonio S, Zito G, Panella MM. Vitamin D, reproductive disorders and assisted reproduction: evidences and perspectives. Int J Food Sci Nutr 2019; 71:276-285. [PMID: 31928386 DOI: 10.1080/09637486.2019.1661978] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Vitamin D is an important nutrient involved in many fundamental health outcomes. However, its influence on female reproductive function remains ambiguous. Cholecalciferol seems to have a role in the reproductive processes and in the patients affected by polycystic ovary syndrome, endometriosis, uterine myomas and premature ovarian failure. Moreover, it may play an important role in the assisted reproductive techniques, given that it is capable of influencing oocyte quality, but also an adequate preparation of the endometrium for embryonic implantation. Although promising, available evidence is based on a limited number of in vitro, in vivo and clinical studies. We provide an overview of the association between vitamin D and female infertility reporting the most recent data published in the literature. Nevertheless, properly randomised clinical trials are mandatory to achieve more conclusive results about the promising role of vitamin D in the management of female assisted reproduction.
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Affiliation(s)
- Michele Fichera
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Péter Török
- Faculty of Medicine, Institute of Obstetrics and Gynaecology, University of Debrecen, Debrecen, Hungary
| | | | - Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | | | - Simone Garzon
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Annunziata Carlea
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | | | - Gabriella Zito
- Department of Obstetrics and Gynecology, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Marco Marzio Panella
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
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González-González L, González-Ramírez R, Flores A, Avelino-Cruz JE, Felix R, Monjaraz E. Epidermal Growth Factor Potentiates Migration of MDA-MB 231 Breast Cancer Cells by Increasing NaV1.5 Channel Expression. Oncology 2019; 97:373-382. [PMID: 31430760 DOI: 10.1159/000501802] [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: 05/21/2019] [Accepted: 06/27/2019] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Breast cancer is one of the leading causes of death worldwide and is the result of dysregulation of various signaling pathways in mammary epithelial cells. The mortality rate in patients suffering from breast cancer is high because the tumor cells have a prominent invasive capacity towards the surrounding tissues. Previous studies carried out in tumor cell models show that voltage-gated ion channels may be important molecular actors that contribute to the migratory and invasive capacity of the tumor cells. METHODS In this study, by using an experimental strategy that combines cell and molecular biology assays with electrophysiological recording, we sought to determine whether the voltage-dependent sodium channel NaV1.5 regulates the migratory capacity of the human breast cancer cell line MDA-MB 231, when cells are maintained in the presence of epidermal growth factor (EGF), as an inductor of the epithelial-mesenchymal transition. RESULTS Our data show that EGF stimulates the migratory capacity of MDA-MB 231 cells, by regulating the functional expression of NaV1.5 channels. Consistent with this, the stimulatory actions of the growth factor were prevented by the use of tetrodotoxin, an Na+ channel selective blocker, as well as by resveratrol, an antioxidant that can also affect Na+ channel activity. DISCUSSION The understanding of molecular mechanisms, such as the EGF pathway in the progression of breast cancer is fundamental for the design of more effective therapeutic strategies for the disease.
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Affiliation(s)
| | - Ricardo González-Ramírez
- Department of Molecular Biology and Histocompatibility, Dr. Manuel Gea González General Hospital, Mexico City, Mexico
| | - Amira Flores
- Institute of Physiology, Meritorious Autonomous University of Puebla (BUAP), Puebla, Mexico
| | - José E Avelino-Cruz
- Institute of Physiology, Meritorious Autonomous University of Puebla (BUAP), Puebla, Mexico
| | - Ricardo Felix
- Department of Cell Biology, Center for Research and Advanced Studies of the National Polytechnic Institute (Cinvestav-IPN), Mexico City, Mexico,
| | - Eduardo Monjaraz
- Institute of Physiology, Meritorious Autonomous University of Puebla (BUAP), Puebla, Mexico
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Yuanyuan Z, Zeqin W, Xiaojie S, Liping L, Yun X, Jieqiong Z. Proliferation of Ovarian Granulosa Cells in Polycystic Ovarian Syndrome Is Regulated by MicroRNA-24 by Targeting Wingless-Type Family Member 2B (WNT2B). Med Sci Monit 2019; 25:4553-4559. [PMID: 31215527 PMCID: PMC6597143 DOI: 10.12659/msm.915320] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 02/11/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Polycystic ovarian syndrome (PCOS) is a common endocrine disorder causing infertility among reproductive-age women. The molecular mechanisms underlying the development of PCOS are not well understood, and effective treatment options and therapeutic targets for PCOS are not available. This study was designed to investigate the role and therapeutic potential of miR-324 in PCOS. MATERIAL AND METHODS We used quantitative real time-polymerase chain reaction (qRT-PCR) to assess expression. Cell viability was determined by [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] (MTT) assay. Acridine orange/ethidium bromide (AO/EB) and annexin V/PI staining were performed to examine apoptosis. Western blot analysis was used to determine protein expression. RESULTS Results showed that the expression of miR-324 was aberrantly and significantly downregulated in PCOS ovarian tissues and KGN ovarian granulosa cells. Nonetheless, ectopic expression of miR-324 expression inhibited the viability of KGN cells via induction of apoptotic cell death. In silico analysis showed Wingless-Type family member 2B (WNT2B) to be the target of miR-324, which was also validated by dual-luciferase reporter assay. We also found that the expression of WNT2B was upregulated in the KGN cells, and overexpression of miR-324 inhibited WNT2B expression. Similar to WNT2B overexpression, WNT2B silencing decreased the viability of the KGN. Furthermore, overexpression of WNTB2 in KGN partially reversed the growth-inhibitory effects of miR-324 overexpression. CONCLUSIONS miR-324 regulates the proliferation of KGN cells in PCOs and be essential in the management of PCOS.
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Affiliation(s)
- Zhong Yuanyuan
- Department of Obstetrics and Gynecology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Wang Zeqin
- Department of Obstetrics and Gynecology, Ninth Hospital of Wuhan, Wuhan, Hubei, P.R. China
| | - Song Xiaojie
- Department of Obstetrics and Gynecology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Liu Liping
- Department of Obstetrics and Gynecology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Xiang Yun
- Department of Clinical Lab, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Zhou Jieqiong
- Department of Obstetrics and Gynecology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
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Li Z, Peng A, Feng Y, Zhang X, Liu F, Chen C, Ye X, Qu J, Jin C, Wang M, Qiu H, Qi Y, Huang J, Yang Q. Detection of T lymphocyte subsets and related functional molecules in follicular fluid of patients with polycystic ovary syndrome. Sci Rep 2019; 9:6040. [PMID: 30988342 PMCID: PMC6465402 DOI: 10.1038/s41598-019-42631-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 04/04/2019] [Indexed: 12/18/2022] Open
Abstract
Immune responses play an important role in the pathogenesis of polycystic ovary syndrome (PCOS). However, the characteristics of T lymphocyte subsets in PCOS remain insufficiently understood. In this study, lymphocytes of follicular fluid (FF) were obtained from oocyte retrieval before in-vitro fertilization (IVF) in infertile women with or without PCOS. The levels of cluster of differentiation 25 (CD25), CD69, programmed death 1 (PD-1), interferon-γ (IFN-γ), interleukin 17A (IL-17A) and IL-10 in T lymphocytes were determined by flow cytometry. Our results showed that the percentage of FF CD8+ T cells was significantly decreased in infertile patients with PCOS (P < 0.05). Furthermore, the levels of CD69 and IFN-γ were significantly decreased and the level of PD-1 was increased in both CD4+ and CD8+ T cells from infertile patients with PCOS (P < 0.05). Moreover, the expression of PD-1 on CD4+ or CD8+ T cells was positively correlated with the estradiol (E2) levels in the serum and reversely correlated with the expression of IFN-γ in CD4+ or CD8+ T cells in infertile patients with PCOS. These results suggested that T cell dysfunction may be involved in the pathogenesis of PCOS.
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Affiliation(s)
- Zitao Li
- Reproductive medical center, Guangdong Women and Children Hospital, Guangzhou Medical University, 511400, Guangzhou, China
| | - Anping Peng
- Clinical laboratory, Traditional Chinese Medicine Hospital of Guangdong province, 510120, Guangzhou, China
| | - Yuanfa Feng
- Department of Pathogenic Biology and Immunology, Sino-French Hoffmann Institute, Guangzhou Medical University, 511436, Guangzhou, China
| | - Xiaona Zhang
- The Sixth Affiliated Hospital of Sun Yat-Sen University, 510655, Guangzhou, China
| | - Fenghua Liu
- Reproductive medical center, Guangdong Women and Children Hospital, Guangzhou Medical University, 511400, Guangzhou, China
| | - Chuangqi Chen
- Reproductive medical center, Guangdong Women and Children Hospital, Guangzhou Medical University, 511400, Guangzhou, China
| | - Xin Ye
- Department of Pathogenic Biology and Immunology, Sino-French Hoffmann Institute, Guangzhou Medical University, 511436, Guangzhou, China
| | - Jiale Qu
- Department of Pathogenic Biology and Immunology, Sino-French Hoffmann Institute, Guangzhou Medical University, 511436, Guangzhou, China
| | - Chenxi Jin
- Department of Pathogenic Biology and Immunology, Sino-French Hoffmann Institute, Guangzhou Medical University, 511436, Guangzhou, China
| | - Mei Wang
- Department of Pathogenic Biology and Immunology, Sino-French Hoffmann Institute, Guangzhou Medical University, 511436, Guangzhou, China
| | - Huaina Qiu
- Department of Pathogenic Biology and Immunology, Sino-French Hoffmann Institute, Guangzhou Medical University, 511436, Guangzhou, China
| | - Yanwei Qi
- Department of Pathogenic Biology and Immunology, Sino-French Hoffmann Institute, Guangzhou Medical University, 511436, Guangzhou, China
| | - Jun Huang
- Department of Pathogenic Biology and Immunology, Sino-French Hoffmann Institute, Guangzhou Medical University, 511436, Guangzhou, China. .,State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 510120, Guangzhou, China.
| | - Quan Yang
- Reproductive medical center, Guangdong Women and Children Hospital, Guangzhou Medical University, 511400, Guangzhou, China. .,Department of Pathogenic Biology and Immunology, Sino-French Hoffmann Institute, Guangzhou Medical University, 511436, Guangzhou, China. .,State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 510120, Guangzhou, China.
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Di Guardo F, Cerana MC, D'urso G, Genovese F, Palumbo M. Male PCOS equivalent and nutritional restriction: Are we stepping forward? Med Hypotheses 2019; 126:1-3. [PMID: 31010486 DOI: 10.1016/j.mehy.2019.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/17/2019] [Accepted: 03/04/2019] [Indexed: 01/30/2023]
Abstract
Polycystic ovarian syndrome (PCOS) is an endocrine disorder characterized by alteration of menses, polycystic ovaries, clinical and or biochemical signs of hyper-androgenism in the context of metabolic abnormalities such as obesity and insulin resistance that play a fundamental role in pathogenesis of the disease as well as in development of long-term complications including cardiovascular disease (CVD) and type II diabetes mellitus (DM II). Latest evidence supports the hypothesis of a genetic component in the aetiology of PCOS that seems to be inherited through an oligo-genic mechanism and cluster in families. Recent studies identified the existence of a male PCOS correspondent syndrome in which the genes responsible for PCOS susceptibility in women may be inherited by male relatives of women with PCOS. The same hormonal, clinical and metabolic alterations of women with PCOS have been found in their male relatives suggesting a relation between the syndrome in its male equivalent. Considering clinical manifestations of male PCOS equivalent, the early onset andro-genetic alopecia (AGA) is considered a clinical marker of insulin resistance, supported by the findings of a case-control study that reported an increased prevalence of hyperinsulinemia and insulin-resistance-associated disorders such as dyslipidaemia, hypertension and obesity, in men with early onset of alopecia (<35), compared with age-matched controls. Moreover, AGA and insulin resistance show higher levels of active androgens, highlighting that low SHBG levels occur in both the diseases and that the two conditions may concur to a worsening of the disease. With regards to the existence of a male PCOS equivalent syndrome, in particular with refer to its phenotypic hallmark of early onset AGA, our hypothesis supposes a beneficial effect of diet restriction used for PCOS as therapy for male patients affected by PCOS equivalent syndrome. Several observational studies and some randomized trials reported that modest reductions of body weight decrease the risk of development of many diseases, including diabetes and cardiovascular disease and contributes to increase insulin sensitivity in PCOS women. Weight reduction may be adopted for men affected by PCOS equivalent syndrome in order to reduce both levels of circulating androgens, insulin resistance and related-complications such as CVD and DM II.
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Affiliation(s)
- Federica Di Guardo
- Department of Medical Surgical Specialties, University of Catania, Via Tindaro 2, 95124 Catania, Italy.
| | - Maria Cecilia Cerana
- Department of Internal Medicine, The University of Connecticut, 263 Farmington Ave, Farmington, CT 06030, United States
| | - Gisella D'urso
- Department of Medical Surgical Specialties, University of Catania, Via Tindaro 2, 95124 Catania, Italy
| | - Fortunato Genovese
- Department of Medical Surgical Specialties, University of Catania, Via Tindaro 2, 95124 Catania, Italy
| | - Marco Palumbo
- Department of Medical Surgical Specialties, University of Catania, Via Tindaro 2, 95124 Catania, Italy
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Szczuko M, Drozd A, Maciejewska D, Zapałowska-Chwyć M, Stachowska E. Decrease in the Level of Nervonic Acid and Increased Gamma Linolenic Acid in the Plasma of Women with Polycystic Ovary Syndrome after a Three-month Low-glycaemic Index and Caloric Reduction Diet. Open Life Sci 2019; 14:224-236. [PMID: 33817156 PMCID: PMC7874768 DOI: 10.1515/biol-2019-0026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 03/14/2019] [Indexed: 01/16/2023] Open
Abstract
The aetiology of polycystic ovary syndrome (PCOS) remains uncertain and thus dedicated studies are still of much importance. Patients in this group are at high risk for metabolic syndrome, diabetes and ischemic heart disease. Our goal was to use a dietary intervention, facilitating the regression of the disease, through the observation of lipid and hormonal profiles, carbohydrate metabolic parameters and metabolomics of plasma fatty acids. There were 39 Caucasian women with PCOS aged 26.76 ±5.08 that qualified for this study. Fatty acid profiles were investigated using gas chromatography. The results of plasma fatty acids were compared with the initial results and the control group. A three-month caloric reduction diet with low glycemic index (GI) reduces the level of nervonic acid and is a great alternative in PCOS therapy. The introduction of rapeseed oil and olive oil to the lowered GI reduction diet caused the increase in the ratio of average length chain fatty acids (C10:0, C14:0) and the enhancement of synthesis pathways for pentadecanoic acid (C15:0) and gamma-linolenic acid (GLA, C18:3n-6), but did not inhibit the synthesis of the derivatives of arachidic acid (C20:0). Additionally, a decrease in the level of nervonic acid (C24:1) was observed. Biochemical analysis of blood showed the improvement of plasma lipid fractions, but a significant reduction of androgen levels was not observed. A reduction diet with lowered GI lead to many positive effects in the improvement of the biochemical parameters of women with PCOS. It should be continued for a prolonged period of time, until the synthesis pathways for inflammatory factors are silenced.
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Affiliation(s)
- Małgorzata Szczuko
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University in Szczecin, SzczecinPoland
| | - Arleta Drozd
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University in Szczecin, SzczecinPoland
| | - Dominika Maciejewska
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University in Szczecin, SzczecinPoland
| | - Marta Zapałowska-Chwyć
- Clinic of Gynecology and Urogynecology, Pomeranian Medical University in Szczecin, SzczecinPoland
| | - Ewa Stachowska
- Department of Biochemistry and Human Nutrition, Pomeranian Medical University in Szczecin, SzczecinPoland
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Sinha P, Chitra T, Papa D, Nandeesha H. Laparoscopic Ovarian Drilling Reduces Testosterone and Luteinizing Hormone/Follicle-Stimulating Hormone Ratio and Improves Clinical Outcome in Women with Polycystic Ovary Syndrome. J Hum Reprod Sci 2019; 12:224-228. [PMID: 31576080 PMCID: PMC6764220 DOI: 10.4103/jhrs.jhrs_161_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Laparoscopic ovarian drilling (LOD) is one of the common modes of treatment for women with polycystic ovary syndrome (PCOS) who are resistant to clomiphene citrate. The data related to the effect of LOD on sex hormones are limited. Aim: The objective of the study was to investigate the effect of LOD on hormonal parameters and clinical outcomes in women with PCOS. Settings and Design: This study was conducted in a tertiary care hospital. Materials and Methods: Fifty PCOS patients who were admitted for LOD were enrolled in the study. Serum testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) levels were estimated in all the patients before and after LOD. Statistical Analysis: Paired t-test was used to assess the differences in hormonal parameters before and after LOD. Results: LOD reduces testosterone (P < 0.001), LH (P < 0.001), and LH/FSH ratio (P < 0.001), increases FSH (P < 0.001) levels, and improves the rate of ovulation (38/50) and clinical pregnancy (21/50) in PCOS. When subgroup analysis was done, LOD significantly reduced testosterone and LH/FSH ratio in ovulatory and conceived groups. Furthermore, the menstrual cycle became regular, and hirsutism and acne were reduced after LOD in women with PCOS. Conclusions: LOD reduces testosterone and LH/FSH ratio and improves clinical outcome in PCOS.
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Affiliation(s)
- Priyanka Sinha
- Department of Obstetrics and Gynecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Thyagaraju Chitra
- Department of Obstetrics and Gynecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Dasari Papa
- Department of Obstetrics and Gynecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Hanumanthappa Nandeesha
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Reyes-Muñoz E, Sathyapalan T, Rossetti P, Shah M, Long M, Buscema M, Valenti G, La Rosa VL, Cianci S, Vitale SG. Polycystic Ovary Syndrome: Implication for Drug Metabolism on Assisted Reproductive Techniques-A Literature Review. Adv Ther 2018; 35:1805-1815. [PMID: 30311070 PMCID: PMC6224003 DOI: 10.1007/s12325-018-0810-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Indexed: 02/07/2023]
Abstract
Polycystic ovary syndrome (PCOS) affects 6-10% of women and could be considered one of the most common endocrine alterations in women of reproductive age. The syndrome is characterized by several hormonal and metabolic alterations, including insulin resistance and hyperandrogenism, which play a severe detrimental role in the patient's fertility. We aimed to offer an overview about drug metabolism in the PCOS population. Nevertheless, we did not find any study that directly compared drug metabolism between PCOS and healthy women. We therefore decided to summarize briefly how hormonal and insulin sensitizer drugs act differently in healthy and PCOS women, who show altered steroidogenesis by theca cells and metabolic imbalance, focusing especially on assisted reproductive techniques. To date, data about drug metabolism in the PCOS population appears to be extremely limited. This important gap could have significant implications for therapeutic approaches and future perspectives: the dosage of drugs commonly used for the treatment of PCOS women should be tailored according to each patient's characteristics; we should implement new clinical trials in order to identify the best pharmacologic strategy for PCOS patients undergoing in vitro fertilization (IVF); it would be advisable to create an international expert panel to investigate the drug metabolism in the PCOS population.
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Affiliation(s)
- Enrique Reyes-Muñoz
- Department of Endocrinology, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | | | - Paola Rossetti
- Unit of Diabetology and Endocrino-Metabolic Diseases, Hospital for Emergency Cannizzaro, Catania, Italy
| | - Mohsin Shah
- Department of Physiology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Min Long
- Department of Endocrinology, Translational Research Key Laboratory for Diabetes, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Massimo Buscema
- Unit of Diabetology and Endocrino-Metabolic Diseases, Hospital for Emergency Cannizzaro, Catania, Italy
| | - Gaetano Valenti
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | | | - Stefano Cianci
- Unità Operativa Ginecologia Oncologica, Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Salvatore Giovanni Vitale
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
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Ortiz-Flores AE, Luque-Ramírez M, Escobar-Morreale HF. Pharmacotherapeutic management of comorbid polycystic ovary syndrome and diabetes. Expert Opin Pharmacother 2018; 19:1915-1926. [PMID: 30289728 DOI: 10.1080/14656566.2018.1528231] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Polycystic ovary syndrome (PCOS) is a common endocrine disorder in premenopausal women. Insulin resistance and glucose intolerance are very prevalent metabolic complications in women with PCOS, especially in those presenting with weight excess. Therapeutic strategies targeting insulin resistance in PCOS are of interest because of their overall safety and their beneficial effects on metabolic and reproductive features. AREAS COVERED The authors review systematically all of the available therapeutic interventions targeting insulin resistance and/or disturbances of glucose metabolism in women with PCOS. EXPERT OPINION The diagnosis of glucose tolerance disorders in women with PCOS requires an oral glucose tolerance test. Strategies addressing weight excess and abdominal adiposity, from lifestyle modification to insulin sensitizers, may improve insulin resistance and glucose tolerance in women with PCOS. However, amelioration of signs and symptoms of PCOS usually requires the loss of large amounts of weight for it to be noticeable. Bariatric surgery has emerged as the most successful approach for obese patients with PCOS, because glucose intolerance, diabetes, and PCOS resolve in most cases through follow-ups. At present, the role of novel drugs targeting insulin resistance and/or diabetes such as inositols, berberine, resveratrol, and incretin-based therapies are yet to be properly established.
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Affiliation(s)
- Andrés E Ortiz-Flores
- a Diabetes, Obesity and Human Reproduction Research Group , Hospital Universitario Ramón y Cajal & Universidad de Alcalá & Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) , Madrid , Spain
| | - Manuel Luque-Ramírez
- a Diabetes, Obesity and Human Reproduction Research Group , Hospital Universitario Ramón y Cajal & Universidad de Alcalá & Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) , Madrid , Spain
| | - Héctor F Escobar-Morreale
- a Diabetes, Obesity and Human Reproduction Research Group , Hospital Universitario Ramón y Cajal & Universidad de Alcalá & Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) & Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) , Madrid , Spain
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Nigam A, Elahi AA, Varun N, Gupta N. Primary amenorrhoea and clitoromegaly in a nulliparous woman: successful medical and surgical management. BMJ Case Rep 2018; 2018:bcr-2018-226122. [PMID: 30275027 DOI: 10.1136/bcr-2018-226122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Clitoromegaly is an important sign of virilisation and poses difficulty in sex determination, when present since birth. The diagnosis and treatment in an adult is a major challenge to the treating gynaecologist. The primary reason for its development is androgen excess due to congenital adrenal hyperplasia, polycystic ovarian syndrome, ovarian virilising tumours, neurofibromas, adrenal neoplasm and prolonged intake of anabolic steroids. A case of young nulliparous married woman who presented with primary amenorrhoea and clitoromegaly and was managed successfully has been reported.
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Affiliation(s)
- Aruna Nigam
- Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Arifa Anwar Elahi
- Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Neha Varun
- Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Nidhi Gupta
- Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Sciences and Research, New Delhi, India
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Fernando S, Biggs SN, Horne RSC, Vollenhoven B, Lolatgis N, Hope N, Wong M, Lawrence M, Lawrence A, Russell C, Leong K, Thomas P, Rombauts L, Wallace EM. The impact of melatonin on the sleep patterns of women undergoing IVF: a double blind RCT. Hum Reprod Open 2018; 2017:hox027. [PMID: 30895239 PMCID: PMC6276665 DOI: 10.1093/hropen/hox027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 11/29/2017] [Accepted: 12/18/2017] [Indexed: 12/17/2022] Open
Abstract
STUDY QUESTION Does melatonin result in a dose–response effect on sleep quality and daytime sleepiness in women undergoing IVF? SUMMARY ANSWER Melatonin, even when given at high doses twice per day, does not cause significant daytime sleepiness or change night time sleep quantity or quality. WHAT IS KNOWN ALREADY Melatonin is being increasingly used as an adjuvant therapy for women undergoing IVF owing to its antioxidative effects. It is widely considered to be sedative but there are scant objective data on the effects of melatonin on sleep in the setting of IVF. STUDY DESIGN SIZE, DURATION The study was a double-blind placebo-controlled randomized trial of 116 women recruited between September 2014 and September 2016. PARTICIPANTS/MATERIALS, SETTING, METHOD Women who were undergoing their first cycle of IVF at private IVF centers were recruited into the RCT and randomized to receive either placebo, 2 mg, 4 mg or 8 mg of melatonin, twice per day (BD) from Day 2 of their cycle until the day before oocyte retrieval. Each participant wore an accelerometer that provides an estimate of sleep and wake activity for up to 1 week of baseline and throughout treatment (up to 2 weeks). They also kept sleep diaries and completed a Karolinska sleepiness score detailing their night time sleep activity and daytime sleepiness, respectively. MAIN RESULTS AND THE ROLE OF CHANCE In total, 116 women were included in the intention-to-treat analysis (placebo BD (n = 32), melatonin 2 mg BD (n = 29), melatonin 4 mg BD (n = 26), melatonin 8 mg BD (n = 29)). There were no significant differences in daytime Karolinska sleepiness score between groups (P = 0.4), nor was there a significant dose–response trend (β=0.05, 95% CI −0.22–0.31, P = 0.7). There were no differences in objective measures of sleep quantity or quality, including wake after sleep onset time, sleep onset latency, and sleep efficiency before and after treatment or between groups. There was an improvement in subjective sleep quality scores from baseline to during treatment in all groups, except 8 mg BD melatonin: placebo (percentage change −13.3%, P = 0.01), 2 mg (−14.1%, P = 0.03), 4 mg (−8.6%, P = 0.01) and 8 mg (−7.8%, P = 0.07). LIMITATIONS, REASONS FOR CAUTION As this was a subset of a larger trial, the melatonin in ART (MIART) trial, it is possible that the sample size was too small to detect statistically significant differences between the groups. WIDER IMPLICATIONS OF THE FINDINGS While this study suggests that melatonin can be used twice per day at high doses to achieve sustained antioxidation effects, with the reassurance that this will not negatively impact daytime sleepiness or night time sleep habits, the sample size is small and may have missed a clinically significant difference. Nevertheless, our findings may have implications not only for future studies of fertility treatments (including meta-analyses), but also in other medical fields where sustained antioxidation is desired. STUDY FUNDING/COMPETING INTERESTS This study was funded by the Monash IVF Research and Education Foundation (PY12_15). S.F. is supported by the National Health and Medical Research Council (Postgraduate Scholarship APP1074342) and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists Ella Macknight Memorial Scholarship. E.W. is supported by an National Health and Medical Research Council Program Grant (APP1113902). S.F., E.W., R.H., B.V., N.L., N.H., M.W., M.L., A.L., P.T., K.L. have nothing to declare. L.R. is a Minority shareholder in Monash IVF Group, has unrestricted grants from MSD®, Merck-Serono® and Ferring® and receives consulting fees from Ferring®. S.N.B. reports consulting fees from Johnson & Johnson Consumer Inc®, outside the submitted work. TRIAL REGISTRATION NUMBER This trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (Project ID: ACTRN12613001317785). TRIAL REGISTRATION DATE 27/11/2013 DATE OF FIRST PATIENT’S ENROLMENT 1/9/2014
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Affiliation(s)
- Shavi Fernando
- Departments of Obstetrics and Gynaecology.,Hudson Institute of Medical Research, 27-31 Wright st, Clayton, Victoria3168, Australia.,Monash Women's, Monash Health, 246 Clayton Rd, Clayton 3168, Victoria, Australia
| | - Sarah Nichole Biggs
- Paediatrics, Monash University, Wellington Rd, Clayton, Victoria 3800, Australia.,Hudson Institute of Medical Research, 27-31 Wright st, Clayton, Victoria3168, Australia
| | - Rosemary Sylvia Claire Horne
- Paediatrics, Monash University, Wellington Rd, Clayton, Victoria 3800, Australia.,Hudson Institute of Medical Research, 27-31 Wright st, Clayton, Victoria3168, Australia
| | - Beverley Vollenhoven
- Departments of Obstetrics and Gynaecology.,Monash IVF, 7/89 Bridge rd, Richmond, Victoria 3121, Australia.,Monash Women's, Monash Health, 246 Clayton Rd, Clayton 3168, Victoria, Australia
| | | | - Nicole Hope
- Monash IVF, 7/89 Bridge rd, Richmond, Victoria 3121, Australia
| | - Melissa Wong
- Monash IVF, 7/89 Bridge rd, Richmond, Victoria 3121, Australia
| | - Mark Lawrence
- Monash IVF, 7/89 Bridge rd, Richmond, Victoria 3121, Australia
| | | | - Chris Russell
- Monash IVF, 7/89 Bridge rd, Richmond, Victoria 3121, Australia
| | - Kenneth Leong
- Monash IVF, 7/89 Bridge rd, Richmond, Victoria 3121, Australia
| | - Philip Thomas
- Monash IVF, 7/89 Bridge rd, Richmond, Victoria 3121, Australia.,Monash Women's, Monash Health, 246 Clayton Rd, Clayton 3168, Victoria, Australia
| | - Luk Rombauts
- Departments of Obstetrics and Gynaecology.,Monash IVF, 7/89 Bridge rd, Richmond, Victoria 3121, Australia.,Monash Women's, Monash Health, 246 Clayton Rd, Clayton 3168, Victoria, Australia
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Rizzo G, Baroni L. Soy, Soy Foods and Their Role in Vegetarian Diets. Nutrients 2018; 10:E43. [PMID: 29304010 PMCID: PMC5793271 DOI: 10.3390/nu10010043] [Citation(s) in RCA: 189] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 11/30/2017] [Accepted: 01/03/2018] [Indexed: 02/07/2023] Open
Abstract
Soy is a basic food ingredient of traditional Asian cuisine used for thousands of years. In Western countries, soybeans have been introduced about a hundred years ago and recently they are mainly used for surrogate foods production. Soy and soy foods are common nutritional solutions for vegetarians, due to their high protein content and versatility in the production of meat analogues and milk substitutes. However, there are some doubts about the potential effects on health, such as the effectiveness on cardiovascular risk reduction or, conversely, on the possible disruption of thyroid function and sexual hormones. The soy components that have stimulated the most research interest are isoflavones, which are polyphenols with estrogenic properties highly contained in soybeans. In this review, we discuss the characteristics of soy and soy foods, focusing on their nutrient content, including phytoestrogens and other bioactive substances that are noteworthy for vegetarians, the largest soy consumers in the Western countries. The safety of use will also be discussed, given the growing trend in adoption of vegetarian styles and the new soy-based foods availability.
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Affiliation(s)
| | - Luciana Baroni
- Primary Care Unit, Northern District, Local Health Unit 2, 31100 Treviso, Italy.
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Laganà AS, Vitale SG, Noventa M, Vitagliano A. Current Management of Polycystic Ovary Syndrome: From Bench to Bedside. Int J Endocrinol 2018; 2018:7234543. [PMID: 30538744 PMCID: PMC6261402 DOI: 10.1155/2018/7234543] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 10/31/2018] [Indexed: 12/26/2022] Open
Affiliation(s)
- Antonio Simone Laganà
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, Varese, Italy
| | - Salvatore Giovanni Vitale
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Marco Noventa
- Department of Woman and Child Health, University of Padua, Padua, Italy
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50
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Satish S, Srivastava A, Yadav P, Varshney S, Choudhary R, Balaramnavar VM, Narender T, Gaikwad AN. Aegeline inspired synthesis of novel amino alcohol and thiazolidinedione hybrids with antiadipogenic activity in 3T3-L1 cells. Eur J Med Chem 2018; 143:780-791. [DOI: 10.1016/j.ejmech.2017.11.041] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 11/15/2017] [Accepted: 11/17/2017] [Indexed: 12/14/2022]
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