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Zyguła A, Sankiewicz A, Sakowicz A, Dobrzyńska E, Dakowicz A, Mańka G, Kiecka M, Spaczynski R, Piekarski P, Banaszewska B, Jakimiuk A, Issat T, Rokita W, Młodawski J, Szubert M, Sieroszewski P, Raba G, Szczupak K, Kluza T, Kluza M, Pierzyński P, Wojtyla C, Lipa M, Warzecha D, Wielgos M, Cendrowski K, Gorodkiewicz E, Laudanski P. Is the leptin/BMI ratio a reliable biomarker for endometriosis? Front Endocrinol (Lausanne) 2024; 15:1359182. [PMID: 38567305 PMCID: PMC10985179 DOI: 10.3389/fendo.2024.1359182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Background The aim of this study was to analyze the concentration of leptin in peritoneal fluid and plasma and to assess their role as potential biomarkers in the diagnosis of endometriosis. Materials & methods Leptin adjusted for BMI (leptin/BMI ratio) was measured using surface plasmon resonance imaging (SPRI) biosensors. Patients with suspected endometriosis were included in the study. Plasma was collected from 70 cases, and peritoneal fluid from 67 cases. Based on the presence of endometriosis lesions detected during laparoscopy, patients were divided into a study group and a control group (patients without endometriosis). Results Leptin/BMI ratio in plasma did not differ between women with endometriosis and the control group (0.7159 ± 0.259 vs 0.6992 ± 0.273, p= 0,7988). No significant differences were observed in peritoneal leptin/BMI ratio levels in patients with and without endometriosis (0.6206 ± 0.258 vs 0.6215 ± 0.264, p= 0,9896). Plasma and peritoneal leptin/BMI ratios were significantly lower in women with endometriosis - related primary infertility compared to women with endometriosis without primary infertility (0.640 ± 0.502 vs 0.878 ± 0.623, p < 0.05). The difference was observed in case of primary infertility, but not in terms of the secondary one. No significant differences were noted between leptin/BMI ratio in the proliferative phase and the secretory phase (0.716 ± 0.252 vs 0.697 ± 0.288, p= 0,7785). Conclusion The results of present study do not support the relevance of leptin concentration determination as a biomarker of the endometriosis. Due to the limited number of samples in the tested group, further studies are needed to confirm its role.
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Affiliation(s)
| | - Anna Sankiewicz
- Bioanalysis Laboratory, Faculty of Chemistry, University of Bialystok, Bialystok, Poland
| | - Agata Sakowicz
- Department of Medical Biotechnology, Medical University of Lodz, Lodz, Poland
| | - Ewa Dobrzyńska
- Chair and Department of Obstetrics, Gynecology and Gynecological Oncology, Medical University of Warsaw, Warsaw, Poland
| | - Agnieszka Dakowicz
- Department of Rehabilitation, Medical University of Bialystok, Bialystok, Poland
| | | | | | - Robert Spaczynski
- Center for Gynecology, Obstetrics and Infertility Treatment Pastelova, Poznan, Poland
- Collegium Medicum, University of Zielona Gora, Zielona Gora, Poland
| | - Piotr Piekarski
- Gynecological Obstetric Clinical Hospital of Poznan University of Medical Sciences, Minimally Invasive Gynecological Surgery, Poznan, Poland
| | - Beata Banaszewska
- Chair and Department of Laboratory Diagnostics, Poznan University of Medical Sciences, Poznan, Poland
| | - Artur Jakimiuk
- Department of Reproductive Health, Institute of Mother and Child in Warsaw, Warsaw, Poland
- Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior, Warsaw, Poland
| | - Tadeusz Issat
- Department of Obstetrics and Gynecology, Institute of Mother and Child in Warsaw, Warsaw, Poland
| | - Wojciech Rokita
- Collegium Medicum, Jan Kochanowski University in Kielce, Kielce, Poland
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, Kielce, Poland
| | - Jakub Młodawski
- Collegium Medicum, Jan Kochanowski University in Kielce, Kielce, Poland
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, Kielce, Poland
| | - Maria Szubert
- Department of Gynecology and Obstetrics, Medical University of Lodz, Lodz, Poland
- Department of Surgical Gynecology and Oncology, Medical University of Lodz, Lodz, Poland
| | - Piotr Sieroszewski
- Department of Gynecology and Obstetrics, Medical University of Lodz, Lodz, Poland
- Department of Fetal Medicine and Gynecology, Medical University of Lodz, Lodz, Poland
| | - Grzegorz Raba
- Clinic of Obstetric and Gynecology in Przemysl, Przemysl, Poland
- Medical College of Rzeszow University, Rzeszow, Poland
| | - Kamil Szczupak
- Clinic of Obstetric and Gynecology in Przemysl, Przemysl, Poland
- Medical College of Rzeszow University, Rzeszow, Poland
| | - Tomasz Kluza
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | - Marek Kluza
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | | | - Cezary Wojtyla
- OVIklinika Infertility Center, Warsaw, Poland
- Women’s Health Research Institute, Calisia University, Kalisz, Poland
| | - Michal Lipa
- Departament of Obstetrics and Perinatology National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
| | - Damian Warzecha
- OVIklinika Infertility Center, Warsaw, Poland
- City South Hospital, Warsaw, Warsaw, Poland
- Department of Biomedical Fundamentals of Development and Sexology, Faculty of Education, University of Warsaw, Warsaw, Poland
| | - Miroslaw Wielgos
- Departament of Obstetrics and Perinatology National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
- Premium Medical Clinic, Warsaw, Poland
- Medical Faculty, Lazarski University, Warsaw, Poland
| | - Krzysztof Cendrowski
- Chair and Department of Obstetrics, Gynecology and Gynecological Oncology, Medical University of Warsaw, Warsaw, Poland
| | - Ewa Gorodkiewicz
- Bioanalysis Laboratory, Faculty of Chemistry, University of Bialystok, Bialystok, Poland
| | - Piotr Laudanski
- OVIklinika Infertility Center, Warsaw, Poland
- Chair and Department of Obstetrics, Gynecology and Gynecological Oncology, Medical University of Warsaw, Warsaw, Poland
- Women’s Health Research Institute, Calisia University, Kalisz, Poland
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Kufel-Grabowska J, Podolak A, Bartoszkiewicz M, Maliszewski D, Ossowska D, Spaczynski R. Abstract P6-05-47: Preimplantation genetic testing for BRCA gene mutation carriers - the future of health care in Poland? Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p6-05-47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Introduction Genetic background is rarely the cause of breast cancer incidence. Mutations in genes that increase the risk of breast cancer (most commonly BRCA1/2) are diagnosed in about 5-10% of patients. The lifetime risk of breast cancer in BRCA1/2 gene mutation carriers is 80%, and for ovarian cancer from 40-60%, while the chance of passing the mutation to offspring is 50%. The use of pre-implantation genetic testing (PGT-M) of the embryo during in vitro treatment prevents the transfer of mutated gene associated with an increased risk of cancer to the child. The significantly limited availability and high cost of PGT-M in Poland prevent its widespread use. The aim of the survey was to assess interest in PGT-M by female carriers of mutations in genes that increase cancer risk in Poland.
Material and Methods The survey covered 103 persons, 102 with diagnosed mutations in genes that increase cancer risk. The questionnaire consisted of 22 questions regarding: age and gender of the patients, carriage of mutations in genes that increase the risk of cancer (age of mutation diagnosis, type of mutation, preventive measures taken, carriage of mutations in the family, incidence of cancer among relatives, and care of relatives during illness), and knowledge of pre-implantation diagnosis and attitudes regarding the use of PGT-M to avoid passing the defective gene to offspring.
Results The study included 101 women (98.1%) and 2 men (1.9%), with a median age of 38 years (22-74). Fifty-two (50.5%) were diagnosed with cancer: 50 with breast cancer and 2 with ovarian cancer. Eighty-one subjects (78.6%) were diagnosed with a mutation in the BRCA1 gene, seventeen (16.5%) in the BRCA2 gene, three (2.9%) in the CHEK2 gene, two (1.9%) in the TP53 gene and one (1%) in the PALB gene. The median age of mutation diagnosis was 34 years (18-66). A significant proportion of patients took prophylactic measures, sixty-one (59.2%) underwent risk-reducing mastectomy (RRM), and forty-six (44.7%) risk-reducing salphingo-oophorectomy (RRSO). Ninety-five subjects (92.2%) declared regular visits to a genetic counseling center. Thirty-two persons (31.1%) had a family history of cancer (1-5 members in the family), mainly in 1st degree relatives – parents and siblings (about 60% of cases), the predominant cancers were breast cancer (106 cases), ovarian cancer (38 cases) and prostate cancer (7 cases); eighty-two family members died of cancer, seventy-five (72.8%) respondents accompanied family members in the dying process. Twenty-six individuals (25.2%) knew what PGT-M was, information was obtained from an oncologist (11), gynecologist (7), geneticist (6), other patients (6) and most often from the Internet (17). Seventy-four respondents (71.8%) had children. Thirty-three (32%) declared that information about carrying a mutation in a gene that increases cancer risk influenced their decision to have offspring. Sixty-eight (64.1%) of the respondents, with prior knowledge of PGT-M and with the availability of the method, would have used the diagnosis in combination with in vitro fertilization to avoid passing the defective gene to offspring. Fifty subjects (48.5%) were willing to cover the costs of this procedure.
Conclusions PGT-M in combination with in vitro fertilization is a safe and effective method of preventing the transfer of a defective gene to offspring. Due to the lack of availability and high cost of the procedure, it is not available in daily clinical practice among carriers of mutations in genes that increase the risk of cancer in Poland. Their own incidence of cancer, multiple incidences in family members and involvement in the dying process may influence patients’ decisions to have offspring and motivate them to seek out centers offering PGT-M. The results of this survey indicate the need to offer pre-implantation testing to patients despite the lack of reimbursement and to increase its availability in Poland.
Citation Format: Joanna Kufel-Grabowska, Amira Podolak, Mikołaj Bartoszkiewicz, Daniel Maliszewski, Dominika Ossowska, Robert Spaczynski. Preimplantation genetic testing for BRCA gene mutation carriers - the future of health care in Poland? [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-47.
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Affiliation(s)
| | | | | | - Daniel Maliszewski
- 4Wojewódzki Szpital Specjalistych w Słupsku, Szpital Specjalistyczny w Kościerzynie, Swissmed Health Center
| | | | - Robert Spaczynski
- 6Pastelova Center for Gynecology, Obstetrics and Infertility, Poznan, Poznan, Poland
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Jach R, Spaczynski R, Kurzawa R, Radwan M, Rzepka J, Swornik M, Pabian W. Updating the recommendations of the Working Group for the Preservation of Fertility in Oncological and Hematological Patients and Other Patients Treating Gonadier Therapies "ONCOFERTILITY" (GROF) of the Polish Society of Oncological Gynecology regarding cryopreserves and autologous transplant. Ginekol Pol 2021:VM/OJS/J/76198. [PMID: 34541656 DOI: 10.5603/gp.a2021.0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/28/2021] [Accepted: 07/05/2021] [Indexed: 11/25/2022] Open
Abstract
Update of the recommendations of the Fertility Preservation Working Group in Oncological, Hematological and Other Patients Treated with Gonadotoxic Therapies "ONCOFERTILITY" (GROF) of the Polish Society of Oncological Gynecology regarding cryopreservation and autologous ovarian tissue transplantation. The Fertility Preservation Working Group in Oncological, Hematological and Other Patients Treated with Gonadotoxic Therapies "ONCOFERTILITY" (GROF) of the Polish Society of Oncological Gynecology has developed current clinical guidelines and recommendations to improve the quality of healthcare provision in the area of reproductive health in patients undergoing therapy that may impair their reproductive potential. The guidelines are based on current scientific evidence available at the time of writing this document. In the absence of scientific evidence on some aspects, a consensus was reached among GROF stakeholders. The purpose of the guidelines is to assist healthcare professionals in making decisions in specific clinical situations regarding the selection of an appropriate and effective diagnostic and therapeutic process. The document provides practical guidelines for the management of cryopreservation and autologous ovarian tissue transplantation.
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Affiliation(s)
- Robert Jach
- Collegium Medicum, Jagiellonian University, Cracow, Poland.
| | - Robert Spaczynski
- Division of Infertility and Reproductive Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
| | - Rafal Kurzawa
- Vitrolive, The Fertility Partnership, Szczecin, Poland
| | | | - Jakub Rzepka
- Narodowy Instytut Onkologii im. Marii Skłodowskiej-Curie - Państwowy Instytut Badawczy Klinika Ginekologii Onkologicznej w Warszawie
| | | | - Wojciech Pabian
- Szpital Uniwersytecki w Krakowie Oddział Kliniczny Endokrynologii Ginekologicznej i Ginekologii
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Banaszewska B, Siakowska M, Chudzicka-Strugala I, Chang RJ, Pawelczyk L, Zwozdziak B, Spaczynski R, Duleba AJ. Elevation of markers of endotoxemia in women with polycystic ovary syndrome. Hum Reprod 2021; 35:2303-2311. [PMID: 32869098 DOI: 10.1093/humrep/deaa194] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/30/2020] [Indexed: 12/24/2022] Open
Abstract
STUDY QUESTION Is polycystic ovary syndrome (PCOS) associated with an elevation of markers of endotoxemia? SUMMARY ANSWER In women with PCOS serum levels of lipopolysaccharides (LPS), the LPS to high-density lipoprotein (HDL) ratio and LPS-binding protein (LBP) are significantly greater than those of normal control subjects. WHAT IS KNOWN ALREADY Mononuclear cells from women with PCOS respond excessively to LPS by releasing pro-inflammatory cytokines. In rat ovarian theca-interstitial cell cultures LPS stimulates androgen production. STUDY DESIGN, SIZE, DURATION Cross-sectional study comparing markers of endotoxemia in women with PCOS (n = 62), healthy ovulatory women with polycystic ovary morphology (PCOM, n = 39) and a control group of healthy ovulatory women without PCOM [normal (NL), n = 43]. PARTICIPANTS/MATERIALS, SETTING, METHODS LPS was measured using a chromogenic assay. LBP was measured by ELISA. Total cholesterol and lipids were measured using a homogeneous enzyme colorimetric method. Androgens, gonadotrophins, prolactin, insulin, high-sensitivity C-reactive protein (hs-CRP) and sex hormone-binding globulin were determined by electrochemiluminescence assays. Glucose was measured using an enzymatic reference method with hexokinase. MAIN RESULTS AND THE ROLE OF CHANCE Women with PCOS, when compared with NL subjects, had a significantly higher mean LPS (P = 0.045), LPS/HDL ratio (P = 0.007) and LBP (P = 0.01). Women with PCOM had intermediate levels of markers of endotoxemia. Comparison among all groups revealed that markers of endotoxemia correlated positively with testosterone level, ovarian volume, number of antral follicles and hirsutism score, but negatively with the number of spontaneous menses per year. In multiple regression analysis, all measures of endotoxemia correlated independently and positively with hs-CRP and with ovarian volume. LIMITATIONS, REASONS FOR CAUTION This cross-sectional study reveals that markers of endotoxemia are associated with several clinical features observed in women with PCOS. However, responsible mechanisms and causation remain unknown. Steroid quantification was carried out by electrochemiluminescence assays and not by the current gold standard: liquid chromatography-mass spectrometry. Hence, the relationship of endotoxemia with features of PCOS and the extent to which endotoxemia contributes to reproductive and metabolic dysfunction warrants further investigation. WIDER IMPLICATIONS OF THE FINDINGS This study reveals the novel observation that markers of endotoxemia are elevated in young and otherwise healthy women with PCOS without significant metabolic dysfunction. Moreover, the association of clinical and endocrine markers of PCOS with those of endotoxemia may represent a pathophysiologic link to reproductive dysfunction as well as metabolic and long-term cardiovascular risks associated with this disorder. STUDY FUNDING/COMPETING INTEREST(S) Intramural funding from Poznan University of Medical Sciences. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Beata Banaszewska
- Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Martyna Siakowska
- Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - R Jeffrey Chang
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
| | - Leszek Pawelczyk
- Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Barbara Zwozdziak
- Department of Medical Microbiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Robert Spaczynski
- Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Antoni J Duleba
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
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Abstract
As obesity is considered to be a pandemic of the twenty-first century, the bariatric surgery becomes more common through the global population. The adverse effects of obesity on fertility can be reversed through the bariatric surgery procedures. In this review, we presented the effects of bariatric surgery on hypothalamic-pituitary-ovarian axis and fertility, ovarian reserve, and contraception efficacy.
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Affiliation(s)
- Radoslaw Slopien
- a Department of Gynecological Endocrinology , Poznan University of Medical Sciences , Poznan , Poland
| | - Nikodem Horst
- b Department of General of Colorectal Surgery , Poznan University of Medical Sciences , Poznan , Poland
| | | | | | - Robert Spaczynski
- d Department of Infertility and Reproductive Endocrinology , Poznan University of Medical Sciences , Poznan , Poland
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