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Goyal S, Vanita V. The Rise of Type 2 Diabetes in Children and Adolescents: An Emerging Pandemic. Diabetes Metab Res Rev 2025; 41:e70029. [PMID: 39744912 DOI: 10.1002/dmrr.70029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 10/21/2024] [Accepted: 11/12/2024] [Indexed: 01/11/2025]
Abstract
AIM This review explores the increasing prevalence of Type 2 Diabetes Mellitus (T2DM) in children and adolescents, focusing on its etiology, risk factors, complications, and the importance of early detection and management. It also highlights the need for a multidisciplinary, family-centered approach in managing T2DM in pediatric populations, with an emphasis on nutrition, exercise, and lifestyle interventions. MATERIALS AND METHODS A literature review was conducted using PubMed, Google Scholar, and Scopus to incorporate studies from 2015 to 2024 on T2DM in youths/adolescents/children, focusing on epidemiology, risk factors, and prevention strategies. Studies on Type 1 Diabetes Mellitus (T1DM) or adult populations were excluded. RESULTS T2DM is a complex metabolic disorder with various societal, behavioral, environmental, and genetic risk factors. It accounts for one in three new childhood diabetes cases, with rising incidence among American Indian/Alaska Native, Black, and Hispanic/Latino children. The increase in T2DM incidence correlates with growing childhood obesity rates. Early onset significantly raises the risk of complications like retinopathy, nephropathy, neuropathy, cardiovascular diseases, nonalcoholic fatty liver disease, and obstructive sleep apnea. Early detection, screening, and treatment can prevent or delay these complications. A family-centered, multidisciplinary approach is essential for effective management, including lifestyle and behavioral support. CONCLUSIONS T2DM in children is a growing health concern with severe implications. Early detection and management, including nutrition and exercise counseling, are critical in reducing long-term complications. A multidisciplinary approach is vital for improving outcomes and minimizing morbidity and mortality.
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Affiliation(s)
- Shiwali Goyal
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Vanita Vanita
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, India
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Taieb A, Asma G, Jabeur M, Fatma BA, Nassim BHS, Asma BA. Rethinking the Terminology: A Perspective on Renaming Polycystic Ovary Syndrome for an Enhanced Pathophysiological Understanding. Clin Med Insights Endocrinol Diabetes 2024; 17:11795514241296777. [PMID: 39494232 PMCID: PMC11528641 DOI: 10.1177/11795514241296777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Accepted: 10/16/2024] [Indexed: 11/05/2024] Open
Abstract
Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder that affects women at various stages of life, presenting a wide range of symptoms and health implications. The term "Polycystic Ovary Syndrome" can be misleading, prompting many within the medical community and advocacy groups to advocate for a name change. Critics argue that this terminology can complicate understanding and awareness of the disease among patients. The primary concern is that PCOS emphasizes the ovarian aspect, fostering the misconception that PCOS is merely a gynecological disorder. In reality, PCOS impacts multiple organ systems, particularly metabolic health. Patients frequently experience insulin resistance, weight gain, irregular menstrual cycles, and hirsutism-symptoms that extend beyond ovarian dysfunction. In light of these issues, there is increasing support for renaming PCOS to better reflect its systemic implications and minimize confusion. The current name may hinder understanding and potentially lead to inadequate disease management. Alternative names have been proposed, including "Ovarian Dysmetabolic Syndrome," which our team supports, as well as "Metabolic Reproductive Syndrome" and "Hyperandrogenic Persistent Ovulatory Dysfunction Syndrome." These alternatives aim to highlight the hormonal imbalances and metabolic disturbances associated with the condition, fostering inclusivity and reducing stigma for all affected individuals. This narrative review provides a historical overview of PCOS, tracing its recognition from early descriptions to contemporary guidelines. We discuss the evolving understanding of its pathophysiology and the rationale behind the proposed name change. By adopting a new nomenclature, we can enhance understanding among healthcare professionals, increase inclusivity for affected women, reduce the stigma and anxiety linked to the diagnosis, and offer a more accurate representation of the condition's complex pathophysiology.
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Affiliation(s)
- Ach Taieb
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Laboratory of Exercise Physiology and Pathophysiology; L.R, Sousse, Tunisia
| | - Gorchane Asma
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Methnani Jabeur
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
- Laboratory of Exercise Physiology and Pathophysiology; L.R, Sousse, Tunisia
| | - Ben Abdessalem Fatma
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Ben Haj Slama Nassim
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Ben Abdelkrim Asma
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
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Eroglu S, Cakmakliogullari EK. Relationship between polycystic ovary syndrome and high periostin level. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20240138. [PMID: 39045965 PMCID: PMC11288256 DOI: 10.1590/1806-9282.20240138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 03/03/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVE There is growing evidence suggesting a relationship between periostin levels, inflammation, and ovarian dysfunction. In this prospective case-control study, we aimed to investigate serum periostin levels and their relationship with metabolic parameters in patients with polycystic ovary syndrome. METHODS We conducted a prospective case-control study involving 45 polycystic ovary syndrome patients and 45 control subjects, matched in a 1:1 ratio. Serum samples collected from both study and control groups were analyzed using enzyme-linked immunosorbent assay. RESULTS The demographic characteristics were similar between the polycystic ovary syndrome and control groups (p>0.05). Periostin levels were significantly higher in patients with polycystic ovary syndrome compared with the control group (4.67±2.46 vs. 2.60±1.41 ng/mL, respectively; p=0.000). CONCLUSION Our study revealed a significant elevation in periostin levels among polycystic ovary syndrome patients compared with controls. These findings suggest that periostin could serve as a potential marker for assessing disease severity in polycystic ovary syndrome patients.
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Affiliation(s)
- Semra Eroglu
- Samsun University, Department of Gynecology and Obstetrics – Samsun, Turkey
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Guo X, Chen L, He J, Zhang X, Xu S. Genetically predicted high sex hormone binding globulin was associated with decreased risk of polycystic ovary syndrome. BMC Womens Health 2024; 24:357. [PMID: 38902677 PMCID: PMC11188236 DOI: 10.1186/s12905-024-03144-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 05/14/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Previous observational studies have indicated an inverse correlation between circulating sex hormone binding globulin (SHBG) levels and the incidence of polycystic ovary syndrome (PCOS). Nevertheless, conventional observational studies may be susceptible to bias. Consequently, we conducted a two-sample Mendelian randomization (MR) investigation to delve deeper into the connection between SHBG levels and the risk of PCOS. METHODS We employed single-nucleotide polymorphisms (SNPs) linked to serum SHBG levels as instrumental variables (IVs). Genetic associations with PCOS were derived from a meta-analysis of GWAS data. Our primary analytical approach relied on the inverse-variance weighted (IVW) method, complemented by alternative MR techniques, including simple-median, weighted-median, MR-Egger regression, and MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) testing. Additionally, sensitivity analyses were conducted to assess the robustness of the association. RESULTS We utilized 289 SNPs associated with serum SHBG levels, achieving genome-wide significance, as instrumental variables (IVs). Our MR analyses revealed that genetically predicted elevated circulating SHBG concentrations were linked to a reduced risk of PCOS (odds ratio (OR) = 0.56, 95% confidence interval (CI): 0.39-0.78, P = 8.30 × 10-4) using the IVW method. MR-Egger regression did not detect any directional pleiotropic effects (P intercept = 0.626). Sensitivity analyses, employing alternative MR methods and IV sets, consistently reaffirmed our results, underscoring the robustness of our findings. CONCLUSIONS Through a genetic epidemiological approach, we have substantiated prior observational literature, indicating a potential causal inverse relationship between serum SHBG concentrations and PCOS risk. Nevertheless, further research is needed to elucidate the underlying mechanism of SHBG in the development of PCOS.
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Affiliation(s)
- Xiaofeng Guo
- The Second Affiliated Hospital of Zhejiang University School of Medicine, LanXi Hospital; LanXi People's Hospital, Jinhua, 321100, China
| | - Langlang Chen
- The Second Affiliated Hospital of Zhejiang University School of Medicine, LanXi Hospital; LanXi People's Hospital, Jinhua, 321100, China
| | - Jianhua He
- The Second Affiliated Hospital of Zhejiang University School of Medicine, LanXi Hospital; LanXi People's Hospital, Jinhua, 321100, China
| | - Xiaozhi Zhang
- The Second Affiliated Hospital of Zhejiang University School of Medicine, LanXi Hospital; LanXi People's Hospital, Jinhua, 321100, China
| | - Shui Xu
- The Second Affiliated Hospital of Zhejiang University School of Medicine, LanXi Hospital; LanXi People's Hospital, Jinhua, 321100, China.
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Zhao H, Zhang J, Xing C, Cheng X, He B. Metformin versus metformin plus pioglitazone on gonadal and metabolic profiles in normal-weight women with polycystic ovary syndrome: a single-center, open-labeled prospective randomized controlled trial. J Ovarian Res 2024; 17:42. [PMID: 38374053 PMCID: PMC10875752 DOI: 10.1186/s13048-024-01367-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/02/2024] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVE To investigate the effects of metformin (MET) monotherapy and pioglitazone plus MET (PIOMET) therapy on gonadal and metabolic profiles in normal-weight women with polycystic ovary syndrome (PCOS). METHODS Sixty normal-weight women with PCOS were recruited between January and September 2022 at the Shengjing Hospital of China Medical University. They were randomly assigned to the MET or PIOMET groups for 12 weeks of MET monotherapy or PIOMET therapy. Anthropometric measurements, menstrual cycle changes, gonadal profiles, and the oral glucose insulin-releasing test (OGIRT) were performed at baseline and after the 12-week treatment. RESULTS Thirty-six participants completed the trial. MET and PIOMET therapies improved menstrual cycles after the 4- and 12-week treatments; however, there was no statistical difference between the two groups. PIOMET therapy improved luteinizing hormone (LH), luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio, and free androgen index (FAI) levels after the 4-week treatment, whereas MET monotherapy only improved total testosterone (TT) levels compared to baseline (P < 0.05). Both MET and PIOMET therapies improved TT and anti-Mullerian hormone (AMH) levels after the 12-week treatment (P < 0.05). In addition, only PIOMET therapy significantly improved sex hormone-binding globulin (SHBG), FAI, and androstenedione (AND) levels than the baseline (P < 0.05). PIOMET therapy improved SHBG and AMH levels more effectively than MET monotherapy (P < 0.05). Furthermore, PIOMET treatment was more effective in improving blood glucose levels at 120 and 180 min of OGIRT compared to MET monotherapy (P < 0.05). CONCLUSIONS In normal-weight women with PCOS, PIOMET treatment may have more benefits in improving SHBG, AMH, and postprandial glucose levels than MET monotherapy, and did not affect weight. However, the study findings need to be confirmed in PCOS study populations with larger sample sizes.
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Affiliation(s)
- Han Zhao
- Department of Endocrinology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Wuxi, Jiangsu, 214000, PR China
- Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, 110000, PR China
| | - Jiaqi Zhang
- Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, 110000, PR China
| | - Chuan Xing
- Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, 110000, PR China
| | - Xiangyi Cheng
- Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, 110000, PR China
| | - Bing He
- Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, 110000, PR China.
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Della Corte L, Boccia D, Palumbo M, Mercorio A, Ronsini C, Bifulco G, Giampaolino P. Is There Still a Place for Surgery in Patients with PCOS? A Review. Life (Basel) 2023; 13:1270. [PMID: 37374053 DOI: 10.3390/life13061270] [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: 04/18/2023] [Revised: 05/14/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE The surgical management of polycystic ovary syndrome (PCOS) represents an unclear option compared to medical therapy, and it is necessary to deepen the role of minimally invasive surgery, represented by laparoscopic ovarian drilling (LOD) and transvaginal hydrolaparoscopy (THL), for the treatment of PCOS in infertile women resistant to drug therapy and to establish its success in terms of ovulation and pregnancy rates. METHODS A search was performed in the main electronic databases (MEDLINE, EMBASE, Web of Science, PubMed, and the Cochrane Library) from 1994 to October 2022 in order to evaluate the role of surgery in patients with PCOS resistant to pharmacological treatment. Only original scientific articles in English were included. RESULTS Seventeen studies were analyzed in this review. In all analyzed studies, more than 50% of the population underwent spontaneous ovulation after surgical treatment without great differences between the two surgical techniques (LOD and THL). More than 40% of patients delivered, with a higher rate after LOD, although eight ectopic pregnancies and sixty-three miscarriages were reported. A lower risk of adhesion formation after THL has been reported. No clear data regarding the effect of surgery on the regularization of the menstrual cycle has been described. A reduction in LH and AMH serum levels as well as the LH/FSH ratio compared to preoperative levels for both surgical techniques has been described. CONCLUSIONS Despite the scarcity and heterogeneity of data, surgical therapy could be considered an effective and safe approach in the management of PCOS patients with resistance to pharmacological treatment who desire to become pregnant.
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Affiliation(s)
- Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples "Federico II", 80131 Naples, Italy
| | - Dominga Boccia
- Department of Public Health, School of Medicine, University of Naples "Federico II", 80131 Naples, Italy
| | - Mario Palumbo
- Department of Public Health, School of Medicine, University of Naples "Federico II", 80131 Naples, Italy
| | - Antonio Mercorio
- Department of Public Health, School of Medicine, University of Naples "Federico II", 80131 Naples, Italy
| | - Carlo Ronsini
- Department of Woman, Child and General and Specialized Surgery, School of Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Giuseppe Bifulco
- Department of Public Health, School of Medicine, University of Naples "Federico II", 80131 Naples, Italy
| | - Pierluigi Giampaolino
- Department of Public Health, School of Medicine, University of Naples "Federico II", 80131 Naples, Italy
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Zhao H, Zhang J, Cheng X, Nie X, He B. Insulin resistance in polycystic ovary syndrome across various tissues: an updated review of pathogenesis, evaluation, and treatment. J Ovarian Res 2023; 16:9. [PMID: 36631836 PMCID: PMC9832677 DOI: 10.1186/s13048-022-01091-0] [Citation(s) in RCA: 107] [Impact Index Per Article: 53.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/26/2022] [Indexed: 01/12/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by chronic ovulation dysfunction and overabundance of androgens; it affects 6-20% of women of reproductive age. PCOS involves various pathophysiological factors, and affected women usually have significant insulin resistance (IR), which is a major cause of PCOS. IR and compensatory hyperinsulinaemia have differing pathogeneses in various tissues, and IR varies among different PCOS phenotypes. Genetic and epigenetic changes, hyperandrogenaemia, and obesity aggravate IR. Insulin sensitization drugs are a new treatment modality for PCOS. We searched PubMed, Google Scholar, Elsevier, and UpToDate databases in this review, and focused on the pathogenesis of IR in women with PCOS and the pathophysiology of IR in various tissues. In addition, the review provides a comprehensive overview of the current progress in the efficacy of insulin sensitization therapy in the management of PCOS, providing the latest evidence for the clinical treatment of women with PCOS and IR.
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Affiliation(s)
- Han Zhao
- grid.412467.20000 0004 1806 3501Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning 110000 People’s Republic of China
| | - Jiaqi Zhang
- grid.412467.20000 0004 1806 3501Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning 110000 People’s Republic of China
| | - Xiangyi Cheng
- grid.412467.20000 0004 1806 3501Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning 110000 People’s Republic of China
| | - Xiaozhao Nie
- grid.412467.20000 0004 1806 3501Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning 110000 People’s Republic of China
| | - Bing He
- Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, 110000, People's Republic of China.
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Mohd Shukri MF, Norhayati MN, Badrin S, Abdul Kadir A. Effects of L-carnitine supplementation for women with polycystic ovary syndrome: a systematic review and meta-analysis. PeerJ 2022; 10:e13992. [PMID: 36132218 PMCID: PMC9484467 DOI: 10.7717/peerj.13992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/11/2022] [Indexed: 01/19/2023] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is a disorder in reproductive age women and is characterized by hyperandrogenic anovulation and oligo-amenorrhea, which leads to infertility. Anovulation in PCOS is associated with low follicle-stimulating hormone levels and the arrest of antral follicle development in the final stages of maturation. L-carnitine (LC) plays a role in fatty acid metabolism, which is found to be lacking in PCOS patients. This systematic review and meta-analysis aimed to determine the effectiveness of LC supplementation for patients with PCOS. Methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychological Information Database (PsycINFO), and the World Health Organization International Clinical Trials Registry Platform for all randomized control trials, comparing LC alone or in combination with other standard treatments for the treatment of PCOS from inception till June 2021. We independently screened titles and abstracts to identify available trials, and complete texts of the trials were checked for eligibility. Data on the methods, interventions, outcomes, and risk of bias from the included trials were independently extracted by the authors. The estimation of risk ratios and mean differences with a 95 percent confidence interval (CI) was performed using a random-effects model. Results Nine studies with 995 participants were included in this review. Five comparison groups were involved. In one comparison group, LC reduced the fasting plasma glucose (FPG) (mean differences (MD) -5.10, 95% CI [-6.25 to -3.95]; P = 0.00001), serum low-density lipoprotein (LDL) (MD -25.00, 95% CI [-27.93 to -22.07]; P = 0.00001), serum total cholesterol (MD -21.00, 95% CI [-24.14 to -17.86]; P = 0.00001), and serum triglyceride (TG) (MD -9.00, 95% CI [-11.46 to -6.54]; P = 0.00001) with moderate certainty of evidence. Another comparison group demonstrated that LC lowers the LDL (MD -12.00, 95% CI [-15.80 to -8.20]; P = 0.00001), serum total cholesterol (MD -24.00, 95% CI [-27.61 to -20.39]; P = 0.00001), and serum TG (MD -19.00, 95% CI [-22.79 to -15.21]; P = 0.00001) with moderate certainty of evidence. Conclusion There was low to moderate certainty of evidence that LC improves Body Mass Index (BMI) and serum LDL, TG, and total cholesterol levels in women with PCOS.
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Affiliation(s)
| | - Mohd Noor Norhayati
- Department of Family Medicine, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Salziyan Badrin
- Department of Family Medicine, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Azidah Abdul Kadir
- Department of Family Medicine, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Sinha B, Ghosal S. A Meta-Analysis of the Effect of Sodium Glucose Cotransporter-2 Inhibitors on Metabolic Parameters in Patients With Polycystic Ovary Syndrome. Front Endocrinol (Lausanne) 2022; 13:830401. [PMID: 35265039 PMCID: PMC8900375 DOI: 10.3389/fendo.2022.830401] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/17/2022] [Indexed: 11/28/2022] Open
Abstract
Objective Polycystic ovary syndrome (PCOS) is the most common endocrinopathy among women of childbearing age and is associated with multiple morbidities. However, treatment for this condition is mainly applied for symptomatic relief and does not address the complex pathophysiology of this condition. This meta-analysis was conducted on the usage of sodium-glucose cotransporter 2 inhibitors (SGLT-2is) in PCOS because this group of drugs presents an attractive strategy to address the metabolic and hormonal defects by managing the pathophysiological defects observed in this syndrome. Methods We included prospective trials that enrolled patients with established PCOS and compared an SGLT-2i group versus a control group with at least 2 weeks of follow-up. The standardized mean difference (SMD) was used for effect size estimation from individual studies and was pooled using the fixed effect model. Results We included four trials with a pooled population of 158 patients with documented PCOS who received either an SGLT-2i or standard management. From a metabolic perspective, significant improvements were observed in the reduction in body weight (SMD: -0.68, 95% CI -1.16 to -0.19, <0.01), fasting plasma glucose (FPG) (SMD: -0.59, 95% CI -0.99 to -0.19, P<0.01), and insulin resistance as assessed with the HOMA-IR (SMD: -0.39, 95% CI -0.76 to -0.03, P=0.03). In addition, a significant improvement was noted in dehydroepiandrosterone sulphate (DHEAS) levels (SMD: -0.55, 95% CI -0.94 to -0.16, P<0.01). Conclusion SGLT-2i use is associated with salutary outcomes of metabolic and anthropometric markers of PCOS and likely favourable hormonal effects. Clinical Trial Registration [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021268564], PROSPERO 2021 CRD42021268564.
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Affiliation(s)
- Binayak Sinha
- Department of Endocrinology, AMRI Hospitals, Kolkata, India
| | - Samit Ghosal
- Department of Endocrinology, Nightingale Hospital, Kolkata, India
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Madhu SV. Youth-onset type 2 diabetes mellitus—a distinct entity? Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-00993-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Siamashvili M, Davis SN. Update on the effects of GLP-1 receptor agonists for the treatment of polycystic ovary syndrome. Expert Rev Clin Pharmacol 2021; 14:1081-1089. [PMID: 34015974 DOI: 10.1080/17512433.2021.1933433] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RA) offer a unique opportunity to simultaneously address various comorbid associated conditions and phenotypic presentations of polycystic ovary syndrome (PCOS) as these agents improve insulin sensitivity, reduce cardiovascular disease (CVD) risk, result in weight loss, and improve nonalcoholic fatty liver disease.Areas covered: The authors describe trials conducted during the last 5 years and provide an update on exenatide and liraglutide use in PCOS women. Information from the studies investigating GLP-1 RAs effects on reducing CVD risk in PCOS is also presented.Expert opinion: Exenatide and liraglutide are good options for the treatment of PCOS when used alone or in combination with metformin. Especially strong consideration should be given to GLP-1 RAs when developing treatment strategies for PCOS women who are overweight or obese, glucose intolerant, have CVD or its attendant risk factors, and/or are seeking treatment for infertility.
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Affiliation(s)
- Maka Siamashvili
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Stephen N Davis
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Kheirollahi A, Teimouri M, Karimi M, Vatannejad A, Moradi N, Borumandnia N, Sadeghi A. Evaluation of lipid ratios and triglyceride-glucose index as risk markers of insulin resistance in Iranian polycystic ovary syndrome women. Lipids Health Dis 2020; 19:235. [PMID: 33161896 PMCID: PMC7648985 DOI: 10.1186/s12944-020-01410-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/20/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Insulin resistance has a vital role in the pathophysiology of polycystic ovary syndrome (PCOS). Previous investigations have shown that some lipid ratios could be a simple clinical indicator of insulin resistance (IR) in some disorders and ethnicities. The present study was conducted to evaluate the correlation between triglyceride to HDL-cholesterol (TG/HDL-C), total cholesterol to HDL-cholesterol (TC/HDL-C), as well as fasting triglyceride-glucose (TyG) indices with IR (as measured by homeostasis model assessment of IR (HOMA-IR), quantitative insulin sensitivity check index (QUICKI) and fasting glucose to insulin ratio (FGIR)) among the Iranian women diagnosed with PCOS. METHODS In the current study, a total of 305 women with PCOS were evaluated. TG/HDL-C, TC/HDL-C, and TyG indices were calculated. Fasting insulin level was measured using ELISA technique. IR was defined as a HOMA-IR value of ≥2.63, FG-IR value of < 8.25, and QUICKI value of < 0.33. RESULTS The insulin-resistant (IR) and insulin-sensitive (IS) groups, established by the HOMA-IR, FG-IR, and QUICKI values were different in terms of TG/HDL-C, TC/HDL-C, and TyG indices. These indices were associated with IR even after adjusting for age and BMI. ROC curve analyses showed that TyG, TG/HDL-C, and TC/HDL-C strongly predicted HOMA-IR with area under the curve (AUC) of 0.639, 0.619, and 0.623, respectively (P < 0.05). Further, TC/HDL-C was a good predictor of FG-IR with AUC of 0.614 (P = 0.04). CONCLUSION TyG, TG/HDL-C, and TC/HDL-C indices might be good indicators of IR among Iranian women diagnosed with PCOS.
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Affiliation(s)
- Asma Kheirollahi
- Department of Comparative Biosciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Maryam Teimouri
- Department of biochemistry, School of Paramedicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mehrdad Karimi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Vatannejad
- Department of Comparative Biosciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran.
| | - Nariman Moradi
- Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Nasrin Borumandnia
- Urology and Nephrology Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asie Sadeghi
- Student Research Committee, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran. .,Department of Clinical Biochemistry, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
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Huang X, Hao YL, Zhen XL, Zhou RM, Wang N, Cao SR, Li Y. Association between the vascular endothelial growth factor gene polymorphisms and the risk of polycystic ovary syndrome in Northern Chinese women. Gynecol Endocrinol 2019; 35:706-709. [PMID: 30935253 DOI: 10.1080/09513590.2019.1579789] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The present study aimed to investigate whether the single nucleotide polymorphisms (SNPs) rs2010963 and rs833061 in vascular endothelial growth factor (VEGF) gene is correlated with the risk of polycystic ovary syndrome (PCOS) in Northern Chinese women, as a preliminary study. This case-control study comprised 118 women with PCOS and 130 healthy women as controls. Genotyping of the two polymorphisms within the VEGF gene 5'-untranslated region and promoter region were performed using polymerase chain reaction ligase detection reaction method. The data showed that there was a significant difference in the genotype and allele distribution of the rs2010963 polymorphism between the PCOS group and the control group (p = .020 and .033, respectively). The women carrying the C allele (G/C + C/C genotype) had a lower risk of PCOS compared with the women with G/G genotype [odds ratio (OR = 0.55; 95% confidence interval (CI) = 0.33-0.91]. Our study shows for the first time that the rs2010963 polymorphism may be associated with a risk of PCOS in Northern Chinese women.
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Affiliation(s)
- Xi Huang
- a Department of Molecular Biology , The Fourth Hospital of Hebei Medical University , Shijiazhuang , Hebei , China
| | - Ya-Li Hao
- b Department of Reproductive Medicine , The Fourth Hospital of Hebei Medical University , Shijiazhuang , Hebei , China
| | - Xiu-Li Zhen
- b Department of Reproductive Medicine , The Fourth Hospital of Hebei Medical University , Shijiazhuang , Hebei , China
| | - Rong-Miao Zhou
- a Department of Molecular Biology , The Fourth Hospital of Hebei Medical University , Shijiazhuang , Hebei , China
| | - Na Wang
- a Department of Molecular Biology , The Fourth Hospital of Hebei Medical University , Shijiazhuang , Hebei , China
| | - Shi-Ru Cao
- a Department of Molecular Biology , The Fourth Hospital of Hebei Medical University , Shijiazhuang , Hebei , China
| | - Yan Li
- a Department of Molecular Biology , The Fourth Hospital of Hebei Medical University , Shijiazhuang , Hebei , China
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Sachdeva G, Gainder S, Suri V, Sachdeva N, Chopra S. Comparison of Clinical, Metabolic, Hormonal, and Ultrasound Parameters among the Clomiphene Citrate-Resistant and Clomiphene Citrate-Sensitive Polycystic Ovary Syndrome Women. J Hum Reprod Sci 2019; 12:216-223. [PMID: 31576079 PMCID: PMC6764232 DOI: 10.4103/jhrs.jhrs_89_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objective: The objective of the study is to compare the clinical, metabolic, hormonal, and ultrasound parameters among the clomiphene citrate (CC)-sensitive and CC-resistant polycystic ovary syndrome (PCOS) women. Materials and Methods: This was a prospective observational study. Setting: The study was conducted at the infertility outpatient department in a government hospital. Sample Size: A total of 164 women with PCOS-related infertility were included. Intervention: Incremental dose of CC from 50 mg/day to 100 mg/day to 150 mg/day over three cycles was given. Response: Ovulation was the outcome. Those who failed to ovulate with 150 mg CC were CC resistant. Results: Of the total 164 PCOS women, 88 (53.7%) were CC resistant and 76 (46.3%) were CC sensitive. Of the 76 PCOS women who ovulated, maximum, i.e., 37 (22.6%) women ovulated with 100 mg CC. The most common diagnostic feature of PCOS in this study was hyperandrogenism (96.3%). CC-resistant PCOS women had significantly higher weight, waist circumference, waist-hip ratio, and body mass index (BMI). Significantly longer menstrual cycles and hyperandrogenism were significantly more common in CC-resistant group. CC-resistant group had a significantly higher ovarian reserve (ovarian volume, antral follicle count, and anti-Müllerian hormone values). Baseline luteinizing hormone (LH) values and LH-follicle stimulating hormone ratio were significantly higher in the CC-resistant group. Conclusion: Clomiphene-resistant PCOS women have significantly higher hyperandrogenism, longer cycles, more deranged metabolic profile, higher BMI, and ovarian reserve. These differences should be kept in mind while deciding the ovulation induction protocol.
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Affiliation(s)
- Garima Sachdeva
- Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shalini Gainder
- Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vanita Suri
- Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Naresh Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Seema Chopra
- Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Łagowska K, Bajerska J, Jamka M. The Role of Vitamin D Oral Supplementation in Insulin Resistance in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2018; 10:1637. [PMID: 30400199 PMCID: PMC6266903 DOI: 10.3390/nu10111637] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 10/16/2018] [Accepted: 10/22/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To evaluate the effect of vitamin D supplementation (alone or with co-supplementation) on insulin resistance in patients with polycystic ovary syndrome (PCOS). METHODS We performed a literature search of databases (Medline, Scopus, Web of Knowledge, Cochrane Library) and identified all reports of randomized controlled trials (RCTs) published prior to April 2018. We compared the effects of supplementation with vitamin D alone (dose from 1000 IU/d to 60,000 IU/week) or with co-supplements to the administration of placebos in women diagnosed with PCOS. The systematic review and meta-analysis protocol was registered in the International Prospective Register of Systematic Reviews (Prospero) as number CRD42018090572. MAIN RESULTS Eleven of 345 identified studies were included in the analysis; these involved 601women diagnosed with PCOS. Vitamin D as a co-supplement was found to significantly decrease fasting glucose concentrations and the HOMA-IR value. HOMA-IR also declined significantly when vitamin D was supplemented with a dose lower than 4000 IU/d. CONCLUSIONS Evidence from RCTs suggests that the supplementation of PCOS patients with continuous low doses of vitamin D (<4000 IU/d) or supplementation with vitamin D as a co-supplement may improve insulin sensitivity in terms of the fasting glucose concentration (supplementation with vitamin D in combination with other micronutrients) and HOMA-IR (supplementation with vitamin D in continuous low daily doses or as co-supplement).
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Affiliation(s)
- Karolina Łagowska
- Institute ofHuman Nutrition and Dietetics, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624 Poznań, Poland.
| | - Joanna Bajerska
- Institute ofHuman Nutrition and Dietetics, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624 Poznań, Poland.
| | - Małgorzata Jamka
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznań University of Medical Sciences, Szpitalna 27/33, 60-572 Poznań, Poland.
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Firmansyah A, Chalid MT, Farid RB, Nusratuddin N. The correlation between insulin-like growth factor binding protein 1 (IGFBP-1) and homeostasis model assessment of insulin resistance (HOMA-IR) in polycystic ovarian syndrome with insulin resistance. Int J Reprod Biomed 2018; 16:679-682. [PMID: 30775682 PMCID: PMC6350850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND The underlying etiology of polycystic ovarian syndrome (PCOS) is unknown and assumed to have a strong correlation with insulin resistance. Homeostasis Model Assessment of insulin resistance (HOMA-IR) is a good tool to assess insulin resistance. Low levels of serum Insulin-like Growth Factor-Binding Protein-1 (IGFBP-1) in PCOS women led to the hypothesis that hyperinsulinemia in PCOS inhibits the production of IGFBP-1, which in turn stimulates excessive androgen production. OBJECTIVE The study is aimed to analyze the correlation between the levels of IGFBP-1 and HOMA-IR on insulin resistance in PCOS. MATERIALS AND METHODS A cross-sectional study among 105 PCOS women, including 60 women with insulin resistance were recruited. The mean of IGFBP-1 and HOMA-IR were 6.507±4.7821 μg/l and 3.633±1.666 respectively. RESULTS Low levels of IGFBP-1 were detected in all insulin resistance women. There was a correlation between HOMA-IR and overweight (p=0.045), while IGFBP-1 showed no correlation with overweight (p=0.106). In addition, no correlation between IGFBP-1 with HOMA-IR as a marker of insulin resistance was detected. CONCLUSION Despite the decrease in IGFBP-1, it seems that there is no correlation between IGFBP-1 with HOMA-IR as a marker of insulin resistance.
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Insulin Sensitizers Modulate GnRH Receptor Expression in PCOS Rats. Arch Med Res 2018; 49:154-163. [PMID: 30104075 DOI: 10.1016/j.arcmed.2018.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 07/30/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Insulin sensitizers like metformin and pioglitazone are clinically used since last decades for the treatment of PCOS, but their efficacy and possible role in PCOS patients remains questionable. Also, the mechanism by which these insulin sensitizers show effect is not clear. AIM OF THE STUDY To evaluate the effect of metformin and pioglitazone on leutinizing hormone and follicle stimulating hormone receptor mRNA expression, hyperandrogenism and insulin resistance in high fat diet induced and letrozole induced PCOS in rats. METHODS Pre-pubertal female rats were divided into four groups: group I received normal pellet diet and group II, III and IV received high fat diet. After 105 d of dietary manipulation, metformin and pioglitazone treatment was given to group III and group IV animals respectively for 21 d. Similarly, adult female rats were divided into four groups: group I received 1% carboxymethyl cellulose (CMC) and group II, III, IV received letrozole for 21 d. After 21 d of letrozole administration, metformin and pioglitazone treatment was given to group III and group IV animals respectively for 21 d. Oral glucose tolerance test, lipid profile, fasting glucose, insulin, estrus cycle, hormonal profile, ovary weight, leutinizing hormone receptor and follicle stimulating hormone receptor mRNA expression was measured. Polycystic ovarian morphology was assessed through histopathological changes of ovary. RESULTS AND CONCLUSION Metformin and pioglitazone treatment improve both metabolic and reproductive parameters of PCOS including hyperinsulinemia and hyperandrogenism. LH receptor and FSH receptor mRNA expression were altered by pioglitazone and metformin treatment.
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Lascar N, Brown J, Pattison H, Barnett AH, Bailey CJ, Bellary S. Type 2 diabetes in adolescents and young adults. Lancet Diabetes Endocrinol 2018; 6:69-80. [PMID: 28847479 DOI: 10.1016/s2213-8587(17)30186-9] [Citation(s) in RCA: 512] [Impact Index Per Article: 73.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 05/12/2017] [Accepted: 05/17/2017] [Indexed: 12/11/2022]
Abstract
The prevalence of type 2 diabetes in adolescents and young adults is dramatically increasing. Similar to older-onset type 2 diabetes, the major predisposing risk factors are obesity, family history, and sedentary lifestyle. Onset of diabetes at a younger age (defined here as up to age 40 years) is associated with longer disease exposure and increased risk for chronic complications. Young-onset type 2 diabetes also affects more individuals of working age, accentuating the adverse societal effects of the disease. Furthermore, evidence is accumulating that young-onset type 2 diabetes has a more aggressive disease phenotype, leading to premature development of complications, with adverse effects on quality of life and unfavourable effects on long-term outcomes, raising the possibility of a future public health catastrophe. In this Review, we describe the epidemiology and existing knowledge regarding pathophysiology, risk factors, complications, and management of type 2 diabetes in adolescents and young adults.
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Affiliation(s)
- Nadia Lascar
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - James Brown
- Aston Research Centre for Healthy Ageing (ARCHA), Aston University, Birmingham, UK
| | - Helen Pattison
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Anthony H Barnett
- Diabetes and Endocrine Centre, Heart of England NHS Foundation Trust, Birmingham, UK; University of Birmingham, Birmingham, UK
| | - Clifford J Bailey
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Srikanth Bellary
- Aston Research Centre for Healthy Ageing (ARCHA), Aston University, Birmingham, UK.
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20
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Insulin resistance improvement by cinnamon powder in polycystic ovary syndrome: A randomized double-blind placebo controlled clinical trial. Phytother Res 2017; 32:276-283. [DOI: 10.1002/ptr.5970] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 10/06/2017] [Accepted: 10/09/2017] [Indexed: 01/05/2023]
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Kominiarek MA, Jungheim ES, Hoeger KM, Rogers AM, Kahan S, Kim JJ. American Society for Metabolic and Bariatric Surgery position statement on the impact of obesity and obesity treatment on fertility and fertility therapy Endorsed by the American College of Obstetricians and Gynecologists and the Obesity Society. Surg Obes Relat Dis 2017; 13:750-757. [DOI: 10.1016/j.soard.2017.02.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 02/08/2017] [Indexed: 12/30/2022]
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Macruz CF, Lima SM, Salles JE, da Silva GM, Scalissi NM. Assessment of the body composition of patients with polycystic ovary syndrome using dual-energy X-ray absorptiometry. Int J Gynaecol Obstet 2017; 136:285-289. [DOI: 10.1002/ijgo.12066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 10/13/2016] [Accepted: 11/17/2016] [Indexed: 12/15/2022]
Affiliation(s)
- Carolina F. Macruz
- Department of Obstetrics and Gynecology; Santa Casa de Sao Paulo School of Medical Sciences; Sao Paulo Brazil
| | - Sônia M.R.R. Lima
- Department of Obstetrics and Gynecology; Santa Casa de Sao Paulo School of Medical Sciences; Sao Paulo Brazil
| | - João E.N. Salles
- Clinic Endocrinology Unit; Department of Internal Medicine; Santa Casa de Sao Paulo School of Medical Sciences; Sao Paulo Brazil
| | - Gustavo M.D. da Silva
- Department of Obstetrics and Gynecology; Santa Casa de Sao Paulo School of Medical Sciences; Sao Paulo Brazil
| | - Nilza M. Scalissi
- Clinic Endocrinology Unit; Department of Internal Medicine; Santa Casa de Sao Paulo School of Medical Sciences; Sao Paulo Brazil
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Csenteri OK, Sándor J, Kalina E, Bhattoa HP, Gődény S. The role of hyperinsulinemia as a cardiometabolic risk factor independent of obesity in polycystic ovary syndrome. Gynecol Endocrinol 2017; 33:34-38. [PMID: 27468791 DOI: 10.1080/09513590.2016.1203410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The aim of this study was to utilize various insulin resistance measuring methods to determine whether insulin resistance and other parameters impact the serum lipid levels of polycystic ovary syndrome (PCOS) patients and how the serum lipid levels in these patients are affected by the body mass index (BMI). Our dataset included patients between the ages of 16 and 42 (N = 228) from the outpatient endocrinology clinic of the Department of Obstetrics and Gynecology, who demonstrated increased hair growth and bleeding disorders and came for a routine oral glucose tolerance test (OGTT). Differences in the serum lipid levels were evaluated by t-test and linear regression analysis after adjusting for BMI. A stepwise regression model was constructed to evaluate the influence of each variable on the lipid levels. In PCOS patients, we found that dyslipidemia is more prevalent among hyperinsulinemic women compared with normoinsulinemic women, even after normalizing for BMI. PCOS patients with insulin resistance, determined by the insulin sensitivity index (ISI) method, showed more significant lipid abnormalities such as low high-density lipoprotein (HDL) and apo-A levels and high total cholesterol, low-density lipoprotein (LDL) and apo-B levels than if insulin resistance (IR) determination was based on insulin level or homeostatic model assessment (HOMA).
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Affiliation(s)
| | - János Sándor
- b Division of Biostatistics and Epidemiology , Department of Preventive Medicine, Faculty of Public Health
| | - Edit Kalina
- c Department of Laboratory Medicine , Faculty of Medicine, University of Debrecen , Debrecen , Hungary , and
| | - Harjit Pal Bhattoa
- c Department of Laboratory Medicine , Faculty of Medicine, University of Debrecen , Debrecen , Hungary , and
| | - Sándor Gődény
- a Department of Preventive Medicine , Faculty of Public Health
- d Endocrinology Clinic, Department of Obstetrics and Gynecology, University of Debrecen Clinical Center , Debrecen , Hungary
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Rashidi H, Toolabi M, Najafian M, Sadrian E, Safapoor N, Nazari P. The relationship of serum 25-dihydroxy vitamin D3 concentrations with metabolic parameters in non-obese women with polycystic ovarian syndrome. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2016. [DOI: 10.1016/j.mefs.2016.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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Ghaffarzad A, Amani R, Mehrzad Sadaghiani M, Darabi M, Cheraghian B. Correlation of Serum Lipoprotein Ratios with Insulin Resistance in Infertile Women with Polycystic Ovarian Syndrome: A Case Control Study. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2016; 10:29-35. [PMID: 27123197 PMCID: PMC4845526 DOI: 10.22074/ijfs.2016.4765] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 01/07/2015] [Indexed: 12/11/2022]
Abstract
Background Dyslipidemia and insulin resistance (IR), occurring in most infertile women with polycystic ovarian syndrome (PCOS), increase the risk of cardiovascular disease
(CVD) and type 2 diabetes. This study aimed to assess the relationships between lipoprotein ratios and IR in PCOS women. Materials and Methods Thirty six infertile women with PCOS selected based on Androgen Excess Society (AES) criteria and 29 healthy women matched for age were recruited to
this case-control study. After physical measurements, fasting serum glucose (Glu), insulin
and lipid profile levels [triglycerides (TGs), total cholesterol (TC), low-density lipoproteincholesterol (LDL-C) and high-density lipoprotein-cholesterol (HDL-C)] were measured,
while lipoprotein ratios (TC/HDL-C, LDL-C/HDL-C, TG/HDL-C) were calculated. IR
was also calculated using homeostasis model assessment (HOMA)-IR. The optimal cutoffs of lipoprotein ratios in relation to HOMA-IR were calculated based on the Receiver
Operating Characteristics (ROC) curve analysis using the area under curve (AUC). Results Waist circumference (WC), insulin levels, HOMA-IR, TG levels, and all lipoprotein ratios were significantly higher, while HDL-C was lower in PCOS group
as compared to healthy controls. All lipoprotein ratios, TG levels, and WC are significantly correlated with insulin levels and HOMA-IR. Among lipoprotein ratios, the
highest AUC of the ROC belonged to TG/HDL-C ratio with sensitivity of 63.6% and
specificity of 84.4% (TG/HDL-C>3.19) as a marker of IR in infertile PCOS women. Conclusion Lipoprotein ratios, particularly TG/HDL-C, are directly correlated with insulin levels and can be used as a marker of IR (HOMA-IR) in infertile PCOS patients.
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Affiliation(s)
- Aisa Ghaffarzad
- Department of Nutrition, School of Paramedicine, Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reza Amani
- Department of Nutrition, University Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahzad Mehrzad Sadaghiani
- Women's Reproductive Health Research Centre, Department of Infertility and Reproductive, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoud Darabi
- Laboratory of Chromatography, Department of Biochemistry and Clinical Laboratories, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bahman Cheraghian
- Department of Epidemiology and Biostatistics, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
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Association of single-nucleotide polymorphisms rs2197076 and rs2241883 of FABP1 gene with polycystic ovary syndrome. J Assist Reprod Genet 2015; 33:75-83. [PMID: 26650609 DOI: 10.1007/s10815-015-0626-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 11/22/2015] [Indexed: 01/31/2023] Open
Abstract
PURPOSE The objective of this study was to evaluate the association between single-nucleotide polymorphisms (SNPs) rs2197076 and rs2241883 in fatty acid-binding protein 1 (FABP1) gene and polycystic ovary syndrome (PCOS). METHODS The two alleles rs2197076 and rs2241883 in FABP1 gene in 221 PCOS women and 198 normal women were amplified and sequenced. Allele frequency comparison was performed between the PCOS and control groups, and genotype-phenotype correlation analysis was performed using dominant and recessive models to assess the association of FABP1 and the main features of PCOS. RESULTS Allele frequency analyses showed a strong association of SNPs rs2197076 and rs2241883 of FABP1 gene with PCOS (P < 0.001). The additive, dominant, and recessive genotype model analyses further supported this association even after adjusting for age and body mass index (BMI). The minor allele frequency (MAF) of rs2241883 in obese PCOS women was less than that in obese control women. Further genotype-phenotype correlation analysis showed that SNP rs2197076 had a stronger association with the main features of PCOS than SNP rs2241883. CONCLUSION In the association of SNPs in FABP1 gene with PCOS, rs2197076 was more closely associated with its main features than rs2241883 and seemed to play a more important role in the pathogenesis of PCOS.
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Xue H, Zhao H, Zhao Y, Liu X, Chen Z, Ma J. Association of common variants of FTO in women with polycystic ovary syndrome. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:13505-13509. [PMID: 26722565 PMCID: PMC4680510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 09/28/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common and complex multisystemic genetic disease. Previous genome-wide association study (GWAS) of PCOS has found several potentially causative single nucleotide polymorphisms (SNPs) in Han Chinese population. The goal of present investigation was to assess the potential association between rs1121980, rs1421085, rs1558902, rs8050136 SNPs and PCOS. In order to make a better elucidation of this disease, further investigations of association between SNPs susceptibility and PCOS become necessary. METHODS In the present study, we enrolled 212 patients with PCOS and 198 control subjects. Four polymorphisms of FTO gene (rs1121980, rs1421085, rs1558902, rs8050136) were genotyped by Taqman-MGB method, and their relationship with PCOS was speculated. RESULTS The allele frequency has no significant difference between the PCOS group and the controls. Genotype frequencies of the four SNPs in the additive, dominant and recessive models showed no significant difference between PCOS cases and controls. CONCLUSIONS Our results demonstrate that FTO gene has little association in PCOS development.
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Affiliation(s)
- Hongxi Xue
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Key Laboratory of Reproductive MedicineJinan, China
- Department of Reproductive Medicine, Rizhao City Hospital of Traditional Chinese MedicineRizhao, China
- National Research Center for Assisted Reproductive Technology and Reproductive GeneticsJinan, China
- The Key Laboratory for Reproductive Endocrinology of Ministry of EducationJinan, China
| | - Han Zhao
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Key Laboratory of Reproductive MedicineJinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive GeneticsJinan, China
- The Key Laboratory for Reproductive Endocrinology of Ministry of EducationJinan, China
| | - Yueran Zhao
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Key Laboratory of Reproductive MedicineJinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive GeneticsJinan, China
- The Key Laboratory for Reproductive Endocrinology of Ministry of EducationJinan, China
| | - Xin Liu
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Key Laboratory of Reproductive MedicineJinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive GeneticsJinan, China
- The Key Laboratory for Reproductive Endocrinology of Ministry of EducationJinan, China
| | - Zijiang Chen
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Key Laboratory of Reproductive MedicineJinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive GeneticsJinan, China
- The Key Laboratory for Reproductive Endocrinology of Ministry of EducationJinan, China
| | - Jinlong Ma
- Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Key Laboratory of Reproductive MedicineJinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive GeneticsJinan, China
- The Key Laboratory for Reproductive Endocrinology of Ministry of EducationJinan, China
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Li L, Ryoo JE, Lee KJ, Choi BC, Baek KH. Genetic variation in the Mcp-1 gene promoter associated with the risk of polycystic ovary syndrome. PLoS One 2015; 10:e0123045. [PMID: 25902044 PMCID: PMC4406762 DOI: 10.1371/journal.pone.0123045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 02/18/2015] [Indexed: 11/19/2022] Open
Abstract
Monocyte chemoattractant protein-1 (MCP-1) is a pivotal chemokine in the inflammatory response, which plays an important role in recruiting monocytes to sites of injury and infection. However, the exact mechanism of Mcp-1 associated with PCOS risk was unknown. In this study, we explored whether the Mcp-1 -2518G>A polymorphism increases the risk of PCOS. We performed a comparative study of -2518G>A polymorphism of the Mcp-1 gene with PCOS. In addition, luciferase reporter assay was performed to evaluate the Mcp-1 transcriptional activity. A strong association was observed between the -2518G>A polymorphism of Mcp-1 gene and PCOS (p-value = 0.016, odd ratio (OR) = 0.693). A p-value under 0.05 is considered statistically significant. The genotype and allelic frequencies were assumed to be in Hardy-Weinberg equilibrium (HWE). The luciferase assays in 2 cell lines showed that the Mcp-1 -2518G>A substitution can increase the expression of Mcp-1. MCP-1 levels in serum for PCOS group were significantly higher than those in serum for controls (p-value = 0.02). Furthermore, the patients carrying a genotype A/A had significantly increased levels of MCP-1 in serum compared with levels of the MCP-1 of the patients with genotypes G/G and G/A (p-value = 0.031). This is the first study on the genetic variation of the Mcp-1 gene and PCOS. This finding suggests that the Mcp-1 -2518G>A polymorphism is associated with PCOS risk by affecting transcriptional activity, leading to an increased expression level of Mcp-1.
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Affiliation(s)
- Lan Li
- Department of Biomedical Science, CHA University, Bundang CHA Hospital, Gyeonggi-do, Republic of Korea
| | - Ji Eun Ryoo
- Hankuk Academy of Foreign Studies, Yongin, Republic of Korea
| | - Kyung-Ju Lee
- Department of Gynecology and Obstetrics, CHA University, CHA General Hospital, Seoul, Republic of Korea
| | - Bum-Chae Choi
- Department of Obstetrics and Gynecology, CL Women’s Hospital, Gwangju, Republic of Korea
| | - Kwang-Hyun Baek
- Department of Biomedical Science, CHA University, Bundang CHA Hospital, Gyeonggi-do, Republic of Korea
- * E-mail:
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Polycystic ovary syndrome: A review for dermatologists. J Am Acad Dermatol 2014; 71:859.e1-859.e15; quiz 873-4. [DOI: 10.1016/j.jaad.2014.05.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 05/05/2014] [Accepted: 05/05/2014] [Indexed: 01/19/2023]
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Gacaferri Lumezi B, Goci A, Lokaj V, Latifi H, Karahoda N, Minci G, Telaku D, Gercari A, Kocinaj A. Mixed form of hirsutism in an adolescent female and laser therapy. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e9410. [PMID: 25068069 PMCID: PMC4103002 DOI: 10.5812/ircmj.9410] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 06/05/2013] [Accepted: 02/12/2014] [Indexed: 11/18/2022]
Abstract
Introduction: Hirsutism is a common disorder of excess growth of terminal hair in an androgen-dependent male distribution in women, including the chin, upper lip, breasts, back, and abdomen. It is very important to identify the etiology of hirsutism and adequate treat is prior to any cosmetic therapy. Case Presentation: The case was a 17-year-old female with severe hirsutism, oligomenorrhea, and obesity. She was evaluated to identify the etiology and diagnosed as a case of polycystic ovarian syndrome (PCOS), nonclassic congenital adrenal hyperplasia (NC-CAH), and hyperandrogenic insulin-resistant acanthosis nigricans (HAIR-AN) syndrome, which is a rare combination of hirsutism etiology. She was successfully treated according to the underlying pathology, and laser photoepilation was used as the preferred hair removal method. Discussion: Establishing the etiology, using the evidence–based strategies to improve hirsutism, and treating the underlying disorder, are essential for proper management of women with hirsutism.
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Affiliation(s)
- Besa Gacaferri Lumezi
- Department of Physiology and Immunology, University Clinical Center of Kosovo, Pristina, Kosovo
- Corresponding Author: Besa Gacaferri Lumezi, Department of Physiology and Immunology, University Clinical Center of Kosovo, Bulevardi i deshmoreve p.n. 10 000, Prishtina, Kosovo. Tel/Fax: +37-744186036, E-mail:
| | - Aferdita Goci
- Child and Adolescent Mental Health Center, University Clinical Center of Kosovo, Pristina, Kosovo
| | - Violeta Lokaj
- Department of Physiology and Immunology, University Clinical Center of Kosovo, Pristina, Kosovo
| | - Hatixhe Latifi
- Department of Physiology and Immunology, University Clinical Center of Kosovo, Pristina, Kosovo
| | - Natyra Karahoda
- Department of Physiology and Immunology, University Clinical Center of Kosovo, Pristina, Kosovo
| | - Ganimete Minci
- Department of Physiology and Immunology, University Clinical Center of Kosovo, Pristina, Kosovo
| | - Drita Telaku
- Department of Pediatrics, University Clinical Center of Kosovo, Pristina, Kosovo
| | - Antigona Gercari
- Department of Dermatology, University Clinical Center of Kosovo, Pristina, Kosovo
| | - Allma Kocinaj
- Department of Dermatology, University Clinical Center of Kosovo, Pristina, Kosovo
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Gődény S, Csenteri O. Importance of the interdisciplinary, evidence-based diagnosis of polycystic ovary syndrome. Orv Hetil 2014; 155:1175-88. [DOI: 10.1556/oh.2014.29941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Polycystic ovary syndrome is recognized as the most common hormonal and metabolic disorder of women. This heterogeneous endocrinopathy characterized by clinical and/or biochemical hyperandrogenism, oligo- or amenorrhoea, anovulatory infertility, and polycystic ovarian morphology. The prevalence, clinical feature and the risk of co-morbidity vary depending on the accuracy of the diagnosis and the criteria used. Evidence suggests that those women are at high risk who fulfil the criteria based on National Institute of Health. The complex feature of the syndrome and the considerable practice heterogenity that is present with regards to diagnostic testing of patients who are suspected to have polycystic ovary syndrome require an interdisciplinary, evidence-based diagnostic approach. Such a method can ensure the patient safety and the effectiveness and efficiency of the diagnosis. This paper summarises the highest available evidence provided by well-designed studies, meta-analysis and systematic reviews of the clinical feature and the clinical implications of the diagnostic criteria of polycystic ovary syndrome. Orv. Hetil., 2014, 155(30), 1175–1188.
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Affiliation(s)
- Sándor Gődény
- Debreceni Egyetem, Népegészségügyi Kar Megelőző Orvostani Intézet Debrecen Kassai u. 26. 4028
| | - Orsolya Csenteri
- Debreceni Egyetem, Népegészségügyi Kar Megelőző Orvostani Intézet Debrecen Kassai u. 26. 4028
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Association study of gene LPP in women with polycystic ovary syndrome. PLoS One 2012; 7:e46370. [PMID: 23056290 PMCID: PMC3463595 DOI: 10.1371/journal.pone.0046370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 08/29/2012] [Indexed: 11/19/2022] Open
Abstract
Background Previous genome-wide association study (GWAS) of polycystic ovary syndrome (PCOS) in Han Chinese population has found that SNPs in LPP gene were nominally significant in PCOS patients (P around 10E-05). Replication of the GWAS was applied to further confirm the relationship between LPP gene and PCOS. Methods Three polymorphisms of LPP gene (rs715790, rs4449306, rs6782041) were selected and replicated in additional 1132 PCOS cases and 1142 controls. Genotyping of LPP gene was carried out by Taqman-MGB method. Results In rs715790, the allele frequency is significantly different between the PCOS group and the control group. Meta-analysis showed that the allele frequencies of the three SNPs rs715790 (Pmeta = 1.89E-05, OR = 1.23), rs4449306 (Pmeta = 3.0E-04, OR = 1.10), rs6782041 (Pmeta = 2.0E-04, OR = 1.09), were significantly different between PCOS cases and controls. Conclusions Our results suggest that LPP gene might be a novel candidate for PCOS.
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Predictors of insulin resistance and metabolic complications in polycystic ovarian syndrome in an eastern Indian population. Indian J Clin Biochem 2012; 28:169-76. [PMID: 24426204 DOI: 10.1007/s12291-012-0253-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2012] [Accepted: 08/23/2012] [Indexed: 12/15/2022]
Abstract
The purpose of this study was to assess the predictive values of central obesity and hyperandrogenemia in development of insulin resistance and dyslipidemia in the polycystic ovarian syndrome (PCOS) patients in our region. Differences of fasting blood glucose level, insulin resistance index HOMA-IR, lipid parameters, waist hip ratio (WHR), body mass index, LH/FSH ratio and testosterone levels between 45 PCOS cases and 35 age matched controls were obtained. Strength of association between different parameters in the case group was assayed by Pearson's correlation analysis. Dependence of insulin resistance and WHR on different predictors was assessed by multiple linear regression assay. Total cholesterol, LDL cholesterol, LH, FSH, LH/FSH ratio, WHR and insulin resistance were significantly higher in the case group (p < 0.05). Serum testosterone showed strong correlation with insulin resistance and LH/FSH ratio (r = 0.432 and 0.747, p = 0.01 and 0.001 respectively) in the PCOS patients while WHR and serum testosterone level stood out to be most significant predictors for the insulin resistance (β = 0.361 and 0.498; p = 0.048 and 0.049 respectively). Hyperandrogenemia and central obesity were the major factors predicting development of insulin resistance and its related metabolic and cardiovascular complications in our PCOS patients. We suggest early monitoring for androgen level and WHR in these patients for predicting an ensuing insulin resistance and modulating the treatment procedure accordingly to minimise future cardiovascular risks.
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Malik SM, Traub ML. Defining the role of bariatric surgery in polycystic ovarian syndrome patients. World J Diabetes 2012; 3:71-9. [PMID: 22532886 PMCID: PMC3334389 DOI: 10.4239/wjd.v3.i4.71] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 03/21/2012] [Accepted: 04/10/2012] [Indexed: 02/05/2023] Open
Abstract
Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women. To meet PCOS criteria, women must have a combination of hyperandrogenism, anovulation and ultrasound findings. Almost 10% of all reproductive age women worldwide show signs of PCOS. Although women often seek care for gynecological or body image concerns, many PCOS women are at risk for metabolic syndrome (MS). Many of the metabolic consequences are overlooked and undertreated by physicians because these patients tend to be young, reproductive age women. MS and obesity coexist commonly with PCOS. These young women are predisposed to glucose abnormalities and ultimately diabetes mellitus, dyslipidemia and eventually cardiovascular disease. Bariatric surgery can be an effective means of weight loss in PCOS women. Surgical techniques have become safer and less invasive over time and have been found to be effective in achieving significant weight loss. Surgical options have also increased, giving patients more choices. Bariatric surgery may prevent or reverse metabolic syndrome. Bariatric surgery may also have reproductive benefits in PCOS patients. Although bariatric surgery has historically been performed in older, reproductive aged women, it has recently gained favor in adolescents as well. This is of particular importance due to the prevalence of both PCOS and MS in adolescents. Treatment of PCOS and MS certainly requires a combination of medical therapy, psychological support and lifestyle modifications. These treatments are difficult and often frustrating for patients and physicians. Bariatric surgery can be effective in achieving significant weight loss, restoration of the hypothalamic pituitary axis, reduction of cardiovascular risk and even in improving pregnancy outcomes. Ultimately, bariatric surgery should be considered part of the treatment in PCOS women, especially in those with MS.
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Affiliation(s)
- Shaveta M Malik
- Shaveta M Malik, Michael L Traub, Department of Obstetrics and Gynecology, Staten Island University Hospital, Staten Island, NY 10305, United States
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Zhai HL, Wu H, Xu H, Weng P, Xia FZ, Chen Y, Lu YL. Trace glucose and lipid metabolism in high androgen and high-fat diet induced polycystic ovary syndrome rats. Reprod Biol Endocrinol 2012; 10:5. [PMID: 22276997 PMCID: PMC3278365 DOI: 10.1186/1477-7827-10-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2011] [Accepted: 01/25/2012] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND There is a high prevalence of diabetes mellitus (DM) and dyslipidemia in women with polycystic ovary syndrome (PCOS). The purpose of this study was to investigate the role of different metabolic pathways in the development of diabetes mellitus in high-androgen female mice fed with a high-fat diet. METHODS Female Sprague-Dawley rats were divided into 3 groups: the control group(C), n = 10; the andronate-treated group (Andronate), n = 10 (treated with andronate, 1 mg/100 g body weight/day for 8 weeks); and the andronate-treated and high-fat diet group (Andronate+HFD), n = 10. The rate of glucose appearance (Ra of glucose), gluconeogenesis (GNG), and the rate of glycerol appearance (Ra of glycerol) were assessed with a stable isotope tracer. The serum sex hormone levels, insulin levels, glucose concentration, and the lipid profile were also measured. RESULTS Compared with control group, both andronate-treated groups exhibited obesity with higher insulin concentrations (P < 0.05) but similar blood glucose concentrations. Of the two andronate-treated groups, the andronate+HFD group had the most serious insulin resistance (IR). Estrus cycles were completely acyclic, with polycystic ovaries and elevated serum lipid profiles in the andronate+HFD group (P < 0.05). Ra of glucose and GNG increased significantly in the andronate+HFD rats. However, the Ra of glycerol was similar in the three groups. CONCLUSIONS Andronate with HFD rat model showed ovarian and metabolic features of PCOS, significant increase in glucose Ra, GNG, and lipid profiles, as well as normal blood glucose levels. Therefore, aberrant IR, increased glucose Ra, GNG, and lipid metabolism may represent the early-stage of glucose and lipid kinetics disorder, thereby might be used as potential early-stage treatment targets for PCOS.
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Affiliation(s)
- Hua-Ling Zhai
- Endocrinology and Metabolism Research Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
| | - Hui Wu
- Endocrinology and Metabolism Research Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
| | - Hui Xu
- Endocrinology and Metabolism Research Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
| | - Pan Weng
- Endocrinology and Metabolism Research Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
| | - Fang-Zhen Xia
- Endocrinology and Metabolism Research Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
| | - Yi Chen
- Endocrinology and Metabolism Research Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
| | - Ying-Li Lu
- Endocrinology and Metabolism Research Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
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Xiang SK, Hua F, Tang Y, Jiang XH, Zhuang Q, Qian FJ. Relationship between Serum Lipoprotein Ratios and Insulin Resistance in Polycystic Ovary Syndrome. Int J Endocrinol 2012; 2012:173281. [PMID: 22792101 PMCID: PMC3389691 DOI: 10.1155/2012/173281] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 04/26/2012] [Indexed: 11/26/2022] Open
Abstract
Objective. To investigate the association between serum lipoprotein ratios and insulin resistance in women with polycystic ovarian syndrome (PCOS). Methods. 105 PCOS patients and 109 controls were randomly enrolled in the study. Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2), total testosterone (T), fasting glucose (FBG), fasting insulin (FINS), serum triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL-C), and low-density lipoprotein (LDL-C) levels were checked, and then TG/HDL-C ratio, TC/HDL-C, ratio and LDL-C/HDL-C ratio were calculated. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to calculate the insulin resistance. Results. All lipoprotein ratios were significantly higher in PCOS patients as compared to healthy controls (P < 0.05). TG/HDL-C ratio, TC/HDL-C ratio, and LDL-C/HDL-C ratio were significantly correlated with HOMA-IR (P < 0.05). The ROC curve demonstrated that TC/HDL-C ratio had higher sensitivity and specificity in diagnosing PCOS with insulin resistance. Conclusion. This study demonstrates that serum lipoprotein ratio significantly correlates with insulin resistance and can be used as the marker of insulin resistance in PCOS patients.
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