scholarly journals Biomediators in Polycystic Ovary Syndrome and Cardiovascular Risk

Biomolecules ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1350
Author(s):  
Srdan Pandurevic ◽  
Djuro Macut ◽  
Flaminia Fanelli ◽  
Uberto Pagotto ◽  
Alessandra Gambineri
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Molecular Mechanisms ◽  
Polycystic Ovary ◽  
Clinical Manifestations ◽  
Molecular Heterogeneity ◽  
Ovary Syndrome ◽  
Metabolic Complications ◽  
Early Predictors ◽  
Cv Disease

Polycystic ovary syndrome (PCOS) is extremely heterogeneous in terms of clinical manifestations. The variability of the syndrome’s phenotype is derived from the genetic and molecular heterogeneity, with a great deal of environmental factors that may have long-term health consequences, such as metabolic and cardiovascular (CV) diseases. There is no doubt that women with PCOS suffer from metabolic complications more than their age-matched counterparts in the general population and at an earlier age. Obesity, low steroid hormone-binding globulin (SHBG), hyperandrogenemia, insulin resistance, and compensatory hyperinsulinemia are biomediators and early predictors of metabolic complications in PCOS. Doubts remain about the real risk of CV diseases in PCOS and the molecular mechanisms at the basis of CV complications. Based on that assumption, this review will present the available evidence on the potential implications of some biomediators, in particular, hyperandrogenism, estrogen-progesterone imbalance, insulin resistance, and low SHBG, in the processes leading to CV disease in PCOS, with the final aim to propose a more accurate CV risk assessment.

scholarly journals Molecular Mechanisms of Insulin Resistance in Polycystic Ovary Syndrome: Unraveling the Conundrum in Skeletal Muscle?

2019 ◽  
Vol 104 (11) ◽  
pp. 5372-5381 ◽  
Author(s):  
Nigel K Stepto ◽  
Alba Moreno-Asso ◽  
Luke C McIlvenna ◽  
Kirsty A Walters ◽  
Raymond J Rodgers
Keyword(s):  
Insulin Resistance ◽  
Skeletal Muscle ◽  
Polycystic Ovary Syndrome ◽  
Molecular Mechanisms ◽  
Current Knowledge ◽  
Polycystic Ovary ◽  
Evidence Synthesis ◽  
Basic Research ◽  
Future Research ◽  
Ovary Syndrome

Abstract Context Polycystic ovary syndrome (PCOS) is a common endocrine condition affecting 8% to 13% of women across the lifespan. PCOS affects reproductive, metabolic, and mental health, generating a considerable health burden. Advances in treatment of women with PCOS has been hampered by evolving diagnostic criteria and poor recognition by clinicians. This has resulted in limited clinical and basic research. In this study, we provide insights into the current and future research on the metabolic features of PCOS, specifically as they relate to PCOS-specific insulin resistance (IR), that may affect the most metabolically active tissue, skeletal muscle. Current Knowledge PCOS is a highly heritable condition, yet it is phenotypically heterogeneous in both reproductive and metabolic features. Human studies thus far have not identified molecular mechanisms of PCOS-specific IR in skeletal muscle. However, recent research has provided new insights that implicate energy-sensing pathways regulated via epigenomic and resultant transcriptomic changes. Animal models, while in existence, have been underused in exploring molecular mechanisms of IR in PCOS and specifically in skeletal muscle. Future Directions Based on the latest evidence synthesis and technologies, researchers exploring molecular mechanisms of IR in PCOS, specifically in muscle, will likely need to generate new hypothesis to be tested in human and animal studies. Conclusion Investigations to elucidate the molecular mechanisms driving IR in PCOS are in their early stages, yet remarkable advances have been made in skeletal muscle. Overall, investigations have thus far created more questions than answers, which provide new opportunities to study complex endocrine conditions.

scholarly journals SAT-627 Racial and Ethnic Differences in Metabolic Disease in Obese Adolescents with Polycystic Ovary Syndrome

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Stanley Andrisse ◽  
Yesenia Garcia Reyes ◽  
Laura Pyle ◽  
Kristen Nadeau ◽  
Megan Moriarty Kelsey ◽  
...  
Keyword(s):  
Metabolic Disease ◽  
Insulin Resistance ◽  
General Population ◽  
Polycystic Ovary Syndrome ◽  
Hepatic Steatosis ◽  
Race And Ethnicity ◽  
Polycystic Ovary ◽  
Hispanic Youth ◽  
Ovary Syndrome ◽  
Metabolic Complications

Abstract Background: Polycystic ovary syndrome (PCOS) affects up to 15% of women and is associated with a multitude of metabolic complications including insulin resistance, type 2 diabetes, cardiovascular disease, and hepatic steatosis. In the general population, metabolic disease rates vary by race and ethnicity. The interaction of race and ethnicity with PCOS-related metabolic disease in adolescent youth has not been extensively examined. Methods: Secondary analysis of data from overweight and obese (>90 BMI%ile) adolescent (12-21 years) female participants with PCOS enrolled across 4 protocols. Measurements included fasting hormone and metabolic measures, a 2-hour oral glucose tolerance test and MRI for hepatic fat. Groups were compared by ANOVA, with and without correction for BMI or chi-square tests for proportions. Results: Participants included 39 white (NHW 15.7±0.2 years; 97.7±0.2 BMI%ile), 50 Hispanic (15.2±0.3 years; 97.9±0.3 BMI%ile) and 12 black (NHB 16.0±0.6 years; 98.6±0.4 BMI%ile) adolescents. BMI%ile was different between groups (p=0.04), but age of menarche, free testosterone and hirsutism severity were not. Hepatic markers of insulin resistance were worse in Hispanic youth, including lower sex hormone binding globulin and TG/HDL ratio (p<0.001), although HOMA-IR was worst in NHB (p=0.009) and Hispanic (p=0.036) compared to NHW youth. There were no significant differences in insulin concentrations—either fasting or during the OGTT—although fasting C-peptide was higher in Hispanic (p=0.008) compared to NHW youth. Fasting and 2-hour glucose concentrations were not different between groups. HbA1c was highest in NHB (5.7±0.4%, p<0.001 vs. NHW, p=0.026 vs. Hispanic), then Hispanic (5.5±0.3, p<0.001 vs. NHW), then NHW (5.2±0.3) youth. Fasting triglycerides differed between groups (p=0.029), being highest in Hispanic youth (129 [105,167] mg/dL). The frequency of hepatic steatosis (NHW 42%, Hispanic 62% NHB 25%, p=0.032) and the metabolic syndrome components HDL <40 mg/dL (NHW 61%, Hispanic 82% NHB 50%, p<0.001) and HbA1c 5.7-6.4% (NHW 5%, Hispanic 36% NHB 50%, p<0.001) were different between the groups. Conclusions: Adolescents with PCOS appear to show similar racial and ethnic variation to the general population in terms of metabolic disease components.

scholarly journals Metabolic Consequences Of Obesity On The Hypercoagulable State Of Polycystic Ovary Syndrome: A Risk For Severe SARS-Cov-2 Infection?

2020 ◽  
Author(s):  
Abu Saleh Md M ◽  
Thozhukat Sathyapalan ◽  
Ilhame Diboun ◽  
Mohamed Elrayess ◽  
Alexandra E Butler ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Hypercoagulable State ◽  
Plasminogen Activator Inhibitor 1 ◽  
Gamma Chain ◽  
Heparin Cofactor Ii ◽  
Ovary Syndrome ◽  
Metabolic Complications ◽  
Coagulation Proteins

Abstract Introduction: Polycystic ovary syndrome (PCOS) women have a hypercoagulable state and are also at high risk for severe COVID-19 leading to thromboembolic complications and increased mortality; however, whether this is intrinsically due to PCOS or, alternatively, a consequence of its metabolic complications is unclear. Methods: We determined plasma coagulation pathway protein levels in PCOS (n=146) and control (n=97) women recruited to a PCOS biobank. Circulating levels of a panel of 18 clotting pathway proteins were determined by Slow Off-rate Modified Aptamer (SOMA)-scan plasma protein measurement.Results: Cohorts were age matched, though PCOS had elevated body mass index (BMI)(p<0.001), insulin (p<0.001) and C-reactive protein (CRP)(p<0.0001). Eight pro-coagulation proteins were elevated in PCOS: plasminogen activator inhibitor-1 (PAI-1)(p<0.0001), fibrinogen (p<0.01), fibrinogen gamma chain (p<0.0001), fibronectin (p<0.01), von Willebrand factor (p<0.05), D-dimer (p<0.0001), P-selectin (p<0.05), and plasma kallikrein (p<0.001). However, two anticoagulant proteins, vitamin K-dependent protein-S (p<0.0001) and heparin cofactor-II (p<0.001) were elevated and prothrombin was decreased (p<0.05). CRP, as a marker of inflammation, and insulin resistance (HOMA-IR) correlated with 11 and 6 of the clotting proteins, respectively (p<0.05). When matched for BMI<25 (16 PCOS, 53 controls) HOMA-IR remained elevated (p<0.05) and heparin cofactor-II was increased (p<0.05). In a multivariate analysis accounting for inflammation, insulin resistance and BMI, there was no correlation of PCOS with any of the coagulation proteins.Conclusion: The hypercoagulable State in PCOS can be fully accounted for by BMI, inflammation and insulin resistance suggesting that only obese PCOS women would be predisposed to an enhanced risk for severe COVID-19-related disease.

Evaluation of serum lipid profile and sex hormones in women with polycystic ovary syndrome - A comparative study

2021 ◽  
Vol 16 (11) ◽  
pp. 13-18
Author(s):  
Pravesh Hegde ◽  
Lakshmi Manjeera ◽  
Prasanna Shetty Kumar ◽  
Shilpa S. Shetty ◽  
Suchetha N. Kumari
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Lipid Profile ◽  
Sex Hormones ◽  
Polycystic Ovary ◽  
Clinical Manifestations ◽  
Sex Hormone ◽  
Control Group ◽  
Ovary Syndrome ◽  
The Mean

Polycystic ovary syndrome (PCOS), an endocrinological disorder with lipid disturbances leads to a wide spectrum of clinical manifestations including menstrual irregularities, infertility, obesity and hyperandrogenism. This study aimed to determine the levels of lipid profile and sex hormones and its effect on PCOS from a State in southern India. This comparative hospital-based study was conducted in the State of Karnataka, India from June 2019 to January 2020. 57 age-matched PCOS and 67 healthy controls were enrolled for the study. Fasting glucose, insulin, lipid profile and sex hormone levels were analyzed after taking informed consent from all participants. The mean age of patients with PCOS was 25.05 ± 6.04 years and the mean age of subjects in the control group was 27.36 ± 7.08 years. Lipid profile showed statistically significant increased levels of triglyceride 147.3±86.6 (p<0.05) and decreased levels of HDL 52.2±8.7 (p<0.05) whereas hormones LH and testosterone were significantly higher in women with PCOS when compared to controls. The altered lipid profile, sex hormone and insulin levels exhibit a key role in the pathophysiology of PCOS that affects health. Insulin resistance is found to be linked with dyslipidemia in PCOS. Our findings suggest that the differences found may play a key role in the pathophysiology of PCOS which in turn affects the health and therefore it is advisable to emphasize the necessity for screening insulin resistance and perform early and periodic examination of lipid profile and sex hormones in women with PCOS to reduce complications.

Molecular mechanisms of insulin resistance in polycystic ovary syndrome

2006 ◽  
Vol 12 (7) ◽  
pp. 324-332 ◽  
Author(s):  
Evanthia Diamanti-Kandarakis ◽  
Athanasios G. Papavassiliou
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Molecular Mechanisms ◽  
Polycystic Ovary ◽  
Ovary Syndrome

scholarly journals Metabolic consequences of obesity on the hypercoagulable state of polycystic ovary syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Abu Saleh Md Moin ◽  
Thozhukat Sathyapalan ◽  
Ilhame Diboun ◽  
Mohamed A. Elrayess ◽  
Alexandra E. Butler ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Hypercoagulable State ◽  
Plasminogen Activator Inhibitor 1 ◽  
Gamma Chain ◽  
Heparin Cofactor Ii ◽  
Ovary Syndrome ◽  
Metabolic Complications ◽  
Coagulation Proteins

AbstractPolycystic ovary syndrome (PCOS) women have a hypercoagulable state; however, whether this is intrinsically due to PCOS or, alternatively, a consequence of its metabolic complications is unclear. We determined plasma coagulation pathway protein levels in PCOS (n = 146) and control (n = 97) women recruited to a PCOS biobank. Circulating levels of a panel of 18 clotting pathway proteins were determined by Slow Off-rate Modified Aptamer-scan plasma protein measurement. Cohorts were age matched, though PCOS had elevated body mass index (p < 0.001), insulin (p < 0.001) and C-reactive protein (CRP) (p < 0.0001). Eight pro-coagulation proteins were elevated in PCOS: plasminogen activator inhibitor-1 (p < 0.0001), fibrinogen (p < 0.01), fibrinogen gamma chain (p < 0.0001), fibronectin (p < 0.01), von Willebrand factor (p < 0.05), D-dimer (p < 0.0001), P-selectin (p < 0.05), and plasma kallikrein (p < 0.001). However, two anticoagulant proteins, vitamin K-dependent protein-S (p < 0.0001) and heparin cofactor-II (p < 0.001) were elevated and prothrombin was decreased (p < 0.05). CRP, as a marker of inflammation, and insulin resistance (HOMA-IR) correlated with 11 and 6 of the clotting proteins, respectively (p < 0.05). When matched for BMI < 25 (16 PCOS, 53 controls) HOMA-IR remained elevated (p < 0.05) and heparin cofactor-II was increased (p < 0.05). In a multivariate analysis accounting for inflammation, insulin resistance and BMI, there was no correlation of PCOS with any of the coagulation proteins. The hypercoagulable state in PCOS is not intrinsic to the disease as it can be fully accounted for by BMI, inflammation and insulin resistance.

scholarly journals Effects of Mixed of a Ketogenic Diet in Overweight and Obese Women with Polycystic Ovary Syndrome

2021 ◽  
Vol 18 (23) ◽  
pp. 12490
Author(s):  
Raffaele Ivan Cincione ◽  
Francesca Losavio ◽  
Fabiana Ciolli ◽  
Anna Valenzano ◽  
Giuseppe Cibelli ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Adipose Tissue ◽  
Polycystic Ovary Syndrome ◽  
Ketogenic Diet ◽  
Polycystic Ovary ◽  
Therapeutic Option ◽  
Significant Risk ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Metabolic Complications

Polycystic ovary syndrome (PCOS) is a commonly occurring endocrine disorder characterized by hirsutism, anovulation, and polycystic ovaries. Often comorbid with insulin resistance, dyslipidemia, and obesity, it also carries significant risk for the development of cardiovascular and metabolic sequelae, including diabetes and metabolic syndrome. The relationship between central obesity and the development of insulin resistance is widely verified. Adipose tissue excess and the coexistent dysregulation of adipocyte functions directly contribute to the pathogenesis of the metabolic complications observed in women with PCOS. In the light of these evidence, the most therapeutic option prescribed to obese women with PCOS, regardless of the phenotype e from the severity of clinical expression, is lifestyle correction by diet and physical activity. The aim of this study is to evaluate the beneficial effects of ketogenic diet in 17 obese women with PCOS. Our results showed that the ketogenic diet inducing therapeutic ketosis, improves the anthropometric and many biochemical parameters such as LH, FSH, SHBG, insulin sensitivity and HOMA index. In addition, it induces a reduction in androgenic production, whereas the contextual reduction of fat mass reduced the acyclic production of estrogens deriving from the aromatization in the adipose tissue of the androgenic excess, with an improvement of the LH/FSH ratio. This is the first study on the effects of the ketogenic diet on PCOS, however, further studies are needed to elucidate the mechanism underlying ketogenic diet effects.

scholarly journals Molecular Mechanisms in Skeletal Muscle Underlying Insulin Resistance in Women Who Are Lean With Polycystic Ovary Syndrome

2018 ◽  
Vol 104 (5) ◽  
pp. 1841-1854 ◽  
Author(s):  
Solvejg L Hansen ◽  
Pernille F Svendsen ◽  
Jacob F Jeppesen ◽  
Louise D Hoeg ◽  
Nicoline R Andersen ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Skeletal Muscle ◽  
Polycystic Ovary Syndrome ◽  
Molecular Mechanisms ◽  
Polycystic Ovary ◽  
Ovary Syndrome
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