Dyslipidemia in relation to body mass index and insulin resistance in Chinese women with polycystic ovary syndrome

Dyslipidemia is a common metabolic disorder in women with polycystic ovary syndrome (PCOS) and has been reported to be different in PCOS sufferers from various ethnic and geographic backgrounds. This study aims to investigate the prevalence of dyslipidemia in Chinese women with PCOS and its relationship to body mass index (BMI) and insulin resistance (IR). In this paper, a retrospective study was performed on 507 PCOS patients and 1246 age- and BMI-matched controls. Anthropometric indices of hormonal, adiposity, and metabolic variables were measured. All patients were divided into subgroups according to BMI and the homeostasis model assessment (HOMA) values. Accordingly, the prevalence of IR was 38.1 percent in our subjects. We found that mean fasting total triglyceride, low density lipoprotein (LDL) cholesterol and total cholesterol levels were significantly higher and the mean high density lipoprotein (HDL) cholesterol level was significantly lower in the IR group than in the non-IR (NIR) group. The prevalence of dyslipidemia was 24.7 percent in PCOS patients and the prevalence of dyslipidemia was significantly higher in the IR group than in the NIR group (39.9 percent vs 15.3 percent, P<0.05). The HOMA index was found to be positively correlated with TG, TC and LDL, and negatively correlated with HDL. TG and HDL levels remained significantly correlated with HOMA even after adjustment for BMI. Generally, the prevalence of various patterns of dyslipidemia in PCOS patients increased with HOMA value. In conclusion, the prevalence of IR and dyslipidemia were both found to be high in PCOS women in our study, although no higher than other ethnicities. Lipid abnormality was demonstrated to be associated with IR and BMI in Chinese PCOS women. We speculate that insulin sensitizer might ameliorate dyslipidemia through improving IR in PCOS women.     

Metabolic syndrome in polycystic ovary syndrome

Both metabolic syndrome (MS) and polycystic ovary syndrome (PCOS) are common among women. The exact prevalence of MS in women with PCOS is dependent upon the diagnostic criteria used for each. However, the frequent co-occurrence of both MS and PCOS in women is suggestive of a common aetiology. In this short review article we argue that insulin resistance, as a consequence of abdominal obesity, may represent such a common aetiology. We also review the literature on the prevalence of MS in women with PCOS and consider the impact that the particular criteria used to diagnose both MS and PCOS may have had on these estimates of prevalence.     

Proteomics and polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder of heterogeneous etiology. Proteomics techniques have been used for elucidating the physiopathology of PCOS, yet the proteins identified so far were rarely the same across tissues and studies. The present review discusses the current challenges in the application of proteomics to the study of PCOS. A well-defined research design and an appropriate selection of study populations, samples and proteomic platforms are essential in clinical proteomics. Furthermore, the findings derived from proteomic approaches should be validated by complementary techniques, and the reproducibility of the results has ideally to be confirmed by different studies. Only when meeting these requirements, the proteins identified by proteomic techniques should be considered as candidates for future studies aiming to define specific molecular phenotypes of PCOS and their possible role in the metabolic and hormonal abnormalities characteristic of this syndrome.     

A common variant in the adiponectin gene and polycystic ovary syndrome risk

In this study, we explored whether polymorphisms in insulin receptor (INSR), adiponectin (ADIPOQ), parathyroid hormone (PTH), and vitamin D receptor (VDR) genes are associated with polycystic ovary syndrome (PCOS). A total of 362 subjects, including 181 women with PCOS and 181 controls were enrolled in this case-control study. Two SNPs (rs2059806 and rs1799817) in the INSR gene, two SNPs (rs2241766 and rs1501299) in the ADIPOQ gene, one SNP (rs6256) in the PTH gene, and one SNP (rs757343) in the VDR gene were analyzed using PCR-RFLP method. We observed no significant difference in genotype and allele frequencies between the women with PCOS and controls for the rs2059806, rs1799817, rs1501299, rs6256, and rs757343 polymorphisms either before or after adjustment for confounding factors including age and BMI. However, the ADIPOQ rs2241766 “TT” genotype compared with “TG and GG” genotypes was associated with a 1.93-fold increased risk for PCOS (P = 0.006, OR = 1.93, 95% CI = 1.20–3.11), and the differences remained significant after adjustment for age and BMI (P = 0.039, OR = 1.72, 95% CI = 1.03–2.86). Furthermore, the ADIPOQ rs2241766 “T” allele was significantly overrepresented in women with PCOS than controls (P = 0.006; OR = 1.80, 95% CI = 1.18–2.70), and the difference remained significant after Bonferroni correction. Our findings suggest that the ADIPOQ rs2241766 “TT” genotype is a marker of increased PCOS susceptibility. This study also indicates for the first time that there are no significant association between INSR rs2059806, PTH rs6256, and VDR rs757343 gene polymorphisms and PCOS risk. However, these data remain to be confirmed in larger studies and in other populations.     

多囊卵巢综合征患者血清VitD水平及与炎症因子之间的相关性研究

目的 了解多囊卵巢综合征（PCOS）患者血清中25-羟维生素D（25-OH-VitD3）水平情况,并探讨其与白细胞介素-6（IL-6）、肿瘤坏死因子（TNF-α）、转化生长因子（TGF-β）、单核细胞趋化蛋白-1（MCP-1）及C-反应蛋白（CRP）之间的相关性。方法 选择2017年8月—2018年12月来医院妇科门诊就诊并确诊为PCOS的患者共135例作为PCOS组,选择同期来医院体检的健康妇女共120例作为对照组,采用化学发光法检测血清中25-OH-VitD3水平,免疫比浊法检测CRP水平及采用酶联免疫吸附法（ELISA）检测IL-6、TNF-α及TGF-β水平,并对检测结果进行统计学分析。结果 PCOS组患者血清中25-OH-VitD3水平为31.87±6.29 nmol/L,明显低于对照组的65.08±13.76 nmol/L,差异有统计学意义（t=3.190,P<0.05）。PCOS组患者血清IL-6、TNF-α、TGF-β、MCP-1及CRP水平分别为23.71±11.23 ng/L、20.54±3.16 ng/L、76.54±8.03 ng/L、375.92±40.15 ng/L及13.48±3.10 mg/L,均明显高于对照组,差异均有统计学意义（t=9.065,8.091,10.178,13.052,7.059,Ps<0.05）。通过Pearson相关性分析,25-OH-VitD3水平与IL-6、TNF-α、TGF-β、MCP-1及CRP水平均呈明显的负相关（r= -0.562,-0.628,-0.780,-0.850,-0.505,Ps<0.05）。结论 25-OH-VitD3低表达水平可能通过其免疫调节及抑制炎症因子生成能力下降,引起各种炎症因子水平升高,导致PCOS的发病。因此,维生素D可能与PCOS病的发生和发展有密切关系。     

Body mass index: risk predictor for cosmetic day surgery

Body mass index (BMI; weight per unit surface area) is the scientific yardstick by which overweight is gauged relative to the population norm. The contrary association between obesity and diabetes or hypertension is only too well known. Less appreciated is the heightened sensitivity to respiratory depressants such as sedatives and analgesics in the obese (BMI >/= 30) and the increased incidence of sleep apnea in the morbidly obese (BMI >/= 35)-either or both of which raise the risk of cosmetic surgery when sedation or anesthesia is contemplated. Guided by the BMI, a gender-independent measure of fatness, the surgeon now can inform the patient of her or his relative operative risk and offer an objective rationale for advising overnight hospitalization rather than office-based day surgery.The BMI is readily calculated when height and weight are expressed in metric units, much less so when measured in foot-pound units. In fact, the calculations are sufficiently cumbersome that the BMI remains underused in U.S. office surgery. The author's complimentary "BMI Calculator"-an Excel workbook available on-line to society members-is designed so that office staff need enter only height (in feet and inches) and weight (in pounds) to print the BMI for the patient's permanent record.The BMI places patient weight relative to height in proper perspective for aesthetic surgery, whether with sedation or under general anesthesia. The BMI ought to be as routine a part of the preoperative assessment as blood pressure or hemoglobin content.     

Calpain-10 variants and haplotypes are associated with polycystic ovary syndrome in Caucasians

PCOS is known to be associated with an increased risk of T2DM and has been proposed to share a common genetic background with T2DM. Recent studies suggest that the Calpain-10 gene (CAPN10) is an interesting candidate gene for PCOS susceptibility. However, contradictory results were reported concerning the contribution of certain CAPN10 variants, especially of UCSNP-44, to genetic predisposition to T2DM, hirsutism, and PCOS. By means of MALDI-TOF MS technique, we genotyped an expanded single nucleotide polymorphism panel, including the CAPN10 UCSNP-44, -43, -56, ins/del-19, -110, -58, -63, and -22 in a sample of 146 German PCOS women and 606 population-based controls. Statistical analysis revealed an association between UCSNP-56 and susceptibility to PCOS with an odds ratio (OR) of 2.91 (95% CI=1.51-5.61) for women carrying an AA genotype compared with GG. As expected, the 22-genotype of the ins/del-19 variant, which is in high linkage disequilibrium (r2=0.98) with UCSNP-56, was also significantly associated (OR=2.98, 95% CI=1.55-5.73). None of the additionally tested variants alone showed any significant association with PCOS. A meta-analysis including our study (altogether 623 PCOS cases and 1,224 controls) also showed significant association only with ins/del-19. The most common haplotype TGG3AGCA was significantly associated with a lower risk for PCOS (OR=0.487, P=0.0057). In contrast, the TGA2AGCA haplotype was associated with an increased risk for PCOS (OR=3.557, P=0.0011). By investigating a broad panel of CAPN10 variants, our results pointed to an allele dose-dependent association of UCSNP-56 and ins/del-19 with PCOS.     

Rodent models for human polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is the most frequent female endocrine disorder, affecting 5%-10% of women, causing infertility due to dysfunctional follicular maturation and ovulation, distinctive multicystic ovaries and hyperandrogenism, together with metabolic abnormalities including obesity, hyperinsulinism, an increased risk of type 2 diabetes, and cardiovascular disease. The etiology of PCOS is unclear, and decisive clinical studies are limited by ethical and logistic constraints. Consequently treatment is palliative rather than curative and focuses on symptomatic approaches. Hence, a suitable animal model could provide a valuable means with which to study the pathogenesis of the characteristic reproductive and metabolic abnormalities and thereby identify novel and more effective treatments. So far there is no consensus on the best experimental animal model, which should ideally reproduce the key features associated with human PCOS. The prenatally androgenized rhesus monkey displays many characteristics of the human condition, including hyperandrogenism, anovulation, polycystic ovaries, increased adiposity, and insulin insensitivity. However, the high cost of nonhuman primate studies limits the practical utility of these large-animal models. Rodent models, on the other hand, are inexpensive, provide well-characterized and stable genetic backgrounds readily accessible for targeted genetic manipulation, and shorter reproductive life spans and generation times. Recent rodent models display both reproductive and metabolic disturbances associated with human PCOS. This review aimed to evaluate the rodent models reported to identify the advantages and disadvantages of the distinct rodent models used to investigate this complex endocrine disorder.     

Neuroendocrine dysfunction in polycystic ovary syndrome

Polycystic ovarian syndrome (PCOS) is a common disorder characterized by ovulatory dysfunction and hyperandrogenemia (HA). Neuroendocrine abnormalities including increased gonadotropin-releasing hormone (GnRH) pulse frequency, increased luteinizing hormone (LH) pulsatility, and relatively decreased follicle stimulating hormone contribute to its pathogenesis. HA reduces inhibition of GnRH pulse frequency by progesterone, causing rapid LH pulse secretion and increasing ovarian androgen production. The origins of persistently rapid GnRH secretion are unknown but appear to evolve during puberty. Obese girls are at risk for HA and develop increased LH pulse frequency with elevated mean LH by late puberty. However, even early pubertal girls with HA have increased LH pulsatility and enhanced daytime LH pulse secretion, indicating the abnormalities may begin early in puberty. Decreasing sensitivity to progesterone may regulate normal maturation of LH secretion, potentially related to normally increasing levels of testosterone during puberty. This change in sensitivity may become exaggerated in girls with HA. Many girls with HA-especially those with hyperinsulinemia-do not exhibit normal LH pulse sensitivity to progesterone inhibition. Thus, HA may adversely affect LH pulse regulation during pubertal maturation leading to persistent HA and the development of PCOS.     

Ethnic group differences in cardiometabolic disease risk factors independent of body mass index among American youth

Objective: The purpose of this analysis was to identify any ethnic group differences in the prevalence of cardiometabolic disease risk factors independent of BMI in United States youth. Design and Methods: Data on 3,510 boys and girls aged 8‐11 years from the 1999‐2008 National Health and Nutrition Examination Surveys were analyzed to determine the prevalence of 1 or ≥3 cardiometabolic disease risk factors: abnormal waist circumference and systolic (SBP) and diastolic blood pressure (DBP), increased concentrations of fasting triglyceride, and decreased concentrations of high‐density lipoprotein (HDL) cholesterol before and after adjusting for BMI. Results: Abnormal waist circumference and HDL‐cholesterol significantly differed by ethnic group before and after adjusting for BMI (P < 0.01). Non‐Hispanic blacks were significantly less likely to have abnormal HDL‐cholesterol concentrations than were Hispanics and non‐Hispanic whites, but non‐Hispanic whites were significantly more likely to have elevated triglycerides and three or more abnormal cardiometabolic risk factors than non‐Hispanic blacks. Conclusion: These findings point to ethnic group disparities not related to BMI alone, even in children as young as 8‐11 years. Programs to prevent and treat eventual cardiometabolic disease in children could be tailored for specific ethnic backgrounds as a result.     

Serum metabolomics analysis of patients with polycystic ovary syndrome by mass spectrometry

Polycystic ovary syndrome (PCOS) is a set of symptoms caused by elevated androgens (male hormones) in females. PCOS is the most common endocrine disorder among women between 18 and 44 years. Currently, the pathogenesis of PCOS remains unclear. Liquid chromatography–mass spectrometry (LC/MS)‐based metabolomics is becoming more and more useful for medical research, especially in revealing the mechanism of the disease. The aim of this study was to investigate the difference of serum metabolic profiles in patients with PCOS and healthy control to better understand the mechanism of this disease. Ten patients with PCOS and 10 healthy people were recruited for this study. The serum samples were collected for LC/MS analysis. Multivariate statistical analysis was performed to discover and identify the potential biomarkers. Six biomarkers were found and identified. The biomarkers belonged to different metabolic pathway including lipid metabolism, carnitine metabolism, androgen metabolism, and bile acid metabolism. Those biomarkers also played different roles in disease progression. Metabolomics is a powerful tool used in research of the mechanism involved in this disease to provide useful information for better understanding of PCOS.     

Screening for and treatment of polycystic ovary syndrome in teenagers

Polycystic ovary syndrome (PCOS) usually arises during puberty and is marked by hyperinsulinemia and hyperandrogenism. Adolescents with PCOS are at an increased risk of developing health problems later on in life such as type 2 diabetes, cardiovascular disease, and infertility. Furthermore, the physical signs of PCOS can be detrimental to a teenage girl's self-image. Early diagnosis and treatment of PCOS in adolescents are essential in ensuring adulthood health and restoring self-esteem. Treatments for an adolescent with PCOS include diet and exercise, metformin, and oral contraceptive pills. Each of these options has been shown to be effective in improving certain aspects of PCOS, and probably the best treatment plan involves some combination of them.     

Body mass index,height and early-onset basal cell carcinoma in a case-control study

IntroductionBasal cell carcinoma (BCC) is the most common malignancy in the US. Body mass index (BMI) and height have been associated with a variety of cancer types, yet the evidence regarding BCC is limited. Therefore, we evaluated BMI and height in relation to early-onset BCC (under age 40) and explored the potential role of ultraviolet (UV) radiation exposure and estrogen-related exposures in the BMI-BCC relationship.MethodsBCC cases (n = 377) were identified through a central dermatopathology facility in Connecticut. Control subjects (n = 389) with benign skin conditions were randomly sampled from the same database and frequency matched to cases on age (median = 36, interquartile range 33–39), gender, and biopsy site. Participants reported weight (usual adult and at age 18), adult height, sociodemographic, phenotypic, and medical characteristics, and prior UV exposures. We calculated multivariate odds ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regression models.ResultsAdult BMI was inversely associated with early-onset BCC (obese vs. normal OR = 0.43, 95% CI = 0.26–0.71). A similar inverse association was present for BMI at age 18 (OR = 0.54, 95% CI = 0.34–0.85). Excluding UV exposures from the BMI models and including estrogen-related exposures among women only did not alter the association between BMI and BCC, indicating limited mediation or confounding. We did not observe an association between adult height and BCC (OR per cm = 1.00, 95% CI = 0.98–1.02).ConclusionsWe found a significant inverse association between BMI and early-onset BCC, but no association between height and BCC. This association was not explained by UV exposures or estrogen-related exposures in women.     

Body mass index and screening for colorectal cancer: gender and attitudinal factors

Background: Overweight/obese women and men are at increased risk for colorectal cancer (CRC) incidence and mortality. Research examining body mass index (BMI) and CRC screening has had mixed results. A clearer understanding of the extent to which high-BMI subgroups are screened for CRC is needed to inform planning for CRC screening promotions targeting BMI. Methods: Data were obtained from a random, population-based sample of women and men at average-risk for CRC (aged 50–75 years) during 2004 (n = 1098). Multiple logistic regression analyses were conducted to evaluate whether BMI category was significantly associated with the probability of reporting recent CRC screening and with the probability of agreeing with statements denoting attitudes/perceptions about CRC and screening. Attitudes/perceptions about CRC and screening were evaluated as potential mediators and moderators of the association between BMI category and CRC screening. Results: After controlling for characteristics associated with CRC screening, overweight and obese women were each 40% less likely to have CRC screening than women with normal-BMI (OR = 0.6, 95% CI:0.4–0.9 and OR = 0.6, 95% CI:0.3–0.9). BMI category was unrelated to screening among men. Obese women (but not men) were less aware than normal-BMI women that obesity increased risk for CRC (OR = 0.5, 95% CI:0.3–0.9) and less worried about CRC (OR = 0.5, 95% CI:0.3–0.8). However, findings suggest that attitudes/perceptions about CRC and screening did not mediate or moderate the association between BMI category and CRC screening. Conclusion: Overweight/obese women are at increased risk for CRC because of their greater BMI and their propensity not to screen for CRC. Study findings suggest that potentially modifiable perceptions, e.g., lack of awareness of risk for CRC and less worry about CRC, in this subgroup may not explain the relationship between BMI category and reduced screening.     

FTO and MC4R gene variants are associated with obesity in polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is the leading cause of anovulatory infertility in women. It is also associated with metabolic disturbances that place women at increased risk for obesity and type 2 diabetes. There is strong evidence for familial clustering of PCOS and a genetic predisposition. However, the gene(s) responsible for the PCOS phenotypes have not been elucidated. This two-phase family-based and case-control genetic study was designed to address the question of whether SNPs identified as susceptibility loci for obesity in genome-wide association studies (GWAS) are also associated with PCOS and elevated BMI. Members of 439 families having at least one offspring with PCOS were genotyped for 15 SNPs previously shown to be associated with obesity. Linkage and association with PCOS was assessed using the transmission/disequilibrium test (TDT). These SNPs were also analyzed in an independent case-control study involving 395 women with PCOS and 176 healthy women with regular menstrual cycles. Only one of these 15 SNPs (rs2815752 in NEGR1) was found to have a nominally significant association with PCOS (χ² = 6.11, P = 0.013), but this association failed to replicate in the case-control study. While not associated with PCOS itself, five SNPs in FTO and two in MC4R were associated with BMI as assessed with a quantitative-TDT analysis, several of which replicated association with BMI in the case-control cohort. These findings demonstrate that certain SNPs associated with obesity contribute to elevated BMI in PCOS, but do not appear to play a major role in PCOS per se. These findings support the notion that PCOS phenotypes are a consequence of an oligogenic/polygenic mechanism.     

Association between vaspin rs2236242 gene polymorphism and polycystic ovary syndrome risk

Vaspin, an adipocytokine that has been isolated from the visceral adipose tissue, is a member of the serine protease inhibitor family. In humans, serum vaspin levels are correlated with body mass index (BMI) and obese women with polycystic ovary syndrome (PCOS). The present study is the first investigation to examine the association between vaspin rs2236242 gene polymorphism and risk of PCOS in Iranian patients. This case–control study was performed on 150 patients with PCOS and 150 healthy women. The vaspin genotypes were determined using tetra-amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR). Our finding showed that there are significant differences in genotype frequencies between case and control group regarding vaspin rs2236242 polymorphism (OR = 0.59, CI = 0.37–0.95, p = 0.03). The A allele decreased the risk of PCOS (OR = 0.67, CI = 0.46–0.96, p = 0.03) as compared to the T allele. There was no significant association between vaspin rs2236242 gene polymorphism and PCOS after adjusting genotypes for BMI. In conclusion, our data suggest a significant association between vaspin rs2236242 polymorphism and the PCOS but this relationship is affected by obesity status.     

Inappropriate gonadotropin secretion in the polycystic ovary syndrome

In this study was investigated the diagnostic significance of double stimulation test with (that is of 25 micrograms rapid injection intravenously twice at an interval of 120 minutes and the misure of maximal net increment of serum LH after the first GnRH injection expressed as delta 1 and after the second injection, expressed as delta 2) to discriminate patients with idiopatic hirsutism. This test was effectuated on 8 patients with PCO (presence of polycystic ovaries on Ecografya and/or Laparoscopy) and 8 patients with idiopatic hirsutism (presence of normal morphology ovaries). Basal LH, FSH, E1, E2 and delta 4 levels were also measured. The value of LH delta 2 were more elevated in patients with PCO (p less than 0,0002) than the patients with idiopatic hirsutism. Consequently it as been value of LH delta 2 to discriminate the two different groups of patients. In PCO patients were also found: -a positive linear correlation between LH delta 1 and basal concentration serum of E2 (p less than 0,001); -a significant increase of basal levels serum of delta 4 (p less than 0,02); while the values of basal LH and LH delta 1 were found superior only on 4 of the initial 8 patients, the basal values of E1 and E2 were at the superior found of the norm and basal FSH, FSH delta 1 and FSH delta 2 values were found normals.