Abstract
PCOS is the most common cause of anovulation in reproductive-aged women with 70% experiencing ovulatory problems. Advanced glycation end products are highly reactive molecules that are formed by non-enzymatic reactions of sugars with proteins, nucleic acids and lipids. AGEs are also present in a variety of diet where substantial increase in AGEs can result due to thermal processing and modifications of food. Elevation in bodily AGEs, produced endogenously or absorbed exogenously from high-AGE diets, is further exaggerated in women with PCOS and is associated with ovulatory dysfunction. Additionally, increased expression of AGEs as pro-inflammatory receptors in the ovarian tissue has been observed in women with PCOS. In this review, we summarize the role of dietary AGEs as mediators of metabolic and reproductive alterations in PCOS. Once a mechanistic understanding of the relationship between AGEs and anovulation is established, there is a promise that such knowledge will contribute to the subsequent development of targeted pharmacological therapies that will treat anovulation and improve ovarian health in women with PCOS.
Highlights
polycystic ovary syndrome (PCOS) is an endocrine disorder that is characterized by hyperandrogenism, oligo/anovulation and polycystic ovaries and it affects up to 25% of reproductive-aged women [1]
These findings suggest that the elevated serum advanced glycation end products (AGEs) are associated with elevated AMH and with anovulation observed in PCOS
In a recent experiment, increased glucose, insulin and testosterone levels were found in high-AGE fed female Wistar rats along with significant down- regulation of receptor for advanced glycation endproducts (RAGE) expression (p = 0.041) which was negatively correlated with serum insulin and testosterone levels signifying the role of diet rich is AGEs in the development of insulin resistance [17]
Summary
PCOS is an endocrine disorder that is characterized by hyperandrogenism, oligo/anovulation and polycystic ovaries and it affects up to 25% of reproductive-aged women [1]. Elevated serum AGEs levels have been observed in patients with hyperglycemia, insulin resistance, diabetes, renal insufficiency, atherosclerosis, aging, rheumatoid arthritis and recently PCOS [6,7,8]. These high circulating levels of AGEs can cause cellular damage after deposition in different tissues [9]. Positive correlation with AMH/AGEs ratio to number of follicles PCOS: higher AGE and RAGE immunoexpression in granulosa cells PCOS: higher AGEs’ levels with increased RAGE expression, higher testosterone and free androgen index (FAI), waist-to-hip ratio and HOMA The activation of AGE-RAGE axis is involved in the dysregulation of adipokines in obesity, thereby contributing to the development of obesity-associated insulin resistance.
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