Abstract
BackgroundPolycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder accompanied with an increased risk of developing type 2 diabetes mellitus and cardiovascular disease; despite being a common condition, the pathogenesis of PCOS remains unclear. Our aim was to investigate the potential metabolic profiles for different phenotypes of PCOS, as well as for the early prognosis of complications.MethodsA total of 217 women with PCOS and 48 healthy women as normal controls were studied. Plasma samples of subjects were tested using two different analytical platforms of metabolomics: 1H nuclear magnetic resonance (NMR) and gas chromatography/time-of-flight mass spectrometry (GC/TOF-MS).ResultsOur results showed that carbohydrate, lipid and amino acid metabolisms were influenced in PCOS. The levels of lactate, long-chain fatty acids, triglyceride and very low-density lipoprotein were elevated, while glucose, phosphatidylcholine and high-density lipoprotein (HDL) concentrations were reduced in PCOS patients as compared with controls. Additionally, the levels of alanine, valine, serine, threonine, ornithine, phenylalanine, tyrosine and tryptophan were generally increased, whereas the levels of glycine and proline were significantly reduced in PCOS samples compared to controls. Furthermore, the ratio of branched-chain amino acid to aromatic amino acid concentrations (BCAA/AAA) in PCOS plasma was significantly reduced in PCOS patients and was insusceptible to obesity and insulin sensitivity.ConclusionsOur results suggested that the enhanced glycolysis and inhibited tricarboxylic acid cycle (TAC) in women with PCOS. Decrease of BCAA/AAA ratio was directly correlated with the development of PCOS. Ovulatory dysfunction of PCOS patients was associated with raised production of serine, threonine, phenylalanine, tyrosine and ornithine. Elevated levels of valine and leucine, and decreased concentrations of glycine in PCOS plasma could contribute to insulin sensitivity and could be considered as the potential biomarkers for long-term risk assessment of diabetes mellitus.
Highlights
Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder accompanied with an increased risk of developing type 2 diabetes mellitus and cardiovascular disease; despite being a common condition, the pathogenesis of polycystic ovary syndrome (PCOS) remains unclear
Baseline characteristics Of 217 PCOS patients according to the Rotterdam guidelines, they were 72 patients (33.2%) presented with the classic PCOS phenotype (HA+AO+PCO); 74 patients (34.1%) with chronic anovulation and polycystic ovaries but no clinical or biochemical hyperandrogenism (AO+PCO); 33 patients (15.2%) with hyperandrogenism and chronic anovulation but normal ovaries (HA+AO); 38 patients (17.5%) with hyperandrogenism and polycystic ovaries but ovulatory cycles (HA+PCO)
A broad spectrum of metabolic and biochemical changes in PCOS subgroups compared with the control group were indicated, including the obviously enhanced triglyceride and low-density lipoprotein (LDL) level and reduced high-density lipoprotein (HDL) level, a marked augment in serum concentrations of androgens such as androstenedione, increased ratio of luteinizing hormone (LH) to follicle-stimulating hormone (FSH)
Summary
Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder accompanied with an increased risk of developing type 2 diabetes mellitus and cardiovascular disease; despite being a common condition, the pathogenesis of PCOS remains unclear. Hyperandrogenism, oligomenorrhea, chronic anovulation, and hyperinsulinemia are common clinical manifestations of PCOS [2] Women with this syndrome have an increased risk of developing type 2 diabetes mellitus (DM2) and cardiovascular disease (CVD) [1,3,4]. Insulin resistance, dyslipidemia and inflammation have been recognized as risk factors for developing DM2 and CVD in PCOS [10,11] This highlights the need to understand the metabolic dysfunction in PCOS for prevention of long-term complications through appropriate screening, diagnosis and intervention
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