Non-obese Polycystic Ovary Syndrome Patients Research Articles

Lipid accumulation product is an effective predictor of metabolic syndrome in non-obese women with polycystic ovary syndrome.

To explore the correlation of lipid accumulation product (LAP) with metabolic syndrome (MS) and to assess the predictive value of LAP for MS risk in polycystic ovary syndrome (PCOS) with different body mass index (BMI). A total of 242 PCOS patients and 150 controls were recruited and divided into normal-weight, overweight, and obese groups, then further divided into MS and without MS subgroups. Clinical and anthropometric variables and laboratory results were recorded. LAP was calculated from waist circumference (WC) and triglyceride using sex-specific formulae. Logistic regression analysis and receiver operating characteristic (ROC) curve were applied to determine and analyze the predictive value of LAP for MS. The prevalence of MS among PCOS patients was 45.04%, which was significantly higher than that of the controls (10%). Stratified by BMI, the incidence of MS in the normal-weight, overweight, and obese PCOS groups were 15.58%, 41.43%, and 71.58%, respectively. Logistic regression analysis indicated that LAP was an independent risk factor for MS in both normal-weight and overweight groups; however, the results were not significant in the obese group. ROC curve analysis showed that LAP had an outstanding discrimination index for MS in normal-weight (AUC=0.960, cut-off value=42.5) and overweight (AUC=0.937, cut-off value=47.93) PCOS patients, with a sensitivity of 0.917/0.931 (normal-weight/overweight) and a specificity of 0.969/0.854 (normal-weight/overweight), respectively. Normal-weight and overweight PCOS patients also have a fairly high incidence of MS and should receive as much attention as obese patients. Compared to applying multiple clinical indicators, LAP is more convenient and facilitates acquiring early and accurate diagnoses of MS among non-obese PCOS patients using fewer MS markers.

Relationship of vitamin D level with HOMA IR and LH in PCOS patients

Background: the most prevalent endocrine disorder in young women is polycystic ovary syndrome (PCOS). In many patients, vitamin D insufficiency aggravates the condition. Early diagnosis of insulin resistance and vitamin D insufficiency will simplify management and reduce morbidity in the future. This study analyzes the relationship between vitamin D levels and HOMA IR and LH in PCOS patients and compares the levels of LH and HOMA IR between obese and non-obese PCOS. Method: This study used a cross-sectional study on 48 women of reproductive age who were diagnosed with PCOS according to the Rotterdam criteria and who met the inclusion and exclusion criteria. Subjects were taken by consecutive sampling, measured levels of vitamin D, HOMA IR, and LH, then correlated and compared between obese and non-obese. Results: 48 samples were included in the study conducted within 3 months. A significant relationship was found between vitamin D and HOMA IR levels in PCOS patients with a p-value of 0.000. There was a significant relationship between vitamin D and LH levels in PCOS patients with a p-value of 0.000. There were significant differences in HOMA IR and LH levels in obese and non-obese PCOS patients, with higher HOMA IR in obese patients with a p-value of 0.001 and higher LH levels in non-obese PCOS patients with a p-value of 0.045. Conclusion: there was a significant relationship between vitamin D levels and HOMA IR and LH in PCOS patients and a significant difference in HOMA IR and LH in obese and non-obese PCOS patients.

Delta neutrophil index in obese and non-obese PCOS patients.

We aimed to evaluate the usefulness of delta neutrophil index (DNI), a new inflammatory marker, in polycystic ovary syndrome (PCOS). This retrospective case-control study was conducted at a tertiary health center. The DNI and other blood parameters obtained from the complete blood count examination of 227 individuals, consisting of 72 PCOS patients and 155 controls, were compared between the two groups. A receiver operating characteristic analysis was performed to examine the relationship between DNI and PCOS. DNI, white blood cell (WBC) count, and neutrophil count were significantly higher in the PCOS group than in the control group (P=0.028, 0.011, and 0.037; respectively). DNI and WBC counts were significantly higher in nonobese-PCOS patients (P=0.018 and 0.041; respectively). When the obese-PCOS and obese-control groups were compared, only neutrophil count was significantly higher in obese-PCOS patients (P=0.016). Significance was observed at cut-off values of 0.015 (area under the curve [AUC]=0.588) (P=0.034; sensitivity, 78%; specificity, 35%; Youden's index=0.133) for DNI: 9.35 (AUC=0.594) (P=0.022) for WBC; and 5.38 (AUC=0.628) (P=0.002) for neutrophils. Higher DNI in PCOS patients and similar results in the non-obese-PCOS group were observed when obese and non-obese-PCOS patients were considered separately. However, the lack of difference in the obese-PCOS group strengthens the hypothesis that there is obesity-independent inflammation in PCOS.

Relationship between blood uric acid levels and body composition in patients with polycystic ovary syndrome

Objective: To analyze the difference in blood uric acid levels between patients with polycystic ovary syndrome (PCOS) and healthy women of childbearing age, and to investigate the correlation between body composition and blood uric acid levels. Methods: A total of 153 eligible childbearing age patients with PCOS treated at Tianjin Medical University General Hospital from January 2018 to March 2022 were selected, and 153 healthy women with normal menstruation were selected as the control group. Fasting blood uric acid levels were measured by venous blood test, and body composition was measured by a body composition analyzer. Group comparisons were made to analyze the correlation between body composition and blood uric acid levels. Results: The incidence of hyperuricemia was higher in patients with PCOS than that in the control group [30.1% (46/153) vs 2.0% (3/153)], with a statistically significant difference (χ2=44.429, P<0.001). Blood uric acid level was also significantly higher in patients with PCOS than that in the control group [(371±98) vs (265±67) μmol/L; t=11.170, P<0.001]. Among PCOS patients, there were statistically significant differences in weight, body mass index (BMI), body fat mass, skeletal muscle mass, percent body fat, lean body weight, fat mass/lean body weight, percent skeletal muscle, and visceral fat level between the hyperuricemia group and the normal blood uric acid group (all P<0.001), but no significant difference was observed in waist-hip ratio (P=0.348). The following body composition indicators: weight, BMI, waist-hip ratio, body fat mass, skeletal muscle mass, percent body fat, visceral fat level, lean body weight, and fat mass/lean body weight in all subjects, the PCOS patients and the control group, were positively correlated with blood uric acid levels (all P<0.01). The blood uric acid level in PCOS obese patients was higher than that in non-obese PCOS patients, and the difference was statistically significant [(425±83) vs (336±91) μmol/L; t=6.133, P<0.001]. The blood uric acid level in central obesity PCOS patients was also higher than that in non-central obesity PCOS patients [(385±95) vs (299±79) μmol/L], the difference was statistically significant (t=4.261, P<0.001). The blood uric acid level in normal-weight obese PCOS patients was higher than that in normal-weight non-obese PCOS patients [(333±73) vs (277±54) μmol/L], and the difference was statistically significant (t=2.848, P=0.006). Blood uric acid levels in normal-weight [(315±74) vs (255±67) μmol/L], overweight [(362±102) vs (276±57) μmol/L], and obese PCOS patients [(425±83) vs (303±74) μmol/L] were all higher than those in the corresponding control groups, with statistically significant differences (all P<0.001). Conclusions: PCOS patients have a higher incidence of hyperuricemia than healthy women of childbearing age. Blood uric acid levels are closely correlated with body composition indicators, such as weight, BMI, waist-hip ratio, body fat mass, skeletal muscle mass, percent body fat, and visceral fat level. Body composition analysis of women with PCOS could help identify potentially obese people more accurately and carry out individualized treatment, thereby reducing the risk of metabolic abnormalities.

Assessment of early vascular changes in adult females with polycystic ovary syndrome: correlation with insulin resistance

Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder in females in the reproductive period with estimated prevalence of 5% to 18% [1]. It contributes to the mortality and morbidity in patients with PCOS due to the increased risk of different metabolic and cardiovascular (CV) complications [2]. Despite the presence of obesity in 40-60% of cases [3], the disease may occur in non-obese women. The occurrence of metabolic disorders in non-obese PCOS patients, suggests that the syndrome itself may play a role in the development of metabolic and CV co-morbidities [4]. The identification of early stages of atherosclerosis in patients with PCOS might be useful in the development of new strategies to control modifiable CV risk factors [5]. Assessment of vascular endothelial function (ED) as an initial reversible step in atherosclerosis development, may serve as an integral index for CV risk factor burden [6]. In addition, carotid intima media thickness (CIMT) is a helpful marker for atherosclerosis and for the identification of increased risk of CV disease [7]. Our study assessed the early vascular changes in Egyptian women with PCOS both physically and functionally by looking at the CIMT using high resolution Doppler ultrasound and by measuring ED using brachial artery flow–mediated vasodilatation (FMD). Our results indicate that patients with PCOS have significant ED and premature atherosclerosis which is, to a great extent, independent of obesity and IR. This suggests that PCOS patients are at increased risk for premature CVD and may benefit from early detection and management.

Cord blood anti-Müllerian hormone levels are higher in female newborns from women with polycystic ovary syndrome (PCOS) when compared to non-PCOS controls, irrespective of body mass index; a prospective case-control study.

To compare cord-blood anti-Müllerian hormone levels between female newborns from women with and without polycystic ovary syndrome. A prospective case-control study was conducted in Ankara University School of Medicine, Department of Obstetrics and Gynecology between June 2020 and January 2021. In total, 408 women gave birth to a female during the study period. Of those, 45 had a polycystic ovary syndrome-like history. We did not find the preconceptional history of 16 women. Two women were excluded due to other endocrine disorders. The polycystic ovary syndrome group consisted of 27 women with polycystic ovary syndrome that gave birth to a female newborn during the study period and the non-polycystic ovary syndrome control group consisted of 33 women who had regular cycles prior to pregnancy, were never diagnosed with polycystic ovary syndrome, and gave birth to female newborns. The primary outcome measure was the cord-blood anti-Müllerian hormone levels. The median cord-blood anti-Müllerian hormone levels of female newborns from polycystic ovary syndrome patients were significantly higher than those in the non-polycystic ovary syndrome group (0.33ng/ml vs. 0.12ng/ml, respectively; p<0.001). In addition, cord blood anti-Müllerian hormone levels were significantly higher in both obese and non-obese polycystic ovary syndrome patients when compared to body-mass-index-matched non- polycystic ovary syndrome patients (0.37ng/ml vs. 0.06ng/ml, respectively; p=0.013 and 0.30ng/ml vs. 0.11 ng/ml, respectively; p=0.003). The cord blood anti-Müllerian hormone levels were higher in female newborns of women with polycystic ovary syndrome when compared to non-polycystic ovary syndrome controls. The effect of polycystic ovary syndrome seems to be greater than body mass index on cord blood anti-Müllerian hormone levels.

Evidence for Increased Expression of SIRT3 Associated with Hyperandrogenism in Granulosa Cells of Non-Obese PCOS Patients

Background: SIRT3 regulates the generation of reactive oxygen species (ROS) in human granulosa cells (GCs). Increased levels of oxidative stress may cause follicular dysplasia in GCs of polycystic ovary syndrome (PCOS) patients. However, expression and regulation of SIRT3 in GCs of PCOS patients have not yet been investigated. The present study is conducted to determine the correlation between SIRT3 and hyperandrogenism in luteinized GCs of PCOS patients. Methods: The mRNA and protein expression of SIRT3 were analysed in the luteinized GCs from the controls and non-obese PCOS patients. Dihydrotestosterone (DHT) was added to the primary cultured GCs to test the effects of androgen excess on intracellular ROS and SIRT3 expression. A DHT-induced PCOS murine model was used to confirm the effects in vivo. Results: In the matched case-control study including 32 pairs of the controls and non-obese PCOS patients, we showed that the expression of SIRT3 was increased in luteinized GCs of non-obese PCOS patients compared with normovulatory controls. Moreover, DHT induced oxidative stress and SIRT3 expression in human GCs, which was further confirmed in a murine PCOS model. Conclusions: These results indicated that the increased expression of SIRT3 was induced by hyperandrogenism in GCs of non-obese PCOS patients.

Progesterone and progesterone-induced blocking factor (PIBF) levels in non-obese women with polycystic ovary syndrome

Purpose: This study aimed to evaluate the level of progesterone and progesterone-induced blocking factor (PIBF), an immune mediator, in non-obese patients with polycystic ovary syndrome (PCOS).&#x0D; Materials and Methods: Totally 72 patients were recruited into study and divided into 2 groups: The first group was patients diagnosed with PCOS (n = 36) and the second was the healthy control group (n=36). The diagnosis of PCOS was made according to Rotterdam diagnostic criteria. All patients were 18–35 years old and non-obese (body mass index (BMI) &lt; 25 kg/m2). Follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), thyroid-stimulating hormone (TSH), prolactin (PRL), total testosterone, and dehydroepiandrostenedione sulfate (DHEA-S) levels were measured on the third day of the menstrual cycle. On the 21st day of the same menstrual period, fasting blood glucose, insulin, progesterone, and PIBF levels were measured. &#x0D; Results: Demographic and clinical characteristics of study participants were similar between the two groups. Serum FSH, E2, TSH, PRL, DHEA-S, total testosterone, fasting blood glucose, fasting insulin, homeostatic model assessment for insulin resistance (HOMA-IR), and hemoglobin A1c values were similar between the groups. Differences in LH, LH/FSH ratio, serum progesterone, and serum PIBF were statistically significant.&#x0D; Conclusion: Progesterone and PIBF levels decreased in non-obese PCOS patients. We suggest that even in the absence of obesity, which is the origin and enhancer of inflammation in PCOS, low PIBF as the underlying immunomodulator will drive complications.

Metformin Improves the Hepatic Steatosis Index in Non-Obese Patients with Polycystic Ovary Syndrome.

Non-alcoholic fatty liver disease (NAFLD) is a common yet little recognized health problem in women with polycystic ovary syndrome (PCOS). In a retrospective setting, we investigated the effects of metformin treatment on the hepatic steatosis index (HSI) as a readily available biomarker panel for NAFLD. HSI values of >36 are considered to be highly suggestive for NAFLD. In our cohort, HSI values indicating NAFLD were found in 60/81 (74.1%) women at baseline. The mean HSI improved significantly after the metformin treatment from 43.2 ± 1.0 to 41.0 ± 1.1. Subgroup analyses of non-obese (body mass index (BMI) < 30 kg/m2), obese (BMI 30–35 kg/m2) and very obese (BMI > 35 kg/m2) women yielded mean baseline HSI values of 35.5 ± 4.5, 41.2 ± 2.7 and 51.2 ± 4.7, respectively. A significant improvement in the HSI of 1.5 ± 2.1 was observed after metformin treatment in non-obese women but not in the obese subgroups. The data suggest a new aspect of metformin treatment in non-obese PCOS patients, namely, a possible improvement in NAFLD. This study highlighted hepatic steatosis as a common comorbidity in PCOS patients that can severely affect their long-term health, and therefore, deserves more attention in the management of PCOS patients.

Follicular free fatty acid metabolic signatures and their effects on oocyte competence in non-obese PCOS patients.

Polycystic ovary syndrome (PCOS) is a common cause of anovulatory infertility in women. This study identified changes in free fatty acids profiles in the follicular fluid that may lead to better diagnosis and management of infertility in PCOS women. Polycystic ovary syndrome (PCOS) is a heterogeneous disease characterized by various endocrine/metabolic disorders and impaired reproductive potential. Alterations in oocyte competence are considered potentially causative factors for infertility in PCOS women and analyzing the composition of follicular fluid in these patients may help to identify which changes have the potential to alter oocyte quality. In this study, free fatty acid metabolic signatures in follicular fluid were performed to identify changes that may impact oocyte competence in non-obese PCOS women. Sixty-four non-obese women (32 with PCOS and 32 age- and BMI-matched controls) undergoing in vitro fertilization were recruited. Embryo quality was morphologically assessed. Free fatty acid metabolic profiling in follicular fluid was performed using gas/liquid chromatography-mass spectrometry. Principal component analysis and orthogonal partial least squares-discriminant analysis models were further constructed. Nine free fatty acids and 24 eicosanoids were identified and several eicosanoids synthesized by the cyclooxygenase pathway were significantly elevated in PCOS patients compared to controls. The combination of PGE2, PGF2α, PGJ2, and TXB2 had an area under the curve of 0.867 (0.775-0.960) for PCOS discrimination. Furthermore, follicular fluid levels of PGE2 and PGJ2 were negatively correlated with high-quality embryo rate in PCOS patients (P < 0.05). Metabolomic analysis revealed that follicular fluid lipidomic profiles undergo changes in non-obese PCOS women, which suggests that identifying changes in important metabolic signatures may give us a better understanding of the pathogenesis of PCOS. Furthermore, elevated PGE2 and PGJ2 concentrations may contribute to impaired oocyte competence in non-obese PCOS patients.

MiR-124-3p Combined with ANGPTL2 Has High Diagnostic Values for Obese and Nonobese Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects 5–20% of women of reproductive age. Interestingly, serum miR-124-3p and ANGPTL2 are differentially expressed in PCOS patients. Accordingly, this study set out to explore the clinical roles of serum miR-124-3p/ANGPTL2 in PCOS. Firstly, miR-124-3p/ANGPTL2 expression patterns were detected in the serum of 102 PCOS patients and 100 healthy subjects. miR-124-3p or/and ANGPTL2 diagnostic efficacy on PCOS was further analyzed, in addition to the measurement of lipid metabolism, glucose metabolism, sex hormone indexes, and inflammation levels. Correlations between serum miR-124-3p/ANGPTL2 expressions and age, BMI, Ferriman–Gallwey score, lipid metabolism, glucose metabolism, sex hormone indexes, TNF-α, and IL-6 in PCOS patients were determined. The expression correlation and binding relationship of ANGPTL2 and miR-124-3p were identified. In addition, miR-124-3p was downregulated and ANGPTL2 was upregulated in the serum of obese and nonobese PCOS patients. miR-124-3p expression was found to be negatively correlated with Ferriman–Gallwey score and serum total testosterone (T), and negatively related to prolactin (PRL). ANGPTL2 expression was positively correlated with FNS and inversely linked with PRL. TNF-α and IL-6 were negatively correlated with miR-124-3p, but positively correlated with ANGPTL2. Furthermore, there was a negative correlation and a targeting relationship between ANGPTL2 and miR-124-3p expression in the serum of obese and nonobese PCOS patients. Collectively, our findings indicated that miR-124-3p might target ANGPTL2 expression in obese and nonobese PCOS patients, and further underscored the diagnostic value of their combination.

The association between triglycerides/high-density lipoprotein cholesterol ratio, insulin resistance, and serum androgen levels in patients with polycystic ovary syndrome

Objectives: Insulin resistance and dyslipidemia are common comorbidities of polycystic ovary syndrome. We aim to evaluate the association between triglycerides/high-density lipoprotein cholesterol ratio, insulin resistance, and serum androgen levels in patients with polycystic ovary syndrome. Methods: We enrolled a total of 40 polycystic ovary syndrome patients and 20 healthy control subjects in this cross-sectional study. The polycystic ovary syndrome patients were divided into two subgroups obese and non-obese. The triglycerides/high-density lipoprotein cholesterol ratio and homeostatic model assessment of insulin resistance were calculated for all individuals. Demographic characteristics, serum levels of metabolic parameters, and androgens were compared between the study subgroups. P-value &amp;lt; 0.05 was accepted as statistically significant. Results: The triglycerides/high-density lipoprotein cholesterol ratio was higher in obese polycystic ovary syndrome patients than in other groups (3.64 ± 3.06 vs. 1.07 ± 0.36 in control and 1.18 ± 0.53 in non-obese group, p &amp;lt; 0.005). The triglycerides/high-density lipoprotein cholesterol ratio was positively correlated with homeostatic model assessment of insulin resistance (r=0.546, p &amp;lt; 0.001), total testosterone (r=0.402, p = 0.010), and free androgen index (r=0.609, p &amp;lt; 0.001) while was negatively correlated with sex hormone-binding globulin (r=-0.497, p = 0.001). Obese polycystic ovary syndrome patients had higher serum total testosterone levels, higher free androgen index, and lower sex hormone-binding globulin than non-obese polycystic ovary syndrome patients (0.71 ± 0.49 ng/mL vs. 0.45 ± 0.16 ng/mL, p = 0.006; 3.1 ± 1.91 vs. 1.01 ± 0.49, p &amp;lt; 0.005; and 26 ± 10.3 nmol/L vs. 59.6 ± 43.7 nmol/L, p &amp;lt; 0.005, respectively). Obese polycystic ovary syndrome patients had also worse lipid parameters, including high triglycerides and low high-density cholesterol when compared with other groups. Conclusions: The triglycerides/high-density lipoprotein cholesterol ratio was correlated with the homeostatic model assessment of insulin resistance, and androgenic hormonal profiles including total testosterone and free androgen index in patients with polycystic ovary syndrome.

Role of Oxidative Stress in Obese and Nonobese PCOS Patients.

Objective The aim of this study was to evaluate the relationship between the oxidant-antioxidant status, endothelial dysfunction, lipid metabolism, and metabolic syndrome risk in women with polycystic ovary syndrome (PCOS). Materials and Methods Forty-five obese (BMI >30 kg/m2) woman diagnosed with PCOS in the study, forty-five nonobese (BMI <30 kg/m2) PCOS diagnosis working groups, and forty-nine healthy control groups were created with patients. Serum malondialdehyde (MDA) levels with antioxidant activities, such as SOD, GSH, GPx, and CAT activities, were measured by spectrophotometry. Results There was a statistically significant difference in the mean serum MDA level in the obese PCOS group compared to the nonobese group and the control group (p < 0.001). When the antioxidant parameters, such as SOD, GPx, GSH, and CAT, were compared with the healthy control group, nonobese, and obese PCOS groups, the difference between the groups was statistically significant (p < 0.001). A positive correlation was observed between MDA and BMI, triglyceride, LDL, SBP, DBP, and HOMA-IR in the PCOS patient group. Conclusion Oxidative stress and decreased antioxidant parameters in PCOS patients were correlated with hyperinsulinemia, hypertension, and dyslipidemia findings, and we think that this oxidative stress condition may contribute to metabolic syndrome and cardiovascular diseases in PCOS patients.

Correlation of Serum Homocysteine Levels and Hyperinsulinaemia with Body Mass Index in Polycystic Ovarian Syndrome.

ABSTRACTBackground:Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies affecting women in reproductive age group. The interrelationship of serum homocysteine, homoeostatic assessment of insulin resistance (HOMA-IR) and body mass index amongst overweight, obese and non-obese PCOS patients is not fully established.Aims:We aimed to study the correlation of serum homocysteine levels and hyperinsulinaemia with body mass index (BMI) in PCOS patients.Study Setting and Design:This was a case–control study in which 35 women with PCOS and 35 non-PCOS women acting as controls were enrolled.Materials and Methods:Cases were identified by Rotterdam's criteria. (IR) indices, HOMA determination and serum homocysteine levels were determined and their correlation with BMI was studied.Statistical Analysis Used:Student's t-test and analysis of variance test were used for statistical analysis. The Pearson correlation coefficient was then used to estimate the correlation.Results:On overall evaluation, a significant positive correlation of fasting insulin, HOMA-IR and serum homocysteine) was observed (P < 0.05), however, on evaluating the correlation of these markers independently in cases and controls, only fasting insulin and HOMA-IR showed a significant correlation. In a multivariate model where PCOS was considered a dependent variable with age, fasting glucose, HOMA-IR, serum homocysteine and body mass index as the independent variables, only serum homocysteine levels were found to be significantly associated with the dependent variable (odds ratio = 1.172; 95% confidence interval = 1.032–1.330).Conclusion:PCOS women had significantly higher mean fasting glucose, fasting insulin, HOMA-IR and homocysteine levels as compared to non-PCOS controls. Mean HOMA-IR, homocysteine and fasting insulin levels showed a significant incremental trend with increasing BMI category in overall evaluation as well as in cases and controls independently.

PLASMA NEPRILYSIN LEVELS IN PATIENTS WITH POLYCYSTIC OVARY SYNDROME.

Insulin resistance has been detected in a majority of patients with polycystic ovary syndrome (PCOS). Elevated neprilysin levels are associated with insulin resistance. The present study aims to investigate plasma neprilysin and its relationship with endocrine and metabolic characteristics in patients with PCOS. Thirty-five premenopausal PCOS patients and 35 healthy volunteers of similar age were included in the study. Demographic characteristics, biochemical and hormonal findings and also plasma neprilysin levels were determined in these patients and healthy controls. In our study, HOMA-IR values were significantly higher in PCOS patients (3.3 ± 1.8) compared with the controls [(1.6 ± 1), p<0.01]. Plasma neprilysin levels were significantly higher in the PCOS group compared to the control group (1502.1 ± 1641.2 vs. 764.6 ± 562.6 pg/mL). There was no difference in plasma neprilysin levels when PCOS patients were classified as overweight-obesity (BMI≥25kg/m2) or non-obesity (BMI<25kg/m2). Our findings revealed significantly higher levels for plasma neprilysin and HOMA-IR values in PCOS patients when compared to controls. No significant differences were noted between obese PCOS patients and non-obese PCOS patients in terms of plasma neprilysin levels.

Serum X-box-binding protein 1 levels in PCOS patients

Objective X-box binding protein-1 (XBP1) is a possible indicator of metabolic syndrome and diabetes. This study aimed to evaluate the relationship between serum XBP1 levels and polycystic ovary syndrome (PCOS). Method A prospective observational study was conducted with 88 patients. The first group was defined as the control group with ovulatory and normal-BMI patients (n = 28). The second group comprised of nonobese PCOS patients (n = 30). The third group included overweight/obese patients with PCOS (n = 30). Fasting plasma glucose, serum lipids, follicle stimulating hormone, luteinizing hormone, total testosterone, dehydroepiandrosterone and XBP1 levels l were evaluated in all groups. Results There was a significant difference in XBP1 levels between the study groups, and higher levels were observed both in the nonobese and obese PCOS groups than in the healthy controls (p < .001). The median level of XBP1 was 73.7 pg/ml in the control group, 114.11 pg/ml in the nonobese PCOS group, and 151.61 pg/ml in the overweight/obese PCOS group. A cutoff level of XBP1 at 95.79 pg/ml level was determined with a significant AUC (area under the curve) level of 99% and high specificity and sensitivity rates to predict PCOS. Also, a significant positive correlation was observed between XBP1 levels and BMI, waist circumference, fasting plasma glucose and triglyceride levels (p < .05). Conclusions XBP1 levels were significantly higher in PCOS patients, particularly in overweight/obese PCOS patients, than in the controls. Also, the parameters associated with metabolic syndrome were related to XBP1 levels.

Circulating resistin and follistatin levels in obese and non-obese women with polycystic ovary syndrome: A systematic review and meta-analysis.

This meta-analysis was performed to resolve the inconsistencies regarding resistin and follistatin levels in women with polycystic ovary syndrome (PCOS) by pooling the available evidence. A systematic literature search using PubMed and Scopus was carried out through November 2020 to obtain all pertinent studies. Weighted mean differences (WMDs) with corresponding 95% confidence intervals (CIs) were calculated to evaluate the strength of the association between the levels of resistin and follistatin with PCOS in the overall and stratified analysis by obesity status. A total of 47 publications, 38 for resistin (2424 cases; 1906 controls) and 9 studies for follistatin (815 cases; 328 controls), were included in the meta-analysis. Resistin levels were significantly higher in PCOS women compared with non-PCOS controls (WMD = 1.96 ng/ml; 95%CI = 1.25-2.67, P≤0.001) as well as in obese PCOS women vs. obese controls, and in non-obese PCOS women compared with non-obese controls, but not in obese PCOS vs. non-obese PCOS patients,. A significantly increased circulating follistatin was found in PCOS patients compared with the controls (WMD = 0.44 ng/ml; 95%CI = 0.30-0.58, P≤0.001) and in non-obese PCOS women compared with non-obese controls and in obese PCOS women vs. obese controls, but, no significant difference in follistatin level was observed in obese PCOS compared with non-obese PCOS women. Significant heterogeneity and publication bias was evident for some analyses. Circulating levels of resistin and follistatin, independent of obesity status, are higher in women with PCOS compared with controls, showing that these adipokines may contribute to the pathology of PCOS.

Association of circulating monocyte chemoattractant protein-1 levels with polycystic ovary syndrome: A meta-analysis.

Polycystic ovary syndrome (PCOS) is a common hormonal disorder that has a huge impact on the human infertility. Increased levels of various circulating inflammatory cytokines have been observed in PCOS patients, which can contribute to the pathogenesis of PCOS. Monocyte chemoattractant protein-1 (MCP-1), a secretory chemokine, is a potent chemotactic factor that recruits monocytes/macrophages to inflammatory foci. Several previous studies comparing the circulating MCP-1 levels between non-PCOS and PCOS patients have yielded contradictory results. Therefore, the aim of this meta-analysis was to investigate whether circulating MCP-1 levels vary between non-PCOS and PCOS patients. Research articles published before November 11, 2020, were screened to identify eligible studies. Heterogeneity, sensitivity, and publication bias were analyzed using STATA software. Standardized mean difference (SMD) with a 95% confidence interval (CI) was calculated by the STATA software using a random-effects model. 11 studies were included in this meta-analysis involving 897 individuals: 368 non-PCOS patient and 529 PCOS patients. Our pooled meta-analysis results show that circulating MCP-1 levels were significantly higher in PCOS patients than in non-PCOS patients (SMD=0.84, 95% CI=[0.37, 1.31], Z=3.50, p<0.01). However, due to the limited number of studies included in this meta-analysis, subgroup analysis determined that circulating MCP-1 levels were not significantly varied between obese non-PCOS and obese PCOS patients (SMD=0.42, 95% CI=[-0.65, 1.49], Z=0.77, p=0.442) as well as between non-PCOS and PCOS patients without obesity (SMD=2.04, 95% CI=[-0.84, 4.93], Z=1.39, p=0.166). In addition, circulating MCP-1 levels were also not significantly different between obese and non-obese PCOS patients (SMD=-0.04, 95% CI=[-0.68, 0.60], Z=0.11, p=0.909). Our findings reveal that circulating MCP-1 levels are upregulated in women with PCOS and are associated with an increased risk of PCOS.

Circulating Adipokine Levels in Nonobese Women With Polycystic Ovary Syndrome and in Nonobese Control Women: A Systematic Review and Meta-Analysis.

Levels of circulating adipokines in nonobese polycystic ovary syndrome (PCOS) patients have been reported in many studies. However, the results are inconsistent. The aim of this meta-analysis is to assess whether the levels of circulating adipokines are changed in nonobese PCOS relative to nonobese healthy controls. To identify eligible studies, a literature research was performed in the PubMed, Embase, and Web of Science databases without restricting by region, journal, or language. A total of 81 studies met the eligibility criteria. The meta-analysis showed that the circulating level of adiponectin (standardized mean difference [SMD]: -0.95; 95% CI: -1.36 to -0.53) was significantly decreased in nonobese PCOS patients. In contrast, the circulating levels of chemerin (SMD: 1.13; 95% CI: 0.08 to 2.18), leptin (SMD: 0.47; 95% CI: 0.13 to 0.81), resistin (SMD: 0.45; 95% CI: 0.03 to 0.88), and visfatin (SMD: 1.38; 95% CI: 0.68 to 2.09) were significantly increased in nonobese PCOS patients. There were no significant changes in the circulating levels of apelin (SMD: 0.32; 95% CI: -1.34 to 1.99), irisin (SMD: 1.01; 95% CI: -0.68 to 2.70), omentin (SMD: -0.37; 95% CI: -1.05 to 0.31), or vaspin (SMD: 0.09; 95% CI: -0.14 to 0.32). Thus, scientific evidence suggests that the circulating adipokine levels are altered in nonobese PCOS patients compared to nonobese healthy controls. Therefore, independent of the degree of obesity, dysregulated circulating adipokine levels might play important roles in the occurrence and development of PCOS.

The relationship between glomerular filtration rate, and metabolic and inflammatory parameters in obese and non-obese patients with polycystic ovary syndrome

AimTo investigate the relationship between glomerular filtration rates (GFR), and homeostasis model assesment of insulin resistance (HOMA-IR), C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR) in patients with polycystic ovary syndrome (PCOS). Material and methodsThirty-one overweight and obese PCOS patients with body mass index (BMI)≥25kg/m2 and 25 non-obese PCOS patients with BMI<25kg/m2 were included into patients’ group, while 23 overweight and obese, and 25 non-obese age-and BMI-matched healthy individuals (aged between 18 and 40 years), were enrolled as controls. Levels of serum creatinine, glucose, insulin, CRP, and complete blood count were measured. eGFR, HOMA-IR and NLR were also calculated. ResultsIn PCOS group, HOMA-IR (p=0.001), CRP (p=0.025) and waist hip ratio (WHR) (p=0.011) were higher than controls. In obese PCOS sub-group, HOMA-IR (p=0.004) and WHR (p=0.002) were higher than obese controls. In non-obese PCOS sub-group, HOMA-IR (p=0.001) were higher than non-obese controls. In obese PCOS sub-group; HOMA-IR (p=0.001) and CRP (p=0.001) levels were significantly higher than non-obese PCOS sub-group. In terms of other parameters, no significant difference was found between the groups. The analysis showed a negative correlation between GFR, and BMI and HOMA-IR in PCOS group, between GFR, WHR and insulin levels in obese PCOS sub-group, and between BMI, and HOMA-IR and NLR in non-obese PCOS sub-group. ConclusionAlthough HOMA-IR and CRP were higher in PCOS group, there was no difference in NLR and GFR levels between those with PCOS and controls.