Polycystic Ovary Syndrome Group Research Articles

Hyperandrogenemia impairs endometrial vitamin D receptor expression in polycystic ovary syndrome.

To determine the effects of hyperandrogenemia and other phenotypic parameters on endometrial vitamin D receptor (VDR-X2 and VDR-X4) expression in women with polycystic ovary syndrome (PCOS) undergoing ovarian stimulation and total embryo freezing. Forty-four PCOS patients were divided into four phenotypes according to the criteria for hyperandrogenemia (HA), ovulatory dysfunction (OD), and polycystic ovary morphology (PCOM): phenotype A (HA+OD+PCOM), phenotype B (HA+OD), phenotype C (HA+PCOM), and phenotype D (OD+PCOM). Endometrial VDR expression was determined by real-time PCR and immunohistochemistry. Twenty age- and body mass index (BMI)-matched couples with male infertility were included as controls. VDR-X2 and VDR-X4 expression levels were significantly lower in the PCOS group than in the control group. A significant downregulation was detected in the relative VDR-X2 and X4 expression in phenotypes A, B, and C compared to the control group. VDR-X2 and X4 expression in phenotype D was significantly higher than in phenotypes A and B. A significant negative correlation was detected among VDR-X2, VDR-X4, serum testosterone (T), androstenedione (A), DHEAS, and insulin resistance (IR). Multivariate analysis revealed that serum T, A, DHEAS, and IR levels were independently associated with both VDR-X2 and VDR X4 relative gene expression after adjusting for age and BMI. The VDR mRNA and immunoreactivity of each phenotype overlapped. The clinical pregnancy rates for each phenotype were similar. VDR expression in the endometria of patients with PCOS was defective. Hyperandrogenemia and insulin resistance are the key drivers of defective VDR expression in the endometrium of patients with PCOS.

Expression of miR-93 and Glucose Transporter Type 4 Mediated by Ginkgolide in Peripheral Blood with Polycystic Ovary Syndrome and Its Clinical Significance

Decreased Glucose transporter 4 (GLUT4) expression leads to abnormal glucose regulation. miR-93 regulates GLUT4 expression and studies have shown that, ginkgolide mediates miR-93 and GLUT4 in polycystic ovary syndrome (PCOS). 50 patients with PCOS and 50 healthy women were recruited. RT-qPCR detected miR-93 and GLUT4 expression. Luteinizing hormone (LH) (11.84 ± 4.08), T (76.87±30.24), FINs (20.06±11.37) and HOMA-IR (3.75±1.04) in the PCOS group was higher than control group (7.42±3.63, 43.58±13.9, 8.74±4.62, 1.55±0.39) (P < 0.05). miR-93 expression in peripheral blood of PCOS group was significantly elevated, while GLUT4 mRNA expression was reduced (P < 0.05). miR-93 negatively correlated with GLUT4. miR-93 in insulin resistance (IR) group was higher than non-IR group, while GLUT4 was lower (P<0.05). miR-93 positively correlated with T (r=0.374, P =0.019), FINs (r=0.322, P =0.026) and HOMA-IR (r = 0.507, P = 0.005), while GLUT4 had a negative correlation. miR-93 and GLUT4 are abnormally expressed in PCOS, which is related to complications such as IR and endocrine metabolism.

Comparison of hormonal levels between infertile PCOS and non-PCOS females

Background: Polycystic ovary syndrome (PCOS) is a complex condition characterized by elevated androgen levels, menstrual irregularities cystic ovaries. Other clinical features include obesity, acne, amenorrhea, excessive hair growth, and infertility. PCOS has been linked to insulin resistance and obesity and many patients with PCOS have insulin resistance and hyper-insulinemia, which play a significant role in the pathogenesis of PCOS Method: This study was conducted during the period starting from November 2022 to May 2023. One hundred infertile female patients aged range 18–46 years. Women complaining from infertility included in this study were divided into 2 groups: Group I: PCOS group, including 42 females diagnosed with PCOS. Group II: Non-PCOS group, involving 58 females with either male factors or unexplained causes of infertility. Results: BMI was significantly higher among PCOS females (28.61 ± 1.06 vs.25.62 ± 1.65; p=0.046), there was significantly higher LH levels (6.12 ± 0.12 vs. 4.59 ± 0.31; p=004), LH/FSH ratio (1.20 ± 0.12 vs. 0.78 ± 0.05; p=0.001) and significantly lower FSH levels among PCOS patients (5.62 ± 0.62 vs. 6.67 ± 0.58; p=0.043). There were also no significant correlations among PCOS women between BMI with LH, FSH, LH/FSH ratio, E2, prolactin and testosterone hormones

Effect of Zinc on Blood Biochemical and mTOR Gene Expression in Rats with Polycystic Ovarian.

Zinc (Zn) is a significant element of the reproductive system and is associated with several enzymes that regulate different metabolic pathways. Organic Zn can significantly affect polycystic ovarian syndrome (PCOS) pathogenesis. Insulin resistance (IR) is a common complication of PCOS. Mammalian target of rapamycin (mTOR), which controls crucial cell functions, is regulated by insulin and nutrients. It has two complexes, namely, mTORC1 and mTORC2. mTOR associates with its binding partner's regulatory associated protein of mTOR (Raptor) and rapamycin-insensitive companion of mTOR (Rictor), which form these distinct complexes, respectively, and is activated in PCOS. This research aimed to evaluate the effect of Zn on the expression of mTOR signaling genes (Raptor and Rictor) and IR in PCOS model rats. Different Zn supplements, including standard diet (SD): (control - or + , SD without supplementation), Zn25, Zn75, and Zn175 (daily given three levels of 25, 75, and 175mg Zn methionine (ZnMet)/kg for 6weeks, respectively), were applied to the control and PCOS groups. Fasting glucose (FG), fasting insulin (FI), IR indices, and Raptor and Rictor expression levels were measured in both groups. The results showed that PCOS induction dramatically increased FG, FI, IR indices, and mTOR-related gene expression; however, different Zn supplementation concentrations, especially at 75mg/kg, reduced the effects of PCOS induction. Organic Zn collectively exerted positive effects on Estradiol Valerate (EV)-induced PCOS rats by reducing IR and mTOR signaling gene (i.e., Raptor and Rictor) expression. Moreover, this study revealed a correlation between Zn and IR. Therefore, Zn supplementation could be a valuable therapeutic method for treating PCOS.

Correlation between melatonin and vitamin D3 deficiency in Iraqi female patients with polycystic ovarian syndrome

Polycystic ovary syndrome (PCOS) is the most common hyperandrogenic disorder in women and one of the leading causes of anovulatory infertility. Depletion of vital hormones in the organism, such as in the case of PCOS, has been identified as one factor contributing to poor pregnancy outcomes and associated issues in women. Vitamin D level in PCOS patients regulates fertility through membrane-bound receptors in oocytes, regulating luteinizing hormone (LH), and progesterone surges.The objective. To examine the correlation between melatonin and vitamin D3 deficiency in Iraqi pregnant women with PCOS under the age of 40.Material and methods. Two hundred women were recruited for the study and divided into two groups: patients with PCOS (n=100) and healthy females without PCOS (n=100). All participants were administered medical questionnaires, and their body mass index (BMI) was determined. Blood samples from participants were obtained for biochemical analysis to assess follicle-stimulating hormone (FSH), luteinizing hormone (LH), anti-Müllerian hormone (AMH), melatonin, and vitamin D levels.Results. The results revealed that 65% of PCOS patients were between 20 and 30 years old and healthy control persons did not show any variations based on age. Patients with PCOS had significantly (p<0.001) higher levels of LH and FSH (1.98±0.07 nmol/mL and 11.15±0.25 mIU/L, respectively) compared with healthy controls (1.06±0.02 nmol/mL and 6.67±0.25 mIU/L, respectively). The PCOS group had significantly (p≤0.01) reduced mean vitamin D3 level related to the control group. There was no significant correlation between vitamin D3 and melatonin levels in the PCOS group. The study showed that BMI was significantly higher in women with PCOS compared to healthy women. The study also found a positive relationship between BMI and AMH concentration, as well as between FSH and vitamin D3 levels in women with PCOS. However, there was no association between vitamin D3 and melatonin or BMI. Conclusion: The study found that D3 deficiency is a significant component in female PCOS patients that might be a new biomarker for PCOS in Iraqi women.

Fasting GLP-1 Levels in Women with PCOS and CAH

Abstract Background Polycystic ovarian syndrome (PCOS) is the most prevalent condition associated with increased androgens, but some rare diseases, e.g., congenital adrenal hyperplasia (CAH), should also be considered in the differential diagnosis of hyperandrogenemia. The potential role of incretin hormones has been thoroughly studied in different metabolic conditions, but data about women with PCOS and CAH are insufficient. Aims Therefore, the present study aims to investigate the fasting GLP-1 levels in women with PCOS and CAH compared to healthy women and to establish the possible associations with the ovarian and adrenal androgens, obesity, and hyperinsulinemia in these conditions. Methods Fasting GLP-1 levels were measured in 47 women with PCOS, 11 CAH patients, and 26 healthy volunteers. The associations between the GLP-1, metabolic, and hormonal characteristics in the investigated groups have been studied. Results GLP-1 levels did not differ between healthy women and patients with PCOS but were significantly higher in CAH patients (p = 0.025). CAH patients were similarly obese as PCOS women, but they showed increased testosterone (p = 0.009), 11-ketotestosterone (p = 0.046), 17-OH-progesterone (p < 0.001), and insulin levels (p = 0.043), and lower luteinizing hormone (p = 0.002) and dehydroepiandrosterone-sulfate levels (p = 0.004). In the PCOS group, the fasting GLP-1 levels were positively related to BMI (r = +0.327; p = 0.024) but not to other hormonal or metabolic indices. Conclusions Our results show increased fasting GLP-1 and insulin levels in CAH individuals compared with PCOS patients but similar fasting GLP-1 levels in PCOS and healthy women. Further studies are necessary to clarify the incretin effects and the role of incretin-based therapy in women with different hyperandrogenic states and increased metabolic risk.

CORRELATION OF LEPTIN AND ADIPONECTIN LEVELS WITH METABOLIC AND HORMONAL PROFILES IN PCOS PATIENTS: A COMPARATIVE STUDY WITH NORMAL CONTROLS

Objective: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder characterized by metabolic and reproductive abnormalities, including insulin resistance and hyperandrogenism. Leptin and adiponectin, two adipokines involved in metabolic regulation, are known to be dysregulated in PCOS. This study aims to investigate the correlation between leptin and adiponectin levels and their association with metabolic and hormonal profiles in PCOS patients compared to healthy controls. Methods: A prospective, observational study was conducted involving 120 women diagnosed with PCOS and 50 healthy controls. Leptin and adiponectin levels were measured using enzyme-linked immunosorbent assay (ELISA). The adiponectin-to-leptin ratio (ALR) was calculated, and correlations with BMI, LH/FSH ratio, and other metabolic parameters were analyzed. Data were analyzed using appropriate statistical methods. Results: Leptin levels were significantly higher in the PCOS group compared to controls (25.34 ng/ml vs. 11.16 ng/ml, p<0.0001), while adiponectin levels were significantly lower (2.93 mcg/ml vs. 21.44 mcg/ml, p<0.0001). The adiponectin-to-leptin ratio was markedly reduced in PCOS patients (0.13 vs. 2.05, p<0.0001). A significant correlation was observed between the adiponectin/leptin ratio and the LH/FSH ratio (r = 0.2138, p = 0.019). Conclusion: This study highlights the dysregulation of leptin and adiponectin in PCOS, suggesting their potential role in metabolic and reproductive dysfunction. The adiponectin-to-leptin ratio emerges as a promising biomarker for insulin resistance and metabolic risk in PCOS patients.

Visfatin and VEGF levels are not increased in adolescent girls with polycystic ovary syndrome.

PCOS is one of the most commonly occurring endocrinopathies among women and increasingly affects adolescent populations. The connection between PCOS and various endocrinological, psychological, and CVD is increasingly recognized. Some studies have shown elevated levels of visfatin and VEGF among patients with PCOS, which are markers of vascular endothelial dysfunction. In our study, we evaluated the concentration of these parameters, focusing solely on a group of adolescents with PCOS, to assess whether these early markers of CVD are present at an early stage of diagnosis. In total, 80 adolescent girls participated in the study. 47 adolescents diagnosed with PCOS were included in the study group (mean age 15.68 ± 1.18 years, BMI 26.66 ± 6.41 kg/m2), while the remaining 33 regularly menstruating individuals (mean age 15.79 ± 1.22 years, BMI 25.44 ± 7.24 kg/m2) were assigned to the control group. Each participant underwent imaging, biochemical, and hormonal tests. Additionally, markers of endothelial dysfunction: VEGF and visfatin, were measured in all adolescents. Both VEGF and visfatin levels did not differ significantly between PCOS and control group (p=0.30 and p=0.15, respectively). In the group of adolescent girls with PCOS, visfatin was significantly correlated with HDL, FSH, cortisol, and testosterone levels >55 ng/dl. VEGF was significantly correlated with fasting glucose, glucose levels after OGTT, estradiol, and waist circumference >80 cm. It can be indirectly inferred that both visfatin and VEGF should not be used as early markers for cardiometabolic complications among adolescent patients with PCOS. On the other hand, low visfatin levels, through their negative correlation with HDL, may have a protective effect on cardiovascular complications, while low VEGF levels, through their positive correlation with glucose levels, may have a protective influence on carbohydrate metabolism disorders.

Women With Polycystic Ovary Syndrome and Excess Body Fat Exhibit Atypical Sympathetic Autonomic Modulation That is Partially Reversed by Aerobic Physical Training.

The aetiology of impairments in autonomic modulation of heart rate variability (HRV) in polycystic ovary syndrome (PCOS) remains unclear, as does the impact of aerobic physical training (APT) on controlling endocrine-metabolic disorders and HRV. This is because these women often present excess body fat. Therefore, we assessed whether the dysregulation in autonomic modulation of HRV in women with PCOS is due to endocrine-metabolic disorders and whether the combination of excess body fat with endocrine-metabolic disorders amplifies cardiovascular autonomic deficits. We also investigated whether APT positively influences autonomic modulation of HRV in PCOS. Non-randomised clinical trial. Women with and without PCOS with different percentages of body fat. Participants were divided into four groups: women without PCOS with a body fat percentage between 22% and 29% (CONTROL group; 22%-29%); CONTROL (30%-37%) group; PCOS (22%-29%) group; and PCOS (30%-37%) group. Hemodynamic, metabolic, and hormonal characteristics and HRV parameters were obtained before and after 16 weeks of APT. The PCOS (22%-29%) group exhibited lower vagal modulation than the CONTROL (22%-29%) group. In contrast, no significant differences were observed between the CONTROL (30%-37%) and PCOS (30%-37%) groups. Furthermore, the PCOS (30%-37%) group demonstrated lower sympathetic modulation than the PCOS (22%-29%) group. After APT, the PCOS (22%-29%) group increased in vagal modulation, while the PCOS (30%-37%) group increased in sympathetic modulation. PCOS affects vagal modulation; however, this effect may be masked at elevated levels of body fat. Additionally, the combination of excess body fat with endocrine-metabolic dysregulation appears to reduce sympathetic modulation, possibly due to sympathetic drive hyperactivity. APT positively affected HRV in both PCOS groups.

Carotid artery intima-media thickness in women with polycystic ovary syndrome: A cross-sectional study.

Obesity in polycystic ovary syndrome (PCOS) may increase the risk of cardiovascular disease. Carotid intima-media thickness (CIMT) is an acceptable marker in assessing the risk of heart disease. This study aimed to evaluate the CIMT in PCOS women compared to non-PCOS women. This cross-sectional study was conducted on 48 women who referred to Imam Reza hospital, Kermanshah, Iran from July 2020-2021. Women were divided into 2 groups of PCOS and non-PCOS women (n = 24/each). The intima-media thickness of participants' carotid artery was measured on both sides in 3 areas, and its mean was recorded. The mean thickness of the carotid artery intima-media in the case group was within the normal range; but it was significantly higher than the control group (0.71 0.17 vs. 0.57 0.09 mm, p = 0.019). Considering the higher thickness of CIMT in women with PCOS, it can be concluded that PCOS increases the risk of heart diseases in women.

Vitamin D has therapeutic effects on obesity and hyperandrogenemia in PCOS mouse model induced by low dose DHEA and high-fat diet

Polycystic ovary syndrome (PCOS) is the most complex and common reproductive endocrine disease among reproductive age women. This study aimed to investigate the effects of vitamin D (Vit.D) in a PCOS mouse model induced by low dose DHEA and high-fat diet. Prepubertal female mice were divided into 4 groups randomly: control, PCOS, PCOS with low dose Vit.D(LDVD), and PCOS with high dose Vit.D(HDVD) groups (n = 10 per group). PCOS mice were administrated with high-fat diet and subcutaneous injection with 6 mg/kg/day dehydroepiandrosterone throughout the study. After the first 30 days, 1,25(OH)2D3 was intend to be administered by intraperitoneal injection for 40 consecutive days, 1.3 µg/kg/week in LDVD group, and 13 µg/kg /week in HDVD group. However, the mice in HDVD group appeared to be fatigue and anorexic after the Vit.D injections, then all died within two weeks. The body weights and testosterone levels in PCOS group were significantly higher than those in the control and LDVD groups (P < 0.001). The total cholesterol levels in the control group were lower than those in PCOS and LDVD groups (P < 0.001). Further, the ratio of liver to body weight was different among groups (P < 0.001). Our data illustrates that Vit.D has therapeutic effects on obesity and hyperandrogenemia in PCOS mouse model induced by low dose DHEA and high-fat diet. However, over dose of Vit.D is toxic. Further researches are needed to elucidate the mechanisms.

Utilizing follicular fluid on endometrial stromal cells enhances decidualization by induced inflammation.

Polycystic ovary syndrome (PCOS) is a disease associated with inflammation and the follicular fluid of this patient contains proinflammatory cytokines. Abdominal obesity (AO) is also linked to increased levels of proinflammatory cytokines. This study investigated the induction of inflammation and decidualization of in vitro cultured endometrial stromal cells (ESCs) obtained from women with a normal uterus using the follicular fluid of PCOS and non-PCOS patients with or without abdominal obesity. Forty patients under 35 years old, referred to the Royan Institute, were divided into four groups: PCOS with AO, PCOS without AO, non-PCOS with AO, and non-PCOS without AO. Follicular fluid samples were added to the culture medium of ESCs for each group. The rate of decidualization was measured by examining decidual markers. The study also investigated morphological changes in uterine endometrial cells, cell migration rates, and gene expression across all groups. We found that the non-PCOS group without AO had the highest decidualization potential and the highest expression of decidualization markers (P ≤ 0.05). Groups with an inflammatory phenotype of PCOS or abdominal obesity showed the highest expression of decidual pathway markers. The expression levels of inflammatory and proliferative markers in the PCOS group with AO were significantly higher than in the other groups (P ≤ 0.05). The inflammatory profile present in the follicular fluid may trigger the decidualization process. Consequently, in the future, follicular fluid could be utilized as a natural supplement with human cells to promote decidualization and enhance endometrial receptivity in assisted reproductive technology.

Effects of carvacrol on hormonal, inflammatory, antioxidant changes, and ovarian reserve in polycystic ovary syndrome in Wistar rats.

The study, which explored the effects of carvacrol on female reproductive health, particularly in terms of hormonal, inflammatory, antioxidant, and ovarian reserves in polycystic ovary syndrome, could significantly influence future treatments and clinical practice. The study, conducted on thirty-five female Wistar albino rats, was designed to mimic the conditions of polycystic ovary syndrome in humans. The rats were randomly assigned into five groups: control (C), vehicle (V), polycystic ovary syndrome (PCOS), carvacrol (CAR), and polycystic ovary syndrome+ carvacrol (PCOS + CAR). The following practices were applied to the groups during the study. Normal saline was administered to the C group, DMSO to the V group, letrozole (1mg/kg/day) to the PCOS group, carvacrol (20mg/kg) to the CAR group, and letrozole and carvacrol together to the PCOS + CAR group for twenty-one days. At the end of the administration, blood, and ovarian samples were taken for hormone analysis (E2, and AMH), inflammatory (TNF-α, IL-6), oxidant-antioxidant analysis (malondialdehyde (MDA), glutathione (GSH), glutathione peroxidase (GSH-Px), and catalase), and histopathological examinations. Ovary, and body weights were measured, and the ovary index was calculated. As a result, it was observed that carvacrol caused beneficial effects through inflammatory, and antioxidant mechanisms in PCOS.

Serum Selenium Levels and Their Relationship with Insulin Resistance in Individuals with Polycystic Ovary Syndrome.

Growing evidence indicates a potential link between polycystic ovary syndrome (PCOS) and selenium (Se) levels. This study aims to assess Se concentrations in Saudi women with and without PCOS and to explore the relationships between Se levels, insulin resistance (IR), adiponectin, and lipid markers. We randomly recruited 197 women aged 18 to 40, both with and without PCOS, for this age-matched case-control study. The PCOS participants were categorized into three groups based on their Se levels. All participants underwent interviews, and their anthropometric measurements and blood samples were collected for further analysis of biochemical variables. There was a notable difference between the two groups studied across all biochemical variables. Specifically, fasting blood glucose, insulin, the homeostasis model assessment (HOMA-IR) index, total cholesterol, low-density lipoprotein cholesterol, and triglycerides were significantly higher in the PCOS group compared to the control group (p < 0.01). Conversely, Se, high-density lipoprotein cholesterol, and adiponectin levels were significantly lower in women with PCOS than in their age-matched controls (p < 0.01). HOMA-IR was identified as the sole independent predictor of serum Se levels, explaining 17.2% of the variability in its circulating levels (β = - 0.57; 95% CI: - 0.96 to - 0.18, p = 0.004). The findings reveal that women with PCOS have lower serum Se levels compared to the controls. Furthermore, the results confirm a correlation between Se levels and insulin resistance.

Proteomic Analysis of Follicular Fluid in Polycystic Ovary Syndrome: Insights into Protein Composition and Metabolic Pathway Alterations.

This study explores the proteomic composition of follicular fluid (FF) from women undergoing oocyte retrieval for in vitro fertilisation (IVF), with a focus on the effects of polycystic ovary syndrome (PCOS). FF samples were collected from 74 patients, including 34 with PCOS and 40 oocyte donors. Proteomic profiling using machine learning identified significant differences in protein abundance between the PCOS and control groups. Of the 484 quantified proteins, 20 showed significantly altered levels in the PCOS group. Functional annotation and pathway enrichment analysis pointed to the involvement of protease inhibitors and immune-related proteins in the pathophysiology of PCOS, suggesting that inflammation and immune dysregulation may play a key role. Additionally, HDL assembly was identified as a significant pathway, with apolipoprotein-AI (APOA1) and alpha-2-macroglobulin (A2M) as the major proteins involved. Notably, myosin light polypeptide 6 was the most downregulated protein, showing the highest absolute fold change, and may serve as a novel independent biomarker for PCOS.

Association between QTc and Poincare plot in polycystic ovary syndrome in young adolescents: A cross-sectional study

ABSTRACT Context: PCOS is one of the most neglected noncommunicable diseases, and early detection would be of great value to primary care physicians. Sympathovagal imbalance detected using heart rate variability (HRV) can be used to detect early autonomic changes if any. Aim: The present study aimed to evaluate QTc and Poincare plot (nonlinear analysis of HRV) in young adolescent PCOS patients. Materials and Methods: It was a cross-sectional study involving 25 PCOS and 25 healthy individuals of age group 12–18 years. HRV was evaluated using the lead II ECG for 10 min from which QTc was calculated manually using the Bazett formula. Student’s t-test was used to assess differences between means. A P value &lt; 0.05 was taken for statistical significance. The association between QTc and Poincare plot descriptors was assessed by Pearson’s correlation analysis. Results: HRV linear analysis domain represented as the LF/HF ratio was reported to significantly increased among the PCOS group (P = 0.04). Similarly, the nonlinear analysis of HRV by Poincare plot reported a significant decrease in SD1 (P = 0.04) and SD2 (P = 0.02). The heart rate was significantly increased among the PCOS group (P &lt; 0.001). QTc did not show any significant increase among the PCOS group (P = 0.09). QTc was reported to be positively correlated with SD1 (r = 0.37, P &lt; 0.01), SD2 (r-0.33, P = 0.02), LF HF ratio (r = 0.52, P &lt; 0.001), and BMI (r = 0.92, P &lt; 0.001), respectively. Conclusion: The study suggests that HRV nonlinear analysis can be used as a simple noninvasive tool to evaluate cardiovascular autonomic changes.

Angiotensin-converting-enzyme gene insertion-deletion polymorphism and renin angiotensin aldosterone system activity in different phenotypes of polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a common condition. Its pathophysiology involves an interaction between genetic and environmental factors, resulting in different reproductive and metabolic subtypes. Genetic variation in the angiotensin converting enzyme (ACE) gene has been implicated in the pathophysiology of the syndrome. Our project aims to investigate the relationship between the ACE I/D (insertion/deletion) polymorphism and circulating levels of ACE activity, renin and aldosterone in PCOS. Patients and methodsPCOS and healthy donors were enrolled over 2 years. The Rotterdam criteria were used to segregate 4 phenotypes. Enrolled controls were matched to PCOS patients for body mass index. Clinical data were recorded and blood samples were taken for analysis of ACE I/D polymorphism and biochemical parameters. Hardy-Weinberg equilibrium evaluation, mean/median comparison and Spearman correlation were performed. ResultsA total of 102 women with PCOS and 107 controls were involved in the study. The most common polymorphism was ID, both in the control and PCOS groups. Renin levels in PCOS patients were positively correlated with luteinizing hormone (LH) and anti-mullerian hormone (AMH) in the ID genotype and with testosterone, free androgen index and insulin in the DD genotype. ConclusionThe ACE I/D variation may influence the pathophysiology of PCOS subtypes, together with an indirect relationship with renin. Our findings may provide valuable therapeutic insights into the management of PCOS, particularly regarding the potential need for ACE inhibitors or renin inhibitors tailored to ACE gene I/D genotypes or specific subtypes.

Gut microbiota in women with polycystic ovary syndrome: an individual based analysis of publicly available data

Polycystic ovary syndrome (PCOS) represents a prevalent endocrine disorder affecting numerous females worldwide. Dysbiosis of gut microbiota has been linked to the occurrence of PCOS; however, research into the characteristics of gut microbiota in PCOS patients, especially those from different regions and with different testosterone level, remains limited. Additionally, it is still unclear whether gut microbiota helps to distinguish different PCOS subtypes. We searched four electronic databases (PubMed, Web of Science, Cochrane Library, and ClinicalTrials.gov) from Jan 1, 2010 to May 1, 2024. This combined analysis included studies providing the raw data of gut microbiota in PCOS patients. We reanalyzed the characteristics of gut microbiota in PCOS patients from different regions and with different testosterone level. Fourteen publications satisfying the inclusion criteria were included in the combined analysis. Based on data from 948 individuals, we found alpha-diversity was not significantly different between PCOS and healthy control (HC) groups. However, gut microbiota composition was distinct in PCOS patients compared with healthy individuals. Specifically, Fusobacterium, Ruminococcus_gnavus_group, and Escherichia-Shigella increased, while Dysosmobacter, Schaedlerella, Merdimonas, Clostridiisalibacter, Flintibacter etal. decreased in PCOS women. Regionally, Alistipes was enriched in primarily European patients, while Blautia and Roseburia were more abundant in Chinese patients. Subtype analysis revealed that the gut microbiota of PCOS patients with higher testosterone level (PCOS-HT) differed significantly from those with lower testosterone level (PCOS-LT). Prevotella, Blautia, Dialister, Ruminococcus_torques_group and UCG-002 were enhanced in PCOS-HT patients, while Alistipes, Dysosmobacter, Phocaeicola and Faecalibacterium were diminished. Importantly, a set of eight genera effectively differentiated PCOS-HT patients from PCOS-LT patients with an AUC of 0.95. This systematic anatomization of gut microbiota revealed the microbial characteristics of PCOS patients, particularly those with different testosterone level, thus laying the foundations for further research into pathogenesis of PCOS, and the development of effective diagnostic, treatment, and intervention strategies. This work was supported by the National Natural Science Foundation of China (No. 81973217, 82260304), the Hainan Province Clinical Medical Center (QWYH202175), and the Specific Research Fund of The Innovation Platform for Academicians of Hainan Province (YSPTZX202311).

Does Prevalence of Female Sexual Dysfunction Differ among Infertile Patients with or without Polycystic Ovary Syndrome: A Cross-Sectional Study.

While the effects of polycystic ovary syndrome (PCOS) and infertility on women's health have often been discussed, not many studies have assessed the other complications of infertility. One of these complications is female sexual dysfunction (FSD), a range of psychosexual disorders. The aim of this study is to investigate the prevalence of FSD in PCOS and its comparison with other causes of infertility. In this cross-sectional study, two questionnaires were filled out by two groups (60 people each) of infertile patients, due to PCOS and other causes, referred to Arash Women's Hospital from December 2018 to 2019. The data was analyzed in SPSS software to evaluate the frequency of FSD in the whole study population and each group separately as well as its relationship with age, history of pregnancy, the literacy level of the patient or spouse, body mass index (BMI), infertility duration, hirsutism, and acne. The frequency of FSD in the study group had a significant inverse relationship with the women's level of education (P=0.044), although no such correlation was found with age, pregnancy history, spouse's literacy level, BMI, duration of infertility, acne, and hirsutism. In the comparison group, there was a significant relationship between the duration of infertility and FSD (P=0.002). The prevalence of FSD in the study and comparison groups was 43.1 and 52%, respectively. The prevalence of FSD sub-domains in all categories, except for pain, was higher in the study group. PCOS, compared to other groups, presented at a relatively younger age. In the PCOS group, patients with lower education levels were more likely to suffer from FSD. This suggests the effect of education and awareness on the sexual performance of these people. No significant difference in FSD experience was found between PCOS and other groups.

Evaluation of the Effects of Naringenin on the Hypothalamic mRNA Levels of nesfatin-1 and CRH in a Rat Model of PCOS

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder and a leading cause of infertility in women. Studies suggest that naringenin may improve ovarian function; however, its molecular mechanism within the hypothalamus-pituitary-gonad (HPG) axis remains unclear. Objectives: This study investigated the role of naringenin on the expression of corticotropin-releasing hormone (CRH) and nesfatin-1 genes in the hypothalamus of PCOS rats. Methods: Twenty rats, each weighing 180 - 200 g, were divided into four groups (n = 5). Polycystic ovary syndrome was induced by administering estradiol valerate (2 mg per rat). The control and PCOS groups received saline, while the other two PCOS groups received intraperitoneal injections of naringenin at doses of 20 and 50 mg/kg for 14 days. Hypothalamic samples were collected to measure gene expression via real-time PCR. Results: The PCOS group showed a significant decrease in CRH and nesfatin-1 gene expression compared to the control group (P ≤ 0.05). Naringenin treatment significantly increased the expression of CRH and nesfatin-1 genes in comparison to the PCOS group (P ≤ 0.05). Conclusions: Naringenin appears to have therapeutic potential in improving ovarian function in PCOS. Its effects are mediated through up-regulation of hypothalamic neuropeptides upstream of GnRH neurons.