Efficacy of sex hormone-binding globulin on predicting metabolic syndrome in newly diagnosed and untreated patients with polycystic ovary syndrome
- 作者列表："Fu, Chen","Minjie, Chen","Weichun, Zhang","Huihuang, Yin","Guishan, Chen","Qingxia, Huang","Xiaoping, Yang","Lan, Chen","Ping, Wang","Chujia, Lin","Guoshu, Yin
Purpose The aims of this study were to investigate the correlation of sex hormone-binding globulin (SHBG) and the components of metabolic syndrome (MetS) and explore the ability of SHBG to predict MetS in newly diagnosed and untreated patients with polycystic ovary syndrome (PCOS). Methods Ninety-eight newly diagnosed and untreated patients with PCOS and 37 healthy volunteers were recruited. A receiver operating characteristic (ROC) curve was used to explore the best cutoff values of SHBG for predicting that the patients with PCOS would fulfill at least one abnormal index of MetS components, at least two abnormal indexes of MetS components, or MetS. Results The numbers of patients with PCOS who fulfilled none, one, or two of the MetS criteria items and MetS were 33, 31, 19, and 15, respectively. SHBG was negatively correlated with BMI ( r = − 0.615, P < 0.001), systolic blood pressure (SBP) ( r = − 0371, P < 0.001), diastolic blood pressure (DBP) ( r = − 0.285, P = 0.004), triglycerides (TG) ( r = − 0.431, P < 0.001), fasting serum insulin (I_0) ( r = − 0.549, P < 0.001), HOMA-IR ( r = − 0.557, P < 0.001), and plasma glucose 2 h after glucose load (G_120) ( r = − 0.337, P < 0.001) and positively correlated with high-density lipoprotein cholesterol (HDL-C) ( r = 0.629, P < 0.001) in patients with PCOS. The optimal cutoff value of SHBG for predicting MetS in patients with PCOS was 21.3 nmol/L, with a sensitivity of 100.0% (95% CI 78.0–100.0%) and specificity of 85.12% (95% CI 77.5–90.9%). Conclusions Sixty-five patients had varying degrees of metabolic abnormalities, accounting for 66.3% of the patients with PCOS. SHBG was associated with metabolic indexes, including BMI, SBP, DBP, TG, I_0, HOMA-IR, G_120, and HDL-C, and can therefore be employed as a useful index for MetS prediction.
目的: 本研究旨在探讨性激素结合球蛋白 (SHBG) 与代谢综合征 (MetS) 组分的相关性。并探讨 SHBG 对新诊断和未治疗的多囊卵巢综合征 (PCOS) 患者 MetS 的预测能力。方法招募 98 例新诊断和未治疗的 PCOS 患者和 37 例健康志愿者。采用受试者工作特征 (ROC) 曲线探索 SHBG 预测 PCOS 患者至少满足 MetS 组分一项异常指标的最佳截断值。metS 成分至少两项异常指标，或 MetS。结果符合 MetS 标准项目中无 1 项、 1 项或 2 项和 MetS 的 PCOS 患者分别为 33 、 31 、 19 和 15 例。SHBG 与 BMI ( r =-0.615，P <0.001) 、收缩压 (SBP) ( r =-0371，P <0.001) 呈负相关,舒张压 (DBP) ( r =-0.285，P = 0.004)，甘油三酯 (TG) ( r =-0.431，P <0.001),空腹血清胰岛素 (I_0) ( r =-0.549,P <0.001) 、 HOMA-IR ( r =-0.557，P <0.001) 和葡萄糖负荷后 2 h 血浆葡萄糖 (G_120) ( r =-0.337，P <0.001)，与高密度脂蛋白胆固醇 (HDL-C) 呈正相关 (r = 0.629，P <0.001) 在 PCOS 患者中。SHBG 预测 PCOS 患者 MetS 的最佳截断值为 21.3 nmol/L，敏感性为 100.0% (95% CI 78.0-100.0%) 和特异性为 85.12% (95% CI 77.5-90.9%)。结论 65 例患者存在不同程度的代谢异常，占 PCOS 患者的 66.3%。SHBG 与代谢指标相关，包括 BMI 、 SBP 、 DBP 、 TG 、 I_0 、 HOMA-IR 、 G_120 和 HDL-C,因此可以用作 MetS 预测的有用指标。
METHODS:Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder amongst women of reproductive age, whose aetiology remains unclear. To improve our understanding of the molecular mechanisms underlying the disease, we conducted a genome-wide DNA methylation profiling in granulosa lutein cells collected from 16 women suffering from PCOS, in comparison to 16 healthy controls. Samples were collected by follicular aspiration during routine egg collection for IVF treatment. Study groups were matched for age and BMI, did not suffer from other disease and were not taking confounding medication. Comparing women with polycystic versus normal ovarian morphology, after correcting for multiple comparisons, we identified 106 differentially methylated CpG sites with p-values <5.8 × 10 that were associated with 88 genes, several of which are known to relate either to PCOS or to ovarian function. Replication and validation of the experiment was done using pyrosequencing to analyse six of the identified differentially methylated sites. Pathway analysis indicated potential disruption in canonical pathways and gene networks that are, amongst other, associated with cancer, cardiogenesis, Hedgehog signalling and immune response. In conclusion, these novel findings indicate that women with PCOS display epigenetic changes in ovarian granulosa cells that may be associated with the heterogeneity of the disorder.
METHODS::Introduction: Approximately 1% of adolescents have polycystic ovary syndrome (PCOS) and almost 40-70% of these patients are overweight or obese. Obese adolescents with PCOS have more severe insulin resistance and hyperandrogenemia, a more adverse lipid profile and a worse quality of life than normal-weight adolescents with PCOS. Accordingly, weight loss is an important component of the management of these patients.Areas covered: The authors discuss the different options for weight loss in obese adolescents with PCOS. Lifestyle changes appear to be effective but adherence to this intervention is suboptimal. There are also limited data regarding the optimal diet in this population. Few small studies have evaluated the effects of pharmacotherapy in these patients. Conflicting data have been reported regarding the effects of metformin on body weight. Notably, agents that have been approved for weight loss in adults have not been evaluated in adolescents with PCOS.Expert opinion: More studies are needed to identify the most appropriate diet for obese adolescents with PCOS. Well-designed randomized controlled studies are also needed to define the safety and efficacy of pharmacotherapy in this population.
METHODS::Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Although much is understood concerning the pathology of PCOS, further investigation into the influence of microribonucleic acids (miRNAs) on the proliferation of ovarian granulosa cells (GCs) is needed. This study investigated the role of specific miRNAs in ovarian dysfunction of PCOS and its effect on the proliferation of GCs. Initially, miRNA profiling was performed on the ovarian cortexes of 15 rats in which PCOS had been induced and 15 rats without PCOS (non-PCOS). This mechanical study was performed on ovarian GCs extracted from human chorionic gonadotrophin (hCG)-induced rats. Insulin was used to treat GCs to establish the PCOS cell model. Increased Equus caballus mir-9119 expression was observed and confirmed in the insulin-induced model of PCOS in GCs (GC-PCOS) as well as in the hCG-induced rats when compared to non-PCOS rats and cells. Observation and confirmation were carried out through both miRNA array and quantitative PCR. In contrast, downregulation of the nuclear factor kappa B (NFκB) p65 was observed in the PCOS cell model. Additionally, annexin V, FITC, and propidium iodide flow cytometry showed overexpression of miR-9119-induced apoptosis. In this study, we revealed that miR-9119 inhibition regulates p65 expression levels in insulin-treated GCs by binding to the 3'-untranslated of p65. Additionally, regulation of p65 expression was positively correlated with the expression of the double-stranded RNA endoribonuclease DICER. Moreover, RNA silencing/overexpression of p65 affected the functional role of miR-9119. In conclusion, GCs of PCOS, the expression of miR-9119, and targeted NFκB/p65-DICER axis are upregulated in order to maintain cell viability and prevent apoptosis, thereby promoting Anti-Müllerian hormone production in GCs. This study may provide a new understanding of the mechanism of GC dysfunction.