| Annotation |
Polycystic ovary syndrome (PCOS) is associated with hyperandrogenism, abdominal obesity, dyslipidemia, hyperinsulinemia, insulin resistance. The investigators assumed that the high levels of homocysteine are as the result by metabolic disorders, hyperandrogenism and leads to endothelial dysfunction, high levels of endotelin-1. There are disputable data of the increased concentration of homocysteine in serum at women with PCOS in the scientific literature.
OBJECTIVE. To determine the levels of homocysteine at young women with PCOS and estimate the relationship of homocysteine and hormonal parameters, metabolic parameters and levels of endothelin-1.
METHODS. We examined 65 patients (age 26.1±0.2 years) with PCOS and 15 healthy women with a normal menstrual function. All patients with PCOS were divided into two groups: first group – 45 women with a normal body mass index (21,4±0,3 kg/m2), second group – 20 women with obesity (28,8±0,7 kg/m2). The basal levels of total testosterone (T), estradiol (E2), endothelin-1, homocysteine, insulin and index HOMA were investigated at all women.
RESULT(S).The results indicate that 51.5% women with PCOS have high levels of homocysteine (103.7±0.4 mmol / l) in the blood serum.
It was established that the frequency of hyperhomocysteinemia in patients with PCOS, independent of body weight (χ2 = 1.2; p> 0.05), HOMA index (χ2 = 0.07; p> 0.05), insulin levels (χ2 = 1.07; p>0.05), T levels (χ2 = 1.23; p>0.05), E2 levels (χ2 = 0.96; p>0.05).
It has been proved that the content of ET-1 in the serum of young women with PCOS (2,29 ± 0,2 fmol/ml) is much higher than the average healthy women (0,83±0,2 fmol/ml; p>0.05). It has been found that the frequency of the of high level of ET-1 at women with PCOS with presence of hyperhomocysteinemia is increas than at patients with normal level of homocysteine.
The results indicate that hyperhomocysteinemia is an independent risk factor for the formation of endothelial dysfunction and may contribute to remote complications of the disease.
Screening of hyperhomocysteinemia at a young age can be a useful indicator of hidden disorders of endothelial function and diseases of the reproductive system.
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| Bibliography |
- Beljakov N. A. Metabolicheskij sindrom u zhenshhin / N. A. Beljakov, G. B. Seidova, S. Ju. Chubrieva [i dr.] // – SPb.: Izdatel'skij dom SPbMAPO, - 2005.– 440 s.
- Grodnickaja E. Je. Folacin v kompleksnoj pregravidarnoj podgotovke u zhenshhin s gipergomocisteinemiej i privychnym nevynashivaniem beremennosti / E. Je. Grodnickaja, M. A. Kurcer, M. B. Shamanova // Problemy reprodukcii. – 2008. – Tom 6, № 14. – S. 84 – 86.
- Kushakov A. Insulinorezistentnost' i jendotelial'naja disfunkcija pri metabolicheskom sindrome / A. Kushakov, R. Sajfutdinov, L. Anginova [i dr.] // Kazanskij medicinskij zhurnal. – 2011. – T. 92, № 2. – S. 173 – 176.
- Korpacheva-Zіnich O. V. Statevі osoblivostі gomocisteїnemії u hvorih na cukrovij dіabet 2 tipu v zalezhnostі vіd іnsulіnemії ta androgennogo zabezpechennja (ogljad lіteraturi ta vlasnі danі) / O. V. Korpacheva-Zіnich, M. D. Halangot // Problemi endokrinnoї patologії. – 2010. – № 2. S. 103 – 111.
- Manuhin I. B. Anovuljacija i insulinorezistentnost' / I. B. Manuhin, M. A. Gevorkjan, N. B. Chagaj // – M.: GJeOTAR-Media, - 2006. – 416 s.
- Reznikov A. G. Rol' aktivnyh soedinenij folievoj kisloty pri ispol'zovanii kombinirovannyh oral'nyh kontraceptivov / A. G. Reznikov // Reproduktivnaja jendokrinologija. – 2012. – Tom 2, № 4. – S. 48 – 51.
- Grechanіna O. Ja. Spadkovі porushennja obmіnu amіnokislot: metod. rekomendacії M-vo ohoroni zdorov’ja Ukraїni / O. Ja. Grechanіna, O. P. Zdibs'ka, Ju. B. Grechanіna [i dr.] // – H., - 2013. – 112 s.
- Chernuha G.E. Sindrom polikistoznyh jaichnikov kak faktor riska formirovanija jendotelial'noj disfunkcii jaichnikov / G. E. Chernuha, I. B. Blinova, T. V. Balahonova // Problemy reprodukcii – 2008. – T.14, № 2. – S. 40 – 44.
- Shmeleva V. M. Znachenie gomocisteina v patogeneze tromboza i ateroskleroza / V. M. Shmeleva // – Uchebnye zapiski SPb.: GMU im. akad. I.P. Pavlova. – 2004. – T. HІ, № 3 (prilozhenie). – S. 25 – 31.
- Azziz R. Criterial for Defining Polycystic Ovary Syndrome as a Predominantly Hyperandrogenic Syndrome: An Androgen Excess Society / R. Azziz, E. Carmini, D. Dewailly [et al.] // Guideline. – 2006. – Vol.9, № 11. – R. 4237 – 4245.
- Balletshofer B.M. Endothelial dysfunction is detectable in young normotensive first-degree relatives of subjects with type 2 diabetes in association with insulin resistance / B. M. Balletshofer, K. Rittig, M. D. Enderle // Circulation – 2000. – Vol. 101, № 15. – P. 1780 – 1784.
- Byractar F. Plasma homocysteine levels in polycystic ovary syndrome and congenital adrenal hyperplasia / F. Byractar, D. Dereli, A. G. Ozgen [et al.] // Endocrin. J. – 2004. – Vol. 51, № 6. – R. 601 – 608.
- Bednarek-Tupikowska G. The effect of estrogen deficiency, estrogen and estro-progestagene therapy on total plasma homocysteine and serum lipid peroxide levels in postmenopausal women / G. Bednarek-Tupikowska, K. Tupikowski, B. Bidzinska [et al.] // Ginecol. Pol. – 2005. – Vol.76, № 9. – P. 687 – 692.
- Badaway A. Plasma homocystein and polycystic ovary syndrome: The missed link / A. Badaway, O. State, F. Gavad // Eur. J. Obstet. Gynecol. Reprod. Biol. – 2007. – Vol. 131, № 1. – R. 68 – 72.
- Bagos P.G. MTHFR C677T polymorphisms in PCOS: a meta-analysis / P.G. Bagos // Mol. Hum. Reprod. – 2009. – Vol. 15, № 1. – R. 19 – 26.
- Carmel R. Homocysteine in Health and Disease / R. Carmel, D. W. Jacobsen // Cambridge: University Rest. – 2001. – 500 p.
- Bronavalli S. Pharmacological therapy of Polycystic Ovary Syndrome / S. Bronavalli, D. Ehrmann // Clin. Obstet. Gynecol. – 2007. – Vol. 50, № 1. – P. 244 – 254.
- Battaglia C. Vascular risk in young women with polycystic ovary and polycystic ovary syndrome / C. Battaglia, F. Mancini, A. Cianciosi [et al.] // Obstet. Gynecol. – 2008. – Vol. 111, (2Pt1) – R. 385 – 395.
- Frosst P. A candidate genetic risk factor for vascular disease: a common mutation in methylenetetrahydrofolate reductase / P. Frosst, H. J. Blom, R. Milos [et al.] // Nature Genetics. – 1995. – Vol. 10. – R. 111 – 113.
- Fowler B. Homocysteine: overview of biochemistry, molecular biology, and role in disease processes / B. Fowler // Semin. Vasc. Med. – 2005. – Vol. 5, № 2. – R. 77 – 86.
- Forgen T. Impact of folate and homocysteine metabolism on human reproductive health / T. Forgen, P. Monnier-Barbarino, J. M. Alberto [et al.] // Hum. Reprod. – 2007. – Vol. 13, № 30. – R. 225 – 238.
- Falbo A. Serum and follicular anti Mullerian hormone levels in women with polycystic ovarian syndrome (PCOS) under metformin / A. Falbo, M. Pocca, T.Russo [et al.] // J. Ovarian Research. – 2010. – Vol.16, № 3. – P. 186 –192.
- Homocysteine Studies Collaboration. Homocysteine and risc of ischemic heart disease and stroce: a meta-analysis // JAMA. – 2002. – Vol. 288, № 13. – R. 2015 – 2022.
- Kilic-Okman T. Relationship between homocysteine and insulin resistance in women with polycystic ovary syndrome / T. Kilic-Okman, S. Guldiken, M. Kucuk // Endocr J. – 2004. – Vol. 51, № 5. – R. 505 – 508.
- Kravariti A. Predictors of Endothelial Dysfunction in Young women with Polycystic Ovary Syndrome / A. Kravariti, K.Naka, S. Kalantaridou [et al.] // J. Clin. Endocrinol. Metab. – 2005. – Vol. 90, № 9. – P. 5088 – 5095.
- Matthews D. R. Homeostasis model assessment: insulin resistance and B-cell function from fasting plasma glucose and insulin concentrations in man / D. R. Matthews, J. P. Hosker, A. S. Rudenski [et al.] // Diabetologia. – 1985. – Vol. 28, № 7. – R. 412 – 419.
- Mancini F. Endotelian function and its relationship to leptin, homocysteine, and insulin resistance in lean and overweight eumenorrheic women and PCOS patients: a pilot study / F. Mancini, A. Cianciosi, G. M. Reqqiani // Fertil. Steril. –2009. – Vol. 91, № 6. – R. 2537 – 2544.
- Maleedhu P. Status of Homocysteine in Polycystic Ovary Syndrome (PCOS) / P. Maleedhu, P. K. Kodumuri, D.V. Devi // J. Clin. Diagn. Res. – 2014. – Vol. 8, № 2. – R. 31 – 33.
- Nafiye Y. The effect of serum and intrafollicular insulin resistance parameters and homocysteine levels of nonobese, nonhyperandrogenemic polycystic ovary syndrome patients on in vitro fertilization out come / Y. Nafiye, K. Sevtap, D. Muammer [et al.] // Fertil. Steril. – 2010. – Vol. 93, № 6. – R. 1864 – 1869.
- Qiao J. Extra-and intra- ovarian factors in polycystic ovary syndrome: impact on oocyte maturation and embryo developmental competence / J. Qiao, H. L. Fend // Hum. Reprod. Updata. – 2011. – Vol. 17, № 1. – R. 17 – 33.
- Raji Kana Kkaparambil B-vitamin and homocysteine status determines ovarian response to gonadotropin treatment I sheep / Raji Kana Kkaparambil, Ravinder Singer, Li Dongfang [et al.] // Biology of Reproduction. –2009. – Vol. 80, № 4. – R. 743 – 752.
- Sills E. S. Plasma homocysteine, fasting insulin, and androgen patterns among women with polycystic ovaries and in fertility / E. S. Sills, M. G. Genton, M. Perloeet [et al.] // J. Obstet. Gynecol. Res. – 2001. – Vol. 27, № 3. – R. 163 – 168.
- Teede H. J. Endothelian Function and Insulin Resistance in Polycystic Ovary Syndrome: The Effects of Medical Therapy / Helena J. Teede, Cariline Meyer, Samantha K. Hutchison [et al.] // – 2010. – Vol. 65, № 5. – R. 322 – 333.
- Vitvitsky V. Testosterone regulation of renal cystathionine betasynthase: implications for sex-dependent differences in plasma homocysteine levels / V.Vitvitsky, A. Prudova, S. Stabler [et al.] // Am. J. Physiol. Renal. Physiol. – 2007. – Vol. 293, № 2. – P.594 – 600.
- Yilmaz M. Levels of lipoprotein and homocystein in non-obese and obese patients with polycystic ovary syndrome / M. Yilmaz, A. Biri, N. Bukan [et al.] // Gynecol. Endocrinol. – 2005. – Vol.20, № 5. – R. 258 – 263.
- Zhu B. T. On the mechanism of homocysteine pathophysiology and pathogenesis: a unifying hypothesis / B. T. Zhu // Histol.Histopathol. – 2002. – Vol.17, – P. 1283 – 1291.
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