The relationship between epicardial adipose tissue thickness and oxidative stress parameters in patients with isolated polycystic ovary syndrome

Abstract

Purpose: The aim of this study is to evaluate the correlation between epicardial adipose tissue thickness and oxidative stress parameters in patients with polycystic ovarian syndrome.

Methods: The study included 35 patients with PCOS and 35 healthy women. Transthoracic echocardiography was used to measure the epicardial adipose tissue thickness (EATT) of all patients. For all patients, serum TOS, TAS, hs-CRP, and insulin levels were measured according to the literature, and the HOMA-IR values were calculated. Independent samples t-test, Pearson’s correlation analysis, multivariate logistic regression analysis, and receiver operator characteristic curve (ROC) analysis were used in the statistical analysis.

Results: Between the patient group and the control group, EATT was significantly higher in the PCOS group compared to the control group (5.4?±?1.4?mm and 3.9?±?1.6?mm, respectively; p?<?0.001). Similarly, TOS, TAS, and hs-CRP levels were significantly higher in the PCOS group compared to the control group (p?<?0.01 for all). The correlation analysis showed a significant positive correlation between EATT and TAS and hs-CRP (r?=?0.349, p?<?0.01 and r?=?0.352, p?<?0.01, respectively). Multivariate regression analysis showed a significant correlation between PCOS and EATT, TAS, and diastolic blood pressure (p?<?0.05 for all).

Conclusions: Epicardial adipose tissue may play a major role in PCOS pathogenesis by leading to an increase in oxidative stress.     

Does a risky outcome of antenatal screening test indicate oxidative stress?

Abstract

Objective: The study aimed to investigate a possible relationship between second trimester aneuploidiy screening results and oxidative stress in foetal amnion and maternal serum.

Methods: Concerning the outcome of the second-trimester screening test, 50 pregnant women of high risk were included in the experimental group, whereas 50 pregnant women with normal scores who wished to proceed with the amniocentesis procedure due to advanced maternal age and counselling were included in the control group. The biochemical parameters of total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI) were measured in the amniotic fluid samples and maternal serum samples.

Results: OSI in the maternal serum samples, as well as TAS and TOS in the amniotic fluid, was significantly higher in the control group compared to the experimental group (p?<?0.001, p?=?0.047, p?=?0.005, respectively). There was no significant difference in the TAS and TOS in the maternal serum samples or the OSI in the amniotic fluid between the groups.

Conclusions: The results indicate that the positivity of the screening test is not significantly correlated with oxidative stress, a factor regarded as a pathological mechanism in various diseases. Potential maternal anxiety could underlie the elevated oxidative stress in the control group.     

Primary pneumococcal peritonitis in pregnancy

Objective: To compare cord blood oxidative stress markers (OSM) between intrauterine small fetuses with high umbilical artery (UA) Doppler indices and normal indices. Methods: Forty women who had oligohydramnios and intrauterine growth-restricted fetuses with abnormal (n = 20, group I) or normal Doppler indices (n = 20, group II) were included. All patients underwent fetal Doppler ultrasound studies. Cord blood was collected at birth and six OSMs (ischemia-modified albumin (IMA), hepatocyte growth factor (HGF), malondialdehyde (MDA)) levels, total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI) were studied. Results: The mean cord blood IMA, MDA, TOS, and OSI values for group I were significantly increased when compared to the group II (p < 0.001 for IMA, MDA, TOS, and OSI). However the mean cord blood HGF and TAS values were statistically significantly decreased in group I, compared with group II (p < 0.001 for HGF, and TAS). A significant positive (for IMA, MDA,TOS levels, and OSI ratio) and negative (for HGF and TAS levels) correlations between UA pulsatility index (PI) and cord blood OSM were found. Conclusion: The correlation between cord blood OSM and Doppler blood flow changes shown in this study may contribute to understanding the underlying oxidative stress-related mechanisms.     

The effect of maternal number of births on oxidative and antioxidative systems in cord blood

Objective: The aim of this study is to evaluate the relationship between cord blood oxidative and antioxidative status and maternal parity number. Methods: Patients are grouped according to the maternal parity number: primiparous group (n?=?36), multiparous group (n?=?40), and grand multiparous group (n?=?26). Cord blood samples are obtained in all subjects and assessed for total antioxidant capacity (TAC), total oxidant status (TOS) and oxidative stress index (OSI). The serum TAC and TOS were evaluated by using an automated colorimetric measurement method. Results: TAC levels are significantly higher and oxidative stress indicators are significantly lower in newborns of primiparous women compared to multiparous women p?<?0.05 for all). TAC level is increased, whereas TOS and OSI levels are decreased in newborns of grand multiparous mothers compared to primiparous mothers. TAC level is significantly higher, whereas TOS and OSI levels are significantly lower in newborns of grand multiparous women compared to multiparous women (p?<?0.05 for all). Conclusions: These results suggest a relation between higher maternal parity and increased oxidative stress and decreased antioxidant defense capacity. On the other hand, the compensatory mechanisms improve the antioxidant defense system in newborns of grand multiparous women and may prevent oxidative stress.     

Dehydroepiandrosterone sulfate/free androgen index ratio predicts a favorable metabolic profile in patients with polycystic ovary syndrome

Potential effect of hyperandrogenemia on metabolic disturbances in polycystic ovary syndrome (PCOS) has always been a matter of interest. We analyzed the records of 125 patients with PCOS and 54 age-matched healthy women. All participants underwent biochemical and hormonal assessment and a 75?g oral glucose tolerance test was performed. PCOS and control groups were comparable in terms of age. Dehydroepiandrosterone sulfate/free androgen index (DHEAS/FAI) ratio was negatively correlated with body mass index (BMI) (p?<?.001), fasting glucose (p?=?.02), area under the curve (AUC) of glucose (p?=?.03), AUC of insulin (p?=?.001), homeostasis model assessment-estimated insulin resistance (HOMA-IR) (p?<?.001), and triglycerides (TG) (p?=?.009), and positively correlated with insulin sensitivity index (ISI) (p?<?.001) and high-density lipoprotein cholesterol (HDL-C) (p?<?.001) among PCOS patients. In logistic regression analysis, higher DHEAS/FAI ratio levels were associated with lower risk of low HDL-C [RR(95%CI); 0.97(0.95–0.98); p?<?.001] as well as atherogenic dyslipidemia (TG/HDL-C) [RR(95%CI); 0.97(0.94–0.99); p?=?.035] even after adjustment for BMI in the PCOS group. Androgens, DHEAS and FAI act differently on metabolic parameters. Our results demonstrate that high DHEA-S/FAI ratio levels are associated with a more favorable metabolic profile.     

Mode of delivery changes oxidative and antioxidative properties of human milk: a prospective controlled clinical investigation

Objective: To evaluate the influence of delivery mode on oxidative stress in human breast milk.

Methods: Thirty-three women who delivered by vaginal birth and 55 women who underwent cesarean section (CS) were included in this study. Colostral samples were collected on the second day after delivery. Total antioxidative status (TAS), total oxidative status (TOS), oxidative stress index (OSI), malonyldialdehyde (MDA), and glutathione peroxidase (GSH-Px) levels were determined and compared.

Results: Colostrum TAS was significantly higher in women of vaginal birth, than in women with CS (p?<?0.001). Milk TOS and OSI were found to be significantly increased in women with CS under general anesthesia. A marked increase in colostral GSH-Px levels after vaginal delivery was also noticed (p?<?0.001).

Conclusion: This study revealed that vaginal birth is associated with decreased oxidative stress in colostrum than CS, which suggest that mode of delivery plays an important role in the antioxidative production of breast milk.     

Carbon dioxide pneumoperitoneum induces systemic oxidative stress: a clinical study

Objective

To investigate the effect of carbon dioxide pneumoperitoneum on systemic oxidative stress by using serum oxidative stress markers (ischemia modified albumin (IMA), malondialdehyde (MDA), total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI)) and to compare their effectiveness at clinically accepted safe intra-abdominal pressure levels (<12 mmHg).

Study design

A total of 33 consecutive patients who had a unilateral ovarian cyst were enrolled for this prospective clinical study. All women underwent a laparoscopic ovarian cystectomy procedure. Venous blood was collected from patients preoperatively, 10 min after induction of anesthesia and 30 min after insufflation. Preoperative, 10_min, and 30_min serum IMA, MDA, TOS, OSI and TAS levels were compared.

Results

The mean age was 29.3 ± 6.4 and the range of operation time was 45–80 min. The mean serum IMA levels showed a significant increase 30 min later from CO₂ insufflation (p < 0.05). Significant alterations were not observed in serum MDA, TOS, OSI or TAS levels.

Conclusions

Laparoscopic surgery causes systemic ischemia and this ischemic effect can be revealed by measuring serum ischemia modified albumin. IMA is more sensitive than MDA, TOS, OSI and TAS in early detection of systemic oxidative stress.     

Total antioxidant,total oxidant and serum paraoxonase levels according to lipid administration method in parenterally fed premature infants

Objective: The aim of our study was to determine whether lipid solutions delivered separately or in mixture with total parenteral nutrition (TPN) solutions effect the balance between oxidant and antioxidant levels in premature infants.

Methods: A total of 60 preterm newborns who were delivered at their 30–34 gestational weeks and received TPN were included in the study. Premature newborns were randomized into two groups based on the delivery method of the lipid solution, separately (Group 1) or in mixture with TPN solutions (Group 2). Total antioxidant status (TAS), total oxidant status (TOS) and paraoxonase (PON-1) levels were analyzed in both blood samples, and oxidative stress index (OSI) was also calculated.

Results: Thirty cases from both groups were included in the study. Statistically significant decrease in the level of TAS and increase in the level of PON-1 were detected at 72?h of TPN therapy in both groups (p?p?p?>?0.05).

Conclusion: Our study showed that according to lipid administration method any difference for oxidant–antioxidant balance was not detected.     

No increase in sperm DNA damage and seminal oxidative stress in patients with idiopathic infertility

The most common cause of male infertility is idiopathic. Standard investigations reveal no abnormality in such cases. The aim of the study was to investigate the levels of sperm DNA damage and seminal oxidative stress and their relationships with idiopathic infertility. The study included 30 normozoospermic infertile men seeking infertility treatment and 20 fertile donors. Semen analysis was performed according to the World Health Organization guidelines. Sperm DNA damage was assessed by alkaline single cell gel electrophoresis (comet assay) after preparation with two-step discontinuous Percoll gradient. Seminal oxidative stress was measured by a novel automated method. DNA damage score, total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI) were not different in idiopathic infertile men compared with controls. No correlations were also found between DNA damage score and TAS, TOS levels and OSI in idiopathic infertile group. We did not find any relationship between sperm DNA damage and oxidative stress in normozoospermic infertile men. We think that the pathophysiology of idiopathic infertility cannot be explained by sperm DNA damage or seminal oxidative stress.     

Immediate breastfeeding and skin-to-skin contact during cesarean section decreases maternal oxidative stress,a prospective randomized case-controlled study

Objective: Immediate skin-to-skin contact (ISSC) and early breastfeeding are recommended for the wellbeing of the neonate. In this study, we aimed to evaluate the effect of ISSC and early breastfeeding on maternal oxidative stress and postoperative pain.

Methods: A total of 90 patients were randomized into two groups based on the timing of skin-to-skin contact and breastfeeding. Group 1 (n?=?45) was provided ISSC and breastfeeding in the operating room during the cesarean section (C/S). Group 2 (n?=?45) breastfed their babies 1?h after the C/S. As markers of oxidative stress, maternal serum levels of total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress indices (OSI) were evaluated. Maternal oxytocin levels and the relation between these parameters and postoperative pain were also evaluated.

Results: The postoperative TAS levels were significantly higher, whereas TOS and OSI levels were lower in Group 1 than Group 2. Negative correlations between oxytocin level and postoperative TOS and OSI were observed, as was a positive correlation between oxytocin level and postoperative TAS.

Conclusions: The effect of ISSC and early breastfeeding on mothers was documented for the first time in this study. Our results demonstrated ISSC and early breastfeeding during C/S reduce maternal oxidative stress.     

Serum adiponectin is a potential biomarker for metabolic syndrome in peri-and postmenopausal women

Abstract

Metabolic syndrome (MetS) increases its prevalence during menopausal period and there is no appropriate marker for screening before the cardiovascular damage begun. This study aims to find the diagnostic accuracy and the appropriate cutoff level of serum adiponectin for the screening of MetS in peri- and postmenopausal women. Women aged at least 40?years old attending health checkup clinic were recruited. Anthropometric measurements, blood pressure, MENQOL, and blood chemistry (glucose, adiponectin, HDL-C, LDL-C, and TG) were recorded. MetS was defined by JIS 2009 criteria. 290 peri-and postmenopausal women mean age 54.25?±?8.6?years were recruited. 66% was postmenopause and 21.4% of them has MetS. The socioeconomic and lifestyle factors seem similar among women with and without MetS. In the participants with MetS, the prevalence of abdominal obesity was higher (96.8% vs 49.6%, p?<?.001, respectively) and more prevalence of android fat distribution pattern was observed (76.2% vs 36%, p?<?.001, respectively). Serum adiponectin was significantly lower in women with MetS (6.0?±?4.6 vs 9.2?±?5.2?μg/mL, p?<?.001 in MetS and non-MetS, respectively). Serum adiponectin is a good biomarker for MetS and we recommend the cutoff level of serum adiponectin lower than 7.15?μg/mL for screening of MetS (AUC (95% CI) of = 0.72 (0.64–0.79), p?<?.001).     

Women with polycystic ovary syndrome have greater muscle strength irrespective of body composition

Abstract

The aim of this study was to compare metabolic parameters, body composition (BC) and muscle strength of women with and without polycystic ovary syndrome (PCOS). This was a case–control study that evaluated 40 women with PCOS and 40 controls. Androgens and insulin resistance were measured. BC was based on dual-energy X-ray absorptiometry. Isometric handgrip and maximal dynamic muscle strength (1-RM) strength tests were performed. Median total testosterone (p?<?0.01), free androgen index (p?<?0.01), insulin (p?<?0.01) and homeostasis model assessment-insulin resistance (p?=?0.02) were higher and sex hormone binding globulin (SBHG) (p?=?0.04) was lower in the PCOS group. Normoweight women with PCOS had higher percentages of android body fat. However, the prevalence of android fat distribution was higher in the PCOS than in the control group (p?=?0.04). The strength 1-RM in bench press (p?<?0.01), muscle strength relative to lean muscle mass in the dominant lower limb (p?=?0.04) and isometric handgrip strength tests (p?=?0.03) was higher in the PCOS group. PCOS was a determinant of strength in the bench press exercise (p?=?0.04). The hyperandrogenism was a predictor of increased strength in biceps curl exercises (p?=?0.03) in the dominant lower limb (p?=?0.02) and isometric handgrip strength (p?=?0.03). In conclusion, women with PCOS have greater muscle strength and a higher prevalence of central obesity, but no difference in BC. Muscle strength may be related to high androgen levels in these women.     

The plasma level and gene expression of resistin in polycystic ovary syndrome

Objectives.?To investigate the relationship between plasma resistin, polycystic ovary syndrome (PCOS), and insulin resistance (IR). To compare the mRNA level of resistin in mononuclear cells and monocyte-derived macrophages in women with PCOS and controls.

Materials and methods.?Patients with PCOS and controls were enrolled and IR was considered as the stratified factor for subgroups. Fasting blood was collected to determine the levels of sex hormones, insulin, glucose, blood lipid, and resistin. Resistin gene expression was evaluated by quantitative real-time RT-PCR in mononuclear cells and monocyte-derived macrophages cultured with or without rosiglitazone for 96?h.

Results.?No significant difference of plasma resistin levels was found among PCOS-IR, PCOS-non-IR, control-IR, and control-non-IR groups. There were no significant differences in resistin mRNA expression between participants with and without PCOS and with and without IR. Resistin mRNA expression in monocyte-derived macrophages was higher than that in mononuclear cells (p?=?0.04), and could be reduced by rosiglitazone (p?<?0.001).

Conclusions.?Plasma resistin does not correlate with normal weight PCOS or IR. Resistin gene expression in mononuclear cells and monocyte-derived macrophages in PCOS and IR is the same as controls. Further researches on the role of resistin in the pathogenesis of PCOS or IR should concentrate on the tissue level.     

Insulin resistance but not impaired β-cell function: a key feature in Chinese normal-weight PCOS women with normal glucose regulation

Objective: To evaluate insulin sensitivity and β-cell function in Chinese polycystic ovary syndrome (PCOS) women while taking into account the confounding variables including body mass index (BMI), blood glucose levels, ethnicity, medication history and a family history of type 2 diabetes. Study design: Cross-sectional analysis. Setting: Clinical research center in China.Subjects: 76 PCOS women and 20 age-matched healthy control women. Intervention: No. Main outcome measures: All subjects underwent botnia euglycemic-hyperinsulinemic clamp to assess their insulin sensitivity expressed as M value and β-cell function expressed as deposition index (DI). Results: Compared with age-matched controls, both DI and M (p?<?0.05, respectively) value were lower in PCOS group with normal glucose regulation (NGR), and they (p?<?0.05, respectively) were the lowest in PCOS group with impaired glucose regulation (IGR). The subgroup analysis showed that compared with normal-weight controls, DI (p?=?0.072) was similar but M value (p?<?0.05) was lower in normal-weight PCOS group with NGR, and DI (p?<?0.05) and M value (p?<?0.05) were lower in overweight PCOS group with NGR. DI and M value (p?<?0.05, respectively) of overweight PCOS group with IGR were the lowest among all groups. Conclusions: There was insulin resistance but not impaired β-cell function in Chinese normal-weight PCOS women with NGR. Insulin resistance may be an intrinsic factor prior to impaired β-cell function of PCOS.     

Myeloperoxidases and polycystic ovary syndrome

New biological markers are emerging trying to identify earlier cardiovascular high risk subjects. Myeloperoxidases have been involved in the role of atherosclerosis process, by the beginning of the endothelial dysfunction up to the plaque rupture and clinical manifestation, and it has been demonstrated that this enzyme has also a prognostic value. We aimed to assess myeloperoxidases levels in patients with polycystic ovary syndrome (PCOS) with insulin resistance (IR), considering that these women represent a high risk group for cardiovascular disease. We developed a transversal study, comprising 26 patients with PCOS and IR and 30 controls (PCOS without IR). IR was considered with HOMA-IR?≥3.0. IR absence was considered when HOMA-IR?<3.0, triglycerides?<200, BMI?<28.7, and BMI<27.8 in patients with familial history of type 2 diabetes. All patients went through anamnesis, physical examination, transvaginal ultrasound, and blood samples. IR PCOS patients had higher levels of myeloperoxidase (22.3?×?18.1, p?=?0.047), and also higher BMI. Myeloperoxidase levels correlated directly with insulin. In conclusion, IR PCOS young patients have higher myeloperoxidase levels.     

DNA damage and oxidative stress in patients with mild preeclampsia and offspring

Objective

Oxidative stress has been shown to play an important role in the pathogenesis of pre-eclampsia, and DNA damage frequently occurs in cells exposed to such stress. The aim of the present study was to investigate DNA damage and oxidative stress in mildly pre-eclamptic women and their offspring.

Study design

We studied 25 mildly pre-eclamptic mothers, 20 healthy controls, and their infants. Mononuclear leukocyte DNA damage, total antioxidant status (TAS), and total oxidant status (TOS) were determined and the oxidative stress index (OSI) was calculated.

Results

DNA damage, and TOS and OSI levels were significantly increased, and TAS levels significantly decreased, in maternal and cord blood samples of the mildly pre-eclamptic group. A positive correlation between the extent of DNA damage and diastolic blood pressure was evident in pre-eclamptic mothers and there was a negative correlation between the extent of DNA damage and TOS.

Conclusion

Both oxidative stress and DNA damage are elevated in mildly pre-eclamptic patients and their offspring. Increased oxidative stress may be important in inducing DNA damage in pre-eclamptic patients.     

Paraoxonase levels in women with polycystic ovary syndrome

OBJECTIVE: To determine paraoxonase (PON1) levels and whether paraoxonase activity is associated with an increased propensity for the development of cardiovascular disease in women with polycystic ovary syndrome (PCOS). STUDY DESIGN: Thirty-one subjects with PCOS and 33 healthy controls were evaluated in this controlled clinical study. Lipid subfractions, fasting glucose, insulin and other hormone (gonadotropin, androgen) and PON1 levels were measured. Homeostasis model assessment (HOMA-R) was used to estimate insulin resistance. Statistical analysis was made with Student's t test and Pearson correlation analysis. RESULTS: The women with PCOS had significantly lower serum high-density lipoprotein (HDL), apolipoprotein A1, basal PON1, arylesterase and salt-stimulated PON1 (SSP) levels than did the controls. Also, fasting insulin levels and HOMA-R were significantly higher in women with PCOS as compared with healthy subjects. Basal PON1 was positively associated with apolipoprotein A1, arylesterase and SSP but inversely correlated with HOMA-R. HDL was negatively associated with fasting insulin and HOMA-R. CONCLUSION: Decreased PON1 activity might contribute to an increased propensity for the development of cardiovascular disease in women with PCOS in addition to known risk factors, such as insulin resistance, hypertension, dyslipidemia and increased oxidative stress.     

Relationship between oxidative stress and clinical pregnancy in assisted reproductive technology treatment cycles

PurposeTo examine the relationship between serum total oxidant (TOS) and antioxidant (TAS) levels and clinical pregnancy in assisted reproductive technology (ART) cycles.MethodsPrior to and after oocyte pick-up (OPU) and embryo transfer (ET), blood samples were collected from gynecologically normal females (n = 70) who were enrolled for ART solely due to male factor infertility. TAS, TOS levels and oxidative stress indexes (OSI: TOS/TAS) in four phases of treatment cycle (pre and post OPU and ET) between clinically pregnant and non-pregnant patients were compared. Critical cut-off values of significantly different TAS, TOS levels and OSIes for clinical pregnancy were established.ResultsThe TAS levels in patients with clinical pregnancy were significantly higher in all of the four phases of the cycle. Post-OPU and pre-ET TOS levels were significantly higher in clinically pregnant patients. According to OSIes; only the pre-OPU OSI was significantly lower in clinically pregnant patients compared with non-pregnant ones. Moreover, the highest area under the ROC curve (AUC) from the seven different significant measurements [1) pre-OPU OSI, 2) pre-OPU TAS, 3) post-OPU TAS, 4) pre-ET TAS, 5) post-ET TAS, 6) post-OPU TOS, 7) pre-ET TOS] was related to pre-OPU OSI.ConclusionsIn ART cycles, women with a higher total antioxidant status prior to and after OPU and prior to and after ET have an increased probability of clinical pregnancy. Additionally; OSI before OPU was one of the most important determinants for clinical pregnancy, so the oxidant and antioxidant balance is as important as the antioxidant concentration alone.     

Association between anti-Mullerian hormone and insulin resistance in non-obese adolescent females with polycystic ovary syndrome

Objective: The present study was designed to evaluate the association between anti-Mullerian hormone (AMH) and insulin resistance (IR) in non-obese adolescent females with polycystic ovary syndrome (PCOS) with and without IR.

Methods: Seventy-seven consecutive non-obese patients were recruited and distributed into three groups according to diagnoses of PCOS and IR. Group I included 27 females diagnosed with PCOS and IR, group II included 18 females diagnosed with PCOS but without IR, and group III included 32 controls without PCOS.

Results: Group I had significantly higher AMH levels compared to group II and group III (p?p?p?=?0.004). There was a significant positive correlation between serum AMH and HOMA-IR levels in adolescent females with PCOS (p?=?0.003).

Conclusion: We found that serum AMH levels were higher in non-obese adolescent females with PCOS and IR than in PCOS patients without IR and the healthy controls. There was a significant positive correlation between AMH levels and IR in non-obese adolescent females with PCOS.