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.     

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.     

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.     

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.     

The effects of acrylamide and vitamin E on kidneys in pregnancy: an experimental study

Objectives: The objective of this study is to investigate possible damages to kidney tissues of pregnant rats and their fetuses exposed to acrylamide during pregnancy and possible protective effects of vitamin E against these damages.

Material and methods: Rats were randomly assigned to five groups of control, corn oil, vitamin E, acrylamide, vitamin E?+?acrylamide, six pregnant rats in each. Mother and fetal kidney tissues were examined for malondialdehyde (MDA), reductase glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), total antioxidant status (TAS), total oxidant status (TOS), urea, creatine, trace elements such as Zn and Cu in the serum and histopathological analyses were conducted.

Results: It was determined that acrylamide, administered during pregnancy, statistically significantly increased MDA and TOS levels, maternal serum urea, creatinine, and Zn levels, while it decreased GSH, TAS, SOD, and CAT levels (p?≤?.05) when compared with all other groups in the kidney tissues of pregnant rats and their fetuses and caused tubular degeneration, hemorrhage, narrowing, and closure in Bowman’s space, and, in the E vitamin group, it statistically significantly increased GSH, TAS, SOD, CAT, urea, creatinine, and Zn levels when compared with other groups and lowered TOS and MDA levels to those of the control group (p?Conclusion: It was observed that acrylamide administered during pregnancy caused oxidative stress in kidney tissues of mother rats and their fetuses, resulting in tissue damage, and vitamin E application, which is considered to be a powerful antioxidant, inhibited 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.     

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.     

Paraoxonase-1 is not affected in polycystic ovary syndrome without metabolic syndrome and insulin resistance,but oxidative stress is altered

Paraoxonase-1 (PON1) activity is decreased in polycystic ovary syndrome (PCOS) having metabolic syndrome (MetS) or insulin resistance (IR). We aimed to assess PON1 activity and oxidative stress in PCOS without MetS or IR. Metabolic and hormonal parameters, high-sensitive C-reactive protein (hs-CRP), oxidative stress parameters (total antioxidant status (TAS), total oxidative stress (TOS), oxidative stress index (OSI), lipid hydroperoxide (LOOH), total free sulfhydryl (?SH) groups), PON and arylesterase were analyzed in 30 normal weighed patients with PCOS without MetS or IR and 20 normal controls. Hs-CRP, PON, arylesterase, and TAS levels of PCOS and control groups were similar. LOOH, TOS, and OSI of PCOS group were higher than in the controls (p?<?0.05; p?<?0.001, and p?<?0.001, respectively). ?SH group levels showed a positive correlation with free testosterone (fT). TOS positively correlated with free androgen index (FAI), body mass index (BMI), waist-to-hip ratio (WHR), LOOH, and OSI. This study showed that oxidative stress is increased in PCOS even in the absence of MetS or IR. PON1 activity appears not to be affected in PCOS without MetS and IR. Several metabolic and antropometric risk factors may aggravate this altered oxidative state in PCOS.     

Protective effect of alpha-lipoic acid in methotrexate-induced ovarian oxidative injury and decreased ovarian reserve in rats

To determine whether the possible oxidative effect of methotrexate (Mtx) on ovary and to evaluate the effectiveness of alpha lipoic acid (ALA), which may be useful in many oxidative stress models.

Thirty-two female Wistar-albino rats were randomly divided into four groups; control group, alpha lipoic acid group (ALA 100?mg/kg, 10?days), multiple dose Mtx group (Mtx 1?mg/kg 1, 3, 5, 7?days) and Mtx and ALA group (Mtx 1?mg/kg 1, 3, 5, 7?days and ALA 100?mg/kg, 10?days). Serum total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI), tumor necrosis factor-alpha (TNF-α), tissue malondialdehyde (MDA) and activities of glutathione peroxidase (GSH-Px) and catalase (CAT) and anti-Mullerian hormone (AMH) and total ovarian follicle count were evaluated.

Mtx administration caused a significant decrease in TAS, a significant increase in TOS and OSI, a significant increase in MDA levels and a decrease in GSH-Px and CAT activity. Moreover the proinflammatory cytokine (TNF-α) was increased in the Mtx group. And AMH values and total follicle count were significantly decreased in Mtx group. However, ALA treatment reversed biochemical results and AMH levels and total follicle count.

Alpha lipoic acid ameliorates methotrexate induced oxidative damage of ovarian in rats.     

Assessment of oxidant/antioxidant system in newborns and their breast milks

Aim: In this study, it is aimed to investigate total oxidant and antioxidant status of newborns and their breast milks. Methods: Totally, 184 infants who were born in our hospital were included in the study. Study group was divided into two main study groups, including term and preterm groups; main study groups were also divided into two sub-groups, AGA and SGA. TOS and TAC levels were measured in cord blood of all newborns and in mother milks. Groups were statistically compared with each other in terms of TOS, TAC and OSI levels. Results: The study included 92 preterm newborns (Group I) and 92 term newborns (Group II). TOS, TAC and OSI levels were found significantly higher in Group I than Group II (p < 0.0001, p = 0.17, p < 0.0001, respectively). When sub-groups of Group I and Group II, namely TAGA, TSGA and PAGA and PSGA, were compared with each other. TOS and OSI levels were significantly higher and TAC levels were significantly lower in TSGA group relative to TAGA group (p < 0.0001; p = 0.001; p < 0.0001, respectively). No statistically significant difference was found between Group I and Group II and between sub-groups of Group I and II with regards the TOC, TAC and OSI levels of mother milk. Conclusion: In preterm newborns and term SGA infants, total oxidant stress is increased and antioxidant capacity is low. No significant difference was found between mother milks of preterm and term AGA and SGA infants.     

Chemokine (C-C motif) ligand-2 (CCL2) and oxidative stress markers in recurrent pregnancy loss and repeated implantation failure

Purpose

The main purpose of this study is to evaluate the inflammatory response and oxidative stress together in the cases of recurrent pregnancy loss (RPL) and repeated implantation failure (RIF).

Methods

This is a cross-sectional study conducted to compare infertile patients who have RIF and patients with RPL histories in terms of CCL2, TAS, TOS, and OSI. To this end, two study groups were formed by primary-infertile women with RIF history and women with nulliparous RPL history who consulted a university hospital between 2014 and 2016, and a control group was formed by multiparous women who had no pregnancy loss. With 30 women in each group, 90 women in total were included in the study. CCL2, TAS, and TOS blood levels were measured and oxidative stress index was calculated in all participants.

Results

The patients with RPL and RIF had higher levels of CCL2 than those in the control group. The TOS, TAS, and OSI levels did not differ in RPL and RIF groups from the control group. No statistically significant relationship was found between CCL2 and the TOS, TAS, and OSI values.

Conclusions

Oxidative stress markers in the pregestational period did not have a predictive value in the RPL and RIF. CCL2 might be useful in risk prediction.

     

Biochemical investigation of the toxic effects of acrylamide administration during pregnancy on the liver of mother and fetus and the protective role of vitamin E

Objectives: To investigate the toxic effects occurring in the liver tissues of the pregnant rats and the fetuses, which are administered acrylamide and vitamin E as a protector during pregnancy.

Materials and methods: This research was conducted with the permission of Laboratory Animals Ethical Board of Inonu University Faculty of Medicine. Forty rats, of which their pregnancy is validated via vaginal smear, were distributed into five different groups. On the 20th day of pregnancy, pregnant rats and fetuses are decapitated. Malondialdehyde (MDA), reduced glutathione (GSH), total antioxidant status (TAS), total oxidant status (TOS) and xanthine oxidase (XO) levels were measured in the liver samples taken from mother and fetuses.

Results: It was detected that acrylamide administered during pregnancy increased MDA, TOS, XO levels statistically significantly and decreased the GSH level (p?≤?0.05) in the pregnant rat liver tissue when compared to all other groups. In the vitamin E administered group; GSH, TAS levels significantly increased statistically and TOS and XO levels dropped to levels of the control group (p?≤?0.05), in comparison to all other groups. Among all groups, no biochemical changes were observed in the fetus liver tissue (p?>?0.05).

Conclusion: The liver of pregnant rats functions as a protective pre-filter by detoxifying acrylamide effectively and the acrylamide that reaches fetus liver is detoxified by the cytochrome P-450 system of the fetus liver. To be able to figure out the biochemical mechanism, more advanced studies are needed.     

The effect of low-dose aspirin on fetal weight of idiopathic asymmetrically intrauterine growth restricted fetuses with abnormal umbilical artery Doppler indices: a randomized clinical trial

Objective: To investigate the effect of aspirin on fetal weight in fetuses with idiopathic asymmetrical intrauterine growth restriction (IUGR) complicated by abnormal umbilical artery Doppler indices.

Materials and methods: The study was a randomized controlled trial conducted at Woman’s Health Hospital, Assiut, Egypt, between June 2016 and the January 2017 included 60 pregnant women (28?30 weeks) with idiopathic asymmetrical IUGR associated with abnormal umbilical artery Doppler indices. Women were randomly assigned to group I (aspirin 75?mg) daily for four weeks or group II (no intervention). The primary outcome was the fetal weight after four weeks. Secondary outcomes included Doppler blood flow changes in the umbilical artery plus delivery and neonatal outcomes.

Results: The estimated fetal weight and umbilical artery blood flow increased significantly in aspirin group (p?=?.00) when compared with no intervention group. As regard neonatal outcomes; aspirin group showed better results and encouraging outcomes (p?Conclusions: Aspirin improves fetal weight and umbilical artery blood flow in idiopathic asymmetrical IUGR fetuses complicated by abnormal umbilical artery Doppler blood flow.     

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.     

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.     

The effect of galactagogue herbal tea on oxidant and anti-oxidant status of human milk

Abstract

Objective: Human milk (HM) has antioxidant constituents which protect newborns against oxidative damage. We aimed to evaluate whether maternal consumption of herbal tea containing fenugreek had any effects on global oxidant and antioxidant capacity of HM.

Methods: Volunteer mothers 18–35 years of age without any antenatal or perinatal risk factors were randomly assigned to receive galactagogue herbal tea (Humana still-tee®, Herford, Deutschland) 3 cups/d or same amount of water as placebo. The total antioxidant capacity (TAC), total oxidant status (TOS) and the oxidative stress index (OSI) of breast milk samples taken in the 1st day and 7–10?d were compared between groups.

Results: Herbal tea (n?=?40) and placebo (n?=?40) groups had similar TAC, TOS and OSI values in the 1st day samples. TAC, TOS and OSI values in the breast milk samples taken on 7–10th day were also similar. OSI increased significantly in 7–10 day samples compared to 1st day in each group, while TAC and TOS levels did not differ.

Conclusion: Galactagogue herbal tea containing fenugreek has no detectable effect on global oxidant and antioxidant status of HM. OSI increases in course of lactation compared to colostrums irrespective of galactagogue use.     

Umbilical artery blood flows among pregnancies with single umbilical artery: a prospective case-control study

Objectives: To evaluate peak systolic velocity (PSV) in the umbilical artery (UA) among patients with single umbilical artery (SUA) as compared with patients with three vessel cords.

Methods: A prospective case-control study was performed. UA blood flow velocimetry was obtained from fetuses with SUA and from a control group with three vessel cord. PSV and pulsatility index (PI) were measured. Patients’ characteristics were compared for statistical differences and a linear regression model was constructed for the different groups.

Results: UA Doppler velocimetry measurements were obtained from 29 patients with SUA and from 29 controls matched for gestational age. The differences between UA PI with and without SUA were significant (F?=?3.471; p?=?0.0379) showing a lower PI in the SUA group. However, no significant statistical difference was found in PSV between these two groups (F?=?0.149; p?=?0.86).

Conclusions: While the impedance in the UA of patients with a SUA was lower compared with patients with a normal umbilical cord, the PSV did not differ.     

Outcome of small-for-gestational-age fetuses according to umbilical artery Doppler: Is there any yield from additional middle cerebral artery Doppler?

Abstract

Objective.?To investigate the outcome of small-for-gestational-age (SGA) fetuses in relation to the features of umbilical artery (UA) Doppler and to explore the prognosticator of middle cerebral artery (MCA) Doppler in SGA fetuses with normal UA impedance.

Methods.?Two hundred ninety-seven patients were classified into Group 1 with normal UA and MCA pulsatility index (PI), Group 2 with normal UA but abnormal MCA PI and Group 3 with abnormal UA PI/absent or reversed end diastolic flow. Neonatal outcomes were compared between each group.

Results.?Neonatal intensive care unit (NICU) admission, duration of hospital stay and perinatal mortality were higher in Group 3 as compared to the others. Group 2 had a lower birth weight and more fetuses with 5-min Apgar score <7 than Group 1; NICU admission and need for ventilators were also significantly higher than Group 1.

Conclusions.?SGA fetuses with abnormal UA Doppler suffered more morbidity and mortality compared to those with normal UA Doppler. SGA fetuses with normal UA PI but abnormal MCA PI had worse outcomes compared to those with normal UA and MCA PI.     

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.     

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.