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Polycystic ovary syndrome(PCOS)is a heterogeneous disorder closely associated with reproductive endocrine dysfunction in the women.The etiology and pathogenesis of PCOS remain unclear.PCOS is the result of the combination of endocrine metabolic disorders,genetics,and environmental factors.Hyperandrogenemia(HA)and insulin resistance(IR)are the fundamental pathophysiological changes in the development of PCOS,and their interactions exacerbate the clinical manifestations of the PCOS patients.The family aggregation and twin study results confirm the genetic predisposition of PCOS;the genome-wide association study(GWAS)results confirm some risk loci and candidate genes of PCOS.The unhealthy lifestyle habits and environmental endocrine disruptors also play an important role in the progression of PCOS,and the gut microbita is involved in the pathogenesis of PCOS.This article provides a comprehensively retrospective analysis on the recent studies about PCOS,and reviews both internal factors and external factors related to the etiology and pathogenesis of PCOS.
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Objective:To analyze the medication and compatibility law of TCM compounds with national patents for the treatment of polycystic ovary syndrome (PCOS); To provide reference for the new TCM prescriptions for the treatment of PCOS.Methods:TCM compound patents for PCOS were retrieved from the China National Intellectual Property Administration's Chinese Patent Announcement Website from the establishment of the website to April 20, 2023. SPSS 25.0, IBM SPSS Modeler 18.0, and Cytoscape 3.8.0 were used to carry out frequency statistics, association rule analysis on the data, and a TCM core complex network and systematic clustering analysis were built.Results:126 compound patents were included, involving 392 kinds of Chinese materia medica, with a total frequency of 1 709 times. The medicinal property was mainly warm, the taste was mainly sweet, and the meridian was mainly liver meridian. High frequency drugs included Angelica Sinensis (46 times), Cuscutae Semen (44 times), Cyperi Rhizoma (42 times), Rehmanniae Radix Praeparata (41 times), Salviae Miltiorrhizae Radix et Rhizoma (37 times), etc. Commonly used medicinal pairs included Poria-Atractylodis Macrocephalae Rhizoma (support 16.67%, confidence 76.19%), Angelica Sinensis-Paeoniae Radix Alba (support 15.87%, confidence 80.00%), etc. The triple drug combinations were Cyperi Rhizoma-Pinelliae Rhizoma-Poria (support 12.70%, confidence 81.25%). The core prescriptions included "Poria, Pinelliae Rhizoma, Citri Rettculatae Pericarpium, Cyperi Rhizoma, Salviae Miltiorrhizae Radix et Rhizoma, Epimedii Folium, Atractylodis Macrocephalae Rhizoma, Morindae Officinalis Radix, Gleditsiae Spina, Acori Tatarinowii Rhizoma", etc. Potential prescriptions were "Hordei Fructus Germinatus, Setariae Fructus Germinatus, Sargentodoxae Caulis, Puerariae Lobatae Radix, Leonuri Fructus" and so on.Conclusion:The treatment of PCOS with TCM compounds with national patents mainly focuses on drying dampness and strengthening the spleen, tonifying kidney yang and nourishing kidney yin, promoting blood circulation.
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Objective To investigate the mechanism of Guizhi Fuling Pills in the treatment of polycystic ovary syndrome(PCOS)and endometriosis(EMT).Methods TCMSP was utilized to obtain the active ingredients and related targets of the constituent Chinese medicines of Guizhi Fuling Pills.GeneCards,PharmGKB,and TTD databases were used to screen PCOS and EMT disease targets,respectively.The Venn R diagram was drawn after obtaining the intersecting targets of drugs and diseases using the Venn R package in R software,the drug-active ingredient-potential target interactions network diagram was made in Cytoscape,the intersecting target protein-protein interactions(PPI)network diagram was drawn in the STRING platform,and Cytoscape was used to optimize the PPI network and screen the core targets.R language was applied for Gene Ontology(GO)enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis,and AutoDockTools was for molecular docking.Results A total of 85 active ingredients and 191 corresponding targets of Guizhi Fuling Pills were obtained,and 77 potential targets of Guizhi Fuling Pills for the treatment of PCOS and EMT.The core active ingredients of Guizhi Fuling Pills for PCOS and EMT were quercetin,β-sitosterol,kaempferol,hederagenin,baicalein,and the core targets were AKT1,EGFR,IL-6,TNF,and TP53.GO functional analysis yielded 2 020 biological process,34 cellular components,126 molecular functions,and KEGG enrichment analysis yielded 165 signaling pathways.Molecular docking showed that the core components in the formula docked well with the targets.Conclusion Guizhi Fuling Pills may regulate the signaling pathways of lipid and atherosclerosis,AGE-RAGE signaling pathway,fluid shear stress and atherosclerosis,and chemical carcinogenesis-receptor activation through quercetin,β-sitosterol,kaempferol,hederagenin,and baicalein,and act on AKT1,EGFR,IL-6,TNF,and TP53,thus treating PCOS and EMT with homotherapy for heteropathy.
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Asprosin is a protein-like hormone composed of 140 amino acids,which is mainly secreted by adipo-cytes.Polycystic ovary syndrome(PCOS)and asthenospermia are common causes of infertility.Asprosin promotes the production of estradiol in small granular cells induced by follicle stimulating hormone(FSH)and progesterone in small granular cells induced by insulin-like growth factor 1(IGF-1),which functions in the growth of ovarian folli-cles and ovulation of dominant follicles.Asprosin promotes the secretion of sex hormones and the production of nu-trients,increasing the number,survival time and motility of sperms by acting on the hypothalamus and testicles.Asprosin is involved in regulation of follicle growth and spermatogenesis,so this finding may potentially support the development of new strategies for the treatment of infertility.
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Objective To investigate the association between body mass index(BMI),sex hormone and single nucleotide polymorphisms(SNPs)of follicle-stimulating hormone receptor(FSHR)gene rs2268361 and rs2349415 and its correlation with the risk of polycystic ovary syndrome(PCOS).Methods Peripheral blood was collected from 213 PCOS patients and 207 healthy controls,attending the Department of Reproductive Medicine at the First Hospital of Shanxi Medical University,and 32 follicular fluids were randomly collected from each of the PCOS and control groups from March to August 2021.Calculation of BMI of the PCOS and control groups;The levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),testosterone(T),progesterone(P)and prolactin(PRL)in peripheral blood of the two groups were detected by immunochemiluminescence method.Polymerase chain reaction(PCR)and high-resolution melting curve(HRM)were used to analyze the polymorphisms of rs2268361 and rs2349415 in FSHR of the two groups.Quantitative real-time PCR was used to detect the expression of FSHR gene mRNA in peripheral blood and ovarian granulosa cells.Results There was a strong positive correlation between LH and LH/FSH(r=0.88,P<0.05);The levels of BMI,E2,LH,LH/FSH and T in PCOS group were significantly higher than those in control group(P<0.05);FSH level was significantly lower than that of control group(P<0.001).HRM analysis showed the frequencies of CC,CT and TT genotypes at rs2349415 were 55.9%,34.3%and 9.8%in PCOS group and 68.6%,23.2%and 8.2%in control group,respectively.The frequencies of C and T alleles were 73.0%and 27.0%in PCOS group and 80.2%and 19.8%in control group,respectively.There were significant differences in genotype frequencies and allele frequencies between the two groups(P<0.05);The expression level of FSHR mRNA was higher in ovarian granulosa cells in PCOS group than in control group(P=0.004),the expression level of FSHR mRNA in rs2349415 TT genotype was higher than that in CC(P=0.002)and CT(P=0.035)genotype.Conclusion High levels of BMI, LH, E2 and T allele of rs2349415 increased the risk of PCOS.
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Objective To investigate the changes of sex hormone levels in polycystic ovary syndrome(PCOS)in infertile population after the assisted reproductive technology treatment,and to provide an evidence for the choice of the treatment.Methods The medical data of patients admitted to the First Affiliated Hospital of Kunming Medical University from January 2016 to June 2021 were collected and divided into PCOS group(103)and non-PCOS group(589)according to whether they were diagnosed with PCOS,and the sex hormone changes of the two groups were compared.Results The patients in PCOS group were younger and had the higher BMI,more sinus follicles,higher AMH value,and lower total Gn usage.The number of LH/FSH>2 in PCOS group was higher than that in non-PCOS group(P<0.05).After the treatment,LH in both groups decreased,FSH,E2 and(P<0.05)increased;The difference of LH and E2 before and after the treatment in PCOS group was greater than that in non-PCOS group<0.05).Conclusion Compared with non-PCOS infertile patients,the changes of sex hormone indexes in PCOS infertile patients before and after the treatment were more obvious.In order to obtain the better clinical effect in patients with polycystic ovaries,it is recommended to pay attention to the changes of related sex hormone levels in the course of subsequent treatment,and choose a reasonable treatment plan.
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Objective:To investigate the effects of basal luteinizing hormone(bLH)and different luteinizing hor-mone/follicle stimulating hormone ratio(LH/FSH)on the pregnancy outcome of in vitro fertilization or intracyto-plasmic sperm injection(IVF/ICSI)in patients with polycystic ovary syndrome(PCOS).Methods:From July 2013 to January 2020,424 PCOS patients who underwent flexible gonadotropin-releasing hormone antagonist protocol for ovulation induction in first IVF/ICSI were collected retrospectively from the department of reproductive medi-cine,The First Affiliated Hospital of Nanjing Medical University.The patients were divided into normal bLH(LH≤10 U/L,316 cases)and high bLH(LH>10 U/L,108 cases)group according to different levels of bLH;At the same time,according to the different levels of LH/FSH ratio,they were divided into low ratio(LH/FSH≤1,227 cases)group,median ratio(1<LH/FSH<2,142 cases)group and high ratio(LH/FSH≥2,55 cases)group.The general condition,ovulation induction and pregnancy outcomes of the groups were analyzed and compared Binary Logistic regression was used to analyze the related factors affecting live birth.Results:①The basal FSH and AMH in high bLH group were higher than those in normal bLH group,and the difference was statistically significant(P<0.05).In terms of ovarian induction,the number of oocytes retrieved and endometrial thickness on HCG injection day in the high bLH group were smaller than those in the normal bLH group,but the total duration of antagonist used was longer and the differences were statistically significant(P<0.05).Furthermore the pregnancy outcomes of the two groups had no statistical difference(P>0.05).②Compared with patients in different LH/FSH ratio groups,the high ratio group had higher AMH and antral follicle count(AFC)than the other two groups,and the differences were statistically significant(P<0.05).In terms of ovulation induction,the high ratio group had lower numbers of retrieved eggs,transferred embryos,and endometrial thickness on HCG day compared to the other two groups,with statistically significant differences(P<0.05).There was no statistically significant difference in pregnancy outcome indicators among the three groups of patients(P>0.05).③Binary Logistic regression analy-sis showed no significant correlation between live birth rate and bLH,LH/FSH ratio(P>0.05),but the live birth rate was related to the number of embryos transferred(P<0.05).Conclusions:Elevated bLH level and LH/FSH ratio may affect the outcomes of ovulation induction in women with PCOS(such as the number of oocytes re-trieved and endometrial thickness on HCG injection day),but there is no significant correlation with live birth rate of assisted reproduction.
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Objective To study the regulation effects of Bazhen Decoction combined with Baizhu Fuzi Decoction on glucose metabolism and estrogen level in rats with polycystic ovary syndrome.Methods The rat model of polycystic ovary syndrome was established by subcutaneous injection of human chorionic gonadotropin(HCG)combined with insulin.Rats were randomly divided into the polycystic ovary syndrome group,the Baizhu Fuzi Tang group(6.4 g/kg),the Bazhen Tang group(9.2 g/kg),the Bazhen Tang combined with Baizhu Fuzi Tang group(11.55 g/kg)and the diethylstilbestrol group(0.5 mg/kg).A blank control group(unmodulated rats)was set up with 10 rats in each group.The uterine index of rats was determined and calculated.Fasting blood glucose(FBG),2 h postprandish blood glucose(2 h PBG)and fasting insulin(FINS)were determined and insulin sensitivity index(ISI)and insulin resistance index(IR)were calculated.Serum estradiol(E2),testosterone(T),luteinizing hormone(LH),follicle stimulating hormone(FSH),prolactin(PRL),anti-Mullerian tube hormone(AMH)and insulin-like growth factor 1(IGF-1),C-reactive protein(CRP),interleukin(IL)-6,tumor necrosis factor(TNF)-α,total peroxidase activity(T-AOC),superoxide dismutase(SOD)and malondialdehyde(MDA)levels in ovarian tissue were detected by enzyme-linked immunosorbent assay(ELISA).The pathological changes of ovarian tissue were detected by hematoxylin-eosin(HE)staining.Real-time quantitative polymerase chain reaction(qPCR)was used to determine mRNA levels of ARA70,CBP,SCR1 and HOXA10 in endometrium and mRNA expressions of AMPK,GLUT4 and PPARγ in ovarian tissue.Western blot assay was used to determine expression levels of AMPK,GLUT4 and PPARγ in ovarian tissue.Results Compared with the polycystic ovary syndrome group,uterine index,FINS,FBG,2 h PBG,IR levels,serum T,LH,FSH,PRL,AMH,IGF-1 levels,ovarian tissue CRP,IL-6,TNF-α,T-AOC and MDA level,endometrial ARA70,CBP,SCR1 mRNA level of rats decreased significantly in the Baizhu Fuzi decoction group,the Bazhen decoction group and the Bazhen decoction combined with Baizhu Fuzi decoction group(P＜0.05).ISI level,serum E2 level,ovarian tissue SOD level,endometrial HOXA10 mRNA level,ovarian tissue AMPK,GLUT4 and PPARγ mRNA and protein levels were significantly increased(P＜0.05).The above indexes were significantly changed in the Bazhen decoction and Bazhu Fuzi decoction group than those of the Bazhu Fuzi decoction group and the Bazhen decoction group(P＜0.05).Conclusion Bazhen Decoction combined with Baizhu Fuzi Decoction can regulate glucose metabolism,inhibit ovarian tissue oxidation and inflammatory damage,improve endometrium tolerance,regulate estrogen level,and improve the progression of polycystic ovary syndrome in rats.The mechanism may be related to the regulation of AMPK/GLUT4/PPARγ pathway.
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BACKGROUND:At present,many drugs used in the treatment of polycystic ovary syndrome are super-designated drugs,and the treatment of patients with polycystic ovary syndrome still faces great challenges.Studies have shown that human umbilical cord mesenchymal stem cells can repair ovarian function,but few studies have reported their therapeutic effect on polycystic ovary syndrome. OBJECTIVE:To investigate the therapeutic effect of human umbilical cord mesenchymal stem cells on polycystic ovary syndrome,and to preliminarily explore the correlation between mitochondrial autophagy and the improvement of polycystic ovary syndrome by human umbilical cord mesenchymal stem cells. METHODS:Polycystic ovary syndrome mouse model was established by subcutaneous injection of dehydroepiandrosterone for 20 days into C57BL/6J mice.Human umbilical cord mesenchymal stem cells(2×106)were injected through the caudal vein.After treatment,vaginal secretions were collected for 10 consecutive days to detect the estrus cycle of mice.At 2 weeks after treatment,the levels of sex hormones in the peripheral blood of mice,including luteinizing hormone and follicle-stimulating hormone,were detected by ELISA.Hematoxylin-eosin staining was used to evaluate ovarian histopathology.Finally,mitochondrial autophagy in ovaries was observed by transmission electron microscopy. RESULTS AND CONCLUSION:(1)After human umbilical cord mesenchymal stem cell therapy,follicles at different stages(primitive follicles,primary follicles,and secondary follicles)appeared in the ovary of polycystic ovary syndrome mice,and luteal tissue could be seen,indicating that ovulation function of mice was effectively improved.(2)Polycystic ovary syndrome mice treated with human umbilical cord mesenchymal stem cells had sex hormone levels.(3)Untreated polycystic ovary syndrome mice were found to be in the estrous stage for a long time,lacking estrous interphase and estrous phase,but after human umbilical cord mesenchymal stem cell therapy,the estrous cycle returned to a normal level.(4)After treatment with human umbilical cord mesenchymal stem cells,the mitochondrial autophagy of polycystic ovary syndrome mice was significantly reduced.(5)The results show that human umbilical cord mesenchymal stem cells can effectively improve the symptoms of endocrine disorders and promote ovulation in polycystic ovary syndrome mice,which may be related to the inhibition of mitochondrial autophagy.
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BACKGROUND:Oxidative modification of high-density lipoprotein occurs in patients with polycystic ovary syndrome.However,the relationship between oxidized high-density lipoprotein and ovulation dysfunction and its mechanism are unknown. OBJECTIVE:To investigate the effect and potential mechanism of oxidized high-density lipoprotein on ovarian granulosa cell apoptosis. METHODS:Polycystic ovary syndrome rat model was established,then the high-density lipoprotein was harvested from the rat serum of heart blood.The degree of oxidation of the high-density lipoprotein was detected by high-density lipoprotein inflammation index assay,malondialdehyde assay and lipoprotein agarose gel electrophoresis assay.The normal rat ovarian granulosa cells were isolated and treated with high-density lipoprotein and oxidized high-density lipoprotein isolated from the model rat serum.Cell viability was detected by CCK-8 assay.Cell apoptosis was detected by flow cytometry.The generation of reactive oxygen species was detected by H2DCF-DA staining.The p38 signaling activity was detected by western blot assay.Ovarian granulosa cells were pretreated with reactive oxygen species inhibitors N-acetylcysteine,tetramethylpiperidine(Tempol)and p38 inhibitor SB203580,and then treated with oxidized high-density lipoprotein.Finally,cell apoptosis,reactive oxygen species production and p38 signaling activity were detected. RESULTS AND CONCLUSION:A portion of the high-density lipoprotein from the serum of polycystic ovary syndrome model rats affected oxidative modification.High-density lipoprotein and oxidized high-density lipoprotein isolated from the model rat serum inhibited granulosa cell viability and promoted apoptosis(all P<0.05).They promoted rat granulosa cell reactive oxygen species production and p38 activation(all P<0.05).N-acetylcysteine,Tempol and SB203580 reversed oxidized high-density lipoprotein induced granulosa cell apoptosis(all P<0.05).N-acetylcysteine and Tempol suppressed oxidized high-density lipoprotein-induced p38 activation(all P<0.05).SB203580 did not have a regulatory effect on reactive oxygen species production(P>0.05).In summary,polycystic ovary syndrome can promote partial oxidative modification of high-density lipoprotein.The oxidized high-density lipoprotein promotes rat granulosa cell apoptosis by the activation of the reactive oxygen species-initiated p38 signaling pathway.
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Objective:To investigate the correlation between the expression of serum preprotein convertase subtilisin/kexin type 9 (PCSK9), secreted frizzled related protein-4 (SFRP-4) and sex hormone, glucose and lipid metabolism in obese polycystic ovary syndrome (PCOS) patients.Methods:A total of 130 patients with polycystic ovary syndrome diagnosed and treated in Xuzhou Maternal and Child Health Hospital from April 2021 to October 2022 were selected as the study subjects, the patients were divided into obese group (60 cases) and non obese group (70 cases) according to body mass index. Enzyme linked immunosorbent assay was applied to detect the serum levels of PCSK9 and SFRP-4. The correlation between serum PCSK9, SFRP-4 levels and sex hormones (luteinizing hormone, testosterone, follicle stimulating hormone), glucose metabolism indicators [fasting blood glucose (FPG), glycosylated hemoglobin (HbA 1c), fasting insulin (FINS), homeostatic model assessment insulin resistance index (HOMA-IR)], lipid metabolism indexes [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)] in patients with obese polycystic ovary syndrome was analyzed by Pearson method. Results:The serum levels of PCSK9 and SFRP-4 in obese group were significantly higher than those in non obese group: (679.36 ± 162.21) μg/L vs. (421.68 ± 103.74) μg/L, (302.87 ± 70.58) μg/L vs. (184.21 ± 52.45) μg/L, the difference was statistically significant ( P<0.05). Compared with the non obese group, the obese group had significantly higher levels of luteinizing hormone and testosterone: (18.36 ± 5.34) U/L vs. (9.47 ± 2.21) U/L, (3.61 ± 0.97) nmol/L vs. (3.02 ± 0.84) nmol/L ( P<0.05), and significantly lower levels of follicle stimulating hormone: (7.28 ± 1.62) U/L vs. (8.03 ± 2.10) U/L, with statistically significant differences ( P<0.05); the levels of FPG, HbA 1c, FINS and HOMA-IR in obese group were significantly higher than those in non obese group: (5.46 ± 0.67) mmol/L vs. (5.04 ± 0.49) mmol/L, (7.96 ± 0.98)% vs. (6.68 ± 0.77)%, (34.08 ± 3.64) U/L vs. (23.67 ± 2.52) U/L, 8.27 ± 1.84 vs. 5.30 ± 1.52, and the differences were statistically significant ( P<0.05); compared with the non obese group, the obese group had significantly increased levels of TC, TG and LDL-C: (4.86 ± 0.67) mmol/L vs. (4.12 ± 0.54) mmol/L, (1.64 ± 0.36) mmol/L vs. (1.06 ± 0.21) mmol/L and (2.81 ± 0.56) mmol/L vs. (2.14 ± 0.42) mmol/L ( P<0.05), and HDL-C level was significantly reduced: (1.11 ± 0.25) mmol/L vs. (1.52 ± 0.40) mmol/L, with statistically significant differences ( P<0.05); the levels of serum PCSK9 and SFRP-4 in obese polycystic ovary syndrome patients were positively correlated with luteinizing hormone, testosterone, FPG, HbA 1c, FINS, HOMA-IR, TC, TG and LDL-C ( P<0.05), and negatively correlated with follicle stimulating hormone and HDL-C ( P<0.05). Conclusions:The serum PCSK9 and SFRP-4 levels in obese polycystic ovary syndrome patients are elevated, which is related to sex hormones, glucose and lipid metabolism.
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Objective:To explore the diagnostic value of ultrasound elastography (UE) in patients with obese polycystic ovary syndrome (PCOS).Methods:A total of 86 PCOS patients diagnosed in the Second People′s Hospital of Beilun District, Ningbo City from June 2019 to April 2022 were selected as the study group, including 32 patients with body mass inde(BMI) ≥25 kg/m 2 (obese group) and 54 patients with BMI < 25 kg/m 2 (non-obese group). Another 40 women with healthy physical examination and matching age and BMI of the study group were selected as the normal control group. All of them underwent routine vaginal ultrasound and UE examination, and the differences of parameters in each group were compared. The receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic efficacy of relevant parameters for PCOS and obesity PCOS. Results:The number of follicles and ovarian volume in the study group were higher than those in the normal control group, and the PI and RI of ovarian interstitial artery were lower than those in the normal control group: (17.50 ± 3.23) unit vs. (8.15 ± 2.01) unit, (12.97 ± 3.20) ml vs. (5.36 ± 1.82) ml, 0.82 ± 0.14 vs. 0.93 ± 0.20, 0.52 ± 0.12 vs. 0.58 ± 0.10, there were statistical differences ( P<0.05). The number of follicles and ovarian volume in the obese group were significantly higher than those in the non-obese group: (18.98 ± 3.45) unit vs. (16.62 ± 3.17) unit, (15.00 ± 3.15) ml vs. (11.77 ± 2.63) ml, there were statistical differences ( P<0.05); but the PI and RI between the obese group and the non-obese group had no significant differences ( P>0.05). In the study group, 56 cases (65.12%) had type 1 elastic pattern, which was significantly higher than 4 cases (10.00%) in the normal control group ( χ2 = 17.61, P<0.01). The elastic pattern was no significant difference between the obese group and the non-obese group ( P>0.05). The elastic coefficient (B/A ratio) in the study group was higher than in the normal control group:7.86 ± 1.51 vs. 4.53 ± 1.10, there was statistical difference ( P<0.05). The B/A ratio in the obese group was higher than that in the non-obese group and the normal control group: 8.76 ± 1.35 vs. 7.32 ± 1.34, 4.53 ± 1.10, there were statistical differences ( P<0.05). The ROC curve analysis showed that the area under the curve (AUC) of B/A ratio for the diagnosis of PCOS was 0.962, when the cut-off value was 5.56, the corresponding sensitivity and specificity were 93.02% and 87.50%. The AUC of B/A ratio for the diagnosis of obese PCOS was 0.788, when the cut-off value was 8.35, the corresponding sensitivity and specificity were 78.12% and 85.19%. Conclusions:The UE has great diagnostic value for PCOS and certain discrimination performance for obese PCOS.
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Objective To investigate the effect of anti-Mullerian hormone(AMH)levels on the development potential of oocytes in patients with polycystic ovarian morphology(PCOM)complicated with infertility during in vitro fertilization-embryo transfer.Methods A total of 480 infertile patients who met the inclusion and exclusion criteria were selected(160 cases in control group,104 cases in PCOM group and 216 cases in PCOS group),AMH levels were compared among different groups.According to the serum AMH level(4.7ng/ml as normal value,＞4.7ng/ml as high value),both PCOM and PCOS patients were divided into normal AMH group and high AMH group.The differences of oocyte indexes and their correlation between different AMH levels in PCOM and PCOS patients were ana-lyzed.Results The basal androgen level in PCOS group was significantly higher than that in PCOM group(P＜0.01).The comparison of serum AMH value showed that the control group＜PCOM group＜PCOS group(P＜0.001).Laboratory indexes showed that the num-ber of mature oocytes,2PN,fertilization,D3 cleavage and total embryos in the high AMH group were significantly higher than those in the normal AMH group in PCOM and PCOS patients(P＜0.05).The AMH levels was positively correlated with the number of mature oo-cytes,2PN,fertilization,D3 cleavage and total embryos(P＜0.05).In the PCOS group,the number of dominant follicles,oocytes,high-quality embryos and available embryos in the high AMH group were significantly higher than those in the normal AMH group(P＜0.05),and the AMH levels was positively correlated with the number of dominant follicles,oocytes,high-quality embryos and available embryos(P＜0.05).However,there was no significant difference in the above indicators among different AMH levels in PCOM group(P＞0.05).Conclusion The serum AMH level of PCOM patients with infertility is higher than that of the control group,but lower than that of PCOS patients.PCOM patients with high AMH level can obtain better quality oocytes and more embryos,and increase the number of transplantation in patients with repeated transplantation failure,thereby improving the clinical pregnancy rate.
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Polycystic ovary syndrome(PCOS)is characterized by high heterogeneity and heredity,and its exact pathogenesis is still not clear.Some studies have shown that epigenetic disorders,such as hyperandrogen-induced methyla-tion or acetylation of lysine at different sites(K4,K9,and K27)in histone H3,methylation and demethylation modifica-tion of genes related to steroids,hormone receptors and follicular development,and transcriptional control of microRNA or long noncoding RNA,play a central role in the occurrence and development of PCOS.This article reviews the research ad-vances in epigenetic mechanisms(histone modifications,DNA methylation,and noncoding RNA)of PCOS,in order to provide a reference for the prediction and early prevention of PCOS.
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Objective To develop a health-promoting lifestyle scale for women with polycystic ovary syndrome(PCOS),and to test its reliability and validity,and preliminarily apply it.Methods Based on the Pender health promotion model,the item pool of the scale was constructed through literature research,semi-structured interviews and group discussions.After 2 rounds of Delphi expert consultation and pre-survey,the initial scale was formed.From April to July 2022,316 patients with PCOS in the health management center,reproductive medicine center and endocrinology department of a tertiary hospital in Nanjing were selected for item analysis,exploratory factor analysis and reliability test,respectively.From August to October 2022,358 PCOS patients were selected for confirmatory factor analysis.From November 2022 to February 2013,294 PCOS patients were selected,and the scale was used to investigate the status of health-promoting lifestyle in PCOS patients.Results The health-promoting lifestyle scale for PCOS patients included 5 dimensions and 33 items.The total content validity index of the scale was 0.942,and the content validity index of each item was 0.810-1.000.5 common factors were extracted by 2 exploratory factor analyses,and the cumulative variance contribution rate was 62.399％.Confirmatory factor analysis showed that the model fit was good.The Cronbach's a coefficient of the total scale was 0.930;the split-half reliability was 0.842;the test-retest reliability was 0.888.The preliminary application results showed that the total score of health-promoting lifestyle in PCOS patients was(96.925±14.273),and the average score of items was(2.937±0.433),which was at a medium level.Conclusion The health-promoting lifestyle scale for PCOS patients has good reliability and validity,which can be used as a tool for medical staff to assess the level of health-promoting lifestyle of PCOS patients,and can help nurses to quickly identify the level and dimensions of health-promoting lifestyle of patients,so as to formulate individualized precise health management plans.
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AIM To investigate the effects of astragaloside IV on improving insulin resistance(IR)in obese rat model of polycystic ovary syndrome(PCOS),and to analyze its effect on ovarian MAPK/ERK pathway as well.METHODS The obese PCOS rat models established by feeding of letrozole combined with high-fat and high-sugar diet were randomly divided into the model group,the metformin(135 mg/kg)group and the low-dose and high-dose astragaloside Ⅳ(25,50 mg/kg)groups,with 8 rats in each group in contrast to those of the control group.After 21 days oral administration,the rats had their body weight recorded;their ovarian index calculated;their levels of fasting blood glucose(FBG),serum triglyceride(TG),total cholesterol(TC),follicle-stimulating hormone(FSH),testosterone(T),estradiol(E2),luteinizing hormone(LH)and fasting insulin(FINS)measured;their HOMA-IR and LH/FSH values calculated;their ovarian expressions of MAPK/ERK pathway related proteins detected by Western blot;and their ovarian expression of vascular endothelial growth factor(VEGF)protein detected by immunofluorescence staining.RESULTS Compared with the control group,the model group showed increased polycystic pathological changes,levels of body weight,ovarian index,serum TG,TC,LH,FSH,T,FINS,and FBG,values of LH/FSH and HOMA-IR,and ovarian p-ERK1/2/ERK1/2,p-MEK1/2/MEK1/2,p-Raf/Raf,and VEGF protein expressions(P<0.01);and decreased serum E2 level(P<0.01).Compared with the model group,both astragaloside Ⅳ and metformin groups shared significantly alleviated ovarian polycystic lesions,and decreased body weight,levels of ovarian index,serum TG,TC,LH,FSH,T,FINS,and FBG,values of LH/FSH and HOMA-IR,ovarian p-ERK1/2/ERK1/2,p-MEK1/2/MEK1/2,p-Raf/Raf,and VEGF protein expressions(P<0.05,P<0.01),and increased serum E2 level(P<0.05,P<0.01).CONCLUSION Upon the obese PCOS rat models,astragaloside Ⅳ can antagonize their IR,improve their hormone levels and alleviate their ovarian lesions via inhibiting the activation of MAPK/ERK pathway.
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[Objective]To explore the medication rule of traditional Chinese medicine(TCM)in the treatment of polycystic ovary syndrome(PCOS)through data mining based on the distribution of syndromes.[Methods]Randomized controlled trials of TCM syndrome differentiation in the treatment of PCOS from CNKI,Wanfang Data Platform,VIP full-text database,Web of Science and PubMed were systematically searched.Exce12019,SPSS Modeler 18.0,SPSS Statistics 26.0 and other softwares were used for data analysis to explore the drug characteristics and rules of TCM treatment of PCOS based on syndrome distribution.[Results]A total of 281 literatures were included,including 3 427 frequent Chinese drugs,among which spleen deficiency phlegm dampness was the most involved syndrome type,and Angelicae Sinensis Radix,Poria cocos,Cuscuta chinensis Lam and so on were the most frequently used Chinese medicines.The amount of prescription drugs was mostly between 10～20 g,deficiency tonic drugs were the most common efficacy type in prescription,and warm and plain were the most common drug properties.Sweet and pungent were the most common drug flavors,while liver,kidney and spleen channels were the most common drug normalization channels.Drug types were also different under different syndrome types.Association rule analysis and cluster analysis were conducted on the top 3 syndrome types,and complex network diagram and tree diagram were drawn to explore the characteristics and rules of TCM treatment of PCOS under different syndrome types.[Conclusion]The clinical manifestations of PCOS are highly heterogeneous,and the treatment mainly focuses on tonifying the spleen and kidney,regulating Qi,resolving phlegm and removing blood stasis.The treatment methods of patients with different syndrome types are also different.TCM syndrome differentiation has unique advantages in the treatment of PCOS with significant effects,and the clinical treatment should be based on reasonable syndrome differentiation.
ABSTRACT
“Deficiency cause， cold accumulation， and qi stagnation” originates from Essentials from the Golden Cabinet （《金匮要略》）， which is a guiding principle for the pathogenesis of women's diseases， pioneering the differentiation and treatment of women's diseases based on patterns， and having a profound influence on future generations. Following the classical principles and simplifying the complexities， this paper explored the pathogenesis and mechanism of polycystic ovary syndrome （PCOS） from the perspective of “deficiency cause， cold accumulation， and qi stagnation”， and believed that depletion of essence and blood， long-term accumulation of internal cold， and qi constraint and blood stasis are the causes of PCOS， with depletion of essence and blood， and lack of nourishment of zang-fu （脏腑） organs as the root， and cold pathogen invasion， qi constraint and blood stasis as the branch. The main treatment principle is “treating deficiency with supplementation”， and dispelling pathogen while reinforcing healthy qi， along with “treatment of cold by warming” and “treatment of stagnation by dispersing”. This is of great significance for the treatment of polycystic ovary syndrome. Clinically， these methods can be used flexibly to guide treatment and formula selection for PCOS， with the goal of harmonizing qi and blood and regulating menstruation.
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OBJECTIVE To investigate the effects of erianin （ERI） on the apoptosis of ovarian granulosa cells in rats with polycystic ovary syndrome （PCOS） and its mechanism. METHODS PCOS rat model was constructed by subcutaneous injection of dehydroepiandrosterone， and the successfully constructed rats were randomly divided into PCOS group， ERI low-dose， medium- dose and high-dose groups （10， 20， 40 mg/kg） and ERI high dose + verteporfin group （40 mg/kg ERI + 10 mg/kg verteporfin）， with 10 rats in each group. Another 10 normal rats were selected as the normal group. Rats in each administration group were given corresponding dose of ERI and/or intraperitoneal injection of vitiporfin， and rats in the PCOS group and normal group were orally administered an equal volume of 1% dimethyl sulfoxide， once a day， for 6 consecutive weeks. After administration， the body weight， fasting blood glucose （FPG）， serum levels of estradiol （E2）， testosterone （T）， follicle stimulating hormone （FSH） and luteinizing hormone （LH） were detected in each group； morphological changes in ovarian tissue were observed， and the apoptosis of ovarian tissue cells was analyzed. Apoptosis-associated proteins [B-cell lymphoma-2 （Bcl-2）， Bcl-2 associated X protein （Bax）， Caspase-3] and Hippo-YAP signaling pathway associated proteins [large tumor suppressor kinase 1 （LATS1）， phosphorylated LATS1 （p-LATS1） and Yes associated protein （YAP）， phosphorylated YAP （p-YAP）， transcriptional co-activator with PDZ binding motif （TAZ）] were detected in ovarian tissue. RESULTS Compared with PCOS group， the ovarian polycystic characteristics of the ERI low-dose， medium-dose，and high-dose groups were reduced， the number of atretic follicles was reduced， and the granulosa cell layer was thickened； the body mass， FPG， T， LH， LH/FSH， the number of cystic follicles， cell apoptosis index， protein expressions of Bax， Caspase-3， p-LATS1 and p-YAP were greatly decreased （P＜0.05）； the number of corpus luteum， protein expressions of E2， Bcl-2， LATS1， YAP and TAZ were greatly increased （P＜0.05）. Compared with ERI high-dose group， the above indexes in ERI high-dose + vitiporfin group were inhibited （P＜0.05）. CONCLUSIONS ERI can promote the proliferation of ovarian granulosa cells and improve the level of sex hormones in PCOS rats， and its mechanism of action may be related to the inhibition of the Hippo-YAP signaling pathway.
ABSTRACT
OBJECTIVE To investigate the effects of erianin （ERI） on the apoptosis of ovarian granulosa cells in rats with polycystic ovary syndrome （PCOS） and its mechanism. METHODS PCOS rat model was constructed by subcutaneous injection of dehydroepiandrosterone， and the successfully constructed rats were randomly divided into PCOS group， ERI low-dose， medium- dose and high-dose groups （10， 20， 40 mg/kg） and ERI high dose + verteporfin group （40 mg/kg ERI + 10 mg/kg verteporfin）， with 10 rats in each group. Another 10 normal rats were selected as the normal group. Rats in each administration group were given corresponding dose of ERI and/or intraperitoneal injection of vitiporfin， and rats in the PCOS group and normal group were orally administered an equal volume of 1% dimethyl sulfoxide， once a day， for 6 consecutive weeks. After administration， the body weight， fasting blood glucose （FPG）， serum levels of estradiol （E2）， testosterone （T）， follicle stimulating hormone （FSH） and luteinizing hormone （LH） were detected in each group； morphological changes in ovarian tissue were observed， and the apoptosis of ovarian tissue cells was analyzed. Apoptosis-associated proteins [B-cell lymphoma-2 （Bcl-2）， Bcl-2 associated X protein （Bax）， Caspase-3] and Hippo-YAP signaling pathway associated proteins [large tumor suppressor kinase 1 （LATS1）， phosphorylated LATS1 （p-LATS1） and Yes associated protein （YAP）， phosphorylated YAP （p-YAP）， transcriptional co-activator with PDZ binding motif （TAZ）] were detected in ovarian tissue. RESULTS Compared with PCOS group， the ovarian polycystic characteristics of the ERI low-dose， medium-dose，and high-dose groups were reduced， the number of atretic follicles was reduced， and the granulosa cell layer was thickened； the body mass， FPG， T， LH， LH/FSH， the number of cystic follicles， cell apoptosis index， protein expressions of Bax， Caspase-3， p-LATS1 and p-YAP were greatly decreased （P＜0.05）； the number of corpus luteum， protein expressions of E2， Bcl-2， LATS1， YAP and TAZ were greatly increased （P＜0.05）. Compared with ERI high-dose group， the above indexes in ERI high-dose + vitiporfin group were inhibited （P＜0.05）. CONCLUSIONS ERI can promote the proliferation of ovarian granulosa cells and improve the level of sex hormones in PCOS rats， and its mechanism of action may be related to the inhibition of the Hippo-YAP signaling pathway.